PubMed Health⌕ Search

Biomedical subjects

E Ford

Publications and source records attributed to E Ford.

At least 19 recordsLinked to original sources
PubMed1992

Proximal and distal cannulation of the internal jugular vein for ECMO in a primate.

Extracorporeal membrane oxygenation (ECMO) is lifesaving for infants with severe respiratory distress but is complicated by severe intracranial hemorrhage in 10% to 30% of patients. Intracranial venous hypertension, as a result of ligation of the internal jugular vein (IJV), has been hypothesized as a contributing factor to cerebral edema and subsequent hemorrhage. Accessory cephalad IJV cannulation may serve as a means of additional venous drainage to the pump as well as protection against intracranial venous hypertension. Proximal and distal cannulation of the IJV were studied in a primate model. The parameters monitored included sagittal sinus, right and left ventricular pressures as well as venous pressure in the ECMO circuit. The cephalad venous cannula was clamped and unclamped at 30-minute intervals. There was no significant difference in sagittal sinus or intracranial pressures during periods of cephalad cannula clamping or unclamping. Venous return was augmented when the cephalad cannula was unclamped. Cephalad cannulation has no demonstrable protective effect on intracranial, subarachnoid or venous pressures but does improve venous return to the ECMO circuit. It is concluded that cephalad venous cannulation is not necessary in all cases and should be reserved for those patients requiring additional venous drainage to support pump flow.

Animals↗
PubMed1992

Comparability of risk factors for coronary heart disease among blacks and whites in the NHANES-I Epidemiologic Follow-up Study.

The incidence of new coronary events and the predictive strength of the major coronary risk factors were evaluated in a biracial sample drawn from the general U.S. population. In this cohort of 12,599 persons, free of reported coronary heart disease (CHD) at baseline, both hospitalizations and deaths coded to this cause were recorded prospectively. Based on CHD as the underlying cause of death, black men and women experienced higher age-adjusted mortality than their white counterparts (BM = 6.15, WM = 5.59, BW = 3.72 and WW = 2.58 [cumulative deaths, percent]), while having lower hospitalization rates than did whites. In a univariate logistic regression model, with all incident events as the endpoint, the predictive strength of the coronary risk factors was remarkably similar for the four sex-race groups. Notable exceptions included smoking, where the data from this study are problematic, and body mass index, where a relationship was noted only among white women. In a multivariate model, the beta coefficients were similar for age, systolic blood pressure, cholesterol, and income; the statistical significance varied among the groups. Within the power of this study to examine between-race differences, the predictive strength of the standard risk factors are very similar. None of the within-sex, between-race differences in the multivariate relationships were significant, although sizable percentage differences were noted. Blacks appeared to receive less hospital care for CHD, despite higher rates of fetal events.

Black or African American↗
PubMed1992

Racial differences in mortality from cardiovascular disease in Atlanta, 1979-1985.

Mortality from cardiovascular disease (CVD) for the period 1979 to 1985 in the Atlanta metropolitan population was reviewed for racial differences. About 28% of the population was black in 1980. Of 22,585 deaths from hypertension, stroke, ischemic heart disease, and atherosclerosis, 78.7% occurred among whites and 21.3% among blacks. Overall, ischemic heart disease accounted for 47.7% of these four types of CVD deaths for both races and sexes. Age-specific and age-adjusted rates were compared. Among these four causes of death, blacks have the greatest excess of deaths from hypertension over whites for both males and females; the excesses were more than 200% when the rates were age-adjusted. The excess risk of death from hypertension occurred for all ages in blacks, with an excess of about 10 times in 30- to 49-year-olds. An excess risk from stroke also occurred in blacks below the age of 75; the risk reversed afterward. The age-specific mortality rates revealed an excess from ischemic heart disease only between the ages of 30 and 59 years and from atherosclerosis between 40 and 59 years of age for black men. This age-related crossover in females did not occur until the age of 75 years for deaths attributed to these causes. These data suggest that blacks were at highest risk for all four causes at younger age groups.

Adult↗
PubMed1991

Assessing population-based programs to reduce blood cholesterol level and saturated fats.

This article reviews seven community-based programs for prevention of cardiovascular disease and their effects on blood cholesterol levels and saturated fat intake. In two programs, cholesterol levels were reduced more in the intervention area than in the reference area. In two other programs, cholesterol increased less in the intervention area than in the reference area. In one program, cholesterol levels initially fell in the intervention group and increased in the reference group; after the first 4 years, the levels also started to increase in the intervention group. The final two programs reduced cholesterol equally in both groups. Only two programs reported on the intake of saturated fats; in both, intake of saturated fat was reduced more in the intervention area than in the reference populations. In one program area, total intake of fat was reduced more than in the reference area. Published data do not allow us to draw conclusions regarding which components of the programs were most important. These studies show that the average blood cholesterol level can be affected in a general population.

Cardiovascular Diseases↗
PubMed1991

Genotypic identification of pathogenic Mycobacterium species by using a nonradioactive oligonucleotide probe.

Commercial DNA hybridization assays (Syngene, Inc., San Diego, Calif.) utilizing alkaline phosphatase-labeled oligonucleotide probes for the identification of Mycobacterium tuberculosis complex and M. avium complex (MAC) were evaluated with 261 isolates of mycobacteria. On the basis of biochemical criteria, the test for MAC was 98% specific and more sensitive (95 of 99, 95%) than Gen-Probe (88 of 99, 89% sensitivity); the major difference in sensitivity noted between the two systems was related to the hybridization of seven MAC strains to the SNAP X probe. The M. tuberculosis complex probe correctly identified all 62 isolates of M. tuberculosis and all 11 isolates of M. bovis, for a sensitivity of 100%. There were two discrepant reactions with mycobacteria other than M. tuberculosis complex isolates.

Bacteriological Techniques↗
PubMed1990

Trends in hospitalization rates for heart failure in the United States, 1973-1986. Evidence for increasing population prevalence.

Discharge data from a representative sample of short-stay US hospitals were examined to obtain information regarding trends in the prevalence of congestive heart failure from 1973 through 1986. During this 14-year period, the number of discharges more than doubled and the age-adjusted rates increased from 53% to 88% among the four major sex-race groups. On average, nonwhite men experienced annual hospitalization rates 33% higher than white men, while for women the corresponding nonwhite rates were 50% higher. Hospitalization rates during this period remained constant for persons younger than 55 years but rose sharply in the elderly. Concurrently, a slight decline in case fatality rates for an individual hospitalization was seen. The two factors accounting for the growing prevalence of congestive heart failure seem to be the increasing average age of the population and the longer survival of persons with chronic heart disease. The role of improved medical therapy during the period of this study remains uncertain. Increasing demands to provide care for the congestive heart failure syndrome are likely to continue in the coming years, and medical facilities should develop new intervention strategies to treat or prevent the underlying conditions leading to heart failure as well as decrease the need for hospitalization in this common disorder.

Adult↗
PubMed1989

The size of the hepatitis delta agent.

The size of the hepatitis delta virus was determined by filtration of infectious plasma through polycarbonate membranes and the inoculation of filtrates into chimpanzees. Chimpanzees inoculated with filtrates of 50 nm and 30 nm, but not 15 nm filters, developed delta hepatitis. The minimum size of infectious hepatitis delta virus was estimated to be approximately 30 nm, which is consistent with measurements of particles thought to be the virus.

Animals↗
PubMed1989

A large outbreak of epidemic keratoconjunctivitis: problems in controlling nosocomial spread.

Between July 1985 and January 1986, 401 patients with adenovirus epidemic keratoconjunctivitis (EKC) were seen at the Illinois Eye and Ear Infirmary. Of the cases, 110 (27%) were nosocomial; the other 291 patients had community acquired infection. The highest attack rates of EKC occurred in patients attending specialty clinics; the overall attack rate among clinic patients was 4.7/1,000 clinic visits. All nosocomial cases were caused by adenovirus type 8; community acquired cases were a mixture of adenovirus types 8 and 37. Adenoviruses were isolated from conjunctival cultures up to 14 d after the onset of clinical illness. Initial efforts to prevent nosocomial transmission were unsuccessful. However, when a plan to triage all patients on entry to the infirmary and to sort patients and personnel caring for infected patients into cohorts was implemented, nosocomial transmission of EKC was promptly and effectively halted, despite the continuation of the community epidemic for another 4 mo. This outbreak clearly demonstrates the efficacy of rigorous infection control in preventing nosocomial transmission of adenovirus EKC.

Adenoviridae Infections↗
PubMed1989

Increased membrane-bound calcium in platelets of hypertensive patients.

The fluorescent indicator chlortetracycline was used to estimate membrane-bound calcium in mild, untreated hypertensive patients (n = 39) and normotensive controls (n = 42). All participants were black. After incubation with chlortetracycline, platelet-rich plasma was centrifuged into a pellet and fluorescence was measured with a microspectrofluorometer. At an interval of 45 minutes mean fluorescence values were 11% higher in the hypertensive than in the normotensive group (567 +/- 95 vs. 512 +/- 100 counts/sec, p less than 0.02). With both groups of participants combined, a correlation of borderline statistical significance was noted between diastolic blood pressure and chlortetracycline fluorescence (r = 0.213, p = 0.056). In parallel experiments, sodium and potassium concentrations were measured in red blood cells. Intracellular sodium was also significantly higher in the hypertensive group (p less than 0.01). These data indicate that the total cell burden of calcium is increased in the platelets of hypertensive individuals, possibly a result of abnormal cell metabolism of calcium, and further suggest that circulating platelets in hypertensive individuals may be in a hyperaggregable state.

Adult↗
PubMed1989

Coronary arteriography and coronary bypass survey among whites and other racial groups relative to hospital-based incidence rates for coronary artery disease: findings from NHDS.

To assess racial differences in health care utilization for coronary artery disease (CAD) the data of the National Hospital Discharge Survey (NHDS) from 1979-84 were examined. Discharge rates for acute myocardial infarction (AMI) were utilized as a measure of hospital-based incidence and relative need for the designated cardiac procedures. Although 35-74 year old Black men had discharge rates of AMI that were 77 per cent of those observed for White men, they underwent coronary arteriography half as often and were only a third as likely to have coronary artery bypass graft (CABG) surgery. Black women in this age range were hospitalized at a slightly higher rate than White women for AMI, yet experienced a 19 per cent lower rate of coronary arteriography and a 52 per cent lower rate of CABG surgery. These data suggest a racial bias in the pattern of care delivered for CAD in US hospitals at the present time.

Adult↗
PubMed1989

Red cell sodium and potassium in hypertension among blacks.

Intracellular sodium and potassium were estimated in a series of normotensive (n = 120) and hypertensive (n = 97) blacks attending an outpatient screening clinic. All participants were free of other major medical illnesses and had not taken prescription medications, including antihypertensives, for at least two weeks. Mean intracellular sodium was 11% higher in the hypertensives than the normotensives (8.51 +/- 2.46 v 7.77 +/- 2.27 mmol, respectively, P = 0.02). A significant correlation was noted between diastolic blood pressure and cell sodium (r = 0.138, P = 0.04) when measurements from both groups were combined. Logistic regression analysis likewise demonstrated a borderline significant role of cell sodium in determining case-noncase status (P = 0.06); this finding was independent of other covariates, such as age and obesity. No relationship was noted between cell potassium and blood pressure. A significant correlation was noted between cell sodium and potassium (r = 0.272; P = 0.001); whereas no relationships were found among cell sodium and body mass index, age, sex, habitual alcohol intake, or educational achievement. These data, obtained from the largest series of US blacks reported to date, confirm and extend the finding that the intracellular concentration of sodium in the erythrocyte is increased in hypertensives. The data also lend support to the contention that abnormal sodium metabolism at the cellular level may play a role in the biochemical pathway leading to hypertension.

Adult↗
PubMed1988

Sex differences in high density lipoprotein cholesterol in urban blacks.

Descriptive data on high density lipoprotein (HDL) cholesterol in the black urban population of the United States are limited. We examined 119 men and 130 women aged 21-70 years who were attending a screening clinic at Cook County Hospital in Chicago, Illinois, in 1985-1986 for minor complaints; all participants were black. For men, lipid values were: total cholesterol, 209.5 +/- 50.6, HDL cholesterol, 55.2 +/- 16.5; for women, values were: total cholesterol, 215.6 +/- 47.4, HDL cholesterol, 59.2 +/- 17.2. Correlates of HDL cholesterol were different in men and women. Alcohol consumption and body mass index were significantly related to HDL cholesterol in men; however, education was the only significant factor among women. It was anticipated that the increased obesity among the women in this sample (mean body mass index, 31 kg/m2; range, 18.4-50.0 kg/m2) compared with men (mean body mass index, 27 kg/m2; range, 19.4-45.0 kg/m2) would explain part of the narrowing of the gap between the sexes in HDL cholesterol values. The association between HDL cholesterol and body mass index among women, however, was weak and nonsignificant. The increased susceptibility of black women to coronary artery disease has not been adequately explained and undoubtedly reflects a complicated interaction of epidemiologic factors.

Adult↗