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Biomedical subjects

S Whitman

Publications and source records attributed to S Whitman.

At least 19 recordsLinked to original sources
PubMed2000

Marked declines in human immunodeficiency virus-related mortality in Chicago in women, African Americans, Hispanics, young adults, and injection drug users, from 1995 through 1997.

BACKGROUND: Declines in human immunodeficiency virus (HIV)-related mortality between 1995 and 1996 were seen across the United States but were small to nonexistent among people in marginalized sectors who are most likely to contract HIV and die of its effects. No comprehensive analysis describing HIV-related mortality in 1997 was available. OBJECTIVE: To describe Chicago's HIV-related mortality trends up to and including 1997, with specific attention focused on marginalized populations. METHODS: An analysis of cross-sectional HIV-related mortality data with emphasis on the years 1995 through 1997 was conducted for Chicago, Ill. Numbers, proportions, and rates of declines in HIV-related deaths were examined for the city as a whole and also among those diagnosed at Cook County Hospital, as a proxy for people with very low socioeconomic status. RESULTS: Between 1995 and 1996 there was an overall decline of 19% in HIV-related mortality in Chicago but small or no declines among women, African Americans, Hispanics, injection drug users, and people aged 20 to 29 years and more than 50 years. Between 1995 and 1997 there was an overall decline of 61%. At that time the declines were spread more evenly across diverse groups. There were almost no significant differences between the declines for these groups at Cook County Hospital and in the rest of Chicago. CONCLUSIONS: The HIV-related mortality has fallen dramatically in Chicago since 1995, the year of its maximum. During 1997, declines were seen among all groups. Declines were also seen among the most disenfranchised of the city. Access to care and the new combination therapies are apparently sustaining life for many in Chicago.

Adult↗
PubMed2000

Alternatively spliced products CC3 and TC3 have opposing effects on apoptosis.

The human gene CC3 is a metastasis suppressor for small cell lung carcinoma (SCLC) in vivo. The ability of CC3 to impair the apoptotic resistance of tumor cells is likely to contribute to metastasis suppression. We describe here an alternatively spliced RNA of CC3, designated TC3, that encodes an unstable protein with antiapoptotic activity. TC3 and CC3 proteins share amino-terminal sequences, but TC3 has a unique short hydrophobic carboxyl terminus. Overexpression of CC3 results in massive death of rodent fibroblasts, but TC3 protects cells from CC3-induced death and from other death stimuli such as treatment with tumor necrosis factor or overexpression of Bax protein. The death-inducing activity of CC3 resides within its amino-terminal domain, which is conserved in TC3. The carboxyl terminus of TC3 is responsible for the antiapoptotic function of TC3; mutations in this domain abolish the ability of TC3 to protect cells from apoptosis. TC3 protein is short-lived due to its rapid degradation by proteasome, and it forms complexes with a regulatory subunit of proteasome known as s5alpha. The signal for the rapid degradation of TC3 resides within its carboxyl terminus, which is capable of conferring instability on a heterologous protein. The proapoptotic activity of CC3 in SCLC cells is induced by a wide variety of signals and involves disruption of the mitochondrial membrane potential (Deltapsim). The CC3 protein has sequence similarity to bacterial short-chain dehydrogenases/reductases and might represent a phylogenetically old effector of cell death similar to the recently identified apoptosis-inducing factor. CC3 and TC3 have opposing functions in apoptosis and represent a novel dual regulator of cell death.

Acetyltransferases↗
PubMed1999

Asthma hospitalizations and mortality in Chicago: an epidemiologic overview.

STUDY OBJECTIVES: To characterize the patterns and correlates of asthma hospitalizations and mortality in Chicago. DESIGN: Cross-sectional analysis of discharge data for 1996 and mortality time trend data for the period from 1990 to 1997. SETTING: The city of Chicago, IL, with Cook County, IL, and US data employed for comparisons. POPULATION STUDIED: People who were hospitalized with a primary diagnosis of asthma and people whose underlying cause of death was asthma. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: The 1996 asthma hospitalization rate for Chicago was 42.8 per 10,000, more than twice as high as suburban Chicago or US rates. Medicaid patients were overrepresented. Length of stay was longer for older patients and Medicaid patients. Age-adjusted asthma mortality in Chicago was 4.7 times higher in non-Hispanic blacks than in non-Hispanic whites. The black/white asthma mortality ratio is 2.5:1 for the nation overall. Asthma mortality rates for Hispanics in Chicago were between those of non-Hispanic whites and blacks but have almost doubled during this decade. CONCLUSIONS: The rising asthma mortality and high asthma hospitalization rates in Chicago constitute a significant public health problem. Comorbidities more common in urban environments, such as substance abuse, may play a unique role in determining the distribution of adverse outcomes within Chicago's population. Asthma hospitalizations and deaths may vary in their risk profiles, and this should be taken into account when developing research and intervention strategies.

Adolescent↗
PubMed1999

The relation of gestation length to short-term heat stress.

OBJECTIVES: This study examined the association between gestation length and heat exposure during the summer months of the Chicago heat wave of 1995. METHODS: Birth data from Illinois vital records containing 11,792 singleton vaginal births were analyzed to calculate mean gestational ages. RESULTS: No evidence was found to suggest an association between shortened gestation and increased maximum apparent temperature. CONCLUSIONS: The data propose no special precautions for pregnant women exposed to short-term heat stress of the intensity evaluated in this study. However, the possible effects of chronic heat exposure on gestation cannot be ruled out.

Chicago↗
PubMed1998

The big cities health inventory, 1997.

This manuscript reports on the publication of a unique document, The Big Cities Health Inventory, 1997: The Health of Urban U.S.A., which was released in July 1997 by the Chicago Department of Public Health (CDPH). The report presents data on 20 important health indicators such as AIDS, cancers, tuberculosis, sexually transmitted diseases, homicide, heart disease, infant mortality and low birthweight. Indicators of morbidity are gathered from participating local health departments and indicators of mortality and maternal and child health are obtained from vital records files provided by the National Center for Health Statistics (NCHS). The data are displayed and analyzed in two sections. The first consists of a series of tables presenting overall rates, gender and race/ethnicity-specific rates and city rankings according to these measures. These rankings provide meaningful comparisons between and within cities for specific demographic characteristics. The second component presents sample analyses which illustrate the possible uses of this information. The report represents an important tool for health professionals, researchers, policy makers and community advocates dedicated to promoting healthier cities. Such array of city-level data, to our knowledge not available from any other source, could indeed begin to lead to public health interventions that will impact the well-being of residents of large urban areas.

Cause of Death↗
PubMed1997

Redefining the growth of the heterosexual HIV/AIDS epidemic in Chicago.

UNLABELLED: A dramatic shift in the relative distribution of the five categories of heterosexual transmission for AIDS cases diagnosed in Chicago since 1991 prompted a mode-of-transmission validation study of what had become the most frequently reported heterosexual exposure: heterosexual relations with a person with AIDS (PWA) or documented HIV infection whose risk is not specified. METHODS: For 395 cases with originally reported heterosexual exposure, one or more of three supplemental data sources were employed: medical records were reviewed, medical providers were interviewed, and patients or proxies (i.e., spouse, significant other, or family member) were interviewed when possible. When reported HIV exposure could not be validated or reclassified, the transmission category employed was "no identifiable risk" (NIR). RESULTS: Eighty-five percent (336 of 395 cases) were reclassified into different transmission categories. Most notably, 69% (272 of 395 cases) were reclassified into transmission categories that did not involve heterosexual contact, including NIR. The cumulative percentage of cases attributable to heterosexual contact declined from 8% to 5% as a result of reclassification. Additionally, reclassification resulted in a reduction of nearly 50% in the number of AIDS cases attributable to heterosexual contact diagnosed in 1993 and 1994. CONCLUSIONS: In Chicago, an emerging problem in AIDS surveillance appears to be the use of an ambiguous heterosexual exposure category as a default when other information is not readily available. This study has found the growth in AIDS cases among persons exposed to HIV through heterosexual contact to be much slower than previously perceived. This finding may have important implications for the national debate over the extent to which heterosexual people are being infected and how funding and prevention strategies should be prioritized.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Periodontal regeneration in naturally occurring Class II furcation defects in beagle dogs after guided tissue regeneration with bioabsorbable barriers.

THE EFFICACY OF A BIOABSORBABLE polylactic acid based barrier was evaluated using naturally occurring buccal Class II furcation defects in beagle dogs. Sixteen furcation sites (8 control and 8 experimental) were treated in 6 adult animals. After full thickness flap reflection, exposed furcations and root surfaces were thoroughly root planed. In experimental sites a customized barrier was formed and fitted to cover the defect. Surgical flaps were replaced slightly coronal to the cemento-enamel junction. Animals were sacrificed at 6 months and specimens processed for histologic evaluation. Histologic and histometric analyses were done using 6 micrograms step serial sections in the buccal-lingual plane, corresponding to the buccal-lingual extent of the furcation. Results were: mean total defect experimental sites 1.92 mm; control sites 1.47 mm. Mean new cementum formation experimental sites 1.36 mm (71% of initial defect); control sites 0.25 mm (17% of initial defect). Mean new bone formation experimental sites 1.42 mm (74% of initial defect); control sites 0.20 mm (14% of initial defect). Mean junctional epithelium formation experimental sites 0.42 mm (22% of initial defect); control sites 1.21 mm (82% of initial defect). Statistical analysis demonstrated significant differences in all healing parameters favoring experimental (barrier-treated) sites. In this model, regeneration (new bone, cementum, and periodontal ligament) of 71% of the original defect in experimental sites and only 14% in control sites demonstrated a response that highly favored use of the barrier.

Alveolar Bone Loss↗
PubMed1997

Mortality in Chicago attributed to the July 1995 heat wave.

OBJECTIVES: This study assessed mortality associated with the mid-July 1995 heat wave in Chicago. METHODS: Analyses focused on heat-related deaths, as designated by the medical examiner, and on the number of excess deaths. RESULTS: In July 1995, there were 514 heat-related deaths and 696 excess deaths. People 65 years of age or older were overrepresented and Hispanic people underrepresented. During the most intense heat (July 14 through 20), there were 485 heat-related deaths and 739 excess deaths. CONCLUSIONS: The methods used here provide insight into the great impact of the Chicago heat wave on selected populations, but the lack of methodological standards makes comparisons across geographical areas problematic.

Age Distribution↗
PubMed1996

Epidemiology of AIDS among Hispanics in Chicago.

The purpose of this study was to describe the epidemiology of AIDS among Hispanics in Chicago. These data are needed to tailor prevention and treatment programs across diverse Hispanic ethnic subgroups. To pursue Hispanic origin for the 1,289 Hispanic persons diagnosed with AIDS in Chicago, death certificates for those cases contained in Chicago's AIDS Reporting System (ARS) file that were decreased were examined for information on national origin; the AIDS case reporting form was modified in January 1994 to collect data on Hispanic ethnic origin; care providers were contacted for further information; and medical records were investigated to determine Hispanic ethnic origin. Ethnic origins obtained from all sources are according to patient self-report. All reference to Hispanic ethnic subgroups in this study include U.S.-born and foreign-born Hispanics. Ethnic subgroup was identified for 989 Hispanic persons (77% of the 1,289 Hispanic cases) in the ARS. Data collected indicate that for all races and across Hispanic ethnic subgroups, Puerto Ricans have had the highest annual AIDS case rate since 1987. The mode of transmission for Puerto Rican males is predominantly through injection drug use (IDU), whereas for Mexican males the predominant mode of transmission is through males having sex with other males (MSM). For all Hispanic females, heterosexual contact was the predominant mode of transmission, with the largest proportion being sex partners of IDUs. The descriptive epidemiology of AIDS across Hispanic ethnic subgroups in Chicago highlights the need to target specific interventions among Puerto Ricans. In particular, culturally sensitive interventions tailored for Puerto Rican IDUs and their sex partners are needed, as are interventions for all Hispanic females who are at increased risk for heterosexual transmission.

Acquired Immunodeficiency Syndrome↗
PubMed1996

The epidemiology of homicide in Chicago.

Public health agencies across the country are beginning to view violence as a problem that demands a public health response. However, before such a response can be mounted effectively, there must be a sound data-based understanding of this epidemic. With this in mind, the Chicago Department of Public Health implemented an epidemiological analysis of homicide in the city. Using vital records, police data, and census data, we found that the city's homicide rate in 1993 was 31 per 100,000 population. This rate placed Chicago 14th among other large cities in the United States and 4th out of the eight cities with a population > 1 million. The homicide rate in the city has been increasing over the past 30 years, but not steadily. For some intervals, the homicide rate has remained almost constant. African Americans, Hispanics, the young, and males are overrepresented in the epidemic. While guns accounted for almost 75% of all homicides in Chicago in 1993, gangs accounted for only 15%. Homicide cannot be viewed in isolation from the context of society. The literature suggests that poverty and racism are important risk factors for this epidemic. Although we cannot wait until these risk factors are remedied to develop violence prevention interventions, we also cannot proceed effectively without understanding this context.

Black or African American↗
PubMed1993

Breast cancer screening in an urban public hospital. Five-year results.

BACKGROUND: This report describes the first 5 years of the Breast Cancer Screening Program (BCSP) at Cook County Hospital (CCH), a hospital that serves a predominantly African-American and low-income population. METHODS: A retrospective review of hospital cancer registry staging for breast cancers diagnosed between 1984 and 1988 was performed. RESULTS: Between 1984 and 1988, 499 new breast cancers were diagnosed at CCH, of which 33% were diagnosed after referral from the BCSP. The percentage of early breast cancers, defined as Stages 0 or 1, was 25% in women referred from the BCSP, compared with 6% for women referred from other clinical areas (P < 0.001). During this same period of time, the proportion of women at CCH with localized breast cancer increased from 30% in 1980-1983 to 40% from 1984-1988 (P < 0.05), an increase that can be attributed to the BCSP. Only 21% of the breast cancers detected by the BCSP were found by mammography alone. Of these, 91% were localized. CONCLUSIONS: The BCSP has had an impact on the proportion of early breast cancer diagnosed at CCH. Despite these efforts, the proportion of early breast cancer diagnosed at CCH (12%) is significantly less than that seen for all African-American women with breast cancer in Illinois (32%; P < 0.001).

Adult↗
PubMed1993

Race, income, and survival from breast cancer at two public hospitals.

BACKGROUND: Some studies have shown that adjustment for socioeconomic status reduces breast cancer survival differences between blacks and whites. The purpose of this study is to evaluate the effect of age, race, stage, treatment, and income status on breast cancer survival among women attending public hospitals in Chicago, Illinois. METHODS: Hospital Cancer Registry data on 887 black women and 265 white women with breast cancer onset between 1973-1985 were analyzed using Cox regression and Kaplan-Meier techniques. The purpose was to examine the effect of age, race, stage, treatment, and income on breast cancer survival. RESULTS: Black women with breast cancer were younger and poorer than white women with breast cancer. There were no significant differences between blacks and whites with regard to stage, estrogen receptor status, or type of treatment. Black women had lower 5-year breast cancer survival rates compared to white women (50.2% versus 60.2%; P = 0.05), and survival was lower when adjusted for stage and age. However, when adjusted for income in addition to stage and age, the effect of race on survival was reduced (from relative risk = 1.26; 95% confidence interval = 1.02, 1.57 to relative risk = 1.17%; 95% confidence interval = 0.95, 1.38). CONCLUSIONS: Income influences breast cancer survival differences between blacks and whites in this population.

Black or African American↗
PubMed1993

Referral adherence in an inner city breast and cervical cancer screening program.

BACKGROUND: Early detection and immediate follow-up treatment for cancer of the breast and cervix can reduce morbidity and mortality. This report describes adherence to follow-up appointments for suspected breast and cervical malignancies in a population of low-income black women who participated in a community-based nurse-managed screening program. METHODS: Components of the program that were part of the intervention included the following: a consistent referral mechanism augmented by a computerized tickler system; education of women about the importance of follow-up; and active nurse assistance in the follow-up process. Referral for follow-up of suspected malignancies or for other questionable findings was made to the public sector hospital clinics (86%) or to other providers of the women's choice (14%). RESULTS: Follow-up rates for suspected malignancies of the breast were high (92%) in this population of women, sometimes described as less likely to adhere to recommendations for continued care. In contrast, adherence rates for gynecologic conditions were lower (70%). CONCLUSIONS: This screening program and follow-up system has relevance to systems that serve similar groups of low-income women.

Adult↗
PubMed1993

Do chart reviews and interviews provide the same information about breast and cervical cancer screening?

The National Cancer Institute of the United States has set a goal for the year 2000 that 80-90% of eligible women should have a Pap smear every 3 years and that 80% of women aged 50-70 should receive an annual breast examination and mammogram. Very few studies have examined how we might best measure our progress towards this goal. Specifically, should we employ interview data or data derived from medical records? To respond to this question, data were gathered at two different public health clinics in poor areas of Chicago using both techniques. The interviews estimated significantly higher proportions of women receiving Pap smears, breast examinations, and mammograms in the previous 12-month interval than were estimated from randomly selected medical records. A review of the literature suggests the same pattern exists when other studies using these two data gathering processes are compared. We are thus left with a serious problem, one that must be resolved before we will be able to fully assess our progress in increasing breast and cervical cancer screening.

Aged↗
PubMed1992

Psychopathology in epilepsy. The role of psychology in altering paradigms of research, treatment, and prevention.

This article offers a brief review of the literature examining epilepsy and abnormal behavior. The generally accepted concept of epilepsy as a high psychiatric risk disorder is reexamined in light of research that has investigated the influence of selection bias. A conceptual model that organizes the known or postulated risk variables (neurological, psychosocial, and medication) is presented, with emphasis on psychology's potential contribution.

Adaptation, Psychological↗
PubMed1991

Patterns of breast and cervical cancer screening at three public health centers in an inner-city urban area.

In an effort to examine breast and cervical cancer screening patterns among poor African-American urban women, medical records were abstracted at three public health centers located in the inner city of Chicago. The proportions of eligible women at these three centers who received Pap smears, breast examinations, and mammograms were computed. These proportions were notably low and differed significantly among the three centers. Because the literature is now suggesting that an appropriate sequence best defines adequate screening, sequences of screenings were also determined and were found to be lacking. All of these screening histories fall far below the screening objectives set by the National Cancer Institute for the year 2000. This information suggests that interventions are needed that will help health centers serving poor women to deliver more frequent cancer screening.

Black or African American↗
PubMed1990

Psychosocial predictors of psychopathology in epilepsy.

The 30-item version of the GHQ was administered to 102 adults with epilepsy, and four sets of variables (neurological, psychosocial, medication, demographic) were used to predict psychiatric distress. Psychopathology was found to be associated with increased perceived stigma, elevated number of stressful life events during the past year, poor adjustment to epilepsy, financial stress, vocational problems, external locus of control, and an earlier onset of epilepsy. Multiple regression procedures reduced this list to three independent predictors of psychopathology: an increased number of stressful life events in the past year, poor adjustment to epilepsy, and financial stress.

Adaptation, Psychological↗