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Biomedical subjects

D Kalman

Publications and source records attributed to D Kalman.

At least 19 recordsLinked to original sources
PubMed2006

Pregnancy outcomes, infant mortality, and arsenic in drinking water in West Bengal, India.

Between 2001 and 2003, the authors studied pregnancy outcomes and infant mortality among 202 married women in West Bengal, India. Reproductive histories were ascertained using structured interviews. Arsenic exposure during each pregnancy, including all water sources used, was assessed; this involved measurements from 409 wells. Odds ratios for spontaneous abortion, stillbirth, neonatal mortality, and infant mortality were estimated with logistic regression based on the method of generalized estimating equations. Exposure to high concentrations of arsenic (> or =200 microg/liter) during pregnancy was associated with a sixfold increased risk of stillbirth after adjustment for potential confounders (odds ratio (OR) = 6.07, 95% confidence interval (CI): 1.54, 24.0; p = 0.01). Arsenic-related skin lesions were found in 12 women who had a substantially increased risk of stillbirth (OR = 13.1, 95% CI: 3.17, 54.0; p = 0.002). The odds ratio for neonatal death was 2.81 (95% CI: 0.73, 10.8). No association was found between arsenic exposure and spontaneous abortion (OR = 1.01, 95% CI: 0.38, 2.70) or overall infant mortality (OR = 1.33, 95% CI: 0.43, 4.04). This study adds to the limited evidence that exposure to high concentrations of arsenic during pregnancy increases the risk of stillbirth. However, there was no indication of the increased rates of spontaneous abortion and overall infant mortality that have been reported in some studies.

Arsenic Poisoning↗
PubMed2002

An acute clinical trial evaluating the cardiovascular effects of an herbal ephedra-caffeine weight loss product in healthy overweight adults.

OBJECTIVE: This study was undertaken to determine the acute effects of a commercial weight loss supplement containing herbal ephedrine and caffeine on cardiovascular function in healthy overweight adults. DESIGN: Randomized double blind clinical trial evaluating the cardiovascular effects of an ephedra-caffeine (Xenadrine(TM); XEN) based herbal product vs placebo (PLA). SUBJECTS: Twenty-seven healthy overweight adults (age 21-60 y; body mass index > or = 25 kg/m(2)). MEASUREMENTS: Systolic and diastolic blood pressure, heart rate, serial electrocardiograms (EKG) and Doppler echocardiograms. RESULTS: A comparison of means between the groups indicated no statistically significant differences at the start of the study for the variables above. There were no serious adverse events. When examining the effects of XEN vs PLA on cardiovascular health/function, there were no significant effects observed in heart rate, systolic blood pressure, diastolic blood pressure, left ventricular ejection fraction, heart valve function or in cardiovascular physiology within the parameters measured. CONCLUSION: These findings indicate that, over a 14-day period, ingestion of the commercial weight loss supplement in a healthy overweight population did not produce any noticeable cardiovascular side effects.

Adult↗
PubMed2001

Oligomerization-dependent regulation of motility and morphogenesis by the collagen XVIII NC1/endostatin domain.

Collagen XVIII (c18) is a triple helical endothelial/epithelial basement membrane protein whose noncollagenous (NC)1 region trimerizes a COOH-terminal endostatin (ES) domain conserved in vertebrates, Caenorhabditis elegans and Drosophila. Here, the c18 NC1 domain functioned as a motility-inducing factor regulating the extracellular matrix (ECM)-dependent morphogenesis of endothelial and other cell types. This motogenic activity required ES domain oligomerization, was dependent on rac, cdc42, and mitogen-activated protein kinase, and exhibited functional distinction from the archetypal motogenic scatter factors hepatocyte growth factor and macrophage stimulatory protein. The motility-inducing and mitogen-activated protein kinase-stimulating activities of c18 NC1 were blocked by its physiologic cleavage product ES monomer, consistent with a proteolysis-dependent negative feedback mechanism. These data indicate that the collagen XVIII NC1 region encodes a motogen strictly requiring ES domain oligomerization and suggest a previously unsuspected mechanism for ECM regulation of motility and morphogenesis.

Angiogenesis Inhibitors↗
PubMed2001

Concurrent versus delayed smoking cessation treatment for persons in early alcohol recovery. A pilot study.

This pilot study investigated the efficacy of initiating a smoking cessation intervention early in inpatient treatment for alcohol dependence versus shortly after an inpatient stay. Thirty-six male smokers recruited from an inpatient substance abuse treatment program were randomly assigned to begin smoking cessation either two weeks (concurrent treatment) or six weeks (delayed treatment) after admission to the substance abuse program. Smoking cessation treatment involved three sessions of individual smoking cessation treatment plus eight weeks of transdermal nicotine replacement. Significantly fewer participants began the delayed treatment than the concurrent treatment. Few participants were smoking-abstinent at follow-up, and the timing of treatment onset did not have an impact on smoking outcome. Clinical trials with larger samples may be needed to better evaluate the efficacy of concurrent versus delayed treatment and to test the efficacy of more aggressive interventions with smokers in early alcohol recovery.

Alcoholism↗
PubMed2001

The metabolism of orally ingested 19-nor-4-androstene-3,17-dione and 19-nor-4-androstene-3,17-diol in healthy, resistance-trained men.

The purpose of this investigation was to determine the metabolism of 2 over-the-counter steroids (Nortesten, which contains 36 mg of 19-nor-4-androstene-3,17-dione and 36 mg of 19-nor-4-androstene-3,17-diol) in healthy, resistance-trained men. Subjects were administered either low (72 mg) or high doses (144 mg) of Nortesten twice daily for 10 days. All subjects tested positive via urinalysis for the presence of nortestosterone at days 3, 5, 7, and 10. There was no change in the urine testosterone-epitestosterone ratio at any day. Furthermore, as determined by serum chemistry tests, there was no effect on renal, hepatic, hematological, or bone marrow function. Thus, short-term ingestion of 19-nor-4-androstene-3,17-dione and 19-nor-4-androstene-3,17-diol may result in a positive drug test result without any harmful side effects.

Administration, Oral↗
PubMed2000

Pesticide exposure of children in an agricultural community: evidence of household proximity to farmland and take home exposure pathways.

Children's exposure to organophosphorus (OP) pesticides in an agricultural community in central Washington State was determined. Spot urine and hand wipe samples were collected from 109 children 9 months to 6 years of age, as were house dust samples, and wipe samples from various surfaces. Children were categorized based on parental occupation (agricultural vs nonagricultural) and on household proximity to pesticide-treated orchards. Median house dust concentrations of dimethyl OP pesticides in homes of agricultural families were seven times higher than those of reference families (1. 92 vs 0.27 microg/g; P<0.001). Median pesticide metabolite concentrations in agricultural children were five times higher than those in reference children (0.05 vs 0.01 microg/ml; P=0.09). Median pesticide concentrations in housedust (P=0.01) and metabolite concentrations in urine (P=0.01) from agricultural families were significantly higher in the children living near treated orchards (within 200 ft or 60 m) than those living more distant. Ten of 61 agricultural children had detectable OP pesticide levles on their hands, whereas none of the reference children had detectable levels. These findings indicate that children living with parents who work with agricultural pesticides, or who live in proximity to pesticide-treated farmland, have higher exposures than do other children living in the same community

Agriculture↗
PubMed2000

Matching alcoholics to treatment. Failure to replicate finding of an earlier study.

The purpose of the present study was to investigate whether sociopathic alcoholics respond differentially to different types of treatment. An earlier study found that alcoholics with antisocial personality disorder had somewhat better outcomes if treated in individually focused versus relationship-focused cognitive-behavioral treatment. The present study was designed to attempt to replicate these findings. One hundred and forty-nine alcoholics (42 of whom scored high on a measure of sociopathy) were randomly assigned to receive either individually focused cognitive-behavioral treatment or a relationship-focused community reinforcement approach. Follow-up evaluations were conducted every 4 months for 2 years. Results failed to support the study hypothesis. Drinking outcomes were similar for sociopathic alcoholics in both treatment conditions. Directions for future research are identified.

Adult↗
PubMed2000

Smoking and drinking among alcoholics in treatment: cross-sectional and longitudinal relationships.

OBJECTIVE: The relationship between tobacco dependence and alcohol dependence has received considerable scrutiny in the past few years. The present study of alcoholics in treatment for alcoholism extended previous work by investigating the cross-sectional and longitudinal relationships between drinking and smoking variables. METHOD: Male and female alcoholics (N = 116) completed a standard assessment of smoking and drinking pretreatment followed by a laboratory assessment of reactivity to alcohol cues. Participants' drinking and smoking were evaluated again 6 months following treatment. RESULTS: (1) Pretreatment tobacco dependence, pretreatment alcohol dependence, urge to smoke and urge to drink were positively correlated; (2) smoking rates and drinking rates were not correlated either before or following treatment; (3) pretreatment smoking history did not predict posttreatment drinking; (4) the rate of smoking declined following treatment for alcoholism for 45% of the smoking patients who completed a 6-month follow-up, independent of relapse status; and (5) relapsers who smoked more heavily also drank less frequently during follow up. CONCLUSIONS: Consistent but modest cross-sectional relationships between drinking and smoking variables before alcohol treatment decrease after treatment for alcohol dependence. A spontaneous improvement in smoking rate occurs in many (45%), particularly among those who smoked more heavily pretreatment and thus benefit most by the reduction. Directions for future research are discussed.

Adolescent↗
PubMed1999

Intranuclear localization of human papillomavirus 16 E7 during transformation and preferential binding of E7 to the Rb family member p130.

To study intracellular pathways by which the human papillomavirus 16 oncogene E7 participates in carcinogenesis, we expressed an inducible chimera of E7 by fusion to the hormone-binding domain of the estrogen receptor. The chimeric protein (E7ER) transformed rodent fibroblast cell lines and induced DNA synthesis on addition of estradiol. In coimmunoprecipitation experiments, E7ER preferentially bound p130 when compared to p107 and pRb. After estradiol addition, E7ER localization changed to a more intense intranuclear staining. Induction of E7 function was not correlated with binding to p130 or pRb but rather with intranuclear localization and modest induction of binding to p107.

Cell Nucleus↗
PubMed1999

The effects of pyruvate supplementation on body composition in overweight individuals.

A 6-wk, double-blinded, placebo-controlled study was done to ascertain the effects of pyruvate supplementation (6 g/d) on body weight, body composition, and vigor and fatigue levels in healthy overweight Caucasian men and women. Twenty-six individuals were randomly assigned to a placebo group (seven men, seven women) and a pyruvate-supplemented group (three men, nine women). In addition, all subjects participated in a 3 d/wk exercise program, which consisted of a 45-60 min aerobic/anaerobic routine. After 6 wk of treatment, there was a statistically significant decrease in body weight (-1.2 kg, P<0.001), body fat (-2.5 kg, P<0.001), and percent body fat (23.0% pre versus 20.3% 6 wk post) in the pyruvate group. Furthermore, Profile of Mood States fatigue and vigor scores improved significantly for the pyruvate group (P<0.05) at 6 wk (vigor) and 4 and 6 wk (fatigue). There was no significant change in total lean body mass in the pyruvate group. The placebo group demonstrated a significant increase (P<0.05) for POMS vigor at 2 and 4 wk with no changes occurring in any of the remaining parameters measured. Thus, the ingestion of 6 g of pyruvate for 6 wk, in conjunction with mild physical activity, resulted in a significant decrease in body weight and fat mass.

Adult↗
PubMed1999

The role of arterial embolization in renal cell carcinoma.

Twenty-five years ago arterial embolization was introduced to facilitate the surgical excision of the carcinomatous kidney or to palliate symptoms, such as haemorrhage from non-resectable tumours. The role of this technique in the therapeutic armamentarium has been a source of debate in the literature. We reviewed all the available literature. A total of 389 papers were evaluated. Fifty-one publications and 3225 case histories met explicit entry criteria for inclusion. Until now no prospective randomized study of this approach to the management of renal carcinoma has been published. In the majority of studies the patients are grouped together irrespective of indication, i.e. pre-operative or palliative. Few articles are prospective or contain clear information regarding tumour stage, indication and adequate follow-up. Although we are not able to distinguish with certainty the effect of embolization on the course of the disease, it seems that complete pre-operative renal artery embolization facilitates the excision of large vein-invading tumours. The optimal delay between embolization and operation is probably one day. The embolization material of choice is ethanol. Palliative embolization in non-operable tumours with serious haemorrhage seems to have been successful in most cases. The scientific basis for the implementation of renal artery embolization in renal cell carcinoma is weak. We believe that either controlled trials or parallel prospective cohort studies should be undertaken to compare treatment of selected locally advanced renal carcinomas with and without embolization.

Carcinoma, Renal Cell↗
PubMed1999

Ras family GTPases control growth of astrocyte processes.

Astrocytes in neuron-free cultures typically lack processes, although they are highly process-bearing in vivo. We show that basic fibroblast growth factor (bFGF) induces cultured astrocytes to grow processes and that Ras family GTPases mediate these morphological changes. Activated alleles of rac1 and rhoA blocked and reversed bFGF effects when introduced into astrocytes in dissociated culture and in brain slices using recombinant adenoviruses. By contrast, dominant negative (DN) alleles of both GTPases mimicked bFGF effects. A DN allele of Ha-ras blocked bFGF effects but not those of Rac1-DN or RhoA-DN. Our results show that bFGF acting through c-Ha-Ras inhibits endogenous Rac1 and RhoA GTPases thereby triggering astrocyte process growth, and they provide evidence for the regulation of this cascade in vivo by a yet undetermined neuron-derived factor.

Actins↗
PubMed1999

Masters athletes: factors affecting performance.

In recent years there has been an increase in interest in issues related to the enhancement of the performance of the masters athlete. Many of the changes in health status that have been thought to be the normal result of aging have been found to be actually the result of a long-standing sedentary lifestyle. Thus, masters athletes may be able to increase their athletic performance to higher levels than what was once thought. Decreases in muscle strength thought to be the result of aging do not appear to be so. The masters athlete may be able to maintain and increase strength in situations where strength training has not been previously engaged in. However, the literature lacks longitudinal studies demonstrating improvements in strength with age in masters athletes who have maintained habitual strength training. Studies in the past have shown that aging results in changes in fibre type, with a shift towards a higher percentage of type I fibres. This again may be an adaptation to lack of use. Decreases in heart function and aerobic capacity appear to be immutable, but in the masters athlete the rate of this decrease can be slowed. The masters athlete has certain elevated nutritional needs over younger athletes. Degenerative joint disease, although effecting most persons as they age, is not a certain result of aging and disability as the condition is reduced in the active person. Some orthopaedic conditions are related to decreases in flexibility of soft tissues that appear to accompany the aging process. Performance improvement in the masters athlete requires the same commitment to hard training that it requires from younger athletes, with some modifications for changes that are associated with aging.

Adult↗
PubMed1998

Activity differentially regulates the surface expression of synaptic AMPA and NMDA glutamate receptors.

Distinct subtypes of glutamate receptors often are colocalized at individual excitatory synapses in the mammalian brain yet appear to subserve distinct functions. To address whether neuronal activity may differentially regulate the surface expression at synapses of two specific subtypes of ionotropic glutamate receptors we epitope-tagged an AMPA (alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid) receptor subunit (GluR1) and an NMDA (N-methyl-D-aspartate) receptor subunit (NR1) on their extracellular termini and expressed these proteins in cultured hippocampal neurons using recombinant adenoviruses. Both receptor subtypes were appropriately targeted to the synaptic plasma membrane as defined by colocalization with the synaptic vesicle protein synaptophysin. Increasing activity in the network of cultured cells by prolonged blockade of inhibitory synapses with the gamma-aminobutyric acid type A receptor antagonist picrotoxin caused an activity-dependent and NMDA receptor-dependent decrease in surface expression of GluR1, but not NR1, at synapses. Consistent with this observation identical treatment of noninfected cultures decreased the contribution of endogenous AMPA receptors to synaptic currents relative to endogenous NMDA receptors. These results indicate that neuronal activity can differentially regulate the surface expression of AMPA and NMDA receptors at individual synapses.

Adenoviridae↗
PubMed1998

Impact on health service costs of medical technologies used in management of prostatic cancer.

The aim of the study was to calculate the direct costs for the management of prostatic cancer throughout the need for care period. The impact of new medical technologies was analysed on the basis of an earlier cost study. The records of all 128 men in a defined population who died in 1992-93 and had been diagnosed with prostatic adenocarcinoma were retrospectively reviewed from diagnosis to death. The median cost per case, SEK 86,400, was significantly lower than the average cost per case, SEK 135,000, largely because of a few high-cost patients (in 20% of cases the cost exceeded SEK 250,000). Analysis of cost distribution throughout the need for care period showed that about 84% of the total cost per case was incurred during the the 3 years up to death. Estimated total direct care costs due to prostatic cancer in Sweden in the mid-1980s and early 1990s rose from approx. SEK 550 million to approx. SEK 780 million (1993 prices).

Adenocarcinoma↗
PubMed1998

Smoking cessation treatment for substance misusers in early recovery: a review of the literature and recommendations for practice.

Recent surveys have documented the very high incidence of smoking among treatment populations of alcohol and other drug misusers. While the health risks of smoking are well-documented in the literature, addictions professionals have traditionally been reluctant to address the problem of nicotine dependence with their clients. Recently, researchers have begun to investigate the impact of smoking cessation treatment on substance misusers who are also nicotine dependent. The purpose of this paper is to provide addictions treatment professionals with an overview of the research in this area and to highlight gaps in the knowledge base. In addition, this paper will review recent developments in the treatment of nicotine dependence and discuss their applicability to nicotine-dependent persons who are in treatment for the misuse of alcohol or another drug.

Alcoholism↗
PubMed1997

Nutritional aspects of cancer-related fatigue.

Fatigue, which may well be the most common experience of patients with cancer, remains underappreciated by health care professionals. Perhaps one reason is that because of its complexity and many components, fatigue is not completely understood. Knowledge of fatigue models, such as the integrated Fatigue Model of Piper, can help dietitians identify potential causes of fatigue such as activity-rest patterns, and identification can lead dietitians to early intervention. Understanding cancer treatment factors, such as nausea and decreased participation in activities of daily living, that are believed to play a part in fatigue form another level on which dietitians can provide intervention. Through intervention, dietitians, working with patients and other members of the multidisciplinary team, may increase the understanding and appreciation of fatigue as well as provide relief from it. Efforts to maintain nutritional status can decrease or prevent some of the fatigue associated with cancer and its treatment. Therefore, the goal of clinical dietitians who work with a fatigued patient with cancer is to use nutrition management to minimize therapeutic side effects and maximize the patient's nutritional parameters.

Fatigue↗