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Biomedical subjects

R Christianson

Publications and source records attributed to R Christianson.

15 recordsLinked to original sources
PubMed1995

When jobs are scarce.

"Sorry, we're not hiring." This is becoming a common refrain for those of you searching in today's EMS job market. JEMS has received numerous letters from people frustrated by their inability to find employment following training. A spot-check of organizations and employers around the country suggests that, indeed, EMS positions are scarce. The waiting time for employment in many large urban services can be from six months to two years or more, and one director from a busy midwestern ALS service said he was receiving approximately 75 to 100 applications for every paramedic opening.

Attitude↗
PubMed1994

Fetal deaths in Mexican-American, black, and white non-Hispanic women seeking government-funded prenatal care.

Hispanics of Mexican origin constitute the largest minority population in the Southwestern United States, yet little is known about their reproductive health. This study assessed ethnic differentials in fetal mortality at 20 or more weeks gestation and identified the social and behavioral predictors associated with this outcome among low-income Hispanic, black non-Hispanic and white non-Hispanic women. Records were used of 80,431 patients attending federally funded prenatal care clinics in California from 1984 through 1989. The fetal death rate per 1,000 live births and fetal deaths was 7.8 for Hispanic, 8.4 for white non-Hispanic and 20.5 for black non-Hispanic women. These rates indicated favorable reproductive outcomes for Mexican Americans despite their social risk profile. An analysis of stillbirths by gestational age showed that Hispanic women stood a significantly lower risk of short-gestational stillbirths than non-Hispanics. In contrast, Hispanic women had a higher proportion of term stillbirths. Hispanic acculturation was a significant predictor of short-term gestation fetal deaths only. The inability to pay for health care was a strong predictor of fetal deaths for all ethnic groups, underscoring the need to ensure adequate access to maternity care for low-income women.

Acculturation↗
PubMed1989

MRI of the mandible.

Eighteen patients with abnormalities of the mandible and two normal volunteers were studied with MRI. Correlation was made with MR, CT, plain X-rays, clinical examination, and surgical findings when possible. In primary tumors of the mandible, MR was able to differentiate between solid and cystic lesions. In the cases of secondary invasion of the mandible by malignant tumors, MR was able to demonstrate replacement of the normal high signal bone marrow by low signal tumor. In some cases, the extent of marrow involvement shown on MR and confirmed at surgery was significantly underestimated by clinical examination, plain films, and CT. From this limited experience, it appears that MR may play an important role in imaging pathology of the mandible.

Humans↗
PubMed1978

Congenital heart disease in a cohort of 19,502 births with long-term follow-up.

The Child Health and Development Studies are longitudinal studies of pregnancy and the normal and abnormal development of the offspring. Women who were membres of the Kaiser Foundation Health Plan entered the study in early pregnancy, and their children were examined frequently until the youngest child in the study was 5 years old. This is a more intensive follow-up than hitherto reported. Of the 19,044 live-born children, 163 had definite and another 31 had possible congenital heart disease; the crude incidence rates per 1,000 live births were 8.8 for definite congenital heart disease and 10.4 for definite plus possible congenital heart disease. The incidence rate of congenital heart disease was 7.9 percent among all stillborn fetuses subjected to autopsy and 10.2 percent among those in this group with autopsies evaluated as being detailed enough to detect heart disease. Among the live-born children with congenital heart disease, 21 died in the neonatal period and 22 died in later infancy and childhood; about half the deaths were judged to have been due to heart disease. About 30 percent of the children with congenital heart disease had associated severe anomalies of other systems. In the whole cohort, 50 children had diagnosed chromosomal abnormalities (2.63/1,000 live births) and about 30 percent of them had congenital heart disease. Among the group of 163 children with definite congenital heart disease, the diagnosis was made in 46 percent by age 1 week, in 88.3 percent by age 1 year and 98.8 percent by age 4 years.

Abnormalities, Multiple↗
PubMed1976

Influence of blood pressure changes with and without proteinuria upon outcome of pregnancy.

A prospective study of 10,074 white gravidas and 2,880 black gravidas carried out during the years 1959 to 1967 has been analyzed with respect to the impact of elevated blood pressures and/or proteinuria upon pregnancy outcome. Edema was not considered because no evidence is available to indicate that its occurrence increases risk. The mean arterial pressure exhibited during the fifth and sixth months of pregnancy was found to be of significance, as well as the absolute levels of blood pressure attained prior to labor and delivery. The degree of rise in blood pressure was not of importance in itself. However, categories with significant proteinuria had greater increases in mean arterial pressure than did comparable categories without it. Significant proteinuria alone but especially with hypertension was also detrimental to pregnancy outcome. Eight categories incorporating early and late hypertension with and without proteinuria were created, and these were given descriptive diagnostic labels. Only "gestational hypertension," as defined, proved to be essentially devoid of risk to the fetus. In all other non-normotensive categories there was an increase in the stillbirth rate, the perinatal mortality rate, the frequency of intrauterine growth retardation, and neonatal morbidity. In every category, each of these untoward events was greater in black than in white gravidas, and a higher percentage of blacks was noted in each of the hypertensive categories. It is believed that hypertension, significant proteinuria, or both are associated with decreased uteroplacental blood flow which is the common denominator for all of these deleterious effects. The study suggests that "gestational hypertension" occurring late but without proteinuria may or may not represent an early stage of "pre-eclampsia" but does not, at least, place the infant at any substantially increased risk.

Black or African American↗
PubMed1976

The impact of mean arterial pressure in the middle trimester upon the outcome of pregnancy.

Data on the outcome of pregnancy are based upon a prospective study of 14,833 single births to women whose blood pressures during the fifth and sixth months of gestation were recorded. With each 5 mm, Hg rise in the mean arterial pressure (MAP) there is a progressive increase in the perinatal mortality rate. At each MAP level, the stillbirth rates and neonatal mortality rates are higher in blacks than in whites. When middle-trimester MAP is 90 mm. Hg or more, there is a significant increase in (1) the stillbirth rate, (2) the frequency of proteinuria, hypertension, and diagnosed pre-eclampsia in the third trimester, and (3) the frequency of intrauterine fetal growth retardation. We believe that all of these events are due to an impaired uteroplacental circulation, with which elevated blood pressures are associated. Women who have an average MAP of 90 or more during the fifth and sixth months should be considered in a high-risk category.

Adolescent↗
PubMed1976

Placental ratio in white and black women: relation to smoking and anemia.

In a study of 7,000 pregnancies it was found that, particularly in black women, hemoglobin levels were lower in smokers than in nonsmokers. This is the reverse of previously reported findings in nonpregnant persons. At delivery, the mean ratio of placental weight to birth weight (placental ratio) was higher in the infants of smokers than of nonsmokers. This observation is discussed in the light of reported elevated placental ratios at high altitudes or after severe anemia of pregnancy. The relationships are complex, and are not uniform with respect to ethnic group.

Anemia↗
PubMed1976

Diuretic drugs and pregnancy.

Perinatal mortality and delivery patterns are compared for 4035 gravidas who were prescribed diuretic drugs during pregnancy and 13,103 gravidas who were not. Diuretic drugs were prescribed primarily for edema; gravidas with hypertensive disorders were excluded. The 2 groups, differing in both condition and drug excluded. The 2 groups, differing in both condition and drug usage, had significantly different gestational age distributions. The gravidas prescribed diuretic drugs delivered infants of higher mean birthweight and had significantly higher incidences of induction of labor, stimulation of labor, uterine inertia, and meconium staining. Their perinatal mortality rates also tended to be higher. The findings support the contention that higher risk is associated with one or more factors differentiating the 2 groups, namely, edema, undefined factors associated with edema, or the consumption of a diuretic drug.

Adult↗