Search PubMed⌕ Search

Biomedical subjects

M Day

Publications and source records attributed to M Day.

At least 19 recordsLinked to original sources
PubMed1995

Feasibility study of N-of-1 trials with blood pressure self-monitoring in hypertension.

The objective of this study was to assess individual responses to antihypertensive treatment by N-of-1 trials using blood pressure self-monitoring in 79 patients of both sexes referred to a hypertension clinic. Thirty-five patients who remained untreated (study 1) and 44 N-of-1 trial participants (study 2) were consecutively selected if their clinic blood pressure was between 160/95 and 220/115 mm Hg and there were no hypertensive complications. Blood pressure was measured daily at home for 21 days (three consecutive measures, morning and evening). Each N-of-1 trial was a single-blind treatment consisting of two successive 10-day treatment pairs, each pair comprising 5 days of placebo followed by 5 days of 20 mg enalapril once daily in the morning. Study 1 showed no significant blood pressure regression toward the mean over 20 days and justified the choice of 5-day treatment periods in study 2. In study 2, blood pressure fell significantly 12 hours after the first administration of enalapril and rose within 24 hours of the end of the 5-day active treatment period. Using evening blood pressure values (12 hours after enalapril intake) from the first treatment pair, 33 patients were classified as responders (diastolic blood pressure fall > or = mm Hg). In 16 of these 33 patients, the fall in blood pressure above 6 mm Hg was not maintained in the morning, 24 hours after drug intake. Response reproducibility was tested by comparison with the second treatment pair: the observed agreement was only 0.71 (chance-corrected agreement: 0.34) when defined according to both evening and morning values.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Self-measurement of blood pressure at home to evaluate drug effects by the trough: peak ratio.

AIM: Studies were carried out to assess (1) the statistical and clinical meaning of the trough:peak ratio and (2) the value of self-measurement of blood pressure at home in monitoring the duration of action of antihypertensive drugs in individual patients and in groups of patients. PATIENTS AND METHODS: Data from previous single-blind trials in 44 individual patients were reanalysed. The trough:peak ratio was calculated from mean blood pressure values. RESULTS: There are two major limitations in using this method. (1) Estimates of the trough:peak ratio are biased by the inclusion of non-responders. These patients have the usual random variations in blood pressure, and small differences can result in a spuriously high trough:peak ratio which may lead to an overestimate of the actual ratio. (2) The standard deviation of the trough:peak ratio is large; for a given mean trough:peak ratio some patients have the required 24-h drug cover, whereas others do not. The large standard deviation is partly a result of statistical problems, since four different blood pressure values are used to calculate the ratio. It is therefore essential to increase the precision of the measurement to decrease the standard deviation. CONCLUSIONS: Self-measurement of blood pressure at home might be a useful and inexpensive way of estimating the trough:peak ratio. As repeated measurements of blood pressure can be carried out at home under standardized conditions, this method increases the precision of each measurement. It is possible, therefore, to calculate individual trough:peak ratios and the drug regimen (once or twice a day) can be individualized.

Antihypertensive Agents↗
PubMed1993

Plasmid replication and maintenance in binary fissile microorganisms.

The mechanisms of nonconjugative plasmid replication (in the single cell) and maintenance (at the population level) are of concern to the microbiologist and to the genetic engineer who wishes to exploit their ability to express cloned genes. This article concentrates mainly on Escherichia coli as the host organism and examines the mechanisms by which both naturally occurring and genetically engineered plasmids persist in populations during periods of growth. Additional strategies to ensure high yields of recombinant product are briefly considered.

Cell Division↗
PubMed1992

Autosomal dominant polycystic kidney disease with primary hyperaldosteronism.

We report three cases of primary aldosteronism associated with autosomal dominant polycystic kidney disease. The diagnosis of primary hyperaldosteronism was based on the presence of hypokalaemia with excessive urinary potassium excretion and/or the characteristic hormonal changes. Renal function impairment due to autosomal dominant polycystic kidney disease could mask hypokalaemia. The interpretation of adrenal imagery may be hindered by adjacent renal cysts. In one case an adrenal adenoma was detected and surgically removed, with only partial correction of the blood pressure. This could be explained by the persisting underlying autosomal dominant polycystic kidney disease. We conclude that in a hypertensive patient with polycystic kidney disease, extrarenal causes of hypertension may be present.

Adult↗
PubMed1992

[Treatment of hypertension in diabetes: threshold of intervention and therapeutic options].

Early screening for hypertension in diabetic patients and for glycoregulation abnormalities in hypertensives is justified by the additive cardiovascular risks when hypertension and diabetes co-exist and by the accelerated development of diabetic nephropathy and retinopathy if hypertension co-exists. In insulin-dependent diabetes, hypertension is generally preceded by microalbuminuria, known to be reduced by angiotensin converting enzyme inhibitors. The requirement for nephropathy prevention and the hemodynamic and/or tissular effects of this therapeutic class could justify their use at a blood pressure level less than that conventionally considered hypertensive. This strategy must be confirmed by prospective trials, already underway, evaluating the nephroprotective efficacy of this therapy. In non-insulin-dependent diabetes, hypertension is often present before the diabetes is diagnosed and antihypertensive therapy, especially thiazide diuretics, could play a demasking or favorizing role. The optimal blood pressure level to which these patients at high renal and coronary risk should be lowered still has to be determined. A prospective study, comparing the effects of strict (treated diastolic blood pressure less than 80 mmHg) and less strict (treated diastolic blood pressure between 90 and 100 mmHg) hypertensive control on coronary event prevention in essential hypertension, is in progress and will have important implications for hypertension treatment in diabetics. Appropriate treatment of other risk factors, such as hyperlipidaemia and smoking, contributes to coronary and renal prevention in all diabetic hypertensives.

Albuminuria↗
PubMed1990

Localization of the NGFI-A protein in the rat brain.

Antibodies are used to localize the NGFI-A protein in the rat brain. The protein is found in a wide variety of neurons. However, not all neurons are stained. The protein is either absent or present at undetectable levels in glial cells. Neuronal nuclei stain intensely, cytoplasmic staining is lighter. Seizures cause a detectable increase in the intensity of staining.

Amino Acid Sequence↗
PubMed1990

Auxiliary springs in continuous arch treatment: Part 2. Appliance use and case reports.

In the second part of this series, three clinical examples are presented to illustrate the use of auxiliary space-closure springs with clinically manageable moment-to-force ratios and new canine brackets to accommodate these springs within the framework of conventional and straight-wire 0.018-inch appliance systems. Eligiloy retraction spring models (0.1650 inch x 0.02150 inch) in the edgewise mode were developed for translational movements along a main archwire. The effects of different preactivation bends for influencing intraarch anchorage are shown for the conditions of reciprocal closure, posterior protraction, and anterior retraction.

Adolescent↗
PubMed1990

Auxiliary springs in continuous arch treatment: Part 1. An analytical study employing the finite-element method.

This report describes the results of a finite-element analysis with ANSYS (Version 4.3) from Swanson Analysis Systems and 1 mm-long, 2-D elastic beam elements to modify and refine the designs of maxillary and mandibular springs for space-closure management. This system permitted static analysis by means of modern software systems instead of expensive and cumbersome mechanical bench studies. Our examination of anterior and posterior reactions led to what we believe are optimal designs with clinically manageable moment/force ratios and new canine brackets that accommodate these springs within the framework of conventional and straight-wire appliance systems. Three degrees of freedom were used at each node for translations in the x and y directions and a rotation about the z axis, producing 182 elements with 183 nodes for the mandibular model and 146 elements with 147 nodes for the maxillary model. Elgiloy retraction spring models (0.1650 inch x 0.02150 inch) in the edgewise mode were developed so that the effects of three different preactivation bends could be refined by computer analysis. Sixty-four analyses were performed for each spring, with each of three angle bends (theta 1, theta 2, and theta 3) varied from 0 degrees to 45 degrees in 15 degrees increments. The employment of this computer method promises to simplify the design and development of complex interacting orthodontic systems. Clinical cases are presented in Part 2 of this series, which illustrates the application of auxiliary springs.

Computers↗
PubMed1989

Further results from a census based mortality study of fertiliser manufacturers.

The results of a further follow up of two cohorts of men identified as manufacturers of fertilisers in the 1961 and 1971 censuses of England and Wales are reported. Both cohorts have now been followed up until 1985 through the National Health Service Central Register. In the 1961 cohort the previous findings are replicated--low mortality from all causes, all cancers, and all circulatory diseases, and no evidence of dose response relation nor excess mortality from cancer at any site. In the 1971 cohort there remain more deaths from cancer than expected but none of the observed deaths from individual cancers differs significantly from expectation by comparison with national mortality rates or rates for other employed men. Evidence of an association between cancer mortality and frequency of exposure to nitrate containing dust is strengthened in the reanalysis of the 1971 cohort after longer follow up, but a negative trend, significant for digestive organ cancers, is observed in the analysis by product type in which manufacturers of straight nitrogen and compound fertilisers might have been expected to be most at risk. Failure to find specifically any excess mortality from gastric cancer and the contradictory dose response relations, weigh against the notion that the nonsignificant excesses of cancers in the 1971 cohort are related to nitrate exposure.

Air Pollutants, Occupational↗
PubMed1988

Pharmacokinetics of xamoterol after intravenous and oral administration to patients with chronic heart failure.

The pharmacokinetics of xamoterol, a beta-adrenergic partial agonist under clinical evaluation for the treatment of mild to moderate heart failure, have been studied in 8 cardiac failure patients (NYHA Class II) of mean age 62 years. After i.v. dosing, the elimination half-life was 7.4 +/- 0.4 h, the total body clearance was 228 +/- 30 ml.min-1 and the volume of distribution at steady-state was 56 +/- 9 l. 72.5 +/- 4.3% of the dose was recovered unchanged in urine. After the oral dose, the absolute bioavailability of xamoterol was shown to be 5.9%. Peak plasma concentrations occurred 1 to 2.5 h after the oral dose. The apparent elimination half-life was significantly longer after oral doses (16 +/- 2 h) compared to that observed after an intravenous dose. Renal clearance of xamoterol exceeded glomerular filtration rate as measured by creatinine clearance. The pharmacokinetics of xamoterol in cardiac failure patients with good renal function (creatinine clearance greater than 90 ml.min-1) were similar to published data in young healthy male volunteers.

Administration, Oral↗