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Biomedical subjects

B Blair

Publications and source records attributed to B Blair.

22 records · Page 2Linked to original sources
PubMedDate not supplied

Clinical predictors of treatment reduction in hypertensive patients.

OBJECTIVE: To demonstrate that some hypertensive patients under good blood pressure (BP) control can reduce medications, and to identify predictors of successful reduction. DESIGN: Observational study with 11-month follow-up. SETTING: Outpatient hypertension clinic at the Seattle Veterans Administration Hospital. PATIENTS: 59 males (51% of those eligible) with diastolic BP less than 95 mm Hg for greater than or equal to 6 months; 57 patients (97%) completed the study. INTERVENTION: Gradual reduction of medications unless diastolic BP rose above 95 mm Hg. MEASUREMENTS AND MAIN RESULTS: Intensity of treatment with BP medications was assessed using a scale of their comparative "vigors." 35 patients (59%) reduced medications successfully. By the end of the study, systolic BP had risen by 8.2 +/- 12.3 mm Hg (mean +/- SD) in successful patients, while diastolic BP did not change significantly. Two predictors of treatment reduction were statistically significant in both univariate and multivariate analyses: successful patients had been treated more intensively (2.7 +/- 1.7 vs. 1.3 +/- 0.5 "vigor units," p = 0.0001), and they had been enrolled in the clinic longer (5.5 +/- 3.0 vs. 3.1 +/- 2.3 years, p = 0.003). Lower systolic BP, higher urinary sodium excretion, lower compliance, and younger age were significant predictors of treatment reduction on univariate analysis only. Age less than or equal to 65 years had the highest sensitivity (86%) for treatment reduction, while treatment with two or more "vigor units" had the highest specificity (79%) and likelihood ratio (3.3). CONCLUSIONS: Treatment reduction is feasible in many well-controlled hypertensives, though systolic BP rises. Patients with high intensity and long duration of treatment are most likely to reduce medications successfully.

Antihypertensive Agents↗
PubMedDate not supplied

The influence of acromioclavicular joint morphology on rotator cuff tears.

A detailed anatomic study of 123 shoulders was performed to define the location of the acromioclavicular (AC) joint within the supraspinatus outlet and to determine the correlation of AC joint morphologic characteristics with the presence of full-thickness rotator cuff tears (RCTs). The presence, location, and extent of RCTs were first documented for each shoulder, and 2 anatomic landmarks consisting of the anterolateral acromial corner and the inferior midpoint of the AC joint were identified and their positions digitized in 3 dimensions to calculate outlet space and clearance and AC joint locations. High resolution x-ray films were then obtained to determine the extent of degenerative changes including the location and size of inferior osteophytes and joint space. These specimens were cleaned of all soft tissues, and additional measurements were made. All data were entered into a computerized database and analyzed with respect to age, sex, and the presence of RCT. Comparison of age-matched RCT versus non-RCT groups revealed no significant differences in the position of the AC joint within the supraspinatus outlet. When AC joint morphologic characteristics were compared with those of a nontear, age-matched group, no significant differences with regard to joint space narrowing were found, but significantly larger and greater number of osteophytes were identified on both sides of the joint in the RCT group. In conclusion, the position of the AC joint is fairly constant within the supraspinatus outlet and does not appear to predispose to RCTs. The morphology of the AC joint contribution of the tears seems to be acquired in nature rather than inherent in its location within the outlet.

Acromioclavicular Joint↗
PubMedDate not supplied

The New Stories/New Cultures after-school enrichment program: a direct cultural intervention.

This article describes the organization, curriculum, and outcomes for New Stories/New Cultures, an activity-based program for after-school enrichment in five schools in the low-income neighborhood near a major American university. The program encourages students (70% Hispanic-American, 30% African-American) to experience themselves as producers of culture, not just as consumers. Its methods include (a) creative team use of video equipment and other expressive media and (b) lessons about media literacy (i.e., making critical choices about images and activities depicted in popular culture and commercials). Outcome measures with the cohort of fifth and sixth graders support the programs occupation-based philosophy. They show that students are more likely to experience themselves as building skills when engaged in activities that are both challenging and enjoyable. The students reported greatest engagement and enjoyment in activities that were creative, team-based, and involving media production. These same activities were correlated with increased self-esteem. The term direct cultural intervention is used to describe the application of occupational principles and critical perspectives to provide a population with conceptual tools and skills for interpreting and successfully navigating the social world.

Black or African American↗