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Biomedical subjects

J J Hoover

Publications and source records attributed to J J Hoover.

14 recordsLinked to original sources

Effect of estrogen/progestin potency on clinical chemistry measures. The Lipid Research Clinics Program Prevalence Study.

The effects of oral contraceptives of varied estrogen/progestin composition on clinical measurements of hepatic, thyroid, and renal function and carbohydrate metabolism were examined in 1,355 women in the Lipid Research Clinics Program Prevalence Study. In general, bilirubin and alkaline phosphatase levels are lower with both oral contraceptives and postmenopausal estrogen use, suggesting an estrogen effect. The least bilirubin reduction is seen with a progestin dominant oral contraceptive. A significant decrement in aspartate aminotransferase is observed in users of one high estrogen dose oral contraceptive and in postmenopausal Premarin users, while aspartate aminotransferase is higher in postmenopausal users of higher dose ethinyl estradiol. Globulins are slightly higher in all hormone use categories, suggesting an estrogen effect on hepatic secretion of this protein class into the circulation. Fasting glucose concentrations are generally slightly lower even in the progestin dominant oral contraceptives, where glucose intolerance has been described. Thyroxine concentrations are generally elevated in all women using oral contraceptives. A relationship to estrogen dose is seen in women with thyroxine concentrations greater than the 99th percentile and in postmenopausal estrogen users. Creatinine concentration is greater with the use of Ovral, a progestin dominant oral contraceptive, and lower with two estrogen dominant oral contraceptives and Premarin, suggesting a competitive effect of estrogen and progestin. Among the clinical laboratory tests considered here, oral contraceptive effects seem to be largely estrogen mediated with a suggestion of competitive effect of estrogen versus progestin only on bilirubin and creatinine levels. These observations differ from lipoproteins where opposing hormonal effects are more clearly reflected in changing lipoprotein concentrations.

Adult

Lipid and lipoprotein triglyceride and cholesterol interrelationships: effects of sex, hormone use, and hyperlipidemia.

The interrelationships of lipid and lipoprotein cholesterol and triglyceride concentrations in normolipidemic and hyperlipidemic employees of the Pacific Northwest Bell Telephone Company were examined bivariately using correlation analysis and multivariately by factor analysis. Application of the latter resulted in the identification of three distinct lipoprotein lipid clusters, which succinctly describes their metabolic relationships. Among normolipidemic subjects, the interrelationships were found to be similar in male and female subjects, but hormone use by women considerably altered interrelationships that involved high-density lipoprotein cholesterol (HDL-C) and triglyceride. Among hyperlipidemic subjects, we found that elevation in cholesterol level alone rarely altered relationships, but elevation in triglyceride level either alone or in conjunction with an elevation in cholesterol concentration was associated with substantial changes in relationships involving the low-density lipoprotein (LDL) fraction. In many instances, positive relationships between LDL cholesterol (LDL-C) and other lipoprotein lipids became inverse in the presence of triglyceride elevation. We conclude that hormone use by women and hypertriglyceridemia with or without an elevation in cholesterol level clearly alter lipoprotein relationships, whereas pure hypercholesterolemia does not. These alterations provide a basis for investigating pathophysiologic mechanisms in hypertriglyceridemia.

Adult

Effects of oral contraceptives on lipoprotein triglyceride and cholesterol: relationships to estrogen and progestin potency.

Hormone formulation and estrogen/progestin potency were evaluated in relation to triglyceride and cholesterol concentrations in total plasma and lipoprotein fractions and in relation to lipid composition among a random sample of female telephone company personnel. Triglyceride concentrations in whole plasma, very low-density lipoprotein, and high-density lipoprotein (HDL) were elevated in response to increasing estrogen potency as were triglyceride concentrations in low-density lipoprotein (LDL). LDL cholesterol rose with increasing estrogen potency in contraceptive users but was slightly lower in postmenopausal estrogen-treated women. Plasma HDL cholesterol varied according to estrogen and progestin levels. The LDL cholesterol/triglyceride ratio was reduced for all combination oral contraceptives examined. Sequential oral contraceptives of postmenopausal estrogens did not significantly alter the cholesterol/triglyceride ratio in any lipoprotein fraction. Potential arteriosclerotic risk from sex hormone use may vary among oral contraceptive formulations.

Adult

How blind was the patient blind in AMIS?

The Aspirin Myocardial Infarction Study (AMIS) was a double-blind placebo-controlled trial to test the effect of aspirin on the survival of 4524 people who had experienced a prior heart attack. Shortly before their closeout visits, 400 of the participants were randomly selected to be interviewed concerning their perceptions of their treatment assignments; 380 were actually interviewed. A bare majority (52)% correctly identified their study therapy, 28% mistakenly named the alternative treatment, 13% declined to guess, and 7% specified extraneous substances. According to the proposed formula for evaluating the patient blind, only 24% of the sample made "informed" guesses regarding their therapy, while the remainder guessed in an uninformed way or not at all. Those who tested their capsules (usually be taste) showed proportionately more correct responses than the nontesters. Correctness also varied with the reasons for the subjects' guesses (e.g., side effects). Among the sample as a whole, most people were only moderately or less than moderately certain their guess was correct. Even among those who were in fact correct, only 18% were absolutely certain of their choice.

Adult

Distribution of lipoproteins triglyceride and lipoprotein cholesterol in an adult population by age, sex, and hormone use- The Pacific Northwest Bell Telephone Company health survey.

This report describes the distribution of lipoprotein triglyceride and lipoprotein cholesterol in employees of the Pacific Northwest Bell Telephone Company. Means, medians, and selected percentiles are presented for very low, low, and high density lipoproteins (VLDL, LDL, and HDL, respectively) in 606 randomly selected white subjects aged 20-59. Results are specific for age decade, sex, and female sex hormone usage. Women who use sex hormones have significantly higher concentrations of triglycerides in all of the fractions across all age decades from 20 to 59 than do women not taking hormones. The average VLDL, LDL, and HDL triglyceride levels in women taking hormones are 69, 25 and 18 mg/dl which are considerably higher than the corresponding averages of 44, 17 and 12 mg/dl noted in women not taking hormones. Men have the highest average VLDL triglyceride value (85 mg/dl) but their average triglyceride concentrations in the LDL and HDL fractions (18 and 12 mg/dl) approximate those of women not taking hormones. This study in a well-defined population provides references standards for lipoprotein triglyceride concentrations. These results can be used to evaluate the effect of sex hormone treatment on the lipoprotein triglyceride content in VLDL, LDL and HDL, and to assess triglyceride content as a potential risk factor in men and older women.

Adult

Type III hyperlipoproteinemia: diagnosis in whole plasma by apolipoprotein-E immunoassay.

Because the cholesterol-rich very low density (VLD) lipoproteins of subjects with type III hyperlipoproteinemia are distinctively enriched in apolipoprotein E, a radial immunodiffusion assay for apolipoprotein E in whole plasma was developed. Its diagnostic usefulness was tested in randomly selected (n = 174) and hyperlipidemic (n = 61) subsets of an adult employee population and a hyperlipidemia clinic referral group (n = 63), which included 18 patients with well-documented type III hyperlipoproteinemia. Apolipoprotein-E levels were normally distributed among the random population subset, were equal between the two sexes, and increased little with age. The mean and 99th percentile values were 24.6 and 40.1 mg/dl, respectively. All subjects with type III patterns as assigned by standard criteria from both population (n = 4) and referral sources exceeded this 99th percentile (chi +/- SD = 54.7 +/- 9.7 mg/dl). Hence a plasma apolipoprotein-E concentration exceeding 40 mg/dl appears diagnostic of type III hyperlipoproteinemia, representing the first application of an apolipoprotein immunoassay to improved diagnosis of the hyperlipoproteinemias.

Adult

Quantitation of apolipoprotein A-I of human plasma high density lipoprotein.

High density lipoproteins (HDL) may be controlled via their major apolipoprotein, A-I. To study this apolipoprotein, a simple, precise, and accurate immunodiffusion assay for A-I was developed and applied in a sample of Bell Telephone Company employees. A-I showed a slight increase with age in men (r=0.11, n=263) and women (r=0.15, n=257). A-I correlated closely with HDL cholesterol (r=0.72). It was weakly related to total triglyceride in women (r=0.24) but was inversely related in men (r=-0.17). Women on estrogen had the highest A-I levels (149 mg/dl +/- 26, x +/- S.D., n=29, p is less than 0.05), followed by women on combination oral contraceptives (141 +/- 26, n=80) whereas women on no medication had lower levels (129 +/- 25, n=99, p is less than 0.01) but men had the lowest levels (120 +/- 20, p is less than 0.01) In a separate group of 14 women given estrogen for 2 wks (1 mug/kg/day), A-I increased by 24%. Thus A-I is increased by exogenous and, most likely, endogenous estrogen, Among hyperlipidemic referral subjects, those with hypercholesterolemia (n=43) and hypertriglyceridemic women (n=33) had normal A-I levels. Among hypertriglyceridemic men both A-I and HDL cholesterol values were decreased (115 +/- 20, p is less than 0.01 and 37 +/- 3, p is less than 0.01, respectively, n=68) but were significantly lower among a group of myocardial infarction survivors (107 +/- 16, p is less than 0.01, and 27 +/- 6, p is less than 0.01, respectively, n=24). High density lipoprotein levels and the content of cholesterol in HDL associated with A-I appear to be decreased in coronary heart disease.

Adult

Hyperlipidemia in the Pacific Northwest Bell Telephone Company Health Survey. Part 1. Lipoprotein cholesterol and triglyceride concentrations.

Lipoprotein triglyceride and cholesterol concentrations and characteristics are described in normolipidemic and in three categories of hyperlipidemic subjects participating in the Pacific Northwest Bell Telephone Company Health Survey. For this study, 350 white participants 20 to 59 years of age with cholesterol or triglyceride values exceeding the age, sex, and hormone-use specific, population-based 90th percentile values were defined as having hypercholesterolemia, hypertriglyceridemia, or combined hyperlipidemia; 722 participants were classified as normolipidemic. In hypercholesterolemia, very low density lipoprotein cholesterol and triglyceride and high density lipoprotein cholesterol concentrations were higher than in normolipidemia. In hypertriglyceridemia, high density lipoprotein cholesterol was significantly lower in men and women not using sex hormones and low density lipoprotein triglyceride was significantly higher in men and women using hormones compared to normolipidemia. In combined hyperlipidemia, high density lipoprotein cholesterol concentrations were lower than in normolipidemia, but higher than in pure hypertriglyceridemia. The presence of beta migrating very low density lipoprotein and chylomicrons was seen primarily in hypertriglyceridemic or combined hyperlipidemic men. Sinking prebeta lipoprotein was equally common (20%) among all normolipidemic and hypercholesterolemic subjects, but was less common (5% to 10%) in hypertriglyceridemic and combined hyperlipidemic men and female hormone users. Quantitative and qualitative lipoprotein abnormalities associated with hyperlipidemia were found to vary by gender and by sex hormone use in women and were often, but not always, more marked in men.

Adult

Hyperlipidemia in the Pacific Northwest Bell Telephone Company Health Survey. Part 2. Lipoprotein lipid interrelationships.

The relationships of lipoprotein cholesterol and triglyceride among lipoprotein fractions have potential significance for understanding atherogenesis and distinguishing among different classes of hyperlipidemia. We have compared these relationships in normolipidemic, hypercholesterolemic, hypertriglyceridemic, and combined hyperlipidemic participants in the Pacific Northwest Bell Telephone Company Health Survey. The cholesterol/triglyceride ratio in each lipoprotein fraction was moderately higher (1% to 26%) in hypercholesterolemia but significantly lower (20% to 50%) in hypertriglyceridemia, compared to normolipidemia. In combined hyperlipidemia, the very low density lipoprotein ratios were lower than in normolipidemia, but larger than in hypertriglyceridemia. These changes were directionally the same, but differed quantitatively, in both men and women. Correlation coefficients between cholesterol and triglyceride within each fraction varied by gender and sex hormone use. The largest correlations were seen in combined hyperlipidemic men for very low density lipoproteins, normolipidemic men for low density lipoproteins, and combined hyperlipidemic women taking hormones for high density lipoproteins. The correlation of very low and low density lipoprotein cholesterol was generally negative and was strongest for hormone users (r = -0.81) and weakest for nonusers (r = -0.06). Very low density lipoprotein triglyceride and high density lipoprotein cholesterol correlations were generally negative and were strongest in hypertriglyceridemic women not taking hormones (r = -0.55) and weakest in normolipidemic hormone users (r = -0.10). This correlation was positive for hypertriglyceridemic and combined hyperlipidemic hormone users.

Adult

Epidemiological correlates of high density lipoprotein subfractions, apolipoproteins A-I, A-II, and D, and lecithin cholesterol acyltransferase. Effects of smoking, alcohol, and adiposity.

Recent data suggest that the protection against ischemic heart disease afforded by high density lipoprotein (HDL) cholesterol (C) may be concentrated in the HDL2 subfraction. To examine the behavioral correlates of the HDL subfractions, we recalled 33 men and 17 women of a random sample from the Pacific Northwest Bell Telephone Company Health Survey. Adiposity and very low density lipoprotein (VLDL) triglyceride were negatively correlated with HDL2C. Smoking was not correlated with HDL2C, but was negatively correlated with HDL3C (men, rs = -0.635, p = 0.001; women, rs = -0.534, p = 0.014); this relationship was independent of alcohol consumption, adiposity, and VLDL triglyceride. Alcohol consumption was also more strongly related to HDL3C (men, rs = 0.248, p = 0.082; women, rs = 0.586, p = 0.007). Lecithin cholesterol acyltransferase (LCAT) mass was negatively related with HDL2C, but was positively correlated with HDL3C and apolipoprotein A-II. Smoking was negatively correlated with LCAT mass. Since it is believed that HDL3C is not associated with the risk of ischemic heart disease and since both smoking and alcohol consumption may mainly affect HDL3C, the current study suggests that the increase in risk of ischemic heart disease with smoking and the possible decrease with alcohol consumption may be mediated through mechanisms other than their effects on HDLC.

Adult

Postheparin plasma triglyceride lipases. Relationships with very low density lipoprotein triglyceride and high density lipoprotein2 cholesterol.

Hepatic triglyceride (HTGL) and lipoprotein lipase (LPL) probably have major roles in the removal of triglyceride from triglyceride-rich lipoprotein and in the formation of high density lipoprotein (HDL). However, no population-based study of their activity and relationship to lipoprotein lipid levels has been reported. To determine these relationships, we recalled 33 men and 17 women of a randomly selected sample of the Lipid Research Clinics Pacific Northwest Bell Telephone Company Health Survey. The subjects were 53 +/- 7 years old (mean +/- SD) with total triglyceride levels of 120 +/- 57 mg/dl and total cholesterol levels of 224 +/- 35 mg/dl. Postheparin plasma LPL activity (127 +/- 61 nmol/min/ml) was not significantly correlated with either age, sex, or adiposity. In contrast, HTGL activity was significantly higher in men (235 +/- 84 nmol/min/ml) than women (170 +/- 91 nmol/min/ml, p less than 0.02), and was correlated with age in men and with adiposity in women. In both men and women, HTGL activity was related positively with VLDL triglyceride and inversely with HDL2 cholesterol. When the association between HTGL activity and VLDL triglyceride was examined with values from men and women pooled, the relationship was not weakened after adjustment for the linear effect of sex, adiposity, LPL, or HDL2 cholesterol.

Adult

Study skills and the education of students with learning disabilities.

This article discusses an area of education for students with learning disabilities that is often neglected. The topic of study skills education, although not new to education in general, has only recently been emphasized in the literature for students with handicaps. An overview of the study skill proficiency (or lack of it) of students with learning disabilities is provided, followed by the presentation of 15 student study skill strategies designed to assist students in their use of various study skills. These strategies may be employed appropriately and effectively with many students with learning disabilities provided that individual needs and abilities are considered. The article concludes with a discussion about the implementation of a study skills program, including guidelines to follow in this process.

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