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Biomedical subjects

R Frye

Publications and source records attributed to R Frye.

At least 19 recordsLinked to original sources
PubMed2000

Long-term clinical outcome in the Bypass Angioplasty Revascularization Investigation Registry: comparison with the randomized trial. BARI Investigators.

BACKGROUND: The Bypass Angioplasty Revascularization Investigation (BARI) included 4039 patients with multivessel coronary artery disease; 1829 consented to randomization, and 2010 did not but were followed up in a registry. Thus, we can evaluate the outcome of physician-guided versus random assignment of percutaneous transluminal coronary angioplasty (PTCA) versus coronary artery bypass graft surgery (CABG). METHODS AND RESULTS: We compared the baseline features and outcomes for PTCA and CABG in the overall registry and its predesignated subgroups. We assessed the impact of treatment by choice versus random assignment by comparing the results in the registry with those of the randomized trial. Statistical adjustments for differences in baseline characteristics were made. Within the registry, nearly twice as many patients were selected for PTCA (1189) as CABG (625); mortality at 7 years was similar for PTCA (13.9%) and CABG (14.2%) (P=0.66) before and after adjustment for baseline differences between patients selected for PTCA versus CABG (adjusted RR, 1.02; P=0.86). In contrast to the randomized trial, the 7-year mortality rate of treated diabetics in the registry was equally high (26%) with PTCA or CABG. Seven-year mortality was higher for patients undergoing PTCA in the randomized trial than in the registry (19.1% versus 13.9%, P<0.01) but not for those undergoing CABG (15.6% versus 14.2%, P=0.57). The adjusted relative mortality risk for PTCA in the randomized versus registry population was 1.17 (P=0.16). CONCLUSIONS: BARI physicians were able to select PTCA rather than CABG for 65% of registry patients who underwent revascularization without compromising long-term survival either in the overall population or in treated diabetics.

Angina Pectoris↗
PubMed1999

Radar and optical observations of asteroid 1998 KY26

Observations of near-Earth asteroid 1998 KY26 shortly after its discovery reveal a slightly elongated spheroid with a diameter of about 30 meters, a composition analogous to carbonaceous chondritic meteorites, and a rotation period of 10.7 minutes, which is an order of magnitude shorter than that measured for any other solar system object. The rotation is too rapid for 1998 KY26 to consist of multiple components bound together just by their mutual gravitational attraction. This monolithic object probably is a fragment derived from cratering or collisional destruction of a much larger asteroid.

Journal Article↗
PubMed1998

Medicaid MCO members require extra attention to avoid "preventable diseases".

As more Medicaid recipients move into managed care plans, providers and payers are taking a closer look at Medicaid patients and their special needs. They're finding that interventions with a strong focus on patient education and community support are highly successful at helping Medicaid recipients avoid so-called preventable diseases.

Communication↗
PubMed1998

A neighborly way to reduce Medicaid costs.

One of the keys to controlling the costs of Medicaid managed care patients is to treat them before they become ill. Richard Frye, Ph.D., profiles the Community Health Worker Outreach Program in Baltimore, which trains residents of neighborhoods with high numbers of Medicaid beneficiaries how to teach their chronically ill neighbors about improving their health.

Baltimore↗
PubMed1997

Myocardial infarction and cardiac mortality in the Bypass Angioplasty Revascularization Investigation (BARI) randomized trial.

BACKGROUND: Cardiac mortality and myocardial infarction (MI) rates are used to evaluate the efficacy of coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA). We compared 5-year cardiac mortality and MI rates in 1829 patients with multivessel disease randomized to CABG or PTCA. METHODS AND RESULTS: The 5-year cardiac mortality rate was 8.0% in patients assigned to PTCA compared with 4.9% in those assigned to CABG (relative risk [RR] of 1.55 with a 95% confidence interval [CI] of 1.07 to 2.23; P=.022). In a subgroup of 1476 nondiabetic patients, there were no significant differences between treatment groups in cardiac mortality either overall (4.6% versus 4.2%; RR= 1.04, 95% CI, 0.65 to 1.66; P=.908) or in subgroups based on symptoms, left ventricular function, number of diseased vessels, or stenotic proximal left anterior descending artery. The two treatment groups had similar event rates for the combined end point of cardiac death or MI. The RR for cardiac mortality in 264 patients who sustained an MI compared with those who did not was 5.9 (P<.001). MIs were more common after CABG during index hospitalization (P=.004), but in the PTCA group, they were more common after discharge (P<.001). CONCLUSIONS: The Bypass Angioplasty Revascularization Investigation (BARI) trial indicates 5-year cardiac mortality in patients with multivessel disease was significantly greater after initial treatment with PTCA than with CABG. The difference was manifest in diabetic patients on drug therapy. There were no significant differences overall for the composite end point of cardiac mortality or MI between treatment groups or for cardiac mortality in nondiabetic patients regardless of symptoms, left ventricular function, number of diseased vessels, or stenotic proximal left anterior descending artery.

Angioplasty, Balloon, Coronary↗
PubMed1997

The physician's role in minimizing prehospital delay in patients at high risk for acute myocardial infarction: recommendations from the National Heart Attack Alert Program. Working Group on Educational Strategies To Prevent Prehospital Delay in Patients at High Risk for Acute Myocardial Infarction.

Physicians and other health care professionals play an important role in reducing the delay to treatment in patients who have an evolving acute myocardial infarction. A multidisciplinary working group has been convened by the National Heart Attack Alert Program (which is coordinated by the National Heart, Lung, and Blood Institute of the National Institutes of Health) to address this concern. The working group's recommendations target specific groups of patients: those who are known to have coronary heart disease, atherosclerotic disease of the aorta or peripheral arteries, or cerebrovascular disease. The risk for acute myocardial infarction or death in such patients is five to seven times greater than that in the general population. The working group recommends that these high-risk patients be clearly informed about symptoms that they might have during a coronary occlusion, steps that they should take, the importance of contacting emergency medical services, the need to report to an appropriate facility quickly, treatment options that are available if they present early, and rewards of early treatment in terms of improved quality of life. These instructions should be reviewed frequently and reinforced with appropriate written material, and patients should be encouraged to have a plan and to rehearse it periodically. Because of the important role of the bystander in increasing or decreasing delay to treatment, family members and significant others should be included in all instruction. Finally, physicians' offices and clinics should devise systems to quickly assess patients who telephone or present with symptoms of a possible acute myocardial infarction.

Algorithms↗
PubMed1996

Mini ecosystem in space--preliminary experiment on board STS-77.

An enclosed ecosystem which is stable on Earth will behave differently when brought into space. Micro-gravity and radiation will affect the dynamics of material circulation or the activities of small creatures of the ecosystem. One series of space experiments aiming to address such issues was planned in the United States (It is termed as ABS--Autonomous Biological System) and Japanese group has been involved with cooperating with the analysis of the flight samples. Before the ecosystem will be on board Russian Space Station "Mir" later 1996 for 3 months, a preliminary flight was carried out in May 1996 on Space Shuttle (STS-77) for 10 days flight. It was the first of such experiments to fly one whole ecosystem in space.

Animals↗
PubMed1996

CYP2D6 mRNA expression in circulating peripheral blood mononuclear cells correlates with in vivo debrisoquine hydroxylase activity in extensive metabolizers.

Extensive metabolizers of drugs which are oxidized by cytochrome P450s show wide interindividual variability in drug metabolism. Elucidation of the relationship between specific P450 isozyme mRNA expression and variability in metabolism of specific drugs could improve understanding of the molecular mechanism involved. In this study, a novel non-radiometric reverse transcription polymerase chain reaction based assay was used to quantify CYP2D6 mRNA levels in peripheral blood mononuclear cells in twelve human volunteers who were phenotyped as extensive metabolizers of debrisoquine. We report a significant correlation (r=0.724, p= 0.008) between CYP2D6 mRNA levels in circulating peripheral blood mononuclear cells and the in vivo debrisoquine recovery ratio. This suggests that interindividual variability in extensive metabolizers could be related, in part, to differences in gene expression. Circulating peripheral blood mononuclear cells can provide an accessible ex vivo measure of this phenomenon.

Actins↗
PubMed1995

Bypass Angioplasty Revascularization Investigation: patient screening, selection, and recruitment.

Percutaneous transluminal coronary angioplasty (PTCA) is currently performed in many patients seeking care because of severe manifestations of multivessel coronary artery disease. Previously, the majority of such patients would have undergone coronary artery bypass grafting (CABG). No definitive evidence is available as to which initial revascularization strategy has the best long-term clinical and economic outcomes. The Bypass Angioplasty Revascularization Investigation (BARI) is the largest of several recent clinical trials that were designed to test the hypothesis that an initial strategy of PTCA in selected patients with multivessel coronary artery disease does not compromise long-term clinical outcome compared with an initial strategy of CABG. This report describes how patients were screened, selected, and recruited in BARI and how this process may influence the results and the interpretation of the trial. During the enrollment period, 25,200 patients undergoing diagnostic coronary angiography at the participating institutions or with off-site angiograms referred to BARI investigators were screened for BARI eligibility. Excluded from screening were patients without coronary artery disease, those with single-vessel disease, prior revascularization, primary congenital, valvular, or myocardial disease, and age > 80 years. Slightly more than half of the patients screened (12,670) were not clinically eligible for BARI because of left main disease, insufficient symptoms, emergency revascularization, or other logistic reasons. Thus, 12,530 patients had severe angina and/or ischemia and were clinically eligible for BARI. Nearly 33% of them (4,110) had multivessel disease, which was suitable for both PTCA and CABG.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon, Coronary↗
PubMed1991

Promoting comprehensive school health programs through summer health promotion conferences.

This study reports on the evaluation of the second North Carolina Healthful Living Institute (HLI), a statewide conference to promote comprehensive school health education. A comparison of year one and year two evaluation results is included. Based on a theoretical framework derived from the theory of diffusion of innovations within organizations, the impact of the HLI was assessed by studying characteristics of school districts sending representatives to the HLI and the composition of teams from each school district, and using pretest and posttest measures of participants' perceptions of the importance of health as a content area and participants' perceptions of the importance of the various components of comprehensive school health. Results indicate the effect of school health promotion conferences is linked to characteristics of school district teams, with the Institute needing to attract more varied teams, and teams from smaller, rural districts.

Adult↗
PubMed1989

Olfactory function in chemical workers exposed to acrylate and methacrylate vapors.

An investigation of the olfactory function of 731 workers at a chemical facility which manufacturers acrylates and methacrylates was undertaken using a standardized quantitative test. In a cross-sectional analysis of the data, no associations of chemical exposure with olfactory test scores were observed. A nested case-control study designed to evaluate the cumulative effects of exposure on olfactory function, however, revealed elevated crude exposure odds ratios (95% confidence interval) of 2.0 (1.1, 3.8) for all workers and 6.0 (1.7, 21.5) for workers who never smoked cigarettes. Logistic regression analysis, adjusting for multiple confounders, revealed exposure odds ratios of 2.8 (1.1, 7.0) and 13.5 (2.1, 87.6) in these same groups, respectively, and a dose-response relationship between olfactory dysfunction and cumulative exposure scores--semi-quantitative indices of lifetime exposure to the acrylates. The data also revealed decreasing exposure odds ratios with increasing duration since last exposure to these chemicals, suggesting that the effects may be reversible.

Acrylates↗
PubMed1989

Influence of nasal obstruction on smell function.

This article has reviewed studies that document a relationship between loss of smell function and disturbances in nasal airflow function. In some cases (for example, hypertrophied adenoids and nasal sinus disease), medical or surgical intervention appears to be useful in restoring some, if not all, of the smell loss associated with the disorder. In other cases (for example, septoplasty), empirical evidence of such efficacy is wanting. Given the current research interest on these topics, however, a clear understanding of both the positive and negative influences of surgical and medical interventions in most cases of obstructive nasal disease or malformities will be forthcoming.

Adenoidectomy↗
PubMed1985

Immunoenzymetric assay for creatine kinase MB with subunit-specific monoclonal antibodies compared with an immunochemical method and electrophoresis.

Results of an immunoenzymetric assay (TANDEM-E CKMB) for creatine kinase (CK; EC 2.7.3.2) MB isoenzyme, in which subunit-specific monoclonal antibodies are used, were compared with those by an immunochemical method (Isomune-CK) and electrophoresis (Corning agarose gel). The study involved 200 patients; greater than 500 samples were analyzed by all three methods. The analytical performances were acceptable. Between-method correlation coefficients ranged from 0.881 to 0.975. Two reference intervals were established for the immunoassays: 0-4 micrograms/L (TANDEM) and 0-4 U/L (Isomune) for "normal" patients; 0-9 micrograms/L (TANDEM) and 0-14 U/L (Isomune) for noninfarct patients. Agreement with respect to increased CK-MB as defined by the reference intervals for the noninfarct patient was 96% between TANDEM and electrophoresis, 90% between Isomune and electrophoresis. All three methods are acceptable for use in determining CK-MB, but the overall diagnostic efficiencies for the mass or activity concentration of the isoenzyme and for its proportion of total CK activity, based on the predictive value model, are 92% (electrophoresis, 0-7 U/L), 90% (electrophoresis, 0-4%), 92% (TANDEM, 0-9 micrograms/L), 88% (TANDEM, 0-3% index), 88% (Isomune, 0-14 U/L), and 83% (Isomune, 0-4%). All three methods can detect CK-MB in serum, but its presence is not necessarily diagnostic of acute infarct. We recommend using the actual concentration of CK-MB to evaluate patients with suspected acute myocardial infarct, and the percentage of CK-MB when total CK is very high.

Antibodies, Monoclonal↗