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Biomedical subjects

J Ahern

Publications and source records attributed to J Ahern.

29 records · Page 2Linked to original sources
PubMed1993

Phase I study of the oral nonsteroidal aromatase inhibitor CGS 20267 in healthy postmenopausal women.

We have performed a phase I study of the effect of a single dose of CGS 20267, an oral nonsteroidal aromatase inhibitor, in 12 healthy volunteer postmenopausal women. Each subject received 2 single doses of CGS 20267 (0.1, 0.5, or 2.5 mg) or placebo separated by a washout period of at least 6 weeks. There was statistically significant suppression of serum estrone and estradiol at all three doses of CGS 20267 tested. Serum estrone and estradiol concentrations were maximally suppressed by 76% and 79% from baseline levels, respectively. Urinary excretion of estrone and estradiol was also suppressed, although this did not reach statistical significance. Serum concentrations of aldosterone, cortisol, 17 alpha-hydroxyprogesterone, androstenedione, testosterone, FSH, LH, and TSH were unaffected by CGS 20267. The drug was well tolerated, with no significant side-effects. This study has shown CGS 20267 to be a potent and specific aromatase inhibitor, and further studies are now needed to assess its clinical efficacy.

17-alpha-Hydroxyprogesterone↗
PubMed1980

Improved glucose tolerance four hours after taking guar with glucose.

To gain some insights about the possible cumulative metabolic effect after a high-fibre meal, 6 subjects took two 80 g oral glucose loads, 4 h apart. Addition of 22.3 g guar to the first load decreased the rise in blood glucose and insulin after the second (guar-free) load by 50% (p less than 0.002) and 31% (p less than 0.02) respectively. This corresponded with decreased 3-hydroxybutyrate levels at the start of the glucose tolerance test after guar (by 20%, p less than 0.02). When no guar was added to the first glucose load, both 3-hydroxybutyrate and non-esterified fatty acids tended to rise before the second test. No significant effect was seen in the responses of the gut hormones, gastric inhibitory peptide and enteroglucagon. Spreading the intake of the first 80 g of glucose over the initial 4 h (2 subjects) similarly flattened the glycaemic but increased the insulin response. The effect of guar on carbohydrate and fat metabolism, therefore, lasts at least 4 h and may result in improved carbohydrate tolerance to subsequent guar-free meals.

Adult↗
PubMedDate not supplied

The impact of the Trial Coordinator in the Diabetes Control and Complications Trial (DCCT). The DCCT Research Group.

The Diabetes Control and Complications Trial (DCCT) is a multicenter, randomized clinical trial studying the effects of two different diabetes regimens on the development and progression of early vascular complications in persons with insulin-dependent diabetes mellitus (IDDM). All of the centers have a Trial Coordinator. We administered a self-report questionnaire to each center to document the different activities for which the Trial Coordinator assumed responsibility in successfully orchestrating the trial. All Trial Coordinators were responsible primarily for recruitment, screening, medical management, education and training, and adherence and administration. Although documentation indicated that the Trial Coordinator was responsible for all of the above activities, the original applications reflected that very few of the Principal Investigators anticipated such a wide variety of duties. A Trial Coordinator was named in only 13 of the 21 applications and of these, only 6 actually assumed the position. This study points out the need to develop a means to define characteristics, background, and training appropriate for candidates for a Trial Coordinator position in future studies.

Allied Health Personnel↗
PubMedDate not supplied

Use of continuous subcutaneous insulin infusion in young adolescents with diabetes mellitus: a case study.

Continuous subcutaneous insulin infusion (CSII) was initiated in a young female adolescent with severe insulin resistance, decreased growth velocity, and poor metabolic control. The patient's insulin dose had been 3 u/kg/day, and it was hypothesized that her insulin requirements would be much less when only regular insulin was used. Because of the potential risk of severe hypoglycemia from giving regular insulin in amounts equivalent to her injection total daily dose as a constant subcutaneous infusion, the patient was hospitalized to begin pump therapy. Hourly glucose levels were collected for 24 hours to determine insulin requirements with this therapy. The patient subsequently required a significantly reduced dose of insulin (1.2 u/kg/day) with CSII, and her growth velocity improved. Metabolic control based on glycosylated hemoglobin levels also improved. Insulin pump treatment proved to be a viable solution for this young adolescent who required large doses of insulin to maintain reasonable control. Challenges of using this type of therapy in young patients are discussed.

Blood Glucose Self-Monitoring↗
PubMedDate not supplied

A primer on the use of insulin pumps in adolescents.

Optimal metabolic control to minimize long-term complications is a major treatment goal for adolescents with diabetes mellitus. Reaching this goal is extremely challenging in this population due to unique physiological changes and psychosocial variables that affect metabolic control. Continuous subcutaneous insulin infusion (CSII) may be an excellent treatment alternative for selected adolescents to help overcome some of these challenges. CSII allows for minute insulin changes at variable times throughout the day, providing greater lifestyle flexibility. The purpose of this paper is to review the use of insulin pump therapy in adolescents. Specific strategies regarding screening, initiation, and maintenance of this therapy are described, and case examples are used for illustration. Implications for nursing practice and diabetes education are discussed.

Adolescent↗