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Biomedical subjects

G R Cutter

Publications and source records attributed to G R Cutter.

At least 37 records · Page 2Linked to original sources
PubMed1990

Warning symptoms, uterine contractions, and cervical examination findings in women at risk of preterm delivery.

The presence of various reputed warning signs of preterm labor, the frequency of contractions, and the presence of cervical examination findings and their value in predicting preterm labor and spontaneous preterm delivery were assessed. The frequency of contractions and all cervical examination findings increased during pregnancy, as did backache, pressure, and cramping. The frequency of diarrhea, discharge, and bleeding remained constant. Of the various warning signs, only diarrhea and discharge were associated with the diagnosis of preterm labor. None of the warning signs were associated with spontaneous preterm delivery. Various patterns of contractions tended to be associated with higher rates of preterm labor and preterm delivery, but results were generally not statistically significant. Most cervical examination findings were statistically associated with both preterm labor and preterm delivery.

Adult↗
PubMed1990

Cigarette smoking behavior is strongly related to educational status: the CARDIA study.

The prevalence and correlates of cigarette smoking were examined in 5,116 men and women ages 18-30 years including both blacks and whites of varied educational levels. Prevalence of smoking was approximately 30% in each race by gender subgroup after adjusting for age and education. The prevalence decreased with increasing education, from 54% among participants with less than a high school education to 12% among those with graduate degrees (P less than 0.001). Cessation rates followed a similar pattern, with former smokers twice as common among those with more education. Differences in smoking prevalence across occupational groups were largely explained by differences in educational achievement. More educated individuals smoked fewer cigarettes per day and chose brands with lower nicotine yield. Race and gender were not strongly related to smoking prevalence. However, among smokers, whites reported smoking 50% more cigarettes per day than blacks but the average nicotine and tar content of the cigarette was nearly three times higher among blacks than whites. The strong inverse relationship between education and cigarette smoking patterns has important implications for public health efforts directed at the prevention of cigarette smoking.

Adolescent↗
PubMed1990

Alcohol intake and blood pressure in young adults: the CARDIA Study.

Associations between self-reported average daily alcohol intake and blood pressure were assessed in 5031 black and white men and women ages 18-30 from the Coronary Artery Risk Development in Young Adults Study (CARDIA). In general, intake was positively but weakly related to both systolic and diastolic blood pressure. Associations with systolic pressure were generally stronger than those with diastolic pressure. With average daily alcohol intake categorized as none, 0.1-9.9 ml, 10.0-19.9 ml, 20.0-29.9 ml, and 30.0+ ml, mean systolic pressure, adjusted for age, body mass index, education, smoking, and physical activity, increased progressively with increasing intake in black and white men and in white women. Mean diastolic pressure increased progressively with increasing intake only in white men and women, but was highest for those averaging 30.0+ ml per day in black women as well as white men and women. Mean pressures were also compared for those averaging 75.0+ ml per day (men) or 50.0+ ml per day (women) vs those reporting no intake. Differences in adjusted mean pressures for white men were 3.2 mmHg (95% confidence limits (CL) -0.3, 6.8) for systolic pressure and 1.7 mmHg (-1.6, 5.0) for diastolic pressure. In black men differences were 4.4 mmHg (1.4, 7.4) and 3.4 mmHg (0.6, 6.3), respectively. Differences in white women were 1.4 mmHg (-2.5, 5.3) for systolic pressure and 0.9 mmHg (-2.7, 4.5) for diastolic pressure and for black women, -0.2 mmHg (-4.3, 3.8) and 1.9 mmHg (-1.9, 5.8). Separate analyses in smokers and nonsmokers of the associations between alcohol intake and blood pressure suggested that associations may differ by smoking status in some sex-race groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

A positive association between maternal serum zinc concentration and birth weight.

A study was conducted on a cohort of 476 women (364 black, 112 white), who attended the Jefferson County Health Department clinic for their prenatal care, to ascertain the relationship between maternal serum zinc concentration measured early in pregnancy and birth weight. For all subjects maternal serum zinc was significantly related to birth weight after various independent determinants of birth weight were controlled for. The data in this study indicate a threshold for maternal serum zinc concentration below which the prevalence of low birth weight increases significantly. Pregnant women who had serum zinc concentrations in the lowest quartile had significantly higher prevalence of low birth weight than did those mothers who had serum zinc concentrations in the upper three quartiles during pregnancy. These findings suggest that maternal serum zinc concentration measured early in pregnancy could be used to identify those women at higher risk of giving birth to a low-birth-weight infant.

Adult↗
PubMed1990

Racial differences in serum cotinine levels among smokers in the Coronary Artery Risk Development in (Young) Adults study.

Cotinine was measured in the serum of nearly all 5,115 18-30 year old, Black and White, men and women participating in the Coronary Artery Risk Development in (Young) Adults Study, 30 percent of whom reported current cigarette smoking. Ninety-five percent of the reported smokers had serum cotinine levels indicative of smoking (greater than 13 ng/ml). The median cotinine level was higher in Black than White smokers (221 ng/ml versus 170 ng/ml; 95 percent CI for difference: 34, 65) in spite of the fact that estimated daily nicotine exposure and serum thiocyanate were higher in Whites. The difference persisted after controlling for number of cigarettes, nicotine content, frequency of inhalation, weekly sidestream smoke exposure, age, gender, and education. A reporting bias and nicotine intake were ruled out as explanations for the racial difference suggesting that the metabolism of nicotine or the excretion of cotinine may differ by race. Racial differences in cotinine levels may provide clues to the reasons for the observed lower cessation rates and higher rates of some smoking-related cancers in Blacks.

Adolescent↗
PubMed1989

A randomized, controlled trial of very early prophylactic ligation of the ductus arteriosus in babies who weighed 1000 g or less at birth.

We speculated that prophylactic ligation of the ductus arteriosus would reduce mortality and morbidity in very-low-birth-weight infants. To test this hypothesis, we randomly assigned 84 babies who weighed 1000 g or less at birth and required supplemental oxygen either to receive standard treatment (n = 44) or to undergo prophylactic surgical ligation of the ductus arteriosus on the day of birth (n = 40). The ductus was ligated in babies in the control group only if the shunt was hemodynamically important. All the babies were followed for one year. The incidence of necrotizing enterocolitis was reduced in the group that underwent prophylactic ligation (3 of 40 [8 percent]) as compared with the control group (13 of 44 [30 percent]; P = 0.002). The frequency of death, bronchopulmonary dysplasia, retinopathy of prematurity, and intraventricular hemorrhage was similar in both groups. Because early enteral feeding may have increased the incidence of necrotizing enterocolitis, we analyzed separately the babies who were fed early. Among the infants who were fed within 14 days of birth, those who underwent prophylactic ligation had a lower incidence of necrotizing enterocolitis (1 of 11 [9 percent]) than those who did not (13 of 24 [54 percent]; P = 0.001). Within the control group, the infants who were fed within 14 days of birth and whose ductus was ligated for medical reasons within 5 days of birth had a lower incidence of necrotizing enterocolitis (2 of 10 [20 percent]) than those whose ductus was ligated later or not at all (11 of 14 [79 percent]; P = 0.004). We conclude that early surgical closure of the ductus arteriosus reduces the risk of necrotizing enterocolitis in infants of very low birth weight who require supplemental oxygen.

Bronchopulmonary Dysplasia↗
PubMed1989

Prematurity, postdates, and growth retardation: the influence of use of ultrasonography on reported gestational age.

The preterm and postterm delivery rates and the percentage of infants with intrauterine growth retardation are dependent on the gestational age recorded at delivery. At our institution a sharp increase in the preterm delivery rate and a coincident decrease in the postterm delivery rate and the rate of intrauterine growth retardation were noted. Over a 3-year period, while the characteristics of the obstetric population changed only slightly, the gestational age distribution shifted, with a decrease in the mean gestational age of about 1 week and a risk in the reported preterm delivery rate from 12% to 17%. About 15% of this rise was explained by an increase in obstetric interventions, and another 15% can be explained by changes in the way physicians rounded off gestational age. The majority of the increase in the preterm delivery rate was related to changes involving ultrasonographic examinations. These changes included a greater percentage of the population examined, trends toward earlier examinations, a tendency for the physicians to use ultrasonography rather than the last menstrual period in choosing the final gestational age, the use of different standards, an increase in the number of structures measured, and the weight given to various structures for determination of gestational age. It is apparent that changes in use of ultrasonography had a profound effect on the reported gestational age distribution at our institution.

Birth Weight↗
PubMed1989

Intrauterine growth retardation: standards for diagnosis.

An intrauterine growth-retarded infant is commonly defined as one weighing less than the 10th percentile in birth weight for its gestational age. However, because there is no standard population from which to derive these percentiles, the birth weights that serve as the cutoff point in various published studies may differ by several hundred grams at any gestational age. For this reason, we examined the studies from which the currently used 10th-percentile standards are derived to determine which factors may be responsible for the variation. In addition to obvious differences in the populations and geographic areas on which they were based, studies differed in how gestational age was determined, whether the gestational age was "rounded" or given in completed weeks, which types of infants were excluded, whether the studies were hospital or population based, and whether they were controlled for sex of the infant and race and parity of the mother. These differences in study methodology may be as or more important than the population differences in defining the 10th percentile cutoffs. A single national standard for intrauterine growth retardation would allow comparison between studies of risk factors, diagnostic tests, management, and long-term follow-up status of fetuses and infants with intrauterine growth retardation.

Birth Weight↗
PubMed1989

Fluorescence microscopy of DES-induced morphologic transformation in unfixed, cultured cells.

Cultured baby Syrian hamster kidney cells (BHK 21), synchronized with hydroxyurea (HU), were treated with varying amounts of the carcinogen diethylstilbestrol (DES) during the first mitosis. DES-induced morphologic transformation was assessed by fluorescence microscopy of acridine orange, supravitally stained cells. Traditional karyotyping techniques were used to monitor DES-induced aneuploidy in parallel cell cultures. A total of 618 photomicrographs were obtained by systematic manual scanning of three replicate experiments each using three different DES treatment levels and a no DES control. These photomicrographs were randomized and graded blind by three independent observers. Each photomicrograph was graded for cellular morphologic transformation and a judgement as to whether DES treatment had been used. A definite dose-response relationship for both morphologic transformation, as well as for aneuploidy was observed. These findings portend a significance for use of fluorescence microscopy of morphologic transformation of unfixed supravitally stained mammalian cells, for the rapid assessment (24 h or less) of compounds that promote aneuploidization and carcinogenesis.

Acridine Orange↗
PubMed1989

Portable tonometers: a clinical comparison of applanation and indentation devices.

Optometric services to outpatient clinics, nursing homes and hospitals require portable equipment for ocular assessment. Of the various tonometric methods available, Goldmann applanation tonometry remains the standard. We present a clinical comparison of the hand-held version of Goldmann's instrument (Perkins tonometer) and the less expensive Schiotz tonometer. In a clinical comparison, we measured the intraocular pressure (IOP) of 51 inpatient and outpatient veterans (100 eyes) during routine examination. In each case the Perkins applanation tonometer was used first. This measurement was followed by IOP measurements using the Schiotz indentation tonometer with the 7.5 g and 5.5 g plunger loads. Plunger loads were alternated so that each was used, initially, 50% of the time. Good correlations, ranging from +.85 to +.68, were achieved between the applanation and indentation modes. Compact portability, lower cost and comparable reliability make the Schiotz tonometer a viable option for IOP screening.

Adult↗
PubMed1988

Association of Ureaplasma urealyticum infection of the lower respiratory tract with chronic lung disease and death in very-low-birth-weight infants.

Endotracheal aspirates from 200 infants who weighted less than or equal to 2500 g and who had evidence of respiratory disease were cultured within 24 h of birth for mycoplasmas, chlamydiae, viruses, and bacteria to evaluate the relation between lower respiratory tract infection and development of chronic lung disease and/or death. Ureaplasma urealyticum, an organism not visible on gram stain, not recovered on routine bacteriological media, and not susceptible to antibiotics commonly used to treat neonatal infections, was the single most common organism isolated. 14% of isolates were from infants born by caesarean section with intact membranes, which indicated that infection had occurred in utero. The findings probably represented true infection of the lower respiratory tract because the organism was recovered in pure culture in numbers greater than 10(3) from 85% of the infants, and also from the blood in 26% of infants. Those infants less than or equal to 1000 g with Ureaplasma urealyticum infection of the lower respiratory tract were twice more likely to have chronic lung disease or to die than were infants of similar birth-weight but who were uninfected, or infants greater than 1000 g. Very-low-birth-weight infants infected with ureaplasmas did not differ from those uninfected, either in demographic features or in potential risk factors for chronic lung disease.

Animals↗
PubMed1988

CARDIA: study design, recruitment, and some characteristics of the examined subjects.

In 1984, a prospective cohort study, Coronary Artery Risk Development in Young Adults (CARDIA) was initiated to investigate life-style and other factors that influence, favorably and unfavorably, the evolution of coronary heart disease risk factors during young adulthood. After a year of planning and protocol development, 5,116 black and white women and men, age 18-30 years, were recruited and examined in four urban areas: Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota, and Oakland, California. The initial examination included carefully standardized measurements of major risk factors as well as assessments of psychosocial, dietary, and exercise-related characteristics that might influence them, or that might be independent risk factors. This report presents the recruitment and examination methods as well as the mean levels of blood pressure, total plasma cholesterol, height, weight and body mass index, and the prevalence of cigarette smoking by age, sex, race and educational level. Compared to recent national samples, smoking is less prevalent in CARDIA participants, and weight tends to be greater. Cholesterol levels are representative and somewhat lower blood pressures in CARDIA are probably, at least in part, due to differences in measurement methods. Especially noteworthy among several differences in risk factor levels by demographic subgroup, were a higher body mass index among black than white women and much higher prevalence of cigarette smoking among persons with no more than a high school education than among those with more education.

Adult↗
PubMed1988

Plasmid-containing strains of Streptococcus mutans cluster within family and racial cohorts: implications for natural transmission.

The transmission of mutans streptococci is thought to occur along familial lines based on investigations which have shown common strains within family units by using phenotypic typing methods, such as bacteriocin production and immunity profiles and serotyping. Difficulties in implementing these typing methods, coupled with conflicting interpretations of results between laboratories, led us to study the conservation of Streptococcus mutans strains within a mother-child cohort by using a genotypic marker, plasmid DNA. Plasmids (all 5.6 kilobases in size) were observed at an overall frequency of 3.3%, with a significantly different frequency in whites (1.5%) compared with blacks (6.6%). Plasmid-containing strains were significantly clustered in mother-child pairs compared with nonrelated individuals (58 versus 3.3%; P less than 0.001). Moreover, the different plasmid groups (I and II) were highly conserved within racial boundaries (P = 0.007). In those instances in which we were able to characterize distinct strains by either biotype or plasmid profile, we found that mothers harbored a more heterogeneous population of mutans streptococci than did their children. This suggested, among other possibilities, that children acquire additional strains as they approach adulthood. Alternatively, we may have been unable to detect more heterogeneity of strains in children because of quantitative differences of strains in saliva. We present collective data which show that strains of S. mutans are highly conserved within not only mothers and their children but also racial groups, suggesting vertical transmission of this organism within human populations. Moreover, we show that levels of S. mutans found in the saliva of the mother correlated with levels found in her child, demonstrating a quantitative relationship within mother-child pairs.

Family↗
PubMed1987

Fetal deaths in Alabama, 1974-1983: a birth weight-specific analysis.

Birth weight-specific fetal death rates were evaluated for Alabama for the years 1974-1983. The fetal death rate for the total low birth weight group improved less than 20% during the decade, whereas the fetal death rate for the 2500-3999-g birth weight group improved 40%, and the fetal death rate for the group of 4000 g or more improved 71%. By 1983, 76% of all stillbirths weighed less than 2500 g, compared with 66% in 1974. In contrast, in both years, only about 7% of live births weighed less than 2500 g. This study suggests that increased reporting of stillbirths of less than 500 g has contributed to the recent apparent lack of improvement in stillbirth rates in Alabama.

Alabama↗
PubMed1985

Low birth weight, intrauterine growth retardation, and preterm delivery.

The relationship between low birth weight, intrauterine growth retardation, and preterm delivery in infants born at a perinatal center is described. Between 20% and 30% of infants born weighing 500 to 2000 gm and nearly 50% of infants born weighing 2001 to 2750 gm had intrauterine growth retardation. For infants within the same low-birth weight group, infants with intrauterine growth retardation had one half to one sixth of the neonatal mortality rate of non-growth-retarded infants. However, only in the 501 to 1000 gm group did the difference in mortality between infants with and without intrauterine growth retardation substantially influence the composition of the group of survivors.

Birth Weight↗
PubMed1985

Dietary therapy slows the return of hypertension after stopping prolonged medication.

This study asks whether prolonged antihypertensive therapy will "cure" a substantial percent of rigorously treated hypertensive patients and whether nutritional change will add an antihypertensive effect and reduce the relapse rate. Of 584 eligible patients normotensive while receiving therapy, 496 were randomized into control and discontinued-medication groups with and without dietary intervention. At 56 weeks, 50% of those who were no longer receiving medication remained normotensive by study criteria. Randomization either to weight-loss group (mean loss of 4.5 kg [10 lb]) or to sodium-restriction group (mean reduction of 40 mEq/day) increased the likelihood of remaining without drug therapy, with an adjusted odds ratio of 2.17 for the sodium group and 3.43 for the weight group. Highest success rates were in the nonoverweight mild hypertensives with sodium restriction (78%) and the overweight mild hypertensives who were reducing their weight (72%). These data demonstrate that weight loss or sodium restriction, in hypertensives controlled for five years, more than doubles success in withdrawal of drug therapy.

Clinical Trials as Topic↗