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Biomedical subjects

P Rose

Publications and source records attributed to P Rose.

At least 109 records · Page 6Linked to original sources
PubMed1984

Vitamin D and parathyroid hormone status in children with the nephrotic syndrome and chronic mild glomerulonephritis.

The serum concentrations of 25-hydroxyvitamin D (25(OH)D), 1,25-dihydroxyvitamin D (1,25(OH)2D), calcium, creatinine, albumin and immunoreactive parathyroid hormone (iPTH) were measured in eight children with chronic glomerulonephritis not treated with prednisone (group I), in nine non-edematous children with the nephrotic syndrome treated with prednisone for more than 18 months (group II) and in five children with overt edema also treated with prednisone (group III). Serum creatinine was under 1.2 mg/dl in all 22 patients. Reductions in serum calcium, albumin and 25(OH)D were found in group III patients only, whereas both group II and group III patients showed reduced values of 1,25(OH)2D (p less than 0.001 vs. group I or controls). Chronic glucocorticoid administration in children with glomerulonephritis and minimally impaired renal function (group II) is associated with a reduction in the circulating level of 1,25(OH)2D, since children with comparable type and degree of renal disease but non glucocorticoid treatment (group I) have normal 1,25 (OH)2D values. Children with nephrotic edema (group III) have greater reduction of 1,25(OH)2D values, as well as lower 25(OH)D values and serum calcium values, presumably related to a urinary loss of vitamin D-binding protein. No changes in iPTH were evident in either glucocorticoid-treated or edematous patients, suggesting that the acute elevation in iPTH seen after prednisone treatment is an acute phenomenon. Additional short-term studies are needed to more clearly define the effect of glucocorticoids on vitamin D metabolism.

Calcium↗
PubMed1983

The influence of various carbon fibre braiding techniques and methods of fixation on the extensibility of ligament prostheses.

An alloplastic ligament prosthesis with carbon fibres should not only be biocompatible but should also restore the biomechanical function of a natural system, which includes restoring its elasticity. Tests with new types of braided carbon fibre strands showed their elastic extensibility to increase with increasing number of filament tows and increasing braid angle. The best results were obtained with 32 tows and a 43 degrees braid angle. This strand type was tested in vitro as a medial collateral ligament prosthesis with two methods of fixation in human knees and, in like manner, in vivo in sheep knees. Biomechanical tests in vitro using human cadaver knees and sheep knees after 12 weeks' implantation showed an elasticity similar to that of normal natural ligaments.

Animals↗
PubMed1983

An outbreak of cutaneous leishmaniasis in Guyana: epidemiology, clinical and laboratory aspects.

An outbreak of cutaneous leishmaniasis reached epidemic proportions among military personnel in Guyana during the period from November, 1977 to March, 1980. As the patients presented from widely separated areas of the hinterland it is likely that cutaneous leishmaniasis is endemic throughout the virgin tropical rain forest of Guyana, although infection is normally sporadic. A striking clinical feature was the 'spirotrichoid' involvement of the draining lymphatics and nodes in half the cases, which histologically all came from the middle region of the spectrum (groups II, III or IV of Ridley's 1980 classification). All the cases tested were serologically positive to a Leishmania braziliensis antigen. One hundred and ten patients were successfully treated with pentamidine, with minimal side-effects, but some required a second course. Four relapsed patients all belonged to the same histological group.

Adolescent↗
PubMed1983

Long-term influence of calcitriol (1,25-dihydroxyvitamin D) and supplemental phosphate in X-linked hypophosphatemic rickets.

Ten patients with hypophosphatemic rickets (eight with X-linked familial form) were treated with vitamin D2 (10,000 to 75,000 units per day) and oral phosphate (1.5 to 3.6 gm) for a total of 438 treatment months. Therapy was then changed to calcitriol (17 to 34 ng/kg/day) and the same phosphate dose. Patients served as their own controls, and significant biochemical changes noted were an increase in immunoreactive parathyroid hormone from 29 +/- 9 (SD) microliters Eq/ml (pre-phosphate) to 62 +/- 34 on vitamin D2 plus PO4, then decreasing to 40 +/- 20 on a regimen of 1,25-dihydroxyvitamin D (1,25(OH)2D) plus PO4; serum PO4 rose from 2.44 +/- 0.45 (SD) mg/100 ml to 3.06 +/- 0.79 and then to 3.43 +/- 0.76; alkaline phosphatase activity decreased from 677 +/- 298 (SD) IU/liter to 457 +/- 183 to 290 +/- 176. Serum calcium and creatinine levels were unchanged. Both urinary calcium excretion and calcium-creatinine ratio decreased after therapy with 1,25(OH)2D. Urinary phosphate excretion was higher after calcitriol administration. Serum 1,25(OH)2D levels were low in these vitamin D2-treated patients, and an inverse relationship between serum 25(OH)D and 1,25(OH)2D was found. Improved bone mineralization was evident from serial assessment by photon absorptiometry, and radial bone mineral content rose from 75.3% +/- 2.2% of expected to 82.2% +/- 1.4% (P less than .005). Stature was improved when assessed by standard deviation for chronologic age but did not reach statistical significance. Long-term 1,25(OH)2D plus phosphate therapy appears to be more efficacious than vitamin D2 in this form of rickets, particularly in improving phosphate homeostasis.

Adolescent↗
PubMed1982

Circulating vitamin D metabolite concentrations in childhood renal diseases.

Vitamin D metabolites were measured in children, untreated with glucocorticoids, who had renal disease. Two groups were defined in relation to endogenous creatinine clearance values: those with impaired clearance , 0 to 48 ml/min per 1.73 m2; and those with unimpaired clearance, 75 to 150 ml/min per 1.73 m2. Serum 1.25(OH)2D was 16 +/- (SD) 12 pg/ml in impaired patients (N=24) and 48 +/- 16 pg/ml in unimpaired patients (N=18). The latter level is not different from healthy childhood controls (43 +/- 12 pg/ml; N=194). Serum samples of 25(OH)D2 and D3 were comparable in each group and not different from control values of 33.2 +/- 10.3 ng/ml. Serum 24,25(OH)2D was 0.6 +/- (SD) 0.14 ng/ml in patients with a clearance of less than 13 ml/min per 1.73 m2, 1.39 +/- 0.54 ng/ml in those with a clearance of 18 to 48 ml/min per 1.73 m2, and 152 +/- 0.91 ng/ml in patients without an impairment of clearance. Only patients with the lowest clearance had values different from control values of 1.70 +/- 0.57 ng/ml. In our study we suggest that a significant reduction in 24,25(OH)2D and 1,25(OH)2D are found at low clearance values in children with tubulointerstitial disease. Our study further suggests that a reduction in renal tubular mass is important in accounting for these changes in vitamin D metabolite values.

24,25-Dihydroxyvitamin D 3↗
PubMed1980

Supranormal 25-hydroxyvitamin D and subnormal 1,25-dihydroxyvitamin D: their role in X-linked hypophosphatemic rickets.

Serum 25-hydroxyvitamin D (25-OH-D) and 1,25-dihydroxyvitamin D (1,25-(OH)2D) and bone mineral content by the photon-absorption technique were determined in eight patients with X-linked hypophosphatemic rickets treated for at least 24 months with oral sodium phosphate and high-dosage ergocalciferol (vitamin D2). Mean 25-OH-D2 level was 129.5 +/- 67.5 ng/mL (mean +/- SD); the level of 25-OH-D3 was 10.5 +/- 5.8 ng/mL. These values were significantly higher than in normal subjects (total 25-OH-D mean of 27 +/- 10 ng/mL). Serum 1,25-(OH)2D was 16.9 +/- 8.5 pg/mL (mean +/- SD) in the eight patients, significantly lower than 47 +/- 16 pg/mL in 27 age-matched controls. Values indicative of significant demineralization were found in seven of the eight phsophate-treated patients, who had no radiologic evidence of rickets. These results suggest that any theory of the pathogenesis of this disorder must account for inappropriate renal vitamin D metabolism and for renal hyperphosphaturia. The failure of high-dosage oral phosphate and ergocalciferol to fully correct demineralization may suggest a role for calcitriol (1,25-(OH)2D3) as a therapeutic agent.

Absorption↗
PubMed1978

Effect of prednisone on growth and bone mineral content in childhood glomerular disease.

Children with acquired glomerular disease were divided into two groups: Group 1 patients received short-term daily or long-term alternate-day prednisone (up to 2.7 mg/kg/48 hr); group 2 patients received no corticosteroids. Height, bone mineral content (BMC), and bone density were evaluated in the two groups and compared to those of 800 sex- and age-matched controls; BMC and bone density were assessed by the photon absorption technique. Significant demineralization was present in 18 of 25 prednisone-treated and none of the 17 nonprednisone-treated patients (P less than .001). Group 1 patients were 5.3 +/- 0.7% shorter than controls, while group 2 patients were only 1.9 +/- .8% shorter (P less than .02). Height velocity was 2.6 +/- 0.8 cm/yr in group 1 and 5.1 +/- 0.8 cm/yr in group 2 patients (P less than .05). When prednisone therapy was discontinued, six patients had an increase in height and BMC toward normal values. This study suggests that BMC and height velocity are correlated. Both appear to be influenced by alternate-day prednisone therapy rather than by glomerular disease per se.

Adolescent↗
PubMed1978

25-hydroxy-vitamin D, diet and sunlight exposure in patients admitted to a geriatric unit.

Dietary intake, sunlight exposure and 25-hydroxy-vitamin D levels were estimated in 62 patients admitted to a geriatric assessment unit. There was a significant correlation between vitamin D intake and 25-hydroxy-vitamin D levels but none between sunlight exposure and these. This suggests that in old age dietary deficiency may be a more important cause of metabolic bone disease than limited sunlight exposure.

Adolescent↗
PubMed1978

Integrated leprosy control in Guyana.

Guyana instituted a "find and treat" leprosy program in 1971 that made use of existing out-patient facilities and staff. The program, based on an integrated domiciliary approach to diagnosis, treatment, and examination of contacts, has proved successful. This article describes development of the program and discusses the prospects for control and eventual eradication of leprosy in Guyana.

Delivery of Health Care↗
PubMed1975

Amphetamines in the treatment of Parkinson's disease.

Twenty-two patients with Parkinsonism were treated with levoamphetamine and 12 of these with dextroamphetamine. Levoamphetamine resulted in a significant improvement in disability from Parkinsonism, although the reduction in total disability, tremor, akinesia, and rigidity scores was slight (ca 20 percent). Dextroamphetamine in lower dosage also reduced disability by some 17 percent. The most disabled patients, including those also on levodopa, showed the greatest response to amphetamines. Previously, amphetamines have been reported to be a selective treatment for the oculogyric crises of post-encephalitic Parkinsonism. Amphetamines are thought to cause the release of catecholamines from central neurones. Their action in Parkinson's disease may be limited because of pre-existing striatal dopamine deficiency. Side-effects of amphetamines, anorexia, and CNS stimulation are different from those caused by levodopa in patients with Parkinson's disease.

Aged↗
PubMedDate not supplied

A comparison of 10 and 14 days of lansoprazole triple therapy for eradication of Helicobacter pylori.

BACKGROUND: Data from large, multicenter, US studies determining the efficacy of triple therapy for the eradication of Helicobacter pylori are lacking, especially for a treatment duration of less than 14 days. METHODS: Patients with H pylori infection and active duodenal ulcer disease or a history of duodenal ulcer disease within the past year were randomized to receive 30 mg of lansoprazole, 1 g of amoxicillin, and 500 mg of clarithromycin twice daily for 10 or 14 days. The primary efficacy end point was the eradication of H pylori as confirmed by negative histological and culture results at 4 to 6 weeks after the completion of treatment. RESULTS: Of 284 patients enrolled in the study from 46 US sites, 236 met the entry criteria. At 4 to 6 weeks after the end of therapy, H pylori was eradicated in 85% (96/ 113) of the patients receiving 14-day triple therapy and in 84% (103/123) of those receiving 10-day triple therapy by per-protocol analysis (95% confidence interval for treatment group differences, -10.5 to 8.1; P>.05). There was also no significant difference between the 14- and 10-day treatment groups when analyzed by an intent-to-treat analysis of H pylori eradication. A similar proportion of patients in each treatment group reported an adverse event related to therapy (34% [46/136] vs 38% [56/148], respectively). CONCLUSIONS: In patients with an active or a recent history of duodenal ulcer, lansoprazole-based triple therapy for 10 or 14 days is highly effective in the eradication of H pylori. The duration of therapy may be reduced from 14 to 10 days without a significant effect on regimen efficacy.

2-Pyridinylmethylsulfinylbenzimidazoles↗