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Biomedical subjects

P Rogers

Publications and source records attributed to P Rogers.

At least 91 records · Page 5Linked to original sources
PubMed1993

Ambulatory blood pressure and heart rate responses to vegetarian meals.

OBJECTIVES: To determine the effects of a vegetarian diet on daytime ambulatory (Accutracker) blood pressures and heart rates, and to relate these to the estimated peak in plasma glucose to determine whether low-glycaemic-index diets reduce sympathetic activity in response to differences in postprandial glucose and insulin. DESIGN: The subjects were matched for age and body mass index and randomly assigned to one of two parallel diet groups. SETTING: Clinical. PARTICIPANTS: Twenty-one normotensive non-vegetarian male hospital workers volunteered for the study and 20 completed it. INTERVENTION: After 2 weeks of baseline measurement the subjects followed an omnivorous or a lacto-ovovegetarian diet for 6 weeks. MAIN OUTCOME MEASURES: Daytime ambulatory blood pressures and heart rate, and postbreakfast catecholamines, insulin and glucose. RESULTS: Ambulatory systolic blood pressure and heart rates were lower in the vegetarian group during the working day. The preprandial rise in diastolic pressure was attenuated on the vegetarian diet. There were no differences in plasma catecholamine, glucose or insulin levels sampled after breakfast on the two dietary regimes. CONCLUSIONS: The blood pressure-lowering effect of a lacto-ovovegetarian diet, which occurs throughout the working day, is associated with lower heart rates, suggesting a central nervous or cardiac mechanism. The possibility that the lower glycaemic index of a lacto-ovovegetarian diet has some effect needs to be investigated further in relation to major meal-times and studied in both normotensive and hypertensive subjects.

Adult↗
PubMed1993

Biochemical and neurohormonal responses to the introduction of a lacto-ovovegetarian diet.

OBJECTIVE: To assess the mechanisms of the blood pressure-lowering effect of a vegetarian diet in the early and later stages of dietary intervention. DESIGN: After 2 weeks without intervention (baseline), 20 normotensive men were matched for age and body mass index and randomly allocated to an omnivorous (control) or a lacto-ovovegetarian diet for 6 weeks in a parallel trial. METHODS: Ambulatory blood pressures were recorded between 0800 and 1700 h on alternate days during the first week of intervention, twice in the second week and weekly thereafter. Blood samples collected after a standard breakfast were analysed for plasma noradrenaline, adrenaline, atrial natriuretic peptide (ANP), renin, aldosterone, glucose and insulin. Factor and multiple regression analyses were used to assess the association among neurohormonal factors, blood pressures and diet. Results were analysed for the first week of the diet and for the entire 6 weeks. RESULTS: Ambulatory blood pressures at work were lower on the vegetarian diet than in the controls. This blood pressure decrease was associated with a factor representing lower plasma catecholamine and renin activity levels throughout the study, and a factor representing reduced plasma glucose and insulin levels in week 1 of intervention only. Plasma ANP levels were significantly higher during week 1 of the vegetarian diet. CONCLUSIONS: A blood pressure lowering effect of a vegetarian diet during normal working activity was shown. Using factors derived from the biochemical variables, results were in keeping with the hypothesis that these effects may be mediated by reduced sympatho-adrenal activity consequent to altered glucose and insulin handling. An early increase in plasma ANP may contribute to the blood pressure reduction.

Adult↗
PubMed1993

Chemotherapy and combined modality advances in children.

The sustained improvements in pediatric cancer therapy are partially due to the large randomized and nonrandomized studies being conducted by multidisciplinary cooperative groups. Theoretic concepts of chemotherapy are better knowledge of the pharmacokinetics, pharmacodynamics, and drug resistance of current and new drugs are enabling a more rational approach to multiagent therapy. Biologic modifiers are adding to our current multimodal therapeutic approach.

Antineoplastic Agents↗
PubMed1993

A pregnancy after planned partial endometrial resection.

A 28-week pregnancy is reported after a planned partial endometrial resection in an infertile patient. The fetus died 32 hours after birth because of prematurity consequent to premature membrane rupture and premature labour. A partial placenta accreta was dealt with at Caesarean section. Complete endometrial resection may not be required to cure menorrhagia. It may be possible to control menorrhagia by targeting specific areas of endometrium associated with menorrhagia. Fertility may be retained by leaving the fundal and peritubal endometrium. The increased risks of pregnancy complications following endometrial resection suggest that more information is required to design endometrial resection so as to both cure menorrhagia and to sustain successful pregnancy.

Adult↗
PubMed1993

Occult malignancy in neonatal sacrococcygeal teratomas. A report from a Combined Pediatric Oncology Group and Children's Cancer Group study.

PURPOSE: Six children who had mature or immature sacrococcygeal teratomas diagnosed in the newborn period have since been registered on a Pediatric Oncology Group/Children's Cancer Group germ cell study with recurrent malignant neoplasia [pure yolk sac tumor (YST) or teratoma with yolk sac elements]. RESULTS: Four of the children have responded to therapy, one has died, and one has been lost to follow-up. Review of the slides from five of the original tumors identified microscopic foci of YST in four. CONCLUSIONS: Detection of such foci in neonatal tumors is important because serum alpha-fetoprotein concentrations may not be helpful since they may normally be high in the newborn period due to fetal production.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

Multianalyte assay system developed for drugs of abuse.

A simple, 10-min immunoassay system has been developed that simultaneously screens for five different classes of drugs of abuse in a urine sample. This system tests for amphetamines, cannabinoids, cocaine metabolites, opiates, and phencyclidine, and each assay has a specific preset cutoff concentration. Accuracy is > 99% for reporting positive or negative results for samples with 200% or 50%, respectively, of the cutoff concentrations of the drugs. Tests of a panel of 96 compounds yielded only three cases of nonspecific reactivity (at a drug concentration of 100 mg/L). Another panel of 12 compounds that could normally be found in urine samples was also evaluated and no interferences were observed. Concordance was > 95% between this system and the comparable automated immunoassays for detecting drugs of abuse. Greater than 98% of GC/MS-confirmed positive samples gave positive results with this assay system.

Autoanalysis↗
PubMed1992

The treatment of simultaneous choriocarcinoma in mother and baby.

Simultaneous occurrence of choriocarcinoma in mother and child is rare. Such a case is described in which a massive intrahepatic tumor in the infant led to its treatment and that of the mother who showed evidence of the same tumor. Both are alive and well 1 year after treatment, the longest recorded infant survival.

Angiography↗
PubMed1992

Rhabdomyosarcoma arising within congenital pulmonary cysts: report of three cases.

Over the past 9 months, three cases of primary pulmonary rhabdomyosarcoma have been treated at British Columbia Children's Hospital. Two patients (aged 24 and 37 months) presented with spontaneous pneumothoraces and had cystic changes in the affected lung on chest radiograph. The third patient (aged 42 months) was evaluated for chronic cough, fever, and failure to thrive. Chest x-ray showed a large mass in the left lower lobe as well as mediastinal adenopathy. All three of these lesions originated within congenital lung cysts, one a peripheral bronchogenic cyst and the others cystic adenomatoid malformations. This report suggests that there is a significant risk for the development of rhabdomyosarcoma within malformed pulmonary tissue.

Cell Transformation, Neoplastic↗
PubMed1992

Association of lifestyle and personality characteristics with blood pressure and hypertension: a cross-sectional study in the elderly.

The association between certain lifestyle and personality characteristics and blood pressure in the elderly was assessed in a cross-sectional study of 843 independent living 60-87 year old volunteers. They comprised 338 women and 505 men of whom 35 and 30% respectively were being treated with antihypertensive drugs. Among untreated volunteers, 28% of women and 28% of men had systolic blood pressure greater than 160 or diastolic blood pressure greater than 95. Isolated systolic hypertension was found in 20% of untreated women and 14% of untreated men. Lifestyle factors and personality characteristics associated with blood pressure were similar to those described in younger adult populations, although there were some differences related to gender and whether subjects were being treated for hypertension. Stepwise multiple regression showed that higher blood pressure was associated with greater body mass index (BMI), alcohol intake and coffee drinking and measures of irritability. Increased physical activity, and high values for measures of suspicion and extraversion were negatively related to blood pressure. Age was positively related to systolic, but not to diastolic blood pressure. The presence of hypertension was significantly associated with self-reports of raised cholesterol, diabetes or angina, as well as past history of heart failure, heart attack or stroke. Thus, in this elderly free-living population blood pressures are still significantly associated with behavioural characteristics which could be further investigated as an alternative or adjunct to antihypertensive therapy.

Aged↗
PubMed1992

Case-mix groups for VA hospital-based home care.

The purpose of this study is to group hospital-based home care (HBHC) patients homogeneously by their characteristics with respect to cost of care to develop alternative case mix methods for management and reimbursement (allocation) purposes. Six Veterans Affairs (VA) HBHC programs in Fiscal Year (FY) 1986 that maximized patient, program, and regional variation were selected, all of which agreed to participate. All HBHC patients active in each program on October 1, 1987, in addition to all new admissions through September 30, 1988 (FY88), comprised the sample of 874 unique patients. Statistical methods include the use of classification and regression trees (CART software: Statistical Software; Lafayette, CA), analysis of variance, and multiple linear regression techniques. The resulting algorithm is a three-factor model that explains 20% of the cost variance (R2 = 20%, with a cross validation R2 of 12%). Similar classifications such as the RUG-II, which is utilized for VA nursing home and intermediate care, the VA outpatient resource allocation model, and the RUG-HHC, utilized in some states for reimbursing home health care in the private sector, explained less of the cost variance and, therefore, are less adequate for VA home care resource allocation.

Aftercare↗
PubMed1992

Early prediction of anthracycline cardiomyopathy using standard M-mode and digitized echocardiography.

In this study, we attempted to identify echocardiographic findings that can be used as early predictors of left ventricular dysfunction due to anthracyclines in 26 pediatric oncology patients. Retrospective review identified six patients (group 1 mean anthracycline dose = 337 +/- 123 mg/m2) who developed clinical evidence of cardiomyopathy and 20 consecutive patients followed prospectively (group 2 mean anthracycline dose = 298 +/- 102 mg/m2) who did not. All of the patients had serial m-mode echocardiography before and at approximately every 50 mg/m2 of anthracycline treatment depending on the dosage schedule. The following measurements were recorded: left ventricular dimensions and wall thickness, indices of left ventricular function, including systolic time intervals, shortening fraction, and ejection fraction. Using digitized echocardiography, the following parameters were recorded: peak and normalized systolic and diastolic velocities of the left ventricular chamber, posterior and septal wall velocities, and percent of posterior wall thickening. Variations from established normal longitudinal bounds and actual changes from pre-anthracycline values were compared for the two groups throughout the course of therapy. At 70 mg/m2 of anthracycline, group 1 showed significant deterioration in shortening fraction (mean change = 8.8 versus 2.5, p = .03), left ventricular velocity in diastole (2.9 versus 0.21, p = .04), left ventricular normalized velocity in systole (.65 versus 0.03, p = .02), and left ventricular normalized velocity in diastole (1.15 versus 0.002, p = .04) compared to group 2. These values were mostly compensated by 125 mg/m2, but they slowly deteriorated again at higher doses of anthracycline, leading to the appearance of clinical evidence of cardiomyopathy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Effects of ipratropium bromide nebulizer solution with and without preservatives in the treatment of acute and stable asthma.

In a recent study, it was suggested that the preservatives in ipratropium bromide nebulizer solution may cause a paradoxic bronchoconstrictor response in 20 percent or more of patients with stable asthma. The frequency of this response in patients with acute asthma is unknown. The aim of this study was to examine the acute effects of the usual dose of nebulized ipratropium bromide (0.25 mg) in patients with either stable or acute asthma using formulations with and without added preservatives. Twenty-five patients with stable asthma and 25 patients with acute asthma were studied. Each subject was given preservative-containing ipratropium bromide, preservative-free ipratropium bromide, pH 7 preservative-free ipratropium bromide, and saline solution in random order using a double-blind crossover technique with at least 4 h between drug administrations. Very frequent measurements of FEV1 were made for 30 min after each drug administration and then 5 mg of albuterol was nebulized and the FEV1 was measured again after another 30 min. Changes in FEV1 were expressed as a percentage of the predicted FEV1. Paradoxic bronchoconstriction to ipratropium was detected in only one patient with acute asthma (12 percent fall in FEV1) but in none of the patients with stable asthma. A 6 percent fall in FEV1 change occurred with the saline solution in this subject suggesting that the response may have been a nonspecific one due to increased bronchial responsiveness. The mean response (+/- 1 SD) to albuterol plus either preservative-containing ipratropium, preservative-free ipratropium, or pH7 preservative-free ipratropium was significantly greater (p less than 0.05) than the response to albuterol alone both in the patients with acute asthma (25 +/- 12 percent, 27 +/- 15 percent, 26 +/- 15 percent, and 20 +/- 15 percent, respectively) and stable asthma (26 +/- 7 percent, 25 +/- 8 percent, 24 +/- 6 percent, and 22 +/- 9 percent) supporting the use of ipratropium bromide as an additional bronchodilator in patients with asthma who do not show a satisfactory response to nebulized beta-adrenergic agonist.

Aerosols↗
PubMed1992

Postural fall in blood pressure in the elderly in relation to drug treatment and other lifestyle factors.

In a study of 843 independent-living men and women aged between 60 and 87 in Perth, Western Australia, stepwise multiple regression, after correction for initial levels of systolic blood pressure, showed that postural fall in systolic blood pressure was positively related to alcohol intake of more than 20 ml/day, the use of sleeping tablets and higher levels of anxiety on the Spielberger state-trait scale, and negatively related to body mass index. Postural fall in blood pressure was not significantly related to treatment for hypertension, age, sex, patterns of usual physical activity, tea or coffee drinking, or the diagnosis of diabetes mellitus. This analysis is the first to examine the relationship between lifestyle factors and the magnitude of the fall in systolic blood pressure on standing after adjustment for the association between the change in a variable and its initial level. Our analysis suggests the need for further study of the possible role of lifestyle factors such as the use of sleeping tablets and alcohol in postural hypotension in the elderly.

Aged↗
PubMed1991

Increased neuropeptide Y concentrations in the lateral hypothalamic area of the rat after the onset of darkness: possible relevance to the circadian periodicity of feeding behavior.

Neuropeptide Y (NPY) is a major hypothalamic peptide which powerfully stimulates feeding when injected into the hypothalamus and is implicated in circadian rhythmicity. To investigate whether NPY is involved in the increased feeding that follows the onset of darkness in rats, NPY levels were measured in discrete hypothalamic areas before and after darkness. Four groups of eight adult female Wistar rats were habituated to a 12:12 hour light:dark cycle, with food presented at the onset of darkness (19.00 hours). One group was sacrificed during the 3 hours before darkness and another in the first 2.5 hours after darkness, with food provided as usual. To distinguish any effects of feeding itself, the study was repeated with two further groups, but food was not provided after darkness. Seven hypothalamic regions were microdissected from slices of fresh brain and acid-extracted for radioimmunoassay of NPY. NPY levels (fmol/microgram protein) were significantly higher (p less than 0.01) in the lateral hypothalamic area (LHA) of the dark-phase group in both studies. In the other six regions, NPY levels did not differ between light and dark phases. The LHA regulates the circadian rhythmicity of feeding and NPY injection here stimulates feeding. Alterations in NPY in the LHA around the onset of darkness may be related to the initiation of dark-phase feeding.

Animals↗
PubMed1991

A comparison of pregnancy rates for 131 donor oocyte transfers using either a sequential or fixed regime of steroid replacement therapy.

This study describes the overall results of 131 donor oocyte transfers between 1982 and 1989 when 30 pregnancies resulted (23% pregnancy rate/transfer). A retrospective comparison of results between an earlier sequential hormone replacement regime and a more recent low dosage, variable length oestrogen replacement shows that the latter offers greater flexibility and a promising trend towards higher pregnancy rates.

Drug Administration Schedule↗
PubMed1990

Further data on the selective expression of Ly-5 isoforms.

Ly-5 (CD45) glycoproteins of the mouse, expressed by all or most hematopoietic cell lineages and specified by a single Ly-5 gene, range in size from isoform T200 of T cells (the smallest), in which exons 4, 5, and 6 are not represented, to isoform B220 of B cells (the largest), in which all three of these optional exons are represented. The main purpose of the present study, utilizing the polymerase chain reaction (PCR), was to ascertain whether known isoforms of intermediate size are generated by single or dual usage of optional exons 4, 5, and 6. Transcripts representing all eight isoforms predictable from varied use of three exons were observed among a diverse panel of nine B-cell tumors in culture, but there was no evident concordance with known contrasting differential features that distinguish members of the B-cell tumor panel. No two B tumors exhibited the same variety of transcripts and the relative quantities of transcripts expressed varied greatly from tumor to tumor. Cloning of B-cell tumors did not alter their distinctive transcript patterns. Separation methods (sodium dodecyl sulfate polyacrylamide gel electrophoresis; SDS-PAGE) did not suffice to segregate all corresponding expressed isoforms but did establish that transcripts representing usage of a single optional exon and of two optional exons were actually translated, which supports a provisional inference that all eight isoforms exist. The considerable diversity of B-cell transcript phenotypes was not seen among seven T-cell leukemias, two cytolytic T-cell lines, and three Th 1 helper T-cell lines, all of which displayed a uniform phenotype comprising major expression of the T200 transcript (no optional exon) and minor expression of a transcript employing exon 5. However, a panel of five cloned Th2 T-cell lines, which represent a second and functionally different branch of the helper/inducer T-cell category, exhibited a characteristic transcript pattern which distinguished them from a panel of three Th1 T-cell lines. The major transcript in the Th2 lines was also T200, but the Th2 lines showed higher representation of transcripts containing optional exons. A single Th2 clone expressed an unusual transcript suggesting a potential isoform not compounded simply by varied inclusion of the three identified optional exons. After activation of the helper T-cell lines with concanavalin A (Con A), expression of transcripts containing optional exons appeared to decrease.

Animals↗