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Biomedical subjects

J Baxter

Publications and source records attributed to J Baxter.

At least 37 records · Page 2Linked to original sources
PubMed1999

Methods and prevalence of ADL limitations in Hispanic and non-Hispanic white subjects in rural Colorado: the San Luis Valley Health and Aging Study.

PURPOSE: The Hispanic population in the United States is the fastest growing minority group, yet there is little understanding of the disability patterns that occur as this population ages. We conducted a cross-sectional study to define the prevalence of limitations of activities of daily living (ADL) and measures of observed function. METHODS: We censussed two rural counties in southern Colorado and selected a stratified sample of both Hispanic and non-Hispanic white (NHW) residents; 81.6% completed the protocol. RESULTS: Among the 1250 subjects aged 65 years and older, Hispanic elderly living in the community had greater ADL disability than NHW subjects, both for any difficulty (p = 0.006), and for needing assistance (p = 0.002). Hispanic persons were less likely to reside in nursing homes (3.4%) compared with NHW persons (9.3%). Hispanic elderly had excess prevalence of dependent ADL tasks (needs assistance or unable to do), (age, gender-adjusted odds ratio = 1.39, 95% CI = 1.01-1.92) in community dwelling and nursing home residents combined. There was no Hispanic excess of less severe difficulty compared with NHW persons, and there was a similar prevalence of limitation on observed functional tasks (timed walk, stooping, rising from a chair) in both groups. CONCLUSIONS: There was a modest Hispanic excess of reported dependent ADL limitation, and no excess of observed functional difficulties. Hispanics enter older age with much less income and education, yet they do not have a marked excess prevalence of limitations in activities of daily living when compared with NHW persons living in the same area.

Activities of Daily Living↗
PubMed1999

Dynamic repositioning of genes in the nucleus of lymphocytes preparing for cell division.

We show that several transcriptionally inactive genes localize to centromeric heterochromatin in the nucleus of cycling but not quiescent (noncycling) primary B lymphocytes. In quiescent cells, centromeric repositioning of inactive loci was induced after mitogenic stimulation. A dynamic repositioning of selected genes was also observed in developing T cells. Rag and TdT loci were shown to relocate to centromeric domains following heritable gene silencing in primary CD4+8+ thymocytes, but not in a phenotypically similar cell line in which silencing occurred but was not heritable. Collectively, these data indicate that the spatial organization of genes in cycling and noncycling lymphocytes is different and that locus repositioning may be a feature of heritable gene silencing.

Alleles↗
PubMed1999

Cognitive functioning and impairment among rural elderly Hispanics and non-Hispanic whites as assessed by the Mini-Mental State Examination.

We conducted a cross-sectional study to determine the distribution of cognitive functioning as measured by the Mini-Mental State Examination (MMSE) among a sample of Hispanic and non-Hispanic White (NHW) residents from two counties in rural, southern Colorado. Residents aged 60 years and older (N = 1,360) were administered the full MMSE, a sociodemographic and medical interview. Protocols were developed to administer the MMSE equitably in both ethnic groups. Younger Hispanics tended to be categorized as severely impaired more than similarly aged NHWs (OR at age 70 = 4.14), however, older Hispanics and NHWs performed similarly after adjusting for education and gender (OR at age 90 = 1.00). The use of a modified MMSE scale that removed the ethnic bias demonstrated that NHWs and Hispanics had similar levels of severe impairment after full adjustment (OR = 0.93). Given the widespread use of the MMSE, these findings indicate the need for further validation of this instrument.

Aged↗
PubMed1998

Higher instrumental activities of daily living disability in Hispanics compared with non-Hispanic whites in rural Colorado. The San Luis Valley Health and Aging Study.

This study examined Hispanic versus non-Hispanic white patterns of needing assistance with instrumental activities of daily living (IADL). The authors interviewed 798 Hispanic and 614 non-Hispanic white residents of rural Colorado, who were aged 60 years and older between 1993 and 1995. Seventy-five participants were nursing home residents at the time of the interview. Community-dwelling Hispanics were 1.6 times as likely as non-Hispanic whites to need assistance with at least one IADL task (95% confidence interval 1.25-2.13). A larger proportion of disabled non-Hispanic whites were in nursing homes but, after including nursing home residents, Hispanics remained significantly more likely to need assistance on at least one IADL task (odds ratio = 1.49, 95% confidence interval 1.16-1.93). Hispanics were also more likely to have difficulty on observed performance tasks. The Hispanic excess was not removed by adjusting for chronic disease, reported difficulty walking, or income. English language proficiency adjustment lowered the Hispanic excess, but adjusting for years of education or Mini-Mental State Examination scores more completely removed the ethnic differences. Higher education was protective for both Hispanic and non-Hispanic white elderly. Efforts to further investigate what facets or correlates of education are operating may offer useful insights into limiting IADL difficulties in future cohorts.

Activities of Daily Living↗
PubMed1998

Executive cognitive abilities and functional status among community-dwelling older persons in the San Luis Valley Health and Aging Study.

OBJECTIVES: The purpose of this study was to evaluate the contribution of the executive cognitive functions to self-reported and observed performance of activities of daily living and instrumental activities of daily living. DESIGN: These data were collected as part of a cross-sectional survey of community-dwelling older persons, using statistical sampling, in a two-county area of southern Colorado. SETTING: Participants were interviewed and administered measures of general cognition, depression, executive functioning, and performance of self-care and instrumental activities, either in their homes or at the study clinic. PARTICIPANTS: A total of 1158 community-dwelling persons between the ages of 60 and 99 participated. Of these, 657 were female, 501 were male, 637 were Hispanic, and 521 were non-Hispanic whites. MEASUREMENTS: Subjects were administered the Mini-Mental State Exam (MMSE), a measure of executive functioning (the Behavioral Dyscontrol Scale), the Center for Epidemiologic Studies Depression scale (CES-D), and the Structured Assessment of Independent Living Skills (SAILS, a measure of observed performance of daily tasks). They also were interviewed regarding their reported ADL and IADL status using measures from the Longitudinal Study on Aging. RESULTS: Both general mental status and executive functioning demonstrated statistically significant univariate associations with all seven functional status measures (both self-report and observed performance). In a series of ordinary least squares regression models, executive functioning was a predictor for self-reported ADLs and observed performance of complex IADL tasks such as managing money and medications. Mental status did not predict self-reported functioning but was a predictor of observed performance. Depression was a significant variable for self-report measures but not for observed performance. Executive functioning and general mental status demonstrated some degree of independence from one another. CONCLUSION: Executive functioning is an important determinant of functional status for both self-reported and observed ADLs and IADLs and should be assessed routinely when evaluating the mental status and functional abilities of older people. These results replicate and extend previous research on executive functioning among older persons by examining these factors in a large bi-ethnic community sample.

Activities of Daily Living↗
PubMed1998

Social network factors associated with perceived quality of life. The San Luis Valley Health and Aging Study.

Demographic and social network factors associations with perceived quality of life (PQOL) were examined in a sample of rural Hispanic and non-Hispanic White (NHW) elderly. A 20-item PQOL scale measured participants' satisfaction with multiple facets of their lives. Age, gender, marital status, and living alone were not associated with this outcome. Hispanic persons with higher incomes had consistently higher ratings of quality of life compared to NHWs. More education was associated with a higher PQOL rating only among NHWs. More close friends and relatives, visiting in homes, and participation in outside activities were all independently related to PQOL. Interaction tests showed that the impact of social networks was stronger in NHWs. These findings suggest that network size and contact are important social factors that can improve quality of life for both ethnic groups. However, differences may need to be examined when judging the magnitude of these associations and when planning interventions.

Aged↗
PubMed1998

The association of non-insulin-dependent diabetes mellitus with perceived quality of life in a biethnic population: the San Luis Valley Diabetes Study.

OBJECTIVES: This study evaluated the association between quality of life and non-insulin-dependent diabetes mellitus (NIDDM) status, and whether this association differs between Hispanics and non-Hispanic Whites. METHODS: Between 1986 and 1989, cross-sectional data on perceived quality of life (PQOL) were collected from 223 persons with NIDDM and 753 non-diabetic subjects. RESULTS: After adjustment, persons with NIDDM rated their PQOL significantly lower than did control subjects. The relationship of diabetes and PQOL did not differ by ethnicity. The number of complications of diabetes was not associated with lower PQOL scores. CONCLUSIONS: Control and treatment strategies should reflect an understanding of the impact that diabetes has on social functioning, leisure activities, and physical and mental health.

Adaptation, Psychological↗
PubMed1997

A randomized, controlled trial of octreotide in the management of patients with acute pancreatitis.

CONCLUSION: In this study, octreotide was not found to be of benefit in the treatment of acute pancreatitis. BACKGROUND: Somatostatin and its long-acting analog octreotide have both been proposed for the treatment of patients with acute pancreatitis, but neither agent has been adequately assessed in patients with severe attacks. METHODS: Fifty-eight patients with moderate or severe acute pancreatitis who were admitted to hospitals within the west of Scotland over an 18-mo period were randomized to receive octreotide, 40 micrograms/h, by continuous i.v. infusion for 5 d, or placebo in addition to standard supportive therapy. RESULTS: There was no significant difference in the incidence of complications (54% octreotide group and 40% placebo group) or mortality (octreotide group 18%; placebo group 20%).

Acute Disease↗
PubMed1996

Self-rated health among Hispanic vs non-Hispanic white adults: the San Luis Valley Health and Aging Study.

OBJECTIVES: This study investigated whether objective health indicators explained lower self-rated health among Hispanics compared with non-Hispanic Whites. It also considered socioeconomic and cultural explanations. METHODS: Health ratings of 429 Hispanics and 583 non-Hispanic Whites aged 20 through 74 were analyzed with logistic regression. RESULTS: Illness indicators were found to be strongly correlated with self-rated health in both ethnic groups, but after such markers were controlled for, Hispanics remained 3.6 times more likely to report fair or poor health (95% confidence interval = 2.4, 5.3). Adjustment for socioeconomic factors accounted for a portion of Hispanics' lower health rating, but the strongest explanatory factor was acculturation. CONCLUSIONS: Because of cultural and economic influences on definitions of health, ethnic differences in self-assessed health may not accurately reflected patterns resulting from objective health measurements.

Acculturation↗
PubMed1995

Correlation of doxorubicin footprints with deletion endpoints in lacO of E. coli.

This study explored the possibility that the sequence location of doxorubicin-induced deletion endpoints might relate to DNA structural alterations caused by doxorubicin binding to DNA. The 3'-OH endpoints of doxorubicin-induced deletions terminating in the 35-bp region of lacO appear to distribute differently from spontaneous deletion endpoints. Doxorubicin-induced deletions focus in the 26-bp palindrome which is separated by a 9-bp region with no reverse complementary, whereas spontaneous deletion 3'-OH endpoints are found distributed throughout the operator region. In order to explore the mechanism of deletion induction by doxorubicin, drug footprinting studies were carried out with DNA labeled at the 5' end of each of the complementary DNA strands encompassed by lacO. Doxorubicin protected the 9-bp region between the palindromic sequences from DNase I cutting and caused enhanced DNase I cleavage at symmetrical sites in the palindrome, which were inherently resistant to the nuclease in the absence of the drug. These symmetrical sites also define regions in which the occurrence of deletion endpoints is enhanced 6-fold in the presence of doxorubicin. This enhanced cutting and mutation occur in regions of the palindrome that are flanked by expected doxorubicin binding sites, but are not themselves binding sites of the drug. Similarly, other sites where the frequency of deletion endpoints increased in response to doxorubicin occurred directly adjacent to regions where doxorubicin appeared to inhibit cutting by DNase I. These results suggest that the binding of doxorubicin in the palindrome directs both the frequency and the specificity of deletion formation in this gene region.

Base Sequence↗
PubMed1995

Scleritis, uveitis, and glaucoma in a patient with rheumatic fever.

PURPOSE: To determine the origin of scleritis, uveitis, and glaucoma in a boy with fever, sore throat, joint pains, and malaise. METHODS: The patient underwent extensive hematologic, serologic, rheumatologic, and radiologic examinations. RESULTS: The patient recovered after extensive medical therapy. He met the Jones criteria for the diagnosis of acute rheumatic fever and had an increased result for antistreptolysin O antibody titer. CONCLUSIONS: Antistreptococcal antibody testing is helpful in diagnosing rheumatic fever as a cause of scleritis, uveitis, and glaucoma.

Acute Disease↗
PubMed1995

Relationship between habitual physical activity and insulin area among individuals with impaired glucose tolerance. The San Luis Valley Diabetes Study.

OBJECTIVE: To determine whether higher levels of physical activity are associated with lower fasting insulin levels and lower insulin areas under the oral glucose tolerance curve in individuals with impaired glucose tolerance (IGT) in a community setting. RESEARCH DESIGN AND METHODS: Data from a cross-sectional study of a population consisting of 219 Hispanic and non-Hispanic white men and women with IGT (by World Health Organization criteria) in two rural Colorado counties were analyzed. Total physical activity was assessed by a 7-day physical activity recall, from which metabolic equivalents (METs) were estimated (expressed as MET h/week). Relationships of MET h/week with fasting insulin levels and insulin areas were assessed while considering obesity, age, and other risk factors known to influence fasting insulin level and insulin area. RESULTS: Among all subjects, univariate analyses showed that higher physical activity levels were associated with lower mean insulin areas and fasting insulin levels (both P < 0.05). Multiple linear regression showed that higher levels of physical activity were significantly associated with lower values of of the insulin area (P < 0.001) but not with fasting insulin levels. The relationship between insulin area and habitual physical activity was independent of obesity, fat distribution, and age. CONCLUSIONS: On the basis of cross-sectional data, we conclude that higher levels of habitual physical activity are associated with lower insulin areas in a population of individuals with IGT. Understanding the impact of physical activity on markers of insulin action in individuals with IGT is important because of the greatly enhanced risk of non-insulin-dependent diabetes mellitus and, hence, cardiovascular disease in this population.

Adult↗
PubMed1994

Hernia repair.

Explore the source record for details and available documents.

Hernia, Inguinal↗
PubMed1994

Comparison of a low-fat, ad libitum complex-carbohydrate diet with a low-energy diet in moderately obese women.

This study compared the effect of a low-fat, ad libitum, complex-carbohydrate (LFAL) diet with a low-energy (LE) diet on weight loss over 6 mo in moderately obese women. Weight loss was 4.4 kg in the LFAL (n = 47) and 3.8 kg in the LE (n = 42) participants. The difference was not statistically significant. The LFAL participants decreased percent energy from fat by 13%, increased percent energy from carbohydrate by 11.4%, and reduced energy intake by 1654 kJ. The corresponding values in the LE group were 3.8%, 3.5%, and 1991 kJ, respectively. Changes in fat and carbohydrate energy were significantly different by treatment (P < 0.0001). Palatability, satiety, and quality of life (QOL) improved in the LFAL group but diminished in the LE group. Palatability and QOL changes were significantly different by treatment (P < 0.029 and P < 0.048, respectively). It is concluded that an LFAL diet can result in substantial weight loss and is associated with improved palatability and QOL compared with an LE diet.

Adult↗
PubMed1994

Risk factors for distal symmetric neuropathy in NIDDM. The San Luis Valley Diabetes Study.

OBJECTIVE: To investigate risk factors for distal symmetric (sensory) neuropathy among prevalent cases of non-insulin-dependent diabetes mellitus (NIDDM) in a population-based study in southern Colorado. RESEARCH DESIGN AND METHODS: Prevalent neuropathy was identified in 77 of 277 people with NIDDM by a standardized history and neurologic examination. Fifteen known or suspected risk factors for neuropathy were determined without knowledge of neuropathy status. RESULTS: Older age at examination, longer duration of diabetes, higher glycohemoglobin percentage, lower fasting C-peptide, insulin use, and presence of retinopathy and nephropathy (microalbumin > or = 200 micrograms/ml) were all significantly associated with neuropathy. Sex, ethnicity (Hispanic versus non-Hispanic white), height, systolic blood pressure, peripheral vascular disease, cigarette and alcohol use, and serum lipid levels were not significantly associated with neuropathy. In a multivariate logistic model, increasing age (odds ratio [OR] = 1.3, 95% confidence interval [CI] = 1.1-1.6), longer duration of diabetes (OR = 1.3, CI = 1.0-1.6), increased glycohemoglobin percentage (OR = 1.5, CI = 1.1-2.1), and insulin use (OR = 2.8, CI = 1.3-6.1) were associated with neuropathy. Retinopathy (OR = 3.0, CI = 1.2-7.7), but not nephropathy, was important when added to this model. CONCLUSIONS: Worse glycemic control and insulin use were independently associated with neuropathy in people with NIDDM. Whether insulin use represents another marker for severity of the metabolic disturbance or is an independent risk factor for neuropathy requires further study. We could not confirm associations of neuropathy with height, with nephropathy, or with retinopathy, independent of duration of diabetes.

Adult↗