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Biomedical subjects

K M Ross

Publications and source records attributed to K M Ross.

9 recordsLinked to original sources
PubMed2006

Is the current BMI obesity classification appropriate for black and white postmenopausal women?

OBJECTIVE: To evaluate the relation between body fatness (%Fat) and body mass index (BMI) and to evaluate the validity of the BMI standards for obesity established by the NIH in older black and white postmenopausal women. RESEARCH METHODS: Height, weight, BMI, and %Fat, assessed by DXA, were determined for 296 healthy, independently living women ranging in age from 50 to 80 years (M+/-s.d.; 64.4+/-7.8 years). RESULTS: Per NIH guidelines, 32% were classified as obese (> or = 30 kg/m2, mean BMI = 28.1+/-5.5 kg/m2). In contrast, using the %Fat criterion of 38% advocated by Lohman to define obesity, 47% of our sample was obese (mean %Fat=37.3+/-6.2%). A moderately high curvilinear relation existed between BMI and %Fat (R = 0.82, SEE = 3.57 %Fat, P<0.05). Race added meaningfully to the prediction of %Fat (P<0.05) such that for the same BMI, black women will have 1% lower body fatness than white women. Based on a %Fat > or = 38 as the criterion for obesity, receiver operating characteristic (ROC) analysis, performed separately by race, indicated that the currently accepted BMI cutpoint for obesity produced low sensitivity (69% and 61% for black and white women, respectively). Alternatively, BMI values > or = 28.4 kg/m2 for black women and > or = 26.9 kg/m2 for white women to define obesity maximized classification accuracy. CONCLUSION: We conclude that current BMI categories may not be appropriate for identifying obesity among postmenopausal women. Furthermore, the relation between BMI and %Fat is different in black compared to white women but remains constant from the sixth through the eighth decade of life.

Absorptiometry, Photon↗
PubMed2001

Congener-independent immunoassay for microcystins and nodularins.

Cyanobacteria (blue-green algae) (e.g., Microcystis and Nodularia spp.) capable of producing toxic peptides are found in fresh and brackish water worldwide. These toxins include the microcystin (MC) heptapeptides (>60 congeners) and the nodularin pentapeptides (ca. 5 congeners). Cyanobacterial cyclic peptide toxins are harmful to man, other mammals, birds, and fish. Acute exposure to high concentrations of these toxins causes liver damage, while subchronic or chronic exposure may promote liver tumor formation. The detection of cyclic peptide cyanobacterial toxins in surface and drinking waters has been hampered by the low limits of detection required and that the present routine detection is restricted to a few of the congeners. The unusual beta-amino acid ADDA (4E,6E-3-amino-9-methoxy-2,6,8-trimethyl-10-phenyldeca-4,6-dienoic acid) is present in most (>80%) of the known toxic penta- and heptapeptide toxin congeners. Here, we report the synthesis of two ADDA-haptens, the raising of antibodies to ADDA, and the development of a competitive indirect ELISA for the detection of microcystins and nodularins utilizing these antibodies. The assay has a limit of quantitation of 0.02-0.07 ng/mL (depending on which congeners are present), lower than the WHO-proposed guideline (1 ng/mL) for drinking water, irrespective of the sample matrix (raw water, drinking water, or pure toxin in PBS). This new ELISA is robust, can be performed without sample preconcentration, detects toxins in freshwater samples at lower concentrations than does the protein phosphatase inhibition assay, and shows very good cross-reactivity with all cyanobacterial cyclic peptide toxin congeners tested to date (MC-LR, -RR, -YR, -LW, -LF, 3-desmethyl-MC-LR, 3-desmethyl-MC-RR, and nodularin).

Cyanobacteria↗
PubMed1999

Lispro or regular insulin for multiple injection therapy in adolescence. Differences in free insulin and glucose levels overnight.

OBJECTIVE: Regular insulin given with the evening meal could contribute to the risk of nocturnal hypoglycemia in adolescents with type 1 diabetes using a multiple injection regimen. To test this hypothesis, we compared glucodynamics and free insulin levels on two separate study nights. RESEARCH DESIGN AND METHODS: A total of 14 adolescents were recruited. On both nights, identical doses of regular insulin or insulin lispro were administered 30 min or 10 min, respectively, before the evening meal, using a double-blind randomized crossover study design. Doses of NPH insulin and carbohydrate content of the evening meal and snack were kept identical. Blood samples were taken every 15 min for blood glucose and every 60 min for free insulin and ketones. RESULTS: After insulin lispro administration, glucose levels were significantly lower between the evening meal and the bedtime snack (analysis of variance [ANOVA] P = 0.02), and four hypoglycemic episodes were recorded. This corresponded to a higher (458 +/- 48 vs. 305 +/- 33 pmol/l, P = 0.02), earlier (64 +/- 4.6 vs. 103 +/- 12 min, P = 0.01), and shorter-lasting (245 +/- 21 vs. 365 +/- 39 min, P = 0.01) insulin peak in contrast to regular insulin. After the bedtime snack, glucose levels increased dramatically during the lispro night and stayed higher, up to 0300 in the morning (ANOVA P = 0.01), corresponding to lower mean insulin levels (146 +/- 20 vs. 184 +/- 27 pmol/l, P = 0.04). No differences were seen in glucose and insulin levels between 0300 and 0800. Four episodes of nocturnal hypoglycemia were documented after the bedtime snack during the regular insulin night, in contrast to one episode after insulin lispro. No differences in ketone levels were observed. CONCLUSIONS: The replacement of regular insulin with insulin lispro may reduce the risk of late hypoglycemia, but redistribution of the evening carbohydrate may be needed to ensure good metabolic control and prevent early postprandial hypoglycemia.

Activity Cycles↗
PubMed1998

Coeliac disease in children and adolescents with IDDM: clinical characteristics and response to gluten-free diet.

A total of 167 children and adolescents with insulin-dependent (Type 1) diabetes mellitus (97 males; age range 1.9-22.4 yrs) in a UK paediatric diabetic clinic were screened for coeliac disease using the IgA endomysial (EMA) test, or, in IgA deficient subjects, the IgG antigliadin (AGA) test. Antibody positive subjects were selected for small bowel biopsy, and confirmed coeliac cases started on a gluten free diet. Clinical features, height (Ht) standard deviation score (SDS), body mass index (BMI) SDS, HbA1c, insulin requirements' haemoglobin (Hb), mean red cell volume (MCV), serum folate and ferritin levels were evaluated at diagnosis and thereafter at 3-6 month intervals. A total of 156 subjects (93.4%) were antibody negative. Eleven (6.6%) were antibody positive (10 EMA/1 AGA; 6 males), of whom 9 had biopsies: 1 normal: 8 coeliac (4.8%; 5 males; 1 'classical'; 1 anaemia; 3 'atypical'; 3 asymptomatic). Seven coeliac subjects were followed during 12-24 months of dietary therapy. Pretreatment mean (range) Ht SDS = 0.08 (-1.66 to 1.88); BMI SDS = 0.32 (-0.82 to 1.29); HbA1c = 8.9 (6.2 to 11.3%); insulin dose = 0.98 (0.51 to 1.29) U kg(-1) day(-1). During treatment antibody status reverted to and remained negative, and symptoms resolved. By 24 months, there was a trend towards increased BMI SDS (mean (range) 1.31 (0.47 to 2.29), p = 0.248) and to reductions in HbA1c (8.1 (6.4-10.8), p = 0.697). Repeat small bowel biopsies were normal in 6 subjects (1 refused). No statistically significant changes occurred in any other parameters. In conclusion, serological screening is effective, although the therapeutic benefit of dietary therapy in asymptomatic cases remains uncertain.

Adolescent↗
PubMed1998

Polyclonal antibodies to domoic acid, and their use in immunoassays for domoic acid in sea water and shellfish.

Ovine antibodies raised against conjugates linked through the secondary amino group of domoic acid (1) were used, together with activated-ester-derived conjugates of domoic acid (DA) as the plate coater, to develop a robust indirect competitive enzyme-linked immunosorbent assay (cELISA) for DA in shellfish and seawater. The ELISA was used to analyze shellfish samples for DA, and was compatible with several extraction procedures. The ELISA had a detection limit below 0.01 ng ml(-1), a limit of quantitation (LOQ) of 0.15 ng ml(-1) and a working range of 0.15-15 ng ml(-1) DA. The LOQ is equivalent to 38 ng g(-1) DA in shellfish flesh, assuming a 250-fold dilution during extraction. This is more than 500 times lower than the maximum permitted level (20 microg g(-1) flesh). The ELISA is designed for use alongside regulatory analyses, and, following formal validation, should be available for pre-screening of regulatory shellfish flesh samples. The ELISA was also shown to be appropriate for analysis of DA in algal cultures and in samples of seawater, and thus has the potential to provide early warning of developing algal blooms.

Animals↗
PubMed1998

Complex ambulatory settings demand scheduling systems.

Practice management systems are becoming more and more complex, as they are asked to integrate all aspects of patient and resource management. Although patient scheduling is a standard expectation in any ambulatory environment, facilities and equipment resource scheduling are additional functionalities of scheduling systems. Because these functions were not typically managed in manual patient scheduling, often the result was resource mismanagement, along with a potential negative impact on utilization, patient flow and provider productivity. As ambulatory organizations have become more seasoned users of practice management software, the value of resource scheduling has become apparent. Appointment scheduling within a fully integrated practice management system is recognized as an enhancement of scheduling itself and provides additional tools to manage other information needs. Scheduling, as one component of patient information management, provides additional tools in these areas.

Ambulatory Care Information Systems↗
PubMedDate not supplied

Integrated enzyme-linked immunosorbent assay screening system for amnesic, neurotoxic, diarrhetic, and paralytic shellfish poisoning toxins found in New Zealand.

Enzyme-linked immunosorbent assays (ELISAs) were developed for amnesic, neurotoxic, and diarrhetic shellfish poisoning (ASP, NSP, and DSP) toxins and for yessotoxin. These assays, along with a commercially available paralytic shellfish poisoning (PSP) ELISA, were used to test the feasibility of an ELISA-based screening system. It was concluded that such a system to identify suspect shellfish samples, for subsequent analysis by methods approved by international regulatory authorities, is feasible. The assays had sufficient sensitivity and can be used on simple shellfish extracts. Alcohol extraction gave good recovery of all toxin groups. The ease of ELISAs permits the ready expansion of the system to screen for other toxins, as new ELISAs become available.

Amnesia↗