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Biomedical subjects

K Warren

Publications and source records attributed to K Warren.

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

A comparison of ambulatory blood pressure and heart rate at home and work on work and non-work days.

OBJECTIVES: First, to test whether there was a change in the blood pressure and heart rate on work days relative to non-work days; secondly, to assess whether there were work-home differences on these days; and, thirdly, to assess whether these changes were similar in both normotensives and hypertensives. DESIGN AND SUBJECTS: Twenty-four working men (17 mild hypertensives and seven normotensives) wore an ambulatory blood pressure monitor for two 24-h periods (at work and home), on a work day ('on day') and on a non-work day ('off day'). METHODS: Means were calculated for each day for each home and work period. On the off day, the 'work' mean was defined using the readings during the usual working hours. To control for the effect of position on the means, statistical procedures that control for position were employed. These means were then analyzed by repeated-measures analysis of variance with two within-person factors. Period (home-work) and Day (on-off), and one between-person factor, Hypertensive Status (mild hypertensive-normotensive). RESULTS: When hypertensives and normotensives were combined, diastolic blood pressure (DBP) was significantly greater at work than at home. However, for both systolic blood pressure (SBP) and DBP this work-home difference was dependent on whether it was the on or the off day, the work-home difference being greater on the work day. Furthermore, the noted work-non-work day changes between work and home were significantly different for DBP for normotensives and mild hypertensives. Normotensives experienced a 6-mmHg decrease in blood pressure on the off day, whereas mild hypertensives had a 3-mmHg average increase on the off day. No significant differences were found in the pattern of work-home differences between on and off days for mild hypertensives and normotensives, although the effect approached significance for SBP, providing an indication that the work-home differences may depend on both hypertensive status and work-non-work day. Heart rate was significantly higher during work than at home. Although normotensives had higher heart rates, the work-home difference was constant across on and off days. Among 10 subjects who agreed to wear the monitor a third time on a second work day, the average work blood pressures during the two work periods were nearly equivalent, arguing against an habituation effect to the monitor. CONCLUSIONS: These data support the notion that, for blood pressure, activity is an important determinant of level. A circadian basis to blood pressure was not supported. We found differences between work and non-work days for normotensives, and a trend towards differences by work-home period and work-non-work day for hypertensives. For heart rate the opposite result was found. Heart rate was affected only by time of day (as denoted by work and home periods) and was stable across on and off days. These results suggest that experimental or statistical control of activity and position may be necessary if ambulatory blood pressure monitoring is to be used as either a diagnostic or research tool.

Activities of Daily Living↗
PubMed1992

The impact of anticipation of job loss on psychological distress and worksite blood pressure.

The impact of occupational stressful life events on psychological distress and blood pressure was examined among employees of a major New York City brokerage firm undergoing massive layoffs. One hundred thirty-nine employees of the firm, who had participated in a blood pressure screening in 1986, were rescreened during the period of layoffs within their company in 1989. About two-thirds of the 139 employees reported being "somewhat" or "very" anxious or upset in 1989 during the period of layoffs, and psychological distress was significantly elevated among those employees reporting possible or definite layoff or job change and/or difficulty in obtaining a comparable job. However, we found no increase in overall blood pressure level, and no effect of anticipation of job loss on 1989 blood pressure when controlling for 1986 blood pressure level, age, body mass index, work hours, and other demographic variables. On the other hand, employment in a department sold to another employer on the day of screening, as well as employment in a clerical job title, were both associated with significant increases in diastolic blood pressure of about 5 mm Hg.

Anxiety↗
PubMed1992

Relation between job strain, alcohol, and ambulatory blood pressure.

"Job strain" (defined as high psychological demands and low decision latitude on the job) has been previously reported to be associated with increased risk of hypertension and increased left ventricular mass index (LVMI) in a case-control study of healthy employed men, aged 30-60 years, without evidence of coronary heart disease. We hypothesized that job strain would be associated with increased ambulatory blood pressure (AmBP). A total of 264 men at eight work sites wore an AmBP monitor for 24 hours on a working day. In an analysis of covariance model, job strain was associated with an increase in systolic AmBP of 6.8 mm Hg (p = 0.002) and diastolic AmBP of 2.8 mm Hg at work (p = 0.03) after adjusting for age, race, body mass index, Type A behavior, alcohol behavior, smoking, work site, 24-hour urine sodium, education, and physical demand level of the job. Alcohol use also had a significant effect on AmBP. However, among subjects not in high-strain jobs, alcohol had no apparent effect on AmBP at work. Instead, alcohol use and job strain interacted such that workers in high-strain jobs who drank regularly had significantly higher systolic AmBP at work (p = 0.007). Among the other risk factors, only age, body mass index, and smoking had significant effects on AmBP. Job strain also had significant effects on AmBP at home and during sleep as well as on LVMI.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

A restorative-orthodontic treatment approach in the older patient.

This report presents a case requiring a combination of restorative dentistry and orthodontic treatment in a mature adult patient. Occlusal splint and periodontal therapies were used initially. Orthodontic treatment combined the use of the occlusal splint and fixed appliance in the maxillary arch. Sectional fixed appliances were used in the mandibular arch. The final restorations were fixed--movable bridges in the mandibular arch and a removable tooth and mucosally borne prosthesis in the maxilla. Retention of the orthodontic result was provided by the fixed prostheses in the lower arch and the continued wear of a full coverage maxillary occlusal splint at night served to prevent relapse of the upper teeth.

Dental Restoration, Permanent↗
PubMed1991

Pica practices of pregnant women.

This report summarizes current knowledge about pica practices during pregnancy through a systematic review of the literature for the period 1950 through 1990. Pica behavior was considered in terms of its prevalence, risk factors, clinical profile, and effect on pregnancy outcome. Data on pica practices by pregnant women are limited and inconclusive but reveal several interesting relationships. The prevalence of pica among pregnant women in high-risk groups declined between the 1950s and the 1970s but now remains steady, affecting about one fifth of high-risk women. Women at high risk of pica are more likely to be black, to live in rural areas, and to have a positive childhood and family history of pica. The clinical picture of the disorder during pregnancy is not well described. The evidence suggests that pica during pregnancy results in anemia, but it is not definitive. Pica also has been associated with maternal and perinatal mortality. We conclude that the behavior is more prevalent than commonly believed, shows no sign of further decline, and may have serious effects, particularly anemia, on mother and infant. Dietetic practitioners who counsel pregnant women should ask questions about pica when they conduct nutrition assessments of their clients.

Black or African American↗
PubMed1991

Occlusal accuracy in restorative dentistry: the role of the clinician in controlling clinical and laboratory procedures.

This paper describes the clinical and laboratory stages necessary to ensure the occlusal precision of fixed restorations. The important diagnostic stages, including elimination of mandibular dysfunction, the occlusal analysis and waxing of diagnostic casts, and the diagnostic use of provisional restorations, are outlined. The importance of having the clinician control all stages of laboratory work, including die trimming, mounting working casts on an articulator, the determination of both anterior and posterior tooth form, and the final occlusal adjustment of the restorations, is emphasized.

Dental Articulators↗
PubMed1991

Endotoxin and cytokine profile in plasma of baboons challenged with lethal and sublethal Escherichia coli.

This descriptive study compares the inflammatory, coagulant, and hemodynamic responses of the baboon to a 2-hr infusion of lethal and sublethal concentrations of Escherichia coli (40 and 4.0 billion organisms per kilogram, respectively). The response to lethal E. coli challenge occurred in three stages: an inflammatory stage marked by a fall in white blood cell count (0-2 hr), a coagulant stage marked by a fall in fibrinogen concentration (2-6 hr), and a hypoxic cell injury stage marked by a rise in SGPT/BUN and by a gradual cardiovascular collapse, and death (6-24 hr). The inflammatory, or first stage coincided with the appearance in plasma of tumor necrosis factor (TNF) and interleukin-1 beta (IL-1 beta), which peaked at 120 and 240-300 min, respectively; a slow but continuous appearance and rise of interleukin-6 (IL-6); and the appearance of endotoxin reaching a maximum at 120 min. This contrasted markedly with the response to sublethal E. coli, in which only one of the three stages was observed (inflammatory) and only minor amounts of the cytokines or endotoxin appeared in the plasma. This study describes the cytokine and endotoxin profiles and the bacteremia in the primate under experimental conditions. It shows for the first time the extreme qualitative differences in their response to lethal and sublethal concentrations of E. coli. It raises the possibility that lethality is associated with an override of the tissue threshold for processing these mediators, as marked by their appearance in plasma in response to lethal E. coli infusion.

Alanine Transaminase↗
PubMed1990

The relationship between 'job strain,' workplace diastolic blood pressure, and left ventricular mass index. Results of a case-control study.

To determine whether "job strain" (defined as high psychological demands and low decision latitude on the job) is associated with increased workplace diastolic blood pressure and the left ventricular mass index, we conducted a case-control study at seven urban work sites of 215 employed men aged 30 to 60 years without evidence of coronary heart disease. After comprehensive blood pressure screening of male employees (N = 2556) at the work site, 87 cases of hypertension and a random sample of 128 controls were studied. In a multiple logistic regression model, job strain was significantly related to hypertension, with an estimated odds ratio of 3.1, after adjusting for age, race, body-mass index, type A behavior, alcohol intake, smoking, work site, 24-hour urine sodium excretion, education, and physical demand level of the job. Controlling for the above variables in subjects aged 30 to 40 years with job strain, we found that the echocardiographically determined left ventricular mass index was, on average, 10.8 g/m2 greater than in subjects without job strain. We conclude that job strain may be a risk factor for both hypertension and structural changes of the heart in working men.

Adult↗
PubMed1990

The effect of work environments on blood pressure: evidence from seven New York organizations.

The prevalence of hypertension defined according to National Health and Nutrition Examination Survey II (NHANES II) criteria (140/90 mmHg and/or taking antihypertensive medication) was analyzed cross-sectionally at seven worksites in New York City (n = 4274; 2616 men and 1648 women), in order to assess whether exposure to different work environments and occupations contributes to blood pressure variation. The prevalence of hypertension across worksites was 26% among men and 12% among women. Blood pressure was significantly different across worksites even after controlling for known risk factors using analysis of covariance. Of the variation in systolic pressure, 34% was predicted significantly by eight variables; after adjusting for upper-arm circumference, age and body mass index, higher pressures were associated with worksite differences (9.0 mmHg), being male (7.2 mmHg), lacking a high-school education (4.3 mmHg), having a clerical occupation (2.9 mmHg) and being unmarried (1.8 mmHg). Similar results for diastolic pressure suggest that researchers should consider worksite and job characteristics as important predictors of blood pressure differences in working populations.

Adult↗
PubMed1990

An investigation into the microhardness of a light cured composite when cured through varying thicknesses of porcelain.

An investigation was carried out to measure the completeness of cure of samples of a composite resin, light cured for 40s and 60s through porcelain discs of varying thickness. Once cured, each specimen was subjected to Vickers microhardness testing to assess the completeness of cure. Composite resin specimens cured without an intervening porcelain disc were used to establish a baseline. The results showed that increasing the thickness of the porcelain disc produced a statistically significant decrease in microhardness of the composite resin. Increasing the cure time from 40s to 60s produced a significant increase in microhardness. The increase in microhardness with increased cure time was more pronounced when the discs of thickness 1 mm and 2 mm were used, and when there was no overlying porcelain disc.

Chemical Phenomena↗
PubMed1990

An assessment of the level of dental and mouthcare knowledge amongst nurses working with elderly patients.

A 60 item questionnaire was completed by a self-selected sample of nurses working with elderly patients. The questionnaire was divided into three sections; to collect personal data, to assess the nurses' attitude to mouthcare and their level of training in this subject, and to assess the level of dental knowledge. This paper identifies the disadvantages of using a self selected as opposed to a random sample. Analysis of the completed questionnaires revealed a fairly high level of basic training in dental and mouthcare matters. There was however, a paucity of specific dental knowledge e.g. there was some confusion over the aetiology and prevention of dental caries and also as to the difference between gingivitis and periodontitis. In addition, few nurses seemed to be aware of the effects systemic disease and drugs may have on the oral tissues. In spite of this most respondents achieved more than 50 per cent correct answers. A number of recommendations to improve nurses' dental knowledge is given at the end of the article.

Aged↗
PubMed1990

Multi-disciplinary treatment planning for the restorative patient.

Many older patients present requiring a multi-disciplinary approach to treatment aimed at restoring their dentition to health, satisfactory function, and appearance. The restorative dentist with specialist knowledge of periodontics, and fixed and removable prosthodontics is well qualified to provide a treatment plan to achieve these goals. The basic principles of formulating a treatment plan are discussed and a case presented which required a combination of occlusal therapy, periodontics, orthodontics and fixed and removable prosthodontics.

Female↗
PubMed1990

Mouthstick prostheses and other gadgets.

Patients who are physically disabled often face immense problems coping with the simple tasks of everyday life. These problems are particularly acute in those patients who have lost the use of their hands or have only restricted hand use. Their ability to work, study or to participate in leisure activities may be severely impaired. This article describes how the dentist may be able to mitigate the effects of restricted hand use by constructing a variety of tools and gadgets designed to help some of these patients lead a more normal life and reduce their reliance on others.

Adult↗