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Biomedical subjects

W S Stryker

Publications and source records attributed to W S Stryker.

13 recordsLinked to original sources
PubMed1992

The use of the Lottes nail in the treatment of closed and open tibial shaft fractures.

During the years 1979 through 1987, 98 patients with 101 acute tibial fractures were initially treated with Lottes' nails at the authors' institution. Ninety-one percent of the fractures healed uneventfully. The average healing times were 15.7 weeks for the 40 closed fractures and 20.5 weeks for the 61 open fractures. Infection occurred in one of the 40 closed fractures (2.5%) and in eight of the 61 open fractures (13.1%). By Gustilo grade, infection occurred in none of the 22 Grade I fractures (0%); one of the 22 Grade II fractures (4.5%); and seven of the 17 Grade III open fractures (41.2%). Seven of the eight malunions resulted from preventable technical errors. Five of the six nonunions healed after a secondary procedure. Lottes nailing is recommended in closed fractures and Grade I and II open fractures when internal fixation is required. Grade III open fractures, treated with the Lottes nail, had a high rate of infection.

Bone Nails↗
PubMed1991

Sunlight and dysplastic nevus risk. Results of a clinic-based case-control study.

The dysplastic nevus (DN) is the most important risk factor and precursor for malignant melanoma. The authors compared the responses of 132 consecutive cases of DN, 186 consecutive cases of cutaneous melanoma, and 239 controls attending the same subspecialty clinic to questions regarding sun sensitivity, sun exposure, and other possible risk factors. Dysplastic nevus cases were younger than controls and were of a higher social class, as indicated by more years of formal education. Sun sensitivity (assessed by reported depth of tan after multiple exposures) was associated with both DN risk and melanoma risk after controlling for age and education in logistic regression analysis (P = 0.009 and 0.03, respectively), but for DN risk this association was nonlinear: the relative risks (versus deep tan) were 2.3 for average tanners, 2.8 for light tanners, and 1.6 for those who reported practically no tan. Sun exposure measures were not associated with DN risk after controlling for age and education, whether or not depth of tan was controlled in the analysis. These observations suggest a role for either sunlight or a trait linked with sun sensitivity in the development of dysplastic nevi.

Adult↗
PubMed1991

Contributions of specific foods to absolute intake and between-person variation of nutrient consumption.

Contributions of specific foods and supplements to absolute intake and between-person variance in consumption of 19 macronutrients, vitamins, and minerals were examined using dietary records of all foods consumed over 4 weeks by 194 US nurses aged 34 to 59 years. To measure their contribution to absolute nutrient intake, we ranked foods by the percentage of the population's total nutrient intake that they provided. To assess the degree to which differences in consumption of specific foods explain between-person variability in nutrient intake, we re-ranked the 20 foods contributing most to absolute intake of each nutrient as independent variables in stepwise multiple regression analyses predicting total intake of that nutrient. The increase in percentage of the variance in nutrient intake explained by the addition of a food to the progressively larger list of food items (expressed as the cumulative R2) served as the measure of contribution to variation in intake. Some nutrients had only a few major sources and were assessed relatively well by a small number of foods. For preformed vitamin A without supplements, 10 foods accounted for 82% of the absolute intake and 98% of total variance. The corresponding percentages for absolute intake and total variance, respectively, were 66% and 94% for beta-carotene; 77% and 92% for cholesterol; and 71% and 95% for vitamin C without supplements. In contrast, 20 foods accounted for only 54% of the absolute intake and 73% of the variance for total energy intake; 58% and 89%, respectively, for total carbohydrates; and 59% and 84%, respectively, for potassium.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Diet, plasma levels of beta-carotene and alpha-tocopherol, and risk of malignant melanoma.

Dietary intake and the plasma levels of retinol, alpha-tocopherol, lycopene, alpha-carotene, and beta-carotene for 204 cases with malignant melanoma were compared with those of 248 controls. Cases and controls were patients 18 years of age or older making their first visit to a dermatology subspecialty clinic for pigmented lesions from July 1, 1982 to September 1, 1985. Intakes of nutrients were estimated using a semiquantitative food frequency questionnaire. No significant associations with malignant melanoma were observed for higher plasma levels of lycopene, retinol, or alpha-carotene in logistic regression analyses after controlling for age, sex, plasma lipids, and known constitutional risk factors (hair color and ability to tan). In similar models, the odds ratio comparing the highest with the lowest quintile was 0.9 (95% confidence interval (CI) 0.5-1.5) for plasma beta-carotene, 0.7 (95% CI 0.5-1.3) for plasma alpha-tocopherol, 0.7 (95% CI 0.4-1.2) for carotene intake, and 0.7 (95% CI 0.4-1.3) for total vitamin E intake. A trend toward reduced risk of melanoma was observed for increasing intake of iron (not including supplements); this was related to the more frequent consumption of baked goods, such as cake, among controls. Alcohol consumption was positively associated with risk of melanoma (chi for trend = 2.1, p = 0.03); the odds ratio for consumption of over 10 g/day compared with persons with no alcohol intake was 1.8 (95% CI 1.0-3.3).

Adult↗
PubMed1990

Food predictors of plasma beta-carotene and alpha-tocopherol: validation of a food frequency questionnaire.

Nutrient intakes from a food frequency questionnaire are usually calculated as the product of frequency of intake and nutrient composition of the food, summed over the food items. This involves assumptions about the accuracy of recording, food composition data, stability during storage and preparation, and bioavailability. This usual method of calculation was compared with one using empirical weights derived by multivariate linear regression. Food intakes reported on a food frequency questionnaire by Boston, Massachusetts, area subjects in 1982-1985 were used to predict plasma levels of beta-carotene among 370 male and female nonsmokers and plasma levels of alpha-tocopherol among 339 male and female nonusers of vitamin supplements. Nutrient intake computed using empirical weights yielded a significant correlation with plasma beta-carotene (r = 0.43, p = 0.0001), similar to the correlation using nutrient intake calculated from food composition tables (r = 0.38, p = 0.0001). However, the use of empirical weights significantly improved the correlation of vitamin E intake with plasma alpha-tocopherol levels (r = 0.32, p = 0.0001), compared with the weak correlation obtained using the food composition table method to calculate intake (r = 0.16). The results support the validity of published food composition data used to compute carotenoid intake and illustrate the potential utility of empirically derived weights for foods to predict plasma levels of some nutrients.

Adolescent↗
PubMed1990

Serum sickness in children after antibiotic exposure: estimates of occurrence and morbidity in a health maintenance organization population.

The computerized outpatient records of the Harvard Community Health Plan, a 230,000-member health maintenance organization, were used to determine the frequency with which serum sickness is recognized in the practice setting after exposure to antibiotics. The medical records of 3,487 children who had been prescribed cefaclor or amoxicillin were searched in December 1986 for coded diagnoses of serum sickness and related conditions. Diagnoses were validated by blinded review of dictated and written office notes. There were 12 cases of serum sickness in 11,523 child-years. During this time, these children were prescribed 13,487 courses of amoxicillin, 5,597 courses of trimethoprim-sulfamethoxazole (TMP-SMZ), 3,553 courses of cefaclor, and 2,325 courses of penicillin V. Serum sickness was considered to be antibiotic-related if it occurred within 20 days of initiation of antibiotic therapy. Five cases were temporally associated with cefaclor, one with both amoxicillin and TMP-SMZ, four with TMP-SMZ alone, and one with penicillin V alone. One case was not associated with any antibiotic exposure. All antibiotic-related cases occurred in children under age 6 years who were treated for otitis media or streptococcal pharyngitis, and most cases began 7-11 days after initiation of antibiotic. All but one of the antibiotic-related cases occurred in children who had relatively heavy lifetime antibiotic exposure. The risk of serum sickness was significantly elevated after cefaclor compared with amoxicillin, even among the most heavily exposed children (relative risk = 14.8, p = 0.01, 95% confidence interval 2.0-352.0). Most cases prompted several physician visits, but none required hospitalization.

Adolescent↗
PubMed1988

The relation of diet, cigarette smoking, and alcohol consumption to plasma beta-carotene and alpha-tocopherol levels.

The relation of diet and nutritional supplements, cigarette use, alcohol consumption, and blood lipids to plasma levels of beta-carotene and alpha-tocopherol was studied among 330 men and women aged 18-79 years. Dietary carotene, preformed vitamin A, and vitamin E intake were estimated by a self-administered semiquantitative food frequency questionnaire. The correlation of dietary carotene with plasma beta-carotene was reduced in smokers compared with nonsmokers (r = 0.02 vs. 0.44 among men; r = 0.19 vs. 0.45 among women). Smokers had much lower plasma levels of beta-carotene than did nonsmokers (geometric mean 8.5 vs. 15.3 micrograms/dl for men; 17.3 vs. 26.3 micrograms/dl for women) despite only slightly lower intakes of carotenoids. In multiple regression analyses, men who smoked one pack per day had 72% (95% confidence interval (CI) 58-89) of the plasma beta-carotene levels of nonsmokers after accounting for dietary carotene and other variables; for women, the corresponding percentage was 79% (CI 64-99). In similar models, men drinking 20 g of alcohol per day had 76% (CI 65-88) of the beta-carotene levels of nondrinkers; women had 89% (CI 73-108) of the levels of nondrinkers. An interaction term for carotene intake and smoking was statistically significant in a model combining both sexes. These results suggest that plasma levels of beta-carotene among smokers and, perhaps, heavy consumers of alcohol may be reduced substantially below levels due to differences in diet. The correlation of calorie-adjusted intake of vitamin E with lipid-adjusted plasma levels of vitamin alpha-tocopherol was 0.53 for men (n = 137) and 0.51 for women (n = 193) and did not differ by alcohol consumption and cigarette use; these correlations were largely accounted for by use of vitamin supplements. In linear regression models, vitamin E intake and plasma lipids were significant predictors of plasma alpha-tocopherol levels.

Adolescent↗
PubMed1987

Reference ranges of retinol, tocopherols, lycopene and alpha- and beta-carotene in plasma by simultaneous high-performance liquid chromatographic analysis.

Using a high-performance liquid chromatographic procedure, age- and gender-based reference ranges for plasma retinol, alpha- and gamma-tocopherol, lycopene, and alpha- and beta-carotene have been established. In addition to confirming higher retinol levels in men than in women (p less than 0.001), this study demonstrates significantly higher plasma levels of both carotenes in women than in men (p less than 0.001). The plasma levels of retinol and beta-carotene showed a positive relationship with age after adjusting for plasma lipids (p less than 0.001 and p less than 0.02, respectively). In contrast to beta-carotene, there was no gender difference for plasma lycopene and a strong (p less than 0.001) inverse relationship of lycopene with age. These results suggest that differences may exist between beta-carotene and lycopene in their intestinal absorption, plasma transport, or tissue metabolism.

Adolescent↗
PubMed1986

Outbreak of hepatitis B associated with acupuncture.

In the period February to May 1980, acute hepatitis B occurred in six patients who had received acupuncture at a chiropractic clinic. Of persons attending the clinic (October 1979 to April 1980), hepatitis B occurred more frequently among those who had received acupuncture (6 of 103) than among those who had not (0 of 408; P less than .0001). Hepatitis patients had received acupuncture during two exposure periods: November 27-28, 1979, and February 19-20, 1980. During these periods the clinic reused acupuncture needles after immersing them overnight in a 1:750 solution of benzalkonium chloride. The sequence of acupuncture sessions suggests that hepatitis B virus remained infectious on the acupuncture needles for 20 to 27 hours despite this procedure. It is recommended that only either disposable needles or reuseable needles that have been physically cleaned and autoclaved after each use be used in acupuncture procedures.

Acupuncture Therapy↗
PubMed1982

Foodborne outbreak of group G streptococcal pharyngitis.

An outbreak of pharyngitis associated with beta-hemolytic streptococci of Lancefield group G occurred among persons who had attended a convention that was held June 21-24, 1979, in a Florida hotel. Seventy-two (31 per cent) of 231 interviewed conventioneers were ill. Group G streptococci were isolated from the throats of 10 (63 per cent) of 16 persons with pharyngitis and 1 (2 per cent) of 41 persons without pharyngitis (p less than 10(-5)). Antistreptolysin O titers in convalescent-phase serum samples from persons with pharyngitis were significantly higher than those from age-matched controls. Fifty-seven (51 per cent) of 111 conventioneers who had attended a convention luncheon developed pharyngitis compared with 12 (10 per cent) of 117 persons who did not (p less than 10(-9)). All persons who had attended the luncheon and had become ill had eaten a chicken salad served at the luncheon. Their median incubation period was two days. The cook who had prepared this chicken salad developed pharyngitis after the luncheon and had a throat culture positive for group G streptococci. No instances of rheumatic fever were identified and secondary illness in household contracts was rare. This outbreak indicates that group G streptococci can cause outbreaks of pharyngitis similar to those caused by group A streptococci and suggests that penicillin therapy and prophylaxis may not be needed.

Animals↗