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Biomedical subjects

E Miller

Publications and source records attributed to E Miller.

At least 307 records · Page 17Linked to original sources
PubMed1988

Oral zinc in macular degeneration.

Macular degeneration associated with age and drusen, an important cause of severe visual loss in older persons, is of unknown cause. The sensory retina and retinal pigment epithelium, which are cell layers in zinc, appear to be prominently involved in the disease process. Because zinc plays a role in the metabolic function of several important enzymes in the chorioretinal complex, we undertook a prospective, randomized, double-masked, placebo-controlled investigation of the effects of oral zinc administration on the visual acuity outcome in 151 subjects with drusen or macular degeneration. Although some eyes in the zinc-treated group lost vision, this group had significantly less visual loss than the placebo group after a follow-up of 12 to 24 months. This is the first controlled oral intervention study to show a positive, if limited, treatment effect in macular degeneration, a major public health problem. Because of the pilot nature of the study and the possible toxic effects and complications of oral zinc administration, widespread use of zinc in macular degeneration is not now warranted.

Administration, Oral↗
PubMed1988

Protein-induced glomerular hyperfiltration: role of hormonal factors.

High protein diets acutely elevate the glomerular filtration rate. To characterize this response we administered 1 g of protein/kg body weight as a beef steak meal to nine, healthy male subjects and measured glomerular filtration rate (inulin clearance), renal plasma flow (p-amino hippurate clearance), plasma renin activity, aldosterone and plasma and urinary catecholamines. The subjects ingested the meal on three separate days and were pretreated with either placebo, 50 mg indomethacin (to inhibit renal prostaglandin synthesis), or 10 mg enalapril (to inhibit angiotensin II synthesis). Following placebo treatment protein feeding significantly increased the glomerular filtration rate, from a pre-meal level of 101 +/- 7 ml/min/1.73 m2 to a post-meal level of 130 +/- 6 ml/min/1.73 m2, P less than 0.005. A parallel rise in renal plasma flow and a fall in renal vascular resistance were noted. Indomethacin pretreatment attenuated the increase in glomerular filtration rate following the protein meal, 105 +/- 6 ml/min/1.73 m2 pre-meal level to 118 +/- 4 ml/min/1.73 m2 post-meal, P greater than 0.1. Enalapril pretreatment had no significant effect on protein-induced glomerular hyperfiltration. Protein feeding following placebo increased plasma aldosterone concentration while the concentrations were unchanged in the studies where enalapril or indomethacin was administered. Protein feeding following placebo or indomethacin did not alter plasma renin activity while plasma renin activity rose following enalapril administration. Urinary norepinephrine excretion rose while plasma norepinephrine concentration was unchanged in all three study groups. A decrease in urinary dopamine excretion was also noted four hours after the protein meal was ingested.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

The efficacy of pertussis vaccines under conditions of household exposure. Further analysis of the 1978-80 PHLS/ERL study in 21 area health authorities in England.

It has been reported that the efficacy of pertussis vaccines appears to be lower when assessed in household contact studies than when assessed in cohort analyses of general populations. This observation may be attributable in part to methodological factors in home contact studies, in particular to the inclusion of retrospectively ascertained cases and of households in which the primary case constituted a vaccine failure. These biases are illustrated using data from a study of the efficacy of pertussis vaccines carried out by the Public Health Laboratory Service Epidemiological Research Laboratory PHLS/ERL in England during 1978-1980. This analysis reveals several factors which should be considered in the design, analysis and interpretation of household contact studies for evaluation of vaccine efficacy.

Child, Preschool↗
PubMed1988

Preoperative saphenous vein mapping for coronary artery bypass.

Saphenous vein mapping by real-time duplex ultrasound scanning allows for the confirmation of the presence of patent vein and determination of the anatomical course of the vein prior to aortocoronary bypass procedures. This technique has proven to be of value in patients whose veins are not evident by physical examination and in those whose length of conduit may be limited by previous vein stripping or thrombophlebitis.

Coronary Artery Bypass↗
PubMed1988

Conservative care of urinary incontinence in the elderly.

Urinary incontinence is a common, costly and demoralizing problem among the elderly. Remedial efforts are often not attempted owing to the misconception that incontinence is an inevitable and irreversible characteristic of aging. In fact, a variety of relatively conservative methods of reducing geriatric incontinence are available. This paper reviews the categories of incontinence, outlines assessment strategies and critiques the literature on biofeedback, exercise, behavior therapy and electrical stimulation as treatments for geriatric incontinence, and briefly considers a role for the chiropractic physician.

Aged↗
PubMed1988

The current epidemiology of pertussis in the developed world: UK and West Germany.

The existence of well established national reporting systems for monitoring pertussis incidence and vaccine uptake in the United Kingdom has allowed the epidemiology of whooping cough and the impact of vaccination to be studied in detail. The increase in pertussis morbidity that followed the decline in vaccine uptake in recent years confirms the continuing need for mass vaccination in a developed country. There is also evidence that pertussis may be responsible for many more deaths than official mortality statistics show. A national study of vaccine efficacy demonstrated over 80% protection against clinical disease during the first 5 years after vaccination. However, there is evidence that the current whole cell vaccine may protect less well against infection with agglutinogen serotype 3 than type 2 organisms which supports the view that both these antigens should be included in acellular vaccines to achieve good protection. In West Germany, unlike the UK, there are no national statistics on pertussis incidence, no national vaccination policy and no figures for vaccine uptake. Local studies have shown that vaccination rates are low and that pertussis is prevalent, particularly in the 2-4 year age-group, which is typical of a country with low uptake; similarly serotype 2 predominates.

Child↗
PubMed1988

Scalpel versus electrocautery in modified radical mastectomy.

Forty nine consecutive mastectomy patients were randomized to one of two groups. Twenty four patients had skin flaps created with the cold scalpel and twenty five with the electrocautery. The two groups were similar with respect to age, stage of disease, size of tumor, and weight. Cautery patients had significantly less operative blood loss when compared with scalpel patients, 352 versus 507 milliliters, respectively, P less than 0.05. No cautery patient required transfusion compared with three transfused scalpel patients, P less than .005. Total postoperative hemovac drainage and hospital stay were not significantly different between the two groups. Although the number of fever days and wound complications were slightly higher in the cautery group, the difference was not statistically significant. The electrocautery may be superior to the scalpel for mastectomy.

Electrocoagulation↗
PubMed1987

Congenital rubella in babies of south Asian women in England and Wales: an excess and its causes.

The incidence of congenital rubella was found to be 2.3 times higher in Asian than non-Asian births in England and Wales. This was attributed in part to higher susceptibility to rubella in Asian than non-Asian women, as shown by antenatal serological data from public health laboratories in Leeds, Luton, and Manchester. Examination of the ethnic origin of pregnant women requesting laboratory testing after contact with rubella or rash and of women with laboratory confirmed rubella in pregnancy also suggested that the disease was being underdiagnosed in pregnant Asian women. Failure to prevent congenital rubella by termination of infected pregnancies may therefore contribute to the increased incidence of the syndrome in Asians. Health education programmes about the dangers of rubella in pregnancy and of the need for vaccination can readily be promoted in the Asian community through existing ethnic organisations. Protection of other ethnic minorities likely to be at similar increased risk may require a vaccination programme aimed at national elimination of rubella.

Asia↗
PubMed1987

Production of and response to growth-stimulating activity in isolated bone cells.

Autologous growth-promoting activity has been shown to be secreted by bone organ cultures. To identify the cellular source of these growth factors, we have studied the activity present in cell extracts prepared from isolated bone cells released early or late from mouse calvariae following collagenase digestion. Previous studies have established that early released cell populations reside on the bone surface and consist of a heterogeneous mixture of cells that are less osteoblastic than late released cells. We find that soluble extracts of the latter cells contain more growth-promoting activity/mg of cellular protein than those of the former. By this criterion late released cells appear to be the major source of endogenous growth factors. On the other hand, upon exposure to bone cell-derived cell extracts, early released cells express a greater-fold increase in [3H]thymidine incorporation into acid insoluble radioactivity than late released osteoblasts because of the high basal mitogenic activity of the latter which may be related to their production of autologous growth factor. These data suggest that both early and later released cells may be major targets for bone growth factors produced in situ by late released osteoblasts.

Animals↗
PubMed1987

Comparative tissue distribution and excretion of [1-14C]acrylamide in beagle dogs and miniature pigs.

Male beagle dogs and miniature pigs were given acrylamide in the diet for 3-4 wk at a dosage of 1 mg/kg/day. They were then given [1-14C]acrylamide as a single oral dose of 1 mg/kg. The animals were killed 6 hr or 1, 2, 4 or 14 days after administration of the radioactive compound and tissues were analysed for radioactivity. The radiolabelled material was distributed to a major extent in muscle tissue in both species (31-35% of the dose at 6 hr and 5-7% at 14 days). Although the nervous system is the primary target for acrylamide monomer toxicity, less than 1% of the administered 14C was found in the brain in both species. No neurotoxic signs were evident during the exposure period at the dosage used. Analysis of discrete areas of the brain for radioactivity revealed that the levels of penetration of [1-14C]acrylamide in brain paralleled the vascularization pattern of the tissues. Approximately 60% of the administered radiolabel was excreted in the urine in both species and smaller amounts were excreted in the faeces. However, recovery in the faeces was higher in pigs (c. 25%) than in dogs (c. 7%) and this and the considerably higher levels demonstrated in the gastro-intestinal tract of the pigs indicated that the absorption of acrylamide was more rapid and more extensive in dogs than in pigs.

Acrylamide↗