Relation among personality and symptoms in nonulcer dyspepsia and the irritable bowel syndrome.

The importance of personality traits in nonulcer dyspepsia and irritable bowel syndrome is a controversial issue. We wished to assess the distribution of abnormal personality traits in nonulcer dyspepsia and the irritable bowel syndrome, define any relation among personality and symptoms, and determine whether personality factors discriminate among patients with functional, psychiatric, or organic gastrointestinal diseases. Patients with nonulcer dyspepsia (n = 31), irritable bowel syndrome (n = 67), organic gastrointestinal disease (n = 64), somatoform disorder (n = 36) and healthy controls (n = 128) were studied.

Ascertainment of risk factors for osteoporosis: comparison of interview data with medical record review.

To determine the accuracy of self-reported risk factors for osteoporosis, an age-stratified random sample of Rochester, MN, women was studied. Results from a structured face-to-face interview were compared with information documented in contemporary inpatient and outpatient health care records in the community. Using the kappa statistic to evaluate concordance of these two data sources, we found substantial agreement for a history of proximal femoral and distal forearm fractures, peptic ulcer disease, estrogen replacement therapy and oral contraceptive use, and cigarette and alcohol exposure.

Lead concentrations in blood and milk from periparturient dairy heifers seven months after an episode of acute lead toxicosis.

In September 1988, 100 of 300 yearling dairy heifers developed blindness, tachypnea, foaming at the mouth, chewing, and facial fasciculations. Twenty-five animals died. Lead toxicosis was diagnosed based on the clinical signs and the presence of excessive concentrations of lead in whole blood, liver, kidney, and rumen contents of affected animals.

Influence of referral bias on the apparent clinical spectrum of infective endocarditis.

Purpose: To assess the effect of referral bias on the clinical spectrum of infective endocarditis.

Patients And Methods: We performed a retrospective study comparing a population-based cohort of incidence cases from Olmsted County, Minnesota, with a cohort of referred cases from the practice of the Mayo Clinic during the period from 1970 to 1987.

Results: In the community cohort, age was an important risk factor for acquiring endocarditis (incidence rate ratio 8.

Effect of season on physical activity score, back extensor muscle strength, and lumbar bone mineral density.

Seasonal variation in physical activity, back extensor muscle strength (BES), and bone mineral density (BMD) of the lumbar spine was studied in 65 healthy postmenopausal women. Physical activity score (PAS) was assessed with an ordinal scale (0-18); this score and the BES were obtained monthly for 2 years (25 readings). BMD values were obtained semiannually (5 readings).

Effect of age on variables relating to calcium and phosphorus metabolism in women.

Lack of adequate data concerning the effect of age on biochemical variables relating to bone and mineral metabolism hampers research on age-related bone loss in women. Furthermore, to detect disease and to monitor therapy, clinical laboratories require reference values derived from an appropriate population sample. Therefore, we determined the age-specific distribution of values for serum concentrations of calcium, inorganic phosphorus, alkaline phosphatase, bone Gla protein, and parathyroid hormone; for creatinine clearance; for fasting urinary calcium:creatinine ratio; and for 24 h urinary excretion of calcium, hydroxyproline, and cyclic AMP in a population-based sample of 301 white women.

Screening for osteoporosis.

Purpose: To review evidence that screening for osteoporosis by measuring bone mass in postmenopausal women would reduce fracture incidence.

Data Identification: An English-language literature search using MEDLINE (1966 to 1989), bibliographic reviews of book chapters and review articles, technology assessments of bone mass measurement, and other publications.

Study Selection: We summarize prospective studies of fracture risk prediction done with widely used bone mass measurement techniques, and we document noncontroversial or peripheral points with recent papers and reviews.

Effect of fluoride treatment on the fracture rate in postmenopausal women with osteoporosis.

Although fluoride increases bone mass, the newly formed bone may have reduced strength. To assess the effect of fluoride treatment on the fracture rate in osteoporosis, we conducted a four-year prospective clinical trial in 202 postmenopausal women with osteoporosis and vertebral fractures who were randomly assigned to receive sodium fluoride (75 mg per day) or placebo. All received a calcium supplement (1500 mg per day).

Incidence of hip fracture in Saskatchewan, Canada, 1976-1985.

The authors ascertained the incidence of hip fracture in Saskatchewan, Canada, residents aged 65 years or older for the 10 years 1976-1985 from computerized hospital discharge records and compared it with rates for several other populations in Northern Europe and the United States. In Saskatchewan, the average annual incidence was 5.5 per 1,000 person-years.

Fluoride in the prevention of osteoporosis and fractures.

Age-related fractures, especially hip fractures, produce sufficient morbidity and mortality to make osteoporosis a disease worth preventing, and accurate techniques exist to identify groups at high risk of fracture by virtue of low bone mass. While the need for prevention is evident, no specific program of fluoride use for this purpose has been devised, and epidemiologic data provide little support for the notion that exposure to fluoride reduces hip fracture incidence. At present, fluoride cannot be recommended as a prophylactic agent for the fractures that are the primary adverse health outcome of osteoporosis.

Screening trace elements and electrolytes in serum by inductively-coupled plasma emission spectrometry.

This rapid, accurate procedure for trace elements and electrolytes in serum requires little sample preparation: to 1 mL of serum a single reagent is added that contains trichloroacetic and hydrochloric acids for protein precipitation, hydroxylamine sulfate for iron reduction, and yttrium as the internal standard. After centrifugation, the supernates are directly analyzed for Na, K, Mg, Ca, Pi, Fe, Cu, and Zn by inductively-coupled plasma emission spectrometry. The CVs were respectively 7.

Comparison of case ascertainment by medical record linkage and cohort follow-up to determine incidence rates for transient ischemic attacks and stroke.

During the period 1960-1972, the medical record linkage index method provided an estimated average annual age- and sex-adjusted rate for first transient ischemic attack (TIA) of 134 per 100,000 population for those age 50 years and older. The cohort method estimate was 237 per 100,000 population (95% confidence limits (CL), 165-310). The discrepancy was due to 18 cases of TIA noted at the time of patient visits in the cohort analysis that were not identified from the medical record analysis.

Incidence of lumbar disc surgery. A population-based study in Olmsted County, Minnesota, 1950-1979.

Age- and sex-specific incidence rates of operation for suspected lumbar disc prolapse were determined for residents of Olmsted County, Minnesota, for the 30-year period 1950 through 1979. The incidence rate (adjusted to the age and sex distribution of the United States white population in 1980) was 52.3 per 100,000 person-years for all such operations and 46.

A population-based study of craniosynostosis.

A population-based study of the incidence of craniosynostosis was conducted among residents of Olmsted County, Minnesota, born between 1 January 1976 and 31 December 1985. This study included only those with primary craniosynostosis who were less than 5 years of age at the time of diagnosis. Cases of craniosynostosis were classified as definite or probable.

Diagnostic value of the Manning criteria in irritable bowel syndrome.

Because unexplained 'functional symptoms' are a major cause of referral to gastroenterologists, the efficiency of the medical history to lead to a positive diagnosis of irritable bowel syndrome, without resorting to the use of expensive tests, remains a key question. Whilst the six criteria of Manning et al are widely used, data on their validity in discriminating irritable bowel syndrome from healthy controls, irritable bowel syndrome from non-ulcer dyspepsia and especially among irritable bowel syndrome subgroups, are not available. To evaluate this, we studied 361 outpatients who completed a bowel disease questionnaire, which objectively measured Manning's (and other) criteria.

Epidemiology of osteoporosis: predicting who is at risk.

A number of risk factors have been associated with osteoporosis, but few of them are particularly strong predictors of low bone mass or increased fracture incidence and the "best" set of variables changes from study to study. This does not provide adequate precision for classifying individual patients, and the focus of risk assessment, especially in perimenopausal women, has been on in vivo bone mass measurements. Prospective studies show that these values correspond to subsequent fracture incidence, and there is currently no alternative to bone mass measurements for stratifying patients by fracture risk.

Possible association of the immunosuppressive and B cell lymphoma-promoting properties of cyclosporine.

Central to the immunosuppressive properties of cyclosporine is a drug imposed blockade of the interleukin-2 gene activation. As IL-6 stimulates antigen-activated T cells to release IL-2, we examined the influence of CsA on IL-6 gene expression and IL-6-supported T cell proliferation. Northern blot analysis revealed that CsA failed to abolish IL-6 gene expression in mitogen-activated peripheral blood mononuclear cells.

Risk for colorectal adenocarcinoma in pernicious anemia. A population-based cohort study.

Study Objective: To determine the long-term risk for colorectal cancer among patients with pernicious anemia.

Design: Historical cohort study.

Setting: Population-based inception cohort of Rochester, Minnesota, residents.