Biomedical subjects

L J Moran

Publications and source records attributed to L J Moran.

16 recordsLinked to original sources

PubMed2006

Flow-mediated dilatation in overweight and obese women with polycystic ovary syndrome.

OBJECTIVE: There remains a large degree of disagreement about the association of polycystic ovary syndrome (PCOS) with impaired endothelial dysfunction and cardiovascular disease (CVD) risk. The purpose of this study was to determine whether overweight and obese women with PCOS have impaired endothelial function compared with weight-matched controls without PCOS and whether endothelial function is associated with cardiovascular risk markers and hormonal parameters. DESIGN: Cross-sectional analysis. SETTING: An outpatient trial at the Commonwealth Scientific Industrial Research Organisation Clinical Research Unit. POPULATION: Overweight and obese women with PCOS (n= 12) and weight-matched controls without PCOS (n= 10). METHODS: Endothelial function, cardiovascular risk markers and hormonal parameters were assessed in the patients. MAIN OUTCOME MEASURES: Endothelial function was assessed by flow-mediated dilatation (FMD) of the brachial artery using high-resolution ultrasound. Lipid profile, fasting insulin level, glucose level, insulin resistance, C-reactive protein level, folate level, Vitamin B(12) level and hormonal parameters. RESULTS: Women with PCOS had significantly higher testosterone levels (P < 0.001) and free androgen index (P= 0.006) compared with the controls without PCOS. Both groups were normoinsulinaemic, and there were no significant differences in any of the markers of CVD between women with and without PCOS. Furthermore, FMD was similar in both groups (PCOS 6.1 +/- 1.2% versus control 5.6 +/- 1.0%, P= 0.77). CONCLUSIONS: Compared with a group of weight-matched women with similar metabolic profiles, normoinsulinemic, overweight and obese women with PCOS did not show any greater impairment in endothelial function assessed by FMD. A normoinsulinemic phenotype of PCOS with low metabolic risk factors may reduce the risk of endothelial dysfunction in overweight and obese women with this syndrome. Further studies are required that directly compare FMD in normoinsulinemic and hyperinsulinaemic women with PCOS.

Adult↗

PubMed2004

Ghrelin and measures of satiety are altered in polycystic ovary syndrome but not differentially affected by diet composition.

Polycystic ovary syndrome (PCOS) is a common endocrine condition in women of reproductive age associated with obesity. It may involve dysregulation of ghrelin, a hormone implicated in appetite regulation. The effect of diet composition on ghrelin is unclear. Overweight women with and without PCOS were randomized to a high-protein (40% carbohydrate, 30% protein; 10 PCOS, six non-PCOS) or standard protein diet (55% carbohydrate, 15% protein; 10 PCOS, six non-PCOS) for 12 wk of energy restriction and 4 wk of weight maintenance. Diet composition had no effect on fasting or postprandial ghrelin or measures of satiety. Non-PCOS subjects had a 70% higher fasting baseline ghrelin (P = 0.011), greater increase in fasting ghrelin (57.5 vs. 34.0%, P = 0.033), and greater maximal decrease in postprandial ghrelin after weight loss (-144.1 +/- 58.4 vs. -28.9 +/- 14.2 pg/ml, P = 0.02) than subjects with PCOS. Subjects with PCOS were less satiated (P = 0.001) and more hungry (P = 0.007) after a test meal at wk 0 and 16 than subjects without PCOS. Appetite regulation, as measured by subjective short-term hunger and satiety and ghrelin homeostasis, may be impaired in PCOS.

Adult↗

PubMed2003

Dietary composition in restoring reproductive and metabolic physiology in overweight women with polycystic ovary syndrome.

Overweight women with polycystic ovary syndrome (PCOS) were randomized to a high protein (HP; 40% carbohydrate and 30% protein; n = 14) or a low protein (LP; 55% carbohydrate and 15% protein) diet (n = 14). The intervention consisted of 12 wk of energy restriction (approximately 6000 kJ/d), followed by 4 wk of weight maintenance. Pregnancies (two HP and one LP); improvements in menstrual cyclicity, lipid profile, and insulin resistance (as measured by the homeostasis model); and decreases in weight (7.5%) and abdominal fat (12.5%) occurred independently of diet composition. Improvements in menstrual cyclicity were associated with greater decreases in insulin resistance and fasting insulin (P = 0.011). On the LP diet, high density lipoprotein cholesterol decreased 10% during energy restriction (P = 0.008), and the free androgen index increased 44% in weight maintenance stages (P = 0.027). Weight loss leads to improvements in cardiovascular and reproductive parameters potentially mediated by improvements in surrogate measures of insulin resistance. An HP weight loss diet may result in minor differential endocrine and metabolic improvements.

Adult↗

PubMed1992

Cost-effectiveness of epoetin alfa therapy for anemia of end-stage renal disease.

The cost-effectiveness of epoetin alfa therapy for anemia in 20 patients with end-stage renal disease was retrospectively studied. Ten patients on continuous ambulatory peritoneal dialysis (CAPD) were given subcutaneous epoetin alfa as part of a multicenter, protocol-controlled study of the efficacy of epoetin alfa. Ten patients on in-center hemodialysis were given intravenous epoetin alfa as part of their routine clinical care. Change in hematocrit was used as the measure of effectiveness of epoetin alfa. Medication, laboratory, and transfusion costs were monitored for the six months preceding the initiation of epoetin alfa and the first six months of treatment. The cost of therapy increased for all patients by an average of $2722 +/- 1118; transfusion costs decreased, whereas medication and laboratory costs increased. Laboratory costs were significantly greater in CAPD patients than in hemodialysis patients during epoetin alfa therapy; no significant differences in medication costs or transfusion costs were noted between the groups. The mean increase in hematocrit for all patients was 7.4 volume percent. Following the initial change in hematocrit, further therapeutic response did not appear to be determined by increasing expenditures. Epoetin alfa was shown to be effective in treating anemia in patients with end-stage renal disease, but it was associated with higher costs of therapy.

Adult↗

PubMed1976

Community health centre evaluation. Paper 1: Working patterns of allied health professionals.

Community health centres are a new development on the Australian health scene and current indications are that they may play a greater role in the delivery of primary health care of the future. Therefore, information about these centres, what they are doing and who they are affecting, must be forthcoming if more public funds are to be channelled their way. The study reported here and in subsequent papers attempts an in-depth examination of the Southern Memorial Hospital--Community Care Centre for the purpose of establishing a base line from which this centre can measure its progress and with which other centres providing health care can compare. This paper reports the methodology of the evaluation study and the results of a survey of the working patterns of allied health professionals.

Allied Health Personnel↗

PubMed1976

Community health centre evaluation -- a two year follow up study. The southern memorial hospital.

The Community Health Programme has been responsible for the provision of more resources at the primary health care level, and it was forecast that these initiatives would give general practitioners expanded opportunities to develop their skills. An attempt to evaluate this forecast is reported here in a study which surveyed a sample of general practitioners practising in the area now served by the Southern Memorial Hospital Community Care Centre. The results of this study are compared with the results of an earlier study which was completed before the Community Care Centre was established.

Australia↗

PubMed1974