PubMed Health⌕ Search

Biomedical subjects

E Ekwo

Publications and source records attributed to E Ekwo.

18 recordsLinked to original sources
PubMed1998

The risk for recurrence of premature births to African-American and white women.

Preterm birth rates are higher for African Americans than for whites, but the risk for recurrence is not well defined. We tested the hypothesis that the base and recurrence rates for premature births are higher for African Americans than for whites. We recruited a cohort of African-American and white women giving birth to singleton infants between 1988 and 1993 at Perinatal Network, a Midwest urban teaching hospital. These women had known reproductive history, delivered two or more singletons, and had no planned abortions, miscarriages, or induced preterm labor. Premature infants were born at less than 37 completed weeks of gestation. The total preterm birth rate among African Americans was 24.5%, significantly higher than the 11.1% for whites (relative risk, 2.22; confidence interval, 1.79 to 2.75). The preterm birth rate among African Americans for the second pregnancy was 30.6%, significantly higher than the rate of 18.2% for the first pregnancy and 24.5% for the third and fourth pregnancies. The preterm birth rates for whites were 11.7% for the first pregnancy, 9.8% for the second, and 12.9% for the third and fourth pregnancies, which were not significantly different from each other. Considering only the first two pregnancies, recurrence accounted for 32.6% of all premature births for both African Americans and whites. After the second pregnancy, 68% of African-American and 41.7% of white premature babies were born to women who had previous preterm infants. We conclude that preterm births are relatively common for African Americans and whites in the first two pregnancies. Women, particularly African-American women with a previous preterm birth at either the first or second pregnancy, require more specific management to prevent recurrence of preterm birth.

Birth Rate↗
PubMed1995

Association of drug abuse and child abuse.

OBJECTIVE: To show that children born to mothers who used drugs during pregnancy were at a higher risk of subsequent abuse or neglect than were children from the general population. METHODOLOGY: This is a retrospective-prospective study of abuse experiences of children born at an urban medical center between January 1985 and December 1990 to women who used illicit drugs during pregnancy. Children exposed in-utero to drugs were identified using results of toxicology screens from birth and maternal records. Evidence of abuse was obtained from the State Central Registry of Abuse and Neglect. The registry contained information on all reported abuses or neglects, the types, findings, and outcomes of the investigations of reported cases. The outcome measure was whether the children had been abused or not during the study period. RESULTS: One hundred and fifty-five (30.2%) of the 513 children exposed in-utero to drugs were reported as abused or neglected and 102 (19.9%) had substantiated reports giving a rate of 84 abuse and neglect cases per 1,000 years of exposure. The yearly substantiated abuse rates varied, the lowest being 30 cases per 1,000 years of exposure in 1986 and the highest 107 cases per 1,000 in 1987. This rate was two to three times that of children living in the same geographic area in the south side of Chicago. Neglect was reported in 72.6% of cases, with the toddlers being the most vulnerable to abuse and neglect. Natural parents were responsible for maltreatment 88% of the time. On logistic regression analysis, the risk of abuse of children increased 1.56-fold (Confidence Interval = 1.25-2.01) that of nonabusing parents among women who had completed high school education or had some college education and 1.80-fold among women with previous planned abortion, after controlling for confounding variables. Other sociodemographic variables of the child or mother did not significantly increase the odds of abuse. CONCLUSIONS: Infants exposed in-utero to drugs have a higher than expected risk of subsequent abuse compared to children in the general population.

Adolescent↗
PubMed1993

Effects of methotrexate on radiologic progression in juvenile rheumatoid arthritis.

OBJECTIVE: To assess the effects of methotrexate (MTX) therapy on radiologic progression in juvenile rheumatoid arthritis (JRA). METHODS: We evaluated serial wrist radiographs for carpal length in 23 JRA patients with bilateral wrist involvement, before and during MTX treatment. These carpal length measurements were compared with established norms for carpal length in a healthy pediatric population. RESULTS: Both clinical responders to MTX (17 of 23 patients) and nonresponders (6 of 23) had decreasing carpal length prior to initiation of the treatment. Eleven of the 17 clinical responders had improved carpal length after a mean of 2.5 years of MTX treatment. All 6 clinical nonresponders had progressive loss of carpal length. CONCLUSION: MTX treatment resulted in radiologic improvement, as measured by carpal length, in the majority of children with JRA who had a clinical response to MTX.

Arthritis, Juvenile↗
PubMed1990

Comparison of education and occupation of adults with achondroplasia with same-sex sibs.

We compared the education and occupation of 20 adults with achondroplasia with their same-sex sibs. While the mean number of years of formal education reported by affected males and females was comparable to that of their same-sex sib, we found differences in the level of occupation between the groups. In general, affected females had a significantly lower occupational level compared to their unaffected sisters. In males and females the number of years of formal education and whether or not individuals had achondroplasia were the 2 most important factors determining occupational level when contrasting affected persons with their unaffected sibs. Education alone accounted for 28 and 42% of the observed variance in occupational level, respectively, for females and males.

Achondroplasia↗
PubMed1984

Prognostic factors predicting control of chronic asthma symptoms in children receiving prophylactic bronchodilator therapy.

The factors predicting the control of asthma symptoms were studied in 312 consecutive children with chronic asthma who were receiving chronic prophylactic bronchodilator therapy. Asthma symptoms were controlled in 232 (74.4%) patients but not in 80 (25.6%) patients after 18 months of therapy. The cumulative percentage of patients in whom asthma symptoms were controlled increased with the duration of therapy. During the first 6 months of therapy, children who had a history of exacerbation of symptoms by fear stimulus or by dust had respectively an 83.3% (p = 0.0001) and a 35.4% (p = 0.003) lower rate of control of asthma symptoms than children without such a history. Similarly, children with a history of worsening asthma symptoms following ingestion of cold foods or drinks had a 71.4% (p = 0.002) lower rate of control of asthma symptoms after 6-12 months of therapy than children without such a history. Certain factors are important for predicting control of asthma symptoms at different times following the initiation of therapy and may relate to the lability of the airways to these stimuli.

Administration, Oral↗
PubMed1979

The physician assistant in rural primary care practices: physician assistant activities and physician supervision at satellite and non-satellite practice sites.

Nineteen practice sites in Iowa were studied to determine the differences in the types of physician (MD) supervision the physician assistant (PA) received at work at satellite (separate from the major practice site of the supervising MD) and non-satellite practice sites. The MDs supervised PA functions in 12.9 per cent of the patients seen by the PAs at non-satellite and 15.9 per cent of patients they saw at satellite practice sites. All patients with presenting manifestations that suggested life-threatening conditions were seen by MDs at satellite and non-satellite sites. The MD spent 9.2 minutes per patient at satellite clinics, compared to 4.4 minutes per patient at non-satellite clinics. PAs working at satellite sites appeared to receive as much supervision as PAs working at non-satellite clinics.

Clinical Competence↗
PubMed1976

Effect of clindamycin on aminoglycoside activity in a murine model of invasive Escherichia coli infection.

Previous studies have demonstrated that the early in vitro bactericidal activity of gentamicin and amikacin is inhibited by clindamycin. To investigate the possible clinical implications of these findings, the effect of clindamycin in combination with gentamicin or amikacin was compared with that of the aminoglycoside alone in the treatment of normal and neutropenic mice with Escherichia coli peritonitis and bacteremia. Mice treated with saline or clindamycin alone experienced rapid multiplication of bacteria in the peritoneal cavity, bacteremia, and subsequent death. Gentamicin or amikacin given 2 h after E. coli inoculation significantly reduced the mortality and peritoneal bacterial counts in normal and neutropenic mice in comparison with untreated controls. Prior or simultaneous administration of clindamycin with either aminoglycoside did not inhibit survival or bacterial clearance from the peritoneum. The only clindamycin effect was slight enhancement of survival of neutropenic mice treated with multiple doses of amikacin and clindamycin in comparison to those treated with amikacin alone.

Aminoglycosides↗
PubMedDate not supplied

Physician's assistants in primary care practices: delegation of tasks and physician supervision.

Little information is available on factors influencing physicians (MDs) to delegate health care tasks to physician's assistants (PAs). Information about assignment of tasks to PAs was sought from 19 MDs engaged in practice in primary care settings in Iowa. These MDs employed 28 PAs. Tasks assigned to PAs appeared to be those that MDs judged to require little or no supervision. Tasks that could be performed efficiently by other non-MD personnel were not asigned to PAs. However, PAs were observed at the practice sites to perform tasks which the MDs had indicated could be appropriately assigned to PAs, as well as some tasks that could be performed by other non-MD personnel. The MDs provided health care to 126 (13.6 percent) of the 925 patients seen by PAs for whom the sequences of patient-provider contact were recorded. In these settings, the PAs functioned with a high degree of autonomy in providing health care. These findings have implications for educators and potential employers of PAs.

Attitude of Health Personnel↗