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S Satterfield

Publications and source records attributed to S Satterfield.

26 records · Page 2Linked to original sources

Small cell carcinoma of the prostate gland with inappropriate antidiuretic hormone secretion: morphological, immunohistochemical and clinical expressions.

Small cell carcinomas of the prostate gland are rare, and their histogenesis and clinical behavior remain poorly defined. We report a case with antidiuretic hormone secretion, which demonstrates direct transformation of the adenocarcinoma into the small cell component. The adenocarcinoma reacted positively for prostatic antigen, and negatively for carcinoembryonic antigen and neuron specific enolase, whereas the small cell component was negative for prostatic antigen, and positive for carcinoembryonic antigen and neuron specific enolase. At biopsy this was interpreted as denoting 2 separate tumors: one of prostatic and the other of nonprostatic origin. The clinical course was rapidly fatal but otherwise manifested the metastatic pattern of prostatic carcinoma. We caution that immunohistochemical reactions may be misleading if not interpreted in the context of other findings in the case. This case is labeled as a small cell carcinoma rather than a poorly differentiated adenocarcinoma of the ordinary type because the tumor exhibited morphological, immunohistochemical and biological features typical for that neoplasm.

Adenocarcinoma↗

Common sexual problems of children and adolescents.

The pediatrician is often expected by families to deal with sexual problems of children and adolescents. The physician should be able to identify problems and to guide parents in more meaningful communication and education of their children. Hopefully, he will be able to identify family conflicts and make the appropriate intervention or referral. He should be aware of his own sexual attitudes so as to avoid having his bias interfere with treatment. The childs behavior should not be isolated, but considered in the context of his family, his peers, and his own growth and development. Often, it is more useful to advise the family than to work with a young child. Adolescents present particular problems because of their conflicts over sexual identity, their reluctance to admit to problems, and frequently a mistrust of adults. They often feel a need for a trusting relationship with an adult, however, and are able to relate to a sensitive, non-judgmental professional.

Adolescent↗

Baseline characteristics of participants in the Physicians' Health Study: a randomized trial of aspirin and beta-carotene in U.S. physicians.

The Physicians' Health Study is a randomized, double-blind, placebo-controlled trial of primary prevention designed to assess the effects of low-dose aspirin on cardiovascular disease and of beta-carotene on risks of cancer. A total of 22,071 U.S. male physicians 40 to 84 years of age were randomized to one of four treatment groups: active aspirin and active beta-carotene, active aspirin and beta-carotene placebo, aspirin placebo and active beta-carotene, or both placebos. Whereas the beta-carotene component of the trial is ongoing, the blinded aspirin component was terminated early primarily because of a statistically extreme benefit of aspirin on first myocardial infarction. We obtained data relating to a large number of variables, including demographics, personal medical history, family history, health habits, and diet before randomization and compared them among the four treatment groups. As expected in a randomized trial of this sample size, the distribution of baseline characteristics was virtually identical among the treatment groups. This comparison indicates certainly no confounding by the baseline variables that were collected and suggests that other unmeasured or unknown potential confounders are also likely to be distributed evenly between the treatment groups. Thus, any observed differences in outcome between these groups likely result from the effects of the treatments themselves.

Adult↗

Biochemical markers of compliance in the Physicians' Health Study.

The Physicians' Health Study is a randomized, double-blind, placebo-controlled trial using a 2 x 2 factorial design to test the effects of low-dose aspirin on risk of cardiovascular disease and beta-carotene supplementation on the incidence of cancer. To evaluate self-reported compliance with assigned treatment, we measured serum thromboxane B2, which is decreased after aspirin use, and plasma beta-carotene in samples of study participants drawn from three geographic locations in three different time periods. Thromboxane B2 levels were markedly lower in those assigned to aspirin (median = 63.5 pg/mL) than in those given aspirin placebo (median = 3,600 pg/mL, P less than .0001). Similarly, those assigned to beta-carotene had significantly higher levels (median = 1,176 ng/mL) than those given placebo (median = 306 ng/mL, P less than .0001). In addition, there was a highly significant positive correlation between levels of these biochemical markers and the self-reports of compliance (r = 0.65 for thromboxane B2 and r = 0.69 for beta-carotene, P less than .0001). These findings support the validity of the self-reported compliance in the Physicians' Health Study.

Adult↗

Risk factors for septicemia-associated mortality in older adults.

Septicemia is the 10th leading cause of death among older adults in the United States; its mortality rate has steadily increased over the past decades. Little is known about factors which predispose to septicemia mortality in the elderly. The authors investigated risk factors for septicemia-associated mortality in 10,269 older adults as part of a longitudinal study of three communities (East Boston, MA; New Haven, CT; and Iowa and Washington Counties, IA). During 6 years of followup, 177 persons (3.2 per 1,000 person-years) had septicemia ICD9 038 (International Classification of Diseases, ninth revision) reported on their death certificate. In a multivariate proportional-hazards model, septicemia mortality was significantly (P < 0.05) and independently associated with age, male sex, history of diabetes, history of cancer requiring hospitalization, smoking one pack of cigarettes per day or more, not drinking alcohol in the year prior to baseline, disability in activities of daily living, cognitive impairment, and missing cognitive testing score. These factors might be useful in developing an at-risk population for testing septicemia treatment or prevention strategies in a community setting. Further investigation is needed to explain underlying mechanisms of increased risk of subsequent septicemia.

Age Factors↗

Recruitment for phase I of the trials of hypertension prevention.

Phase I of the Trials of Hypertension Prevention was a multicenter, randomized, controlled trial designed to determine the efficacy of seven nonpharmacologic interventions in reducing blood pressure among persons with high-normal diastolic blood pressure. The initial goal for recruitment was to enroll 2,100 participants over a nine-month period. The two major strategies for reaching potential participants were direct mailings and work site screenings. The yield from the first screening visit to randomization was 13% overall, with clinic-specific yields ranging from 4.5% to 31.7%. After five months of recruitment, approximately 60% of the goal for that point in the recruitment timetable had been randomized. Clinical centers falling short of their goals at that time altered their recruitment strategies and intensified their efforts, and centers that had exceeded their goals recruited additional participants. As a result, 2,182 participants, or 104% of the goal for recruitment, were randomized over a 13-month period. Those clinics using a cohort, or wave, type of enrollment were most successful in achieving their recruitment goals within the prescribed timetable.

Adult↗

Disability and cognitive impairment are risk factors for pneumonia-related mortality in older adults.

The role of functional and cognitive limitations in the risk of pneumonia-related mortality in older adults was examined. As part of a cohort study in 3 communities (East Boston, MA; New Haven, CT; and Iowa and Washington Counties, IA), 6,234 women and 4,035 men ages 65 or older completed baseline interviews between 1981 and 1983 and were followed for up to 6 years. Sex-specific Cox proportional-hazards regression models were used to examine the association of baseline physical and cognitive functioning with report of pneumonia (ICD9 480-486) as an underlying, immediate, or contributing cause of death. During followup, a total of 243 men and 160 women died with pneumonia. Adjusting for age, race, education, evidence of five chronic diseases, and smoking status, a significantly increased risk of pneumonia mortality (P < 0.05) was found for limitations in activities of daily living and cognitive impairment among both men and women. Inability to walk a half mile, climb stairs, or perform heavy housework was significantly associated with increased risk of pneumonia mortality for women but not for men in the same multivariate models. Men and women whose body-mass index was above the median had significantly lower risk of pneumonia mortality compared with those in the lowest quartile. Further elucidation of the sequence between physical and cognitive impairment and risk of pneumonia will be important in reducing pneumonia-associated morbidity and mortality.

Aged↗