Gender representation in sleep research.
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Female↗
Biomedical subjects
H Driver
Publications and source records attributed to H Driver.
Salmeterol in nocturnal asthma: a double blind, placebo controlled trial of a long acting inhaled beta 2 agonist.
OBJECTIVE: To determine whether inhaled salmeterol, a new long acting inhaled beta adrenergic agonist, reduces nocturnal bronchoconstriction and improves sleep quality in patients with nocturnal asthma. DESIGN: Randomised, double blind, placebo controlled crossover study. SETTING: Hospital outpatient clinics in Edinburgh. SUBJECTS: Twenty clinically stable patients (13 women, seven men) with nocturnal asthma, median age 39 (range 18-60) years. INTERVENTIONS: Salmeterol 50 micrograms and 100 micrograms and placebo taken each morning and evening by metered dose inhaler. Rescue salbutamol inhalers were provided throughout the run in and study periods. MAIN OUTCOME MEASURES: Improvement in nocturnal asthma as measured by peak expiratory flow rates and change in sleep quality as measured by electroencephalography. RESULTS: Salmeterol improved the lowest overnight peak flow rate at both 50 micrograms (difference in median values (95% confidence interval for difference in medians) 69 (18 to 88) l/min) and 100 micrograms (72 (23 to 61) l/min) doses twice daily. While taking salmeterol 50 micrograms twice daily patients had an objective improvement in sleep quality, spending less time awake or in light sleep (-9 (-4 to -44) min) and more time in stage 4 sleep (26 (6-34) min). CONCLUSIONS: Salmeterol is an effective long acting inhaled bronchodilator for patients with nocturnal asthma and at a dose of 50 micrograms twice daily improves objective sleep quality.
Administration, Inhalation↗
Nutrition and enzyme inducers in liver tumor promotion in human and rat.
Phenobarbital and other substances that cause induction of P450 linked enzymes in the liver are potent tumour promoters when given to rats after a single dose of dimethyl or diethyl nitrosamine. The human population is known to be exposed to small amounts of nitrosamines and to inducers of P450 linked enzymes in the liver, from natural foods such as cabbage and other brassicas. Many individuals are exposed to induced doses of phenobarbital used as anti convulsants. Cohort studies have shown that there is no increased risk of liver cancer detectable in people taking phenobarbital who suffer from epilepsy. On investigating the dose response curve for tumour promotion one finds that hepatocellular carcinomas only appear at a high dosage of phenobarbital and it seems likely that the human exposure to inducers in food, and in therapy with anticonvulsants, is in the dosage range well below that which causes promotion of liver cancer. The physiological adaptation to environment must be clearly distinguished from the pathological events which take place in experimental overdose.
Animals↗
The influence of marital adjustment on 3-year left ventricular mass and ambulatory blood pressure in mild hypertension.
BACKGROUND: Of psychosocial stressors, job strain has been associated with a sustained increase in blood pressure. The impact of marital factors on blood pressure and target organ has not been explored. OBJECTIVES: To evaluate whether marital adjustment, measured at baseline by self-report (Dyadic Adjustment Scale) influences left ventricular mass index (LVMI) and ambulatory blood pressure measured over 3 years in patients with mild hypertension. METHODS: A prospective cohort study was conducted on 103 cohabiting males or females, including 72 with technically adequate echocardiograms, who at baseline were unmedicated, employed, and living with a significant other, all for a minimum of 6 months and had repeated elevated office diastolic blood pressure. MAIN OUTCOME MEASURES: Left ventricular mass by M-mode echocardiography indexed to body surface area and blood pressure were measured by ambulatory blood pressure every 15 minutes (daytime) and hourly between 11 PM and 7 AM. RESULTS: Marital adjustment, smoking, drinking, and baseline LVMI contributed significantly to the prediction of 3-year LVMI (semipartial correlation, sr(2) = 0.04, 0.07, 0.03, and 0.22; P =.03,.008,.08, and <.001, respectively) together accounting for 36% of the total variability in follow-up LVMI. Three-year ambulatory blood pressure measures were not significantly related to marital adjustment but there were correlations with Dyadic Adjustment Scale subscales. Low or high levels of spousal contact during 3-year ambulatory blood pressure monitoring were associated with an increase or decrease of 3-year, 24-hour diastolic blood pressure, consistent with the quality of marital adjustment (P =.04) or marital satisfaction (Dyadic Adjustment Scale subscale, P =.008). CONCLUSIONS: In a cohort of subjects with mild essential hypertension, marital adjustment had an influence on 3-year LVMI. Depending on the quality of marital adjustment, spousal contact at 3 years was associated with an increase or decrease of 3-year diastolic blood pressure. Confirmation of these results, including objective marital assessment and the participation of normotensive subjects, is required. Arch Intern Med. 2000;160:3453-3458.
Adaptation, Psychological↗