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Biomedical subjects

H E Thomas

Publications and source records attributed to H E Thomas.

At least 37 records · Page 2Linked to original sources
PubMed1990

Differentiation of Becker muscular dystrophy from limb-girdle muscular dystrophy and Kugelberg-Welander disease using a cDNA probe.

A 31-year-old man previously investigated for a neuromuscular disorder was diagnosed as having either limb-girdle dystrophy, spinal muscular atrophy, or Becker muscular dystrophy. Extensive clinical and special neurological investigations failed to clarify this differential diagnosis. However, recent DNA studies have shown a deletion of the dystrophin gene, thereby providing an unequivocal diagnosis of Becker muscular dystrophy. The application of molecular genetic techniques in the diagnosis of inherited neuromuscular disorders is discussed.

Adult↗
PubMed1990

Physiologic and symptomatic responses of cardiac patients to resistance exercise.

The purpose of this study was to investigate the symptomatic and physiologic responses during moderate to heavy resistance exercise in a population with coronary artery disease. After at least 12 weeks of aerobic training without experiencing complications, 15 male cardiac patients were selected for the study. Approximately one week after a graded exercise test (GXT), each patient's maximal voluntary contraction (MVC) was determined on seven upper-body Nautilus machines. Resistance exercises, consisting of two sets of seven repetitions at a submaximal intensity (75% MVC) for each exercise, were then performed on two nonconsecutive occasions; symptomatic, hemodynamic, and electrocardiographic responses were recorded and analyzed for patients both on and off beta-blockers. During the MVC and submaximal exercise trials, no significant untoward hemodynamic change was noted with heart rate, systolic blood pressure, diastolic blood pressure, or rate pressure product, and no patient complained of angina or developed ischemic electrocardiographic changes. However, three incidences of premature ventricular contractions (PVCs) occurred. During the GXT, there were 13 incidences of angina, ischemia, or PVCs. Patients taking beta-blockers had significantly lower (p less than .01) values for heart rate and rate pressure product during the GXT, MVC, and submaximal trials. These results suggest that clinically stable, aerobically trained cardiac patients may perform moderate to heavy resistance exercises without experiencing complications.

Adult↗
PubMed1989

Role of support networks in maintenance of improved cardiovascular health status.

This study was undertaken to clarify the relationship between maintaining an improved cardiovascular health status and social support networks. Two hundred and ninety participants from a national trial that was carried out to specify the impact of reducing risk for cardiovascular disease were rescreened 3 years after completion of the trial. Original risk status of the participants was compared to risk status at the end to identify who had an improved risk status (n = 204). Risk status of 204 improvers was calculated from the rescreening data to identify maintainers (n = 63) and nonmaintainers (n = 143). No significant differences were found between maintainers and nonmaintainers in sociodemographic status, or in level of general support. Highly significant differences were found for four types of support provided specifically for risk reduction: information/advice (P = 0.002), appraisal (P = 0.004), emotional support (P = 0.01) and availability (P = 0.019). Most of these differences in support were accounted for by the larger support network identified by the maintainers. In addition, compared to nonmaintainers, maintainers' networks were more family-centered (P = 0.012), and were correspondingly more dense (P = 0.021). A discriminant function analysis using the significant variables was able to predict maintenance in 72% of the cases. The significant variables also accounted for 10% of the variance between maintainers and nonmaintainers. The implications of this study are: (1) assessment of support should be specific to the health outcome being studied: (2) research on the impact of social environment on health status will benefit from clearly specifying individual components of social support and social networks; (3) amount of social support provided is related to size of the network and relationship of supporter to the at-risk individual; (4) because social support and social networks account for a small but significant amount of the variance between maintainers and nonmaintainers, these concepts should be included in patient assessments prior to developing a treatment or maintenance plan.

Conflict, Psychological↗
PubMed1988

Human melanoma cells: functional modulation by calciotropic hormones.

Four human melanoma cell lines were examined for their responsiveness to the hormones 1,25-dihydroxyvitamin D3 (1,25[OH]2D3), calcitonin, and parathyroid hormone (1-34). Cells from each of the 4 lines contained high affinity binding sites for 1,25(OH)2D3. At high cell densities, binding of 1,25(OH)2D3 was diminished due to a decrease in receptor number with no apparent change in affinity. Preincubation with 1,25(OH)2D3 (10(-10) to 10(-8) M) increased tyrosinase activity 1.3- to 3.2-fold and 25-hydroxyvitamin D3-24-hydroxylase activity 1.4- to 10-fold. Human calcitonin (0.82 to 82.5 ng/well) raised the intracellular concentration of cyclic adenosine monophosphate 1.4- to 9.4-fold. Tyrosinase activity increased in response to calcitonin in 2 of the cell lines, decreased in the third, and showed no change in the fourth. Human parathyroid hormone (1-34) in concentrations of 1 to 10 ng/ml produced no significant changes in cyclic adenosine monophosphate accumulation, cell numbers, or tyrosinase activity in any of the cell lines. This study indicates that the phenotype of human melanoma cells can be modulated by the calciotropic hormones 1,25(OH)2D3 and calcitonin.

Calcitonin↗
PubMed1986

Overall and coronary heart disease mortality rates in relation to major risk factors in 325,348 men screened for the MRFIT. Multiple Risk Factor Intervention Trial.

The influence of risk factors on CHD and all-cause mortality rates in 35- to 57-year-old men is examined by means of data on 325,348 white men who were screened for the MRFIT. This large data set permits an unusually detailed analysis of factors associated with the 6968 deaths, including 2426 ascribed to CHD, that were detected in the Social Security Administration data set during 6 years of follow-up. Simple cross classification of the data confirms the independent effect of serum cholesterol concentration, diastolic blood pressure, and cigarette smoking as risk factors for CHD and all-cause mortality rates. A distinct escalation of risk is noted for combinations of these risk factors. The strength of the association of each of the risk factors with CHD and all-cause mortality rates diminished with increasing age, although the number of excess deaths attributable to the risk factors increased because of the higher death rates in older men. Comparison of these findings with those observed in the five populations studied in the Pooling Project revealed an overall similarity in the risk relationships. It is estimated that elimination of these risk factors has the potential for reducing the CHD mortality rate by two thirds in 35- to 45-year old men, and by one half in 46- to 57-year-old men.

Adult↗
PubMed1986

The Birmingham Tuberculosis Drug Resistance Register, 1956-1983.

The findings of the Birmingham Drug Resistance Register are recorded for the years 1956-83. In native born patients initial drug resistance was common up to 1969, but few new cases were discovered after 1970. In the immigrant population a peak of male discoveries was noted in 1968 and a peak of female discoveries in 1979, probably due to immigration patterns. In the native born, single drug resistance was the more common pattern; no initial isoniazid resistance has been detected in this group since 1970. The immigrant patients showed a higher proportion of initial multiple drug resistance. The proportion of culture positive respiratory tuberculosis from which drug resistant bacilli were isolated is given for the years 1976-1983. For native born males this was 1%, for native born females 0.6%, for immigrant males 5.1% and for immigrant females 6.5%. The detections of acquired drug resistance were high in 1956, but since 1970 have fallen to low levels, as has the pool of chronic excretors of drug resistant tubercle bacilli.

Aminosalicylic Acid↗
PubMed1985

Clinical-electrocardiographic correlates of newly acquired left bundle branch block: the Framingham Study.

To determine whether any associated electrocardiographic findings in persons with newly acquired complete left bundle branch block (LBBB) correlate with the prevalence of associated clinically apparent cardiovascular abnormalities, electrocardiograms (ECGs) from all 55 members of the Framingham Study cohort in whom LBBB developed during 18 years of routine prospective biennial examinations were reviewed. A QRS axis left of or equal to 0 degrees, left atrial conduction delay and an inverted T wave in lead V6 on the first ECG with LBBB, and an abnormal ECG in the Framingham examination preceding the appearance of LBBB each correlated with the prevalence of systemic hypertension, cardiomegaly, coronary heart disease and congestive heart failure. However, neither the PR interval nor the duration of the QRS complex on the first ECG with LBBB correlated with the prevalence of any of the associated cardiovascular abnormalities. The 8 patients with neither left atrial conduction delay nor a QRS axis left of or equal to 0 degrees on the first Framingham ECG with LBBB nor an abnormal ECG on the examination preceding the appearance of LBBB were 6 times more likely to remain free of all of the clinical cardiovascular abnormalities than the 47 patients with 1 or more of these 3 electrocardiographic findings (p less than 0.001).

Adult↗
PubMed1983

The relationship of the baseline ECG to blood pressure change.

A total of 1,090 male participants (aged 23 to 80 years) of the Normative Aging Study who had baseline BP less than 140/90 mm Hg were observed prospectively for ten years. Blood pressures were taken at five- and ten-year follow-up examinations. Multiple linear regression analysis indicated that baseline levels of systolic pressure, age, R-wave amplitude (aVL), hematocrit, T-wave amplitude (V5), and S-wave amplitude (V4, V5, and V6) were statistically significant predictors of systolic pressure change. Baseline levels of diastolic pressure, R-wave amplitude (aVL), and hematocrit were statistically significant predictors of diastolic pressure change. Multiple logistic regression analysis showed that baseline levels of BP, S-wave amplitude (V1, V2, and V3), body mass index, R-wave amplitude (V4, V5, and V6), and T-wave amplitude (V5) were statistically significant predictors of subsequent hypertension. Whether the identified ECG amplitudes are an indicator of early increases in peripheral resistance or a function of neurohumoral factors, or both, is unknown.

Adult↗
PubMed1983

The relationship of the U wave to the 10-year incidence of myocardial infarction.

The relationship between the baseline electrocardiogram and 10-year incidence of myocardial infarction was examined in a cohort of 1013 men. The men were participants in the Normative Aging Study, a longitudinal study of aging initiated in 1963 at the Veterans Administration Outpatient Clinic in Boston, Massachusetts. Absence of the U wave among these men yielded a relative risk estimate of myocardial infarction of 2.7 as compared to men with a U wave present (95% confidence interval, 1.4-5.2). This association persisted when standard coronary risk factors (cholesterol, blood pressure, and cigarette smoking) were taken into consideration in a multivariate analysis. The results support the conclusion that an abnormality in the electrocardiogram considered to be of little importance indicates an increased risk of myocardial infarction independent of known coronary risk factors.

Adult↗
PubMed1983

Coronary heart disease in police officers participating in the Normative Aging Study.

There is evidence suggesting that male police officers are at a higher risk of developing coronary heart disease than males in the general population. Thus, 1648 men (including 220 police officers and 1428 non-police officers) were followed for 10 years to determine the incidence of coronary heart disease. Subjects were participants of the Normative Aging Study, a longitudinal study of aging initiated in 1963 at the Veterans Administration Outpatient Clinic in Boston, Massachusetts. Comparison of police officers and non-police officers showed no statistically significant differences in the crude incidence rates of coronary heart disease (myocardial infarction, angina pectoris, or death from coronary heart disease) and myocardial infarction alone. When baseline age, serum cholesterol, blood pressure, cigarette smoking, and body mass index were taken into consideration in multiple logistic regression analyses, the lack of significant differences between groups persisted. Police officers relative to non-police officers had an adjusted risk ratio (odds ratio) of 1.4 (95% confidence interval = 0.7-2.4) for coronary heart disease and 1.0 (95% confidence interval = 0.4-2.4) for myocardial infarction. Differences between occupational groups were not statistically significant.

Adult↗
PubMed1982

Factors in predicting blood pressure change.

A total of 1166 male participants (ages 23--80 years) of the Normative Aging Study who had baseline blood pressure less than 140/90 mm Hg were followed prospectively for 10 years. Blood pressures were taken at 5- and 10-year follow-up examinations. Multiple linear regression analysis indicated that baseline levels of systolic pressure, hematocrit, subscapular skinfold thickness and age were significant predictors of systolic pressure change during the follow-up period. Baseline levels of diastolic pressure, hematocrit, and body mass index were significant predictors of diastolic pressure change. Multiple logistic regression analysis revealed that only baseline blood pressure and hematocrit were significant predictors of subsequent blood pressure elevation to more than 159 mm Hg systolic or 94 mm Hg diastolic. Although the mechanisms by which hematocrit and body build affect blood pressure are unknown, these results suggest that identifying hypertension-prone subjects and delaying or preventing hypertension may be possible.

Adult↗
PubMed1981

Comparative features of newly acquired left and right bundle branch block in the general population: the Framingham study.

Cardiovascular abnormalities were prospectively identified in all 55 persons who acquired left bundle branch block and all 70 persons who acquired right bundle branch block during 18 years of follow-up of the Framingham Study cohort. Those with left and right bundle branch block did not differ from each other in the overall prevalence of either hypertension, clinical coronary disease or diabetes. In men, but not in women, left bundle branch block was associated with a significantly greater prevalence of cardiac enlargement and congestive failure than was right bundle branch block. A trend suggesting a higher mortality rate from cardiovascular disease in those with left than in those with right bundle branch block was more apparent in men than in women. It is concluded that in the general adult population, men who acquire left bundle branch block are more likely to have or subsequently acquire advanced cardiovascular abnormalities than are men who acquire right bundle branch block. In women, however, the clinical correlates of the two conduction abnormalities are similar.

Adult↗
PubMed1980

Newly acquired right bundle-branch block: The Framingham Study.

Cardiovascular abnormalities were identified prospectively in all 70 persons who developed complete right bundle-branch block (RBBB) in The Framingham Study during 18 years of biennial follow-up. Most were hypertensive before the appearance of RBBB. Although the initial appearance of RBBB was usually unaccompanied by overt clinical events, the subsequent incidence of coronary disease and congestive failure was two and one-half and four times greater, respectively, than that in matched control subjects without RBBB. The incidence of cardiovascular disease mortality was almost three times greater in persons who developed RBBB than in an age-matched sample of the population-at-large. This excess of cardiovascular disease mortality was related primarily to the high prevalence of associated cardiovascular abnormalities. Only 21% remained free from clinically apparent cardiovascular abnormalities. A QRS duration of greater than or equal to 130 ms and a QRS axis between -45 degrees and -90 degrees identified those most likely to have associated cardiovascular abnormalities.

Adult↗