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Biomedical subjects

J F Price

Publications and source records attributed to J F Price.

At least 37 records · Page 2Linked to original sources
PubMed1999

Relationship between smoking and cardiovascular risk factors in the development of peripheral arterial disease and coronary artery disease: Edinburgh Artery Study.

AIMS: The aim was to determine whether the effect of smoking on the development of peripheral or coronary artery disease might be mediated by other cardiovascular risk factors, including dietary antioxidant vitamin intake, serum low and high density lipoproteins, blood pressure, plasma fibrinogen, blood viscosity and markers of endothelial disturbance and fibrin turnover. METHODS AND RESULTS: 1592 men and women aged 55-74 years were selected at random from 11 general practices in Edinburgh, Scotland and followed-up for 5 years. The incidences of peripheral arterial disease and coronary artery disease were 5.1% and 11.1%, respectively. Both conditions were more common in moderate and heavy smokers than in never smokers: cigarette smoking was a stronger risk factor for peripheral arterial disease than for coronary artery disease. Smoking was associated with reduced dietary antioxidant vitamin intake, serum high density lipoprotein cholesterol and diastolic blood pressure and with increased alcohol intake, serum triglycerides, blood viscosity, plasma fibrinogen, and markers of endothelial disturbance (tissue plasminogen activator and von Willebrand factor antigens). Simultaneous adjustment for these risk factors reduced the relative risk of peripheral arterial disease only slightly, from 3.94 (95% CI 2.04, 7.62) to 2.72 (95% CI 1.13, 6.53) in heavy smokers and from 1.87 (95% CI 0.91, 3.85) to 1.70 (95% CI 0.72, 3.99) in moderate smokers. Similar adjustment also had little effect on the risk of coronary artery disease associated with smoking. CONCLUSION: The combined effect of smoking on the cardiovascular risk factors studied may explain part of its influence on peripheral and coronary arterial disease, but the majority of the effect appears to be due to other mechanisms.

Aged↗
PubMed1999

Retrospective review of cystic fibrosis presenting as infantile liver disease.

The mode of presentation, clinical course, and outcome of 12 infants with cystic fibrosis and liver disease referred over an 18 year period were investigated retrospectively. Median age at presentation was 6.5 weeks (range, 5-12). Two thirds were boys. Conjugated hyperbilirubinaemia was the presenting symptom in 11 patients, and hypoalbuminaemia in one. Jaundice was cleared over a median period of 7.36 months. Eight patients had bile duct proliferation on liver biopsy and one required cholangiography to exclude biliary atresia. Classic histological features of cystic fibrosis were only present in two children biopsied at 8 and 18 months. Three patients had meconium ileus, including one infant with concomitant alpha(1) antitrypsin deficiency, who required early liver transplantation. All other patients had no signs of significant chronic liver disease during a median follow up of 42 months (range, 10-205). Children with cystic fibrosis and infantile liver disease have a good short and medium term prognosis.

Albuminuria↗
PubMed1999

Role of systolic blood pressure and plasma triglycerides in diabetic peripheral arterial disease. The Edinburgh Artery Study.

OBJECTIVE: To determine the risk factors for peripheral arterial disease (PAD) in a diabetic population and to examine whether different levels of these risk factors might explain why diabetic subjects have an increased risk of PAD compared with normal glucose tolerance subjects. RESEARCH DESIGN AND METHODS: There were 1,592 men and women aged 55-74 years selected at random from the age-sex registers of 11 general practices in Edinburgh, Scotland. Subjects underwent a comprehensive medical examination, including assessment for PAD (intermittent claudication on World Health Organization questionnaire or major asymptomatic disease on noninvasive testing) and a glucose tolerance test. RESULTS: Of the subjects, 288 (18.7%) were found to have diabetes or impaired glucose tolerance (IGT). The prevalence of PAD was greater in those with diabetes/IGT (20.6%) compared with those with normal glucose tolerance (12.5%) (odds ratio [OR] 1.64, 95% CI 1.17-2.31). Among the diabetes/IGT group, mean levels of smoking, systolic blood pressure, and triglycerides were higher in subjects with PAD than in those without PAD (P < or = 0.05). Mean levels of systolic blood pressure and plasma triglycerides were also higher in diabetic subjects than in nondiabetic subjects with PAD (P < or = 0.05). In multivariate analysis, those with diabetes/IGT no longer had a significantly higher risk of PAD after adjusting separately for systolic blood pressure (OR 1.22, 95% CI 0.85-1.73) and plasma triglycerides (OR 1.26, 95% CI 0.89-1.79). Simultaneous adjustment for both systolic blood pressure and triglycerides reduced the risk of PAD among diabetic subjects to 1.11 (95% CI 0.78-1.58). CONCLUSIONS: Increased mean levels of triglycerides and systolic blood pressure may help to explain the higher prevalence of PAD in diabetic subjects compared with that in normal glucose tolerance subjects.

Aged↗
PubMed1998

Young people's drug use: facts and feelings.

The study aimed to quantify the major findings of a previous qualitative study on drug use and young people. Findings are reported on drug use; views on the use of cannabis; amphetamines and heroin; and the relationship between these views and reported drug use. Reported usage and feelings about drug use are discussed in relation to the extent to which drug use can be considered to be 'normalised'. There is only weak evidence that normalisation, even of cannabis use, is true for young people towards the end of their compulsory schooling. However the findings provide some evidence for both sides in the 'normalisation debate' against a backdrop of apparent increasing use of drugs. Until more evidence is available, the normalisation debate will continue.

Adolescent↗
PubMed1998

Thermal inactivation of Escherichia coli O157:H7, Salmonella senftenberg, and enzymes with potential as time-temperature indicators in ground turkey thigh meat.

The USDA Food Safety and Inspection Service has proposed to amend cooking regulations to require that any thermal process used for poultry products be sufficient to cause a 7 D reduction in salmonellae. Several enzymes have been suggested as potential indicators of heat processing in poultry, yet no relationship between the inactivation rates of these enzymes and salmonellae had been determine. The thermal inactivation kinetics of endogenous muscle proteins. Escherichia coli O157:H7 and Salmonella senftenberg were compared in ground turkey thigh meat in thermal death time studies. Bacteria counts were determined and muscle extracts were assayed for residual enzyme activity or protein concentration D and zeta values were calculated using regression analysis. S. senftenberg had higher D values at all temperatures and was more heat resistant than E. coli. The zeta values of E. coli on Petrifilm Coliform Count plates and phenol red sorbitol agar plates were 6.0 and 5.7 degrees C, respectively. The zeta values of S. senftenberg were 5.6 and 5.4 degrees C on Petrifilm and agar, respectively. Lactate dehydrogenase (LDH) was the most heat stable protein at 64 degrees C. LDH, glyceraldehyde-3-phosphate dehydrogenase, creatine kinase, triose phosphate isomerase (TPI), acid phosphatase, serum albumin, and immunoglobulin G had zeta values of 3.8,4.3,4.8,5.8,6.3,6.7, and 8.6 degrees C, respectively , in turkey containing 4.3% fat. The zeta values for TPI decreased to 5.4 degrees C in thigh meat containing 9.8% fat. Temperature function of TPI was most similar to that of S. senftenberg, suggesting it might function as an endogenous time-temperature integrator to monitor adequacy of processing when a performance standard based on this pathogen is implemented.

Acid Phosphatase↗
PubMed1997

Growth during one year of treatment with fluticasone propionate or sodium cromoglycate in children with asthma.

The aim of this study was to compare accurately measured growth over 12 months in asthmatic children treated with either fluticasone propionate (FP) 50 micrograms twice daily (b.i.d.) or sodium cromoglycate (SCG) 20 mg four times daily (q.i.d.). After a 2-week run-in, asthmatic children aged 4-10 years from 15 UK centers were randomized in a 3:4 ratio to open-label FP (n = 52) or SCG (n = 70). After 8 weeks, those whose asthma was not adequately controlled were switched from SCG to FP or withdrawn. Standing height was measured (Holtain stadiometry) at baseline, after 8 weeks and at 6 weeks intervals thereafter for 1 year. Morning peak flows (PEFam) were recorded by patients for 2 weeks during baseline, and 1 week before each visit during treatment. Urinary free cortisol (24 h) was measured at baseline, 6 months, and 1 year. After 8 weeks, 22 patients were withdrawn from SCG group (and were switched to FP), and five patients were withdrawn from the FP group due to poor asthma control. A further 21 and 11 patients were withdrawn from the SCG and FP groups, respectively, during the course of the study. There were no significant differences between patients who received FP and SCG for 1 year (n = 34 and n = 26, respectively) in terms of height velocity adjusted for age and gender (HV), or height velocity standard deviation scores adjusted for gender (HVSDS). Mean HV (mean HVSDS) were 6.0 cm/yr (0.1) and 6.5 cm/yr (0.5) for FP and SCG, respectively. There were no treatment differences in mean 24 h urinary free cortisol levels at 6 and 12 months. Mean % predicted PEFam improved over 1 year in both groups but to a greater degree in the FP group. We concluded that growth was normal in mildly asthmatic children receiving FP (50 micrograms bid) for 1 year. There were fewer withdrawals and lung function improved to a greater extent in FP treated patients than in patients receiving SCG.

Administration, Inhalation↗
PubMed1997

Steroid sex hormones and peripheral arterial disease in the Edinburgh Artery Study.

Although treatment with high dose exogenous sex hormones affects cardiovascular risk, the role of physiological levels of endogenous sex hormones in the development of atherosclerotic disease in men and women is unknown. Forty men and 43 women wit peripheral arterial disease and 88 age- and sex-matched controls were selected from participants in the Edinburgh Artery Study, a random survey of 1592 men and women ages 55-74 years from the general population. Compared with sex-matched controls, male cases had higher systolic blood pressure (155.5 mmHg vs. 138.7 mmHg; p < or = 0.01) and waist hip ratio (0.92 vs. 0.89; p < or = 0.05) and female cases had higher lifetime smoking (square root of packyears 2.14 vs. 1.03; p < or = 0.05). Mean estrone levels were slightly higher in male cases than controls (101.9 pmol/Liter vs. 92.1 pmol/Liter; p = 0.09), but this association lost significance after multivariate adjustment for age and body mass index. Mean levels of total and free testosterone, estradiol, and sex hormone binding globulin were not significantly different in cases compared with controls in either sex (p > 0.1). These results, in accordance with previous prospective studies on coronary artery disease, do not support a role for physiological levels of endogenous sex hormones in the development of peripheral arterial disease in men or postmenopausal women.

Age Factors↗
PubMed1997

Haemostatic and rheological factors as predictors of restenosis following percutaneous transluminal angioplasty.

OBJECTIVES: To determine whether pre-angioplasty levels of haemostatic and rheological factors predicted restenosis of the dilated arterial segment following percutaneous transluminal angioplasty. DESIGN AND SETTING: Prospective study, Two regional hospital centres for angioplasty in Edinburgh and Glasgow, Scotland, UK. METHOD: Haemostatic and rheological factors were measured in 102 subjects with atherosclerotic disease of the lower limbs, immediately prior to percutaneous transluminal angioplasty. Subjects were followed up after 2-3 years for restenosis of the original angioplasty site using duplex scanning. RESULTS: Baseline clinical characteristics were similar between subjects who restenosed (n = 27) and those with no restenosis (n = 39), except that occluded lesions were more likely to restenose than stenoses (p < or = 0.05). There was no significant difference in age- and sex-adjusted mean levels of whole blood viscosity, plasma viscosity, haematocrit, von Willebrand factor, fibrin D-dimer or plasminogen activator inhibitor-1 activity between the stenosed and no restenosis groups (p > 0.1), but mean plasma fibrinogen was lower in the restenosed group (3.31 g/l vs. 3.75 g/l; p < or = 0.05). These results persisted after multivariate adjustment for smoking habit and type of lesion dilated. CONCLUSIONS: This study provides no evidence that raised, pre-angioplasty levels of haemostatic and rheological factors predict restenosis following percutaneous transluminal angioplasty of the arteries of the lower limbs.

Angioplasty, Balloon↗
PubMed1997

Blood viscosity and risk of cardiovascular events: the Edinburgh Artery Study.

We examined the relationships of whole blood viscosity and its major determinants to incident cardiovascular events (ischaemic heart disease and stroke) in a prospective study of a random population sample of 1592 men and women aged 55-74 years (the Edinburgh Artery Study). 272 fatal and non-fatal cardiovascular events occurred during 5 years of follow-up (cumulative incidence 17.1%). Age and sex adjusted mean levels of blood viscosity (3.70 v 3.55 mPa.s), haematocrit (46.2 v 45.7%), haematocrit-corrected blood viscosity (3.57 v 3.48 mPa.s), plasma viscosity (1.35 v 1.33 mPa.s) and fibrinogen (2.88 v 2.67 g/l) were significantly higher in subjects who experienced events than in subjects who did not. The relationships of these rheological variables to cardiovascular events were at least as strong as those of conventional risk factors (smoking habit, diastolic blood pressure, and low-density lipoprotein cholesterol). After adjustment for these conventional risk factors, the associations of blood viscosity and haematocrit remained significant for stroke, but not for total events; whereas the associations of plasma viscosity and fibrinogen remained significant for total events and for stroke. These findings suggest that increased blood viscosity may be one plausible biological mechanism through which increases in haematocrit and fibrinogen may promote ischaemic heart disease and stroke. Randomized controlled trials of viscosity reduction in the prevention of cardiovascular events (e.g. by lowering high levels of haematocrit or plasma fibrinogen) are suggested.

Aged↗
PubMed1997

Risk factors and the sex differential in coronary artery disease.

In industrialized countries, the incidence of coronary artery disease is three to four times higher in men than in women. Our review examines whether differences in the prevalence of, or susceptibility to, various coronary risk factors might contribute to this sex differential. Cigarette smoking, hypertension, and hypercholesterolemia are risk factors for coronary artery disease in both sexes and are present at higher levels in middle-aged men than women. To date, such differences have failed to explain the coronary sex differential, although higher biological susceptibilities to smoking, blood pressure, and total cholesterol in men may also be important. Mean levels of protective high-density-lipoprotein cholesterol are higher in women than in men throughout life and may also contribute to the sex differential. In addition, men with a female pattern of abdominal fat distribution are at lower risk of coronary artery disease than those with a male pattern. In diabetic populations, the sex differential is greatly reduced, but studies on the effects of hyperinsulinemia and a lower insulin resistance in women compared with men are scarce. Prospective studies on the effect of fibrinogen and other hemostatic factors in women are also required.

Adult↗
PubMed1997

Prospective study of lung volumes in young asthmatic children.

In a 9-y prospective study, the occurrence and duration of lung volume abnormalities in 21 young asthmatic children (median age at recruitment 4 y, range 3-8 y) was determined. The median functional residual capacity (FRC) at recruitment was 135% of that predicted for height (range 79-187%) and 13 children were hyperinflated. The median FRC decreased significantly after 3 y of follow-up and by 9 y only one child remained hyperinflated. We conclude that persistent elevation of lung volume in young asthmatic children appears to be uncommon.

Age Distribution↗
PubMed1997

Intradecidual sign: is it effective in diagnosis of an early intrauterine pregnancy?

PURPOSE: To determine if the intradecidual sign at sonography is effective in the diagnosis of early intrauterine pregnancy. MATERIALS AND METHODS: In 102 pregnant patients, transvaginal sonography revealed an intrauterine fluid collection without a yolk sac or embryo. Four observers (experienced sonologist, body imaging fellow, 1st-year radiology resident, and premedical student) determined independently whether the intradecidual sign was absent, present, or indeterminate. Interpretations were limited to visualization of only the uterus. RESULTS: Follow-up revealed intrauterine pregnancy in 91 patients (outcome normal in 48 and abnormal in 43) and ectopic pregnancy in 11 patients. Among the four reviewers, sensitivity for diagnosis of an intrauterine pregnancy was 34%-66%, specificity was 55%-73%, accuracy was 38%-65%, positive predictive value was 91%-93%, and negative predictive value was 12%-16%. Three to five ectopic pregnancies were categorized incorrectly as demonstrating the intradecidual sign, depending on the reviewer. CONCLUSION: The intradecidual sign does not appear to be sensitive or specific in diagnosis of an early intrauterine pregnancy. When an intrauterine fluid collection is present without an embryo or yolk sac (with positive pregnancy test results), a follow-up sonogram should be obtained unless contraindicated clinically.

Decidua↗
PubMed1997

Hemostatic factors as predictors of ischemic heart disease and stroke in the Edinburgh Artery Study.

Plasma fibrinogen is a consistent predictor of ischemic heart disease (IHD) in prospective studies, but there are fewer data relating other hemostatic variables to IHD and also to stroke. We therefore studied the relationships of plasma fibrinogen, von Willebrand factor antigen, tissue plasminogen activator (TPA) antigen, factor VII, and fibrin D-dimer to incidence of IHD and stroke and determined whether any associations could be explained by conventional risk factors and baseline heart disease. In the Edinburgh Artery study, 1592 men and women aged 55 to 74 years, randomly sampled from the general population, were followed prospectively over 5 years to detect fatal and nonfatal IHD and stroke events. During the 5 years, 268 new vascular events were identified. Baseline plasma fibrinogen was independently related to risk of stroke in multivariate analysis that adjusted for cigarette smoking, LDL-cholesterol, systolic blood pressure, and preexisting IHD (relative risk [RR] 1.52, 95% confidence interval [CI] 1.17, 1.98). TPA antigen, and fibrin D-dimer were also independently associated with risk of stroke (RR 1.69,95% CI 1.22,2.35 and RR 1.96, 95% CI 1.12,3.41, respectively). Significant relationships were found between TPA antigen and myocardial infarction (P < or = .05). In older men and women, increased coagulation activity and disturbed fibrinolysis are predictors of future vascular events (both IHD and stroke).

Aged↗
PubMed1997

Inhaled corticosteroids: clinical relevance of safety measures.

There seem to be individual, end organ, and tissue variations in responsiveness to glucocorticoids. In some children, 400-800 micrograms/day of inhaled steroid reduces cortisol excretion and short-term growth of the lower leg. These effects only become clinically relevant if the capacity of the adrenal gland to respond to stress is impaired or there is an adverse effect on bone metabolism and height velocity. Low morning plasma cortisol or reduced the cortisol excretion suggests the possibility of adrenal suppression. A stimulation test using adrenocorticotrophic hormone 500 ng is safer and more discriminating than using adrenocorticotrophic hormone 250 micrograms. For research purposes, measurement of urine cortisol metabolites over 24 hours closely approximates adrenal corticosteroid production. The dynamics of bone turnover of children are different to those of adults. Biochemical and physical studies of bone metabolism of children are hampered by a lack of age- and sex-specific normal values. Osteocalcin is probably the marker of choice for bone formation and pyridinium crosslinks for bone resorption. Bone density data in asthmatic children are limited, but so far reassuring. Knemometry is a sensitive technique for comparing the systemic absorption of different inhaled steroids, but does not relate to long-term growth. Growth velocity in asthmatic children is influenced by seasonal variation, delay in puberty, disease severity, and the use of oral steroids. These variables must be taken into account when assessing the effects of inhaled steroids. Height measurements made over a period of less than 1 year are liable to error and misinterpretation. There is no evidence that inhaled steroids, when appropriately prescribed in standard doses, have an adverse effect on long-term growth. However, children taking above-standard doses of inhaled steroids need their growth monitored using stadiometric measurements every 3-4 months by trained personnel using regularly calibrated equipment.

Adolescent↗