PubMed Health⌕ Search

Biomedical subjects

J Hutchinson

Publications and source records attributed to J Hutchinson.

At least 19 recordsLinked to original sources
PubMed1992

AIDS and racism in America.

Institutionalized racism affects general health care as well as acquired immunodeficiency syndrome (AIDS) health intervention and services in minority communities. The overrepresentation of minorities in various disease categories, including AIDS, is partially related to racism. The national response to the AIDS epidemic in minority communities has been slow, showing an insensitivity to ethnic diversity in prevention efforts and AIDS health services.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Azathioprine combined with prednisone in the treatment of idiopathic pulmonary fibrosis: a prospective double-blind, randomized, placebo-controlled clinical trial.

Twenty-seven newly diagnosed patients with idiopathic pulmonary fibrosis (IPF) who were previously untreated for IPF were enrolled in a prospective, double-blind, randomized, placebo-controlled study to compare the therapeutic effect of combined prednisone/azathioprine (n = 14) with prednisone plus placebo (n = 13). Prednisone was started at 1.5 mg/kg/day (not to exceed 100 mg/day) for the first 2 wk followed by a biweekly taper to a maintenance dose of 20 mg/day. Azathioprine was administered at a daily dose of 3 mg/kg (not to exceed 200 mg/day). The patients tolerated the use of azathioprine well with few associated side effects. Changes in lung function at 1 yr, as measured by resting alveolar-arterial oxygen difference P[A-a]O2, FVC, and single breath diffusing capacity for carbon monoxide (DLCOSB), were all somewhat better in the azathioprine/prednisone group compared with the prednisone alone group, although none of these comparisons were statistically significant. Six of 14 (43%) patients randomized to prednisone plus azathioprine died during the 9-yr follow-up period, compared with 10 of 13 (77%) patients randomized to prednisone plus placebo. A Cox model survival analysis shows a nonsignificant but potentially large survival advantage for azathioprine/prednisone (hazard ratio 0.48, with 95% confidence interval increasing from 0.17 to 1.38). When adjusted for age, the survival advantage of azathioprine/prednisone becomes marginally significant (hazard ratio 0.26, with 95% confidence interval increasing from 0.08 to 0.88; p = 0.02 by large sample approximation, p = 0.05 by randomization test). We conclude that combined prednisone and azathioprine is a safe and possibly effective regimen for the treatment of IPF.(ABSTRACT TRUNCATED AT 250 WORDS)

Azathioprine↗
PubMed1991

Evaluation of click-evoked oto-acoustic emissions in the newborn.

Click-evoked oto-acoustic emissions and auditory brainstem responses (ABR) have been recorded in 723 babies taken largely from a neonatal intensive care unit to evaluate the use of oto-acoustic emissions as a method of screening for hearing impairment. Twenty-nine infants failed to pass the initial ABR test and repeat ABR tests carried out up to the age of 3 months. The 'sensitivity' and 'specificity' of the oto-acoustic emission test for the ABR test results up to 3 months of age in surviving infants were 93% and 84% respectively. It is proposed that click-evoked oto-acoustic emissions be considered as the initial method to screen for hearing impairment, test failures being followed up by ABR.

Acoustic Stimulation↗
PubMed1990

Click evoked otoacoustic emissions in neonatal screening.

Seven hundred and twenty-three neonates under intensive care have been tested by evoked otoacoustic emissions (EOAE) and the auditory brain stem response (ABR) to investigate the use of EOAE as a test for hearing impairment. Three hundred and thirty-one have had follow-up tests to the age of at least 2 years. The EOAE test has been found to be practical and quick to perform. The proportion of NICU infants producing a recordable EOAE is 80%, and the sensitivity and selectivity to the ABR result in the period up to 3 months post due date is 93 and 84%, respectively. These figures are high enough and the reduction in time compared to ABR is sufficient for the EOAE to be considered as the primary screen. The follow-up data show mixed results with both false positives and false negatives present. The incidence of severe hearing impairment is close to that expected from retrospective studies at 2 in 331 (1 bilateral, 1 unilateral). Firm conclusions on the sensitivity of EOAE to long-term hearing impairment await the results from larger numbers of infants and further follow up data.

Audiometry, Evoked Response↗
PubMed1989

Click evoked otoacoustic emissions compared with brain stem electric response.

The hearing of 346 babies taken largely from a neonatal intensive care unit has been tested by otoacoustic emissions and brain stem electric response audiometry. A total of 336 (97%) of the babies have been followed up by hearing tests from the age of 8 months. The otoacoustic emission test has been found to be practical with a mean test time of 12.1 minutes compared with 21.0 minutes for brain stem electric response. An otoacoustic emission was recorded bilaterally in 274 (79%) babies. Twenty of the 21 surviving infants who failed brain stem electric response in the neonatal period did not produce an emission. It is concluded that the otoacoustic emission test would make a good first screen to be followed by the brain stem electric response if no otoacoustic emission was present. There is poor agreement between the test results in the neonatal period and those of the follow up period, however, indicating the need for continuous monitoring of those babies failed by brain stem electric response.

Acoustic Stimulation↗
PubMed1989

How to insert a Minitrach.

Minitracheotomy is a technique of cricothyroid cannulation to allow efficient tracheobronchial toilet and the application of other techniques for respiratory support. Indications and contraindications for the procedure are reviewed. Two methods of insertion are described with their potential difficulties. Possible complications and their treatment are considered.

Hemorrhage↗
PubMed1988

Risk of cervical cancer associated with mild dyskaryosis.

In a survey of 1781 patients who had mild dyskaryosis in a cervical smear taken between 1965 and 1984 invasive cancer occurred in 10 women. In four cancer was diagnosed soon after presentation, and in three it developed some years after default from follow up. Invasion occurred in one patient during cytological surveillance and in a further two after referral for colposcopic supervision. A poor correlation was found between a single cervical smear showing mild dyskaryosis and biopsy results. This was, however, improved by a series of smears. During initial surveillance cervical smear results reverted to normal in 46% of our patients within two years. During longer term follow up none of these patients developed invasive cancer, and life table analysis showed that three quarters had not relapsed after 14 years. We also found no evidence to suggest that preinvasive disease is more rapidly progressive in younger women. Our results indicate that cytological surveillance is acceptably safe provided that biopsy is advised if dyskaryosis persists.

Actuarial Analysis↗
PubMed1987

Family resemblance for anthropometric and blood pressure measurements in Black Caribs and Creoles from St. Vincent Island.

This paper examines family resemblance for five anthropometric measurements (height, weight, triceps skinfold, upper arm circumference relaxed [UACR] and flexed [UACF] and for systolic and diastolic blood pressure in a group of adult Caribbean islanders of primarily African ancestry. Six hypotheses about family resemblance are tested by using path analysis and likelihood ratios. Significant intergenerational transmission is found only for height and UACR. For weight, UACF, and diastolic blood pressure, non-transmissible sibling resemblance is the primary component of family resemblance, although significant marital resemblance exists for diastolic blood pressure. Triceps skinfold and systolic blood pressure show no evidence of any family resemblance. Although results for highly heritable traits such as height are comparable to reports from other populations, measurements with a large contribution from common family environment or residual environmental effects, such as triceps skinfold or blood pressure, have much lower family resemblance in this population than in other populations. We hypothesize that this difference is due to the fact that adult children and their parents do not share a common household in this culture and to the presence of major nonfamilial environmental factors contributing to obesity and hypertension in this population.

Adult↗
PubMed1987

The age-sex structure of the slave population in Harris County, Texas: 1850 and 1860.

The effect of the slave system on demography can be revealed by examining the age-sex structure of slave populations. The age-sex structure of slaves in Harris County, Texas is investigated using the 1850 and 1860 slave schedules. Median ages for black and mulatto slaves suggest that the population was young. Population pyramids exhibit a narrow base and top with a broad middle. The high proportion of slaves between 10 and 30 years of age and the increase in population size between 1850 and 1860 were mainly related to the importation of slaves and only partly due to natural increase. The data also show that black slaves were older on small plantations while mulattoes were older on larger farms. It is suggested that differential treatment in terms of purchase practices, assignment of tasks, food allocation, and/or differential susceptibility to infectious diseases may account for this pattern.

Black or African American↗
PubMed1987

Cardiac tamponade resulting from massive chylopericardium after an aorta-coronary bypass operation.

Isolated chylopericardium after a cardiac operation is a rare clinical entity. A case of isolated chylopericardium with cardiac tamponade after a single aorta-coronary artery bypass graft in a 49-year-old man is presented. Nonsurgical management was unsuccessful. Multiple surgical procedures were necessary for complete control of this difficult problem. The cause of chylopericardium in this patient appears to have been injury to the tributaries of lymphatic ducts in the pericardium.

Cardiac Tamponade↗
PubMed1986

Retrospective DNA analysis of head and neck squamous cell carcinoma.

Abnormal cellular DNA content, a hallmark of malignancy, is known to occur in squamous cell carcinoma of the head and neck. The significance of this finding has yet to be elucidated. Paraffin-embedded blocks from 46 squamous cell carcinomas of the head and neck were sectioned, dewaxed, and made into a suspension of bare nuclei by mechanical mincing and enzymatic digestion. The nuclei were stained with propidium iodide, and quantitative DNA measurements were obtained with flow cytometry. The results were compared with existing prognostic factors: DNA aneuploidy was identified in 41% of the specimens and was significantly correlated with tumor size and surgical stage; the relationship between DNA aneuploidy and anatomic site approaches statistical significance. There was no correlation with histologic grade or presence or absence of cervical metastasis.

Aneuploidy↗
PubMed1986

Syndrome of short stature, microcephaly, mental retardation, and multiple epiphyseal dysplasia--Lowry-Wood syndrome.

We describe a brother and a sister with a syndrome of short stature, microcephaly, mental retardation, and multiple epiphyseal dysplasia. The parents were normal. This appears to be the second example of the syndrome first described by Lowry and Wood [1975] in two boys who had epiphyseal dysplasia, short stature, microcephaly, and nystagmus; one of these patients was mildly mentally retarded. The Lowry-Wood syndrome probably is an autosomal recessive trait.

Bone and Bones↗
PubMed1986

Association between stress and blood pressure variation in a Caribbean population.

Based on the work of Selye (The Stress of Life, New York: McGraw-Hill, 1976) it is hypothesized that stress can produce physiological abnormalities, i.e., elevated blood pressure, and that social variables can be used as indicators or risk factors for disease. It is theorized that deviations from acceptable social patterns or traditional life-styles can produce stressful conditions that are associated with disease and that these situations can be demonstrated by examination of certain social characteristics. This association is examined among the Black Caribs of St. Vincent, West Indies. The social variables included in this analysis are marital status (single, married, widowed, or separated), frequency of church attendance (frequently, sometimes, seldom, or never), years of education, and number of children (for women only). The findings show that single individuals have higher pressures than married subjects and that males who never attend church have higher pressures than men who frequently attend church; a relationship was not demonstrated for females. Among males, as the years of education increased, blood pressure also increased, but for females, increased education was associated with lower pressures. Family size was not associated with systolic or diastolic pressure. The analysis of these selected social variables suggests that these variables influence male systolic and diastolic pressures, but only female diastolic pressure.

Adolescent↗
PubMed1986

Compensatory articulation in Broca's aphasia.

Thirteen patients clinically diagnosed as Broca's aphasics, were administered a vowel bite block task to ascertain their on-line compensatory articulation ability. Formant frequencies for F1 and F2 were obtained from a pitch-synchronous spectral analysis of digitized vowel waveforms. Bite block/i/productions were consistently characterized by higher F1 and lower F2 frequencies compared to normal vowel productions. Undershooting of tongue elevation and fronting explains this result. No consistent pattern of "off-target" productions were found for/a/tokens. A multiple correlation analysis among clinically derived quantitative measures (BDAE score, oral and verbal apraxia), experimentally derived measures (bite block performance, articulatory reaction time), and neurological measures (brain lesion volume) was highly successful despite a relatively small sample size. Compensatory articulation was significantly related to both oral apraxia scores (r = -.70) and the BDAE total score (r = -.51). A multiple regression analysis nearly reached statistical significance (p = .11) in predicting bite block performance, with oral apraxia the most powerful predictor variable. Descriptive accounts of loci of brain lesion vis-à-vis compensatory articulation ability are given to delimit brain areas thought to possibly mediate this articulatory adaptive skill. Preliminary speculation supports the notion that an intact Area 44 is a prerequisite for successful compensatory ability.

Adaptation, Physiological↗