Biomedical subjects

J W Runyan

Publications and source records attributed to J W Runyan.

At least 19 recordsLinked to original sources

PubMed1990

Frequent handling in the neonatal intensive care unit and intraventricular hemorrhage.

The association between periventricular-intraventricular hemorrhage (PV-IVH) and frequent handling resulting from various neonatal intensive care procedures and routine interventions was evaluated in a prospective clinical study. Inborn premature babies with birth weight less than or equal to 1500 gm (n = 156) who did not have PV-IVH or who had grade 1 PV-IVH at less than or equal to 1 hour were randomly assigned to the reduced manipulation protocol (n = 62) or to standard care (n = 94). A bedside microcomputer-based data acquisition system was used to monitor the duration of rest or the number of interventions per day. Infants assigned to receive reduced manipulation spent a significantly higher percentage of time each day at rest than did those who received standard manipulation (p less than 0.006). However, the incidence of grades 2 to 4 PV-IVH did not differ significantly (30% in the study vs 37% in the standard manipulation group). When we analyzed the effect of manipulation in relation to risk of PV-IVH, while taking into account other perinatal variables, standard manipulation was not associated with increased risk of grades 2 to 4 PV-IVH. However, low birth weight, maternal smoking, general anesthesia, early grade 1 PV-IVH, low hematocrit, lowest arterial oxygen pressure within the first 6 hours of life, and large base deficit at 6 hours of age all increased the relative risk of grades 2 to 4 PV-IVH.

Cerebral Hemorrhage↗

PubMed1988

Diabetes, hypertension and other associated diseases.

Coexisting hypertension and diabetes mellitus is common particularly in the obese, minorities, and the socioeconomically disadvantaged. Hypertension contributes substantially to the vascular complications of diabetes mellitus and to the increased mortality of diabetes mellitus. Nondrug treatment of both conditions consists of cardiovascular risk factor reduction, emphasizing weight management, salt restriction, smoking cessation, and alcohol moderation. With observing a few precautions the drug treatment of hypertension in diabetes mellitus is similar to that of the nondiabetic.

Diabetes Mellitus, Type 2↗

PubMed1985

Comparison of the use of reserpine versus alpha-methyldopa for second step treatment of hypertension in the elderly.

A retrospective chart analysis was conducted on all new elderly hypertensive patients referred to a community hypertension clinic who were being treated with either reserpine or alpha-methyldopa plus a diuretic. There were no significant differences between the two groups on entry in age, gender, co-morbid diagnoses, or systolic or diastolic blood pressure. There were no significant differences between the two groups in terms of side effects over three years, but the proportion of persons having compliance problems was significantly lower in the reserpine group. Mean diastolic pressures were significantly lower after one, two, and three years, and systolic pressures were lower after one and two years in the reserpine group. Reserpine is at least as effective as alpha-methyldopa in treating hypertension in the elderly and is associated with fewer problems in compliance.

Aged↗

PubMed1984

Treatment of hypertension in the elderly: a time for caution?

The authors review recent studies of treatment of hypertension and suggest modified guidelines for the treatment of elderly hypertensive patients. Treatment is recommended for elderly persons with systolic-diastolic hypertension if the systolic pressure is consistently above 160 mm Hg or the diastolic blood pressure is consistently above 100 mm Hg. Treatment of isolated systolic hypertension should not be excessively vigorous, and systolic blood pressure should not be lowered much below 160 mm Hg.

Aged↗

PubMed1982

Control of systolic blood pressure in elderly black patients.

To study what effect the level of control of systolic blood pressure (SBP) has in elderly persons with systolic-diastolic hypertension, 503 elderly black hypertensive patients were followed up for as long as nine years. The combined rate of hospitalizations and mortality for hypertension-related disorders was significantly (P less than 0.01) higher for the group with inadequate control of SPB (mean, 183.6 mm Hg) than for the group with partial (mean, 151.2 mm Hg) or complete (mean, 131.5 mm Hg) control. The group with complete control of SBP had a significantly (P less than 0.005) higher combined rate of hospitalizations and mortality for hypertension-related disorders than did the group with partial control. This suggests that a target goal for control of systolic as well as diastolic blood pressure should be set for elderly black hypertensive patients. However, the control of SBP should not be to rigorous.

Aged↗

PubMed1981

Analysis of the 1980 heat wave in Memphis.

During the heat wave of 1980, average daily temperatures in Memphis first rose above the mean on June 25 and remained elevated for 26 consecutive days. In July, 1980, 83 heat-related deaths were recorded as compared to non in July 1979. Most of these deaths occurred in elderly, poor, black, inner-city residents. There was a statistically significant increase in total mortality rates, death from natural causes, cardiovascular mortality rates, and the rate for persons dead on arrival. Virtually all the excess mortality was in persons over the age of 60. The rise in heat-related emergency room visits occurred three days prior to the rise in heat-related deaths. Local planning for future heat waves should focus on the inner-city black elderly. Heat-related deaths and emergency room visits should be reported to public health officials.

Adolescent↗

PubMed1980

Cost of chronic disease care.

Explore the source record for details and available documents.

Adult↗

PubMed1980

Evaluation of a decentralized system for chronic disease care: seven years of observation.

Observations of a publicly-financed system for the medical care of a large number of persons with chronic diseases have been made over seven years. The system combines decentralized, nurse-staffed neighborhood clinics, operated by a public health department, with a central referral clinic for consultations and the management of complicated problems. After seven years in the chronic disease program 55% of 1,004 patients with diagnoses of diabetes mellitus, hypertension, and cardiac diseases were still receiving care, 19% had died, and 26% had been lost to the program. In the seventh year, the mean diastolic blood pressure in hypertensives was 84 mm Hg and the mean serum glucose in diabetics was 203 mg/dl. For the group under care, hospital days/1000/year were 74% of the rate during the year before referral to the program and out-patient visits/1000/year were approximately the same as before referral. However, two-thirds of the visits, formerly made to a public hospital, were now being made to neighborhood clinics. The system appears to be an effective method of providing medical services for persons who formerly used the public hospital as their source of outpatient care.

Chronic Disease↗

PubMed1980

Why people are hospitalized. A description of preventable factors leading to admission for medical illness.

We evaluated factors leading to the admission of 136 patients to the general medical services of two large metropolitan hospitals. We developed explicit criteria for the contribution of various specific factors to illness prevention and control in these patients. According to these criteria, the illness was found to be preventable in 44 per cent and the illness could have been controlled without admission in 31 per cent if a standard medical regimen had been followed. Social circumstances of individual patients influenced the admission decision in 21 per cent. Lack of medical or community resources or failure to make use of them contributed to 21 per cent of admissions. Alcohol abuse and smoking were factors in 17 per cent and 15 per cent respectively. Compliance played a role in 21 per cent. In 29 per cent of admissions more than one preventable factor was identified. Personal habits and lifestyle, less-than-optimal management or prior illness, social considerations or lack of community resources were factors in 78 per cent of the admissions.

Alcoholism↗

PubMed1975