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Biomedical subjects

W M O'Fallon

Publications and source records attributed to W M O'Fallon.

At least 307 records · Page 17Linked to original sources
PubMed1984

Fractures after rheumatoid arthritis. A population-based study.

In a population-based study, the incidence of osteoporotic fractures in patients who have been diagnosed as having rheumatoid arthritis was investigated. This incidence was found to be increased, though not dramatically so: the relative risk for hip fracture, for example, was 1.5. Univariate analyses generally indicated increased risk associated with increasing age, earlier age at diagnosis of rheumatoid arthritis, disability, impaired ambulation, steroid use, and thinness, and decreased risk associated with obesity and estrogen use. In multivariate analyses, only aging, impaired ambulation, and thinness were identified as independent risk factors.

Adult↗
PubMed1984

Analysis of plasma lipids and apolipoproteins in insulin-dependent and noninsulin-dependent diabetics.

Plasma triglycerides, cholesterol, high-density lipoprotein (HDL) cholesterol, and apolipoproteins (apo) A-I, A-II, C-II, and C-III were determined and analyzed in 170 diabetic patients and 46 age-matched healthy normal subjects. The diabetics were separated into two groups: insulin-dependent diabetes mellitus (IDDM, n = 78) and noninsulin-dependent diabetes mellitus (NIDDM, n = 92). Significantly increased triglycerides, low HDL cholesterol, and normal cholesterol levels were found in the diabetics. The lipid profiles were similar in the IDDM and NIDDM groups. Plasma apo A-I, but not apo A-II, was low in both groups of diabetics. However, only in the IDDM subjects was there a statistically significant decrease in apo A-I when compared to normal subjects. The decreased apo A-I level negatively correlated with plasma triglycerides. Apo C-II and apo C-III were slightly increased in the diabetics compared to normal subjects. Apo C-II and apo C-III levels significantly correlated with plasma triglycerides (apo C-II, r = 0.70, P less than 0.0001; apo C-III, r = 0.71, P less than 0.0001). Only apo C-II correlated with total cholesterol. Thirty-eight to forty-two percent of the IDDM and NIDDM subjects had a clinical diagnosis of coronary artery disease (CAD) and/or peripheral arteriovascular disease (PAD). In the IDDM subjects, but not in the NIDDM subjects the incidence of CAD and/or PAD was associated with the decreased apo A-I levels as evaluated by a univariate analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Apolipoprotein A-I↗
PubMed1984

A study of HLA antigens in alcoholism.

The concept that alcoholism may be inherited has been suggested on the basis of twin and adoption studies and the further evidence that alcoholism is commonly seen in several members of a family. Genetic marker studies that have been conducted among alcoholics have often yielded seemingly contradictory results. Thus far, genetic marker studies involving HLA antigens have not been used in the study of alcoholism. In the current study, we identified and performed HLA typing in 52 alcoholics to determine whether a significant difference existed between the frequency of HLA-A and HLA-B locus antigens in an alcoholic population and that in a control population consisting of 1,704 nonalcoholic blood donors. In this study, we could not demonstrate a difference in the occurrence of these antigens between the two populations.

Alcoholism↗
PubMed1984

Results of treatment of renal failure by means of home hemodialysis.

Of 630 patients who began hemodialysis treatment for chronic renal failure between 1965 and 1977, 147 successfully completed training for home hemodialysis. Patient compliance was satisfactory, as reflected by the results of monthly blood chemical values, hematocrits, and weight gain between dialysis. Although only 15 patients had previous myocardial infarctions and 4 had had strokes before beginning dialysis, 9 patients subsequently experienced acute myocardial infarctions and 14 had strokes. Of the 45 patients who died while being maintained by hemodialysis, 24 had cardiopulmonary complications and 6 had strokes. Despite such complications, 70 patients were gainfully employed and 32 were active at home or at school, whereas 29 were totally disabled. At last follow-up, 74 remained on home hemodialysis, 53 had functioning renal allografts, and the rest of the patients were being maintained in our dialysis center, had transferred elsewhere, or were being maintained by peritoneal dialysis. The overall estimated 5-year survival rate was 56%, whereas the estimated 5-year survival rate for those maintained by home hemodialysis alone was 52%.

Adolescent↗
PubMed1984

Results of treatment of center hemodialysis patients.

Four hundred eighty-three patients were maintained by hemodialysis in an outpatient hemodialysis center at the Mayo Clinic between 1963 and 1977. Although only 18 patients had experienced a myocardial infarction and 6 had had a cerebral infarction before beginning dialysis, 30 subsequently had acute myocardial infarction and 45 had a stroke. These two complications accounted for 48 of the 98 deaths that occurred during maintenance dialysis. Despite such complications, 183 patients were employed, 124 remained active at home or at school, and 115 were totally disabled. Survival of patients maintained solely by dialysis was 52% at 5 years. For the group as a whole, including patients who received their first allograft, the survival rate at 5 years was 65%.

Adolescent↗
PubMed1984

Changing incidence of abdominal aortic aneurysms: a population-based study.

The apparent incidence of abdominal aortic aneurysms among Rochester, Minnesota residents increased seven-fold between 1951 and 1980, while the incidence of thoracic aortic aneurysms declined somewhat. Rates for abdominal aneurysms rose with age and were greater among men. The overall incidence in 1971-1980 was 36.5 per 100,000 person-years. While all clinical classes of abdominal aortic aneurysms became more frequent, the greatest rise in incidence was for small, asymptomatic, and uncomplicated aneurysms which suggested an important role for more complete case ascertainment in recent years. The secular trend in abdominal aortic aneurysm incidence seems to be different from that observed for stroke or for coronary heart disease in the same community.

Adult↗
PubMed1984

Cryptorchism and maternal estrogen exposure.

A case-control study of in utero estrogen exposure and cryptorchism was carried out using as cases males born in Rochester, Minnesota, during the years 1943-1973 who were diagnosed as having cryptorchism. Two different control groups were selected for comparison, control group I being more closely matched than control group II. The estimated relative risks (RR) for estrogen exposure were 1.3 (95% confidence interval (CI) = 0.5-3.1) and 1.1 (95% CI = 0.5-2.6) for control groups I and II, respectively. In the univariate analysis, the only significantly elevated relative risks found were those for bleeding and spotting in the third trimester for cases versus control group II (RR = 3.7; 95% CI = 1.1-15.7), birth weight less than 2,500 g for cases versus control group II (RR = 3.4; 95% CI = 1.3-9.9), and gestational age of 40 weeks or less for cases versus control group I (RR = 1.8; 95% CI = 1.2-2.9). No elevated relative risks were associated with other problems during the index pregnancy or with prior pregnancies, nor with progestin exposure, smoking, presentation at delivery, or mode of onset of labor. Multivariate analysis also provided no evidence to suggest that in utero estrogen exposure is associated with cryptorchism in male offspring.

Adult↗
PubMed1984

Treatment of recurrent herpes simplex infections with L-lysine monohydrochloride.

In a prospective, randomized, double-blind, placebo-controlled, cross-over study of forty-one patients we found that oral ingestion of 1,248 mg a day of L-Lysine monohydrochloride shows evidence of decreasing the recurrence rate of herpes simplex attacks in nonimmunocompromised hosts. A dose of 624 mg a day was not effective. L-Lysine may also be capable of decreasing the severity of symptoms associated with recurrences. Neither dosage showed any evidence of shortening the healing time compared to placebo.

Administration, Oral↗
PubMed1983

Case-control study of rheumatoid arthritis and prior use of oral contraceptives.

This study was designed to determine whether oestrogens in oral contraceptives and other drugs have a protective effect against development of rheumatoid arthritis. The medical records of 229 women with rheumatoid arthritis and 458 individually matched controls identified through the comprehensive records system for the population of Rochester, Minnesota, were examined for current and prior use of oestrogens. No association was found between rheumatoid arthritis and the use of oral contraceptives, or the use of oestrogens for menopause-related or postmenopausal symptoms.

Adolescent↗
PubMed1983

The epidemiology of juvenile arthritis in Rochester, Minnesota 1960-1979.

A 20-year community-based study of the epidemiology of juvenile arthritis in Rochester, Minnesota from January 1, 1960 to January 1, 1980 is described. Cases were identified using the 1977 revised American Rheumatism Association criteria for juvenile arthritis. Higher incidence and prevalence rates and a greater predominance of pauciarticular disease were observed than previously reported. Lower rates were observed when a minimum of 3 months' disease duration was used to identify incidence.

Adolescent↗
PubMed1983

Trends in right and left-sided colon cancer.

The increasing ratio of proximal to distal colorectal carcinomas was confirmed in this population-based study of 668 new cases diagnosed among Rochester, Minnesota residents between 1940 and 1979. The change was due to a rise in the incidence of proximal lesions (from 15.1 per 100,000 person-years in 1940-59 to 17.3 per 100,000 in 1960-79) and a simultaneous fall in the incidence of distal lesions (from 35.5 to 28.2 per 100,000 person-years). Changes in definitions or referral patterns played no role in these observations, although improved diagnostic capabilities may have had an impact on the incidence of proximal lesions. These discrepant changes in incidence strongly suggest that proximal and distal colonic cancers are different diseases or have a different pathogenesis. The changing incidence rates were not associated with consistent differences in clinical characteristics at the time of initial diagnosis.

Adenocarcinoma↗
PubMed1983

Combined testing of anterior pituitary gland with insulin, thyrotropin-releasing hormone, and luteinizing hormone-releasing hormone.

Provocative tests of hypothalamic-pituitary function were performed in 20 healthy subjects to learn whether the simultaneous testing by three agents--insulin, thyrotropin-releasing hormone, and luteinizing hormone-releasing hormone--was feasible. The responses to simultaneous testing on one day did not differ significantly from those to testing on three separate days. The time and expense of pituitary-hypothalamic testing can thus be much reduced with no impairment of reliability and with no increased risk to the patient.

Adult↗
PubMed1983

Risk factors for spinal osteoporosis in men.

Risk factors for vertebral fractures due to osteoporosis were evaluated in 105 consecutive male patients over a four-year period. An equal number of men with Paget's disease, matched by age, who concurrently attended the same subspecialty clinic served as control subjects. The relative risk for osteoporosis, estimated by the odds ratio, was increased among those who smoke cigarettes (relative risk = 2.3; p = 0.01), drank alcoholic beverages (relative risk = 2.4; p = 0.02), or had an associated medical disease known to affect calcium or bone metabolism (relative risk = 5.5; p less than 0.001). Obesity was protective (relative risk = 0.3; p less than 0.001). As assessed by a multiple logistic model, the risk associated with smoking and drinking increased with age. The effects of these four major risk factors were largely independent of one another and were cumulative. Thus, spinal osteoporosis in men is frequently associated with recognizable risk factors, some of which are potentially remediable.

Adult↗
PubMed1983

Outcome of anesthesia and surgery in hypothyroid patients.

We retrospectively examined the outcome of anesthesia and surgery in 59 hypothyroid patients and in 59 paired euthyroid matched controls. Hypothyroid patients had more preoperative risk factors but did not differ as a group from controls with regard to duration of surgery or anesthesia, lowest temperature and BP recorded during surgery, need for vasopressors, time to extubation, fluid and electrolyte imbalances, incidence of arrhythmias, pulmonary and myocardial infarction, sepsis, need for postoperative respiratory assistance, bleeding complications, or time to hospital dismissal. Analysis of subsets of hypothyroidism (thyroxine level, less than 1.0, less than 3.0, and greater than or equal to 3.0 micrograms/dL) also failed to disclose any significant differences compared with matched controls. Among patients with mild or moderate hypothyroidism, we found no evidence to justify deferring needed surgery until the hypothyroidism has been corrected.

Anesthesia↗
PubMed1982

Cholelithiasis and carcinoma of the colon.

Cholelithiasis and carcinoma of the colon have similar geographic distributions and common dietary and chemical pathogenetic factors. A study was done to test whether an association between cholelithiasis and colonic cancer existed in the population of Rochester, Minnesota. During the period from 1950-1969, 2413 new cases of cholelithiasis were identified in this population. Because the age- and sex-specific prevalence rates of colorectal cancer in this population were also available, the authors calculated the expected number of cases of colorectal cancer at the time of diagnosis of cholelithiasis. The relative risk (observed/expected) of colonic cancer among persons of all ages and both sexes with cholelithiasis was 1.52 (95% confidence interval, 1.1-2.0). Although the association seems significant, there is a potential bias in that the identification of asymptomatic cases of cholelithiasis might be facilitated in patients who have an operation or frequent follow-up examinations for colonic cancer. When the analysis was repeated separately for symptomatic and asymptomatic cases of cholelithiasis, all the excess (and statistical significance) was confined to the asymptomatic group, and apparent confirmation of the suggested bias. Therefore, the authors believe that no real association exists between cholelithiasis and carcinoma of the colon.

Adult↗
PubMed1982

Effect of the fluoride/calcium regimen on vertebral fracture occurrence in postmenopausal osteoporosis. Comparison with conventional therapy.

We assessed the rates of vertebral fracture in patients with postmenopausal osteoporosis. Forty-five patients were not treated (91 person-years of observation); 59 were treated conventionally, with calcium (alone or combined with estrogen) or vitamin D or both (218 years); and 61 were treated with sodium fluoride combined with conventional therapy (251 years). The fracture rate (per thousand person-years) was 834 in untreated patients, 419 in those given calcium with or without vitamin D, 304 in those given fluoride and calcium with or without vitamin D, 181 in those given estrogen and calcium with or without vitamin D, and 53 in those given fluoride, estrogen, and calcium with or without vitamin D. It was reduced in all treatment groups (P less than 0.001 for calcium and P less than 1 x 10(-6) for other combinations); fluoride (one years of treatment) and estrogen (but not vitamin D) independently reduced the rate from that observed with calcium alone (P less than 0.001). The combination of calcium fluoride, and estrogen was more effective than any other combination (P less than 0.001). These results provide grounds for optimism about the efficacy of combinations of available agents with sodium fluoride for fracture in postmenopausal osteoporosis.

Aged↗
PubMed1982

Ophthalmodynamometry and ocular pneumoplethysmography for detection of carotid occlusive disease.

The accuracy of ophthalmodynamometry and ocular pneumoplethysmography for predicting pressure-significant lesions of the internal carotid system was compared in a series of 119 consecutive patients (210 arteries) having cerebral angiography. Overall accuracy (92.5%) for ocular pneumoplethysmography was significantly better than that for ophthalmodynamometry (76%). The difference was most apparent in predicting abnormality (85% for ocular pneumoplethysmography and 49% for ophthalmodynamometry), particularly for bilateral lesions (80% for ocular pneumoplethysmography and 37% for ophthalmodynamometry). There were few false-positive results with either test.

Arterial Occlusive Diseases↗