PubMed Health⌕ Search

Biomedical subjects

J Connett

Publications and source records attributed to J Connett.

18 recordsLinked to original sources

Copper-64-diacetyl-bis(N4-methylthiosemicarbazone): An agent for radiotherapy.

Systemic administration of hypoxia-selective (64)Cu-diacetyl-bis(N(4)-methylthiosemicarbazone) ((64)Cu-ATSM) has increased significantly the survival time of hamsters bearing human GW39 colon cancer tumors. Radiotherapy experiments were performed in animals bearing either 7-day-old (0.5-1.0 g) or 15-day-old (1.5-2.0 g) tumors. Studies compared animals treated with a single dose of 0, 4, 6, 7, 8, or 10 mCi of (64)Cu-ATSM (1 Ci = 37 GBq) with or without the vasodilator hydralazine. A multiple dose regimen of 3 x 4 mCi at 72-h intervals was studied also. Single doses of >6 mCi of (64)Cu-ATSM and the dose-fractionation protocol significantly increased the survival time of the hamsters compared with controls. The highest dose, 10 mCi of (64)Cu-ATSM, increased survival to 135 days in 50% of animals bearing 7-day-old tumors, 6-fold longer than control animals' survival (20 days), with only transient leucopenia and thrombocytopenia but no overt toxicity. Human absorbed doses were calculated from hamster biodistribution; the dose-critical organs were the lower large intestine (1.43 +/- 0.19 rad/mCi) and upper large intestine (1.20 +/- 0.38 rad/mCi). High-resolution MRI and positron-emission tomography using a therapeutic administration of 10 mCi were used to monitor tumor volume and morphology and to assess tumor dosimetry accurately, giving a tumor dose of 81 +/- 7.5 rad/mCi. (64)Cu-ATSM has increased the survival time of tumor-bearing animals significantly with no acute toxicity and thus is a promising agent for radiotherapy.

Animals↗

Leisure time physical activity and the 16-year risks of mortality from coronary heart disease and all-causes in the Multiple Risk Factor Intervention Trial (MRFIT).

PURPOSE: To examine the long-term association of leisure time physical activity (LTPA) and risk of death from coronary heart disease (CHD) and all-causes. METHODS: Data are from a prospective study of 12,138 middle-aged men at high risk for CHD participating in the MRFIT. Men were classified into deciles based on average min/d of LTPA reported at baseline, which were compared with cumulative CHD and all-cause mortality endpoints at the 16-year follow-up. RESULTS: Men in the least-active decile of LTPA who averaged 4.9 min/d of LTPA (range 0 to .9 min/d) had excess age-adjusted mortality rates of 29% and 22% for CHD and all-causes, respectively, as compared to those in combined deciles 2 to 4, who averaged 22.7 min/d of predominantly light and moderate LTPA (range 10-36 min/d). No further decrement in mortality rates was noted in those in the higher declines of LTPA. These associations remained significant (P < 0.05) after proportional hazards adjustments for additional possible confounding variables. CONCLUSION: These data suggest that a relatively small amount (10 to 36 min/d) of daily moderate intensity LTPA can significantly reduce premature mortality, particularly from CHD, in middle-aged and older men at high risk for CHD.

Adult↗

Impact of pneumoperitoneum on trocar site implantation of colon cancer in hamster model.

BACKGROUND: Numerous anecdotal reports have documented the spread of colon cancer to trocar sites after laparoscopic-assisted colectomy. We hypothesized that the pneumoperitoneum of laparoscopy potentiated tumor adherence to trocar sites. PURPOSE: This study was designed to determine the effect of CO2 pneumoperitoneum on the rate of tumor implantation at trocar sites. METHODS: Viable GW-39 human colon cancer cells were injected into the abdominal cavity of hamsters (2 x 10(6) cells/hamster). A midline laparotomy, insertion of four 5-mm trocars, injection of viable cells into the mesentery of the cecum, and free peritoneal cavity was performed in two groups: one control group (41) who did not receive a pneumoperitoneum and a comparison group (50) who underwent pneumoperitoneum for ten minutes at an insufflation pressure of 10 mmHg. Animals were killed at six weeks, and hematoxylin and eosin-stained sections of trocar wounds, midline wound, small intestine, cecum, liver, and lung were examined by a veterinary pathologist, who was blinded to operation. RESULTS: Pneumoperitoneum increased tumor implantation in the cecal mesentery and the midline incision (P < 0.05) but did not effect recurrence in the liver, lung, or jejunum. Trocar site implantation tripled with the addition of pneumoperitoneum increased implantation of pneumoperitoneum (26 vs. 75 percent) (P < 0.0001). CONCLUSION: Pneumoperitoneum increased implantation of free intra-abdominal cancer cells at wound sites on the abdominal wall or within the abdominal cavity in this animal model. The use of pneumoperitoneum during laparoscopy in patients with colon cancer should only be performed in a protocol setting to evaluate the effect of pneumoperitoneum on the treatment of cancer.

Animals↗

Selection of spirometric measurements in a clinical trial, the Lung Health Study.

Although current recommendations for spirometry require that the largest value of FEV1 and FVC should be taken from the largest values of different maneuvers, the validity of this approach was recently questioned. It has been suggested that selection of the maneuver with the largest peak flow or the maneuver with the largest FVC should be used for measurement of spirometric indices. The present analysis was therefore undertaken to determine which method of selection of spirometric maneuvers would give the least short-term variability in a clinical trial population. We examined the spirometry test sessions from 5,885 individuals with mild to moderate chronic airflow obstruction who were screened at two visits 24.9 +/- 17.1 d apart for entry into a multi-center clinical trial, the Lung Health Study. We compared eight potential selection methods for FEV1 and FVC. Using these different selection methods, the coefficient of variation ranged from 4.1 to 4.9% for FEV1 and from 3.5 to 5.7% for FVC. The average absolute difference between the two test sessions ranged from 110 to 123 ml for FEV1 and from 149 to 200 ml for FVC. Although all of the methods gave good results, the mean of the three highest values and the largest single value from all maneuvers provided the least short-term variability for both FEV1 and FVC. We therefore conclude that there is no reason to change the currently recommended selection methods for FEV1 and FVC.

Administration, Inhalation↗

Long-term metered-dose inhaler adherence in a clinical trial. The Lung Health Study Research Group.

Poor adherence to medication regimens is a well-documented phenomenon in clinical practice and an ever-present concern in clinical trials. Little is known about adherence to inhaled medication regimens over extended periods. The present paper describes the 2-yr results of the Lung Health Study (LHS) program, which was developed to maintain long-term adherence to an inhaled medication regimen in 3,923 special intervention participants (as measured by self-report and medication canister weight). The LHS is a double-blind, multicenter, randomized controlled clinical trial of smoking intervention and bronchodilator therapy (ipratropium bromide or placebo) for early intervention in chronic obstructive pulmonary disease (COPD). At the first 4-mo follow-up visit, nearly 70% of participants reported satisfactory or better adherence. Over the next 18 mo, self-reported satisfactory or better adherence declined to about 60%. Canister weight classified adherence as satisfactory or better in 72% of participants returning all canisters at 1 yr, and in 70% of the participants returning all canisters at the 2-yr follow-up. Self-reporting confirmed by canister weight classified 48% of participants at 1 yr as showing satisfactory or better adherence. Overusers were 50% more likely than others to misrepresent their true smoking status, suggesting that canister weights indicating overuse may be deceptive. Results of multiple logistic regression analysis indicate that the best compliance was found in participants who were married, older, white, had more severe airways obstruction, less shortness of breath, and fewer hospitalizations, and who had not been confined to bed for respiratory illnesses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Weight gain as a function of smoking cessation and 2-mg nicotine gum use among middle-aged smokers with mild lung impairment in the first 2 years of the Lung Health Study.

The extent and predictors of weight change were assessed among sustained nonsmoking special intervention participants in the Lung Health Study. The intervention included a 12-session group program and 2-mg nicotine gum. At 12 months, female sustained quitters (SQs; n = 248) had gained a mean of 8.4% (5.3 kg) of their baseline weight, whereas male SQs (n = 443) had gained 6.7% (5.5 kg). By 24 months, female SQs had gained 9.8% of their baseline weight compared with 6.9% for men. Nicotine gum usage delayed a portion of the weight gain. Multiple regression analysis showed that weight gain at 12 months was associated with a higher baseline salivary cotinine level, a lower baseline body mass index, drinking less alcohol per week, and a lower cotinine level at 12 months (indicating less or no nicotine gum use). We conclude that moderate weight gain is a long-term consequence of smoking cessation--a portion of which can be delayed with 2-mg nicotine gum.

Adult↗

Physical activity in Minnesota physicians.

METHODS: A survey inquiring about physical activity was mailed to a random sample of 500 physicians who were current members of the Minnesota Medical Association. RESULTS: Overall, 65.6% of the 393 respondents reported performing regular exercise, while 38.2% participated in exercise vigorous enough to be of cardiovascular benefit (at least three times per week, at least 15-30 min per session, and strenuous enough to cause sweating or shortness of breath). Men reported a significantly higher prevalence of regular exercise and cardiovascular exercise than did women. There was no significant relationship between the prevalence of either regular exercise or cardiovascular exercise and age, specialty, the percentage of primary care performed, the number of patients seen per day, or the number of hours worked per week. CONCLUSIONS: The prevalence of physical activity was higher among physicians in this survey compared with levels reported for the general population.

Adult↗

Physical activity and 10.5 year mortality in the Multiple Risk Factor Intervention Trial (MRFIT).

The effect of habitual leisure time physical activity (LTPA) on the 10.5-year total and cause-specific mortality rates was studied in 12,138 middle-aged men at high risk for coronary heart disease (CHD) who participated in the MRFIT. The level of LTPA as determined by the Minnesota questionnaire was inversely related to rate of death from cardiovascular (CVD), coronary heart disease (CHD), and all-causes, but was unrelated to the cancer death rate. The least active men (LTPA tertile 1) had excess mortality rates of 22%, 27%, and 15% for CVD, CHD, all-causes, respectively, as compared to more active men in the middle third (tertile 2). Additional LTPA (tertile 3) was not associated with further attenuation of mortality rates. Proportional hazards regression analysis only slightly weakened risk differentials. This study supports previous observations that regular LTPA is associated with a reduced rate of CVD mortality, independent of other risk factor levels.

Adult↗

Organophosphate exposure inhibits non-specific esterase staining in human blood monocytes.

The objective of this study was to investigate the association between exposure to triaryl phosphate and monocyte nonspecific esterase staining activity in workers from a plant in Nitro, West Virginia. A cross-sectional study design was used to identify the exposed plant employees, and both a plant and a general population group. In addition to completing a questionnaire for each participant, 30 cc of blood were drawn and analyzed using four techniques, two morphological and two enzymatic. These procedures included a Technicon D-90 autoanalyzer, a Technicon H-6000 autoanalyzer, a manual enzymatic using alpha naphthyl butyrate, and a manual morphologic using Wright-Giesma stain. The results showed a decrease in nonspecific esterase staining with the Technicon D-90. No significant effect on monocyte numbers or esterase positivity was found with the other three techniques.

Adult↗

Leisure-time physical activity levels and risk of coronary heart disease and death. The Multiple Risk Factor Intervention Trial.

The relation of self-selected leisure-time physical activity (LTPA) to first major coronary heart disease (CHD) events and overall mortality was studied in 12,138 middle-aged men participating in the Multiple Risk Factor Intervention Trial. Total LTPA over the preceding year was quantitated in mean minutes per day at baseline by questionnaire, with subjects classified into tertiles (low, moderate, and high) based on LTPA distribution. During seven years of follow-up, moderate LTPA was associated with 63% as many fatal CHD events and sudden deaths, and 70% as many total deaths as low LTPA (P less than .01). Mortality rates with high LTPA were similar to those in moderate LTPA; however, combined fatal and nonfatal major CHD events were 20% lower with high as compared with low LTPA (P less than .05). These risk differentials persisted after statistical adjustments for possible confounding variables, including other baseline risk factors and Multiple Risk Factor Intervention Trial group assignments. It is concluded that LTPA has a modest inverse relation to CHD and overall mortality in middle-aged men at high risk for CHD.

Adult↗

Lessons from the Visual Acuity Impairment Survey pilot study.

The Visual Acuity Impairment Survey (VAIS) pilot study was carried out in three large metropolitan areas of the United States to determine whether it would be feasible to conduct a large two-stage survey of the prevalence of visual acuity impairment and its causes. The study was conducted in conjunction with the Health Interview Survey (HIS), performed by the National Center for Health Statistics and the Census Bureau. In the first stage, a simple vision screening test was administered to 1,868 adults in their homes by specially trained Census Bureau interviewers. All those who failed the test, and a sample of those who passed it, were invited to a local clinic for a check on the accuracy of the screen and a detailed eye examination to establish the cause of the impairment. About 89 per cent of the HIS interviewees took the vision screening test in the home and agreed to have the results released, making it possible for the clinic to invite them for an examination. The principal obstacle to the success of the feasibility study was a low rate (less than 50 per cent) of participation in the clinic examination by the target population. Such low participation would leave the survey open to a serious question about its representativeness. The methods and findings of the pilot study are presented because the lessons may be of value to those attempting similar studies in the future. Suggestions are made for methodological modifications that may enhance the chances for success.

Adult↗

The development of lesions in the glomerular basement membrane and mesangium after transplantation of normal kidneys to diabetic patients.

Renal allograft biopsies at the time of transplantation (baseline) and 2 yr later were obtained in 6 type I diabetic and 12 nondiabetic patients and studied for glomerular basement membrane (GBM) and mesangial changes. Diabetic patients had significantly greater GBM thickness compared with nondiabetics at 2 yr (P = 0.05, rank sum test), and the increase in GBM thickness comparing baseline and 2-yr biopsies was greater in the diabetic compared with nondiabetic patients (P = 0.005, rank sum test). Similarly, diabetic patients developed significant mesangial thickening by light microscopy while no changes were observed in nondiabetic patients (P = 0.001). Electron microscopic morphometric analysis of the percentage of total mesangium was not different on comparing diabetic and nondiabetic patients at 2 yr. There was an increase in the matrix component of the mesangium in the diabetics at this time, although this did not reach statistical significance (P = 0.06). In addition, the surface density of the peripheral glomerular capillary wall, presumably reflecting mesangial expansion, was decreased in the diabetic and unchanged in the nondiabetic patients (P = 0.005). These studies document, for the first time, the development of GBM and mesangial lesions of diabetic nephropathy in normal living related donor and cadaver kidneys transplanted into diabetic patients and support the hypothesis that these lesions are secondary to the diabetic state.

Adult↗

The Minnesota diabetes complications clinical trial. The first three years.

A prospective and randomized clinical trial of an inception cohort of diabetic kidney recipients to test the hypothesis that maximized metabolic control of diabetes prevents or delays diabetic nephropathy in the renal allografts was initiated approximately three years ago. Notwithstanding the fact that all our diabetic patients were on prednisone and therefore metabolically unstable, we achieved and maintained a clear difference between the standard control (group A) and the maximized control patients (group B). At 13 months of study, the mean fasting blood glucose mg% (A: 242 +/- 22, B: 130 +/- 9, p less than 0.001), nonfasting blood glucose (A: 276 +/- 40, B: 135 +/- 10, p less than 0.001), 24 hour urine glucose (A: 85 +/- 16, B: 5 +/- 1, p less than 0.001), and glycosylated hemoglobin % (A: 13 +/- 0.9, B: 10 +/- 0.8, p less than 0.01) were all clearly and statistically significantly higher for the group A patients. These results show the feasibility of such a trial using the tools available today to treat diabetes.

Aftercare↗

Study of chart designs and optotypes for preschool vision screening--I. Comparability of chart designs.

Design variations in children's distance vision screening charts contribute to inconsistencies noted in preschool vision screening programs. This study compares children's distance visual acuity on two chart designs: logarithm of the minimal angle of resolution (LOGMAR) vs a chart of 'standard' design. In theory, the LOGMAR chart offers the advantages of improved precision in measuring inter-patient differences and greater consistency of follow-up measurements. Our findings indicate the following: 1) the ability to complete a test depends upon the child's age, not on chart design; 2) isolation of symbols is required more frequently for the LOGMAR charts than for the standard charts; and 3) on average, children have slightly poorer visual acuity scores on LOGMAR charts than on standard charts.

Child, Preschool↗