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Biomedical subjects

M Sexton

Publications and source records attributed to M Sexton.

At least 55 records · Page 3Linked to original sources
PubMed1986

Verification of smoking status by thiocyanate in unrefrigerated, mailed saliva samples.

A simple method of obtaining an unbiased verification of smoking status was developed for use in a randomized clinical trial. At the end of smoking cessation intervention for pregnant women, each participant mailed a saliva sample to a laboratory for the determination of thiocyanate. For comparison, salivary thiocyanate also was measured by a standard collection method in a reference group of non-study women who did not smoke during pregnancy. Although there may have been up to a 1-week delay between collection and analysis, results show that thiocyanate from unrefrigerated, mailed samples of saliva distinguishes reported smokers from nonsmokers, is positively associated with the amount of smoking, and is negatively associated with the length of cessation. These study findings are consistent with results from other studies in which samples of serum or saliva were collected and shipped under conditions requiring the presence of a staff member. The ability to perform an unbiased smoking status verification using a simple, inexpensive, and noninvasive collection method expands study possibilities, as it eliminates the need for direct, face-to-face contact with study subjects, and for being at their location.

Adolescent↗
PubMed1985

A hypertension treatment program at the workplace to complement community care.

A worksite hypertension control program was established for employees of the state of Maryland. Employees were screened for hypertension, and individuals identified as hypertensive were encouraged to seek care from community physicians. For those choosing not to seek such community care, a treatment program was initiated at the worksite. Of the 417 hypertensives identified, 54 (13%) elected to have their blood pressure treated at the worksite. Comparisons between the group choosing worksite care and the group choosing community care revealed that the worksite group was generally a higher risk group by virtue of having less awareness of their hypertension, being less likely to be on antihypertensive treatment, and being less likely to have their hypertension controlled by medication. This group made relatively little use of community physicians. Increases in hypertension treatment and control were greater in the worksite group after a 2-year follow-up examination. The project suggests an important role for worksite treatment programs for hypertension as a complement to existing community care.

Adult↗
PubMed1985

The effect of antismoking intervention during pregnancy: an assessment of interactions with maternal characteristics.

In a previous experimental study, which included 935 pregnant smokers recruited from private obstetric practices located in a large metropolitan area and from one hospital obstetric clinic, a 92-g difference was found between infants born to women who had antismoking intervention and those born to women in a control group. The current report further examines the effect of intervention on both smoking cessation during pregnancy and birth weight. Specific attention is given to interactions between intervention and maternal characteristics. These maternal characteristics were determined at the time of first prenatal care. A stepwise regression analysis was performed to assess 1) the association of each maternal variable with smoking cessation and birth weight; 2) the effect of intervention on these outcomes after adjusting for the maternal variable; and 3) the interaction effect between intervention and the maternal variable. The effect of intervention on smoking cessation was found to be significantly greater for women who experienced problems early in pregnancy, such as high blood pressure and urinary tract infection. The beneficial effect of intervention on birth weight decreased with age and number of previous low birth weight infants but increased with previous fetal loss. There is some evidence to suggest that the effect of intervention on birth weight is also dependent on the amount of smoking prior to intervention.

Adolescent↗
PubMed1985

Sex, race, age, and hypertension as determinants of employee absenteeism.

This study examined the effects of hypertension on two measures of employee absenteeism with the three confounding variables of sex, race, and age held constant. Subjects were 820 Maryland State employees who participated in a worksite blood pressure screening program. Comparison of official records for the year before (1978) and after screening (1979) revealed a small increase in the frequency of sick calls, a decrease in average duration of sick calls, and no net effect on total number of sick hours. Over the two-year period the average duration of absences was higher for hypertensives when sex, race, and age were held constant; however, the effect was confined to females. The findings indicate that hypertension and absenteeism should be investigated in the context of employees' demographic characteristics since these are related to hypertension and also are important determinants of absenteeism. When multiple regression was used, it became clear that demographic characteristics explained more of the variation in work absences than did blood pressure status. The relationship between hypertension and absenteeism was small, accounting for less than 2% of the variance. Thus employers can be reassured regarding the issue of whether newly detected hypertensives stay away from work. Given the weakness of the relationship found between hypertensive status and absences and the very small proportion of hypertensives who are newly detected, their effect on work absences is inconsequential.

Absenteeism↗
PubMed1985

Malignant melanoma simulating schwannian differentiation.

A malignant melanoma demonstrating palisades of spindled melanocytes strikingly similar to Verocay bodies is reported. Immunohistochemical staining for S-100 protein and neuron-specific enolase revealed uniform positive staining of the neoplastic cells consistent with malignant melanoma. Immunohistochemical staining for myelin basic protein, a marker specific for Schwann cells, was negative in neoplastic cells. Ultrastructural examination revealed numerous melanosomes, confirming the melanocytic nature of this neoplasm. The differential diagnosis and possible histogenesis of this neoplasm are discussed.

Aged↗
PubMed1984

A clinical trial of change in maternal smoking and its effect on birth weight.

These clinical trial results are the first, to our knowledge, from a prospective, randomized, and controlled experiment demonstrating that a reduction of smoking during pregnancy improves the birth weight of the infant. Nine hundred thirty-five pregnant smokers were randomly assigned to treatment and control groups; the former received smoking intervention. At the eighth month of pregnancy, differences between the two groups in salivary thiocyanate level and reported smoking were statistically significant. For single, live births, the treatment group infants had a mean birth weight that was 92 g heavier and were 0.6 cm greater in length than the control group infants. The decrement in weight related to smoking cannot be fully explained by gestational age. The findings suggest that some fetal growth retardation can be overcome by the provision of antismoking assistance to pregnant women.

Adolescent↗
PubMed1984

Salivary thiocyanate in pregnant smokers: a comparison of two collection methods.

Two simple methods of obtaining a salivary thiocyanate sample were tested to determine (1) if salivary thiocyanate could adequately differentiate a group of pregnant women into smokers and nonsmokers and (2) whether the simpler collection method of having the woman spit directly into the container produced as good a measurement of smoking exposure as having the woman chew a dental roll. Results show that thiocyanate measured from saliva samples collected by either of the two tested methods discriminates smokers from nonsmokers among pregnant women. The method of spitting directly into the collection container resulted in as good a discrimination of smokers from nonsmokers as results from the more complicated method of having subjects chew a dental roll. Advantages of using the direct method in large research projects are discussed. This is the first documentation that salivary thiocyanate distinguishes smokers from nonsmokers during pregnancy. The salivary data are consistent with earlier observations of higher serum thiocyanate levels during pregnancy, suggesting that thiocyanate may be metabolized differently during this time.

Adolescent↗
PubMed1983

Sexual abuse of young children.

For an 18-month period, all sexual abuse cases were referred to a project social worker. From her initial interview and the medical records, data were analyzed for 113 children who were 12 years of age or younger. It was found that half were five years or younger and three-fourths of the cases were female children. Reasons were discussed as to why females are more likely to be identified as sexually abused cases. A higher than average rate of gonorrhea was found among the pediatric group studied. While only 44 per cent of abusers were relatives of the abused, almost all (93%) were known to the family. If a relative were the alleged abuser, there was a high probability that it was a father, stepfather, or uncle.

Age Factors↗
PubMed1982

Relationship of demographic characteristics of interviewers to blood pressure measurements.

This report describes findings from the Hypertension Detection and Follow-Up Program (HDFP) on the relationship between traits of interviewers and outcome of blood pressure measurements taken during home interviews. Mean diastolic blood pressure readings and prevalence data for 137,417 respondents taken by 617 interviewers are analyzed. Findings from regression analysis show that the magnitude of the absolute or relative difference in outcome of blood pressure measurements is associated much more positively with the characteristics of race and sex of the respondent than these characteristics in the interviewer.

Adult↗
PubMed1982

Correlates of attendance and compliance in the hypertension detection and follow-up program.

The Hypertension Detection and Follow-Up Program (HDFP) screened 159,000 individuals aged 30-69 years in 14 communities. Using a two-stage process, 10,940 hypertensives were randomized into two treatment groups. The first group was referred to community sources for care (RC), and the second received free Stepped Care (SC) treatment with extensive efforts to reduce the barriers to care. One year after enrollment, attendance showed 85% of SC participants active (white males 88%, white females 84%, black males 83%, and black females 84%). One year attendance rates ranged from a low of 84% for those with baseline DBP 90-104 mm Hg to a high of 90% for those with baseline DBP greater than or equal to 115 mm Hg. There was no apparent association with age, however, attendance exhibited a positive relationship with education, ranging from 83% for those completing less than high school to 94% for those with degrees beyond college. Life tables analyses demonstrated that race, sex, and blood pressure level compliance differences manifest themselves at the early stages of enrollment with little variation among participants once in the program. Pill counts correlated with percent with controlled blood pressure as well as serum potassium and calcium levels. Educational level was also a major predictor of drug adherence ranging from 74.7% to 89.7% (from under 7th grade to above college) having taken greater than or equal to 80% of their pills.

Actuarial Analysis↗
PubMed1980

Effect of diet and Lactobacillus acidophilus supplements on human fecal bacterial enzymes.

The effect of diet and Lactobacillus acidophilus supplements on fecal microflora enzyme activity was studied in humans. The bacterial enzymes that were investigated are known to catalyze reactions that may result in formation of proximal carcinogens. Compared to vegetarians, omnivores eating a "Western-type" diet had higher levels of beta-glucuronidase, nitroreductase, azoreductase, and steroid 7-alpha-dehydroxylase in their fecal microflora. Removal of red meat or addition of fiber in the form of bran or wheat germ to the diet of omnivores for 30 days had no effect on beta-glucuronidase, nitroreductase, or azoreductase activity. However, removal of red meat or addition of fiber reduced fecal steroid 7-alpha-dehydroxylase activity. The addition of viable Lactobacillus acidophilus supplements to the diet of omnivores significantly decreased fecal bacterial beta-glucuronidase and nitroreductase activities. Thirty days after Lactobacillus supplements were curtailed, fecal enzyme levels returned to normal base-line activities. These findings suggested that the metabolic activity of the fecal microflora was influenced by diet and could be altered by Lactobacillus supplements and to a lesser extent by dietary fiber.

Adult↗