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Biomedical subjects

G M Buck

Publications and source records attributed to G M Buck.

At least 37 records · Page 2Linked to original sources
PubMed1993

Predictors of mortality, morbidity, and disability in a cohort of infants < or = 28 weeks' gestation.

This study attempted to identify predictors for mortality, morbidity, disability, and educational handicap at age 4 years in a cohort of 194 infants born at 23 to 28 weeks' gestation at one regionalized tertiary center from 1983 to 1986. Forty-one infants died (21%); standardized neurodevelopmental and functional assessments were conducted on 149 of 153 (97%) survivors at a mean age of 52 months. Five significant predictors of death were identified with logistic regression analysis: gestational age 23 to 26 weeks, intraventricular hemorrhage grades 3 or 4, male gender, five-minute Apgar < or = 3, and absence of prophylactic calf lung surfactant extract. Significant predictors of neurodevelopmental morbidity included sepsis, male gender, and nonwhite race. Significant predictors of disability at age four included neurodevelopmental impairment and severe retinopathy of prematurity. Low socioeconomic status, nonwhite race and male gender were predictive of educational handicap. These findings suggest that outcomes may have distinct pathophysiologies. The role of biomedical events appears strongest for death.

Child, Preschool↗
PubMed1993

Assessment of the impact of female circumcision on the gynecological, genitourinary and obstetrical health problems of women from Somalia: literature review and case series.

Approximately 80 million women worldwide have undergone surgery for circumcision. A variety of health risks resulting from the procedure have been reported in the literature including: bleeding, infection, shock, difficulties with menstruation and urination as well as painful intercourse. Prolonged labor and perinatal difficulties have also been noted. After an extensive literature review, a description of gynecological and obstetrical complications is provided. We had the opportunity to survey 12 Somali refugee women who were temporarily residing in a refugee center in Western New York about their personal experience with circumcision. We were interested in determining whether this convenient sample of women substantiated the clinical sequelae of circumcision reported in the literature. Structured interviews were conducted and included questions on sociodemographic, circumcision and health factors. Our findings, however limited, support the presence of heavy bleeding at the time of the surgery as a complication arising from circumcision.

Adolescent↗
PubMed1992

Kindergarten readiness after extreme prematurity.

OBJECTIVE: To assess kindergarten readiness among survivors of extreme prematurity and to identify predictors of special education requirements. DESIGN: Historic cohort design. SETTING: Regionalized tertiary pediatric center. PARTICIPANTS: One hundred forty-nine (97%) of 153 children who were alive at follow-up (mean +/- SD age, 52.7 +/- 9.9 months). SELECTION PROCEDURES: Study cohort included infants (gestation, 23 to 28 weeks), born between 1983 and 1986 (N = 194), who were alive at follow-up (N = 153, 79% survival). INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Standardized neurodevelopmental and psychometric evaluations were administered by a multidisciplinary team that was blinded to the neonatal course. Thirty-one children (21%) had major neurodevelopmental impairments. By using the McCarthy Scales of Children's Abilities for children free of major impairments, 61 (63%) had one or more minor neurodevelopmental impairments noted. Half of the surviving children were thought to require special education resources at kindergarten entry. Multivariate logistic regression identified three significant predictors of special education: low socio-economic status, nonwhite race, and male gender. CONCLUSIONS: Social and demographic variables were associated with minor neurodevelopmental impairments and special education requirements among extremely premature children. Continued developmental follow-up and targeted interventions to reduce the risk of educational underachievement appear to be warranted.

Child, Preschool↗
PubMed1991

Labor and delivery events and risk of sudden infant death syndrome (SIDS)

The purpose of this study was to assess whether labor and delivery events were risk factors for sudden infant death syndrome (SIDS). A nested case-control design was used. From the 1974 cohort of live births for Upstate New York (exclusive of New York City), resident mothers (n = 132,948), SIDS cases, and living controls were selected. Data were abstracted from hospital delivery and vital records for 148 autopsied cases and 355 frequency-matched controls. With the use of unconditional logistic regression, no increase in SIDS risk was observed for artificial rupture of membranes, medication use during labor, induction/augmentation of labor, or anesthesia for delivery. An increased risk of SIDS was observed for labor 16 hours or more (odds ratio (OR) = 2.6, 95% confidence interval (CI) 1.1-6.5) and vaginal breech delivery (OR = 7.2, 95% CI 0.7-72.2). Significant inverse trends were observed for Apgar scores and risk of SIDS.

Anesthesia, Obstetrical↗
PubMed1991

Risk factors for major neurodevelopmental impairments and need for special education resources in extremely premature infants.

The purpose of this cohort study was to determine the incidence of and risk factors for major neurodevelopmental impairments among survivors of extreme prematurity. The study cohort comprised 100 infants born between 24 and 28 weeks of gestational age at one tertiary center from 1983 to 1984. Twenty-five infants (25%) died; 75 (75%) survived until follow-up (mean, 60 months). Standardized neurodevelopmental and psychometric assessments were performed in blind fashion on 68 of the 75 surviving children (91% follow-up). Informal assessments (parent, teacher, and physician reports) were obtained instead for seven (9%) children who had relocated outside of the area. Overall, 19 children (25%) had one or more major impairments: mental retardation, 9; cerebral palsy, 4; multiple impairments, 5; and blindness, 1. Despite a high prevalence of impairments, 95% of children (n = 71) were functionally independent [corrected]. Special educational resources were definitely necessary for seven (9%) and possibly needed for 36 (48%) additional children. Univariate analyses revealed four significant risk factors for cerebral palsy: hydrocephalus (relative risk = 12.2), grades III and IV intraventricular hemorrhage (relative risk = 5.8), 5-minute Apgar score lower than 7 (relative risk = 5.7), and bronchopulmonary dysplasia (relative risk = 5.5). Hydrocephalus was the only significant risk factor observed for mental retardation (relative risk = 5.4). Risk factors predicting a need for special education resources included sepsis (relative risk = 24.9), low socioeconomic status (relative risk = 16.3), and nonwhite race (relative risk = 3.0). Thus our data suggest that biomedical factors appear to confer the greatest risk of major impairments; sociodemographic factors appear to have a significant impact on educational risk in extremely premature infants who do not die. Continued follow-up with biomedical and developmental-social interventions appears warranted to decrease the risk of educational underachievement in this population.

Birth Weight↗
PubMed1990

Timing of prenatal care and risk of sudden infant death syndrome.

Sudden infant death syndrome (SIDS) is the leading cause of death during post-neonatal life. Mothers whose infants succumb to SIDS are reported to initiate prenatal care later than control mothers. Previous studies have not always controlled for socioeconomic status (SES) of mothers or other potential confounders such as gestational age or birthweight of infants. The purpose of this study was to assess whether timing of prenatal care adjusted for these potential confounders was an independent risk factor for SIDS. SIDS cases (N = 148) were identified from the Upstate New York livebirth cohort for 1974 (N = 132,948) and compared to randomly selected controls (N = 355) who were frequency-matched on maternal age, race, parity and residence and infant's birth date. Data were abstracted from matched vital certificates (97% response), hospital delivery records (89% response) and selected sample of autopsy reports (100% response). Odds ratios (OR) and 95% confidence intervals (CI) were obtained using unconditional logistic regression. A significant inverse relationship was observed for number of prenatal visits and risk of SIDS; a significant direct relationship was observed between trimester prenatal care initiated and risk of SIDS. The results suggest that timing of prenatal care is important in assessing SIDS risk even after adjusting for potential confounders of early prenatal care utilization.

Case-Control Studies↗
PubMed1990

Müllerianosis.

We suggest that müllerianosis is a distinct form of endometriosis, separate in its pathogenesis from transplantation endometriosis of lymphatic, hematogenous, transtubal, or iatrogenic origin, and also distinct from endometriosis of coelomic metaplasia.

Endometriosis↗
PubMed1989

Intrauterine growth retardation and risk of sudden infant death syndrome (SIDS)

The purpose of this study was to assess whether intrauterine growth retardation was associated with an increased risk of sudden infant death syndrome (SIDS). A total of 148 SIDS cases were identified from the Upstate New York (exclusive of New York City) live birth cohort for 1974 (n = 132,948). Dead controls represented all other sudden deaths (n = 114). Live controls were randomly selected and matched to cases on mother's age, race, parity, and residence and infant's birth date (n = 355). Data were collected from vital certificates (response, 97%), medical records (89%), and autopsy reports (100%). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with the use of logistic regression techniques to control for confounding. With live controls, significant risks were observed for gestations less than 37 weeks (OR = 2.2, CI 1.2-4.1), birth weights less than 2,500 g (OR = 2.5, CI 1.3-5.0) and birth lengths less than or equal to 47.0 cm (OR = 3.4, CI 1.8-6.4). Birth length less than or equal to 47.0 cm was the only significant risk factor observed when dead controls were used (OR = 2.9, CI 1.3-6.8). Risk decreased with increasing gestation and birth size. Postterm infants (greater than or equal to 42 weeks) were at lowest risk (live controls OR = 0.9, CI 0.5-1.6; dead controls OR = 0.6, CI 0.3-1.1). When gestational age was controlled for, SIDS infants were found to have reductions in both weight and length; this suggests that responsible mechanisms begin early in pregnancy.

Biometry↗
PubMed1989

Assessment of in utero hypoxia and risk of sudden infant death syndrome.

Few data are available on the role of hypoxia in sudden infant death syndrome (SIDS). The purpose of this study was to assess whether 10 antenatal factors consistent with in utero hypoxia were associated with an increased risk of SIDS. Cases and two sets of controls were chosen from the Upstate New York Live Birth Cohort for 1974 (n = 132,948). One hundred and forty-eight SIDS cases were identified, along with 114 dead controls made up of all other sudden deaths. Randomly selected live controls were frequency-matched to cases on mother's age, race, residence, parity, and infant's birthdate (n = 355). Data were collected from vital certificates (97% response), hospital delivery records (89%), and autopsy reports (100%). Odds ratios and 95% confidence intervals were calculated using Mantel-Haenszel techniques and logistic regression. Abnormal uterine bleeding was the only statistically significant (P less than 0.05) risk factor observed when dead controls were used (OR = 5.4). When live controls were used, statistically significant increases in risk were found for: placenta praevia (OR = 21.8), abruptio placentae (OR = 3.7), multiple birth (OR = 29.6), pregnancy interval less than or equal to 12 months (OR = 3.8), sexually transmitted disease (OR = 6.4), and eclampsia (OR = 17.7). These results lend support to a possible hypoxic aetiology of SIDS; however, differences by control group suggest that some factors are not specific to SIDS alone but may be risk factors for infant mortality in general.

Abruptio Placentae↗
PubMed1989

Sinus disease and surgical treatment: a results oriented quality assurance study.

The efficacy of sinus surgery continues to be an issue of debate among otolaryngologists. In an attempt to address this controversy, a case-series study design was used to assess the perceived efficacy of sinus surgery in terms of the alleviation of sinus symptoms and overall health benefit. Self-administered questionnaires were mailed to 142 individuals who had sinus surgery performed between January 1984, and December 1985. After one follow-up attempt, 114 questionnaires were completed and returned (80% response). Overall, a high percentage of cases reported postoperative improvement in breathing difficulties (90%), nasal congestion (88%), headache/facial pain (85%), recurrent sinus infections (83%), and postnasal drip (80%). In addition, 88% of cases reported the surgery to be of some overall health benefit. These results suggest that sinus surgery, as perceived by surgically treated individuals, may be effective in the management of chronic sinus disease.

Chronic Disease↗
PubMed1987

The influence of secular effects and gravidity on the rate of ectopic pregnancy in a Norwegian population.

In order to assess the influence of secular effects and gravidity on the incidence rate of ectopic pregnancy, information from reproductive history questionnaires was obtained for 7804 gravid females identified through the Norwegian Twin Panel. The overall ectopic pregnancy incidence rate was 5.6 per 1000 estimated conceptions, with rates increasing for women born after 1950. Women experiencing their first pregnancy were at lowest risk for that pregnancy being ectopic. When women were stratified by whether they were born before or after 1950, gravidity still had an effect on the incidence rate of ectopic pregnancy. Conversely, year of birth was influential when stratifying by gravidity. The results obtained here suggest that the recent increase in the incidence of ectopic pregnancy is unrelated to the number of prior pregnancies.

Diseases in Twins↗
PubMed1986

Parental preferences regarding sex education topics for sixth graders.

The purpose of this study was to ascertain which sex education topics parents of preadolescents regarded as appropriate for their children. The sample was comprised of 146 respondents randomly selected from a class list of sixth graders in a suburban school district. A mailed, self-administered questionnaire listing 48 possible topics was used to elicit parental response. Pretesting found the questionnaire to be highly reliable (Cronbach's alpha = .95). Overall, parents strongly supported the inclusion of a broad range of sex education topics regardless of parental age, sex, marital status, income, education, or child's sex. Moreover, parents were largely in agreement with the inclusion of sensitive topics in addition to those which were more physiological or behavioral. Catholics more often than Protestants agreed with the inclusion of birth control, abortion, and sterilization even after controlling for income and education. Thus, the findings suggest that parents of sixth graders find a broad sex education program in the school appropriate. To this end, school officials and sex educators should not overlook the needs of preadolescents for sex education solely on the basis of perceived parental opposition.

Adolescent↗
PubMed1968

Preparation of isolated multiple forms of rabbit brain aldolase.

1. A method is described for partial purification of the total aldolase of rabbit brain by ammonium sulphate precipitation followed by fractionation of the aldolase into five electrophoretically distinct forms. 2. The method allows a laboratory-scale preparation of the five aldolases. 3. With the exception of band 3 the fructose 1,6-diphosphate/fructose 1-phosphate activity ratios of the isolated multiple forms show a continuous increase from isoenzyme 1 to isoenzyme 5; this evidence supports the four-sub-unit model.

Animals↗
PubMedDate not supplied

Infecundity and consumption of polychlorinated biphenyl-contaminated fish.

Biologic capacity for reproduction, or fecundity, may be threatened by environmental contaminants, especially compounds capable of disrupting endocrine pathways. Telephone interviews that focused on reproductive events were conducted with female members of the New York State Angler Cohort Study who became pregnant between 1991 and 1993 and who reported known time to pregnancy (N = 895; 73%). Consumption of polychlorinated biphenyl-contaminated Lake Ontario sportfish and other factors were ascertained in 1991. The authors classified the women as follows: (a) fecund (time to pregnancy < or =12 cycles; n = 723); (b) having resolved infecundity (time to pregnancy > 12 cycles; n = 81); or (c) having unresolved infecundity (time to pregnancy > 12 cycles without pregnancy; n = 94). Adjusted odds ratios for duration of fish consumption for both resolved and unresolved infecundity were elevated (1.46 and 1.19, respectively), although confidence intervals included unity. Frequency of recent fish consumption was associated with an increased risk for select categories, although confidence intervals included one.

Adolescent↗
PubMedDate not supplied

Comparison of information processing technologies.

OBJECTIVE: To examine the type of information obtainable from scientific papers, using three different methods for the extraction, organization, and preparation of literature reviews. DESIGN: A set of three review papers was identified, and the ideas represented by the authors of those papers were extracted. The 161 articles referenced in those three reviews were then analyzed using 1) a formalized data extraction approach, which uses a protocol-driven manual process to extract the variables, values, and statistical significance of the stated relationships; and 2) a computerized approach known as "Idea Analysis," which uses the abstracts of the original articles and processes them through a computer software program that reads the abstracts and organizes the ideas presented by the authors. The results were then compared. The literature focused on the human papillomavirus and its relationship to cervical cancer. RESULTS: Idea Analysis was able to identify 68.9 percent of the ideas considered by the authors of the three review papers to be of importance in describing the association between human papillomavirus and cervical cancer. The formalized data extraction identified 27 percent of the authors' ideas. The combination of the two approaches identified 74.3 percent of the ideas considered important in the relationship between human papillomavirus and cervical cancer, as reported by the authors of the three review articles. CONCLUSION: This research demonstrated that both a technically derived and a computer derived collection, categorization, and summarization of original articles and abstracts could provide a reliable, valid, and reproducible source of ideas duplicating, to a major degree, the ideas presented by subject specialists in review articles. As such, these tools may be useful to experts preparing literature reviews by eliminating many of the clerical-mechanical features associated with present-day scientific text processing.

Bibliometrics↗