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Biomedical subjects

G Oster

Publications and source records attributed to G Oster.

At least 109 records · Page 6Linked to original sources
PubMed1987

Cost effectiveness of labetalol and propranolol in the treatment of hypertension among blacks.

The cost effectiveness of labetalol and propranolol in the treatment of black adults with mild to moderate hypertension was assessed using published reports from US clinical trials of these agents among such patients. Data from these studies suggest that labetalol and propranolol lower diastolic blood pressure among black hypertensive adults by 11.2 mmHg and 8.4 mmHg, respectively. Results indicate that, for a hypothetical cohort of 1,000 patients on monotherapy, patients treated with labetalol would experience two to seven fewer strokes over a ten-year period, depending upon age and sex, and annual drug costs would be reduced by $190. For stepped care, annual costs would be $205 and $212 lower for those treated initially with labetalol. Labetalol therefore may be more cost effective than propranolol among black adults with mild to moderate hypertension.

Aged↗
PubMed1987

Reduction of hypertension-associated heart disease and stroke among black Americans: past experience and new perspectives on targeting resources.

Over the past two decades, national hypertension-control programs and policies have focused on early diagnosis and management. Measured by intermediate results--such as percentages of cases now taking medication--these efforts have been markedly successful, especially among black hypertensives. The ultimate measure of success--reduction in hypertension-associated disease and death--must address the one-third excess prevalent among blacks. Biologic and age-specific variables in diagnosis and treatment must be accommodated. Future gains in efficient use of resources and equity in outcome will require use of new technologies and models of targeting.

Adult↗
PubMed1986

Cost-effectiveness of nicotine gum as an adjunct to physician's advice against cigarette smoking.

A nicotine chewing gum has recently become available for use as an aid in giving up cigarette smoking. Although its efficacy has been demonstrated in clinic-based smoking cessation programs, its value in a primary care setting is uncertain. We examined the cost-effectiveness of nicotine gum as an adjunct to physician's advice and counseling against smoking during routine office visits. Our findings indicate that the cost per year of life saved with this intervention ranges from $4113 to $6465 for men and from $6880 to $9473 for women, depending on age. This compares favorably with other widely accepted medical practices, eg, treatment of hypertension or hyperlipidemia. Our study, therefore, suggests that nicotine gum is a cost-effective adjunct to physician's advice against cigarette smoking in a primary care setting.

Adult↗
PubMed1986

Rates of venous thrombosis after general surgery: combined results of randomised clinical trials.

Despite evidence that prophylaxis against deep-vein thrombosis (DVT) is effective, a large proportion of general surgical patients receive no prophylaxis. To determine the extent to which various prophylactic methods reduce the incidence of postoperative DVT, data from randomised controlled trials of these methods were combined by means of meta-analysis. The rates of DVT diagnosed by the fibrinogen uptake test were: control/no therapy 27.0% (95% confidence limits 21.9%, 32.1%); heparin 9.6% (7.2%, 11.9%); gradient compression stockings 11.1% (5.3%, 16.8%); intermittent pneumatic compression 17.6% (6.1%, 29.1%); heparin plus stockings 6.3% (0%, 17.6%); heparin plus dihydroergotamine 9.9% (6.2%, 13.6%); and stockings plus intermittent pneumatic compression 4.5% (1.1%, 8.0%). These results confirm the value of prophylaxis to reduce the incidence of DVT and suggest that combined treatments may be most effective.

Clinical Trials as Topic↗
PubMed1986

Correlates and consequences of eating dependency in institutionalized elderly.

Loss of independent eating capacity is a major problem for the institutionalized elderly. Few studies have examined the factors associated with loss of functional eating capacity. The authors cross-sectionally studied 240 residents of a skilled nursing facility, classified their functional eating status, identified correlated deficits, and followed these residents for six months. Information was gathered through questionnaires, chart review, and physical examinations. Residents were stratified into independent (68%, N = 164) and dependent (32%, N = 76) eating status groups according to the need for physical assistance during meals. Dependency status did not correlate with age (P = .88) or weight loss (P = .27). Loss of independence in eating was associated with impaired mobility (P = .0001), impaired cognition (P = .0001), modified consistency diets (P = .0001), upper extremity dysfunction (P = .0001), abnormal oral-motor examinations (P = .0002), absence of teeth and dentures (P = .002), behavioral indicators of abnormal oral and pharyngeal stages of swallowing (P = .0001), and increased mortality within six months (P = .0001). Eating dependency is therefore associated with multiple impairments and early mortality.

Activities of Daily Living↗
PubMed1986

Primary prevention and coronary heart disease: the economic benefits of lowering serum cholesterol.

We examined the expected economic benefits of cholesterol lowering for adult men with significant elevations of total serum cholesterol (above 260 mg/dl), incorporating estimates of direct benefits from anticipated reductions in lifetime expenditures for medical care, and estimates of indirect benefits related to extension of work-life secondary to reductions in morbidity and premature mortality. Our findings yield discounted lifetime direct benefits of a 15 per cent reduction in total serum cholesterol of $3 to $208 per person, and discounted lifetime indirect benefits of $1 to $8,946. Benefits increase with an individual's initial cholesterol level and decrease with the age at which an intervention is initiated. Economic benefits increase approximately twofold in the presence of other coronary risk factors, such as cigarette smoking and hypertension. Results suggest that cholesterol-lowering interventions, no matter what their cost, are unlikely to result in substantial direct savings to the health care system. However, the indirect benefits of intervention are quite high for young and middle-aged adults, as well as for those with severe elevations of cholesterol or with additional coronary risk factors.

Adult↗
PubMed1984

The economic costs of smoking and benefits of quitting for individual smokers.

The results of a study that estimated the expected lifetime economic consequences of cigarette smoking for individual smokers are reported herein. The estimates were obtained by combining age- and sex-specific estimates of the incidence-based costs of three smoking-related diseases (lung cancer, coronary heart disease, and emphysema) with estimates of smokers' increased likelihood of developing these illnesses in each remaining year of life relative to nonsmokers. Estimates of the economic consequences of quitting based on these disease cost estimates and on estimates of exsmokers' probability of future disease relative to continuing smokers are also reported. Both the estimates of the economic costs of smoking and the benefits of quitting were calculated separately for men and women between the ages of 35 and 79 who were light, moderate, or heavy cigarette smokers. While the economic costs of smoking varied considerably by sex, age, and amount smoked, they were significant for all groups of smokers. Costs for a 40-year-old man, for example, ranged from $20,000 for a smoker of less than one pack of cigarettes per day to over $56,000 for a smoker of more than two packs of cigarettes per day. The economic benefits of quitting also were found to be sizable for all groups of smokers.

Adult↗
PubMed1984

Muscle sounds.

Explore the source record for details and available documents.

Humans↗
PubMed1983

Chemically induced congenital thymic dysgenesis in the rat: a model of the DiGeorge syndrome.

The DiGeorge syndrome, a variable complex of thymic aplasia, congenital heart disease, hypoparathyroidism, and anomalies of the face and neck, is thought to result from exposure to teratogenic agents. A group of congenital defects closely resembling this syndrome can be produced in newborn rats by the administration of the fat-soluble zinc chelating agent WIN 18,446, a bis-dichloroacetylamine. This drug, nontoxic to adult animals, is a powerful teratogen when administered to pregnant rats during days 9-12 of the 21-day gestation period. Our animal data suggest that the human syndrome results from exposure in utero to agents like WIN 18,446, which damage the fetus during a critical period of organogenesis.

Animals↗
PubMed1982

Perinatal death and respiratory apparatus dysgenesis due to a bis (dichloroacetyl) diamine.

N, N1-bis (dichloroacetyl) diamine 1, 8-octomethylenediamine (WIN 18,446) is an experimental drug which was first investigated as a male contraceptive. It is soluble in lipid solvents but not in water. The administration of 1,200 to 1,600 mg/kg to pregnant rats on the tenth day of gestation produced multiorgan fetal malformations. Smaller doses, 400 to 800 mg/kg, especially if divided over 2 or 3 days, caused perinatal death. Thus, 60 to 100% of offspring of rats given WIN 18,446 on the tenth and 11th days of gestation died at birth or within 4 days (Taleporos et al., 78). The present study investigated such deaths. At doses of 200 mg/kg on day 10 or 50 mg/kg on days 10 and 11, 67% of offspring had defective or absent diaphragms, 48% had tracheobronchiomegaly with cystic lungs, and 67% had pleural hemorrhage. At doses of 100 mg/kg given on 1 day or 25 mg/kg each day for 2 days, 50% had tracheobronchiomegaly with cystic lungs and rudimentary acini. At lower doses (18.8 mg/kg X 2 or 12.4 mg/kg X 3), a majority of fetal lungs had rudimentary acini, thick septa, few capillaries, and wide cuffs of perivascular connective tissue. Thus, a chemical given during organogenesis produced dysgenesis of the respiratory apparatus. Varying the dose produced malformed lungs with persistently deficient acini which model such human lung faults as tracheobronchiomegaly (Mournier-Kuhn Syndrome; Mounier-Kuhn, '32), bronchiolar dysplasia (Wilson-Mikity Syndrome), and perinatal death with acinar failure resembling neonatal hyaline membrane disease.

Abnormalities, Drug-Induced↗
PubMed1980

Low frequency sounds from sustained contraction of human skeletal muscle.

Low frequency audible vibrations are produced by human skeletal muscles undergoing sustained contraction. The effect is easily demonstrable with an electronic stethoscope which amplifies sound below 50 Hz. Autocorrelation analysis of the signal shows that it is periodic with a frequency 25 +/- 2.5 Hz. The quality of the sound is the same for all the skeletal muscles tested and is unaffected by changes in tension, ambient temperature, and blood flow. Electrically-stimulated contraction produces a sound which is indistinguishable from voluntary contraction. The amplitude of the sound increases linearly with tension. The sound signals are uncorrelated both in frequency and phase with electromyographic signals obtained simultaneously while the muscle is contacted. Arguments are presented to show that the sounds may be an intrinsic property of muscle contraction.

Humans↗
PubMed1978

Teratogenic action of bis(dichloroacetyl)diamine on rats: patterns of malformations produced in high incidence at time-limited periods of development.

Win 18,446, a bis(dichloroacetyl)diamine, is a drug that was previously shown to suppress spermatogenesis and to be an effective oral abortifacient in rats. The present study shows that the drug is capable of producing characteristic congenital malformations in high incidence, by a single treatment, and with high survival of fetuses to day 21. Gestation day 11 is the most sensitive time. The teratologies obtained after various schedules of treatment include malformations of the snout (100%), septal heart defects (100%) diaphragmatic hernias (100%), cryptorchism (100%), cervical pockets (100%) and absent or small irregular thymus (92%). Some of these data, namely of the heart, face and thymus, cluster in patterns that indicate that the action of the drug is upon a time-resistricted developmental process. These periods of sensitivity are subsiding or have ended before primordia of these structures appear, but they coincide with the proliferation and migration of those mesenchyme cells that will eventually form or contribute to the structures affected. It is postulated that the drug acts on these mesenchyme cells, or on the extracellular matrix that provides the necessary framework for their dispersal.

Abnormalities, Drug-Induced↗