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Biomedical subjects

C Randolph

Publications and source records attributed to C Randolph.

62 records · Page 4Linked to original sources
PubMedDate not supplied

Effect of troglitazone on fibrinolysis and activated coagulation in patients with non-insulin-dependent diabetes mellitus.

The objective of this study was to determine if treatment of non-insulin-dependent diabetes mellitus (NIDDM) patients with the "insulin sensitizer" troglitazone, both as monotherapy and in combination with insulin, corrects the impaired fibrinolysis and activated coagulation associated with NIDDM. Patients participating in two clinical trials comparing troglitazone and placebo in patients with NIDDM were studied at the time of randomization and after 26 weeks of treatment. Eighteen patients were treated with troglitazone (ten in combination with insulin and eight as monotherapy) and eight were treated with placebo (four in each trial). Plasma concentrations of plasminogen activator inhibitor (PAI-1), prothrombin fragment F1+2, fibrinogen, and von Willebrand Factor (vWF) activity were measured. Plasma PAI-1 concentrations fell significantly from a mean of 68.8 +/- 32.3 ng/mL to 40.4 +/- 20.4 in the troglitazone treated group, but did not change significantly in the placebo treated group. Plasma PAI-1 concentrations were elevated in 15 patients treated with troglitazone and fell to normal in eight of them. There was no significant change in plasma F1+2, vWF, and fibrinogen, but plasma C-peptide and triglyceride concentrations fell significantly with troglitazone. This study demonstrates that troglitazone treatment is associated with a significant fall in plasma PAI-1 antigen concentrations in patients with NIDDM and, therefore, may have a beneficial effect on fibrinolysis.

Adult↗
PubMedDate not supplied

Hypertension education: an important and neglected part of the diabetes education curriculum?

This review highlights the important role of hypertension education in reducing the impact of hypertension on the development and progression of diabetes-related complications. Hypertension is commonly associated with diabetes mellitus and can significantly affect the progression of the complications of diabetes. Lifestyle changes similar to those recommended for diabetes management can result in a lowering of blood pressure and can be maintained on a long-term basis to benefit patients with diabetes and mild hypertension. Recently, a team approach in a hypertension clinic model similar to the team approach for diabetes treatment was shown to be effective in diabetes management. Increased awareness of hypertension education may contribute greatly to reducing the complications of diabetes. Hypertension education should be an important component of the diabetes education curriculum.

Antihypertensive Agents↗
PubMedDate not supplied

Duration of response following cessation of pollen immunotherapy.

Following successful immunotherapy estimates of relapse rate ranged from 22% to 42%, depending on method of follow-up. The time to relapse varied with the method of follow-up, indicating that recall may play a major role in the perception of a relapse. How much of the continued well-being of most patients (58% of contacted patients) is due to immunotherapy or the natural history of the illness cannot be ascertained from this study.

Humans↗
PubMedDate not supplied

Latex hypersensitivity in a horse farmer.

Latex immediate hypersensitivity has been documented in 28% to 67% of spina bifida patients, 2.6%-16.9% of health care workers and at least 1% of the general population. Additionally, it has been confirmed in food-sensitive individuals sensitive to cross-reacting foods such as chestnut, avocado, banana, and passion fruits. Recently it has been observed even in low risk populations that are defined by absence of the conventional risk factors of atopy and exposure. We report the first documented case of latex allergy in a horse farmer who had the joint factors of atopy and exposure. This case exemplifies the paramount importance of screening all patients with a careful history first and appropriate testing for latex allergy when possible.

Adult↗
PubMedDate not supplied

The free running athletic screening test as a screening test for exercise-induced asthma in high school.

As part of a multicenter study envisioned by the American College of Allergy Sports Committee to screen for exercise-induced asthma, 303 high school students, freshman and sophomore gym classes, completed a questionnaire concerning exercise-related asthma, chronic asthma, and atopy. The study group included 124 females (41%) and 179 males (59%) with an average and median age of 15 years and a range of 13-17 years, and included 99% Caucasian and 1% nonCaucasian students, all attending the same parochial high school. After obtaining informed consent, 112 (37%) agreed to a free running test with initial challenge on an outdoor cinder track during April-June 1995. All challenges were conducted between 8:00 A.M. and noon with relative-humidity 59% and average temperature 15 degrees C. The challenge consisted of 7 minutes of continuous running on the cinder track with a doubling of pulse rate to 160/min during the run. Peak expiratory flows were taken at baseline, 0, 5, and 10 minutes postexercise. Twenty nine of 112 (26%) of the students were initially assessed as positive challenges, defined as a 15% decline in peak flow following exercise on the first challenge. However, four students self-recovered; thus 25 of 112 (22%) were qualified as true positives. Of these 25, 20 (80%) agreed to be reexercised. Fourteen of 20 (70%) were positive, yielding a prevalence rate of 14/112 (12.5%). Sixteen of these 20 (80%) were then exercised a third time using spirometry pre- and postexercise. Eight were positive, yielding a prevalence rate of 8/112 (7%). The questionnaire correlated significantly with the challenge, particularly when read by section (p = 0.000001) rather than globally positive or negative (p = 0.00008), with a specificity of 64%, sensitivity of 94%, positive predictive value of 44%, and negative predictive value of 97%. In summary, inexpensive and familiar free-running tests can be a useful screening test to confirm the questionnaire which is sensitive (94%) in ruling in, but has low specificity (64%) in ruling out, exercise-induced asthma.

Adolescent↗