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Biomedical subjects

J E Rossiter

Publications and source records attributed to J E Rossiter.

4 recordsLinked to original sources
PubMed1994

Pediatric barium enema examination: optimizing patient selection with univariate and multivariate analyses.

We prospectively evaluated a total of nineteen symptoms, signs, and laboratory findings in 471 of 557 consecutive pediatric patients (from newborn to age 17) referred for barium enema examinations, to determine predictors of an abnormal study. A univariate analysis was performed, and a logistic regression model was developed. The most frequent indicators for the barium enema examinations were abdominal pain (48%), constipation (27%) and tenderness (25%). Twenty-two percent of the examinations were abnormal, and the most common diagnoses were intussusception (n = 22), appendicitis (n = 17), infectious colitis (n = 15), and Hirschsprung disease (n = 14). The indicators that were most helpful to predict a barium enema abnormality were abdominal mass, leukocytosis, guaiac-positive stools, diarrhea, anemia, tenderness, and age less than 1 year. If barium enema examinations were performed only when at least one of the predictive indicators was present, 29% of examinations would be eliminated, and 4.8% of patients with detectable disease would be missed. The data indicate that identification of certain clinical variables can provide an effective initial strategy for selecting patients to undergo barium enema examinations.

Abdominal Pain↗
PubMed1994

Regional differences in mortality during 15-year follow-up of 11,936 hypertensive veterans.

Several different investigators have reported increased stroke mortality in the southeastern United States, leading to the introduction of the term "Stroke Belt." The results presented here from the Veterans Administration Hypertension Screening and Treatment Program (HSTP) demonstrate an increased all-cause mortality among hypertensive patients seen in HSTP clinics in the southeastern United States when compared with similar patients from other HSTP clinics. Several different groupings of southeastern states were examined and compared with nine states west of the Mississippi River. A total of 11,936 male veterans, 5737 of whom were black, were identified as hypertensive during 1974-1976 in 32 HSTP clinics. Their mean age was 52.4 +/- 10.4 years, and their mean pretreatment blood pressure was 153.8 +/- 19.1/100.4 +/- 9.8 mm Hg. During a minimum of 13.9 years of follow-up, 5360 (44.9%) of these patients died. Proportional hazards modeling was used to fit a basic survival model with terms representing race, age, blood pressure, smoking, and obesity. Risk was increased with higher blood pressure, age, and smoking and with lower body mass index. For 6 HSTP clinics in an 11-state Stroke Belt (defined as states with stroke mortality > 10% above the United States average), the relative risk of death was 1.226 (95% confidence interval, 1.106-1.358) when compared with 9 states west of the Mississippi River. For two different groupings of southeastern states with 10 and 8 HSTP clinics the relative risk of death was 1.231 and 1.295.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Calculating centile curves using kernel density estimation methods with application to infant kidney lengths.

Observing a clinical measurement for an individual is of little value, unless it can be compared with measurements obtained from a healthy population, thought of as standard. The range of measurements observed will, in general, vary with age or some function of time. The usual approach is to assume a distributional form for the population density, but this is inappropriate for variables which do not follow a simple distribution. A method of estimating the centiles of a conditional distribution using multi-dimensional kernel density estimation, to allow conditioning on the value of one or more covariates, is proposed. By careful choice of the kernel used, the percentiles may easily be calculated using a Newton-Raphson procedure. The method is illustrated using kidney lengths and birthweights of a sample of newborn infants.

Anthropometry↗