Search PubMed⌕ Search

Biomedical subjects

J F Heyse

Publications and source records attributed to J F Heyse.

24 records · Page 2Linked to original sources

A model for evaluating the cost-effectiveness of cholesterol-lowering treatment.

We describe and illustrate the use of a generalizable model for evaluating the cost-effectiveness of alternative cholesterol-lowering treatments. We combine standard incidence-based techniques for measuring the cost of illness with logistic risk functions from the Framingham Heart Study to project, for persons with known coronary risk characteristics, the likelihood of developing coronary heart disease (CHD) over a lifetime as well as a number of related outcomes, including the expected loss of years of life due to CHD, the expected lifetime direct and indirect costs of CHD, and the changes in these outcomes that would result from cholesterol-lowering treatment.

Adult↗

Beneficial effects of milrinone and enalapril on long-term survival of rats with healed myocardial infarction.

The long-term survival of rats with healed myocardial infarction and congestive heart failure treated with milrinone, enalapril and the combination of milrinone plus enalapril, was documented. Seven days after sham or coronary ligation, 200 rats (99 sham and 101 myocardial infarcted) were randomized based on electrocardiographic criteria to receive tap water, milrinone (20-40 mg/l drinking water), enalapril (17-25 mg/l) or the combination of milrinone plus enalapril (20-40 mg/17-25 mg per l). The date of spontaneous death was recorded and heart weights and myocardial infarct size (by planimetry) were determined. Long-term enalapril therapy prolonged survival with a median 50% survival (MS50) of 233 days compared to 203 days in the tap water group. Milrinone therapy also prolonged survival with a MS50 of 297 days. The combination therapy prolonged survival with a MS50 of 277 days. In general, there were three times as many rats alive in the treatment groups at the end of one year compared to untreated control groups. Cardiac hypertrophy was evident in all myocardial infarcted groups and heart weights were significantly reduced by all treatments. The average myocardial infarct sizes and the distribution of infarct sizes were not different between groups (36.8-43% of left ventricle). This study demonstrates that long-term therapy with enalapril and milrinone prolongs survival in rats with healed myocardial infarctions. The prolongation of survival was comparable in the milrinone plus enalapril groups, indicating that there was no synergy with these two agents with survival as the end point.

Animals↗

Interactions between caffeine and adenosine agonists in producing embryo resorptions and malformations in mice.

Caffeine has previously been demonstrated to be teratogenic in mice, causing primarily limb reduction defects and cleft palate. To investigate the possibility that the mechanism of caffeine teratogenesis is related to its central stimulant activity, which is thought to result from its activity as an adenosine antagonist, the effects of the stable adenosine agonists L-phenylisopropyladenosine (L-PIA) and chloroadenosine on caffeine teratogenicity were examined. It was found that these adenosine analogs have embryolethal effects when administered intraperitoneally on Days 11 and 12 of gestation at extremely low dosages (minimal effect levels of 1 and 10 mumol/kg, respectively). Caffeine at dosages as low as 129 mumol/kg ip protected against the embryolethal effects of 5 mumol/kg L-PIA if administered simultaneously with L-PIA but not if administered 30 to 60 min after L-PIA. The maternotoxicity of either of the adenosine agonists or caffeine alone was ameliorated by coadministration of the other, particularly when the molar excess of caffeine was approximately 20-fold. These results suggest that the embryotoxicity and maternotoxicity of the adenosine agonists and the maternotoxicity of caffeine are mediated by binding to adenosine receptors. When coadministered with teratogenic dosages of caffeine (1160 to 1290 mumol/kg), L-PIA and chloroadenosine at dosage levels of 1 to 100 mumol/kg did not prevent and in some cases potentiated the teratogenic effects of caffeine. This lack of protection by L-PIA and chloroadenosine suggests that adenosine receptors are not the primary site of action for caffeine-induced teratogenicity. The embryolethal effects of L-PIA and chloroadenosine and the teratogenicity of caffeine occurred only at maternotoxic dosages. However, an analysis of the correlation structure indicates that the embryotoxicities of L-PIA and caffeine were not secondary to maternotoxicity as measured by body weight change.

2-Chloroadenosine↗

Testing the statistical certainty of a response to increasing doses of a drug.

Experiments in which the treatments are composed of a series of doses of a compound and a zero dose control are often used in animal toxicity studies. A test procedure is proposed to assess trends in the response variable. The notion of a no-statistical-significance-of-trend (NOSTASOT) dose is introduced, and questions of multiplicity of statistical tests in this context are addressed.

Animals↗