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Biomedical subjects

G R Cutter

Publications and source records attributed to G R Cutter.

At least 55 records · Page 3Linked to original sources
PubMed1993

Transmission of mutans streptococci to infants following short term application of an iodine-NaF solution to mothers' dentition.

In a randomized clinical trial, six applications of an I2-NaF or a placebo solution were administered to the mothers' dentition at the time of tooth emergence of her infant, to evaluate its effect on transmission of mutans streptococci (MS) to the infant. MS and other bacterial levels were periodically monitored in 48 mother-infant pairs until the child's third birthday. There were significant reductions in maternal salivary MS (P = 0.04), lactobacilli (P = 0.04), total streptococci (P = 0.002), and total cultivable organisms (P = 0.004) immediately following treatment. In children, 3-yr incidence of MS colonization and the time of acquisition of MS or the caries experience did not differ significantly between the two groups. We conclude that short-term application of I2-NaF to the maternal dentition of predentate infants significantly lowers MS, lactobacilli, total streptococci, and total cultivable bacteria in mothers' saliva, but does not influence the incidence and the time of acquisition of MS or the caries experience in children.

Adult↗
PubMed1993

Initial acquisition of mutans streptococci by infants: evidence for a discrete window of infectivity.

Oral bacterial levels of 46 mother-child pairs were monitored from infant birth up to five years of age so that the acquisition of mutans streptococci (MS) by children could be studied. The initial acquisition of MS occurred in 38 children at the median age of 26 months during a discrete period we designated as the "window of infectivity". MS remained undetected in eight children (17%) until the end of the study period (median age of 56 mo). The levels of both MS and lactobacilli in saliva of mothers of children with and without MS were not significantly different. Comparisons between a caries-active cohort colonized by MS (nine of 38) and children without detectable MS revealed similar histories in terms of antibiotic usage, gestational age, and birth weight. Interestingly, half of the children between the ages of one and two years who were not colonized by MS were attended by caretakers other than the mother, while all of the caries-active children during this same time period were cared for by their mothers; the difference was statistically significant. Here we report for the first time that MS is acquired by infants during a defined period in the ontogeny of a child. Support for the notion of a discrete window of infectivity comes from other sources, including animal models.

Adult↗
PubMed1993

Physical activity of public housing residents in Birmingham, Alabama.

OBJECTIVES: Because few data are available concerning physical activity among minority and low-income persons, we characterized physical activity patterns among public housing residents. METHODS: Two separate cross-sectional surveys were conducted 1 year apart of randomly selected residents of eight rental communities administered by the housing authority of Birmingham, Ala. Indigenous interviewers completed 687 interviews in survey 1 and 599 in survey 2. RESULTS: In both surveys, respondents were most frequently young adult African-American women, reflecting the predominance of women in these communities. Participants were generally poorly educated and either unemployed or working in service occupations. Thirty percent of the respondents in both surveys reported no participation in any of 13 physical activities in the previous year; approximately half reported activity levels equivalent to or less than walking 4 hours per week for 8 months of the year. Respondents who were younger and male were significantly more likely to have higher activity levels. CONCLUSIONS: A sedentary life-style is common among this low-income minority group, and, thus, interventions to promote exercise in these communities are needed.

Adolescent↗
PubMed1993

Promoting physical activity in low-income African-American communities: the PARR project.

Data suggest that low-income and minority individuals are less physically active than the general population. We conducted a constituency-based physical activity promotion program, the Physical Activity for Risk Reduction (PARR) project, from 1988 to 1991, with residents of rental communities administered by the Housing Authority of the Birmingham District in Birmingham, Alabama. Data collected through focus groups and by survey of randomly selected residents' exercise practices, beliefs, barriers to and facilitators of physical activity were used to develop specific intervention programs that were implemented and evaluated in six intervention and two control communities through surveys and process evaluations. Trained community residents conducted data collection and interventions. Ninety-nine percent of respondents in the baseline survey were African Americans. Thirty-one percent reported no participation in any of 13 physical activities in the previous year. Significant differences (P < .05) in average attendance by community at group exercise sessions indicated substantial variability in effectiveness of the intervention, due at least in part to factors related to both the communities and the leaders. This variability appeared to explain patterns of change in preintervention and postintervention physical activity scores in intervention communities. Data and experiences from PARR will be applicable to the delivery of similar types of health-related programs in undeserved communities.

Adolescent↗
PubMed1993

Fetal biparietal diameter, head circumference, abdominal circumference and femur length. A comparison by race and sex.

Biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) were compared by race and sex in 5,405 ultrasound examinations done on 2,831 women. Black fetuses had significantly longer FL than white fetuses; male fetuses had larger BPD, HC and AC than females. The differences in BPD, HC and AC correlated with the different birth weights observed between male and female infants, 3,253 vs. 3,153 g. The difference in birth weight between black and white infants, 3,152 vs. 3,331 g, did not correlate with differences in their respective BPD, HC and AC. Earlier delivery accounted for some but not all of the birth weight difference between black and white infants. Our data suggest that there may be differences in body length proportions (longer legs and shorter trunks in black infants) that are important factors in understanding the birth weight difference between black and white infants. Furthermore, fetal race and sex differences could account for some degree of error in the ultrasound estimation of gestational age.

Abdomen↗
PubMed1992

Factors predicting efficacy of phentolamine-papaverine intracorporeal injection for treatment of erectile dysfunction in diabetic male.

Thirty-three diabetic men were instructed in the use of phentolamine-papaverine injections for the treatment of erectile dysfunction over a two-year period. Of these, 12 reported a satisfactory response and 21 reported a nonsatisfactory response. The responders and the nonresponders were retrospectively studied to identify characteristics that would predict a satisfactory response. No difference was found between the two groups in the duration of diabetes, the presence of retinopathy, neuropathy, nephropathy, peripheral vascular disease, or ischemic heart disease. The utilization of insulin, the prevalence of type II diabetes, or the use of drugs which would cause impotence, did not differ between the two groups. There was no difference in the serum testosterone levels between the two groups. Age was the only predictive factor. Only 1 of 14 patients over age sixty had a satisfactory response to treatment while 11 of 19 patients under age sixty had a satisfactory response. Five of the responders and 2 of the nonresponders proceeded to penile implant surgery and reported satisfactory results. While older diabetic men may choose a trial of intracorporeal injections, they should be counselled regarding the high failure rate and alternative forms of therapy.

Age Factors↗
PubMed1992

Distributed data analysis in a multicenter study: the CARDIA Study.

Unlike distributed data entry, which is used in many large epidemiologic studies and multicenter clinical trials, distributed data analysis is a relatively new concept. This paper reports on the usefulness of such a system in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. CARDIA distributes the entire examination dataset to participating centers soon after completion of each round of data collection. The process was designed to encourage more numerous, diverse, and rapid publications, and to allow for more efficient use of the manpower and expertise in centers. Responsibilities of the coordinating center have changed from a conventional coordinating center but remain substantial due to the need for collating, monitoring, verifying, and documenting the distributed data analysis (DDA) system. DDA is successful from the standpoint of implementation and operation--21 manuscripts representing work analyzed at six participating centers had been submitted for publication within 3.5 years of the completion of the baseline examination.

Adolescent↗
PubMed1992

Elevated levels of midtrimester maternal serum alpha-fetoprotein are associated with preterm delivery but not with fetal growth retardation.

OBJECTIVE: Our objective was to determine if the low birth weight associated with unexplained elevations of midtrimester maternal serum alpha-fetoprotein levels is due to prematurity or to fetal growth retardation. STUDY DESIGN: Rates of preterm delivery and fetal growth retardation were analyzed according to incremental maternal serum alpha-fetoprotein levels in 5555 women, predominantly white, who were screened for neural tube defects (group 1) and 843 women, predominantly black, with risk factors for low birth weight (group 2). Statistical methods included chi 2, t tests, analysis of variance, and regression analysis. RESULTS: In both groups increasing levels of maternal serum alpha-fetoprotein are significantly associated with preterm delivery but not with fetal growth retardation. The preterm delivery rate increased in each group from 8% at levels less than 0.5 multiples of the median to 18.1% (p less than 0.001) at levels greater than or equal to 2.5 multiples of the median in group 1 and 28.1% (p = 0.01) in group 2. CONCLUSIONS: Women with unexplained elevations of maternal serum alpha-fetoprotein are at increased risk for preterm delivery but not fetal growth retardation. Because of the wide availability of maternal serum alpha-fetoprotein screening, women at increased risk for preterm delivery can be identified in the midtrimester of pregnancy.

Black People↗
PubMed1992

Blood pressure, growth retardation, and preterm delivery.

The effect of various levels of both diastolic and systolic blood pressure at various times during pregnancy on the rates of intrauterine growth retardation (IUGR) and preterm delivery (PTD) were determined. Low systolic and diastolic pressures were associated with both IUGR and PTD, as were high pressures. Low pressures tended to be associated with spontaneous preterm deliveries, whereas high pressures were associated with more indicated preterm deliveries.

Blood Pressure Determination↗
PubMed1992

Maternal serum folate and zinc concentrations and their relationships to pregnancy outcome.

To evaluate the relationship between folate and zinc, and its effect on pregnancy outcome, maternal serum folate and zinc concentrations were determined at 18 and 30 wk gestation in a defined population of 285 pregnant women as part of a large-scale study to identify risk factors for fetal growth retardation (FGR). These results were correlated with birth weight and Apgar scores of newborn infants and with maternal infections during the perinatal period. A weak linear relationship was observed between maternal serum folate and zinc concentrations at 30 wk gestation. Folic acid supplementation had favorable effects on birth weight and Apgar scores of newborns, and reduced prevalence of FGR and maternal infections. No significant correlation was found between serum zinc concentration and birth weight of infants. The concept that folic acid supplementation has an adverse effect on maternal zinc nutriture and pregnancy outcome was not supported.

Adult↗
PubMed1992

Effect of conventional dental restorative treatment on bacteria in saliva.

Dental caries results from the dissolution of mineralized dental tissues by the metabolic by-products of oral bacteria colonizing the surface of teeth. The principal modality for dealing with this infectious process is through restorative treatment which removes the pathologic tissue and replaces it with a variety of inert materials. The purpose of this study was to evaluate the effect of traditional restorative treatment on select oral bacterial populations. Fifty-two females demonstrating high levels of mutans streptococci (greater than or equal to 2.5 x 10(4) colony forming units (cfu) per ml saliva) with no more than four missing posterior teeth were recruited for this study. Salivary levels of mutans streptococci, lactobacilli, total streptococci, and total cultivable bacteria were evaluated before, during, and after restorative treatment. Initial DMFS scores were established by two standardized examiners using bitewing radiographs and clinical examination, which was conducted under optimal conditions. All restorative treatment was completed by faculty members of the University of Alabama School of Dentistry using treatment plans developed by the DMFS examiners. The participants received a mean of 16.4 restored surfaces, which resulted in significant reductions of all the bacterial populations tested. All microbial populations monitored were predicted to return to their baseline levels within 151 days after restorative treatment in 50% of the participants. This study shows that conventional restorative treatment results in a significant reduction of bacterial populations including those associated with the dental caries process, i.e., mutans streptococci and lactobacilli.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Symptom-limited graded treadmill exercise testing in young adults in the CARDIA study.

Symptom-limited, graded exercise treadmill testing was performed by 4,968 white and black adults, ages 18-30 yr, during the baseline examination for the CARDIA study. The mean estimated maximal exercise capacity by race/gender, expressed as metabolic units (METS), was: white men 13.8, black men 13.0, white women 11.1, and black women 9.4. Exercise test duration was higher in nonsmokers, positively related to physical activity score and pulmonary function (FEV1.ht-2), and inversely related to body mass index. Men had higher mean values than women for both test duration and a measure of submaximal performance, the workload 130 (WL130, the exercise test duration to a heart rate of 130 beats.min-1). Adjusted for age and education, white men had a longer mean test duration than black men (53 s longer, P less than 0.001), but nearly equal mean WL130. White women had higher mean values than black women for both test duration (114 s longer, P less than 0.001) and WL130 (36 s longer, P less than 0.001). Men had higher mean values than women for both outcome measures (P less than 0.001). Thus, in young adults significant gender and ethnic differences exist for exercise test performance, part of which can be explained by personal habits or traits.

Adolescent↗
PubMed1992

Serum folate and fetal growth retardation: a matter of compliance?

Serum folate levels were measured at 30 weeks' gestational age in 289 pregnant women, each of whom had been provided with folate supplementation at enrollment in prenatal care. There was a significant association between low serum folate levels and fetal growth retardation. High folate levels were most likely explained by recent folic acid intake. Therefore, we were concerned that the decreased fetal growth associated with low folate levels may have been related to a combination of psychological and behavioral characteristics for which low serum folate levels were only a surrogate measure. A profile of maternal psychosocial status was created, which included measures of depression, anxiety, self-esteem, mastery, stress, and social support. Poorer psychological scores were significantly related to lower serum folate levels. However, in women with both good and poor psychosocial scores, high folate levels were significantly associated with increased birth weight, a relationship that persisted even after adjusting for maternal race, body mass index, smoking, history of a low birth weight infant, and infant gender. Our findings suggest that women with good psychosocial scores are more likely to take folate, but that the use of folate itself is related to a lower risk of fetal growth retardation and increased birth weight.

Affective Symptoms↗
PubMed1992

The relationships among psychosocial profile, maternal size, and smoking in predicting fetal growth retardation.

OBJECTIVE: We explored the relationships among measures of psychosocial well-being, maternal size, and smoking in predicting infant size at birth. METHODS: Participants in this population-based cohort study were drawn from public health prenatal clinics in Jefferson County, Alabama during 1985-1988. Para 1 and 2 women were screened for 11 risk factors for low birth weight, including small stature, a previous low birth weight infant, and smoking. RESULTS: Poor scores on five of six psychosocial scales, as well as on a combined profile, were associated with a significantly higher relative risk of fetal growth retardation (FGR) only in thinner women, defined as having a body mass index less than the median (relative risk [RR] 2.11, 95% confidence interval [CI] 1.47, 3.04). A significant association between the psychosocial profile and birth weight was demonstrated for thin women in a multivariate analysis adjusting for gestational age, race, infant sex, and smoking (P = .0003). The relationship remained significant when hypertension, alcohol and drug use, and weight gain were added to the model (P = .003). In women with a body mass index above the median, a poor psychosocial profile showed little association with FGR (RR 1.20, 95% CI 0.73, 1.98) and did not have a significant association with birth weight. A poor profile had a greater association with FGR in non-smokers (RR 2.04, 95% CI 1.29, 3.22) than in smokers (RR 1.4, 95% CI 0.95, 2.06). CONCLUSIONS: Greater pre-pregnancy weight for height appears to protect against the adverse effects of a poor psychosocial profile in a population of poor, primarily black women. In thinner women, both smoking and a poor psychosocial profile were associated with a substantially increased rate of FGR, indicating a subgroup of women who may receive greater benefits from intervention programs.

Body Mass Index↗
PubMed1992

The influence of previous low birth weight on birth weight, gestational age, and anthropometric measurements in the current pregnancy.

The effect of a previous low birth weight birth (less than 2750 g) was examined using a series of regression analyses. Effects on birth weight were partitioned into those associated with preterm delivery (128 g) and term delivery (178 g). Among term births, a mean difference of 107 g was associated with a previous birth of less than 2750 g, even after controlling for other risk factors including smoking, drug and alcohol use, maternal race, size, and hypertension. The pattern of measurements seen after a previous birth of less than 2750 g included significantly smaller head, chest, abdomen, arm, and thigh circumferences, but an insignificant impact on skinfold thicknesses and no significant effect on length measurements.

Anthropometry↗
PubMed1991

The relationship between maternal serum zinc levels during pregnancy and birthweight.

A retrospective follow-up study to ascertain the relationship between the level of serum zinc and its rate of change during gestation and birthweight was conducted in 476 women of lower socioeconomic status. Serum zinc concentrations measured at approximately 16 (early) and 32 weeks (later) in gestation were both found to be significant predictors of birthweight. Even after controlling for gestational age at birth and other determinants of birthweight, for each microgram/dl increase in serum zinc early and later in pregnancy, birthweight increased by 5.8 and 8.6 g, respectively. Furthermore, after adjustment for initial zinc levels both the total change (beta = -7.0, P = 0.0007) and the rate of change (beta = -60.8, P = 0.007) in serum zinc during pregnancy were inversely associated with birthweight, i.e., the larger the fall in serum zinc during pregnancy, the smaller the infant. Low serum zinc level (less than 60 micrograms/dl) late in pregnancy was associated with greater than a five-fold increase in the odds (OR = 5.8, 95% CI = 1.8, 16.4) of giving birth to a low birthweight infant. The results of this study suggest a threshold for maternal serum zinc below which the prevalence of low birthweight increases rapidly.

Adolescent↗