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PubMed2003

Longitudinal changes in pituitary-adrenal hormones in South African women with burnout.

The authors' goal was to document baseline pituitary-adrenal hormonal and related metabolic variables in 16 female patients with burnout. Then, following stress management intervention, to compare the changes with an equal number of untreated control subjects. At monthly intervals for 4 mo, 24-h urine samples were obtained for determination of free cortisol excretion. In addition, fasting blood samples were analyzed for levels of cortisol, dehydroepiandrosterone sulfate (DHEAS), ACTH, aldosterone, and catecholamines. Other biochemical measurements included growth hormone, prolactin, insulin, glucose, and lipid components. The Maslach Burnout Inventory, General Health Questionnaire- 28, and Zung depression rating scale were completed on each consecutive visit. The most striking finding was the reduction of urine free-cortisol excretion in the patients compared with controls. Initial urinary free cortisol was significantly lower in the patients (mean +/- SEM = 47.2 +/- 11.0 vs 79.0 +/- 6.8 nmol/L, p = 0.02) and remained significantly reduced at 4 mo (mean +/- SEM = 44.0 +/- 6.1 vs 91.1 +/- 8.8 nmol/L, p = 0.0001). There were no significant changes in the other hormonal and biochemical data. We conclude that there is functional hypocortisolism in burnout, which is not immediately restored on stress management intervention despite clinical and psychological improvement.

Adrenal Cortex Hormones↗
PubMed1994

Inhaled nitric oxide lowers pulmonary capillary pressure and changes longitudinal distribution of pulmonary vascular resistance in patients with acute lung injury.

In acute lung injury (ALI), where pulmonary microvascular permeability is increased, transvascular fluid filtration depends mainly on the hydrostatic capillary pressure. In the presence of intrapulmonary vasoconstriction pulmonary capillary pressure (PCP) may increase thereby promoting transvascular fluid filtration and lung oedema formation. We studied the effect of 40 ppm inhaled nitric oxide (NO) on PCP and longitudinal distribution of pulmonary vascular resistance (PVR) in 18 patients with ALI. PCP was estimated by visual analysis of the pressure decay profile following pulmonary artery balloon inflation. Contribution of venous pulmonary resistance to total PVR was calculated as the percentage of the pressure gradient in the pulmonary venous system to the total pressure gradient across the lung. Inhalation of 40 ppm NO produced a prompt decrease in mean pulmonary artery pressure (PAP) from 34.1 +/- 6.8 to 29.6 +/- 5.7 (s.d.) mmHg; (P < 0.0001). PCP declined from 24.8 +/- 6.2 to 21.6 +/- 5.2 mmHg; (P < 0.0001) while pulmonary artery wedge pressure (PAWP) did not change. PVR decreased from 166 +/- 73 to 128 +/- 50 dyn.sec.cm-5; (P < 0.0001). Pulmonary venous resistance (PVRven) decreased to a greater extent (from 76 +/- 41 to 50 +/- 28 dyn.sec.cm-5; (P < 0.001) than pulmonary arterial resistance (PVRart) (from 90 +/- 36 to 79 +/- 29 dyn.sec.cm-5; (P < 0.01). The contribution of PVRven to PVR fell from 44.3 +/- 10.8 to 37.8 +/- 11.9%; (P < 0.01). Cardiac output (CO) remained constant. The findings demonstrate that NO has a predominant vasodilating effect on pulmonary venous vasculature thereby lowering PCP in patients with ALI.

Administration, Inhalation↗
PubMed1981

Longitudinal changes in standing height and mandibular parameters between the ages of 8 and 17 years.

The purpose of this study was to examine the changes in mandibular dimensions and relationship as they relate to standing height, which is one indicator of skeletal maturation. The subjects for this study consisted of twenty males and fifteen females on whom cephalograms were taken between the ages of 8 and 17 years. Basic statistics summarized the changes in standing height and the mandibular parameters from 8 to 17 years of age. Analysis of variance was used to select five parameters to describe linear and angular changes in the mandible and also to compare the mean growth profiles of each of the facial parameters selected to the growth profile for standing height. Autocorrelation analysis provided a method of assessing the predictability of the growth profiles of the facial parameters from the profile of standing height for the same individual. The findings in the present investigation indicated that (1) the growth profile of height was significantly different from that of the parameters describing mandibular length and relationship; (2) the changes in standing height are significantly different in the maximum, premaximum,, and postmaximum periods of growth in both males and females; (3) the changes in mandibular length (Ar-Pog) are significantly different in the three periods; (4) the changes in mandibular relationship were not significantly different in the maximum and premaximum periods in either males or females, while the magnitude of change in the postmaximum period tended to be smaller than the other two periods; and (5) autocorrelation analysis revealed that the growth profile of height was found to have little predictive value in determining the growth profile of any of the mandibular parameters except for Ar-Pog for females.

Adolescent↗
PubMed2004

Longitudinal change in plasma total homocysteine during pregnancy and postpartum in Brazilian women and its relation with folate status and other factors.

Fasting plasma total homocysteine (tHcy) concentration was determined in a cohort of pregnant Brazilian women (n = 46) supplemented with folic acid from the second trimester of pregnancy. Blood samples were obtained in the first and third trimesters from all women, and 30-40 days postpartum from seventeen women. Plasma tHcy decreased during pregnancy from 10.3 to 8.7 micromol/L, and was 11.6 micromol/L in the postpartum. Plasma and erythrocyte folate increased, consistent with use of the folate supplement, but decreased slightly in the postpartum, whereas the opposite occurred for plasma vitamin B12. tHcy was inversely correlated with plasma and erythrocyte folate in the third trimester (r = -0.585 and -0.460, respectively). This relationship occurred despite the fact that all women had attained what could be considered adequate levels of folate indices. Furthermore, the change (third trimester minus first trimester levels) of tHcy was inversely correlated (p < 0.01) with the changes in plasma (r = -0.573) and erythrocyte folate (r = -0.525). tHcy had no correlation in any of the periods tested with plasma vitamin B12, plasma albumin, hematocrit, hemoglobin, iron indices, dietary intakes of folate, vitamins B12 and B6, and levels of folate supplement.

Brazil↗
PubMed2004

Longitudinal changes in cognition and behavior in asymptomatic carriers of the APOE e4 allele.

OBJECTIVE: To determine whether memory loss is detectable before the symptomatic presentation of mild cognitive impairment (MCI) in those at greater genetic risk for Alzheimer disease (AD) based upon presence or absence of the e4 allele of APOE. METHODS: Participants were age 50 years or older who responded to newspaper advertisements. A total of 212 cognitively normal individuals of known APOE genotype were initially enrolled in a match paradigm that included e4 homozygotes, e3/4 heterozygotes, and e4 noncarriers in a 1:1:2 ratio (53 sets). Of the original 212 individually matched participants, 180 completed at least two epochs of testing including 45 APOE e4/4 homozygotes, 42 APOE e3/4 heterozygotes, and 93 APOE e4 noncarriers, mean age 60 (+/-6.2) years. Of these, four developed MCI or AD during the follow-up period and were excluded from analysis. Longitudinal neuropsychological study included two verbal (Auditory Verbal Learning Test [AVLT], Selective Reminding Test [SRT]) and two visual (Complex Figure Test [CFT], Visual Retention Test) memory tests. RESULTS: Multiple measures on both verbal memory tests showed poorer performance over a mean interval of 33 months in e4 carriers than noncarriers: AVLT total learning, long term delayed recall; SRT free and cued recall. Among those age 50 to 59 years, AVLT long term delayed recall, SRT free and cued recall, and CFT recall declined more in APOE e4 carriers. No differences were found in the domains of language, spatial skills, or executive function. CONCLUSIONS: Memory declined in APOE e4 carriers before the symptomatic presentation of MCI in a cohort whose mean age was 60 years over a median period of 33 months. The decline began prior to age 60.

Aged↗
PubMed1998

Longitudinal changes in quantitative EEG during long-term tacrine treatment of patients with Alzheimer's disease.

Quantitative EEG is a potentially useful tool in demonstrating the effects of treatments with acetylcholinesterase (AChE) inhibitors on the progression of Alzheimer's disease (AD). In order to define the profile of EEG changes during tacrine long-term treatment, for 12 months we followed 15 AD patients receiving an optimal individually tolerable dose. After 3 months theta global field power (GFP) was significantly reduced, and after 6 months both theta and delta GFP decreased. Theta GFP was still reduced after 12 months of treatment when compared to the baseline. Significant decreases in fast activities of beta 1 and beta 2 GFP were also observed. The untreated reference group (n = 10) did not show any significant changes in GFP after 12 months follow-up, although generators of theta activity had a significant shift towards posterior regions. These findings suggest that slowing in fast EEG frequencies during chronic treatment with AChE inhibitors may provide an early indicator of declining treatment efficiency.

Aged↗
PubMed2006

Longitudinal changes in food patterns predict changes in weight and body mass index and the effects are greatest in obese women.

The prevalence of obesity is increasing in most parts of the world. The objective of this study was to examine whether changes in food patterns were associated with changes in BMI among women over 9 y. Data were from 33,840 women participating in the Swedish Mammography Cohort in 1987 and 1997. Diet was assessed with a FFQ at both time points and 4 food patterns were derived using confirmatory factor analysis (Healthy, Western/Swedish, Alcohol, and Sweets). Our exposure variables were defined as change in factor score for each food pattern from 1987 to 1997. Our outcome variable was defined as change in BMI during the same period, and we also examined change in weight. Normal weight and overweight women had positive changes in weight and BMI during follow-up, whereas obese women had negative changes in BMI and weight; we observed a significant interaction between change in food patterns and baseline BMI. Obese subjects who increased their factor score for the Healthy pattern had larger decreases in BMI (beta = -0.18 kg/m(2) for a 1 unit increase in SD score, CI: -0.26 to -0.10; P < 0.0001), whereas normal weight and overweight women who increased their Healthy pattern score had smaller increases in BMI (-0.05 kg/m(2) and -0.11 kg/m(2), respectively; P < 0.05 for both). Obese women who increased their Healthy pattern score >3 SD had almost a 4 kg decrease in weight and a 1 unit decrease in BMI at follow-up. In conclusion, changes in eating patterns were significantly related to changes in BMI over 9 y and the effect was modified by baseline BMI. Pattern analysis is helpful in generating hypotheses regarding the role of diet in obesity, and additional research is needed to understand which elements of our patterns are protective or risk factors for weight gain.

Aged↗
PubMed1994

Longitudinal changes in lung function among asbestos-exposed workers.

To prospectively identify the determinants of persistent or accelerated loss of lung function among workers occupationally exposed to asbestos and assess the relative contribution of cigarette smoking, asbestos-induced pleural fibrosis, and specific findings from bronchoalveolar lavage and high resolution CT scans, we examined the determinants of lung function changes in 117 subjects occupationally exposed to asbestos for at least 1 yr in a high exposure setting. A minimum of 20 yr was required between the first exposure to asbestos and entry into the study. Baseline studies included an independent assessment of dyspnea, lung volumes, diffusing capacity of carbon monoxide (DLCO), a chest radiograph, a high resolution CT (HRCT) scan, and bronchoalveolar lavage (BAL). Subjects were observed for an average of 2 yr (range, 0.5 to 4.0 yr), and lung function was measured on at least two separate occasions (mean, 4.1 separate tests). During the period of observation, there was an average 1.5% decrease in the TLC and a 2.5% decrease in the DLCO. In this longitudinal data set, after controlling for age, height, pack-years of cigarette smoking, and follow-up time, persistently lower measures of TLC were independently related to moderate to severe dyspnea (p = 0.005), diffuse pleural thickening (p = 0.007), and higher concentrations of fibronectin in BAL fluid (p = 0.01). Interstitial lung disease either on the chest radiograph or HRCT scan was not independently associated with persistently lower measures of TLC during the period of observation. However, none of the clinical variables we examined were associated with an accelerated decline in TLC.(ABSTRACT TRUNCATED AT 250 WORDS)

Asbestos↗
PubMed1995

Longitudinal change of refractive error in infants during the first year of life.

Using cycloplegia, the change in ametropia of 113 infants was followed at 3 month intervals over the first year of life. Scatterplots of the spherical equivalent power show that the dioptric differences exhibit a significant myopic shift of -0.38 ds between 26 and 36 weeks and -0.38 ds between 36 and 52 weeks. The spread of the dioptric differences (95% CI) does not appear to be related to the magnitude of the ametropia present and decreases with time. By 12 months of age the frequency distribution of the spherical equivalent appears to become leptokurtic as it is in the adult. On average the astigmatism was of low degree (less than 1 dioptre cylinder) and with the rule. Anisometropia was rarely seen. The results of this longitudinal study point to an optimal time for screening and perhaps prescribing for 'abnormal' refractive error between 9 and 12 months of age.

Aging↗
PubMed2004

Longitudinal changes in diet from childhood into adulthood with respect to risk of cardiovascular diseases: The Cardiovascular Risk in Young Finns Study.

OBJECTIVE: To assess nutrient intakes relevant in the prevention of cardiovascular diseases (CVD) among young adults in Finland and to find past and present determinants of quality of diet. DESIGN: Prospective study, 21 years of follow-up. SETTING: The Cardiovascular Risk in Young Finns Study, Finland. SUBJECTS: At baseline in 1980: 3569 children aged 3-18 y participated (83% of those invited), and every second of them (1780) were selected to the dietary study. At follow-ups in 1986 and 2001: 1200 and 1037 of the original sample, respectively, participated. METHODS: Food consumption was assessed using 48-h dietary recall. Intakes in 2001 were compared with those obtained in 1980 and 1986. Nutrients selected for further examination were those implicated in the risk of CVD: saturated, monounsaturated, polyunsaturated and n-3 fatty acids, fibre and salt. An index describing the quality of adulthood diet was constructed. Multivariate logistic regression was used to identify independent childhood and adulthood determinants of the quality index. RESULTS: The average intakes showed substantial changes since 1980. Intakes of fat and saturated fat had decreased, while the consumption of vegetables and fruit had increased. However, a great disparity was present between the recommended levels and actual intakes for many of the nutrients, particularly salt, saturated fat and fibre. Intake of fat and consumption of vegetables in childhood and physical activity in adulthood were important health behavioural determinants of the cardiovascular quality of the adult diet. Socio-demographic factors, including education of the subject and their parents, had no significant associations with diet. CONCLUSIONS: While intakes of energy and nutrients have changed favourably in Finnish young adults between 1980 and 2001 with regard to the risk of CVD, they are still far from recommended levels. Childhood diet is a significant determinant of adult diet even after 21 y. SPONSORSHIP: This study was supported by the Academy of Finland (grant 77841) and Juho Vainio Foundation.

Adolescent↗
PubMed1997

Cross-sectional and longitudinal changes in total and high-density-lipoprotein cholesterol levels over a 20-year period in elderly men: the Honolulu Heart Program.

PURPOSE: The purpose of this report is to describe levels of total cholesterol and high-density-lipoprotein cholesterol (HDL-C) in a group of elderly men and to compare these levels to those that were observed 20 years earlier. METHODS: From 1965-1968, the Honolulu Heart Program began following 8006 men of Japanese ancestry living on the island of Oahu, Hawaii, in a prospective study of coronary heart disease and stroke. This report presents data for 971 men who participated in a separate fasting study of lipids and lipoproteins that first occurred from 1970-1972 and in those who received repeat examinations 10 and 20 years later. Men were aged 71-93 years at the last examination. RESULTS: Over the 20-year period, total cholesterol declined by 1.6-1.8 mg/dL per year (P < 0.001), from average baseline values of 219-222 mg/dL. Levels of HDL-C rose 0.2-0.3 mg/dL per year (P < 0.001), from average baseline values of 44-46 mg/dL. After adjustment for baseline cholesterol levels, men with prevalent coronary heart disease at the end of the 20-year follow-up experienced significantly greater reductions in total cholesterol levels than men without disease (P < 0.001). Men who developed coronary heart disease within the first 10 years of follow-up had the greatest yearly decline in total cholesterol (1.9 mg/dL), followed by men who developed heart disease later (1.8 mg/dL) and men who remained disease free (1.5 mg/dL). Differences between men with recent and earlier disease were not statistically significant, although men without coronary disease experienced a significantly smaller decrease in total cholesterol than either of these groups (P < 0.05). CONCLUSIONS: Changes in total cholesterol and HDL-C levels with advancing age may be part of a natural aging process. Some changes, however, such as large reductions in total cholesterol, may signal occult disease or declines in overall health. Selective survival may contribute to these findings since improvements in lipid and lipoprotein levels that are beneficial in younger ages were common in this long-lived cohort of men.

Aged↗
PubMed2003

Longitudinal changes in bone density in relation to oral contraceptive use.

The primary aim of this 36-month prospective cohort study was to evaluate the association between use of oral contraceptives (OCs) and bone mineral density in reproductive-age women. The 36-month bone density (g/cm2) at the spine, hip and whole body and percent change from baseline (measured at 6-month intervals) were evaluated among 245 women 18-39 years of age; 89 were using OCs (median duration: 3.7 years at study entry) and 156 were not using any hormonal contraception. Before and after adjustment for covariates (baseline bone density, age, race, ever pregnant, exercise, body mass and calcium intake), women using OCs did not differ significantly from comparison women in percent change in bone density over 36 months or in absolute bone density at 36 months. All p-values for between-group differences were >0.55. In conclusion, within the limitations of this study, OCs did not appear to impact bone density over time in this cohort of reproductive-age women.

Adolescent↗
PubMed1992

Longitudinal changes in lumbar bone density among thyrotoxic patients after attainment of euthyroidism.

Hyperthyroidism increases bone turnover, which, in turn, may lead to bone loss from the spine and hip. Treatment of thyrotoxicosis may restore bone mass, but there are few long term prospective studies. We examined lumbar bone mineral density (BMD) in 21 subjects [11 with hyperthyroidism (HT) and 10 controls of similar age] by dual photon absorptiometry in 1986 and by dual energy x-ray densitometry in 1991. All 11 HT patients were successfully treated and remained euthyroid (mean TSH, 2.25 +/- 0.80 mU/L) for more than 3 yr. Lumbar BMD increased 11.03 +/- 2.38% (P < 0.001) in HT patients, but only 2.6 +/- 2.15% (P = 0.10) in control subjects. Among HT patients, the higher the T3 concentration during hyperthyroidism, the greater the subsequent increase in lumbar BMD (r = 0.72; P < 0.03). Age at treatment, in contrast, was not a significant predictor of eventual spinal bone mass. In conclusion, successful treatment of hyperthyroidism produced a significant increase in lumbar BMD. Hence, bone loss associated with thyrotoxicosis may not be permanent. Future work designed to examine the effect of thyroid hormone on skeletal homeostasis should include large scale longitudinal studies of both men and women.

Absorptiometry, Photon↗
PubMed2000

Longitudinal changes in young people's short-term power output.

PURPOSE: The influences of age, body size, skin-fold thickness, gender, and maturation on the short-term power output of young people were examined using multilevel modelling. METHODS: Subjects were 97 boys and 100 girls, aged 12.2 +/- 0.4 yr at the onset of the study. Sexual maturity was classified according to Tanner's indices of pubic hair. Peak power (PP) and mean power (MP) were determined on two occasions 1 yr apart using the Wingate Anaerobic Test (WAnT). The data were analyzed using multilevel regression modelling. RESULTS: Initial models identified body mass and stature as significant explanatory variables with an additional positive effect of age, which was smaller for girls' MP. A significant gender difference was apparent for both power indices with girls achieving lower values than boys. A significant incremental effect of later maturity (stages 4 and 5 for pubic hair development) was identified for MP only. Subsequent incorporation of sum of two skin-fold thicknesses into the model yielded significant negative parameter estimates for PP and MP and negated both the stature effects and the maturation influence upon MP. CONCLUSION: There are gender differences in the longitudinal growth of performance on the WanT. Regardless of gender differences, body mass and skin-fold thicknesses appear to be the best anthropometric predictors of WAnT determined PP and MP in young people.

Body Mass Index↗
PubMed1983

Longitudinal changes in the ANB angle and Wits appraisal: clinical implications.

The changes in the ANB angle and the Wits appraisal between the ages of 5 and 25 years were evaluated in twenty male and fifteen female subjects. All subjects had clinically acceptable occlusions, and none had undergone orthodontic therapy. Descriptive statistics were calculated, and analysis of variance was performed. The conclusions derived from this investigation are as follows: (1) No significant differences were observed in the changes between male and female subjects for either ANB or Wits between age 5 and adulthood. (2) The ANB angle changes significantly with age, while the Wits appraisal indicates that the relationship between points A and B does not change significantly with age. (3) Correlation coefficients showed that the ANB angle and the Wits appraisal are significantly correlated but the r-values are relatively low. These findings explain the discrepancies that are present in some cases between the measured values of the ANB angle and the clinical judgment of the orthodontist. For a more accurate diagnosis of the anteroposterior apical base relationship, both the ANB angle and Wits appraisal should be used.

Adolescent↗
PubMed1998

Predicting longitudinal changes in caregiver physical and mental health: a stress process model.

Alzheimer's family caregivers (N = 122) reported on physical and mental health, as well as stress process variables, at baseline and at a 1-year follow-up. Hierarchical regression analyses of stress process models revealed that increases in primary stressors (e.g., patient self-care and behavioral problems) did not directly affect changes in the mental and physical health outcome variables. However, analyses of models of direct, mediated, and moderated effects revealed that psychosocial resource variables (appraisals, coping responses, and social support) were related to caregiver outcomes over time through several mechanisms. In particular, benign appraisals of stressors, the use of approach coping, and greater levels of social support were associated with more positive caregiver health outcomes over time.

Activities of Daily Living↗
PubMed2005

Factors influencing longitudinal change in knee cartilage volume measured from magnetic resonance imaging in healthy men.

OBJECTIVE: To determine whether the amount of joint cartilage in healthy, middle aged men is stable or changes over time, and what factors may influence this. METHODS: In a cohort study, 28 healthy men (70% of the original cohort; mean (SD) age, 51.9 (12.8) years) had baseline knee magnetic resonance imaging (MRI) of their dominant knee and repeat MRI of the same knee approximately 2.0 years later. Knee cartilage volume was measured at baseline and follow up. Risk factors assessed at baseline, including sex hormones and metabolic bone markers, were tested for their association with change in knee cartilage volume over time. RESULTS: Mean (SD) reduction in tibial cartilage volume per year was 162 (93) microl. This represented a 2.8% reduction in total tibial articular cartilage per year (95% confidence interval, 0.2% to 5.5%). Tibial cartilage loss was associated with serum free testosterone level, independently of age, body mass index, baseline tibial cartilage volume tibial plateau area, and total bone mineral content. Overall, testosterone accounted for 14.5% (partial r2) of the variation in change in tibial cartilage volume. There was a trend towards a positive association between tibial cartilage loss and urinary N-telopeptide cross-links of type I collagen (Ntx) (p = 0.057). CONCLUSIONS: Further studies will be required to determine whether hormonal manipulation or treatment with antiresorptive drugs will reduce the risk of knee osteoarthritis in men in later life.

Adult↗
PubMed2005

Exposure to hydrogen peroxide at TLV level does not induce lung function changes: a longitudinal study.

This study reports on longitudinal changes in lung function using spirometry of employees at a beverage processing plant, where exposure information (1995-2001) suggests that the threshold limit value (TLV)-Time Weighted Average (TWA) of 1 ppm was not likely exceeded. Changes over time in lung function (Forced Expiratory Volume of 1st second, FEV1; Forced Vital Capacity, FVC; and FEV1/FVC ratio; all expressed as percent of the predicted) were evaluated by using sparse lung function data obtained from 1993 to 2002 in 43 exposed and 31 unexposed workers. The longitudinal changes were assessed using multiple regression analysis where the dependent variable was the annual change of lung function indices and the independent variables were exposure and smoking habits. With regard to exposure, FVC increased, FEV1 was unchanged, and the FEV1/FVC ratio tended to decrease. The latter difference was not significant when FVC was used as a covariate. The FEV1 is significantly worse in smokers than in non-smokers. These data suggest that no lung function changes occur when the H2O2 levels were compliant to the exposure standard. Our findings support the current TLV-TWA of 1 ppm for H2O2.

Adult↗