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Biomedical subjects

J Mor

Publications and source records attributed to J Mor.

At least 19 recordsLinked to original sources
PubMed2002

Percentage of hysterectomy for pelvic organ prolapse in five ethnic groups.

The aim of this study was to determine whether there are differences in the percentage of hysterectomies performed for pelvic organ prolapse between five ethnic groups. Using archived data from January 1984 to January 2000, multiple logistic regression was used to adjust for age and the age-adjusted percentages were compared to Caucasians as odds ratios. A total of 6401 hysterectomies were identified, and 832 (13%) were performed for pelvic organ prolapse. The differences in the age-adjusted percentages were significant. The Japanese (P<0.001), Chinese (P<0.001) and Hawaiian (P<0.05) percentages were lower and those of the Filipinos were not significantly different from those of Caucasians below age 60. The age-adjusted odds ratios of hysterectomy for pelvic organ prolapse relative to Caucasians for Japanese, Chinese and Hawaiians were from 0.5 to 0.7. The differences begin to disappear after age 60. A significantly lower percentage of hysterectomies for pelvic organ prolapse were done in Japanese, Hawaiian and Chinese women. The odds ratios in Filipino women increased after age 60.

Adult↗
PubMed2000

Breastfeeding duration in a multiethnic population in Hawaii.

BACKGROUND: The increasing ethnic diversity in the United States necessitates a study of variations in infant feeding patterns among ethnic groups. This study was conducted as part of Hawaii's surveillance system to identify infant feeding patterns in Hawaii; specifically, to identify factors influencing duration of breastfeeding among ethnically diverse mothers. METHODS: All women who delivered an infant in Hawaii between January 1 and March 31, 1989, were mailed surveys 14 to 19 months after delivery. Fifty-one percent (n = 2011) of women responded, of whom 1574 (78%) did some breastfeeding and are included in the analysis of prediction of weaning (cessation of breastfeeding). Cox regression (survival) analysis was used to predict weaning. RESULTS: The median duration of breastfeeding was 150 days; 45 percent of infants were still breastfeeding at age 6 months and 16 percent at age 1 year. Factors associated with early weaning were Japanese ethnicity; mother born in a country other than the United States, Japan, or the Philippines; first language other than English, or two languages at home; employed full-time outside the home; introduced formula or fruit before age 6 months; received formula from the WIC program; and stopped breastfeeding for convenience, breast problems, problems getting breastfeeding started, insufficient milk, baby refusing the breast, and a sick baby. Factors associated with late weaning were older maternal age; college education; living on a rural island; previous breastfeeding experience; helpful breastfeeding advice from family or friends; receiving WIC for breastfeeding mothers; introducing the cup before age 6 months; and not giving fruit to the baby. CONCLUSION: In Hawaii, programs that address how and when to introduce foods, use of formula, and management of outside employment and breastfeeding should be made available to those groups of women at risk for early weaning to lengthen their duration of breastfeeding.

Breast Feeding↗
PubMed1996

A United States national reference for fetal growth.

OBJECTIVE: To develop a current national fetal growth curve that can be used as a common reference point by researchers to facilitate investigations of the predictors and consequences of small and large for gestational age delivery. METHODS: Single live births to United States resident mothers in 1991 (n = 3,134,879) were used for the development of this curve, which was compared with four previously published fetal growth curves. Techniques were developed to address cases with implausible birth weight-gestational age combinations and to smooth fetal growth curves across gestational age categories. RESULTS: In general, the previously published fetal growth curves underestimated the 1991 United States reference curve. This underestimation is most apparent during the latter weeks of gestation, approximately 33-38 weeks. CONCLUSION: Our findings indicate that the prevalence of fetal growth restriction (FGR) will vary markedly, depending on the fetal growth curve used. Furthermore, many previously published fetal growth curves no longer provide an up-to-date reference for describing the distribution of birth weight by gestational age and for determining FGR that is consistent with the most recent live birth data for the entire United States.

Embryonic and Fetal Development↗
PubMed1994

Health of infant is the main reason for breast-feeding in a WIC population in Hawaii.

OBJECTIVE: To determine factors influencing infant feeding method choices among women who received services from the Special Supplemental Food Program for Women, Infants, and Children (WIC) during pregnancy in Hawaii. DESIGN: A retrospective survey mailed to all resident mothers who had live births in Hawaii between January 1, 1989, and March 31, 1989, and who received WIC services during pregnancy. SETTING: The state of Hawaii. SUBJECTS: The subjects were 322 mothers who received WIC services during pregnancy for whom data were complete, taken from a sample of 2,013 women who had live births in the state of Hawaii (51% response rate) between January 1, 1989, and March 31, 1989, of whom 324 participated in WIC during pregnancy. MAIN OUTCOME MEASURES: Infant feeding method (exclusive breast, exclusive formula or mixed) at hospital discharge. STATISTICAL ANALYSES PERFORMED: The chi 2 analysis for differences among feeding method groups and multiple logistic regression to calculate odds ratios for independent effects of maternal characteristics and other influences on feeding method choice. RESULTS: Reasons for infant feeding choice, timing of the choice, maternal age, parity, and place of residence were the main factor influencing infant method choice. Health of the infant was the primary reason for choice of feeding method and was the strongest determinant of exclusive breast-feeding (odds ratio = 23.99; confidence interval = 9.75-59.02; P < .0001) and was negatively related to the choice to formula-feed (odds ratio = 0.03; confidence interval = 0.01-0.08; P < .0001). APPLICATIONS: Relationship between WIC and hospital lactation consultants could enhance follow up in the hospital and after returning home with WIC mothers who prenatally state an intention to breast-feed. Convenience and bonding are aspects of breast-feeding enjoyed by WIC mothers in Hawaii that could be used in breast-feeding promotion efforts.

Adult↗
PubMed1993

Geographic patterns of low birth weight in Hawaii.

This study examines areal variations in low birth weight, using the census tract as the unit of analysis. Reports from the 1980 U.S. census were used to develop summary indicators of environmental and socio-economic conditions, including poverty, employment, education and crowding, for 155 census tracts in the state of Hawaii. Maternal socio-demographic, prenatal care utilization, and medical risk indicators and low birth weight percentages for resident, single live births were extracted from the Hawaii 1979-1987 vital record live birth files and aggregated by census tract. Multiple regression analysis was used to develop a model that predicted 61% of the variation among census tracts in the percentage of low birth weight. Patterns of low birth weight were primarily associated with ethnic patterns of maternal residence and single marital status. There was no association between inadequate prenatal care and low birth weight at the census tract level.

Adolescent↗
PubMed1988

Immunoregulation with levamisole in children with frequently relapsing steroid responsive nephrotic syndrome.

The immunological and clinical effects of levamisole were studied in 10 children with frequently relapsing steroid responsive nephrotic syndrome (SRNS). The efficacy of the drug was tested during remission of the disease with all patients on alternate day steroid therapy. The lymphocyte proliferative response to phytohemagglutinin (PHA), concanavalin-A (Con-A) and pokeweed mitogen (PWM) were normal. The Con-A induced suppressor T-lymphocyte activity of 7 patients was low before treatment with levamisole 8 +/- 3.7% and increased to normal values during therapy 34 +/- 6%; p less than 0.001 (control 32 +/- 5%). In these 7 children prednisolone dosage could be decreased significantly or discontinued altogether (44.1 +/- 5.3%). Patients without immunoregulatory abnormalities did not respond to levamisole. In 3 out of 4 children tested the percentage of OKT8+ cells rose during levamisole therapy from 19.7 +/- 2.1 to 37 +/- 2.3 (p less than 0.001), thus correcting the elevated pre-treatment OKT4+/OKT8+ ratio from 3.1 +/- 0.2 to 1.5 +/- 0.2; p less than 0.001 (control 1.47 +/- 0.2). These data support the hypothesis that abnormal immunoregulation may play a role in the pathogenesis of SRNS. Treatment with levamisole can be useful in some patients with the frequently relapsing form of the disease.

Adolescent↗
PubMed1986

Stroke in a patient with hemolytic-uremic syndrome with a good outcome.

We report a child with HUS complicated by stupor, hemiparesis, expressive aphasia and focal seizures. CAT scan of the brain demonstrated 2 large cerebral non-hemorrhagic infarcts. Despite the severe neurological involvement the child eventually made a good recovery.

Cerebrovascular Disorders↗
PubMed1986

Natriuretic response to i.v. saline loading after acute poststreptococcal glomerulonephritis.

The outcome of acute poststreptococcal glomerulonephritis (APSGN) is still controversial. Whereas many studies show a good prognosis, particularly in children, late morphologic and functional renal abnormalities have been described. To verify this latter finding, we evaluated the sodium handling of the kidney several years after APSGN. Eleven subjects (9 children and adolescents and 2 adults) were studied 2 to 3 years after APSGN. At the time of the study all patients were well, without pathologic urinary findings and with normal blood pressures. Five healthy subjects (3 adults and 2 children) served as controls. Following two control periods of 30 min, an i.v. saline load (2.5% NaCl, 1 l/1.73 m2 body surface area) was administered over 45 min. Sodium excretion was measured during the control and salt-loading periods, and during four additional 30-min collection periods. No exaggerated natriuresis was found. We therefore conclude that epidemic APSGN in Israel carries not only an excellent clinical but also a good renal functional prognosis.

Adolescent↗
PubMed1983

Jejunal transport in experimental nephrotic syndrome.

In vivo jejunal transport of amino acids, monosaccharides, sodium, and electrolytes were studied in rats made nephrotic with puromycin aminonucleoside (PAN) and in pair-fed controls. Studies were performed 14 days after a single intravenous dose of PAN when rats were no longer edematous, but were still hypoproteinemic. There was decreased absorption of glucose, 3-0-methyl glucose, glycine, phenylalanine, histidine, water, and sodium in the nephrotic animals but transport of fructose, lysine and potassium was similar in the nephrotic and control animals. Enzyme kinetic studies for glucose transport showed a mixed type of inhibition affecting both Vm and Km. The jejunal mucosa of nephrotic and control rats had similar ATP content and enzyme activity for lactase, sucrase, maltase and (Na-K)-ATPase and the ratios of RNA to DNA were similar in the nephrotic and control rats. No abnormality of the jejunum was detected by light or electron microscopy. The data suggest that the impairment of absorption is a result of decreased activity of jejunal membrane carrier mechanisms. The altered transport may be secondary to effects related to the metabolic consequences of nephrotic syndrome and does not appear to be related to acute purine aminonucleoside toxicity, edema or malnutrition.

3-O-Methylglucose↗
PubMed1983

Candida peritonitis-inefficacy of amphotericin-B and 5-fluorocytosine treatment.

A 3 1/2 year old child with chronic renal failure twice developed severe candida peritonitis in the course of treatment with continuous ambulatory peritoneal dialysis. Medical treatment was unsuccessful but removal of the catheter led to immediate cure. This case documents a long held clinical impression that the best, if not the only way of treatment of candida peritonitis is removal of the indwelling catheter. Thus, potentially hazardous, painful and costly medical treatment can and should be avoided.

Amphotericin B↗
PubMed1976

Evoked cerebral responses to noxious thermal stimuli in humans.

Brief pulses of Laser emitted radiant heat were used to induce cutaneous painful sensations in human volunteers. Accurate timing of the stimuli permitted recording of scalp averaged evoked potentials. A late negative-positive component of the EP which correlated in amplitude with the subjective sensation was observed in four subjects. The latency of this component (130-160 msec) correlated with stimulus intensity.

Brain↗
PubMed1975

Inappropriate antidiuretic hormone secretion in an infant with severe pneumonia.

A 6-week-old boy with severe pneumonia developed hyponatremia as a result of the syndrome of inapropriate antidiuretic hormone secretion (SIADH). Cerebral edema and seizures occurred after administration of fluids and diuretics. Fluid restriction and resolution of the pneumonia corrected the severe electrolyte imbalance. The possibility of SIADH should be considered in cases of severe and resistant pneumonia in infancy.

Humans↗
PubMedDate not supplied

Maternal nativity status and pregnancy outcome among U.S.-born Filipinos.

Using 1979-87 Hawaii vital record data on single live births, this study compares by nativity status of the mother the maternal characteristics and pregnancy outcomes of resident Filipino women. Among ethnic minorities in the United States, the pregnancy outcomes of U.S.-born mothers have been reported to compare unfavorably to their foreign-born counterparts. In this study, unequivocally preferential pregnancy outcome indicators were not observed for foreign-born women. Contrary to expectations, a significant, but modest, increase in the risk of preterm delivery was found for infants of Philippines-born mothers, along with a less favorable mean birth weight and gestational age. As a growing minority population in the United States, the atypical determinants and patterns of pregnancy outcome in this population warrants further investigation.

Adolescent↗
PubMedDate not supplied

Area-level predictors of use of prenatal care in diverse populations.

Patterns and predictors of the use of prenatal care in Hawaii were examined by census tract, taking into account summary measures of socioeconomic status, environmental conditions, and aggregated indicators of pregnancy-related risk characteristics of mothers. The objectives of the study were to identify those census tracts with high levels of inadequate use of prenatal care services; to develop a model, based on census tract characteristics, to explain observed geographic variations in the use of prenatal care services; and to identify for further investigation specific localities with unanticipated patterns of use. Data were drawn from 1980 census reports and vital statistics live birth files for the period 1979-87. Regression analysis was used to develop a model that was able to predict 61 percent of the census tract variation in the percentages of inadequate use of prenatal care services. Increased proportions of mothers of Japanese and other Asian-descent and of adults with more than high school education were associated with low levels of inadequate use of prenatal care services. Increased proportions of high parity-for-age risk and Samoan mothers were associated with higher levels of inadequate use. Census tract maps of actual and predicted percentages and studentized residual values were used to identify areas with high and low rates of inadequate use of prenatal care services. The area-level methods used are believed applicable to health care planning in other areas with ethnically or socioculturally diverse populations.

Demography↗