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Biomedical subjects

J R Hunter

Publications and source records attributed to J R Hunter.

At least 55 records · Page 3Linked to original sources

Exogenous estrogens and breast cancer.

Rates of breast cancer at Group Health Cooperative of Puget Sound, Seattle, Washington, a health maintenance organization, remained stable from 1972-1979 in women aged 30-44 years and in women aged 55-64 years, despite the fact that the frequency of use of estrogen-containing drugs has varied substantially. By contrast, rates of breast cancer in women aged 45-54 years appear to have fallen since 1977 in association with a substantial fall in estrogen use in women of this age group. The results are consistent with an etiologic role for current exogenous estrogen in breast cancer in middle-aged women.

Adult↗

Sedating drugs and automobile accidents leading to hospitalization.

The use of central nervous system depressant drugs among 244 people hospitalized for injuries suffered in an automobile accident was similar for drivers presumed at fault for the accident compared with other drivers and passengers. It was only slightly higher in the three groups than it was in the population at large. The absence of an important association in this population might be related to the warnings given to people filling prescriptions for these drugs.

Accidents, Traffic↗

Oral contraceptives and breast cancer.

The incidence of breast cancer among users and non-users of oral contraceptives (OCs) was determined at Group Health Cooperative of Puget Sound, Seattle, Washington, a health care organization which maintains computer files of diagnoses and outpatient drug use. In women 45 years of age or younger, the incidence was nearly identical in users and non-users. In premenopausal women over 45 years of age, there was a positive association between current OC use and breast cancer, the risk ratio estimates and 90% confidence intervals being 4.0 (1.8-9.0) in women 46-50 years of age and 15.5 (5.2-46) in women 51-55 years of age.

Adult↗

Replacement estrogens and breast cancer.

The relation between replacement estrogens and breast cancer in menopausal women (age 45-64 years) was evaluated in the Group Health Cooperative of Puget Sound, Washington State, a prepaid health care organization with fully computerized information on outpatient drug use and hospital diagnoses. Little association between current estrogen use and breast cancer was noted in women with a previous hysterectomy (relative risk (RR) = 1.1; 90% confidence interval (Cl), 0.7-1.8). In women with a natural menopause there was a positive association between current estrogen use and breast cancer (RR = 3.4; 90% Cl, 2.1-5.6). This association was strong in naturally menopausal women aged 45-54 years (RR = 10.2) and weaker in the older age group (RR = 1.9).

Breast Neoplasms↗

Replacement estrogens and endometrial cancer.

We examined the incidence of endometrial cancer in a large prepaid group practice in the Seattle area. From July, 1975, to July, 1977, there was a sharp downward trend in the incidence of endometrial cancer that paralleled a substantial reduction in prescriptions for replacement estrogens. Incidence rates were estimated for estrogen users and nonusers among women 50 to 64 years of age with intact uteri; current long-term users had an annual risk for endometrial cancer between 1 and 3 per cent, whereas nonusers had a risk less than 1/10th as great. These incidence rates remained fairly constant over time among users and nonusers; the drop in overall incidence soon after estrogen use declined suggests that the increased risk associated with estrogens falls quickly after discontinuation. The reduction in incidence of endometrial cancer in this group practice was part of a general decline in the United States after 1975.

Estrogens↗

Variations in surface polymers of Streptococcus mutans.

The cell wall composition of strains of S mutans with respect to sugars and proteins appears to be correlated to the serological grouping although groups c and E are rather similar. There also appear to be similarities in the structure of the polysaccharide formed by the glycosyltransferases from organisms of serological groups b and d. However, the activity of these enzymes appears to be variable in these groups. The most noteworthy difference found was that between the three Ingbritt strains. All three strains gave identical results with regard to their cell wall composition, and presumably this would mean that they were identical serologically. However, Ingbritt LH differed considerably from both the others in the types of polysaccharide formed by their glycosyltransferases from sucrose. Ingbritt B was a reisolate from monkeys, whereas Ingbritt LH was maintained in laboratory culture, and this may explain the difference. Clearly, more work will be required to explain this difference and as c strains are commonly isolated from plaque, it would seem desirable to clear up this point.

Cell Wall↗

Long-term follow-up study of cimetidine.

In a 5-year follow-up study of 8553 recipients of cimetidine at Group Health Cooperative of Puget Sound, we examined the frequency of uncommon serious illness requiring hospitalization that may have been drug induced. With the possible exception of one patient with probable drug-induced liver disease, we did not find any instances of serious illness requiring hospitalization that could be attributed with reasonable certainty to cimetidine. This large study provides reassurance that cimetidine is a relatively safe medication.

Adult↗

INFORM: development of information management and decision support systems for High Dependency Environments.

The long-term aim in the INFORM Project is to develop, evaluate and implement a new generation of Information Systems for hospital High Dependency Environments (HDE-Intensive Care Units, Neonatal Units, Burns Units. Operating and Recovery Rooms, and other specialised areas). The distinguishing feature of the HDE is the very large amount of data that is collected through monitors and paper records about the state of critically ill patients; this has made the role of the staff a technical one in addition to a caring one. The INFORM System will integrate Decision Support with on-line, off-line and observed patient data and, in addition, will incorporate and integrate unit management features. In the Exploratory Phase of the Project, functional requirements have been set out. These are based on four components: conceptual model of the HDE; evaluation of existing HDE Information Systems; development of a novel software architecture using a Knowledge-Based Systems (KBS) methodology, and based on a critical review of KBS applied to the HDE: monitoring of appropriate leading-edge technological developments. The conceptual model has two components: a patient-related information model, and a department-related cost model. The patient-related model is identifying key and difficult areas of decision making. A key aspect of INFORM is integration of clinical Decision Support for these areas into the Information System through a layered software architecture. The lower layers are concerned with monitoring and alarming and the higher levels with patient assessment and therapy planning. The functionality and interconnection of these layers are being determined.

Decision Support Systems, Management↗