Laboratory, reading center, and coordinating center data management methods in the Jackson Heart Study.

Background: Cardiovascular disease (CVD) is the leading cause of death in the United States. In comparison to whites, African-Americans have a higher risk of dying from CVD and have a worse risk factor profile. The Jackson Heart Study (JHS) is designed to investigate the origin and natural history of CVD in African-Americans.

Differences by sex in correlates of work status in rheumatoid arthritis patients.

Objective: To examine differences by sex in correlates of work status in rheumatoid arthritis (RA) patients seen in rheumatology clinical settings.

Methods: Associations of demographic factors, occupation, duration of RA, and scores for disease and psychological scales with work status according to sex were examined in a cross-sectional study of 960 RA patients, aged 18-64 years, of whom 451 were working and 254 were work-disabled. Comparisons of characteristics were conducted by logistic regression between working and work-disabled, and between working and not working subjects.

Skip patterns in DINAMAP-measured blood pressure in 3 epidemiological studies.

Blood pressure measured by the oscillometric, automated device DINAMAP in 3 large population-based studies sponsored by the National Heart, Lung, and Blood Institute (The Atherosclerosis Risk in Communities Study, The Family Heart Study, and the Hypertension Genetic Epidemiology Network Study) were reviewed to determine an apparent skip pattern in the measurement values. Across the 3 studies, 2 different DINAMAP models were evaluated on >350 000 different blood pressure measurements. Measurements were taken in various positions, on both arm and ankles, and under various conditions (eg, resting and during stress).

Breast stimulation to augment labor: history, mystery, and culture.

This paper describes the development of a researchable project, arising from the clinical observation of a physiologic phenomenon during labor. Augmentation of labor by breast stimulation has been used in a variety of cultures for centuries. The process of developing a clinical study of augmentation in the modern obstetric environment is discussed, with reference to cultural attitudes of patients and health care workers.

The association between extent of employment and hypertension among women participants of the Second National Health and Nutrition Survey.

The association between extent of employment and hypertension was examined among 3,824 women participants of the Second National Health and Nutrition Examination Survey. Women in three employment groups (full-time, part-time, and short-term) were compared to homemakers. In covariate-adjusted, logistic regression models, women employed full-time had a somewhat lower, but not significantly different, prevalence of hypertension (OR = 0.

Costs of implementing pharmaceutical care in community pharmacies.

Objective: To estimate the costs and benefits to community pharmacies of converting a traditional practice into one based on pharmaceutical care.

Setting: Community-based ambulatory care pharmacies.

Practice Description: Community pharmacy.

Recall and treatment decisions of primary care providers in response to Pap smear reports.

Introduction: Although the frequency of cervical cancer screening has been extensively studied, little is known about how clinicians decide to screen or recall patients for Pap smears. This study reports the management decisions made by office-based clinicians for 10 different Pap smear reports describing adequacy limitations and cytological diagnoses.

Methods: We surveyed 186 clinicians using a commercial laboratory in the southeastern United States and analyzed results by frequency and comparison statistics.

Familial history of stroke and stroke risk. The Family Heart Study.

Background And Purpose: Although familial history of stroke is generally perceived to be an important marker of stroke risk, very few epidemiological studies have been published to address this hypothesis. We sought to examine whether familial history of stroke is associated with the prevalence of stroke in the Family Heart Study, a National Heart, Lung, and Blood Institute-supported multicenter study of the familial, genetic, and nongenetic determinants of cardiovascular disease in populations.

Methods: The personal and familial histories of stroke were assessed in 3168 individuals (probands) who were at least 45 years old and 29,325 of their first-degree relatives with the use of a standardized questionnaire.

Cardiac autonomic function and incident coronary heart disease: a population-based case-cohort study. The ARIC Study. Atherosclerosis Risk in Communities Study.

Cardiac autonomic activity, as assessed by heart rate variability, has been found to be associated with postmyocardial infarction mortality, sudden death, and all-cause mortality. However, the association of heart rate variability and the incidence of coronary heart disease (CHD) is not well described. The authors report on the association of baseline cardiac autonomic activity (1987-1989) with incident CHD after 3 years (1990-1992) of follow-up of the Atherosclerosis Risk in Communities Study cohort selected from four study centers in the United States by using a case-cohort design.

Gender, racial, and geographic differences in the performance of cardiac diagnostic and therapeutic procedures for hospitalized acute myocardial infarction in four states.

This study compared rates of performance of cardiac procedures in relation to gender, race, and geographic location in patients hospitalized for myocardial infarction. The Atherosclerosis Risk in Communities (ARIC) study provides population data and standardized data collection methods. Hospital records of eligible people aged 35 to 74 years were abstracted in communities of 4 states in the United States: North Carolina, Mississippi, Maryland, and Minnesota.

Memory for and experience of differential competitive behavior of individuals and groups.

Four experiments investigated whether differential experiences with groups and individuals led to previously obtained results of greater competitive expectations in intergroup than interindividual relations. In Experiment 1, participants rated their recalled instances of intergroup relations as more competitive than their interindividual relations. In Experiment 2, a relatively greater proportion of competitive to cooperative intergroup relations were recalled compared with interindividual relations.

Functional and physical interactions between the Epstein-Barr virus (EBV) proteins BZLF1 and BMRF1: Effects on EBV transcription and lytic replication.

The Epstein-Barr virus (EBV) proteins BZLF1 and BMRF1 are both essential for lytic EBV replication. BZLF1 is a transcriptional activator which binds directly to the lytic origin of replication (oriLyt) and plays a critical role in the disruption of viral latency. The BMRF1 protein is required for viral polymerase processivity.

Population-based study of heart rate variability and prevalent myocardial infarction. The Atherosclerosis Risk in Communities Study.

Clinically based studies have indicated that patients who have suffered myocardial infarction (MI) exhibit lower heart rate variability (HRV). Such associations have not been reported at the population level. To investigate whether MI is related to lower HRV in the general population, the authors examined a stratified random sample of 2,243 men and women aged 45-64 years, of whom 260 had had MI and 1,983 were free of any coronary heart disease manifestations.

Assessing medical history in coronary heart disease surveillance: agreement between contemporaneous and retrospective methods.

Coronary heart disease surveillance studies require monitoring of hospitalized events. Retrospective record reviews and patient interviews during hospitalization are common surveillance methods. This study reports the agreement between these two methods in assessing medical history among 4,230 patients enrolled in the Minnesota Heart Survey Registry.

A computer algorithm to impute interrupted heart rate data for the spectral analysis of heart rate variability--the ARIC study.

The shorter term beat-to-beat heart rate data collected from the general population are often interrupted by artifacts, and an arbitrary exclusion of such individuals from analysis may significantly reduce the sample size and/or introduce selection bias. A computer algorithm was developed to label as artifacts any data points outside the upper and lower limits generated by a 5-beat moving average +/- 25% (or set manually by an operator using a mouse) and to impute beat-to-beat heart rate throughout an artifact period to preserve the timing relationships of the adjacent, uncorrupted heart rate data. The algorithm applies Fast Fourier Transformation to the smoothed data to estimate low-frequency (LF; 0.

Mono- and dimethylation of arsenic in rat liver cytosol in vitro.

Production of methylarsonate and dimethylarsinate from radiolabelled [73 As]arsenite and [73 As]arsenate was examined in an assay system that contained cytosol prepared from a 20% homogenate (w/v) of livers from 8- 10-week-old male Fischer 344 rats. After a 60-min incubation at 37 degrees C with added S-adenosylmethionine and glutathione, up to 50% of carrier-free [73As]arsenite and about 15% of carrier-free [73As]arsenate were methylated. Incubation of cytosol at 100% degrees C for 1 min before addition to the assay system completely abolished methylation of arsenite.

Association of vagal tone with serum insulin, glucose, and diabetes mellitus--The ARIC Study.

Reduced vagal activity assessed by heart rate variability (HRV) has been observed in studies of diabetics, but this association has not been reported at the population level. To investigate the association of HRV with diabetes mellitus, as well as fasting serum insulin, and glucose, we examined a stratified random sample of 1933 individuals (154 diabetics and 1779 non-diabetics), aged 45-65 years from the Atherosclerosis Risk in Communities (ARIC) study cohort. Two-minute, resting, supine beat-to-beat heart rate records were collected.

Comparative in vitro methylation of trivalent and pentavalent arsenicals.

The time course and extent of methylation of 1 microM arsenite (iAsIII), arsenate (iAsV), methylarsenite (MeAsIII), methylarsenate (MeAsV), and MeAsIII-diglutathione complex (MeAsIII(GS)2) were examined in an in vitro assay system that contained rat liver cytosol. Precursor arsenicals and methylated metabolites were analyzed by thin-layer chromatography (TLC) or by hydride generation-atomic absorption spectrophotomoetry (HG-AAS). More than 90% of iAsIII was converted to a dimethylated species (Me2As) during a 90-min incubation at 37 degrees C; the amount of monomethylated metabolite was maximal at 15 min.

A managed care workstation for support of ambulatory care in Veterans Health Administration medical centers.

This paper describes the development of a Managed Care Workstation for implementation in a Department of Veterans Affairs hospital. Each VA hospital information system contains a wealth of information in a comprehensive and well integrated M database, however, a clinician's access to the information is hampered by a lack of usable database tools. The Managed Care Workstation is designed to enhance access to VA databases.

Accrual to the Breast Cancer Prevention Trial by participating Community Clinical Oncology Programs: a panel data analysis.

In 1992 patient accrual to the National Cancer Institute-sponsored Breast Cancer Prevention Trial was initiated in the United States and Canada. The Trial will involve 16,000 women who are evaluated to be at high risk of developing breast cancer. Nearly 250 health care organizations are participating in the Trial, including over 40 Community Clinical Oncology Program (CCOP) organizations, which are a component of the NCI's national clinical trials program.

Recombinant human inosine monophosphate dehydrogenase type I and type II proteins. Purification and characterization of inhibitor binding.

Inosine monophosphate dehydrogenase (IMPDH) activity results from the expression of two separate genes, and the resulting proteins (type I and type II) are 84% identical at the amino acid level. Although the type II mRNA is expressed at higher levels in proliferating cells, both mRNAs, and by extrapolation both proteins, are present in normal and malignant cells. Since IMPDH is an important target for the development of drugs with both chemotherapeutic and immunosuppressive activity, we have compared the kinetic and physical properties of the two human enzymes expressed in and purified from Escherichia coli.

Ozone exposure has both a priming effect on allergen-induced responses and an intrinsic inflammatory action in the nasal airways of perennially allergic asthmatics.

Ozone may play a significant role in the exacerbation of airway disease in asthmatics, either by priming the airway mucosa such that cellular responses to allergen are enhanced or by exerting an intrinsic effect on airway inflammation. Previous investigations of nonasthmatic subjects revealed that ozone induces both nasal and bronchial inflammation, suggesting that nasal responses to ozone may be used as a surrogate marker for the effect of this pollutant on bronchial mucosal inflammation. In this study, the effect of exposure to 0.