Search PubMed⌕ Search

Biomedical subjects

D R Rovner

Publications and source records attributed to D R Rovner.

63 records · Page 4Linked to original sources
PubMed1967

Postural augmentation of plasma renin activity and aldosterone excretion in normal people.

Peripheral plasma renin activity and aldosterone excretion rates have been measured in normal people during recumbency, recumbent exercise, tilting, and continuous ambulation. Upright posture induces a prompt elevation in peripheral plasma renin activity beginning in 15 minutes and peaking between 60 and 120 minutes. Aldosterone excretion is increased during 120 minutes of upright posture and correlates directly with the elevation in renin activity. Upright posture induces increased plasma renin activity regardless of the level of sodium intake in the preparatory diet. Concomitant measurements of endogenous creatinine clearance and the rates of excretion of sodium and potassium suggest that a fall in renal arterial perfusion resulting from upright posture induces increased release of renin and the subsequent secondary stimulation of aldosterone secretion. Our data indicate that the changes in plasma renin activity are due to changes in the amount of the enzyme rather than to changes in other elements of the reninangiotensin systm. This report discusses the physiologic importance of postural augmentation of renin production, emphasizing that for proper interpretation of values of plasma renin activity, posture as well as dietary factors must be considered and controlled.

Aldosterone↗
PubMedDate not supplied

Women's and physicians' utilities for health outcomes in estrogen replacement therapy.

Estrogen replacement therapy (ERT) prevents fractures and relieves vasomotor symptoms, but it increases the risk of endometrial cancer. Previous studies and national prescribing patterns show that physicians are conservative in their approach to this therapy. The authors interviewed physicians and perimenopausal women to assess their utilities for the various health outcomes of estrogen replacement therapy. On all outcomes, physicians rated illness episodes followed by recovery as being closer to perfect health than did perimenopausal women. Physicians, in judging which outcomes were most important to women, estimated relief of symptoms above fracture prevention, whereas women rated fracture prevention above symptom relief. These results emphasize the need to assess patients' utilities directly, particularly when utilities for the outcome of a particular therapy may influence the choice of a therapeutic regimen.

Adult↗
PubMedDate not supplied

Essential hypernatremia.

Described is a patient who presented with hypernatremia in the absence of dehydration. Further investigation revealed a tumor in the hypothalamic area, and evidence of anterior pituitary hypofunction. Water loading did not correct hypernatremia, and the results of the water-loading test suggested that hypernatremia had resulted from an elevated "osmotic set point" for the release of antidiuretic hormone, ie, "essential hypernatremia."

Adolescent↗
PubMedDate not supplied

Plasma glucagon in simple obesity: effect of exercise.

Obesity is uniformly associated with hyperinsulinemia, but studies of glucagon have produced conflicting results. We have studied glucagon, insulin, and growth hormone levels in response to a submaximal exercise in a group of normal and obese nondiabetic women. Basal plasma insulin levels were higher in the obese women and remained so throughout the experiment. Fasting and post exercise glucagon levels were similar in both groups. Basal growth hormone levels were lower in the obese group and remained suppressed, whereas a significant increase in growth hormone levels was observed among normal women in response to exercise. We conclude that in response to a submaximal exercise the glucagon levels in obese women are not different compared to normal, despite hyperinsulinemia and suppressed growth hormone levels in the former.

Adult↗
PubMedDate not supplied

Patient satisfaction with health care decisions: the satisfaction with decision scale.

Patient satisfaction measures have previously addressed satisfaction with medical care, satisfaction with providers, and satisfaction with outcomes, but not satisfaction with the health care decision itself. As patients become more involved in health care decisions, it is important to understand specific dynamics of the decision itself. The Satisfaction with Decision (SWD) scale measures satisfaction with health care decisions. It was developed in the context of postmenopausal hormone-replacement therapy decisions. The six-item scale has excellent reliability (Cronbach's alpha = 0.86). Discriminant validity, tested by performing principal-components analysis of items pooled from the SWD scale and two conceptually related measures, was good. Correlation of the SWD scale with measures of satisfaction with other aspects of the decision-making process showed the SWD scale was correlated most highly (0.64) with "decisional confidence," and least with "desire to participate in health care decisions" and "satisfaction with provider." The SWD scale predicts decision certainty in this study. Use in an independent study showed that the SWD scale was correlated with the likelihood of patients' intentions to get a flu shot. Further investigation in relation to other health decisions will establish the utility of the SWD scale as an outcome measure.

Adult↗
PubMedDate not supplied

African-American women's attitudes and expectations of menopause.

INTRODUCTION: In this study, low-income perimenopausal African-American women were surveyed to determine knowledge of menopause and hormone replacement therapy (HRT). METHODS: A 92-item survey assessed perceptions of menopause and health risks to identify preventive strategies in this population. The nonprobability sample of 197 African-American women typically had incomes of < $15,000, age 46-55, high school education or less. RESULTS: Major findings were that African-American women (1) experienced expected levels of occurrence of symptoms, but perceived them as not very bothersome, (2) had a knowledge deficit related to menopause and HRT, and (3) had expectations about menopause that underestimated their lifetime risk of heart disease. CONCLUSION: The lack of knowledge about menopause, HRT, and lifetime risks of heart disease suggests that low-income African-American women need better information for decision making about prevention. However, this sample knew the rank order of major health risks. Health information to the public and culturally relevant patient education are critical prerequisites to any preventive behavioral strategies in this population. Further research should identify culturally based expectations of disease risk and efficacy of prevention strategy to tailor messages to particular subpopulations.

Adult↗