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Biomedical subjects

J M Hodgson

Publications and source records attributed to J M Hodgson.

At least 19 recordsLinked to original sources
PubMed2001

Item characteristics of the Michigan Alcoholism Screening Test.

Items of the Michigan Alcoholism Screening Test (MAST) were individually evaluated regarding disproportional responding. The item with the lowest degree of endorsement (Item 18, related to liver problems) was found to have correspondingly low relationships with other MAST items and with the total score. Weighted items concerned with drug-related arrests were found to detract from the otherwise relatively homogeneous MAST items. Traditional statistical approaches for homogeneity suggest high level internal consistency with the deletion of the aforementioned items. A factor analytic test of homogeneity was confirmed. Recommendations are presented concerning modification of the MAST scoring procedures.

Adolescent↗
PubMed2001

Prediction of the physiologic severity of coronary lesions using 3D IVUS: validation by direct coronary pressure measurements.

This study was performed to determine whether three-dimensional intravascular ultrasound (3D IVUS) could predict the physiologic significance of coronary lesions. Seventeen lesions were evaluated by means of 3D IVUS, pressure measurements, and quantitative coronary angiography. Physiologic parameters were calculated from the 3D IVUS measures using established equations and compared to values measured by pressure guidewire. IVUS minimum lumen area (MLA) correlated with fractional flow reserve (FFR; R2 = 0.55, P = 0.003) and pressure gradient (R2 = 0.52, P = 0.003). Lesion length (L) had a positive correlation with pressure gradient (R2 = 0.45, P = 0.007). By multivariate analysis, the only significant independent determinant of FFR was MLA/L measured by IVUS. The IVUS-predicted pressure gradient and FFR were well correlated with values measured directly (R2) = 0.88, P < 0.001; R2 = 0.90, P < 0.001, respectively). The physiologic severity of coronary lesions is primarily influenced by lumen area and lesion length and can be established by 3D IVUS.

Coronary Disease↗
PubMed2000

Ultrasound-guided strategy for provisional stenting with focal balloon combination catheter: results from the randomized Strategy for Intracoronary Ultrasound-guided PTCA and Stenting (SIPS) trial.

BACKGROUND: Intracoronary ultrasound (ICUS) has provided insights into vascular pathology and interventional therapy. The Strategy for ICUS-Guided PTCA and Stenting (SIPS) trial tested the hypothesis that routine ICUS guidance of coronary interventions improves outcome. METHODS AND RESULTS: A single-center consecutive-patient randomized design (with 6-month angiographic and 2-year clinical follow-up) was used. Consecutive patients (no chronic total occlusions or emergency procedures) were randomized to ICUS-guided provisional stenting or standard angiographic guidance. Quantitative angiographic minimal lumen diameter (MLD), angiographic restenosis, clinically driven target lesion revascularization, and major adverse cardiac events (MACEs) were evaluated. A total of 291 procedures (356 lesions) were included. Procedure success was higher in the ICUS-guided group than the group randomized to standard guidance (94. 7% versus 87.4%, respectively; P:=0.033), whereas time (65.2+/-31.0 versus 60.5+/-34.0 minutes, P:=0.18) and contrast use (209.3+/-94.1 versus 197.5+/-89.5 mL, P:=0.23) were not significantly different. Stenting rates were similar (49.7% versus 49.5%, P:=0.89). Acute gain was greater in the ICUS-guided group than in the standard guidance group (1.85+/-0.72 versus 1.67+/-0.76 mm, respectively; P:=0.02). Angiographic 6-month analysis revealed no difference in MLD (1.71+/-0.94 versus 1.57+/-0.90, P:=0.19) or binary restenosis rate (>50% diameter stenosis) (29% versus 35%, P:=0.42). Clinical follow-up (602+/-307 days) showed a significant decrease in clinically driven target lesion revascularization in the ICUS group compared with the standard guidance group (17% versus 29%, respectively; P:=0.02). CONCLUSIONS: Although angiographic MLD did not differ significantly after 6 months, ICUS-guided provisional stenting improved 2-year clinical results after intervention.

Angioplasty, Balloon, Coronary↗
PubMed2000

Effect of cholesterol-lowering therapy on coronary endothelial vasomotor function in patients with coronary artery disease.

BACKGROUND: Improved endothelial function may contribute to the beneficial effects of cholesterol-lowering therapy. METHODS AND RESULTS: In this randomized, double-blind study, we compared the effect of 6 months of simvastatin (40 mg/d) treatment with that of placebo on coronary endothelial vasomotor function in 60 patients with coronary artery disease. Simvastatin lowered LDL-cholesterol by 40+/-12% from 130+/-28 mg/dL (P<0.001). Peak intracoronary acetylcholine infusion produced epicardial coronary constriction at baseline in both the simvastatin (-17+/-13%) and placebo (-24+/-16%) groups. After treatment, acetylcholine produced less constriction in both groups (-12+/-19% and -15+/-14%, respectively, P=0.97). The increase in coronary blood flow during infusion of the peak dose of substance P was blunted at baseline in both the simvastatin (42+/-50%) and placebo (55+/-71%) groups, reflecting impaired endothelium-dependent dilation of coronary microvessels. After treatment, the flow increase was 82+/-81% in the simvastatin group and 63+/-53% in the placebo group (P=0.16). CONCLUSIONS: Six months of cholesterol-lowering therapy has no significant effect on coronary endothelial vasomotor function in the study population of patients with coronary artery disease and mildly elevated cholesterol levels. These findings suggest that the effects of cholesterol lowering on endothelial function are more complex than previously thought.

Adult↗
PubMed2000

Ad hoc coronary intervention.

Ad hoc coronary intervention is a percutaneous revascularization procedure performed at the same sitting as diagnostic cardiac catheterization. While this appears to be an efficient strategy, the safety and cost of ad hoc coronary intervention compared with delayed coronary intervention have not been clearly documented. Special preparation and precautions are necessary for patients in whom ad hoc coronary intervention is anticipated. Ad hoc coronary intervention is not appropriate if informed consent has not been previously obtained or if it would pose greater risks than delayed intervention. While ad hoc coronary intervention is often efficient and effective, its use should be individualized. Cathet. Cardiovasc. Intervent. 49:130-134, 2000.

Cardiac Catheterization↗
PubMed2000

Gallic acid metabolites are markers of black tea intake in humans.

Gallic acid is one of the main phenolic components of black tea. The objective of this study was to identify urinary gallic acid metabolites with potential for use as markers of black tea intake. In an initial study, nine compounds, assessed by using gas chromatography-mass spectrometry, were found to increase in concentration in urine after 3 cups of black tea over 3 h. A subsequent study employed a controlled crossover design in which 10 subjects consumed 5 cups per day of black tea or water for 4 weeks in random order. Twenty-four hour urine samples were collected at the end of each period. Of the 9 candidate compounds identified in the initial study, only 3 were present at higher concentrations in urine of all 10 subjects during tea-drinking in comparison to water-drinking periods. These compounds were identified as 4-O-methylgallic acid, 3-O-methylgallic acid, and 3, 4-O-dimethylgallic acid, all methyl ether derivatives of gallic acid. It is suggested that these compounds have the potential to be used as markers of black tea intake.

Biotransformation↗
PubMed2000

Acute effects of ingestion of black and green tea on lipoprotein oxidation.

BACKGROUND: Tea has been associated with a reduced risk of cardiovascular disease. One proposed mechanism of this risk reduction involves inhibition of lipoprotein oxidation in vivo by antioxidant polyphenolic compounds derived from tea. However, controlled interventions uniformly failed to show that ingestion of tea can inhibit LDL oxidation ex vivo. The absence of effects in previous studies may be due to the isolation of LDL particles from polyphenolic compounds that are present in the aqueous phase of serum. OBJECTIVE: The objective of this study was to examine the acute effects of ingestion of black and green tea on ex vivo Cu(2+)-induced lipoprotein oxidation without prior isolation of lipoproteins from serum. DESIGN: The acute effects of 4 hot drinks-green tea and black tea (each at a dose equivalent to 4 standard cups), water matched to the teas for caffeine content, and water-were assessed in 20 healthy men by using a Latin-square design. The lag time to lipoprotein diene formation, slope of the propagation phase of the oxidation curve, and area under the oxidation curve were calculated. Urinary concentrations of 4-O-methylgallic acid were used as a marker of uptake and metabolism of polyphenolic compounds from tea. RESULTS: Significant increases in urinary 4-O-methylgallic acid for black and green tea (P < 0. 0001) were observed. Caffeine did not significantly influence lipoprotein oxidation. Compared with the water control, there was a greater lag time for black tea (5.4 +/- 2.9 min; P = 0.05) that was of borderline significance and a similar trend for green tea (4.4 +/- 2.8 min; P = 0.17). Slope and area under the oxidation curve were not altered. CONCLUSION: Black tea has a mild acute effect on ex vivo lipoprotein oxidation in human serum. 2000;71:-7.

Adult↗
PubMed1999

Isoflavonoids do not inhibit in vivo lipid peroxidation in subjects with high-normal blood pressure.

The isoflavonoids genistein and daidzein have been shown to have antioxidant activity in vitro, but their effects on in vivo oxidation have not been assessed. The newly described F2-isoprostanes are believed to currently represent the best available marker of in vivo lipid peroxidation. Therefore we have assessed the effects of a 55 mg daily isoflavonoid supplement on urinary F2-isoprostane concentrations in subjects with high-normal blood pressure (BP). A total of 59 subjects completed an 8-week parallel design, randomized, double blind, and placebo-controlled study. F2-isoprostanes, isoflavonoids and creatinine were measured in 24-h urine samples taken at baseline and at the end of the intervention. There were significant increases in urinary excretion of genistein (5.22+/-0.75 mg/day, P < 0.0001) and daidzein (2.53+/-0.43 mg/day, P < 0.0001) in the group taking the isoflavonoid supplement. Creatinine excretion was significantly correlated with F2-isoprostanes at baseline (r = 0.45, P < 0.01). After adjustment for baseline values, there was no significant difference between groups in creatinine adjusted post-intervention F2-isoprostane concentrations (P = 0.74). In addition, changes in genistein and daidzein excretion were not significantly correlated with changes in F2-isoprostanes in the isoflavonoid treatment group. These results are not consistent with the suggestion that the two soy derived isoflavonoids have in vivo antioxidant activity at a level of intake achievable by dietary means and in subjects with high-normal BP.

Adult↗
PubMed1999

Effects of isoflavonoids on blood pressure in subjects with high-normal ambulatory blood pressure levels: a randomized controlled trial.

Vegetarian diets lower blood pressure (BP), but attempts to identify dietary components responsible have been unsuccessful. Isoflavonoids are commonly consumed as part of vegetarian diets. The objective of this study was to assess the effect of isoflavonoid supplementation on BP. Fifty-nine subjects with high-normal range systolic BP completed a randomized, double blind, placebo-controlled trial of two-way parallel design and 8 weeks duration. One tablet containing 55 mg of isoflavonoids, including 30 mg of genistein, 16 mg of biochanin A (a genistein precursor), 1 mg of daidzein, and 8 mg of formononetin (a daidzein precursor), or one placebo tablet, was taken daily with the evening meal. Significant increases in urinary excretion of genistein (5.22 mg/day, 95% CI: 3.72, 6.72) and daidzein (2.53 mg/day, 95% CI: 1.66, 3.40) were observed in the group taking the isoflavonoid supplement. There were no significant changes in isoflavonoid excretion in the placebo group. Clinic BP was measured at two visits, and ambulatory BP monitoring was performed over one 24-h period, at baseline and postintervention. There was no significant difference between groups, after adjustment for baseline values, in postintervention clinic supine BP (systolic 1.2 mm Hg, 95% CI: -2.3, 4.7; diastolic 0.6 mm Hg, 95% CI: -1.9, 2.5), clinic erect BP (systolic 1.7 mm Hg, 95% CI: -4.0, 8.4; diastolic 0.4 mm Hg, 95% CI: -2.4, 3.2), or 24-h ambulatory BP (systolic -1.4 mm Hg, 95% CI: -4.4, 1.6; diastolic -0.8 mm Hg, 95% CI: -2.3, 0.7). Adjustment for age, gender, and weight change did not alter the result. Therefore, these results do not support the hypothesis that isoflavonoids, and genistein in particular, are major contributors to the BP lowering effect of vegetarian diets.

Adult↗
PubMed1999

Effects on blood pressure of drinking green and black tea.

BACKGROUND: The flavonoid components of tea have been associated in epidemiological studies with a decreased risk of cardiovascular disease. Flavonoids have been shown to have antioxidant and vasodilator effects in vitro; we therefore postulated that drinking green or black tea attenuates the well-characterized acute pressor response to caffeine and lowers blood pressure during regular consumption. OBJECTIVE: To determine whether green and black tea can attenuate the transient pressor effect of caffeine, or lower blood pressure during regular consumption. METHODS: In the first study, the acute effects of four hot drinks - green tea and black tea (at a dose equivalent to four standard cups), water matched to the teas for caffeine content ('caffeine') and water - were assessed in 20 normotensive men using a Latin-Square designed study. Clinic blood pressure was measured before and 30 and 60 min after each drink had been ingested. In the second study, the effects on blood pressure of regular green and black tea ingestion were examined in 13 subjects with high-normal systolic blood pressure and mild systolic hypertension (systolic blood pressure in the range 130-150 mmHg) using a three-period crossover study. Five cups per day of green tea, black tea and caffeine (in hot water and matched to the teas) were consumed for 7 days each, in random order. Twenty-four hour ambulatory blood pressure was measured at the end of each seven-day intervention. Results are presented as means and 95% confidence intervals (CI). RESULTS: An acute pressor response to caffeine was observed. Relative to caffeine, there were further acute increases in systolic and diastolic blood pressure at 30 min among those drinking green tea [5.5 mmHg (95%CI -1.4 to 12.4) and 3.1 mmHg (95%CI -0.1 to 6.3), respectively] and black tea [10.7 mmHg (95%CI 4.0 to 17.4) and 5.1 mmHg (95%CI 1.8 to 8.4), respectively]. The changes in blood pressure at 60 min were not significant The effect on 24-h ambulatory systolic and diastolic blood pressure of regular drinking of green tea [increases of 1.7 mmHg (95%CI -1.6 to 5.0) and 0.9 mmHg (95%CI -1.3 to 3.1), respectively] or black tea [increase of 0.7 mmHg (95%CI -2.6 to 4.0) and decrease of 0.7 mmHg (95%CI -2.9 to 1.5), respectively] was not significant relative to caffeine. CONCLUSIONS: Contrary to our initial hypothesis, tea ingestion caused larger acute increases in blood pressure than caffeine alone. However, any acute effects of tea on blood pressure did not translate into significant alterations in ambulatory blood pressure during regular tea consumption.

Adult↗
PubMed1998

Platelet fatty acids and peripheral blood lymphocyte subsets in an institutionalized elderly population.

The associations between platelet fatty acids and peripheral blood lymphocyte subsets were studied in 78 institutionalized elderly individuals (27 men and 51 women), aged 67 to 100. Platelet fatty acids were assessed by gas chromatography, and peripheral blood lymphocyte subsets were quantitated by immunophenotyping using flow cytometry. It was found that women had a higher number of total T-cells (CD3), T-helper (CD3+4+) cells, and B-cells (CD19). However, no gender differences were observed in the percentages of lymphocyte subsets. In elderly men, after adjusting for age and fatty acid intake, the platelet concentration of omega-3 polyunsaturated fatty acids was positively related to the percentage of CD3 and CD3+4+ bearing lymphocytes (rs = 0.59, P < 0.05; and rs = 0.55, P < 0.05, respectively), and the concentration of total saturated fatty acids was also positively associated with the percentage of B (CD19) cells (rs = 0.50, P < 0.05). However, similar relationships were not observed in elderly women. No significant associations were found between trans fatty acids and any of the lymphocyte subsets in the study population. These findings suggest that fatty acids may be related to immune function. Any effects may be important in the host immune defence, especially in elderly individuals.

Aged↗
PubMed1998

Supplementation with isoflavonoid phytoestrogens does not alter serum lipid concentrations: a randomized controlled trial in humans.

Isoflavonoids are a class of flavonoids that are derived in the human diet mainly from soybean-based foods. The major dietary isoflavonoids, genistein and daidzein, have estrogen-like activity and are classed as phytoestrogens. Because estrogens can lower serum LDL cholesterol and raise HDL cholesterol, the objective of this study was to determine if isoflavonoids could improve serum lipids in healthy subjects. Forty-six men and 13 postmenopausal women not receiving hormone replacement therapy completed a randomized, double-blind, placebo-controlled trial of two-way parallel design and 8 wk duration. One tablet containing 55 mg of isoflavonoids (predominantly in the form of genistein) or one placebo tablet was taken daily with the evening meal. Subjects maintained their usual diet and physical activity, which were unchanged throughout the intervention. Measurement of isoflavonoids and their metabolites in 24-h urine samples provided an assessment of compliance and of isoflavonoid metabolism. Serum total, LDL, HDL and HDL subclass cholesterol, triglycerides and lipoprotein (a) were assessed at baseline and during the last week of intervention. After adjustment for baseline values, no significant differences in postintervention serum lipid and lipoprotein (a) concentrations between groups were identified. Further adjustment for age, gender and weight change did not alter the results. In addition, changes in urinary isoflavonoids were not significantly correlated with changes in serum lipids and lipoprotein (a). Therefore, this study does not support the hypothesis that isoflavonoid phytoestrogens can improve the serum lipids, at least in subjects with average serum cholesterol concentrations.

Adult↗
PubMed1997

Improved procedural results of coronary angioplasty with intravascular ultrasound-guided balloon sizing: the CLOUT Pilot Trial. Clinical Outcomes With Ultrasound Trial (CLOUT) Investigators.

BACKGROUND: Indiscriminate use of balloons larger than the angiographic reference segment lumen results in high rates of ischemic complications after percutaneous transluminal coronary angioplasty (PTCA). We hypothesized that angiographically unsuspected atheromatous remodeling with vessel expansion (the Glagov phenomenon) at and adjacent to PTCA target lesions would safely accommodate oversized balloons in selected patients undergoing PTCA with intravascular ultrasound (IVUS) guidance. METHODS AND RESULTS: After angiographically guided PTCA of 104 lesions in 102 patients, IVUS was performed, and if atheromatous remodeling was present, PTCA was repeated with larger balloons sized halfway between the lumen and external elastic membrane. Plaque occupied a mean of 51+/-15% of the angiographically "normal" reference segments. Further balloon upsizing by 0.25 to 1.25 mm was therefore performed in 76 lesions (73%), increasing the nominal balloon-to-artery ratio from 1.12+/-0.15 after standard PTCA to 1.30+/-0.17 after IVUS-guided PTCA (P<.0001). As a result, the angiographic minimal luminal diameter further increased from 1.95+/-0.49 to 2.21+/-0.47 mm, the % diameter stenosis fell from 28+/-15% to 18+/-14%, and the IVUS lumen area rose from 3.16+/-1.04 to 4.52+/-1.14 mm2 (all P<.0001). The incidence of angiographic dissection was not increased after IVUS-guided balloon upsizing (37% versus 40%, P=.67), and major complications occurred in only 2 patients (1.9%). CONCLUSIONS: The demonstration by IVUS of atheromatous remodeling permits the safe use of balloons traditionally considered oversized, resulting in significantly improved luminal dimensions without increased rates of dissection or ischemic complications.

Aged↗
PubMed1997

Single device approach to ultrasound-guided percutaneous transluminal coronary angioplasty and stenting: initial experience with a combined intracoronary ultrasound/variable diameter balloon.

We evaluated the use of both intracoronary ultrasound (ICUS) information and unique balloon characteristics provided by a combined ICUS/variable diameter balloon catheter during coronary interventions to achieve the maximal residual lumen using the least number of devices. In 47 patients, 64 coronary lesions were treated with either sequential percutaneous transluminal coronary angioplasty (PTCA) (n = 40) or stenting (primary [n = 17], secondary [n = 7]). The result after PTCA was judged satisfactory if the lumen cross sectional area (by ICUS) in the lesion exceeded 65% of the mean reference area. Stent implantation was judged according to revised MUSIC trial criteria. PTCA or stenting was successful in all 64 lesions using 47 combination devices and 10 conventional balloons (mean number of balloons per lesion: 0.90). PTCA group: diameter stenosis decreased from 78 +/- 11 to 23 +/- 13% following inflation at 10.3 +/- 3.0 atm. ICUS lumen area was 4.6 +/- 1.9 mm2 (proximal reference: 7.4 +/- 3.3 mm2, distal reference: 5.7 +/- 1.8 mm2) resulting in a residual area stenosis of 28 +/- 15%. Stent group: diameter stenosis was reduced from 77 +/- 14 to 10 +/- 10% after stenting. ICUS defined minimal lumen area in the stent was 8.2 +/- 2.2 mm2 (proximal reference: 8.7 +/- 2.6 mm2, distal reference: 8.0 +/- 2.2 mm2) resulting in a residual area stenosis of 7.2 +/- 14.6%. No patient death, myocardial infarction, or emergency surgery occurred and only one target lesion required re-PTCA during hospitalization. In conclusion, use of a combined ICUS/variable diameter balloon catheter allows a single device strategy for ICUS-guided PTCA and stenting in the majority (84%) of unselected lesions.

Adult↗