Journal of Chronic Diseases (J Chron Dis )

Publisher: Elsevier


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  • 5-year impact
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  • Article influence
  • Website
    Journal of Chronic Diseases website
  • Other titles
    Journal of chronic diseases
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  • Material type
    Periodical, Internet resource
  • Document type
    Journal / Magazine / Newspaper, Internet Resource

Publisher details


  • Pre-print
    • Author can archive a pre-print version
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    • Author can archive a post-print version
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    • Voluntary deposit by author of pre-print allowed on Institutions open scholarly website and pre-print servers
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    • Articles in some journals can be made Open Access on payment of additional charge
    • NIH Authors articles will be submitted to PMC after 12 months
    • Authors who are required to deposit in subject repositories may also use Sponsorship Option
    • Pre-print can not be deposited for The Lancet
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Survival data on colo-rectal cancer patients from eleven comprehensive cancer centers were analyzed to examine the effect of race, socioeconomic status and other factors on the probability of survival. Complete data on variables of interest were available for 3617 colon cancer patients (2545 Caucasians and 1072 Blacks) and 1528 rectal cancer patients (1179 Caucasians and 349 Blacks). No significant difference was observed between the races with respect to either the follow-up time or the censoring pattern. For each site, Caucasian patients had a lower risk of death at any time point compared to Black patients, and this difference was maintained within categories of disease stage, sex, age and SES. The race effect was statistically significant in all multivariate models. Moreover, only race was significant in models that considered both race and SES. For either cancer, the racial difference in survival was most prominent for localized disease.
    Journal of Chronic Diseases 02/1987; 40(9):857-64.
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    ABSTRACT: To analyze the prognostic importance of arrhythmias on routine 24-hour ambulatory monitoring, we prospectively followed 755 consecutive patients undergoing monitoring at a community hospital in the context of usual medical care. Of the 755 patients, 114 (15%) had ventricular tachycardia on monitoring. At a mean follow-up of 38 months, multivariate survival analysis indicated that congestive heart failure was the strongest correlate of death from all causes (relative risk (RR) = 2.6), cardiac death (RR = 3.5), and the sudden cardiac death (RR = 5.6); ventricular tachycardia was significantly correlated with death from all causes and with cardiac death, but had only a borderline association with sudden cardiac death (RR = 1.9, p = 0.08). While ventricular tachycardia on ambulatory monitoring is of prognostic importance, congestive heart failure, as determined by routine clinical examination, was a more powerful prognostic correlate of deaths from all causes, death from cardiac causes, and sudden cardiac death.
    Journal of Chronic Diseases 02/1987; 40(10):977-84.
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    ABSTRACT: The present study examined the social support system of patients suffering from end stage renal disease. Patients reported receiving considerable support from family, friends, and the medical treatment staff. Patients reported receiving considerably less support from voluntary associations (including religion) and leisure activities. This study also tested the proposition that social support lessens the impact of the stress of kidney disease. Multiple regression analysis indicated that social support variables increased the prediction (i.e. beyond the variance explained by demographic variables) of psychological adjustment. The hypothesis derived from crisis theory that social support would be more predictive of psychological adjustments in patients who recently became ill than in patients who had been ill longer was also supported.
    Journal of Chronic Diseases 02/1987; 40(4):337-44.
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    ABSTRACT: In summary, from the epidemiologic perspective, the conference made it clear that: In modern occurrence research in medicine, quality of life is an important aspect of health outcome, along with duration of life; and it is of interest as a determinant of outcome as well. The concept of quality of life remains ill-defined but is, in the medical sense, some aggregate representation of disability discomfort, and distress resulting from illness and/or medical action. In medicine, quality of life is, in concept, specific to various types of clinical situation; and empirical scales need to be similarly situation-specific. Whereas clinical research on quality of life is already being conducted successfully, further development of scales specific to particular types of clinical situation remains a challenge to theorists of quality of life, as well as to experts on clinimetrics who collaborate with clinical specialists.
    Journal of Chronic Diseases 02/1987; 40(6):641-3.
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    ABSTRACT: A twenty year debate about the appropriate surgery for breast cancer has resulted in two clinical trials comparing radical vs more conservative operations. Despite the favorable results of these trials, the majority of breast cancer patients in North America still undergo mastectomy. We investigated the psychological and social adjustment following total and partial mastectomy in a group of patients randomly assigned to one or the other operation (National Surgical Adjuvant Breast Protocol—B-06).Total mastectomy patients showed higher levels of depression and less satisfaction with body image. Partial mastectomy patients did not display any measurable increase in fear of recurrence. Patients undergoing radiation therapy showed surprising increase in depressive symptoms. Radiation therapy could well be more frightening to breast surgery patients than had been anticipated. These patients may benefit from some anticipatory counselling.
    Journal of Chronic Diseases 02/1987; 40(6):529-534.
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    ABSTRACT: To examine sociodemographic, menstrual, reproductive, and other factors which may influence the age at natural menopause, the authors analyzed data from a large series of women participating in a nationwide breast cancer screening program conducted between 1973 and 1980. Standard life table techniques permitted assessment of factors suspected of varying the time to menstrual cessation among 983 premenopausal women, 1091 surgically menopausal women, and 1423 naturally menopausal women. The median age at natural menopause was 51.1 years. Multivariate analysis indicated that parity, irregularity of menstrual cycles before age 25 or first livebirth, and high socioeconomic status were significantly related to menopausal age. These data provide evidence for the hypothesis that certain environmental and hormonal factors which affect ovulation during reproductive years may ultimately postpone the menopause.
    Journal of Chronic Diseases 02/1987; 40(11):995-1002.
  • Journal of Chronic Diseases 02/1987; 40 Suppl 2:71S-78S.
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    ABSTRACT: This paper presents a definition of "acceptable risk" that is based on the concept of utility. The adverse effects of a specific use of a drug pose an acceptable risk if no alternative treatment has a higher cumulated expected utility in the relevant patient population than that associated with the use of the drug. The implications of this definition for postmarketing management of drugs are explored. In particular, postmarketing surveillance should be expanded to include the quantification of patients' values, a drug's beneficial effects, and its adverse effects. Management actions should be targeted at specific drug uses with unacceptable risks rather than at drugs themselves. This may require the use of education and service action options, as well as regulatory actions aimed at prescribers and dispensers.
    Journal of Chronic Diseases 02/1987; 40(6):621-5.
  • Journal of Chronic Diseases 02/1987; 40(5):371-2.
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    ABSTRACT: Six thousand six hundred thirty two subjects, employed in 420 small and medium-sized companies in the Paris region were examined in a cross-sectional study. Their alcohol consumption, as obtained by interview was found to be higher among males than among females, among workers than among managers, executives, and clerks. Alcohol consumption was positively associated with age, body mass index, coffee and cigarette consumption, occupational exposure to noise and working nights or alternating shifts. A positive, continuous, relationship was observed, for men and women, between alcohol intake and both systolic and diastolic blood pressure. This association was highly significant in the multivariate analysis (multiple linear regression) where alcohol intake, following age and body mass index, was the third predictive factor of blood pressure level in the stepwise regression. The positive association between alcohol consumption and prevalence of arterial hypertension was aggravated by the poor control of hypertension which was found among drinkers. Awareness of hypertension, compliance with an antihypertensive treatment and its efficacy, were negatively associated with alcohol intake. The findings stress the importance of alcohol consumption which was found to be a major risk factor for arterial hypertension and noncompliance with antihypertensive treatment in this population.
    Journal of Chronic Diseases 02/1987; 40(7):713-20.
  • Journal of Chronic Diseases 02/1987; 40(12):1141-5.
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    ABSTRACT: Brief measures to identify coronary-prone (Type-A) behavior in young persons are greatly needed for longitudinal epidemiologic study of cardiovascular diseases. We examined the suitability of a modified 14-item Bortner Self-rating Scale (ABS) for use in an adolescent population. Responses of 549 racially mixed, low to middle income urban high school students were analyzed to see if ABS measurement properties matched those of the parent version. Construct validity was explored by correlating ABS scores with measures of anger expression, social support, life satisfaction, academic achievement and blood pressure. Results disclosed that the distribution and factor structure of adolescent ABS responses closely resembled findings obtained with adults. Scale validity was supported by significant associations of ABS scores with degree of overt anger expression, lack of social support, and dissatisfaction with school and life in and life in general. Academic achievement and blood pressure were found not to correlate with adolescent ABS scores. Possible race and sex differences are considered.
    Journal of Chronic Diseases 02/1987; 40(8):785-93.
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    ABSTRACT: Surgery asks patients to trade present discomfort and risk for future gains. Although research reports on the effectiveness of surgery have largely focused on mortality, length of hospital stay, major complications, and laboratory analyses, the principal criteria guiding surgeons' clinical decisions and patients' acceptance of treatment are most often the patients' subjective feelings and capabilities, the quality of their lives. This is true for both major and minor surgical procedures. We discuss the role of information on functional capacity, overall well-being, and quality of life in the assessment of surgical outcomes. Broadening the choice of endpoints beyond traditional, so-called "hard" variables in surgical studies has advantages for both surgeons and patients.
    Journal of Chronic Diseases 02/1987; 40(6):523-8.
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    ABSTRACT: Data were collected on 433 black medical students at Meharry Medical College (MMC) and 573 white medical students at The Johns Hopkins University School of Medicine (JHMS) during the period of 1958 through 1965 consisting of baseline measurement of some possible precursors of hypertension. Similar methods were employed in both cohorts. Comparison as to prevalence and significance of hypertension precursors revealed the following: Black males had significantly higher casual and resting blood pressures than whites (p less than 0.01); and higher mean changes in blood pressure following the cold pressor test. White males had a significantly higher mean change in heart rate following cold pressor test (p less than 0.01). Upon exercise black males had significantly higher mean change in blood pressure and heart rate (p less than 0.01). There appears to be more blood pressure lability in blacks as indicated by higher mean SBP + DBP changes following the cold pressor test, and by mean pulse pressure level at peak exercise. The difference in blood pressure lability observed between blacks and whites in young adulthood may be one of the earliest identifiers of later differences in the incidence of hypertension. However, of even more importance is the difference in blood pressure levels between the two groups, though both are normotensive.
    Journal of Chronic Diseases 02/1987; 40(7):721-7.
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    ABSTRACT: Serum lipid, lipoprotein cholesterol, and apolipoprotein (A-I and B) levels were compared between 940 black and 1710 white children who were between the ages of 5 and 17 years. Stratification, matching, and analysis of covariance were used to determine whether black-white differences in levels of serum triglycerides (TG), very low- (VLDL-C), and high- (HDL-C) density lipoprotein cholesterol, and apolipoprotein A-I (apoA-I) could be explained by differences in sexual maturation, obesity, cigarette smoking, alcohol intake, oral contraceptive use, insulin, and glucose. Independently of these covariates, blacks had elevated levels of HDL-C and apoA-I (males only), and whites had increased levels of TG and VLDL-C. All differences were statistically significant at the 0.001 level. In addition, racial contrasts tended to be greater in sexually mature, as compared with prepubertal, males; a similar divergence of levels with sexual maturation was not observed in females. HDL-C levels in white males were partially explained (R2 = 0.12) by sexual maturation, insulin, and obesity; apoA-I levels were associated with only sexual maturation and insulin. Racial differences in levels of serum lipids, lipoprotein cholesterol, and apoA-I in early life, therefore, exist independently of differences in several lipoprotein determinants. Since the initial stages of atherosclerosis begin in the young, these black-white lipoprotein contrasts may influence differences in adult coronary heart disease rates between the races.
    Journal of Chronic Diseases 02/1987;
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    ABSTRACT: This paper asks the question: among 1474 Framingham Study participants aged 35-68 years who were healthy at their fourth examination (1954-1958), what are the physiologic, behavioral, and demographic characteristics that distinguish those who survive and report good function from those who do not after 21 years of biennial observations? Although a larger proportion of women than men survived, their functional status was not as good. Multiple logistic regression analysis revealed that age, alcohol intake, cigarette smoking, ventricular rate, and education were all significantly related to functional status for men, with all but the last of these factors inversely related to good function. For women, the only significant predictor other than age was education, which, as with men, was directly associated with good function. The effect of education is probably mediated by numerous factors such as availability and use of health care services, quality of health care, occupation, and lifestyle.
    Journal of Chronic Diseases 02/1987; 40 Suppl 1:159S-167S, 181S-2.
  • Journal of Chronic Diseases 02/1987; 40(7):737-9.
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    ABSTRACT: Health insurance systems are generating large numbers of claims filed by physicians and hospitals for reimbursement and accounting purposes. This paper describes and evaluates a measure of health status derived from physician and hospital claims filed for a sample of older Canadians during 1970–1977. Information on the number, type, and seriousness of reported diagnoses and the number and duration of hospitalizations and surgeries during each year were combined to generate annual Illness Scales ranging from 0 to 24. Alpha coefficients, measures of internal consistency, were between 0.82 and 0.84. Consistent with high validity, Illness Scale scores increased with age, were significantly associated with other health measures, and were strongly predictive of death and hospitalization in the following year. The ability to develop valid and reliable health status measures from insurance claims substantially expands the potential use of these data for research and evaluation.
    Journal of Chronic Diseases 02/1987;

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