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Biomedical subjects

J R Hunter

Publications and source records attributed to J R Hunter.

At least 37 records · Page 2Linked to original sources

A followup study of ibuprofen users.

We followed up 13,230 members of the Group Health Cooperative of Puget Sound under the age of 65 years who were presumed to have taken ibuprofen as out patients. All hospitalizations that occurred within 3 months after a prescription for ibuprofen was filled were reviewed. We found no instances of serious uncommon illness which could be attributed to this drug with any reasonable degree of certainty. In particular, there were no cases of acute liver or kidney disease noted within 3 months of exposure to ibuprofen.

Adult↗

Pyloric stenosis and maternal Bendectin exposure.

As part of a long-term follow-up of structural disorders present at birth or shortly thereafter in infants born at Group Health Cooperative of Puget Sound, all infants with a diagnosis of pyloric stenosis born between July 1, 1977 and June 30, 1982, were identified. Automated pharmacy profiles were examined to determine whether an association between maternal Bendectin use in the first trimester and infantile hypertrophic pyloric stenosis existed. Among the 3,835 women exposed to Bendectin while pregnant, in this group of 13,346 births, 13 had infants who developed pyloric stenosis, and among the 9,511 women not exposed, 13 had infants who developed pyloric stenosis, resulting in a risk ratio estimate of 2.5 (95% confidence interval (CI) 1.2-5.2). When mothers were divided according to the number of prescriptions for Bendectin filled, the relative risk estimate increased from 1.2 (95% CI 0.4-4.4) in women who filled only one prescription to 7.6 (95% CI 4.9-11.6) in women who filled five or more prescriptions for Bendectin during their pregnancy.

Adult↗

Drug toxicity and hospitalization among lithium users.

Among a cohort of 921 outpatients less than 65 years of age at Group Health Cooperative of Puget Sound who took lithium during a 5-year period, lithium-associated toxicity leading to hospitalization was rare. In only one case (muscle fasciculation) was lithium directly implicated as the cause of hospital admission. In five cases described in detail (one case each of hyperparathyroidism, vasculitis, edema, brain stem infarction, and subarachnoid hemorrhage), an etiologic connection with lithium exposure was considered unlikely but could not be ruled out.

Adult↗

Effects of allopurinol in Duchenne's muscular dystrophy.

There is no effective treatment at present for Duchenne's muscular dystrophy (DMD). Recently, clinical improvement and increased muscle strength have been reported after 100 mg of allopurinol was administered daily to 21 boys with DMD in a double-blind crossover study. Its effectiveness was determined by an extensive battery of muscle function, cardiac, and laboratory tests. The ten-month study was divided into four periods; (1) one month of baseline observation; (2) three months of therapy to allopurinol and placebo control groups; (3) three months of therapy to crossed over groups; and (4) three months of therapy to all patients. No statistically significant changes between the allopurinol and control periods occurred in the muscle function tests. The earlier report of clinical improvement during allopurinol treatment was not confirmed.

Adolescent↗

Vasectomy and nonfatal myocardial infarction: continued observation indicates no elevation of risk.

The incidence of nonfatal myocardial infarction among 4,733 vasectomized men followed for 33,969 man-years was 1.3 cases per 1,000 man-years. This incidence was nearly identical in a 5-fold larger series of comparable nonvasectomized men. These data represent a substantially increased long-term followup over that reported previously for these groups and provide continued assurance of the lack of an association between vasectomy and myocardial infarction, particularly 10 or more years after vasectomy.

Adult↗

The influence of growth rate and nutrient limitation on the microbial composition and biochemical properties of a mixed culture of oral bacteria grown in a chemostat.

A sample of human dental plaque was homogenized in transport fluid and inoculated simultaneously into a glucose-limited and a glucose-excess chemostat maintained at pH 7.0 and a dilution rate (D) of 0.05 h-1. In an attempt to ensure the establishment of slow-growing bacterial populations, two further inoculations of each chemostat with fresh samples of dental plaque took place before a steady-state was attained at this dilution rate. The dilution rate was increased step-wise to D = 0.6 h-1, and then returned directly to D = 0.05 h-1. Contrary to chemostat theory, microbial communities with a high species diversity were maintained under all of the experimental conditions employed, although not all of the bacterial populations present in the inocula established successfully in the chemostat. At each steady-state the bacteriological composition and biochemical properties (fermentation products, enzyme assays and acid production) of the communities of each chemostat was determined. Higher cell yields and a slightly more diverse community were obtained from the glucose-limited chemostat at all dilution rates. A complex mixture of end products of metabolism was obtained from the glucose-limited chemostat, suggesting amino acid catabolism, while lactate was the predominant acid of the glucose-excess culture. In washed-cell experiments, communities from the glucose-excess chemostat produced the lower terminal pH values following a pulse of glucose, with the lowest pH values occurring at the higher dilution rates. A film of micro-organisms, which accumulated around the neck of the chemostat, was sampled at the end of the experiment. The microbial composition of the films from each chemostat differed markedly, and both were different to the community of the bulk fluid of the respective chemostat. Spirochaetes and a population of yeasts were detected in the films from the glucose-limited and glucose-excess chemostats, respectively. No invertase or glucosyltransferase activity, and little glucoamylase-specific glycogen was detected in the communities from either chemostat, although significant endogenous activity, particularly at high dilution rates, was obtained with washed-cells from the glucose-excess chemostat. The results suggest that the chemostat could make a valuable contribution to the study of the ecology of dental plaque.

Bacteria↗

Thermal effects of casting materials.

A number of variables are important in controlling the exothermic reaction of cast materials. These reactions can reach temperatures capable of producing burns. The most important variables are plaster type, cast thickness, and the presence of externally applied materials, e.g., vinyl pillows. Moderately important factors are dip water temperature, humidity, room temperature, and used dip water. An insignificant factor is cast-padding thickness.

Burns↗

Vaginal spermicides and miscarriage seen primarily in the emergency room.

Among 813 women who had obtained a vaginal spermicide within 48 weeks of the estimated date of fertilization (EDF), 47 (5.8%) had an early miscarriage. Among women who had obtained oral contraceptives, 35/1,127 (3.1%) miscarried, and among women who obtained neither, 140/4,231 (3.3%) miscarried. The risk ratio estimate comparing spermicide users with nonusers was 1.8 (90% confidence interval 1.4, 2.3). The association was strongest among women who had obtained a spermicide within 12 weeks of the EDF. Examination of abortus material revealed that the association with spermicides was strongest among those where an abnormal fetus was present.

Abnormalities, Drug-Induced↗

Nonestrogenic drugs and breast cancer.

The relation between breast cancer and selected nonestrogenic drugs was evaluated in the Group Health Cooperative of Puget Sound, Seattle, Washington, a prepaid health care organization with computerized information on diagnoses and outpatient drug use. No important positive associations with breast cancer were found in a follow-up study of 302 women aged 35-74 years. These women were newly diagnosed with breast cancer in 1977-1980 and were studied in relation to exposure in the six months prior to diagnosis to one or more of the following drugs: diazepam, digitalis glycosides, medroxyprogesterone acetate, methyldopa, metronidazole, phenothiazines, tricyclic antidepressants, thiazides, thyroid/levothyroxine sodium, or spironolactone. A modest association between recent reserpine use and breast cancer was present (risk ratio = 1.7, 90% confidence interval 0.9-3.3).

Adult↗

Hospitalization rates in vasectomized men.

Six thousand ninety-two men who had undergone vasectomy were observed for 20,491 person-years of observation in a prepaid group practice. The incidences of first-time hospitalizations for a variety of diagnoses were examined as a proxy for disease incidence rates and compared with similarly derived rates in the remaining male membership of the practice. Vasectomized men had comparatively high rates of hospitalization for a variety of diseases of the genitourinary system during the early postvasectomy period. Apart from these, there were no important, statistically convincing elevations in the new hospitalization rates among vasectomized men, as compared with those of the nonvasectomized comparison group.

Adult↗

Vaginal spermicides and congenital disorders.

Among 763 liveborn infants of white women who had obtained a vaginal spermicide in the ten months before conception, the prevalence of certain major congenital anomalies was 2.2%. The prevalence of such anomalies in a comparison group of 3,902 infants was 1.0%. The difference between these groups was due to an excess of limb-reduction deformities, neoplasms, syndromes associated with chromosomal abnormalities, and hypospadias in the infants whose mothers are presumed to have used vaginal spermicides. Pregnancies in women who had used vaginal spermicides ended in spontaneous abortion requiring hospitalization 1.8 times more commonly than did pregnancies in those who had not. Since a well-defined syndrome among babies with congenital disorders whose mothers used spermicides was not present, these results should be considered tentative until confirmed by other data.

Abnormalities, Drug-Induced↗

Vasectomy and non-fatal myocardial infarction.

The incidence of non-fatal myocardial infarction among 4830 vasectomised men was 0.9 cases per 1000 man-years during 24 420 man-years of observation. This was slightly lower than the rate in 24 150 non-vasectomised men, matched with a vasectomised man for calendar year of birth and duration of observation. Review of medical records for a matched sample of study subjects indicated no measurable confounding by important cardiac risk factors.

Adult↗