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Biomedical subjects

G Cutter

Publications and source records attributed to G Cutter.

At least 55 records · Page 3Linked to original sources
PubMed1987

Recruitment in the Coronary Artery Disease Risk Development in Young Adults (Cardia) Study.

Coronary Artery Disease Risk Development in Young Adults (CARDIA) is a longitudinal study designed to trace the development of risk factors for coronary heart disease in 5100 individuals 18-30 years old. The study will compare, by cross-sectional and longitudinal analyses, trends and processes involved in risk factor development by sex, race, age, and other sociodemographic characteristics. Participants for the approximately 4 1/2-hour baseline examination were randomly selected and recruited by telephone from census tracts in Minneapolis and Chicago, by telephone exchanges within the Birmingham city limit, and from lists of the Kaiser-Permanente Health Plan membership in Oakland and Berkeley. A major issue was the desirability of sampling approximately equal numbers by age, race, sex, and education as compared with sampling numbers representative of the population base. The recruitment goal of 5100 was achieved on schedule.

Adolescent↗
PubMed1987

Comparison of hypertension prevalence and control in 5,237 rural and urban Alabama residents.

Selected urban and rural Alabama populations were compared by age, sex, and race on the prevalence of hypertension and uncontrolled hypertension and the percentage of treated hypertensives with controlled blood pressure. We found the following results: (1) Rural women had a significantly higher prevalence of hypertension than urban women. (2) The prevalence of uncontrolled hypertension was significantly higher for urban white men than for their rural counterparts. (3) The prevalence of uncontrolled hypertension was significantly higher for rural black women aged 30 to 39 than for the same age group of urban black women. (4) Rural dwellers generally had much better blood pressure control than urban, though this was not manifested evenly across groups. Statistically significant differences were found for white men and women of all ages combined and in three of four age groups. Reasons for the rural-urban differences are unclear, but the rural area surveyed was served by nurse practitioner clinics that strongly emphasized patient education.

Adult↗
PubMed1986

Prediction of response to sodium intervention for blood pressure control.

In the Dietary Intervention Study of Hypertension (DISH) we found that patients formerly treated with drugs and assigned to sodium-reduction intervention were twice as likely to remain off medication for up to 56 weeks as were the controls assigned to no-diet intervention, after adjusting for covariates. Within the sodium-restriction group approximately 60% of 131 people were Intervention Successes (IS) (urinary sodium less than or equal to 100 mmol/day at 8 weeks). The rest were classed as Non-Intervention Successes (NIS). Of the IS group, 54% were responders (drug-free for at least 56 weeks), but about 56% of the NIS group also remained drug-free. Multiple logistics showed that no one factor was able to predict response among the IS. We conclude that the IS likely to respond to sodium reduction are not readily identifiable a priori. Furthermore, since both IS and NIS showed similar blood-pressure effects from the sodium-restriction regimen compared with controls, the questions arise: whether a factor other than sodium reduction affects the blood pressure response for the sodium-restriction group; or whether the measurement of sodium intake and excretion is sufficiently precise to distinguish compliers from non-compliers.

Antihypertensive Agents↗
PubMed1985

Neonatal mortality in infants born weighing 501 to 1000 grams. The influence of changes in birth weight distribution and birth weight-specific mortality rates on neonatal survival.

We analyzed changes over time in neonatal mortality rates for infants born weighing 501 to 1000 gm. The decline in total mortality in this weight group due to improved small-group, birth weight-specific mortality was contrasted to the increase in mortality caused by changes in the birth weight distribution resulting from the care of smaller infants. Had the birth weight distribution remained unchanged, the total improvement in neonatal mortality for the entire 501 to 1000 gm group would have been substantially greater.

Alabama↗
PubMed1985

The effectiveness of smoking cessation methods for smokers in public health maternity clinics: a randomized trial.

Little insight is available in the literature on how best to assist the pregnant smoker in public health maternity clinics to quit during pregnancy. A randomized pretest/posttest experiment was used to evaluate the effectiveness of two different self-help cessation methods. Three hundred and nine pregnant women from three public health maternity clinics were assigned randomly to one of three groups with one-third assigned to each: a control group; a group receiving the American Lung Association's Freedom From Smoking Manual; and those receiving A Pregnant Woman's Self-Help Guide to Quit Smoking. Using a saliva thiocyanate (SCN) and behavioral report at mid-pregnancy and end of pregnancy to confirm cessation or reduction, 2 per cent in the control group quit and 7 per cent reduced their SCN levels substantially. Of the women assigned to the ALA method, 6 per cent quit and 14 per cent reduced their SCN levels substantially. Of the women who used the Guide, 14 per cent quit and 17 per cent reduced their SCN levels substantially. Results of this trial indicate that health education methods tailored to the pregnant smoker are more effective in changing smoking behavior than the standard clinic information and advice to quit and/or the use of smoking cessation methods not tailored to the needs of the pregnant smoker.

Adult↗
PubMed1984

Issues in the natural history and treatment of coronary heart disease in black populations: surgical treatment.

Patient characteristics, treatment choices, and long-term survival were examined to seek possible explanations for marked differences in the racial distribution among 6594 consecutive patients who underwent arteriography or coronary artery bypass grafting (CABG) from 1970 to 1978. Overall, the percentage of whites undergoing coronary arteriography was 96% compared with 4% of the blacks; only black females showed a secular increase in the relative percentage. Clinical manifestations and predisposing factors for coronary atherosclerosis differed little between the blacks and the whites in this population. Angina, as measured by the Rose Questionnaire, had the same clinical significance in blacks as in whites. Findings indicated that similar covariates of comparable strength appeared to be operative as indices for severity of coronary heart disease in both blacks and whites. On the basis of regression analyses, whites had approximately a three times greater chance of having two or more diseased vessels than did blacks after adjustment for multiple clinical characteristics and risk factors. After adjusting for pertinent variables, whites with three-vessel disease were two and a half times more likely to have CABG than blacks (42.5% vs 16.2%). However, differences in choice of initial therapy for whites and blacks with multiple-vessel disease were significant only in those older than 50 years. Except for older blacks who demonstrated a decreased survival rate when managed surgically, survival rates were similar for blacks and whites. Trends in the evaluation and clinical management of black populations with suspect coronary heart disease should further clarify these preliminary findings.

Black or African American↗
PubMed1982

Correlates of attendance and compliance in the hypertension detection and follow-up program.

The Hypertension Detection and Follow-Up Program (HDFP) screened 159,000 individuals aged 30-69 years in 14 communities. Using a two-stage process, 10,940 hypertensives were randomized into two treatment groups. The first group was referred to community sources for care (RC), and the second received free Stepped Care (SC) treatment with extensive efforts to reduce the barriers to care. One year after enrollment, attendance showed 85% of SC participants active (white males 88%, white females 84%, black males 83%, and black females 84%). One year attendance rates ranged from a low of 84% for those with baseline DBP 90-104 mm Hg to a high of 90% for those with baseline DBP greater than or equal to 115 mm Hg. There was no apparent association with age, however, attendance exhibited a positive relationship with education, ranging from 83% for those completing less than high school to 94% for those with degrees beyond college. Life tables analyses demonstrated that race, sex, and blood pressure level compliance differences manifest themselves at the early stages of enrollment with little variation among participants once in the program. Pill counts correlated with percent with controlled blood pressure as well as serum potassium and calcium levels. Educational level was also a major predictor of drug adherence ranging from 74.7% to 89.7% (from under 7th grade to above college) having taken greater than or equal to 80% of their pills.

Actuarial Analysis↗
PubMed1981

Urinary glycosaminoglycan excretion as a biochemical marker in patients with bladder carcinoma.

Urinary glycosaminoglycan excretion was examined in 25 individuals with bladder cancer in comparison to glycosaminoglycan excretion by eight normal individuals. Urinary glycosaminoglycan was isolated by gel filtration and quantified as macromolecular uronate concentration. Electrophoresis in calcium acetate and densitometry of Alcian blue-stained electrophoretograms were used to separate and quantify the relative amounts of individual glycosaminoglycans. Elevated excretion of macromolecular uronate was noted in 53% of the cancer cases. The highest levels were found among individuals with metastatic disease. Three electrophoretic bands were always detected in the control and cancer groups: chondroitin sulfate, heparan sulfate (both confirmed by chemical and enzymatic degradation), and a third band (Band 1) of unknown composition. A fourth band, corresponding to dermatan sulfate, was seen in some high-grade metastatic tumors. Band 1 excretion was elevated in a significant fraction of all patients. Seven of 12 metastatic cases but only two of 13 localized cases showed increased heparan sulfate excretion. Diagnostic limits were drawn from the observed distributions of normals, and with these limits 92% of the cancer cases, including 12 of 12 metastatic cases, could be identified. The results strongly suggest noninvasive urinary glycosaminoglycan analysis may well provide a new biochemical approach for detecting and monitoring the pathogeneses of bladder cancer.

Chondroitin Sulfates↗
PubMed1980

Mortality surveillance in collaborative trials.

The Hypertension Detection and Follow-Up Program (HDFP) carried out two pilot surveillances covering the enumerated population to test procedures to be used in assessing the ability of the program to influence life expectancy in the total population. A rigorously sequenced pilot survey of 2,611 households was conducted and carefully monitored through two mailings, telephone contacts, home visits, and communication with "contact" persons. The response rates at each stage varied among the 13 centers. Overall, there was a 42.7% yield from the first mailing; 42.5% of those receiving a second mailing was completed; 78.0% for telephone 61.3% for the home visits and 55.2% from the "contact" persons. Overall, 97.4% of all persons had vital status ascertained. The second phase relaxed the rigorous sequential survey requirements and reduced the reporting requirements from every ten days to monthly. Overall, 93.3% were successfully ascertained. Reduced survey structure, slightly increased mobility (from 12% to 13%), increased workload from 200 to 400 households per center, and a longer time interval between initial enumeration and the mortality ascertainment are among the reasons for performance decline.

Adult↗
PubMedDate not supplied

The cancer information service research consortium: an emerging laboratory for cancer control research.

The Cancer Information Service (CIS) was established in 1975 by the National Cancer Institute (NCI) to provide accurate, up-to-date information about cancer to the nation. Although the CIS has in the past served as a venue for cancer communications research, up until very recently the research capacity of the CIS was underutilized. In 1993, this situation changed dramatically with funding from the NCI to form the Cancer Information Service Research Consortium (CISRC). In this article the CISRC is described for the first time, including its research agenda and administrative structure. Early indications from the CISRC suggest that the CIS can serve as one of the premiere laboratories in the country for cancer communications and cancer control research. Several factors are suggested for the early success of the CISRC in sustaining this collaborative effort with the CIS. The progress that has been made by the CISRC could provide a useful model for other large health information programs to maximize their contributions to behavioral science and health promotion research, as well as to establish their own program of policy-relevant research.

Community-Institutional Relations↗
PubMedDate not supplied

Impact of hypertension information on high blood pressure control between 1973 and 1978.

To determine whether the immense multifocal efforts in the United States over the past 7 years to detect and treat high blood pressure (BP), had affected the status of hypertension, data from a national household survey in 1973-74 were compared with data obtained in 1977-78 from a second non-overlapping population in the same three communities. The impact of hypertension programs was measured by assessing change over the 5-year period in BP distribution, degree of awareness, and level of treatment in the population. Our data show that a substantial improvement in the status of high BP detection, treatment, and control has occurred since the early 1970s for all age, sex, and race groups studied.

Adult↗