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Biomedical subjects

M M Ward

Publications and source records attributed to M M Ward.

103 records · Page 6Linked to original sources
PubMed1986

Cardiovascular responses in type A and type B men to a series of stressors.

Fifty-six healthy adult males were administered the Type A Structured Interview and assessed as exhibiting either Type A (N = 42) or Type B (N = 14) behavior pattern. They were monitored for systolic (SBP) and diastolic blood pressure (DBP) and heart rate (HR) responses during a series of six challenging tasks: Mental Arithmetic, Hypothesis Testing, Reaction Time, Video Game, Handgrip, and Cold Pressor. The results indicated that Type A subjects exhibited greater cardiovascular responses than did Type B subjects during some (Hypothesis Testing, Reaction Time, Video Game and Mental Arithmetic) but not all (Handgrip and Cold Pressor) of the tasks. These results are discussed in terms of previously reported findings on conditions that do and do not produce differences in Type A/B cardiovascular stress responses.

Adult↗
PubMed1985

Twin similarity in cardiovascular stress response.

Cardiovascular (CV) responses to laboratory stressors were measured in 12 pairs of identical and 21 pairs of fraternal adult male twins. For this study, blood pressure and heart rate were measured during a mental arithmetic task and the Cold Pressor Test. The analyses of cardiovascular responses to these stressors were designed to test for the presence of a genetic component in cardiovascular reactivity in an adult sample of twins aged 54-64 years. The results suggest that certain measures of cardiovascular reactivity to laboratory stressors may be heritable for both physical and psychological stressors. The possible role of this genetic component in the etiology and course of coronary heart disease is discussed.

Blood Pressure↗
PubMed1983

Epinephrine and norepinephrine responses in continuously collected human plasma to a series of stressors.

The present study employed continuous blood withdrawal to examine epinephrine and norepinephrine responses to a cognitive stressor (mental arithmetic), active physical stressors (handgrip and knee bends), passive painful stressors (venipuncture and cold pressor), and a medical procedure that was considered nonstressful (blood pressure measurements). The data were analyzed by analysis of variance (ANOVA) and by time series analysis. The ANOVA indicated that epinephrine and norepinephrine increased significantly in response to the stressors. Epinephrine showed a greater increase to the cognitive stressor than to the others. Time series analysis, however, showed a more varied pattern. It indicated that the height and duration of response differed considerably across subjects and across interventions. The results from both analytic procedures are compared and discussed in terms of current hypotheses of catecholamine response.

Adult↗
PubMed1981

Work environment, type A behavior, and coronary heart disease risk factors.

Relationships to CHD risk factors of work environment variables, of the Type A behavior pattern, and of their interaction were studied in 384 male salaried workers. Except for an association between physical comfort in the work environment and systolic blood pressure, no significant independent relationships were found between any of the work environment variables or the Type A behavior pattern and coronary heart disease (CHD) risk factors. Type A workers who described their work environments as encouraging autonomy or being high in peer cohesion had lower blood pressures than those who did not. The reverse was found for Type Bs. Type Bs who described their environments as low in physical comfort had higher systolic blood pressure than those who did not. These significant interactions are discussed from the perspective of person-environment fit. Future directions for research and implications for CHD risk reduction are presented.

Behavior↗
PubMed1979

Serum progesterone and estradiol in pregnant women selected for progestagen treatment.

Patients with two or more previous spontaneous second trimester abortions and vaginal cytology indicating a poor progestational response in current pregnancies were selected for treatment with Provera (medroxyprogesterone acetate) and/or Delalutin (17 alpha-hydroxyprogesterone caproate). Serum was examined serially for progesterone (P) and estradiol (E) by radioimmunoassay. Serum from 174 untreated patients with no known complications ranging from 6--40 weeks gestation provided normal distribution data. Of 14 progestagen-treated patients, four aborted during the second trimester. These all had chronically low (greater than 50% of observations were less than 1 standard deviation of the normal population) or falling P/E ratios. The rest delivered normal full-term infants although five of the 10 had chronically low P, seven had chronically low P/E ratios, and in one other P/E was falling. Chronically high E contributed to the low P/E ratio in three cases. Thus, these selected cases with poor obstetrical histories demonstrated steroid patterns outside the +/- 1 standard deviation range, although the steroid levels were still within the normal range. Serum progesterone and estradiol analysis may eventually be useful in identifying patients who will best respond to progestagen treatment.

Abortion, Habitual↗
PubMedDate not supplied

CT-guided stereotactic biopsy of intracranial lesions: correlation between core biopsy and aspiration smear.

Computerized tomography (CT)-guided stereotactic biopsies of intracranial lesions in 29 patients were analyzed, paying particular attention to the correlation between core biopsies and aspiration smears. Seven percent were nondiagnostic due to sampling error. Discrepancies occurred between core biopsies and aspiration smears in 10% of the cases. In two instances of such discrepancies, cytologic findings on the aspiration smear yielded the diagnosis of metastatic tumor. One patient, with herpetic encephalitis, was diagnosed by electron microscopic review of the core biopsy only. One patient died of an intraoperative hemorrhage, a complication of the fine-needle technique.

Biopsy↗
PubMedDate not supplied

Abstinence effects as predictors of 28-day relapse in smokers.

The present analysis sought to determine the relationship between abstinence effects in 64 ex-smokers (mean age = 41.1 years) and the rate at which they relapsed over 4 weeks of biochemically confirmed follow-up. This analysis focused on six abstinence effects that play a central role in the DSM-III-R and DSM IV definitions of withdrawal from nicotine: anger, depression, craving, appetite, confusion, and tension. Significant increases were observed for all six symptoms following cessation, and, with the exception of craving, substantial intercorrelations among the abstinence effects were noted. Cox proportional hazards survival models identified increases in anger, depressed mood, and craving to be significantly associated with a shorter time to relapse (all p < .03). Stepwise Cox proportional hazards survival analysis identified increases in depressed mood and craving as the most significant combination of abstinence effects in relation to time to relapse. A more stringent test of the potency of the relationship between these abstinence effects and time to relapse was conducted in which two other risk factors in this sample, method of quitting and education level, were also included in the model testing sequence. Even after adjustment for these significant risk factors, the increase in craving remained a significant predictor of a higher rate of relapse. This result suggests a robustness to this particular abstinence effect as a determinant of the speed with which ex-smokers relapse over a 1-month interval after cessation.

Adult↗
PubMedDate not supplied

Self-reported abstinence effects in the first month after smoking cessation.

The present study evaluated self-reported subjective complaints (29 single items and 11 scales) at precessation, on quit day, and on Days 1, 2, 3, 7, 14, 21, and 28 after cessation in 46 healthy quitters who remained abstinent for the first month after cessation (biochemically confirmed). Also tested on the same schedule were 29 nonsmokers matched for age and gender. Specific criteria were set for transient and offset effects based on the direction, magnitude, and time course of changes in symptoms after cessation. Results indicated that single-item anger, anxiety, depression, difficulty concentrating, irritability, restlessness, dizziness, and nausea, and the Shiffman-Jarvik Stimulation/Sedation Subscale, the Perceived Stress scale, and the POMS anger, confusion, and tension subscales met the criteria for transient effects, and that single-item desire to smoke, cough, and headache, and the Shiffman-Jarvik Psychological Subscale met the criteria for offset effects. These findings help to clarify which subjective complaints after smoking cessation are transient effects and which are offset effects, a distinction with important implications for understanding nicotine dependence and for designing pharmacological and nonpharmacological interventions for smoking cessation.

Adult↗
PubMedDate not supplied

The direct cost of rheumatoid arthritis.

OBJECTIVES: This analysis estimated the direct cost of rheumatoid arthritis (RA) from a societal perspective. METHODS: Primary and secondary data sets were used to determine the rate of medical resource utilization. National average Medicare or Medicaid reimbursement rates were used to value direct costs (in 1994 dollars). RESULTS: Persons with RA have, on average, dollar 1702 in direct costs for treating RA annually. More than half of the total cost is for medications. Nursing home care accounts for nearly one fifth of the cost and hospitalizations and ambulatory care (combined) comprise another fifth of the total cost. Travel to medical appointments and medical supplies make up the remaining 10%. The projected annual US direct costs are dollar 3.6 billion for treating RA. CONCLUSIONS: The health care utilization in persons with RA is frequent and includes a number of components leading to high annual direct cost.

Journal Article↗
PubMedDate not supplied

Relaxation training for essential hypertension at the worksite: I. The untreated mild hypertensive.

This industry-based randomized study compared the effects of behavioral treatment (BT) and blood pressure monitoring (BPM) on blood pressure (BP) change in 158 unmedicated persons with mild hypertension (diastolic blood pressure 90 to 104 mm Hg). Participants recruited by a three-stage screening were randomly assigned to BT or BPM groups and stratified by entry diastolic blood pressure (DBP), age, and sex. BT participants received relaxation training, with or without the addition of biofeedback, cognitive restructuring, and health behavior change components. During the study, all participants were followed by their usual care physicians and received medical advice. At 18 weeks into the study, after the BT groups completed training, both the BT and BPM groups showed significant reductions in systolic blood pressure (SBP) and DBP assessed in the company medical clinic (7.4 and 9.0 mm Hg SBP and 4.5 and 5.9 mm Hg DBP, respectively). These reductions were maintained throughout the 36-week follow-up period. Reductions in BP assessed at the participants' worksite were similar for BT and BPM participants throughout most of the trial, indicating little advantage to the inclusion of behavioral interventions over monitoring alone. Differences in BP changes observed among participants receiving various combinations of behavioral treatment components indicated that the cognitive restructuring component reduced SBP in the worksite by an additional 5.4 mm Hg (p less than 0.05). Possible explanations for the BP changes observed in the BPM group and implications of the results for the treatment of unmedicated mild hypertensives are discussed.

Adult↗