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Biomedical subjects

S E Sutherland

Publications and source records attributed to S E Sutherland.

At least 37 records · Page 2Linked to original sources
PubMed1995

Coronary disease mortality and risk factors in black and white men. Results from the combined Charleston, SC, and Evans County, Georgia, heart studies.

BACKGROUND: Epidemiologic studies begun in the southeastern United States in the 1960s indicated that the prevalence of coronary disease was two to three times greater among white men than black men and also showed an excess incidence of coronary disease among white men, although hypertension was twice as prevalent among blacks. This study was conducted to determine if racial differences exist in coronary heart disease mortality and coronary risk factors. METHODS: Data from the two population-based cohorts of the Charleston, SC, and Evans County, Georgia, Heart Studies were pooled to make comparisons of coronary disease mortality and its risk factors. A total of 726 black men and 1346 white men aged 35 years or older in 1960 in the combined cohort were followed up for 30 years. RESULTS: There were 125 deaths among the black men and 323 deaths among the white men attributable to coronary disease; the age-adjusted rates were 5.0 per 1000 person-years in the black men and 6.5 per 1000 person-years in white men. Black-white coronary mortality risk ratios were 0.8 when age adjusted and 0.7 when also adjusted for other cardiovascular risk factors. Elevated systolic blood pressure and cigarette smoking were significant predictors of coronary mortality in black and white men. Serum total cholesterol level was a statistically significant risk factor only in white men. Higher education level was significantly protective in black and white men. CONCLUSIONS: Black men experienced significantly less coronary disease mortality than white men. Except for cholesterol level, the risk factors for coronary mortality in black and white men were similar.

Adult↗
PubMed1995

Skin color and cancer mortality among black men in the Charleston Heart Study.

The association between skin color and 30-year cancer mortality in a random sample of black men and a peer-nominated group of high socioeconomic status (SES) black men was evaluated in the Charleston Heart Study, a prospective study, begun in 1960, designed to investigate the epidemiology of coronary heart disease in a biracial cohort. Skin color was used as a continuous variable and as a categorical variable, by tertiles, in a Cox proportional hazards regression model. In the high SES group, there was a statistically significant decreasing relationship between skin color and cancer mortality, with those having the lightest skin having the lowest cancer mortality. In the random sample of black men, the relationship between skin color and cancer mortality was not statistically significant; however, the data indicated a slight protective effect among those with the lightest skin color. Because degree of skin reflectance is a measure of black-white admixture, these results may indicate a genetic mechanism underlying the differences in cancer mortality across skin color groups. Skin color is also recognized as a marker for psychosocial factors. Therefore, poor prognosis among those with darker skin color as a result of failure of early detection, inadequate treatment, and a variety of psychosocial stressors represents an alternative explanation of the study findings.

Black People↗
PubMed1995

Immunoglobulin kappa chain allotypes (KM) in onchocerciasis.

GM and KM allotypes, powerful tools for genetic characterization of human populations, have been shown to play an important role in genetic predisposition to some infectious diseases. Two diverse racial groups--Afro-Ecuadorians and Amerindians--living in a single restricted geographical area of Ecuador, appear to have different risk factors for acquisition and clinical expression of onchocerciasis, a disease caused by the filarial parasite Onchocerca volvulus. In this study, GM and KM allotypes were determined in 25 Afro-Ecuadorians and 24 Amerindians infected with Onchocerca volvulus (INF) and in putative immune individuals (PI). In Afro-Ecuadorians, the frequency of the homozygous KM 3 phenotype was significantly decreased in INF as compared with the PI group (20 vs. 68%; P= 0.0012), while the frequency of the heterozygous KM 1,3 phenotype was increased in INF as compared with the PI subjects (48 vs. 9%; P= 0.0044). These results suggest that in Afro-Ecuadorians KM 3 is associated with a lower relative risk (resistance), whereas KM 1,3 is associated with an increased risk (susceptibility) of onchocerciasis.

Africa↗
PubMed1993

Mortality rates and risk factors for coronary disease in black as compared with white men and women.

BACKGROUND: Currently recognized risk factors for coronary artery disease have been identified primarily from investigations of white populations. In this investigation, we estimated mortality rates for coronary disease and for any cause and identified risk factors for death from coronary disease among whites and blacks. METHODS: Data collected over a 30-year period in the Charleston Heart Study were used to estimate mortality rates and quantify associations with risk factors assessed at the base-line examination in 1960 and 1961 of 653 white men, 333 black men, 741 white women, and 454 black women. RESULTS: There were no significant racial differences in the rate ratios for death from coronary disease; however, women had significantly lower death rates than men. Over the 30-year period, the mortality rates for coronary disease per 1000 person-years were 5.2 for white men (95 percent confidence interval, 4.1 to 6.3), 4.6 for black men (3.0 to 6.2), 2.1 for white women (1.6 to 2.6), and 3.2 for black women (2.3 to 4.0). Significant, or nearly significant, predictors of mortality due to coronary disease were systolic blood pressure in all four groups; serum cholesterol level among white men, white women, and black women; and smoking among white men, white women, and black men. Although the difference was not statistically significant, the risk of death from coronary disease was consistently increased among diabetics in all four groups. A higher level of education was predictive of lower rates of death due to coronary disease among white men and black women. For all causes of death taken together, the rates for blacks were higher than the rates for whites. The presence of hypertension, a history of smoking, and a history of diabetes were significant or nearly significant predictors of mortality from any cause in all four groups. CONCLUSIONS: Although the rates of death from coronary disease were somewhat lower among black men than white men and higher among black women than white women, the black:white mortality rate ratios were not statistically significant, and the major risk factors for mortality from coronary disease were similar in blacks and whites in the 30-year follow-up of the Charleston Heart Study.

Adult↗
PubMed1993

Serum lipoprotein(a) levels in elderly black and white men in the Charleston Heart Study.

Lipoprotein(a) [Lp(a)] is an important genetic trait associated with cardiovascular disease. While Lp(a) levels have been demonstrated to be approximately twice as high in black adults and children compared with whites, this relationship has not been assessed in the elderly. During the 1987 recall of the Charleston Heart Study cohort, plasma Lp(a) [mg/dl] was measured on 113 white men and 83 black men. The average age of those having Lp(a) measurements was 71 years (+/- 6) for white men and 72 years (+/- 9) for black men. The distribution of Lp(a) was skewed in both whites (mean = 14.8, median = 8.2 mg/dl) and blacks (mean = 18.1, median = 12.8 mg/dl). The skewed distribution in elderly black men was in contrast to the bell-shaped distribution commonly reported for younger blacks. The Charleston Heart Study data suggest a shift to lower values among elderly as compared to younger men, with the greatest shift occurring among the black men. For black men who have survived to the 7th, 8th, and 9th decades of life, Lp(a) levels appear to be approaching the lower levels of white men. Despite this shift in distribution among black men, there remained a statistically significant difference in Lp(a) between racial groups.

Aged↗
PubMed1993

Electrocardiographic abnormalities and 30-year mortality among white and black men of the Charleston Heart Study.

BACKGROUND: The long-term predictive significance of a single ECG tracing for mortality was explored among the white and black men of the Charleston Heart Study. METHODS AND RESULTS: The 1960 baseline tracings of men ages 35 to 74 in the Charleston Heart Study cohort were coded according to the Minnesota classification. Tracings were categorized as being normal or having minor or major abnormalities. The 30-year vital status was ascertained for the cohort, and the association between ECG findings and coronary and all-cause mortality was evaluated. The proportion of black men with major abnormalities at the 1960 baseline examination was almost twice that of white men. Rates of all-cause mortality increased with severity of abnormalities for white and black men. The absolute excess risk for black men with major abnormalities was 23.3 per 1000 person-years and 12.8 for white men. The excess risk for coronary mortality was 7.3 for white men and 6.5 for black men. CONCLUSIONS: Many of the findings in this study confirm earlier associations derived from studies of white populations and extend the observations to black men. However, the magnitude of the relative risk for mortality was different for white and black men. After controlling for traditional coronary disease risk factors and minor abnormalities, white men with major abnormalities were 2.72 (95% confidence interval, 1.47, 5.04) times more likely to die of coronary disease compared with black men, who were 1.95 (95% confidence interval, 0.93, 4.11) times more likely to die of coronary disease.

Adult↗
PubMed1992

Skin color and mortality.

The relation of skin color and mortality from all causes, coronary heart disease, and all cardiovascular diseases was explored in 787 black men and women of the Charleston Heart Study Cohort. Associations were studied by examining rates of mortality during the period 1960-1990 by tertiles of skin color, as measured by reflectometer. Across the tertiles of reflectance there were no significant differences in mortality rates, except for sex differences. Proportional hazard regression analyses were used to investigate the relation between skin color, as a continuous variable, and time to death. Covariates for regression analyses were age, sex, skin color, the interaction of skin color and sex, education, blood pressure, serum total cholesterol, cigarette smoking, body mass index, and history of diabetes. Across the random sample of black men and women there was no significant relation between skin color and time to death, except for lighter skin color and all-cause mortality (p = 0.03). Our study results provided no evidence of a long-term effect of darker skin color, as measured by skin reflectance of light, on mortality from all types of cardiovascular disease, coronary disease, or all causes.

Age Factors↗
PubMed1992

A comparison of the effects of cholesterol on CHD mortality in black and white women: twenty-eight years of follow-up in the Charleston Heart Study.

The relationship between cholesterol and 28-year CHD mortality in women was evaluated in the Charleston Heart Study. Linear, quadratic, and cubic models were investigated using Cox proportional hazards regression analysis. In white women, the linear, quadratic, and cubic terms for cholesterol were significant suggesting an asymmetric J-shaped relationship. In black women, only the linear term in all three models was statistically significant suggesting an increasing CHD mortality rate with increasing cholesterol level. The lack of consistency of results by different statistical analyses in black women make conclusions concerning the nature of the relationship between cholesterol and CHD mortality less strong in black women than in white women. Compared with women having a cholesterol value equal to the mean of the group (241 mg/dl), white women having a cholesterol value one standard deviation above the mean (s = 52.5 mg/dl) had a 60% higher CHD mortality rate (hazard ratio = 1.6, 95% CI: 1.2-2.1). In black women, the estimated hazard ratio for a one standard deviation (s = 47.8 mg/dl) increase in cholesterol is 1.4 (95% CI: 1.03-1.8). The results suggest that the relationship of cholesterol to CHD mortality is different in white and black women. The relationship in white women appears to be curvilinear and represented by an asymmetric curve while the relationship in black women is not curvilinear and the overall pattern of association, while possibly linear, is equivocal.

Black People↗
PubMed1992

Does equal socioeconomic status in black and white men mean equal risk of mortality?

Although concerns have been expressed that mortality from coronary disease and all other causes is greater among Blacks than Whites, we hypothesized that, when socioeconomic status is adequately considered, mortality inequalities between Blacks and Whites are insignificant. The study population was a random sampling of Black and White men who were 35 years of age or older when recruited into the Charleston Heart Study in 1960. Education level and occupational status at baseline were used to compare mortality over the ensuing 28 years between Black and White men, who were classified as low or high socioeconomic status. In no instance were Black-White differences in all-cause or coronary disease mortality rates significantly different when socioeconomic status was controlled. We conclude that socioeconomic status is an important predictor of mortality and that, when socioeconomic status is considered, differences in Black-White mortality rates may be small.

Adult↗
PubMed1992

Alterations in tryptophan metabolism in the toxic oil syndrome and in the eosinophilia-myalgia syndrome.

The eosinophilia-myalgia syndrome (EMS) was associated with ingestion of L-tryptophan containing products and was accompanied by altered metabolism of L-tryptophan during the active phase. Many patients with EMS exhibited clinical and histopathological features similar to another epidemic, the toxic oil syndrome (TOS), associated with ingestion of adulterated rapeseed oil. We hypothesized that patients with TOS, like patients with EMS, may have had altered metabolism of L-tryptophan during the acute phase of the illness. Therefore, we quantitated the tryptophan metabolites, L-kynurenine and quinolinic acid, and we measured neopterin, a marker of interferon-gamma (IFN-gamma), in blood obtained during the acute phase of each syndrome. Patients with TOS or EMS had significantly higher L-kynurenine and quinolinic acid than healthy control subjects or rheumatic disease control subjects. Neopterin was also elevated in patients with untreated TOS and EMS, and correlated strongly with L-kynurenine and quinolinic acid. Our data suggest that indoleamine-2,3-dioxygenase (IDO), the rate limiting enzyme of the kynurenine pathway of L-tryptophan metabolism, was activated in both syndromes by cytokines including IFN-gamma, and that perhaps products of tryptophan metabolism played a role in the pathogenesis of EMS and TOS.

Arthritis, Rheumatoid↗
PubMed1991

Influence of missed catch trials on the visual field in normal subjects.

A total of 20 healthy individuals purposely missed an increasing number of individual catch trial questions (false positive or negative errors or fixation losses) when tested on the Humphrey Field Analyzer to determine the effect on the normal visual field. As determined by Statpac, the global indices and probability maps became significantly altered from those for the control fields at a prevalence of 20% for false negatives and 33% for fixation losses and false positives. However, the perimeter's recorded prevalence of missed catch trials showed a wide distribution from the percentage purposely missed. A high prevalence of missed catch trials was also indicated by a greater than normal mean defect and number of questions asked. This study suggests that although the number of missed catch trials are often recorded inaccurately, they help to identify unreliable normal visual fields, as do the mean defect and the number of questions asked.

Adult↗
PubMed1991

Early postoperative prognostic indicators following trabeculectomy.

We compared prognostic indicators manifesting within the first 2 postoperative days, with filtration status 3 months following trabeculectomy in 51 primary open-angle glaucoma patients. Patients with an avascular area in the filtering bleb 2 days after surgery had a significantly lower (P less than .05) intraocular pressure (IOP) (12.6 mm Hg) 3 months postoperatively than patients with vascular blebs (16.3 mm Hg). However, neither the height, breadth, or transparency of the filtering bleb, presence of microcysts, anterior chamber depth, nor IOP during the first 2 postoperative days were related significantly to the filtration status at 3 months.

Female↗
PubMed1990

Longitudinal changes in the bone mineral content of term and premature infants.

With the use of photon absorptiometry, bone mineralization was measured at birth and 8 and 16 weeks after delivery in 12 very-low-birth-weight premature (mean +/- SD gestational age, 31 +/- 1.5 weeks) infants who required minimal medical support. Simultaneously, 19 healthy term infants were studied. Throughout the study, each neonate received modified 84-kJ/30 mL formula containing no added calciferol. The recommended daily allowance (400 IU) of calciferol was given to each infant as an oral supplement. Serum 25-hydroxyvitamin D, calcium, phosphorus, and parathyroid hormone concentrations were monitored biweekly and were normal. Bone mineral content and bone width significantly differed at birth between the term and premature infants. However, by 16 weeks after delivery, the premature infants had exceeded the bone mineral status of the term infants at birth, and their bone mineral content was not significantly lower than that of the term infants. These data indicate improved bone mineralization as compared with previously reported data from very-low-birth-weight neonates.

Absorptiometry, Photon↗
PubMed1990

Factors associated with a learning effect in glaucoma patients using automated perimetry.

We studied 45 primary open-angle glaucoma patients consecutively examined with the program 30-2 on the Humphrey Field Analyzer to determine factors associated with a learning effect between the first two visual field exams. The average mean defect significantly decreased 1.7 dB between exams (P less than 0.05). No difference was noted in learning based on: the time interval between tests, the area of the field tested, age, sex, race, previous perimetric experience or parameters on the initial field exam (i.e. prevalence of false positive and negative errors, central reference level and eye tested (P greater than 0.05). However, learning positively correlated to defect depth and negatively correlated to fixation losses on the initial exam in patients retested within seven months (P less than 0.05). This study suggests predicting which patients require a second baseline field exam to exclude a learning effect is difficult, except in those with glaucomatous field loss or few fixation losses and another field is planned within a half year.

Aged↗
PubMed1989

Predictors of physical disability in elderly blacks and whites of the Charleston Heart Study.

During the 1984/85 recall of the Charleston Heart Study Cohort, physical function data were obtained for 247 white males, 376 white females, 123 black males, 247 black females and 71 high socioeconomic status (SES) black males over 60 years of age. Black females had the highest prevalence of physical disability (55.8%), followed by white females (43.2%), black males (39.0%) and white males (25.8%) and high SES black males (22.3%). Physical disability was 1.5-2.5 times as prevalent among individuals with a history of cardiovascular disease (CVD) than those without such a history. Among individuals without a current history of CVD univariate analyses showed the following as significant (lower 95% CI greater than 1.0) predictors of physical disability: elevated systolic blood pressure in white females, black males, and black females; elevated cholesterol in black females; obesity in black females; and low educational level in white females. Regression analyses indicated that obesity in 1960 accounted for 10.9 and 2.9% respectively of the variability in physical disability scores in 1985 for black females and white females.

Activities of Daily Living↗
PubMed1989

Renal kallikrein responses to dietary protein: a possible mediator of hyperfiltration.

We studied GFR, RPF and renal kallikrein in rats fed 9%, 25%, or 50% protein (casein) diets for 8 to 13 days. CFR and RPF increased progressively with increasing dietary protein. Renal excretion of active kallikrein (microgram/day) was 128 +/- 9, 174 +/- 11 and 228 +/- 14 in 9%, 25%, and 50% protein-fed rats, respectively (P less than 0.02 or less between groups). Prokallikrein excretion in these groups was 23 +/- 7, 77 +/- 11 and 118 +/- 15 micrograms/day, respectively (P less than 0.005 or less between groups). The in vivo renal kallikrein synthesis rate, relative to total protein synthesis, was reduced in 9% protein-fed rats (2.74 +/- 0.24) compared to rats fed 25% (3.93 +/- 0.34, P less than 0.02) or 50% protein (4.41 +/- 0.30, P less than 0.001). These changes in synthesis and excretion rates were not accompanied by changes in renal tissue levels of active or prokallikrein. In all groups, GFR and RPF correlated directly with the renal excretion of active kallikrein, prokallikrein or total kallikrein (r = 0.41 to 0.66, P less than 0.01). Treatment of 50% protein-fed rats with aprotinin, a kallikrein inhibitor, markedly lowered renal and urinary kallikrein-like esterase activity. Left kidney GFR and RPF were significantly reduced in aprotinin-treated rats compared to vehicle-treated rats (1.54 +/- 0.15 and 4.86 +/- 0.38 ml/min vs. 1.89 +/- 0.10 and 5.93 +/- 0.22 ml/min, GFR and RPF, respectively, P less than 0.05 or less).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Osteoradionecrosis of the mandible: a review.

Osteoradionecrosis (ORN) is a complex metabolic and tissue homeostatic deficiency created by radiation-induced tissue injury. Although infection was initially felt to play an important role in its pathogenesis, the role of microorganisms has been relegated to that of a contaminant. Trauma in some cases may provide a possible initiating factor for the process, or in the case of spontaneous ORN, the use of radioactive implants and the higher doses of radiation therapy as practised in the megavoltage era, may have an influence. The role of prevention cannot be over-emphasized. Dental evaluation is an important part of the initial patient assessment. Preservation of good or average teeth is recommended with subsequent regular follow-up and dental care. Post-treatment dental extraction should be minimized and delayed if possible until at least nine-12 months after completion of radiation therapy. Management of ORN requires assessment of the extent, both clinically and radiologically. Conservative management is recommended unless the disease is advanced or progressive. Radiologic evidence of fracture requires surgery. Modern surgical techniques offer satisfactory reconstruction. The role of hyperbaric oxygen remains controversial and limited to centers where hyperbaric techniques exist. The treatment is complex and time-consuming and results are confounded by the concurrent use of local antiseptic/antibiotic measures and surgery.

Humans↗