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Biomedical subjects

G A Grell

Publications and source records attributed to G A Grell.

At least 19 recordsLinked to original sources

Social factors mediating social class differences in blood pressure in a Jamaican community.

Research on the factors mediating social class differences in blood pressure was carried out in a Jamaican community. It was found in a previous report that higher social class is related to lower blood pressure for females, while for males higher social class is related to higher blood pressure. These differences are examined in greater detail here, especially in terms of the historical context of the specific community studied, which is on the fringe of the Kingston urban area, and in terms of the continuing importance of a social class system established under colonial rule. In the current study it is shown that social class differences in blood pressure for males are mediated by perceptions of social support. Social class differences in blood pressure for females are mediated by perceptions of economic stress. It is suggested that specific patterns of the growth of the city, and the historically-based social class system, have resulted in the juxtaposition of lower and middle class Jamaicans within this community, who in turn are influenced by different factors affecting blood pressure.

Adult

Comparative research in social epidemiology: measurement issues.

The aim of comparative research in social epidemiology is to determine how risk factors for disease may vary within and between sociocultural and ethnic groups and in relation to outcomes. This aim assumes that measurement equivalence within and between social groups can be established, an assumption usually left untested. A model is presented here for deriving cross-culturally valid measures that are also intraculturally sensitive. Measurements so derived can then be used to compare cross-cultural and intracultural effects in a single analytic model. This approach is illustrated by pooling data on social stressors, social supports, and blood pressure from three studies.

Adult

Persistence of high leucocyte sodium and blood pressure after pre-eclampsia.

Blood pressure and leucocyte sodium content were measured in black Jamaican patients with pre-eclampsia and pregnant controls. Similar measurements were made in a group of mothers who had pre-eclampsia 36-38 weeks previously and their controls. An increase in cell sodium accompanied the high blood pressure in patients with pre-eclampsia. There was also some elevation of both blood pressure and cell sodium in patients who had had pre-eclampsia 36-38 weeks previously. These findings suggest that disturbances of cellular electrolytes continue into the post-partum period. Changes in intracellular sodium may be important in the pathogenesis of pre-eclampsia as they parallel the increase in blood pressure levels.

Adolescent

Neuropsychiatric manifestations of typhoid fever.

Neuropsychiatric manifestations of typhoid fever are not uncommon, occurring in 18 of 40 consecutive patients at the University Hospital of the West Indies. The clinical presentation ranges from a confusional state to hallucinations or meningism, and the diagnosis may be missed or unduly delayed unless there is a strong index of suspicion.

Adolescent

Success of didactic gastroenterology teaching for postgraduate medical residents.

Although the Doctor of Medicine programme in Internal Medicine at the U.W.I. is a structured course with several teaching formats, the optimally effective form of teaching remains unknown. An experimental didactic teaching course in Gastroenterology was preceded and followed by an examination. This was conducted to determine the effectiveness of this form of teaching. The majority of residents ranked the course favourably. The mean examination score increased by 6.4%, from 25.4% before the course to 31.8% at the end. Although the more senior residents scored higher than their juniors in the pre-test, this difference disappeared in the post-test. Structured didactic teaching requires close supervision, active participation by trainee and reinforcement for the full benefit to be attained.

Clinical Competence

Blood pressure and social class in a Jamaican community.

A study of social factors and blood pressure was conducted in a Jamaican community among a sample of 199 persons ages 30 to 50. After controlling for obesity, age, and respondent tension (and other covariates), interaction effects of social class x sex for systolic and diastolic blood pressure were found. Blood pressure increased with increasing social class for males and decreased with increasing social class for females.

Adult

Comparison of the effectiveness of a beta blocker (atenolol) and a diuretic (chlorthalidone) in black hypertensive patients.

A double-blind crossover trial of atenolol and chlorthalidone was done in black Jamaican hypertensive patients. After an initial four weeks of single drug therapy, the beta blocker and thiazide diuretic were used in combination. Chlorthalidone at a daily dose of 25 mg produced a significant (P less than .05) fall in the mean systolic and diastolic pressures (19.4 mm Hg and 12.2 mm Hg, respectively); atenolol produced a significant fall in the diastolic blood pressure (6.5 mm Hg); and combination therapy produced a reduction in systolic and diastolic blood pressures (27.8 mm Hg and 17.8 mm Hg, respectively). The study showed that combination therapy using a low dose of thiazide diuretic and a beta blocker was synergetic, but that a thiazide was more effective than a beta blocker in lowering the blood pressure in black hypertensive patients.

Adult

The elderly.

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