Biomedical subjects

B Bisson

Publications and source records attributed to B Bisson.

6 recordsLinked to original sources

PubMed1993

Effects of intensive lipid-lowering therapy on the coronary arteries of asymptomatic subjects with elevated apolipoprotein B.

BACKGROUND: Do the benefits of intensive lipid-lowering therapy seen in symptomatic patients extend to high-risk subjects who have never had symptoms? METHODS AND RESULTS: Of 120 men completing the FATS trial, 91 were symptomatic and 29 asymptomatic. All had apolipoprotein B > or = 125 mg/dL, a positive family history, and coronary atherosclerosis. All were counseled in diet and randomized to intensive therapy: colestipol 10 g TID plus either niacin 1 g QID or lovastatin 20 mg BID or to conventional therapy: placebos, or colestipol if low-density lipoprotein cholesterol was elevated. End points included quantitative arteriographic disease change and clinical events over a 2.5-year interval. At baseline, symptomatic and asymptomatic patients had comparable risk profiles, but proximal stenosis severity averaged 36% for symptomatic and 23% for asymptomatic patients (P < .001). Among the 91 symptomatic patients, those in the intensive group experienced definite (> or = 10%S) proximal lesion progression less frequently than conventional (24% of intensive versus 48% of conventional) and definite regression more frequently (36% of intensive versus 15% of conventional) (P = .009). Similarly, among the 29 asymptomatic patients, 19% of intensive versus 38% of conventional had progression and 31% of intensive versus 0% of conventional, regression (P = .04). Ischemia on baseline exercise tolerance testing was associated with significantly greater proximal disease progression among the asymptomatic patients. Clinical cardiovascular events (death, infarction, or revascularization) occurred in 10 of 38 symptomatic patients originally assigned to conventional therapy, compared with 5 of 76 symptomatic patients assigned to intensive (P < .01); no asymptomatic patient had an event. CONCLUSIONS: Asymptomatic subjects with this high-risk profile have less coronary disease at baseline than comparable symptomatic patients, and they have an excellent short-term clinical prognosis. However, asymptomatic subjects are indistinguishable from symptomatic patients in terms of their arterial disease progression with conventional therapy and their regression with intensive. These findings may justify an active treatment strategy in such subjects, particularly those with provokable ischemia.

Adult↗

PubMed1993

A maximum confidence approach for measuring progression and regression of coronary artery disease in clinical trials.

BACKGROUND: Imaging trials using arteriography have been shown to be effective alternatives to clinical end point studies of atherosclerotic vascular disease progression and the effect of therapy on it. However, lack of consensus on what end point measures constitute meaningful change presents a problem for quantitative coronary arteriographic (QCA) approaches. Furthermore, standardized approaches to QCA studies have yet to be established. To address these issues, two different arteriographic approaches were compared in a clinical trial, and the degree of concordance between disease change measured by these two approaches and clinical outcomes was assessed. METHODS AND RESULTS: In the Familial Atherosclerosis Treatment Study (FATS) of three different lipid-lowering strategies in 120 patients, disease progression/regression was assessed by two arteriographic approaches: QCA and a semiquantitative visual approach (SQ-VIS). Lesions classified with SQ-VIS as "not," "possibly," or "definitely" changed were measured by QCA to change by 10% stenosis in 0.3%, 11%, and 81% of cases, respectively. The "best" measured value for distinguishing definite from no change was identified as 9.3% stenosis by logistic regression analysis. The primary outcome analysis of the FATS trial, using a continuous variable estimate of percent stenosis change, gave almost the same favorable result whether by QCA or SQ-VIS. CONCLUSIONS: The excellent agreement between these two fundamentally different methods of disease change assessment and the concordance between disease change and clinical outcomes greatly strengthens confidence both in these measurement techniques and in the overall findings of the study. These observations have important implications for the design of clinical trials with arteriographic end points.

Clinical Trials as Topic↗

PubMed1989

Autoimmune endotheliopathy and chronic herpetic conjunctivitis.

A migrating endothelial line of keratic precipitates associated with overlying corneal edema suggests an immune attack on the corneal endothelium. This is seen most commonly in corneal allotransplantation rejection. The etiology of such lines in the absence of this condition is unclear. We document the presence of an intranuclear virus compatible with herpesvirus in this condition.

Conjunctivitis↗

PubMed1984

Orbitocalvarial swelling and proptosis as an early manifestation of systemic lymphoma.

A 67-year-old woman had acutely diminished vision and painful proptosis of the left eye amidst a background of chronic headache, scalp tenderness, proximal myalgias, intermittent fever, anemia, and elevated erythrocyte sedimentation rates. All symptoms and signs were exquisitely corticosteroid-responsive. She underwent two negative temporal artery biopsies and several extensive negative evaluations for systemic disease. Ultimately deep scalp biopsy, bone biopsy, and bone marrow aspiration were performed, and all revealed a histologically well-differentiated lymphoma.

Aged↗

PubMed1980

Depriving or pair feeding intact controls induces some persisting regulatory deficits similar to those of the recovered lateral rat.

To determine the extent to which acute starvation might contribute to the chronic deficits in regulatory feeding, drinking, and body weight maintenance characteristic of rats with lateral hypothalamic brain lesions, neurologically intact rats were pair-fed (including forced feedings) and pair-watered for 2-4 wk with rats rendered transiently aphagic and adipsic by hypothalamic knife cuts. When the pair-fed rats were subsequently allowed to free-feed, their body weights remained suppressed. In addition, the pair-fed rats failed to eat in response to glucoprivation induced by insulin or 2-deoxy-D-glucose. The pair-fed rat drank less than nondeprived controls, but more than rats with knife cuts, when administered osmotic or volemic challenges to thirst. Other aspects of the recovered lateral syndrome were absent. In a second experiment, intact rats that had recovered from varying durations of semistarvation with or without subsequent forced feedings were tested for regulatory impairments. Deficits in chronic body weight maintenance were found in rats that had been starved and subsequently force-fed. Diminished responses to glucoregulatory challenges were seen in rats that had been starved but not forced-fed as well as in those that had been force-fed but not starved. This impaired eating in response to glucoregulatory challenges abated with repeated testing. Thus, both the acute failure of ingestive behaviors and therapeutic forced feedings can contribute to the impired regulatory eating and driniing that follow recovery from certain types of brain damage.

Animals↗

PubMedDate not supplied

Methane gas explosion during colonoscopy.

This article discusses a complication of colonoscopy that healthcare providers think can not happen: methane gas explosion. Despite proper bowel cleansing, such an incident did occur. This article shows how quick recognition and action can save a patient's life. Colonic preparations are also discussed.

Cautery↗