Biomedical subjects

J E Sutherland

Publications and source records attributed to J E Sutherland.

10 recordsLinked to original sources

PubMed1991

Gastroesophageal reflux disease. When antacids aren't enough.

Gastroesophageal reflux disease is a very common condition that is usually manifested by heartburn or regurgitation. Reflux esophagitis, caused by mucosal exposure to the backflow of caustic gastric contents, is primarily a result of lower esophageal sphincter dysfunction. Diagnostic workup varies but commonly includes esophagoscopy, 24-hour esophageal pH monitoring, and radiography of the upper gastrointestinal tract. Treatment, which progresses from simple life-style changes and antacids to histamine2 receptor antagonists to omeprazole (Prilosec) or surgery, is tailored to individual needs and is generally successful.

Esophagitis, Peptic↗

PubMed1991

The link between stress and illness. Do our coping methods influence our health?

Stress is an important fact of everyday life that can have a major effect on emotional and physical well-being. Stress is best defined as the adaptation response by the body to a stressor (ie, the perceived stimulus). Psychoneuroimmunology is the study of the ways in which psychosocial interactions cause neuroendocrine responses and, at times, physical changes. An increasing body of evidence suggests a causative role for acute and chronic stress in many medical disorders and psychiatric states. Methods of measuring and assessing stress factors need to also evaluate patients' coping and adaptive mechanisms.

Adaptation, Psychological↗

PubMed1990

Proportionate mortality trends: 1950 through 1986.

Mortality trends in the United States from 1950 through 1986 were analyzed for the conditions that are or have recently been among the six leading causes of death. The age-adjusted mortality rate for all causes has decreased from 841.5 to 541.7 per 100,000 population. Cause-specific, age-adjusted mortality rates have declined from 1950 through 1986 for cerebrovascular disease, injuries, perinatal conditions, heart disease, and influenza and pneumonia. Time trends in the proportion of persons dying of each of these diseases, however, have varied; the proportion dying of cerebrovascular disease, injuries, and perinatal conditions has decreased, and the proportion of persons dying of heart disease and influenza and pneumonia has remained fairly stable from 1950 through 1986. During this same time, age-adjusted death rates have increased for chronic obstructive pulmonary disease and have remained fairly stable for malignant neoplasms, while the proportions of persons dying of chronic obstructive pulmonary disease and malignant neoplasms have increased dramatically. For people aged 35 to 64 years, malignant neoplasms have now overtaken heart disease as the leading cause of death. For those aged 65 years and older, heart disease remains the leading cause of death, accounting for almost 50% of all deaths in persons 85 years and older.

Adult↗

PubMed1990

Immitance audiometry.

Immitance audiometry is a safe, simple, reliable, and relatively objective method of determining middle-ear function that provides advantages for examining the difficult patient because minimal cooperation is needed. Acoustic-immitance measurements obtain sophisticated data that give us valuable information about the middle ear mechanism as a whole. It can be used in a quiet office environment. Immitance audiometry can confirm a doubtful otoscopic diagnosis and screen for ear disease. There are limitations to observer reliability with otoscopy, which has good sensitivity but poor specificity, in contrast to immitance audiometry. The tympanogram can be classified into four different patterns on the basis of its characteristics. These patterns are diagnostic, distinguishing normal function from various types of middle ear pathology. Immitance audiometry has very high sensitivity and specificity. The acoustic reflex, a contraction of the stapedius muscle following an intense auditory stimulus, can be valuable in determining a conductive hearing loss and many other otologic diagnoses. As a screening tool, immitance audiometry is most valuable in populations at risk for middle ear effusion, primarily those aged 7 months to 5 years. Significant improvements in measurements of ear function also allow us to be more precise in the diagnoses of otosclerosis, perforation of the tympanic membrane, ossicular discontinuity, facial nerve dysfunction, and brain stem disorders.

Acoustic Impedance Tests↗

PubMed1989

Efficacy of transdermal clonidine for headache prophylaxis and reduction of narcotic use in migraine patients. A randomized crossover trial.

Thirty patients completed a double-blind, randomized crossover study utilizing transdermal clonidine and an identical-appearing placebo. Crossover occurred at 6 weeks, with a total study time of 12 weeks. Subjects were asked to record daily in a special diary (1) the presence or absence of headache, (2) duration of headache, (3) severity of headache, and (4) use of pain medication for headache relief. The severity of the headaches was rated from 1 (very mild) to 5 (very severe). Although the subjects reported a decrease in frequency, duration, and intensity of headaches while using the medicated patch, these differences did not reach statistical significance. Nineteen patients subjectively preferred the medicated patch, while five preferred the placebo (P less than .01). During use of the medicated patch, a significant reduction (P = .039) occurred in use of class II narcotics. Three doses of these substances were used by the patients when treated with clonidine, while 34 doses were taken during placebo use. These findings suggest that clonidine might have a role in reduction of parenteral narcotic use in acute pain syndromes.

Administration, Cutaneous↗

PubMed1987

Moonlighting policy and practice in family practice residencies.

Moonlighting by residents is a controversial, but little-studied topic. A survey on moonlighting policy and practice was sent to all family practice residency program directors, and an 87 percent response rate obtained. Moonlighting is permitted by 97 percent of nonmilitary programs and is generally thought of by program directors as a positive educational experience. It is practiced by over two thirds of the second- and third-year residents in programs that monitor moonlighting. These residents spend an average of 28 hours each month moonlighting. The most commonly used moonlighting sites are hospital emergency rooms, followed by coverage for private practice physicians. Seventy percent of programs require approval for extracurricular work activity. Only 23 percent of residencies limit moonlighting for all residents, but 47 percent have had occasion to deny moonlighting privileges to individual residents.

Data Collection↗

PubMed1986

Hereditary red cell disorders in Southeast Asian refugees and the effect on the prevalence of thalassemia disorders in the United States.

This investigation established the frequency and prevalence of hemoglobin E, alpha and beta thalassemia, and glucose-6-phosphate dehydrogenase deficiency in a group of Southeast Asian individuals and determined the impact upon the prevalence of thalassemia disorders in the United States. The resettlement program of Southeast Asian refugees has significantly increased the total number of serious thalassemic disorders in the United States. For several generations Southeast Asian children will be the principal thalassemic group.

Asia, Southeastern↗

PubMed1986

Drug therapy for preventing peptic ulcer recurrence.

Duodenal ulcers recur in the majority of patients. These patients may be at risk of significant ulcer complications. Risk factors for recurrent ulcers include cigarette smoking and high output of nocturnal acid. Patients at high risk of recurrence are candidates for continuous maintenance therapy. The H2 receptor antagonists and sucralfate are effective in reducing recurrence rates.

Acute Disease↗

PubMedDate not supplied

Obstetrics in family medicine: effects on physician work load, income, and age of practice population.

A survey of active members of the American Academy of Family Physicians was conducted to determine the effect of the practice of obstetrics by family physicians on patient age distribution, physician work load, and physician income. A questionnaire was mailed to 800 randomly selected physicians; the survey response rate was 60.4%. Almost 20% of all respondents had never provided obstetrical care of any type. Another 40% had provided obstetrics previously but had discontinued this service, while the remaining 40% currently provided obstetrical care. Physicians who provided obstetrical services reported a significantly higher mean proportion of children and a significantly lower proportion of middle-aged and elderly adults in their patient panels than did physicians who do not provide obstetrics. Those physicians who had never offered obstetrics saw approximately the same number of patients and worked approximately the same number of hours as did those who provided low-risk, routine obstetrics; however, the former group reported a significantly higher average annual income than did the latter group.

Adolescent↗

PubMedDate not supplied

Differences and similarities between patient and physician perceptions of patient pain.

A reasonably accurate perception of pain severity by physicians can be a useful tool in effectively managing acute pain. This study measured the similarities and differences between patient and physician ratings of patient pain through the use of a linear analogue scale of pain severity. A total of 401 patients presenting with acute pain of up to seven days' duration were studied. Data were gathered from patients presenting to the seven family practice clinics associated with the Department of Family Practice and Community Health at the University of Minnesota. Whereas the physician mean rating of patient pain was found to be significantly lower than the patient mean rating (3.52 vs. 4.37, P = 0.001), raw ratings by physicians and patients were found to have a relatively strong and significant correlation (R = 0.66, P = 0.001). The difference in mean ratings between patients and physicians remained the same regardless of physician or patient gender, patient age, whether or not a diagnosis was made, organ system category in which the pain was located, or training level of physician. The physician mean ratings were always significantly lower than the patient mean ratings, and there was no significant difference in the mean differences in ratings among the subgroups compared.

Acute Disease↗