Biomedical subjects

C D Morris

Publications and source records attributed to C D Morris.

At least 55 records · Page 3Linked to original sources

PubMed1998

An overview of remote sensing and GIS for surveillance of mosquito vector habitats and risk assessment.

This paper provides a brief nontechnical overview of the use of remote sensing to achieve multiple objectives, focusing on mosquito management. It also shows how Geographic Information Systems, combined with remote sensing analysis, have the potential to assist in minimizing disease risk. Examples are used from subtropical Queensland, Australia, where the salt marsh mosquito, Aedes vigilax, and the freshwater species, Culex annulirostris, are vectors of human arbovirus diseases such as Ross River and Barmah Forest virus disease. Culex annulirostris is also implicated in the transmission of Japanese Encephalitis. Mapping the breeding habitats of the species facilitates assessment of the risk of contracting the diseases and also assists in control of the vectors. First, it considers a simple risk model that is applied to data for the city of Brisbane in southeast Queensland. This is then linked to computer-aided analysis of remotely sensed data to map potential ephemeral freshwater breeding sites of Cx. annulirostris. This has the potential to guide control at critical times, for example after heavy summer rainfall or when there is an outbreak of Ross River virus disease. Second, the use of color infrared aerial photography is used to identify the specific parts of the salt marsh in which larvae and eggs of Ae. vigilax are found. Finally, we explore novel ways to map the detailed pattern of water under mangrove forest canopy to identify where mosquitoes are breeding and as an aid to planning modification. For each we discuss the limitations and advantages and the possibilities for combining methods and/or using a single method for multiple objectives.

Animals↗

PubMed1997

Trial of calcium to prevent preeclampsia.

BACKGROUND: Previous trials have suggested that calcium supplementation during pregnancy may reduce the risk of preeclampsia. However, differences in study design and a low dietary calcium intake in the populations studied limit acceptance of the data. METHODS: We randomly assigned 4589 healthy nulliparous women who were 13 to 21 weeks pregnant to receive daily treatment with either 2 g of elemental calcium or placebo for the remainder of their pregnancies. Surveillance for preeclampsia was conducted by personnel unaware of treatment-group assignments, using standardized measurements of blood pressure and urinary protein excretion at uniformly scheduled prenatal visits, protocols for monitoring these measurements during the hospitalization for delivery, and reviews of medical records of unscheduled outpatient visits and all hospitalizations. RESULTS: Calcium supplementation did not significantly reduce the incidence or severity of preeclampsia or delay its onset. Preeclampsia occurred in 158 of the 2295 women in the calcium group (6.9 percent) and 168 of the 2294 women in the placebo group (7.3 percent) (relative risk, 0.94; 95 percent confidence interval, 0.76 to 1.16). There were no significant differences between the two groups in the prevalence of pregnancy-associated hypertension without preeclampsia (15.3 percent vs. 17.3 percent) or of all hypertensive disorders (22.2 percent vs. 24.6 percent). The mean systolic and diastolic blood pressures during pregnancy were similar in both groups. Calcium did not reduce the numbers of preterm deliveries, small-for-gestational-age births, or fetal and neonatal deaths; nor did it increase urolithiasis during pregnancy. CONCLUSIONS: Calcium supplementation during pregnancy did not prevent preeclampsia, pregnancy-associated hypertension, or adverse perinatal outcomes in healthy nulliparous women.

Adult↗

PubMed1997

Nutritional management of cardiovascular risk factors. A randomized clinical trial.

BACKGROUND: Adherence to dietary recommendations for disease management is often hindered by the complexity of incorporating them into the daily diet. Nutrition and cardiovascular scientists and food technologists collaborated to develop a prepared meal plan that meets national dietary guidelines for cardiovascular risk reduction. OBJECTIVE: To assess the clinical effects of this plan, which incorporates all National Academy of Sciences National Research Council recommended dietary allowances for vitamins, minerals, and macronutrients, compared with a patient-selected American Heart Association Step I and Step II diet plan. METHODS: This multicenter, randomized, parallel-intervention trial was conducted at 10 medical centers in the United States and Canada and involved 560 men and women with hypertension, dyslipidemia, or diabetes. Following calculation of prescriptions to meet individual nutritional requirements based on the Harris-Benedict equation, participants were randomized to the Campbell's Center for Nutrition and Wellness (CCNW) plan, which is composed of prepackaged breakfast, lunch, and dinner meals provided to participants, or a nutritionist-guided American Heart Association Step I and Step II diet, in which participants self-selected foods to meet their nutrition prescription for 10 weeks. MAIN OUTCOME MEASURES: Blood pressure (BP); lipid, glucose, glycosylated hemoglobin (HbA1c), and insulin levels; body weight; dietary intake; and quality of life. RESULTS: Patients' BP, lipid levels, carbohydrate metabolism, weight, and quality of life (P < or = .001 for all findings except low-density lipoprotein-high-density lipoprotein ratio, P = .25) all improved on both nutrition plans. Mean differences (+/-SD) between baseline and treatment clinical values for the CCNW and the self-selected diet groups (between-group P values), respectively, were as follows: systolic BP, -6.4 +/- 9.2 mm Hg and -4.6 +/- 9.0 mm Hg (P = .02); diastolic BP, -4.2 +/- 5.7 mm Hg and -3.0 +/- 5.1 mm Hg (P = .006); cholesterol, -0.32 +/- 0.58 mmol/L and -0.27 +/- 0.56 mmol/L (-12.4 +/- 22.5 mg/dL and -10.4 +/- 21.9 mg/dL) (P = .30); glucose, -0.65 +/- 1.88 mmol/L and -0.75 +/- 2.03 mmol/L (-11.7 +/- 34.0 mg/dL and -13.5 +/- 36.6 mg/dL) (P = .10); and HbA1c, -0.4% +/- 0.8% and -0.3% +/- 0.7% (P = .66). Weight loss with the CCNW and self-selected plans, respectively, was as follows: men, -4.5 +/- 3.6 kg and -3.5 +/- 3.3 kg; and women, -4.8 +/- 3.0 kg and -2.8 +/- 2.8 kg. Quality of life was significantly improved for daily and work activities (P < .05) and nutritional health perceptions (P < .05) with the CCNW plan relative to the self-selected group. Overall nutrient intake and compliance were both significantly (P < .001) better with the CCNW plan. CONCLUSIONS: Nutritionally balanced meals that meet the recommendations of national health organizations improved multiple risk factors for patients with cardiovascular disease. The CCNW plan resulted in greater clinical benefits, nutritional completeness, and compliance than the self-selected diet. The CCNW is a comprehensive nutrition plan, convenient for both prescription and practice, and appears viable for effecting favorable dietary changes in patients at high risk for cardiovascular disease.

Adult↗

PubMed1997

Blood pressure and metabolic responses to moderate sodium restriction in isradipine-treated hypertensive patients.

This multicenter, randomized, controlled clinical trial assessed the influence of sodium chloride intake on the antihypertensive effect of the calcium channel blocker isradipine. Participants with uncomplicated hypertension controlled by isradipine entered a 4-week sodium-restricted (60 to 80 mmol/24 h) period. Participants with urinary sodium levels < 120 mmol/24 h (n = 99) were randomized to placebo or sodium chloride (100 mmol/24 h) for 4 weeks, and then crossed over to the alternative treatment for an additional 4 weeks. Mean baseline systolic blood pressure was 151.9 +/- 16.7 mm Hg (mean +/- SD). During open-label isradipine treatment, systolic blood pressures for ad libitum sodium chloride and restriction were 134.1 +/- 11.1 and 132.1 +/- 12.2 mm Hg respectively; for double-blind sodium chloride restriction and supplementation: 133.6 +/- 12.6 and 138.5 +/- 12.8 mm Hg (P < .01). Urinary sodium excretion values for open-label isradipine ad libitum versus restricted were 140.6 +/- 61.9 versus 76.9 +/- 32.4 mmol/24 h; for double-blind restricted versus supplemented, sodium excretion was 120.5 +/- 68.9 v 175.9 +/- 68.7 mmol/24 h (P < or = .0001). Changes in urinary sodium excretion were not predictive of variations in blood pressure. Urinary sodium excretion during sodium restriction correlated directly with HDL-cholesterol (P < .02) and inversely with total cholesterol:HDL-cholesterol (P = .02), despite decreased total and saturated fat intake (P < .01). Sodium restriction was associated with significant reductions (P < .01) in virtually all macronutrients and electrolytes, and thus had an adverse impact on overall nutrition. The antihypertensive action of isradipine was not enhanced by dietary sodium chloride restriction, and the lipoprotein profile was least favorable with sodium chloride restriction.

Adult↗

PubMed1997

Effect of dietary sodium restriction on overall nutrient intake.

Sodium restriction, widely prescribed for hypertensive persons and recommended for the broader US population, may result in nutrient alterations that could either beneficially or detrimentally affect overall diet quality. Most dietary sodium comes from meats (including poultry and fish), grains, and dairy products. These three groups also provide most dietary calcium, iron, magnesium, and vitamin B-6. Thus, reduced consumption of foods that are primary sodium sources could concurrently reduce the dietary content of these other nutrients below recommended daily intakes. This consequence of sodium restriction has not been specifically addressed in clinical trials. Although intake of most food groups was significantly reduced by a sodium-restricted diet in the Hypertension Prevention Trial, three other large clinical trials reported differing effects of sodium restriction on simultaneous energy and nutrient intakes. In the largest study of the effects of a sodium-restricted diet on intake of all major nutrients, sodium reduction was accompanied by lower energy intake and, concomitantly, lower intakes of total fat, saturated fat, protein, carbohydrate, and calcium. Present data are inadequate for determining the potential nutrient alterations of a broad prescription of sodium restriction. Difficulties in interpreting the available data result from the combination of sodium restriction with other interventions, intensive sodium reduction measures that do not reflect clinical implementation, poor compliance with sodium restriction, lack of analysis of changes in patterns of food intake, and interventions that are too short to reflect stable dietary patterns.

Adult↗

PubMed1997

Compliance to a low-salt diet.

Community intervention projects, efforts at single centers, and multicenter, prospective, dietary salt-restriction trials suggest that such an intervention is neither easy to achieve nor simple to maintain. Community-wide interventions based on advertisements, pamphlets, posters, radio messages, instructions in schools or other institutions, and cooperation from food suppliers such as butchers and bakers resulted in a slight decrease in salt consumption, mostly in normotensive women. A demonstration project at a single center showed that lowering salt intake long-term by 50% in hypertensive patients was feasible. That study included self-administered, positive-feedback devices to indicate adherence and a role for a household partner in achieving compliance. Multicenter intervention trials also indicate that reducing salt intake in the long term is feasible. However, in all intervention trials the subjects were highly selected, stable, generally married male volunteers. An elaborate training program involving many health care professionals was necessary and recidivism was common. Successful intervention requires specific goals and delegated responsibilities on the part of the health care team, careful assessment of the patient and the risk factors, as well as motivation for behavioral change, a specific plan for implementation, repetitive educational efforts, and a built-in monitoring mechanism.

Cross-Over Studies↗

PubMed1997

Dietary compliance and cardiovascular risk reduction with a prepared meal plan compared with a self-selected diet.

Noncompliance with therapeutic diets remains a major obstacle to achieving improvements in cardiovascular disease (CVD) morbidity and mortality. This study compared dietary compliance and CVD risk factor response to two dietary interventions designed to treat hypertension, dyslipidemia, and diabetes mellitus. In a multicenter trial, 560 adults were randomly assigned to either a self-selected, mixed-food plan (n = 277), or a nutrient-fortified prepared meal plan (n = 283); each was designed to provide 15-20% of energy from fat, 55-60% from carbohydrate, and 15-20% from protein. Nutrient intake was estimated from 3-d food records collected biweekly throughout the 10-wk intervention. Compliance was determined by evaluating the participants' ability to meet specific criteria for energy intake [+/-420 kJ (100 kcal) from the midpoint of the prescribed energy range], fat intake (< 20%, < 25%, or < 30% of energy from total fat), and the National Cholesterol Education Program/American Heart Association Step 1 and 2 diet recommendations. Compliance with energy, fat, and Step 1 and 2 criteria was better in participants who followed the prepared meal plan than in those who followed the self-selected diet (P < 0.0001). Compliant participants in both groups achieved greater reductions in body weight, systolic and diastolic blood pressure, and total and low-density-lipoprotein cholesterol than noncompliant participants (P < 0.05). In general, better endpoint responses were observed with lower fat intakes regardless of group assignment. The prepared meal plan is a simple and effective strategy for meeting the many nutrient recommendations for CVD risk reduction and improving dietary compliance and CVD endpoints.

Adult↗

PubMed1996

Whose radiograph?

Explore the source record for details and available documents.

Dental Records↗

PubMed1996

The expression of anger and its consequences.

Cluster analysis, using TRYSYS key cluster variable analyses, on 59 anger expression items replicated Spielberger's Anger-In and Anger-Control dimensions and revealed seven additional forms of anger expression: Noisy Arguing, Verbal Assault, Physical Assault-People, Physical Assault-Objects, Reciprocal Communication, Time Out, and Direct Expression. Aggressive dimensions (Noisy Arguing, Verbal Assault, Physical Assault-People and -Objects) correlated positively with each other and with trait anger and negatively with non-aggressive forms of expression (Control, Reciprocal Communication, and Time Out). The latter were positively correlated with each other and negatively with trait anger. Forms of expression correlated logically with the frequency of eight types of anger consequences, and there was evidence of distinct relationships between anger expression and anger consequences; e.g. Physical Assault-People correlated most with frequency of physical altercations, and Noisy Arguing and Verbal Assault with the frequency of verbal fights. Males were more likely to utilize aggressive forms of expression and to suffer consequences involving physical and verbal fights and property damage. Results are discussed in terms of convergent and discriminant validity, and in terms of their implications for assessment, treatment, and future research.

Adaptation, Psychological↗

PubMed1996

Trial of Calcium for Preeclampsia Prevention (CPEP): rationale, design, and methods.

The results of ten clinical trials suggest that supplemental calcium may prevent preeclampsia. However, methodologic problems and differences in study design limit the acceptance of the results and their relevance to other patient populations. Many of the trials were conducted in countries where, unlike the United States, the usual daily diet contained little calcium. Moreover, none of the trials has reported the outcome of systematic surveillance for urolithiasis, a potential complication of calcium supplementation. In response to the need for a thorough evaluation of the effects of calcium supplementation for the prevention of preeclampsia in the United States, the trial of Calcium for Preeclampsia Prevention (CPEP) was undertaken at five university medical centers. Healthy nulliparous patients were randomly assigned to receive either 2 g supplemental calcium daily (n = 2295) or placebo (n = 2294) in a double-blind study. Study tablets were administered beginning from 13 to 21 completed weeks of gestation and continued until the termination of pregnancy. CPEP employed detailed diagnostic criteria, standardized techniques of measurement, and systematic surveillance for the major study endpoints and for urolithiasis. The nutrient intake of each patient was assessed at randomization and at 32-33 weeks gestation. This report describes the study rationale, design, and methods.

Calcium↗

PubMed1996

The value of accident and emergency based physiotherapy services.

OBJECTIVE: To investigate whether accident and emergency (A&E) department based physiotherapy has any advantages over its traditional counterpart in providing treatment for soft tissue injuries. METHODS: Two A&E departments were compared: hospital A had a traditional physiotherapy service, while hospital B had A&E based physiotherapy. Groups of adult patients from these two hospitals were compared over a one month period. Data on injuries, number of physiotherapy treatment sessions, and outcome were recorded. RESULTS: There were 27 referrals for physiotherapy in hospital A during the study period (1.17% of attendances) and 111 referrals in hospital B (4.03%) (P < 0.001). The waiting time for physiotherapy was significantly less at hospital B (3 v 7 d, P < 0.001) despite a far greater number of patients referred. Non-referral at the hospital with the traditional service was due to a perceived long waiting time by the referring doctors. Patients with longer waiting times were found to be less likely to attend their first appointment, and this was therefore more common in the hospital with the traditional service (39.5% v 9.8%). CONCLUSIONS: An A&E based physiotherapy service results in a greater referral rate and a shortened time between referral and first treatment. Further research is needed to evaluate and compare long terms outcomes following treatment by both types of physiotherapy service.

Adult↗

PubMed1996

The duration of excretion of viable bacilli in elderly patients on treatment for cavitating pulmonary tuberculosis.

OBJECTIVE: To determine the period of excretion of viable tubercle bacilli in cavitating pulmonary tuberculosis in elderly patients while on treatment. DESIGN: 10 consecutive black hospital inpatients over the age of 65 years (6 men, 4 women) with positive acid-fast bacilli smears and Lowenstein-Jenssen culture-proven pulmonary tuberculosis and radiological cavitation had weekly smears and cultures until at least three smears or two cultures were negative. INTERVENTION: Supervised treatment comprising rifampicin, pyrazinamide, ethambutol and isoniazid. RESULTS: It look an average of 5.7 weeks (range 4-9 weeks) for the cultures and 8.2 weeks (range 4-14 weeks) for the smears to become negative. CONCLUSION: Patients with cavitating pulmonary tuberculosis continue to excrete viable tubercle bacilli for approximately 6 weeks despite supervised treatment. It is suggested that allowing such patients back into an environment where three are immunocompromised subjects (e.g. elderly people in retirement homes or HIV-positive subjects) is probably hazardous until the patients are culture or smear negative.

Aged↗

PubMed1996

Arboviruses associated with mosquitoes from nine Florida counties during 1993.

Mosquitoes were collected for virus isolation tests from 36 sites in Bradford, Lake, Leon, Manatee, Orange, Osceola, Pasco, Putnam, and Sarasota counties, FL, from April 6 through October 11, 1993. A total of 158,129 adult specimens were collected in 726 trap nights using CDC light traps, usually baited with dry ice. At least 35 species were represented, although 60% of the collections was made up of 3 species (Aedes infirmatus, 6.5%; Anopheles crucians, 14.4%; and Culex nigripalpus, 39.4%). Four of the 36 collecting sites were located at waste-tire sites, where 254 trap nights yielded 27,455 specimens (17.4% of 9-county total). Forty-three virus strains were isolated from 2,812 mosquito pools consisting of 158,129 specimens. The viruses isolated include eastern equine encephalitis (EEE), 5 strains; Everglades (EVE), 2 strains; Keystone (KEY), 6 strains; Tensaw (TEN), 21 strains; trivittatus (TVT), one strain; Shark River (SR), one strain; and Flanders (FLA), one strain. In addition, 2 strains that are either KEY or Jamestown Canyon (JC) virus, and 4 ungrouped viruses remain to be identified. Twenty-one (48.8%) of the 43 virus strains were isolated from mosquitoes collected at waste-tire sites as follows: EEE (1), KEY (5), KEY/JC (1), TEN (13), and one ungrouped virus. The vector relations of the viruses are discussed and the potential importance of waste-tire sites as breeding habitats and harborages for vector and nuisance species is emphasized.

Aedes↗

PubMed1996

Culex annulirostris breeding sites in urban areas: using remote sensing and digital image analysis to develop a rapid predictor of potential breeding areas.

A rapid technique is being developed and assessed to identify urban breeding sites of Culex annulirostris, which is a vector of an arbovirus (Ross River virus). Field survey and laboratory identification were used to identify breeding sites for the species. Ephemeral sites became the focus of the research and other mosquito species were recorded. The sites were located on digitized images of 1: 30,000 color aerial photographs. Training sites were used to create "themes" for the main ephemeral breeding sites and the MicroBRIAN image processing package was used to map the themes to each image. The accuracy and completeness of identification were evaluated with reference to the original field site identification and by further field checks. The accuracy was 87% and the completeness was 75%.

Animals↗

PubMed1996

Control of Aedes albopictus in waste tire piles with reduced rates of temephos-treated granules.

Two days following treatment, larval populations of Aedes albopictus in waste tires treated with granular formulations of temephos were reduced 90% at the 0.11 kg AI/ha rate, 98% at the 0.56 kg AI/ha rate, and 100% at the 1.12, 11.21, and 22.42 kg AI/ha rates. Nearly 100% control was achieved for 8 wk at the 0.5 kg AI/ha rate, for 7 wk at the 1.12 kg AI/ha rate in one replicate, and for at least 5 months at the 11.21 and 22.42 kg AI/ha rates. These results indicate that prolonged control can be achieved with granular formulations at half (11.21 kg/ha) the maximum label rate and that excellent immediate control can be expected at 2.5% the maximum label rate.

Aedes↗

PubMed1996

Fecundity of naturally bloodfed Culiseta melanura.

Naturally bloodfed Culiseta melanura were collected annually from resting boxes in and around a swamp in Oswego County, NY from 1982 to 1989. Females were held individually in a laboratory until they oviposited. Except in 1982, every other female was provided a 10% dextrose solution. Females were classed as alive or dead following oviposition and female size was based on abdomen length, measured after oviposition. Egg rafts from each female were held individually and the numbers of larvae and unhatched eggs were counted. Fecundity (number of eggs laid per female) was based on number of larvae plus unhatched eggs. Rafts from 2,120 females averaged 129 eggs and 106 larvae per raft. Rafts from females that were alive following oviposition were significantly larger and produced more larvae than those of females that died following oviposition. Availability of sugar influenced female survival but not egg raft production. Size and fecundity of females decreased from May through September. These differences were attributed to the temperature and larval density of breeding crypts. Seasonal changes in size may influence the vector efficiency of Cs. melanura.

Animals↗

PubMed1995

Calcium metabolism, calcium supplementation and hypertensive disorders of pregnancy.

In recent years growing attention has been directed towards the possible role of calcium in the development of pregnancy-induced hypertension and preeclampsia. Several studies describe calcium metabolism in normal and hypertensive pregnancy, but so far, they have shown discrepant and inconsistent results. Intracellular free calcium, which plays an important role in vascular smooth muscle contraction, has been claimed as a pathogenic factor in hypertensive disorders of pregnancy. Although there is discordance in the data, a possible role of intracellular calcium in the development of hypertensive disorders of pregnancy cannot be excluded. Observational studies in pregnant women suggest an inverse association between calcium intake and the incidence of hypertensive disorders of pregnancy. Despite large methodological differences, the results from the calcium supplementation trials support this finding. Although it is rather difficult to isolate the effect of calcium intake from the intake of other mineral elements, results from calcium supplementation trials are supportive for calcium being the most important. Proposed mechanisms by which calcium supplementation may lower blood pressure involve changes in parathyroid hormone (PTH) level, the renin-angiotensin system and calcium as a modifier of vascular agent regulation, but none of these have yet been elucidated. At present, circumstantial evidence suggest a positive role for calcium in the prevention of hypertensive disorders of pregnancy, but definite evidence is lacking and further research is warranted.

Calcium↗

PubMed1995

Regulation of parathyroid hormone and vitamin D in essential hypertension.

Patients with essential hypertension have been reported to have a higher serum concentration of parathyroid hormone (PTH) than normotensive individuals although this finding is not universal among studies. To further characterize the status of the calcium regulating hormones in essential hypertension, we measured the parathyroid gland response to acute EDTA-induced hypocalcemia and the renal response of 1,25(OH)2-vitamin D to dietary calcium deprivation in 16 hypertensive (H) and 15 normotensive (N) men. The average mean arterial blood pressure once all antihypertensive medications were discontinued was 108 +/- 7 mm Hg for the hypertensive group and 89 +/- 4 mm Hg for the normotensive group (P < .01). There were no group differences in baseline serum concentrations of ionized calcium, creatinine, intact PTH, and 1,25(OH)2-vitamin D, urinary calcium excretion, and creatinine clearance. After a 1-h infusion of EDTA at 12.5 mg/kg/h, the serum concentration of ionized calcium fell (H: 1.25 +/- .03 to 1.17 +/- .04 mmol/L, N: 1.26 +/- .04 to 1.18 +/- .04 mmol/L, P = NS) and PTH increased (H: 36 +/- 9 to 91 +/- 30 pg/mL, N: 40 +/- 14 to 85 +/- 28 pg/mL, P = NS). With an additional hour of EDTA at a dose of 25 mg/kg/h, serum ionized calcium concentration fell further (H: 1.01 +/- .05 mmol/L, N: 1.03 +/- .06 mmol/L, P = NS) and PTH increased to 150 +/- 58 pg/ml in patients and 130 +/- 32 pg/ml in controls (P < .001). The response suggested an increased maximal parathyroid gland secretory capacity in the hypertensive patients relative to the controls. There was no group difference in the serum concentration of 1,25(OH)2-vitamin D at baseline (H: 32 +/- 6 pg/ml, N: 32 +/- 8 pg/ml, P < .90) and following dietary calcium deprivation for three days (H 50 +/- 12, N 48 +/- 14 P < 0.76). The maximal stimulated PTH level was significantly higher in hypertensive than normotensive subjects in the absence of measured differences in serum ionized calcium concentration, serum 1,25(OH)2-vitamin D concentration, and creatinine clearance. These findings suggest an intrinsic alteration of PTH regulation in patients with essential hypertension, manifest as increased parathyroid gland secretory capacity.

Adolescent↗