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Biomedical subjects

R McDonald

Publications and source records attributed to R McDonald.

At least 91 records · Page 5Linked to original sources

Iron, zinc and magnesium nutrition and athletic performance.

During the last decade there has been considerable interest in the idea that dietary trace elements supplementation can result in an improvement in athletic performance. The current paper discusses this idea as it relates to 3 elements: iron, zinc and magnesium. Emphasis has been placed on examining the implicit assumptions underlying the idea that mineral supplements help the athlete. These assumptions include the beliefs that the athlete has a higher than normal requirement for minerals; that the athlete consumes a diet inadequate in these minerals; and that a marginal deficiency of these elements has a direct effect on athletic performance. Evidence is presented that both iron deficiency and magnesium deficiency can result in a significant reduction in exercise performance; however, the biochemical lesions underlying the reductions in exercise performance have not been identified. There is evidence that dietary magnesium intake may be suboptimal in some individuals, thus dietary supplementation of this element may be useful in some population groups. Excessive magnesium supplementation is not thought to be a serious health problem. Similar to magnesium dietary iron supplements can improve athletic performance in individuals severely deficient in this element. However, few studies have documented a need for iron supplements in healthy athletes. If iron supplements are used, it is important that the level of supplementation is not excessive, as excess iron in the diet can result in an induced zinc deficiency. In marked contrast to iron and magnesium, there is little evidence for the idea that zinc deficiency influences exercise performance in humans. Despite this fact, zinc supplements have been widely advocated for the athlete, as it is known that intense exercise can result in changes in zinc metabolism. If zinc supplements are used, it is important that they are not excessive, as excess zinc in the diet can result in a secondary copper deficiency.

Humans↗

Quality assurance of outcome in mental health care: a model for routine use in clinical settings.

A problem-oriented method of quality assurance of clinical outcome was used in 1,384 patients who were assessed and treated over 8 years by 41 nurse therapist trainees. The clinical audit suggested that for most diagnoses patients' improvement after treatment was usually satisfactory. Though the system was developed to monitor the progress of patients with anxiety, sexual and habit disorders having behavioural psychotherapy, it could also be applied to other disorders like depression and to other treatments. The method is simple enough for routine use, and computerisation would put it within the grasp of most clinics and training programs for all mental health care professionals.

Anxiety Disorders↗

Age-related differences in the bone mineralization pattern of rats following exercise.

The effect of 12 weeks of treadmill exercise on the mineralization of trabecular and cortical bone was studied in rats 7, 14, and 19 months of age. Bone mineralization was evaluated by measuring concentrations of Ca, Mg, and hydroxyproline as well as uptake of 45Ca concentration in the femur, humerus, rib and calvaria. The 7- and 14-month-old rats increased mineralization in those cortical bones directly involved in exercise. The 19-month animal responded to exercise by increasing mineralization in all bones examined, including the nonweight bearing trabecular calvaria and cortical rib. From these data, it is apparent that the older animals undergo a total skeletal mineralization in response to exercise compared with local adaptation in the younger animal. Further, we provide evidence to support the use of the rat as a model in which to study mammalian bone physiology during the aging process.

Aging↗

Identical twins discordant for presenile dementia of the Alzheimer type.

In genetically proven identical female twins, discordant for presenile dementia of the Alzheimer type, the affected twin began to dement at the age of 49, and died 15 years later; the diagnosis was confirmed at post-mortem. The surviving twin remains clinically unaffected 20 years after the onset of dementia in her sister. Environmental aetiological factors are postulated to account for this discordance.

Alzheimer Disease↗

Ketoconazole-induced changes in selected canine hormone concentrations.

The effects of administering ketoconazole at a high dosage (30 mg/kg of body weight/day) and at a low dosage (10 mg/kg/day) on steroidogenesis in the dog were compared. Ketoconazole significantly suppressed basal plasma cortisol concentrations (P = 0.001), cortisol responsiveness to ACTH (P = 0.002 to 0.005), and serum testosterone concentrations (P = 0.0005). The data indicated a rebound effect after ketoconazole treatment was stopped and that testosterone suppression was being overridden at lower ketoconazole doses. Plasma 17-alpha-hydroxyprogesterone concentrations (P = 0.0005) and serum progesterone concentrations (P = 0.014 to 0.003) were significantly increased during ketoconazole treatment. Aldosterone, 11-desoxycortisol, and 17-beta-estradiol concentrations did not change significantly during ketoconazole treatment.

17-alpha-Hydroxyprogesterone↗

Systolic Hypertension in the Elderly Program (SHEP): antihypertensive efficacy of chlorthalidone.

The Systolic Hypertension in the Elderly Program (SHEP) is a randomized, blinded test of the efficacy of antihypertensive drug treatment. In a large feasibility trial, 551 men and women who had isolated systolic hypertension and were at least 60 years old received chlorthalidone (25 to 50 mg/day) or matching placebo as the step I drug. After 1 year, 83% of the chlorthalidone group and 80% of the placebo group were still taking SHEP medications. Of those still taking chlorthalidone, 88% had reached goal blood pressure (BP) without requiring a step II drug, and most had responded to the lower dose (25 mg/day). The BP response was similar in all age, sex and race subgroups, with an overall mean difference between randomized groups of 17 mm Hg for systolic BP (p less than 0.001) and 6 mm Hg for diastolic BP (p less than 0.001). The only common adverse effects were asymptomatic changes in the serum levels of potassium (0.5 mEq/liter lower in the chlorthalidone group, p less than 0.001), uric acid (0.9 mg/dl higher, p less than 0.001) and creatinine (0.08 mg/dl higher, p = 0.02). This study indicates that chlorthalidone is effective for lowering BP in elderly patients with systolic hypertension and sets the stage for a larger trial of the effects of such treatment on the incidence of cardiovascular disease.

Aged↗

Effects of iron deficiency and exercise on myoglobin in rats.

The effects of iron deficiency and endurance training on muscle myoglobin (Mb), body weights, and blood lactic acid concentration were studied in rats. Fifty animals were divided into four groups: anemic trained (AT), normal trained (NT), anemic sedentary (AS), and normal sedentary (NS). Following 5 weeks of dietary control, the mean hemoglobin values for the AT and AS rats were 0.013 +/- 0.002 mmol X l-1 (8.7 +/- 1.4 g X dl-1) and 0.014 +/- 0.003 mmol X l-1 (9.2 +/- 1.7 g X dl-1) respectively, and did not significantly change throughout the study. AT and NT rats were run on a motor driven treadmill 4 days/week for 6 weeks up to a pre-established time of 90 min. Following the training, body weights of the AT (157 +/- 13 g) and NT (153 +/- 13 g) rats were lower than their respective sedentary groups AS (172 +/- 9 g) and NS (176 +/- 15 g). Resting blood lactic acid concentration following training was lower in both trained groups, AT (3.3 +/- 2.0 mM) and NT (2.3 +/- 1.9 mM) compared to AS (8.2 +/- 2.6 mM) and NS (3.8 +/- 1.6 mM). Training increased Mb concentration in hearts of both the anemic and normal trained groups (AT, 0.66 +/- 0.13 mg X g-1; NT, 0.95 +/- 0.08 mg X g-1) compared to the sedentary groups (AS, 0.44 +/- 0.08 mg X g-1; NS, 0.70 +/- 0.13 mg X g-1). Only the AT rats showed an increase in skeletal muscle Mb. This study provides evidence that myoglobin may limit aerobic metabolism.

Anemia, Hypochromic↗

Generalised siderosis from an iris foreign body.

A case is presented of generalised siderosis resulting from a foreign body lodged in the iris. The diagnosis was made 10 years after the initial injury, when the patient presented with another, quite unrelated, eye injury. The metal particle was removed after tests revealed that ocular function was impaired with raised intra ocular pressure, severe field loss and an abnormal electroretinogram (E.R.G.).

Adult↗

Clomipramine and exposure for obsessive-compulsive rituals: i.

Forty chronic obsessive-compulsive ritualizers were randomly assigned to treatment with oral clomipramine or placebo for 8 months. During weeks 4 to 7 these two groups were each randomly split into treatment by relaxation or by exposure in vivo, and during weeks 7 to 10 all patients had exposure in vivo. Double blind assessments were made at weeks 4, 7, 10, 18, 36, 62 and 114. Results are reported to one year. Clomipramine produced significant improvement in rituals, mood and social adjustment, but only in those patients who initially had depressed mood. The clomipramine effect was maximum from weeks 10 to 18 and diminished thereafter. On stopping clomipramine patients often relapsed and improved again on restarting the drug. Relaxation produced little change. Exposure produced significant lasting improvement in rituals, but less change in mood; improvement generalized to social adjustment at follow-up. Clomipramine plus exposure had a slight additive but not interactional effect. Clomipramine enhanced compliance both with exposure and with relaxation. Clomipramine is useful for compulsive ritualizers with depressed mood, but may need continuation for over a year and combination with exposure in vivo. Exposure in vivo remains the treatment of choice for rituals without depressed mood.

Adolescent↗

Chlorambucil therapy in childhood nephrotic syndrome.

Chlorambucil (Leukeran), a cytotoxic agent, was administered to 13 children with the nephrotic syndrome who had responded to steroid therapy, but frequently relapsed. In all patients corticosteroid therapy had become unsatisfactory. Eleven patients have so far remained in remission for an average follow-up period of 31 months since chlorambucil therapy. No side-effects of therapy were observed in this study, but several grave complications of high-dosage therapy have been reported in the recent literature. A dose of 0.2 mg/kg/d for 8 weeks should not be exceeded.

Adolescent↗

Interaction of cromolyn sodium in aqueous solution with magnesium ions.

The interaction of the antiasthmatic drug cromolyn sodium with Mg2+ ions in solution was studied. Selective ion electrode and torsion viscometer measurements were used to establish the degree of interaction. At the concentrations studied, the cromolyn ion had no more affinity for Mg2+ than SO42-. However, thixotropic gels were formed between 4 X 10(-2) M cromolyn sodium and 4 X 10(-4) Mg2+. At lower concentrations of Mg2+, viscosity still increased significantly. However, when the cromolyn concentration was lowered, the increase in viscosity was much less marked.

Chemical Phenomena↗

Register of cases of subacute sclerosing panencephalitis (SSPE) in Southern Africa.

An analysis of cases of subacute sclerosing panencephalitis (SSPE) in Southern Africa to the end of 1976 is presented. In the 2 years since the last report in 1975, 15 new cases have been added to the register. Seven patients from the Cape Province were investigated in Groote Schuur and Red Cross War Memorial Children's Hospitals in Cape Town and a recent postal survey revealed 6 cases in the Transvaal and 1 each from South West Africa and Rhodesia. This analysis indicates that the high incidence and temporal clustering of cases in the Cape Province is continuing, and that the relatively constant annual number of cases in the Transvaal and the apparent absence of the disease in Natal and the Orange Free State are being maintained.

Adolescent↗