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At least 1,135 records · Page 63Linked to original sources
PubMed2004

FAST (focused assessment with sonography in trauma) accurate for cardiac and intraperitoneal injury in penetrating anterior chest trauma.

OBJECTIVE: To evaluate the FAST (focused assessment with sonography in trauma) examination for determining traumatic pericardial effusion and intraperitoneal fluid indicative of injury in patients with penetrating anterior chest trauma. METHODS: An observational prospective study was conducted over a 30-month period at an urban level I trauma center. FAST was performed in the emergency department by emergency physicians and trauma surgeons. FAST results were recorded before review of patient outcome as determined by 1 or more of the following: thoracotomy, laparotomy, pericardial window, cardiologic echocardiography, diagnostic peritoneal lavage, computed tomography, and serial examinations. RESULTS: FAST was undertaken in 32 patients with penetrating anterior chest trauma: 20 (65%) had stab wounds, and 12 (35%) had gunshot wounds. Sensitivity of FAST for cardiac injury (n = 8) in patients with pericardial effusion was 100% (95% confidence interval, 63.1%-100%); specificity was 100% (95% confidence interval, 85.8%-100%). The presence of pericardial effusion determined by FAST correlated with the need for thoracotomy in 7 (87.5%) of 8 patients (95% confidence interval, 47.3%-99.7%). One patient with a pericardial blood clot on cardiologic echocardiography was treated nonsurgically. FAST had 100% sensitivity for intraperitoneal injury (95% confidence interval, 63.1%-100%) in 8 patients with views indicating intraperitoneal fluid but without pericardial effusion, again with no false-positive results, giving a specificity of 100% (95% confidence interval, 85.8%-100%). This prompted necessary laparotomy in all 8. CONCLUSIONS: In this series of patients with penetrating anterior chest trauma, the FAST examination was sensitive and specific in the determination of both traumatic pericardial effusion and intraperitoneal fluid indicative of injury, thus effectively guiding emergent surgical decision making.

Ascites↗
PubMed2001

ETDRS-fast: implementing psychophysical adaptive methods to standardized visual acuity measurement with ETDRS charts.

PURPOSE: To measure visual acuity (VA) on Early Treatment Diabetic Retinopathy Study (ETDRS) charts with a modified faster procedure (ETDRS-Fast), based on adaptive psychophysics methods and to assess the method's validity and reproducibility. METHODS: Whereas the standard method for measuring VA with the ETDRS charts requires that the subject read all the letters beginning with the top row, in the ETDRS-Fast procedure, the subject is asked to read only one letter per row until a mistake is made. Then, following simple rules, the examiner finds a row from which the subject can begin reading all the letters downward, thus making the method identical with the standard method near threshold. VA determination was performed twice with both methods in 57 subjects in two separate sessions to assess validity and reproducibility. RESULTS: In both sessions the correlation between the two procedures was high (intraclass correlation coefficient 0.95), confirming the validity of the ETDRS-Fast procedure. Reproducibility was good for both procedures, with intraclass correlation coefficients of 0.94 for the standard and 0.96 for the ETDRS-Fast method. The ETDRS-Fast procedure allowed a significantly shorter test duration (-30%; P < 0.0001). CONCLUSIONS: Adaptive procedures allow accurate and fast determination of psychophysical thresholds by reducing the number of stimulus presentations when the subject is far from threshold. In the ETDRS-Fast method a few simple rules applied to optotype chart reading allow adaptation to each patient's level of VA. The ETDRS-Fast procedure significantly reduces test time and still yields results that are as accurate as those obtained with the standard method.

Adult↗
PubMedDate not supplied

The relationship between the supply of fast-food chains and cardiovascular outcomes.

OBJECTIVE: To examine the extent to which inter-regional differences in fast-food concentrations account for variations in all-cause mortality and acute coronary syndromes throughout Ontario, Canada. METHODS: Nine distinct fast-food chains were selected based on top sales data in 2001. The per capita rate of fast-food outlets per region was calculated for each of 380 regions throughout Ontario. Outcome measures, obtained using 2001 vital statistics data and hospital discharge abstracts, included regional per capita mortality rates and acute coronary syndrome hospitalization rates; head trauma served as a comparator. All regional outcomes were adjusted for age, gender, and socio-economic status, and were analyzed as continuous and rank-ordered variables as compared with the provincial average. RESULTS: Mortality and admissions for acute coronary syndromes were higher in regions with greater numbers of fast-food services after adjustment for risk. Risk-adjusted outcomes among regions intensive in fast-food services were more likely to be high outliers for both mortality (Adjusted Odds Ratio (OR): 2.52, 95% confidence intervals (CI): 1.54 - 4.13, p < 0.001) and acute coronary hospitalizations (Adjusted OR: 2.62, 95% CI 1.42 - 3.59, p < 0.001) compared to regions with low fast-food service intensity. There was no relationship between the concentration of fast-food outlets and risk-adjusted head-trauma hospitalization rates. INTERPRETATION: Inter-regional cardiac outcome disparities throughout Ontario were partially explained by fast-food service intensity. Such findings emphasize the need to target health promotion and prevention initiatives to highest-risk communities.

Cardiovascular Diseases↗
PubMed2004

[Replacement of insulin by fasting C-peptide in modified homeostasis model assessment to evaluate insulin resistance and islet beta cell function].

OBJECTIVE: To investigate the possibility of using C-peptide to replace insulin in homeostasis model assessment (Homa) to evaluate insulin resistance and islet beta cell function. METHODS: Oral glucose tolerance test (OGTT) was performed in 21 normal subjects, whose venous blood was drawn before taking glucose and 30, 60, 120 minutes after taking glucose. Insulin and C-peptide were determined with radioimmune assay. Homa indices of insulin resistance and islet beta cell function were calculated. Multiple stepwise linear regression model of insulin resistance was measured using C-peptide x blood glucose as independent variables and Homa-IR was used as the dependent variable, while the model of islet beta cell function was determined using C-peptide/(fasting blood glucose - 3.5) as the independent variable and Homaislet as the dependent variable. RESULTS: The modified Homa formula were: Homa-IR (CP) = 1.5 + fasting blood glucose x fasting C-peptide/2800 (F = 5. 511, P = 0.029), Homa-islet (CP-Normal) = 0.27 x fasting C-peptide /(fasting blood glucose - 3.5) + 50, and Homa-islet (CP-DM) = 0.27 x fasting C-Peptide/(fasting blood glucose - 3.5) (F = 212.961, P = 0.000), respectively. The modified Homa-IR (CP) and Homa-IR, Homa-islet (CP) and Homa-islet were highly correlated (r =0.689 and r = 0.788; all P = 0.000). Using Homa and modified Homa formula to evaluate the insulin resistance and islet beta cell function both in the normal and diabetic subjects was similar. CONCLUSION: Fasting C-peptide can substitute insulin in Homa model to assess insulin resistance and islet beta cell function. The modified homeostasis model assessment may be applied in the diabetics using exogenous insulin.

Adult↗
PubMedDate not supplied

Rapid MR imaging of the pediatric brain using the fast spin-echo technique.

PURPOSE: To evaluate diagnostic reliability and to establish optimal scanning techniques of a recently developed Fast Spin-echo MR pulse sequence that allows rapid proton density-weighted and T2-weighted imaging. METHODS: We compared lesion conspicuity and signal intensity measurements on Fast Spin-echo and conventional spin-echo sequences in 81 patients ranging from 1 week to 25 years in age on a 1.5-T MR unit. A total of 28 Fast Spin-echo dual-echo images (14 slice locations) were obtained in 2:08 minutes with a 256 x 128 matrix or in 3:12 minutes with a 256 x 192 matrix at a TR of 2000 msec and two excitations. RESULTS: Lesion conspicuity and characterization on Fast Spin-echo images compared favorably with conventional spin-echo images in our series when pseudo-TEs of 15 and 90 msec were employed for proton density-weighted and T2-weighted images, respectively. Fast Spin-echo images yielded diagnostic information in four nonsedated patients whose conventional spin-echo images were either degraded by motion or unobtainable. Fat signal remained bright on T2-weighted Fast Spin-echo images. Magnetic-susceptibility effects were slightly reduced with Fast Spin-echo but did not pose any diagnostic problem in our series. CONCLUSION: Diagnostically reliable rapid dual-echo brain images can be obtained with Fast Spin-echo sequences.

Adolescent↗
PubMed2006

Metabolic characteristics of patients with apparently normal fasting plasma glucose.

AIMS: To describe the prevalence of dysglycaemia in patients with fasting glucose <6.1 mmol/L. METHODS: Consecutive patients referred for OGTT between July 2002 and December 2003 to eight Diagnostic Medical Laboratory depots in the Auckland region of New Zealand were invited to participate. In addition to a standard OGTT, patients' BMI was calculated and HbA1c, fructosamine, lipids, and insulin concentrations were measured. Patients were grouped according to fasting glucose of <5.5 mmol/L=normal, 5.5-6.0 mmol/L="high fives", 6.1-6.9 mmol/L="old" impaired fasting glucose, and greater than and equal to 7 mmol//L=diabetes. RESULTS: 310 patients were studied. 111 patients had a fasting glucose of <5.5 mmol/L, and of these, 23 had IGT and 2 diabetes on OGTT; 85 patients had a fasting glucose 5.5-6.0 mmol/L, and 18 of these had IGT and 11 diabetes on OGTT; 75 patients had a fasting glucose of 6.1-6.9 mmol/L, and of these, 33 had IGT and 21 diabetes on OGTT; 39 patients had a fasting glucose greater than and equal to 7 mmol/L and 38 were confirmed diabetic on OGTT. CONCLUSION: This study suggests that the upper limit of normal fasting glucose be lowered to <5.5 mmol/L in line with Australian and American Diabetes Society guidelines.

Blood Glucose↗
PubMed1986

Evaluation of plasma and buffy coat ascorbic acid concentrations in dogs before and after a 24-hour fast.

Samples of blood were taken from 15 female and 15 male research laboratory Beagles before and after they were fasted for 24 hours. The mean buffy coat ascorbic acid concentration was significantly higher in dogs after they were fasted than that before they were fasted. In contrast, the mean plasma ascorbic acid concentration was significantly lower in dogs after they were fasted than that before they were fasted. The mean buffy coat ascorbic acid concentrations in blood samples of both fasted and nonfasted female Beagles was significantly greater than those of male Beagles, whereas the mean plasma concentrations of both fasted and nonfasted female Beagles was significantly lower than those of male Beagles. It was observed that whenever there was a decrease in plasma ascorbic acid concentration, there was an increase in buffy coat ascorbic acid concentration, regardless of fasting stress or sex difference.

Animals↗
PubMed1981

Fast outward current controlling electrical activity in rat uterine smooth muscle during gestation.

Action potentials and ionic currents were measured on myometrial strips from 14-16 days and 20-22 days of pregnancy in rats by means of a double sucrose gap technique. 1. In mid-pregnancy, the patterns of outward current showed a distinct fast component. However, conditioning polarizations can induce or suppress the fast outward current in the uterus from different stages of gestation, suggesting a membrane potential dependence. 2. 4-aminopyridine (4-AP) specifically suppressed the fast outward current while the late outward current was more sensitive to tetraethylammonium ions TEA). This allowed a determination of activation and inactivation parameters of the fast outward current. The availability was maximal at - 80 mV and represented 20-25% at - 50 mV. The activation-voltage dependence of the fast outward current in mid-pregnancy was similar to that of the fast component of the outward current during parturition. 3. The apparent depression of the inward current during conditioning hyperpolarizations was suppressed by 4-AP, indicating that the fast outward current overlapped with the inward current. 4. It is suggested that two sets of pharmacologically distinct potassium channels contribute to the outward current in myometrium. Ovarian hormones could control the amount of available fast potassium channels and, by this way, modulate the resting membrane potential during pregnancy.

Action Potentials↗
PubMed1994

Ca(2+)- and Sr(2+)-sensitive ATPase activity of slow skeletal myofibrils in comparison with fast skeletal and cardiac myofibrils.

Ca(2+)- and Sr(2+)-sensitive ATPase of myofibrillar preparations from slow skeletal (chicken anterior latissimus dorsi), fast skeletal (chicken breast) and porcine cardiac ventricular muscles was investigated. Sr2+ at concentrations about 6 times higher than Ca2+ was required for activating the ATPase of slow skeletal or cardiac myofibrils, while Sr2+ about 30 times higher than Ca2+ was required for activating fast skeletal myofibrils. The cooperativity of activation of slow skeletal myofibrils was almost the same as that of cardiac myofibrils, but lower than that of fast skeletal myofibrils. Sr2+/Ca2+ sensitivity ratio of the desensitized (troponin-tropomyosin-depleted) fast skeletal myofibrils reconstituted with troponin-tropomyosin from slow skeletal, fast skeletal, and cardiac muscles were 13, 34, and 5, respectively. The troponin C-depleted fast skeletal myofibrils showed the same Sr2+/Ca2+ sensitivity ratio and the same cooperativity of activation as those of the intact fast skeletal myofibrils when reconstituted with fast skeletal troponin C, and as those of the intact slow skeletal myofibrils when reconstituted with slow skeletal troponin C.

Adenosine Triphosphatases↗
PubMed1993

Hypertonic treatment during premature chromosome condensation allows visualization of interphase chromosome breaks repaired with fast kinetics in irradiated CHO cells.

A class of interphase chromosome breaks was visualized in irradiated (10 Gy) plateau-phase CHO cells after treatment (2-30 min) in hypertonic (500 mM NaCl) growth medium during the period normally allowed for chromosome condensation, in the premature chromosome condensation (PCC) assay. Rejoining of this class of interphase chromosome breaks was fast (t1/2 = 1.5 min) compared to the rejoining of interphase chromosome breaks normally observed in the absence of hypertonic treatment (t1/2 = 76 min), suggesting that they are formed from a different subset of precursor DNA lesions. A fast (t1/2fast = 12 min) and a slow (t1/2slow = 71 min) component were also observed in the rejoining of radiation-induced (50 Gy) DNA double-strand breaks (DSBs), as measured by pulsed-field gel electrophoresis. We propose that fast-repairing DSBs are the precursor lesions underlying the fast-repairing interphase chromosome breaks observed in these experiments. Slowly repairing DSBs are postulated to be the precursor lesions underlying the slowly repairing interphase chromosome breaks visualized using regular protocols for PCC. The visualization of fast-repairing interphase chromosome breaks achieved in these experiments is assumed to be due to a destabilization of chromatin by the hypertonic medium. This chromatin destabilization may cause either an inhibition of the rejoining of the fast component of DSBs during the period allowed for PCC or a transformation of a defined subset of fast-repairing DSBs into chromosome breaks. The latter hypothesis allows a more consistent interpretation of the available results. Transformation of a defined subset of fast-repairing DSBs to interphase chromosome breaks may be equivalent to damage fixation, and may correspond to the fixation of a form of PLD (beta-PLD) sensitive to treatment in hypertonic medium.

Animals↗
PubMed1977

Impact of fast food meals on nutrient intake of two groups.

Two groups in different population centers were studied to determine how often consumers frequented fast food restaurants, and consequently, how heavily they relied on this type of food for nutrients. A questionnaire was answered by 280 customers of two fast food restaurants of the same chain. They were asked how often they patronized fast food restaurants, their specific food choices, and other pertinent questions. Food choices were evaluated for energy and seven nutrients on the basis of published analyses of the menu items of the particular fast food chain. Fifty-two per cent of the subjects in the two groups considered their purchases to be meals. Seventy-seven per cent of these consumed one-third or more of the recommended dietary allowance for protein, but no more than 30 per cent received that amount of the other nutrients examined, including food energy. Calcium and particularly vitamin A were least often consumed in amounts equal to one-third of the recommended allowances. Consumer choices were responsible for low consumption of calcium, but no good sources of vitamin A were included on the menus. Fast food items were purchased so infrequently by the majority of our respondents that nutrient composition of the fast food meals or snacks would be of concern in only a small number of cases. This study indicates that any attempts to improve nutritive value of fast food snacks or meals must include efforts to lead consumers to make wiser food choices, as well as encourage the fast food industry to provide rich sources of all the nutrients in their menus.

Adolescent↗
PubMed1996

[Interventional MRI. Value of low field strength and very fast 3D steady state imaging sequences for the guidance of a "non" ferromagnetic needle].

PURPOSE: The excellent tissue differenciation provided by MRI in the three directions and the lack of ionizing radiations make it ideal for interventional procedures. Many problems must still be solved: the access to the patient, the size of the artefact produced by interventional instruments and the acquisition time. In this study, we evaluated the influence of field strength for standard imaging sequences on the MRI artefact of a non ferro-magnetic biopsy needle. Then, we developed very fast sequences on a opened 0.1 T dedicated magnet to test in vitro and ex vivo the potential ability of this system in the guidance of the needle. MATERIAL AND METHODS: The biopsy needle was a new stainless steel needle made of 49% Nickel. The needle artefact's size measurements were made at 0.1 T, 0.5 T and 1 T on a bicompartmental phantom (one compartment with a long T1 and another with a long T2), with standard gradient echo (400/12/90 degrees) and spin echo (500/25) sequences. At 0.1 T, we optimized very fast steady state 3D FAST (T1 weighted) and 3D CE-FAST (T2 weighted) sequences to reduce the acquisition time, preserving good image contrasts for a field of view reaching 38 mm and 48 x 64 or 24 x 32 matrix. RESULTS: The larger needle artefact observed on gradient echo images varied from 3.6 mm at 0.1 T to 8.6 mm at 1 T. The shortest acquisition time for 4 contiguous slices of 2mm with a 1.2 mm/pixel resolution and a 24 x 32 matrix was 1.5 s for the 3D FAST (16/9/65 degrees) sequence and 3 s for the 3D CE-FAST (29/22/65 degrees) sequence. We realized a complete MRI guided abdominal puncture on a cat cadaver with 4 series of 15 s 3D FAST images (16/9/65 degrees, 4 slices, 5 excitations, 1.2 mm/pixel, FOV = 77 mm). Besides the cat positioning and the image reconstruction time, the whole puncture lasted 1 min (4 x 15 s). CONCLUSION: Low field MRI (0.1 T) combined with very fast 3D steady state sequences is adapted for the real time guidance of biopsy needles.

Biopsy, Needle↗
PubMed1998

[Evaluation of the Humphrey perimetry programs SITA Standard and SITA Fast in normal probands and patients with glaucoma].

PURPOSE: To evaluate the new threshold strategies of the Humphrey Field Analyser, SITA Standard and SITA Fast, in normals and glaucoma patients. METHODS: Fifty healthy volunteers and 50 glaucoma patients were tested twice with three algorithms: Full Threshold, SITA Standard and SITA Fast in two sessions. The second test was taken into account to eliminate learning effect. Glaucoma patients were chosen to cover a large range of deficits. Quantitative analysis of global indexes was performed as well as qualitative comparison of visual fields by a trained optometrist. RESULTS: Compared to Full Threshold, testing time was reduced by 51% in normals and 49% in glaucoma with SITA Standard and by 72% and 69% with SITA Fast, respectively. In glaucoma, mean testing time dropped from 16'01" with Full Threshold to 8'05" with SITA Standard and to 4'55" with SITA Fast. Quantitative comparison showed a high correlation between indexes (MD Full Threshold vs MD SITA Standard: r = 0.98, p < 0.01; PSD Full Threshold vs PSD SITA Standard: r = 0.94, p < 0.01). However SITA Standard and SITA Fast had a tendency to underestimate visual field defects. In glaucomatous subjects, mean MD ameliorated by 1.01 dB with SITA Standard and by 1.71 dB with SITA Fast. Mean PSD ameliorated by 0.04 dB and 0.43 dB, respectively. Qualitative analysis confirmed these last results showing artificial slight or important improvement of visual fields in 21% of the cases with SITA Standard and 30% with SITA Fast, compared to Full Threshold. CONCLUSION: SITA Standard and SITA Fast strategies improve dramatically visual field testing time, by 51% and 72% respectively. However, one should be cautious in comparing results obtained with different algorithms, as these new strategies improve the mean defect and, to a lesser extent, the localized defect.

Adult↗
PubMed2002

Fasting and 2-hour postchallenge serum glucose measures and risk of incident cardiovascular events in the elderly: the Cardiovascular Health Study.

BACKGROUND: The contributions of fasting and 2-hour postchallenge glucose level to cardiovascular events remain ill-defined, especially for nondiabetic adults. This study examined the relative predictive power of fasting and 2-hour glucose level on cardiovascular event risk. METHODS: A total of 4014 community-dwelling adults 65 years or older who participated in the baseline visit of the Cardiovascular Health Study and who were without treated diabetes or previous myocardial infarction or stroke were eligible for analyses. Participants with treated diabetes at baseline were excluded. Incident myocardial infarction or stroke, or coronary death, was the outcome of interest. Age-, sex-, and race-adjusted proportional hazards regression models described individual and joint associations between baseline measures of fasting and 2-hour postchallenge glucose level and event risk. RESULTS: There were 764 incident cardiovascular events during 8.5 years of follow-up. Fasting glucose level of 115 mg/dL (6.4 mmol/L) or more was associated with an increased cardiovascular risk (hazard ratio [HR], 1.66 [95% confidence interval (CI), 1.39-1.98]) in adjusted analyses compared with fasting glucose level less than 115 mg/dL. Two-hour glucose level was associated with a linear risk (HR, 1.02 [95% CI, 1.00-1.04] per 10 mg/dL [0.6 mmol/L]) that included an additional increase in risk for 2-hour glucose level of 154 mg/dL (8.5 mmol/L) or more (HR, 1.29 [95% CI, 1.04-1.59]) in adjusted analyses. In joint fasting and 2-hour glucose models, only 2-hour glucose level remained predictive of event risk. CONCLUSIONS: Two-hour glucose level was better than fasting glucose level alone at identifying older adults at increased risk of major incident cardiovascular events.

Aged↗
PubMed2000

Diurnal variation in fasting plasma glucose: implications for diagnosis of diabetes in patients examined in the afternoon.

CONTEXT: Current diagnostic criteria for diabetes are based on plasma glucose levels in blood samples obtained in the morning after an overnight fast, with a value of 7.0 mmol/L (126 mg/dL) or more indicating diabetes. However, many patients are seen by their physicians in the afternoon. Because plasma glucose levels are higher in the morning, it is unclear whether these diagnostic criteria can be applied to patients who are tested for diabetes in the afternoon. OBJECTIVES: To document diurnal variation in fasting plasma glucose levels in adults not known to have diabetes, and to examine the applicability to afternoon-examined patients of the current diagnostic criteria for diabetes. DESIGN, SETTING, AND PARTICIPANTS: Analysis of data from the US population-based Third National Health and Nutrition Examination Survey (1988-1994) on participants aged 20 years or older who had no previously diagnosed diabetes, who were randomly assigned to morning (n = 6483) or afternoon (n = 6399) examinations, and who fasted prior to blood sampling. MAIN OUTCOME MEASURES: Fasting plasma glucose levels in morning vs afternoon-examined participants; diabetes diagnostic value for afternoon-examined participants. RESULTS: The morning and afternoon groups did not differ in age, body mass index, waist-to-hip ratio, physical activity index, glycosylated hemoglobin level, and other factors. Mean (SD) fasting plasma glucose levels were higher in the morning group (5.41 [0.01] mmol/L [97.4 ¿0.3¿ mg/dL]) than in the afternoon group (5.12 [0.02] mmol/L [92.4 ¿0.4¿ mg/dL]; P<.001). Consequently, prevalence of afternoon-examined participants with fasting plasma glucose levels of 7.0 mmol/L (126 mg/dL) or greater was half that of participants examined in the morning. The diagnostic fasting plasma glucose value for afternoon-examined participants that resulted in the same prevalence of diabetes found in morning-examined participants was 6.33 mmol/L (114 mg/dL) or greater. CONCLUSIONS: Our results indicate that if current diabetes diagnostic criteria are applied to patients seen in the afternoon, approximately half of all cases of undiagnosed diabetes in these patients will be missed.

Adult↗
PubMed2001

Random fasting hyperglycemia as cardiovascular risk factor in the elderly: a 6-year longitudinal study.

A large body of evidence suggests that diabetes increases the risk of coronary heart disease (CHD), but whether fasting hyperglycemia is associated with a major risk for CHD is still under debate. The aim of the present study was to investigate the role played by fasting hyperglycemia in the development of cardiovascular disease (CVD) in an elderly population when associated with common risk factors for CVD (i.e., hypertension, hypercholesterolemia, smoking, etc). We analyzed a sample of 455 subjects aged > or = 60 years. The risk factors taken into account were systolic and diastolic blood pressure levels, use of antihypertensive drugs, total serum cholesterol, serum triglycerides, and smoking habit. Glycemia was measured at entry on a fasting sample. During the follow-up period (mean 6 years), the occurrence of CVD was monitored (criteria for the occurrence of CVD included total cardiovascular mortality, fatal or nonfatal myocardial infarction, symptomatic coronary heart disease [stable and unstable angina], the need for percutaneous transluminal coronary angioplasty or coronary artery bypass graft, fatal or nonfatal stroke, and transient ischemic attack). A total of 427 subjects completed the follow-up. During this period, 73 subjects (17.10%) developed CVD according to the above criteria. A Cox proportional hazard model was designed to evaluate the contribution of variables in predicting CVD. Relative risks and 95% confidence intervals for CVD were calculated from the regression coefficients to study the association between the risk of developing CVD and predicting variables. We found a relation between occurrence of CVD and fasting hyperglycemia: subjects with fasting glycemia, > 126 mg/dl at enrollment, but without previous clinical diagnosis of diabetes, showed a 2.01 times higher risk than those with fasting glycemia < 126 mg/dl. Hence, random fasting hyperglycemia can predict the occurrence of CVD in elderly subjects.

Age Factors↗
PubMed1975

Unaltered metabolism of antipyrine and tolbutamide in fasting man.

Effects of fasting on the metabolsim and distribution of antipyrine and tolbutamide were studied in 13 obese, but otherwise healthy, volunteers. Only 6 of the 13 subjects decreased their metabolic clearance rate (MCR) during fasting; no significant change occurred during fasting in the mean MCR of either drug. These results are in contrast with reported changed rates of drug metabolism in fasting experimental animals. The apparent volume of distribution (aVd) of antipyrine decreased during fasting in each of 7 subjects receiving oral test doses of antipyrine; the mean control value plus or minus standard deviation was 61 plus or minus 16 1, whereas during fasting the mean became 52 plus or minus 17 1. The aVd plus or minus SD of tolbutamide decreased in 4 of the 6 volunteers receiving intravenous test doses of tolbutamide; the mean control value in these6 volunteers was 8.3 plus or minus 1.7 1; during fasting it was 7.4 plus or minus 1.91.

Administration, Oral↗
PubMedDate not supplied

Different mechanisms decrease hepatic collagen and albumin production in fasted rats.

Weight loss is correlated with a specific decrease in collagen synthesis in extrahepatic tissues, mainly through modulation of mRNA levels. Here, we investigated the response to weight loss in the rat liver. Male rats were either fed ad libitum or fasted for 92 hr; fasted animals lost approximately 20% of their initial body weight. Following i.p. injection of [5-3H]proline, hepatic collagen was extracted and de novo collagen production was measured. There was a decrease in the specific radioactivities of purified hepatic collagen (-75%) and albumin (-70%) relative to total hepatic protein, indicating that production of both of these proteins was specifically decreased. In fasted animals, the absolute hepatic collagen production was markedly decreased (-60%), while changes in absolute hepatic protein production were small (-15%). Using hybridization with specific DNA probes, we found that fasting causes about a 70% decrease in albumin mRNA, but the quantities of hepatic procollagen alpha 1(I) and alpha 2(I) mRNAs were unchanged. These results are consistent with regulation of albumin production during fasting by modulation of mRNA levels. The inhibition of hepatic collagen production in fasted animals, however, appears to be modulated at a posttranscriptional level or may result from increased degradation. This response differs from the pretranslational regulation of collagen synthesis in extrahepatic tissues during fasting. Furthermore, our results suggest that decreased body weight could be a potentially complicating variable in studies of collagen metabolism and fibrogenesis in the liver.

Albumins↗