Search PubMed⌕ Search

Biomedical subjects

J A Morrison

Publications and source records attributed to J A Morrison.

At least 55 records · Page 3Linked to original sources

A simple technique for insertion of distal screws into interlocking nails.

Placement of distal interlocking screws into femoral and tibial nails is an exacting technique. Many techniques are described, each with their advantages and disadvantages. We describe an alternative technique using the "third point in space." This method has been successfully used in > 30 cases. It is universal, reproducible, and inexpensive, avoiding the use of distal targeting guides, expensive radiolucent drills, or visual estimations of alignment.

Biometry↗

Techniques for the removal of broken small-diameter tibial nails: a report of two cases.

The availability of small-diameter interlocking nails for unreamed applications has expanded the indications for intramedullary nailing of open tibial shaft fractures. Smaller diameter nails that are inserted without reaming are mechanically weaker than the larger-diameter nails that are inserted after intramedullary reaming. Potentially, nails with a smaller diameter will fail at a higher rate, creating unique difficulties associated with their removal. This article presents two cases that illustrate solutions to those problems.

Adult↗

Correlates of high-density lipoprotein cholesterol in Black girls and White girls: the NHLBI Growth and Health Study.

To determine the correlates of serum high-density lipoprotein cholesterol (HDL-C) in 9- and 10-year-old girls, data were examined from 624 Black girls and 773 White girls. Black girls had, on average, 3.6 mg/dL higher levels than White girls. Each 10-mm increase in sum of skinfolds was associated with a decrease of 1.4 mg/dL; each unit increase in the tricep/suprailiac skinfold ratio was associated with an increase of 2 mg/dL; and each 10% increase in polyunsaturated fat intake was associated with an increase of 3.4 mg/dL. The associations of sedentary activity and sexual maturation with HDL were mediated by differences in adiposity. Interventions to decrease adiposity may be important for the primary prevention of heart disease in women.

Black People↗

Acne vulgaris in premenarchal girls. An early sign of puberty associated with rising levels of dehydroepiandrosterone.

BACKGROUND: This study examined the relationships of pubertal maturation and sex steroid hormones to the development of acne in young girls. Black (n = 317) and white (n = 306) premenarchal girls with a mean age of 9.97 +/- 0.62 years were evaluated for acne prevalence and severity, pubic hair and areolar maturation, and sex steroid hormone levels. RESULTS: Overall, 77.8% of the girls had some acne; of the whole group, 48.3% had only comedonal acne, 2.2% had only inflammatory acne, and 27.3% had both types. Although black girls matured at an earlier age than white girls, racial differences in acne were minimal when adjusted for pubertal maturation. Acne increased with advancing maturation; at Tanner pubic hair stages 1, 2, and 3, the prevalence of acne rose from 73.1% to 84.0% and to 90.6%, respectively. Acne lesion counts at seven facial locations revealed a predominance of midfacial acne on the middle aspect of the forehead, nose, and chin. Sex steroid hormone levels measured in 365 of the girls were found to increase significantly during maturation from prepuberty to early puberty. Testosterone-estrogen-binding globulin and the ratio of testosterone to estradiol decreased. In 118 prepubertal girls, estradiol, total and free testosterone, progesterone, testosterone to estradiol ratio, and testosterone-estrogen-binding globulin levels were no different whether in subjects with acne or without acne. However, the level of dehydroepiandrosterone sulfate, an androgen of adrenal origin, was significantly higher in prepubertal girls with acne. CONCLUSION: Acne, especially the comedonal type, can be the first sign of pubertal maturation in girls, even preceding pubic hair and areolar development. Concentration of dehydroepiandrosterone sulfate is significantly and specifically associated with the initiation of acne in young girls.

Acne Vulgaris↗

Indexes of obesity and comparisons with previous national survey data in 9- and 10-year-old black and white girls: the National Heart, Lung, and Blood Institute Growth and Health Study.

OBJECTIVE: To (1) describe anthropometric and body-size measurements in the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS) population at baseline and (2) examine potential secular trends in the prevalence of obesity in young black and white girls by comparing NGHS baseline data with those of the two National Health and Nutrition Examination Surveys (NHANES I and II) (measured before the NGHS). DESIGN: Cross-sectional analysis of cohort baseline data. SETTING: Recruitment in selected schools (Cincinnati and Berkeley) and among the membership of a group health association (Westat). PATIENTS: Enrolled 2379 girls, 9 and 10 years of age, including 1213 black and 1166 white. MEASUREMENTS: Anthropometric measures, including height, weight, and triceps and subscapular skin folds. Body mass index was used as a measure of body size. Nine- and ten-year-old black girls were taller, heavier, and had larger skin folds than white girls. Compared with age-similar girls in the 1970s, girls in the present study are taller and heavier and have thicker skin folds. The differences in body size were most notable among black girls. CONCLUSIONS: Black girls have a greater body mass than white girls even as young as 9 and 10 years of age. The prevalence of obesity appears to be increasing among young girls, especially in black girls. This progression, if not altered, could lead to increased disease in the future for adult women, particularly black women.

Black People↗

Sexual maturation and obesity in 9- and 10-year-old black and white girls: the National Heart, Lung, and Blood Institute Growth and Health Study.

OBJECTIVE: To assess the relationship between pubertal maturation and obesity in 9- and 10-year-old black and white girls. METHOD: Cross-sectional analysis of cohort baseline data. SUBJECTS: A cohort of 2379 girls recruited from selected schools in Richmond, Calif., and greater Cincinnati, Ohio, and from the membership rolls of a prepaid group practice in greater Washington, D.C. RESULTS: Sixty-four percent of black girls had begun pubertal maturation compared with 33% of white girls. In prepubertal girls, racial differences in height, weight, body mass index (kilograms per square meter) and skin-fold thickness were not significant. Within each race, onset of pubertal maturation was associated with greater height, weight, body mass index, and skin-fold measurements. Within 9-year-old girls who had begun pubertal maturation but not reached menarche, black girls were taller and heavier than white girls. Among pubertal but premenarcheal 10-year-old subjects, black girls were taller and heavier and had greater body mass index and subscapular skin-fold values. After analyses were adjusted for pubertal maturation stage by means of pubic hair development, 10-year-old pubertal black girls remained taller and heavier, but racial differences in body mass index and the sum of skin-fold measurements ceased to be significant. CONCLUSIONS: These findings suggest that the initiation of racial differences in obesity are related, at least temporally, to pubertal maturation.

Black People↗

Mother-daughter correlations of obesity and cardiovascular disease risk factors in black and white households: the NHLBI Growth and Health Study.

OBJECTIVES: This study sought to evaluate obesity as a potential explanatory factor for the increased relative risk for cardiovascular disease in Black compared with White women. METHODS: Familial associations for obesity and cardiovascular disease risk factors were assessed in 720 White and 580 Black mother-daughter pairs from the National Heart, Lung, and Blood Institute's Growth and Health Study by using Pearson's chi square, Spearman's correlations, and partial correlations. RESULTS: Black girls and mothers were significantly heavier and had higher body mass indices than their White counterparts. In each racial group, significant, positive mother-daughter correlations existed for weight, body mass index, and triceps skinfolds, and for all cardiovascular disease risk factors. Obesity measures correlated positively with systolic blood pressure and triglycerides and inversely with high-density lipoprotein cholesterol in girls and mothers of both races. Correlations between mothers and daughters for exercise and ideal body shape were weak and did not explain obesity associations. CONCLUSIONS: Intrafamilial associations of obesity, cardiovascular disease risk factors, and the obesity-cardiovascular disease risk factor relationship support the position that increased cardiovascular disease morbidity and mortality rates in Black women may be linked to excess obesity in Black women compared with White ones.

Black or African American↗

Hypocholesterolemia, hypertriglyceridemia, suicide, and suicide ideation in children hospitalized for psychiatric diseases.

To assess relationships of total plasma cholesterol (TC) and triglyceride (TG) values to suicide, suicide ideation, and hospitalization for psychiatric disease, we studied 220 children, ages 5 to 18 y, hospitalized with affective, adjustment, disruptive, anxiety, schizophrenic, other, and organic psychiatric disorders. The 135 male and 85 female patients had higher TG values (p = 0.0001 and 0.0003, respectively) and higher Quetelet Indices (p = 0.0001 and 0.003, respectively) than the 732 male and 316 female schoolchild controls; male patients had higher TC values than male controls (p = 0.014). Substance abuse in patients was an independent inverse determinant of TC value (p = 0.05); TG value correlated positively with alcohol use (p < or = 0.1) and substance abuse (p < 0.05). After covariance adjustment for age, race, sex, and Quetelet, children having adjustment disorders with depression had much lower covariance-adjusted TC value than control schoolchildren (3.91 versus 4.29 mmol/L, p = 0.003), whereas those with disruptive behavior with oppositional defiant disorder had much higher adjusted TC value (5.09 mmol/L, p = 0.0001). After covariance adjusting for age, race, sex, Quetelet, cigarette smoking, alcohol use, and substance abuse, children having adjustment disorders with concomitant depression had the highest group suicide tendencies (attempts and ideation) and the lowest covariance-adjusted TC value (4.03 mmol/L). Conversely, children having disruptive behavior with attention deficit hyperactivity disorder or disruptive behavior with oppoistional defiant disorder had 50% lower suicide index than those with adjustment disorders with concomitant depression and higher adjusted TC levels (4.45 and 5.12 mmol/L, p = 0.0003).(ABSTRACT TRUNCATED AT 250 WORDS)

Adjustment Disorders↗

Screening elderly populations for cobalamin (vitamin B12) deficiency using the urinary methylmalonic acid assay by gas chromatography mass spectrometry.

PURPOSE: This study assesses the value of the urinary methylmalonic acid (MMA) assay by gas chromatography mass spectrometry as a screening procedure for detection of cobalamin (Cbl) deficiency and estimates the prevalence of undetected Cbl deficiency in elderly populations. SUBJECTS AND METHODS: A total of 809 elderly individuals over age 65 were screened using random spot urine specimens from 4 different sites: a health fair, retirement apartments, a hospital-based elderly assessment center, and a nursing home. Follow-up tests included serum total Cbl, serum MMA, and normalization of urinary and serum MMA levels with Cbl intramuscular (IM) therapy. RESULTS: The prevalence of elevated urinary MMA varied across population groups, from 3.0% in elderly visiting a health fair to 5.1% in elderly residing in retirement apartments. Follow-up on 35 of 36 subjects with elevated urinary MMA levels showed that 18 had low serum total Cbl (less than 180 pg/mL at Hospital 1 or less than 200 pg/mL at Hospital 2), 12 had low-normal Cbl (180 or 200 pg/mL to 350 pg/mL), and 5 had normal Cbl. Of the 12 subjects with low-normal Cbl on retesting, further assessment was performed in 7, and all 7 of these subjects had evidence of Cbl deficiency. Cbl IM therapy was initiated for 23 subjects; 16 were seen for follow-up and all had normal urinary MMA. CONCLUSION: The relatively high prevalence of undetected Cbl deficiency identified in the seniors warrants additional studies of elderly populations. The sensitivity, convenience, and noninvasive nature of the urinary MMA assay by gas chromatography mass spectrometry make it a practical screening test.

Aged↗

Laparoscopic inguinal herniorrhaphy.

Between September 1991 and April 1992, 30 patients were admitted for repair of an inguinal hernia. Four elderly patients were excluded because of other medical conditions. Of the remaining 26 patients laparoscopic hernia repair was carried out successfully in 24; the procedure was abandoned in 2 because of dense adhesions in the pelvis from inflammatory disease. Nineteen of the 24 patients were discharged within 24 hours of operation; the other 5 were treated as outpatients. All patients returned to their normal employment within 7 days of operation. There were no wound infections and no evidence of recurrence at follow-up of up to 10 months. The authors believe that laparoscopic repair may usher in a new era of hernia management.

Adolescent↗

Articulation testing versus conversational speech sampling.

Detailed speech analyses were performed on data from 61 speech-delayed children assessed by both a standard articulation test and a conversational speech sample. Statistically significant differences between the articulation accuracy profiles obtained from the two sampling modes were observed at all linguistic levels examined, including overall accuracy, phonological processes, individual phonemes, manner features, error-type, word position, and allophones. Established sounds were often produced more accurately in conversational speech, whereas emerging sounds were often produced more accurately in response to articulation test stimuli. Error patterns involving word-to-word transitions were available only in the context of continuous speech. A pass-fail analysis indicated that the average subject would receive similar clinical decisions from articulation testing and conversational speech sampling on an average of 71% of consonant sounds. Analyses of demographic, language, and speech variables did not yield any subject characteristics that were significantly associated with concordance rates in the two sampling modes. Discussion considers sources of variance for differences between sampling modes, including processes associated with both the speaker and the transcriber. In comparison to the validity of conversational speech samples for integrated speech, language, and prosodic analyses, articulation tests appear to yield neither typical nor optimal measures of speech performance.

Child↗

Acne vulgaris in early adolescent boys. Correlations with pubertal maturation and age.

To assess the prevalence and severity of acne vulgaris in young adolescent boys, we studied 219 black and 249 white boys in fifth through ninth grades in Cincinnati, Ohio. The mean age was 12.2 +/- 1.4 years, with a range of 9 to 15 years. Pubertal maturation was scored as Tanner pubic hair stages (PH I to V) and pubertal stages (PS I to IV) that included testicular volume assessment. Acne was scored by number of comedonal (open plus closed comedones) and inflammatory (papules plus pustules) lesions. Comedonal and inflammatory lesions were analyzed separately and evaluated both as numerical scores and as grades (1, less than or equal to 10 lesions; 2, 11 to 25 lesions; and 3, greater than or equal to 26 lesions). Grades 2 and 3 were considered clinically significant acne. Acne became progressively more severe with advancing maturity. Mean acne scores correlated better with PS and pubic hair than with age. Black subjects were more mature than white subjects. Black boys in PSI and II had significantly more comedones than white boys; white boys had significantly more inflammatory lesions at PS I and III. Clinically significant comedonal acne was already present in PS I and occurred in 100% of boys in PS IV. In contrast, no boys at PS I and only 50% at PS IV had significant inflammatory acne. Midfacial acne dominated. We concluded that acne prevalence and severity correlate well with advancing pubertal maturation in young adolescent boys. Comedonal acne was more frequent and severe than inflammatory disease. Awareness of the extent and severity of acne in preadolescents and young adolescents may ultimately provide rationale for early intervention and thus prevention of severe acne vulgaris.

Acne Vulgaris↗

Preventive practices for adult cardiovascular disease in children.

BACKGROUND: Differences between family practitioners and pediatricians regarding appropriate interventions for cardiovascular disease prevention in pediatric patients have been described by national surveys of physicians in the two specialties. the purpose of the study reported here was to determine whether similar differences existed in a more complete sample from a confined geographical area in which local standards of care might influence physicians practicing in the locale. METHODS: Members of the Southwestern Ohio Society of Family Physicians and the Cincinnati Pediatric Society were surveyed by questionnaire about their attitudes and practices concerning cardiovascular risk factors in children. The response rate was greater than 70% in each specialty group. RESULTS: Differences in the diagnosis and treatment of hypercholesterolemia were detected: (1) pediatricians screened patients at younger ages and used lower cutoff points for diagnosis (5.0 vs 5.5 mmol/L [192 vs 211 mg/dL]); and (2) family physicians were more likely to treat with medication (57% vs 5%), whereas pediatricians referred hypercholesterolemic patients to specialists more often (71% vs 19%). Both family physicians and pediatricians mislabeled blood pressures at the age-specific 90th percentile as normal (21% and 14%, respectively); this occurred more commonly with younger patients. Blood pressure was the risk factor most often measured, but smoking was the risk factor that received the most counseling by physicians in both specialties. CONCLUSIONS: Both family physicians and pediatricians reported feeling inadequately prepared to counsel lifestyle changes, and ranked obesity, smoking, and cholesterol as topics of greatest interest for continuing medical education courses. Physicians in both specialties did not routinely update family history of cardiovascular disease during well-child visits.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Hormonal studies and physical maturation in adolescent gynecomastia.

As part of a 3-year longitudinal study of lipid and hormonal changes during puberty, 536 boys aged 10 to 15 years were prospectively followed every 6 months to assess development of gynecomastia. The overall prevalence of gynecomastia in the 377 with complete data was 48.5% (51% of white subjects and 46% of black subjects). In the majority of subjects, gynecomastia developed during mid-puberty. Gynecomastia was bilateral in 55% of subjects, on the left side in 19%, and on the right in 26%. Gynecomastia was documented for only one visit in the majority of subjects. When subjects were matched at the onset of gynecomastia for race, visit number, and pubertal rating, there were no significant differences between those with or without gynecomastia in serum estradiol level, testosterone level, estrogen/testosterone, ratio, or dehydroepiandrosterone-sulfate level. However, free testosterone level, weight, and Quetelet index were all significantly lower, and the testosterone-estrogen binding globulin level was significantly greater, in those with gynecomastia. We conclude that approximately half of adolescent boys have transient gynecomastia, usually lasting less than 1 year; those with gynecomastia enter mid-puberty at an earlier age, have a lower Quetelet index, and have lower serum free testosterone levels.

Adolescent↗

Comparison of potassium hydroxide digestion and a modified Kato technique for the semi-quantitative estimation of Schistosoma mansoni eggs in faeces.

A simple method for the semi-quantitative estimation of eggs of Schistosoma mansoni in stools, based on digestion of faeces in 4% potassium hydroxide (KOH), is described. The relative performance of KOH digestion and a modified Kato method showed that the former was more sensitive and that the KOH/Kato ratio for the geometric mean number of eggs per gram, in stools positive by both methods, was 3.51.

Feces↗

Reproductive outcomes of pregnant workers employed at 36 reinforced plastics companies. II. Lowered birth weight.

The authors analyzed the birth weights of infants whose mothers worked during pregnancy in the reinforced plastics industry, where styrene monomer is a primary chemical exposure. Reproductive and work histories were taken by telephone interview from 1535 women employed between 1974 and 1981 at 36 companies. The questionnaire was based on one used by the National Institute for Occupational Safety and Health, and indices of styrene exposure were derived from an historical set of 1500 industrial hygiene samples from the study companies. There was not a significant dose-response trend in decreasing average birth weights. However, women who worked at the most highly exposed jobs--such as laminators, rollers, or spray-up operators at boat manufacturing companies--had offspring with adjusted birth weights of 4% less than the offspring of unexposed women (95% confidence interval = -7.7% to +0.6%) after adjustment for other factors.

Birth Weight↗

Dose-dependent pharmacokinetics of a new oral cephalosporin, cefixime, in the dog.

Cefixime (CL 284,635; FK 027) is a new third-generation oral cephalosporin. To study dose-dependent pharmacokinetics of cefixime in dogs, two balanced four-way crossover studies were conducted. In the first study, oral doses of 50, 100, and 200 mg/kg and an intravenous dose of 50 mg/kg cefixime were administered. In the second study, oral doses of 6.25, 12.5, and 25 mg/kg and an intravenous dose of 12.5 mg/kg cefixime were administered to the same dogs. A period of 1 month separated the two studies. When the two intravenous doses were compared (i.e., 12.5 and 50 mg/kg), a twofold increase in clearance and volume of distribution was observed after the higher dose. The oral systemic bioavailability in the dose range 6.25-50 mg/kg was 55%. It decreased to 44% at 100 mg/kg and 27% at 200 mg/kg. The average peak serum concentrations ranged from 15.8 micrograms/ml at 6.25 mg/kg to 119 micrograms/ml at 200 mg/kg. Within this concentration range, the fraction of free drug in serum (unbound to proteins) increased from 7 to 25%. This concentration-dependent protein binding was primarily responsible for changes in total clearance, volume of distribution, and bioavailability of the drug in dogs.

Administration, Oral↗