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A R Morton

Publications and source records attributed to A R Morton.

116 records · Page 7Linked to original sources
PubMedDate not supplied

Determinants of change in blood pressure during S.W.E.A.T.: the sedentary women exercise adherence trial.

1. In a long-term study of the optimal approach to initiating and maintaining a regular exercise programme in previously sedentary older women (40-65 years), we have assessed determinants of change in resting blood pressure (BP) after 6 and 12 months. 2. Women (n = 126) were randomly assigned to either a centre-based or home-based exercise programme for an initial 6 months. The centre-based group attended supervised sessions three times per week, while the home-based group exercised unsupervised at home three times per week. Both groups were home-based during a second 6 months. Within each arm, subjects were further randomized to either exercise at moderate intensity (40-55% heart rate reserve; HRres) or at vigorous intensity (65-80% HRres). A nonintervention comparison group of 30 women was followed throughout. 3. At 6 months there was a fall in BP with moderate, but not vigorous intensity exercise (-2.7 mmHg; P = 0.025), an effect no longer significant at 12 months. 4. Change in BP was unrelated to improvements in fitness (VO2max), increases in lean tissue mass, number of exercise sessions completed or a composite measure of the total number of exercise sessions completed multiplied by the mean exercise intensity expressed as a percentage of heart rate reserve (%HRres). 5. Continuing participation in any regular exercise was a consistent predictor of change in BP, with those subjects still exercising in the 2 weeks before BP measurement having 1.9 mmHg lower BP at 6 months (P = 0.038) and 3.8 mmHg lower BP at 12 months (P = 0.016). 6. We conclude that the small effects of exercise on resting BP in these older women are predominantly related to continuing participation in lower intensity exercise, rather than to improvements in fitness or body composition.

Adult↗
PubMedDate not supplied

Chlamydia pneumoniae DNA in peripheral blood mononuclear cells in peritoneal dialysis patients.

OBJECTIVE: The aim of the present study was to examine the association between infection with Chlamydia pneumoniae and symptomatic atherosclerosis in peritoneal dialysis (PD) patients. DESIGN: Cross-sectional study. SETTING: Peritoneal Dialysis Unit of Kingston General Hospital. PATIENTS: Fifty-five prevalent PD patients. OUTCOME MEASURES: (1) Infection with C. pneumoniae diagnosed by detection of DNA in peripheral blood mononuclear cells (PBMCs) using polymerase chain reaction. (2) Symptomatic atherosclerosis involving the coronary, cerebral, or peripheral circulation. RESULTS: The DNA of C. pneumoniae was detected in PBMCs in 33 patients (60.0%). Atherosclerosis was present in 16 of 33 (48%) PBMC C. pneumoniae DNA-positive patients, and in 10 of 22 (45%) PBMC C. pneumoniae DNA-negative patients (p = 0.83). Using multiple logistic regression and controlling for a number of known cardiovascular risk factors, PBMC C. pneumoniae DNA status was not predictive of atherosclerosis. The only significant independent predictors of atherosclerosis were diabetes and age. CONCLUSIONS: In prevalent PD patients, a high prevalence of symptomatic atherosclerosis and of Chlamydia pneumoniae DNA in PBMCs were seen; however, the results of the present study do not support the presence of an association between infection with C. pneumoniae and atherosclerosis.

Arteriosclerosis↗
PubMedDate not supplied

A comparison of continuous arteriovenous hemofiltration and intermittent hemodialysis in acute renal failure patients in the intensive care unit.

Our experience with high flow CAVH (1-2 L/hr) and intermittent hemodialysis in our combined medical-surgical tertiary care intensive care unit was reviewed. During a 16 month period, 12 patients received CAVH and 23 patients received hemodialysis (3-7 days/week). Mean CAVH treatment duration was 5.5 days (0.5-18 days). Hemodialysis patients received a mean of 4.3 treatments (1-16). CAVH patients had a mean age of 44.5 +/- 16.4 years (19-68), whereas the hemodialysis patients had a mean age of 60.9 +/- 14 years (34-82) (p = 0.004). Mean admission APACHE II score was 21.3 (11-29) for the CAVH group and 25.5 (10-39) for the hemodialysis group (p = NS). Peak ICU APACHE II score did not differ between groups (CAVH 26.2 [11-37], HD 28 [10-40]; p = NS). There were 4 deaths in the CAVH group (25%) and 19 deaths in the HD group (82%) (p = 0.006: chi-squared test). Although age was significantly different between groups, APACHE II scores were similar. Mortality rate was significantly higher in the hemodialysis group. This supports the hypothesis that CAVH may be the renal replacement therapy of choice in the ICU.

Acute Kidney Injury↗
PubMedDate not supplied

Quantity of dialysis: quality of life--what is the relationship?

Health related quality of life (HRQOL) is increasingly being used to evaluate physical and psychosocial parameters in patients receiving dialysis. In patients with chronic illness, these indices are important adjuncts to biochemical measurements. Inadequate dialysis with low urea clearance (Kt/Vurea) has been linked to adverse outcomes in dialysis patients. Little is known about the relationship between dialysis adequacy and patient reported HRQOL. We evaluated HRQOL in 55 hemodialysis and 60 peritoneal dialysis patients using the RAND 36 Item Health Survey 1.0, measuring the following: physical functioning; role limitations (physical); role limitations (emotional); social functioning; emotional well being; pain; energy; and general health perceptions. Kt/V was also calculated for each patient. Mean HD Kt/V was 1.44 +/- 0.31 (range, 0.5-2.0); mean weekly PD Kt/V was 2.28 +/- 0.90 (range, 1.13-6.02). The relationship between Kt/V and HRQOL was tested using Pearson's correlation. No significant association was found for either treatment group between Kt/V and any of the domains of HRQOL. Thus, HRQOL seems to be influenced by factors other than dialysis adequacy, enhancing its role as an independent measure of patient problems otherwise undetected by traditional objective parameters.

Adult↗