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Biomedical subjects

H Parsons

Publications and source records attributed to H Parsons.

At least 19 recordsLinked to original sources
PubMed2001

Oral vitamin B(12) and high-dose folic acid in hemodialysis patients with hyper-homocyst(e)inemia.

BACKGROUND: Hyper-homocyst(e)inemia is an independent risk factor for atherosclerotic vascular disease in patients with end-stage renal disease (ESRD), although optimal treatment remains unknown. This randomized, double-blind, placebo-controlled study was designed to measure the effect of high-dose oral vitamin B(12) and folic acid on predialysis total homocyst(e)ine levels in patients with ESRD. METHODS: We studied 81 hemodialysis patients who had hyper-homocyst(e)inemia (>16 micromol/L) on varied doses of a multivitamin containing 1 mg of folic acid/day. After screening blood work, all patients were switched to daily multivitamin therapy, including 1 mg of folic acid for four weeks. For all patients, vitamin B(12), 1 mg/day, was added for an additional four weeks. Patients were then randomized to receive four weeks of 0, 5, or 20 mg of folic acid in addition to the multivitamin and vitamin B(12) (all given daily). RESULTS: Screening homocyst(e)ine levels (mean 27.7 micromol/L) decreased by 19.2% after four weeks of treatment with a daily multivitamin containing 1 mg of folic acid (P < 0.001). Homocyst(e)ine levels were reduced further from 22.3 to 18.6 micromol/L (mean reduction 16.7%, 95% CI 11.8 to 21.6%, P < 0.001) after four weeks of therapy with vitamin B(12) (1 mg/day). There was no significant difference in mean reduction of homocyst(e)ine levels after therapy with high-dose folic acid compared with placebo (P = 0.35). CONCLUSIONS: The optimal oral treatment of hyper-homocyst(e)inemia in hemodialysis patients consists of 1 mg of folic acid and 1 mg of oral vitamin B(12) daily. Whether this treatment will lower the risk of future atherosclerotic vascular events remains to be investigated.

Administration, Oral↗
PubMed1996

Treatment of familial hypercholesterolemia in children and adolescents: effect of lovastatin. Canadian Lovastatin in Children Study Group.

OBJECTIVE: Familial hypercholesterolemia (FH), an inherited autosomal dominant disorder of lipoprotein metabolism, is associated with premature atherosclerosis. The recommended pediatric therapy consists of dietary intervention and, when necessary, treatment with bile acid-binding resins. However, compliance has been poor in many children. Therefore, our objectives were to determine the efficacy, safety, and tolerance of the short-term use of lovastatin, a 3-hydroxy 3-methylglutaryl coenzyme A reductase inhibitor, in the control of severe FH in a male pediatric population and to evaluate the dose-response relationship. METHODS: Sixty-nine male patients with FH 12.9 +/- 2.4 years of age (mean +/- SD) participated in this multicenter, randomized, double-blind trial. After a 4-week placebo period, the patients were allocated to four treatment groups (lovastatin 10, 20, 30, 40 mg/d) for 8 weeks. Plasma lipid and apolipoprotein (Apo) concentrations were measured every 2 weeks. Clinical and laboratory evidence of adverse events was monitored periodically throughout the study. RESULTS: All lovastatin doses reduced total cholesterol (-17% to -29%), low density lipoprotein cholesterol (-21% to -36%), and ApoB (-19% to -28%) concentrations. A dose-response relationship was seen, and between-group comparisons showed that results were significantly improved up to a dose of 30 mg/d. We observed a 7% increase in high-density lipoprotein cholesterol and a 4% increase in ApoA1 concentrations. The medication was well tolerated by all patients. No serious clinical adverse experience was reported. Lovastatin increased aspartate aminotransferase concentrations, but there was no evidence of a dose-response relationship, and no value exceeded two times the upper limit of normal. No significant change in alanine aminotransferase was observed. Three patients had marked (more than three times the upper limit of normal) asymptomatic elevations in their creatine kinase values, which returned spontaneously to normal, and no action was required regarding the drug.

Adolescent↗
PubMed1992

Southern hospitality.

Self Memorial Hospital's hostesses are the embodiment of a patient-oriented service philosophy instituted by Bob Borland when he created the $5-million-a-year Hospitality Services department.

Cost Savings↗
PubMed1992

Dietitians view the horizon.

In honor of the American Dietetic Association's landmark 75th anniversary, FM asked ADA members representing six market sectors to share their perspectives on the opportunities & challenges for dietitians in the '90s. An exciting era lies ahead.

Administrative Personnel↗
PubMed1990

The role of photocoagulation in the management of retinoblastoma.

We treated selected patients with retinoblastoma with xenon arc photocoagulation between February 1974 and August 1987. Of 790 individual tumors in 410 affected eyes, 45 were treated by this technique. Overall photocoagulation alone was successful in eradicating 76% of the tumors, while in 24% of the tumors additional treatment with cryotherapy, plaque radiotherapy, external beam radiotherapy, or enucleation was necessary. In cases where the tumor was less than or equal to 3.0 mm in diameter and 2.0 mm in thickness and was confined to the sensory retina, without seeding into the adjacent vitreous, tumor destruction was achieved with photocoagulation. The mean number of photocoagulation sessions needed for complete tumor regression was 2.5. Photocoagulation alone was generally unsuccessful for tumors greater than 4.5 mm in diameter and 2.5 mm in thickness, and supplemental treatment with other modalities was often necessary in such cases. Based on observations in these patients, we point out certain misconceptions regarding photocoagulation of retinoblastomas and define our current indications and contraindications for this treatment modality.

Adolescent↗
PubMed1989

The role of cryotherapy in the management of retinoblastoma.

Between February 1974 and August 1987, we treated 67 retinoblastomas in 47 eyes of 45 patients with cryotherapy (triple freeze-thaw technique). Overall, cryotherapy eradicated 53 (79%) of the tumors, whereas additional treatment with episcleral plaque radiotherapy, external beam radiotherapy, or enucleation was necessary in 14 (21%) of the tumors. Tumor destruction was achieved with one or more cryotherapy treatments in all cases in which the tumor was no greater than 2.5 mm in diameter and 1.0 mm in thickness, and in which the tumor was confined to the sensory retina without seeding into the adjacent vitreous humor. We therefore recommend cryotherapy in such cases. Cryotherapy alone failed in 14 larger tumors, ten of which had clinical evidence of vitreous seeding by tumor cells. Cryotherapy is therefore contraindicated in cases of vitreous seeding or if the tumor exceeds 3.5 mm in diameter and 2.0 mm in thickness. Cryotherapy can be successful for tumors up to 3.5 mm in diameter and 2.0 mm in thickness, but more than one treatment may be necessary.

Combined Modality Therapy↗
PubMed1986

Simultaneous analysis of low plasma levels of deuterium-labeled saturated and unsaturated fatty acids as t-butyldimethylsilyl esters.

A sensitive and accurate method for detection and quantitation of deuterated fatty acids in the presence of large amounts of unlabeled fatty acids is described using mass fragmentography in combination with the preparation of tertiarybutyldimethylsilyl esters (t-BDMS). The method has been applied to determination of deuterated stearic, oleic, elaidic and linoleic acids in human plasma lipoproteins following duodenal perfusion with a micellar mixture of acids. Over a concentration range of 10-1000 ng/ml, the average coefficient of variation for the linoleate was 3% and for the oleate (elaidate) ester was 2%.

Chromatography, Gas↗