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Biomedical subjects

C P West

Publications and source records attributed to C P West.

At least 19 recordsLinked to original sources
PubMed2002

Use of a rat model to evaluate tall fescue seed infected with introduced strains of Neotyphodium coenophialum.

Experimental cultivars of the pasture grass tall fescue are infected with unique strains of the fungal endophyte Neotyphodium coenophialum, which produce low concentrations of ergot alkaloids. A rat model was evaluated as a tool for rapid, initial screening of experimental cultivars considered to be nontoxic. Rats were fed diets that included seed from experimental cultivars of tall fescue with introduced strains of N. coenophialum and a toxic control diet containing seed of the cultivar Kentucky 31 (KY31), with its endemic strain of N. coenophialum. Rats were preconditioned to a nontoxic diet and then fed treatment diets for 13 days with 5 days at thermoneutrality (21 degrees C) followed by 8 days under heat stress (31 degrees C). For most of the 13-day treatment period, rats fed KY31 exhibited depressed daily intake compared to those fed diets of cultivars with introduced endophytes (P < 0.05). In addition, rats fed KY31 exhibited significantly less weight than rats on other diets after heat treatment was imposed. For all initial trials and repeated trials, total intake and total gain calculated at the end of each trial were the most consistent indicators of toxicity.

Animal Feed↗
PubMed2001

Ischemic stroke outcome: racial differences in the trial of danaparoid in acute stroke (TOAST).

OBJECTIVE: To determine racial differences in baseline stroke risk factors and other measures in the Trial of ORG 10172 in Acute Stroke Therapy (TOAST). Differences in these factors could influence response to acute stroke therapy and overall stroke outcome. METHODS: The authors compared baseline demographic, medical, stroke, physical examination, CT, laboratory, and neurologic factors among 292 African-American and 801 white patients who enrolled in the TOAST study. TOAST compared danaparoid (ORG 10172) with placebo among acute ischemic stroke patients who were treated within 24 hours of stroke onset. RESULTS: African-Americans were younger and more frequently had hypertension, diabetes mellitus, congestive heart failure, and prior strokes. In addition, African-Americans had higher mean diastolic blood pressure, more lacunar strokes, and more severe prestroke disability. There were no significant differences between African-Americans and white patients in outcomes at 7 days, overall number of adverse experiences, or occurrence of serious bleeds or hemorrhagic transformations. However, there was a trend toward a higher rate of favorable outcomes in white patients at 7 days. There was no significant difference in very favorable outcome at 3 months between African-American and white patients, but significantly more white patients had favorable outcome at 3 months. CONCLUSION: Although African-Americans possess a number of factors that should predict higher rates of poor stroke outcome after acute therapy, they have the capacity to respond similarly to white patients after acute stroke therapy. Perhaps younger age and presence of lacunar infarction are stronger predictors of good outcomes than was appreciated previously.

Anticoagulants↗
PubMed1999

ELISA for the detection of antibodies to Ebola viruses.

EIAs for IgG and IgM antibodies directed against Ebola (EBO) viral antigens have been developed and evaluated using sera of animals and humans surviving infection with EBO viruses. The IgM capture assay detected anti-EBO (subtype Reston) antibodies in the sera of 5 of 5 experimentally infected animals at the time they succumbed to lethal infections. IgM antibodies were also detected in the serum of a human who was infected with EBO (subtype Reston) during a postmortem examination of an infected monkey. The antibody was detectable as early as day 6 after infection in experimentally infected animals and persisted for <90 days. The IgG response was less rapid; however, it persisted for >400 days in 3 animals who survived infection, and it persisted for approximately 10 years after infection in the sera of 2 humans. Although these data are limited by the number of sera available for verification, the IgM assay seems to have great promise as a diagnostic tool. Furthermore the long-term persistence of the IgG antibodies measured by this test strongly suggests that the ELISA will be useful in field investigations of EBO virus.

Animals↗
PubMed1998

Hysterectomy and myomectomy by laparotomy.

Hysterectomy provides definitive treatment for uterine fibroids. Surgery should be offered to women whose fibroids are symptomatic; it is not indicated on the basis of uterine size alone. Myomectomy is an option for those wishing to preserve uterine function. The prospects for successful pregnancy following myomectomy are encouraging, although there is a significant risk of the later recurrence of fibroids. Laparotomy remains the most appropriate surgical approach for large fibroids, although vaginal, rather than abdominal, hysterectomy may be suitable for some women whose uteri do not exceed a 12-14 week gestation size. There is some evidence that the morbidity of abdominal procedures increases with very large uteri. Uterine shrinkage with GnRH analogues may facilitate vaginal hysterectomy and be useful prior to abdominal hysterectomy or myomectomy for very large fibroids, although cost-effectiveness for its use with abdominal procedures has not been demonstrated.

Female↗
PubMed1998

The effect of physician characteristics on compliance with adult preventive care guidelines.

BACKGROUND AND OBJECTIVES: This study identified physician characteristics and attitudes related to self-reported compliance with adult prevention guidelines. METHODS: A questionnaire was mailed to family practice and internal medicine residents and faculty at the University of Iowa (n = 209). The questionnaire's 78 items fell into seven categories, including physician demographics, history-taking practices, counseling practices, self-perceived effectiveness in changing patient behavior, beliefs about preventive care, knowledge about preventive care, and perceived barriers to the delivery of preventive care. RESULTS: Compliance with history-taking recommendations was independently associated with high knowledge scores, female physician gender, and high self-perceived effectiveness in changing patient behavior. The only factor that was independently associated with counseling efforts was self-perceived effectiveness in changing patient behavior. CONCLUSIONS: Factors that were independently associated with self-reported preventive care efforts include female physician gender, knowledge about preventive care guidelines, and perceived effectiveness in changing patient behavior. After controlling for these factors, other variables such as lack of time, lack of reminder systems, attitudes about preventive care, and amount of formal preventive care education were not related to self-reported compliance with counseling and history-taking recommendations.

Adult↗
PubMed1997

Medroxyprogesterone acetate with Zoladex for long-term treatment of fibroids: effects on bone density and patient acceptability.

A randomized trial was carried out to investigate the effect of 12 months administration of the gonadotrophin-releasing hormone agonist (GnRHa) Zoladex in combination with either placebo or medroxyprogesterone acetate (MPA) from the third month. Bone density, markers of bone resorption, symptoms and uterine volume were monitored in 24 women with symptomatic fibroids or menstrual problems. A total of 21 women were recruited to act as controls for the assessment of bone parameters. Vasomotor side-effects were reduced significantly in the MPA-treated group. The reduction in uterine volume in women with fibroids was not impaired by the addition of MPA. The bone markers osteocalcin and alkaline phosphatase were assessed in plasma, and the cross-links pyridinoline and deoxypyridinoline measured in urine. Changes in these markers are reported which suggest increases in bone resorption during the period of observation. Bone mineral density (BMD) was assessed by dual energy X-ray absorptiometry at the spine and forearm. The net reduction in BMD at the spine in the treated groups was 4.30 +/- 0.59% at 6 months and 7.50 +/- 0.78% at 1 year, with no change in the control group. No change was seen in forearm BMD. No protective effect was observed when MPA was added. At 1 year after the completion of treatment, BMD remained significantly below baseline, and this has implications for the prolonged use of GnRHa.

Adult↗
PubMed1996

A medical audit and patient survey of hysterectomies performed for menstrual disorders.

The aim of the study was to carry out an audit of 283 hysterectomies performed for menstrual disorders over a one year period, and to determine the satisfaction of the women concerned towards their treatment. The medical records of these patients were examined, and they were each sent a questionnaire, 69% of which were completed and returned. The most common presenting symptoms were menorrhagia and dysmenorrhoea. In 53% of cases no clinical abnormality was postulated and in 31% of cases no pathological abnormality was found. The preoperative clinical and pathological diagnoses were in agreement for 59% of patients. Over 90% of women were satisfied with the management of their case by their GP and the gynaecology outpatient clinic. The use of patient-controlled analgesia systems was associated with better post-operative pain relief than intramuscular injections. Thirteen percent of patients required blood transfusion; 21% suffered some form of postoperative complication, most of which were minor. Ninety-four percent of the women were pleased that they had undergone hysterectomy, and 76% wished that they had had the operation sooner. It was concluded that hysterectomy is perceived positively by patients and should not necessarily be considered as a last resort treatment for menstrual disorders.

Adult↗
PubMed1994

Ovarian suppression with the gonadotrophin-releasing hormone agonist goserelin (Zoladex) in management of the premenstrual tension syndrome.

The objective of this study was to determine the effectiveness of ovarian suppression by a GnRH agonist analogue in 32 women with prospectively confirmed severe premenstrual tension. The design was a randomized, double-blind study comparing goserelin 3.6 mg with placebo, both given as a monthly s.c. injection for 3 months. Self-assessment was by daily visual analogue scales (VAS) for anxiety and depression, daily quantitative symptom rating for breast discomfort, swelling, irritability, tension, depression and by monthly Hospital Anxiety and Depression (HAD) scales. Of the 16 women in each group, 15 completed active and 12 completed placebo therapy. Median symptom scores for whole cycles showed a significant reduction of breast discomfort and swelling during active treatment, with no significant improvement in psychological symptoms. Analysis by cycle phase showed that for individual subjects, pre-treatment differences in VAS scores for anxiety and depression were abolished in a significantly greater proportion of actively treated cycles. Within-group comparisons showed a marked placebo effect and, comparing the two groups, differences reached significance only during treatment cycle 1 and the first post-treatment cycle for anxiety with no significant differences for depression. It was concluded that while suppression of ovarian activity with a gonadotrophin-releasing hormone analogue dampens down cyclical mood swings, it has a more marked effect on the physical components of the premenstrual syndrome. Results reconfirm the positive role of placebo in the management of this condition.

Adult↗
PubMed1994

Treatment with the gonadotrophin releasing hormone-agonist goserelin before hysterectomy for uterine fibroids.

OBJECTIVE: To investigate the effect of the gonadotrophin releasing hormone (GnRH)-agonist goserelin, given by monthly subcutaneous injection for three months prior to total abdominal hysterectomy for uterine leiomyomata, on the pre-operative symptoms, difficulty of operation and operative blood loss. DESIGN: Randomised placebo-controlled study. SETTING: Patients were recruited from the gynaecological outpatient departments from hospitals in Edinburgh, Glasgow and Newcastle. SUBJECTS: Seventy-one premenopausal women with uterine leiomyomata who were on the waiting list for hysterectomy. INTERVENTIONS: After the presence of leiomyomata was confirmed using ultrasonography, the women were randomised to receive either the GnRH-agonist goserelin by monthly subcutaneous injection or a sham injection for three months prior to operation. At the monthly visits, patients were asked about treatment related symptoms, fibroid related symptoms, and their bleeding patterns. Blood was taken for haematological assessment. MAIN OUTCOME MEASURES: Haemoglobin concentrations at recruitment, at operation and post-operatively, pre-operative symptoms, operative difficulty and blood loss and post-operative complications. RESULTS: Treatment with goserelin induced amenorrhoea in over 80% of the women, and this was associated with a significant rise in haemoglobin level. At the time of operation, fibroid related symptoms were less in the goserelin group than in the placebo group. The hysterectomy was technically easier and the median (range) operative blood loss was significantly lower in the goserelin group compared with the placebo group (187 (60-600) ml vs 308 (118-1000) ml respectively; P < 0.05, Wilcoxon signed rank test). There was no difference between the two groups in the duration of hospital stay or the frequency of post-operative complications. The fibroids were smaller at the time of operation in the goserelin group, and more women treated with goserelin were able to have their operations through a transverse incision. CONCLUSIONS: This study demonstrates the benefits of goserelin in women having total abdominal hysterectomy for uterine leiomyomata.

Adult↗
PubMed1993

Oral teratoma (epignathus) with intracranial extension: a report of two cases.

Epignathi are unusual congenital tumours presenting as oropharyngeal masses, often resulting in rapid asphyxia following birth. Occasionally, intracranial extension of the tumour is present, and two such cases are described. The presence of this complication, diagnosable by ultrasound examination, indicates that aggressive surgical treatment is inappropriate.

Abortion, Therapeutic↗
PubMed1993

Effects of various supplements on voluntary intake and performance by growing cattle consuming forage moderate to high in crude protein.

Growing cattle were supplemented with substances to lessen or increase ruminal ammonia level to determine if consumption of moderate- to high-crude protein (CP) forage is limited by high ruminal ammonia absorption. In Experiment 1 (5 x 5 Latin square), five Holstein steers (198 kg) had ad libitum access to alfalfa cubes (17% CP) without supplementation or with corn at 0.25 or 0.75% body weight (BW) alone (LC or HC) or with 0.06% BW of zeolite (chabazite; LC-Z and HC-Z). Total daily organic water (OM) intake was not affected by treatment (6.08, 6.14, 6.11, 6.19 and 6.09 kg for control, LC, LC-Z, HC and HC-Z, respectively; SE 0.25). In Experiment 2, Simmental crossbred beef calves grazed fescue-clover paddocks in the spring (clipped forage: 21 to 27% CP) for 84 days and were supplemented with 0.25 or 0.75% BW corn alone or with added zeolite (0.06% BW) or lasalocid (0.5 mg/kg BW). Daily gain did not differ among treatments (1.24 to 1.31 kg/day). In Experiment 3 (6 x 6 Latin square), six Holstein steer calves (168 kg) had ad libitum access to medium-quality, orchardgrass-clover hay (15% CP). Steers received one of the following six treatments: no supplement (Control), 0.35% BW ground corn (C), corn plus 0.049% BW urea (C-U), 0.35% BW soybean meal (S), 0.205% BW feather meal (F) or 0.103% BW feather meal, 0.052% BW blood meal and 0.067% BW corn gluten meal (F-BG). Total daily OM intake was 5.00, 5.14, 5.00, 5.11, 4.84 and 4.70 kg for control, C, C-U, S, F and F-BG, respectively (SE 0.13). In Experiment 4 (6 x 6 Latin square), six Holstein steer calves (226 kg) were fed 0.75% BW of alfalfa cubes (19% CP) plus ad libitum access to medium- to high-quality orchardgrass hay (16% CP). Steers received one of the following six treatments: no supplement (Control), corn at 0.25% BW alone (c) or mixed with 0.12% BW peanut skins (C-PSK), a mix of high-CP feedstuffs high in ruminal escape protein (0.029% BW blood meal, 0.038% BW corn gluten meal and 0.028% BW feather meal; C-REP), 0.139% soybean meal (C-S) or soybean meal plus peanut skins (C-PSK-S). Total daily OM intake was 6.16, 6.25, 6.13, 6.52, 6.50 and 6.60 kg for control, C, C-PSK, C-REP, C-S and C-PSK-S, respectively (SE 0.10).(ABSTRACT TRUNCATED AT 400 WORDS)

Absorption↗
PubMed1993

Homologous intra-uterine insemination has no advantage over timed natural intercourse when used in combination with ovulation induction for the treatment of unexplained infertility.

The objective was to evaluate the role of homologous intrauterine insemination compared with timed natural intercourse, both combined with ovulation induction, in the management of unexplained infertility. A total of 48 couples presenting at a large teaching hospital infertility clinic with unexplained infertility of at least 3 years duration comprised the main study group, and 36 couples with identical entry criteria but under the care of another clinician made up a parallel control group. A randomized design of treatment cycles with within-group and between-group controls was used. Couples in the main study group were treated with either homologous intra-uterine insemination or timed natural intercourse in gonadotrophin-releasing hormone analogue down-regulated cycles, in which ovulation was induced with human menopausal gonadotrophin and human chorionic gonadotrophin. Alternate cycles were monitored to enable optimum timing of natural intercourse provided within-group controls. Couples in the control group underwent timed homologous intravaginal artificial insemination. Cycle fecundity and pregnancy outcome in treated and control groups were monitored. Cycle fecundity of 0.11 in 85 ovulation-induced cycles was significantly higher than 0.02 in 62 within-group and 0.01 in 103 between-group control cycles. There was no difference in conception rates between homologous intra-uterine insemination and timed natural intercourse cycles with ovulation induction. Of the 11 established pregnancies in the ovulation induced group, nine delivered healthy babies (five singleton, three twin, one triplet) and two were ectopic. Results confirmed the value of active management for couples with long-standing unexplained infertility but failed to demonstrate any advantage of homologous intra-uterine insemination over ovulation induction alone.

Adult↗
PubMed1992

Potential role for medroxyprogesterone acetate as an adjunct to goserelin (Zoladex) in the medical management of uterine fibroids.

Twenty women with symptomatic uterine fibroids were treated with the luteinizing hormone-releasing hormone (LHRH) agonist goserelin (Zoladex) combined with medroxyprogesterone acetate (MPA) in an open pilot study comparing two protocols. Ten women received goserelin 3.6 mg monthly combined with oral MPA 15 mg daily for 6 months. The mean uterine volume (497 cm3) measured by ultrasound fell by only 18% after 3 months, with no further reduction at 6 months. The other 10 women received goserelin alone for the initial 3 months, followed by combined treatment for 3 months. The mean uterine volume (557 cm3) fell by 39% after 3 months with no significant regrowth by 6 months. At 6 months post-treatment, uterine volume had not returned to pretreatment size. MPA significantly reduced the frequency of vasomotor side-effects. There were no differences in plasma oestradiol, luteinizing hormone or follicle stimulating hormone concentrations between the protocols and good symptomatic relief was experienced by both groups. Two years after completion, three women in each group have requested surgical treatment. The results indicate that MPA may be a useful adjunct to LHRH analogues in women with fibroids, reducing side-effects and possibly prolonging the response, although positive effects on bone density have yet to be confirmed. The optimum regimen of administration remains to be clarified as the clinical results were the same with both protocols.

Adult↗
PubMed1991

Effects of animal and supplement characteristics on average daily gain of grazing beef cattle.

Effects of animal gender and age, use of a growth stimulant, and supplementation with grain alone or grain plus other substances on ADG by growing beef cattle grazing bermudagrass paddocks with sod-seeded rye, wheat, and ryegrass were determined. Two grazing experiments (Exp. 1: late winter through mid-spring; Exp. 2: late spring through mid-summer) were conducted. Experiment 1 used 96, 12- to 13-mo-old Simmental-cross calves (heifers, 240 kg; steers, 272 kg), half of which were implanted with zeranol. Within each implant treatment, cattle received no supplement or .5% BW (DM) of ground corn alone or plus a mix of protein meals, zinc sulfate, thiamin-HCl, or salt. Daily gain was higher (P less than .05) with than without supplementation and was similar (P greater than .10) among supplement treatments. In Exp. 2, 96 crossbred beef steers, approximately 7 (230 kg) or 15 mo old (250 kg), were not supplemented (control) or received .5% BW (DM) of ground corn on d 1 to 84 (C-C), corn plus a protein meal mix on d 1 to 84 (CP-CP), corn on d 43 to 84 (O-C), corn plus the protein meal mix on d 43 to 84 (O-CP), or corn on d 1 to 42 and corn plus the protein meal mix on d 43 to 84 (C-CP). Daily gain on d 1 to 84 was affected (P less than .05) by supplement, age, implant, and the supplement x implant interaction (nonimplanted: .37, .56, .68, .40, .49, and .49; implanted: .37, .62, .54, .49, .70, and .71 kg for control, C-C, CP-CP, O-C, O-CP, and C-CP, respectively).

Adipose Tissue↗
PubMed1990

Endometriosis.

Explore the source record for details and available documents.

Endometriosis↗
PubMed1989

Estrogenic action of tamoxifen in women treated with luteinizing hormone-releasing hormone agonists (goserelin)--lack of shrinkage of uterine fibroids.

Six premenopausal women with uterine fibroids were treated with a combination of tamoxifen, 20 mg/d, and goserelin, 3.6 mg every 28 days, for a total of 24 weeks. Results were compared with those from six women, matched for pretreatment uterine volume, who had been treated with goserelin alone. During combined therapy, plasma and urinary estrogen concentrations were significantly lower than during goserelin alone, whereas sex hormone binding globulin concentrations were significantly higher. Plasma luteinizing hormone and follicle stimulating hormone (FSH) concentrations were both suppressed, in contrast with results during goserelin alone when FSH levels remained within the pretreatment range. None of the women on combined therapy bled in response to the endocrine changes of the initial treatment cycle. Despite this profound pituitary-ovarian suppression, there was no significant change in uterine volume during combined therapy. These results suggest that tamoxifen is acting as an estrogen agonist in women rendered hypoestrogenic with luteinizing hormone-releasing hormone agonists.

Amenorrhea↗
PubMed1989

Fibroids and menorrhagia.

Fibroids are an important cause of menorrhagia, resistant to conventional methods of medical treatment. The mechanism of their effect on menstrual blood loss is poorly understood but may involve abnormalities of local venous drainage, enlargement of the uterine cavity and abnormalities in prostaglandin production. Their cause remains unknown although it has long been assumed that they are oestrogen-dependent. In the past, study of their aetiology, prevention and treatment has received scant attention. Recent developments including measurement of tissue receptors for steroids and growth factors, non-invasive methods of monitoring fibroid growth and the use of LHRH agonists have enabled further study of their nature and of their response to therapy although much work remains to be done. The majority of women with uterine fibroids associated with menorrhagia are treated by hysterectomy although developments in endoscopic surgery have enabled a more conservative approach in some circumstances. LHRH agonists are the only medical agents which cause substantial shrinkage of fibroids although regression is not permanent. These agents are of value in short-term relief of symptoms and are likely to be a useful adjunct to surgery by reducing both uterine volume and bloodflow. However, because of the consequences of prolonged ovarian suppression, they are not suitable for long-term use unless there are medical contraindications to surgery. It remains to be seen whether their use in low-dose regimens or in combination with other agents will provide a successful, safe and cost-effective alternative to hysterectomy in women whose primary problem is heavy menstrual loss. They do however offer a means of conserving reproductive function in women wishing to retain this option.

Female↗