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Biomedical subjects

J R Hayes

Publications and source records attributed to J R Hayes.

At least 19 recordsLinked to original sources
PubMed1992

Impaired endothelium-dependent and independent vasodilation in patients with type 2 (non-insulin-dependent) diabetes mellitus.

The endothelium plays a pivotal role in modulating the reactivity of vascular smooth muscle through the formation of several vasoactive substances. We examined the effects of endothelium-dependent and independent vasodilators on forearm blood flow in 29 patients with Type 2 (non-insulin-dependent) diabetes mellitus and in 21 control subjects, using venous occlusion plethysmography. Via a brachial artery cannula, increasing amounts of acetylcholine and glyceryl trinitrate were infused in doses of 60, 120, 180 and 240 mmol per min and 3, 6 and 9 nmol per min respectively. NG monomethyl-L-arginine, a stereospecific inhibitor of endothelium derived relaxing factor, was infused to inhibit basal and stimulated release of this dilator substance. Reactive hyperaemic forearm blood flow did not differ between groups. Forearm blood flow responses to each dose of acetylcholine were significantly greater in control than diabetic subjects (p less than 0.01 for all doses). NG monomethyl-L-arginine attenuated forearm blood flow from maximal stimulated values when responses were compared with the natural decline to acetylcholine in forearm flow in both control and diabetic subjects (p less than 0.05 for both groups), but had no effect on basal blood flow responses. Forearm blood flow responses to each dose of glyceryl trinitrate were significantly greater in control than diabetic subjects (p less than 0.05 for all). These data provide evidence for endothelial and smooth muscle dysfunction in diabetes which may have important therapeutic implications.

Acetylcholine↗
PubMed1992

A study of experimental lancets for blood collection to avoid bone infection of infants.

We describe a study made at two pediatric centers to test experimental lancets for blood collection by skin puncture of infants' heels or fingers. Our primary goal is to decrease the hazard of osseous injury while collecting adequate blood, by using three lancet widths at a constant length of 1.0 mm. The three widths used were 1.0, 1.25, and 1.5 mm. When success at skin puncture was defined rigidly on the basis of the blood volume obtained, the data show that success was related neither to the lancets' dimensions as tested nor to the age of the child, but rather to the phlebotomist's skill and experience, which improved with time.

Blood Specimen Collection↗
PubMed1991

Bone mass in healthy children: measurement with quantitative DXA.

Dual-energy x-ray bone densitometry was used to study the lumbar vertebral bone mass in 218 healthy children (134 girls and 84 boys) aged 1-19 years. Vertebral bone mass increased with weight, age, and pubertal Tanner stage. Results of multiple regression analyses showed that Tanner stage and weight were the best predictive indicators of bone mass and bone mineral density. The influences of age, sex, race, physical activity, and diet were not significant when Tanner stage and weight were controlled. Two tables of predictive intervals for lumbar vertebral bone mineral density in healthy children (one based on Tanner stage and weight; the other, on age and weight) are presented. With normative data now available for use with this precise technique, clinicians can better detect abnormal bone mineral density in children and evaluate changes in mineralization over time.

Absorptiometry, Photon↗
PubMed1991

Effect of sustained mesenteric nerve stimulation on intestinal oxygenation in developing swine.

The effects of sustained mesenteric nerve stimulation on intestinal oxygenation were determined in 3- and 35-day-old swine. Studies were conducted in pentobarbital-anesthetized animals during free-flow or constant-flow perfusion. Square-wave stimuli sufficient to induce maximal resistance vessel constriction were applied to postganglionic periarterial mesenteric nerves and each stimulation was sustained until measured variables reached steady state. When vascular resistance data were analyzed without data transformation, autoregulatory escape of intestinal vascular resistance was more complete in 3- than in 35-day-old animals when the escape process was complete; however, expression of these data as escape indexes revealed a similar degree of escape in both age groups. In 35-day-old animals, (a-v)O2 increased during sustained nerve stimulation under free-flow conditions; under constant-flow conditions, (a-v)O2, 86Rb extraction, and capillary permeability-surface area product were lower at completion of the escape process compared with baseline. In 3-day-old swine, these variables remained unchanged from baseline. Intestinal O2 uptake was compromised by sustained nerve stimulation, and this effect was similar in both age groups. We conclude that sustained nerve stimulation reduces intestinal oxygenation to a similar degree in 3- and 35-day-old swine. It is important to note, however, that the response of 3-day-old swine may be dissimilar from that which occurs during immediate postnatal life; indeed, the intestinal hemodynamic response of swine less than or equal to 1 day old should not be extrapolated from the response of 3-day-old animals.

Aging↗
PubMed1991

Depression and chronic fatigue in cancer patients.

Fatigue is a very common symptom among cancer patients. It is crucial to diagnose those patients for whom the fatigue is a symptom of depression, and to treat them appropriately. The key to providing complete and satisfying care is to identify and address the psychologic, social, and medical vulnerabilities of each cancer patient. No one is in a better position to accomplish that than the primary physician.

Depression↗
PubMed1990

Chemical and biological studies of a cigarette that heats rather than burns tobacco.

Cigarettes can be developed that heat rather than burn tobacco. Such products would be expected to have less "tar" and other combustion products than cigarettes that burn tobacco. With one product of this type, benzo(a)pyrene, N-nitrosamines, phenolic compounds, acetaldehyde, acrolein, hydrogen cyanide, and N-heterocyclic compounds have been reduced 10- to 100-fold compared to the Kentucky reference (1R4F) cigarette, a representative low-tar cigarette. The yields of nicotine and carbon monoxide from this new cigarette are less than the yields of 95% and 75%, respectively, of the cigarettes sold in the United States during 1988. Nicotine absorption from smoking this new cigarette is not significantly different from that of tobacco-burning cigarettes yielding equivalent levels of nicotine. The urine mutagenicity of smokers of new cigarettes is significantly less (P less than .05) than that of smokers of tobacco-burning cigarettes and is not significantly different (P greater than .10) from that of nonsmokers. We conclude that cigarettes which heat rather than burn tobacco can reduce the yield of tobacco combustion products. This simplification of smoke chemistry had no effect on nicotine absorption in smokers and resulted in a reduction of biological activity in smokers as measured by urine mutagenicity.

Adult↗
PubMed1990

A comparison of peripheral vasoconstrictor responses and cardiovascular autonomic function tests in diabetic patients.

Venous occlusion plethysmography has been used to measure sympathetic vasoconstrictor responses in the feet and hands to a deep breath and body cooling and to assess blood flow variability. Measurements were made in 14 non-diabetic control subjects and 52 diabetic patients, 30 of whom had evidence of peripheral neuropathy. All the measurements were significantly reduced in the feet of patients with neuropathy. Vasoconstrictor responses were not significantly impaired in the hands of these patients. Cardiovascular autonomic function was assessed in the same subjects by standard tests of reflex heart rate responses and compared to sympathetic vasoconstrictor function as determined by the response to a deep breath. Eighteen of the 30 diabetic patients with peripheral neuropathy had impairment of both cardiovascular and sympathetic vasoconstrictor function. Five had normal vasoconstrictor but impaired cardiovascular responses and two had normal cardiovascular but impaired vasoconstrictor function. It may therefore be important to assess both systems in diabetic patients.

Blood Pressure↗
PubMed1990

A comparison of the free radical chemistry of tobacco-burning cigarettes and cigarettes that only heat tobacco.

Cigarette smoke contains free radicals both in the particulate matter (tar) and in vapor-phase smoke. Vapor-phase smoke decreases the activity of alpha-1-proteinase inhibitor (alpha 1PI) in vitro. The free radical content of the tar and vapor-phase smoke from a cigarette that heats rather than burns tobacco has been compared with data on a standard 1R4F cigarette. No radicals were detected in the tar from the new cigarette and radicals in its vapor-phase smoke are lower by more than 99% relative to the 1R4F standard cigarettes. The vapor-phase smoke from the new cigarette causes essentially no reduction of alpha 1PI activity in vitro. These findings support our previously published mechanisms for the production of radicals in tar and in vapor-phase smoke.

Free Radicals↗
PubMed1990

Optimal sites and depths for skin puncture of infants and children as assessed from anatomical measurements.

Postmortem measurements were made of distances from skin surface to underlying bone/cartilage on 43 children (up to 8 y old; weights from 0.7 to 26.4 kg) to determine optimal sites and lengths of lancet tips for skin puncture of the heel, great toe, and middle finger. For measuring depths, a needle-like probe was devised that minimized disfigurement. As long as the infant's heel was available for puncture prior to callus formation (to about six months), it offered the greatest depth and the bone/cartilage of the lateral/medial sites was considerably deeper than posterior sites. At age six months, the mean distance of skin surface. At age six months, the mean distance of skin surface to bone/cartilage in the middle finger was 2.5 mm, the lower 95% prediction interval being 1.5 mm. Lengths of lancet tips for finger puncture should therefore be made less than 1.5 mm. To get the desired volumes of blood, a compromise must be reached between depth and width of the lancet tip.

Aging↗
PubMed1989

Motor vehicle driving among diabetics taking insulin and non-diabetics.

OBJECTIVE: To determine whether rates of road traffic accidents were higher in diabetics treated with insulin than in non-diabetic subjects. DESIGN: Controlled, five year retrospective survey. SETTING: Diabetic, dermatology, and gastroenterology outpatient clinics. PATIENTS: 596 Diabetics treated with insulin (354 drivers) aged 18-65 attending two clinics and 476 non-diabetic outpatients (302 drivers). MAIN OUTCOME MEASURES: Rates of accidents in diabetic and non-diabetic subjects. RESULTS: A self completed questionnaire was used to record age, sex, driving state, and rates of accidents and convictions for motoring offences among diabetic and non-diabetic volunteers. For the diabetic volunteers further information was obtained on treatment, experience of hypoglycaemia, and declaration of disability to the Driving and Vehicle Licensing Centre and their insurance company. Accident rates were similar (81 (23%) diabetic and 76 (25%) non-diabetic drivers had had accidents in the previous five years). A total of 103 diabetic drivers had recognised hypoglycaemic symptoms while driving during the previous year. Only 12 reported that hypoglycaemia had ever caused an accident. Overall, 249 had declared their diabetes to an insurance company. Of these, 107 had been required to pay an increased premium, but there was no excess of accidents in this group. CONCLUSIONS: Diabetic drivers treated with insulin and attending clinics have no more accidents than non-diabetic subjects and may be penalised unfairly by insurance companies.

Accidents, Traffic↗
PubMed1989

Psychomotor performance and counterregulatory responses during mild hypoglycemia in healthy volunteers.

The effect of mild hypoglycemia on psychomotor performance and counterregulatory responses was studied among 12 healthy volunteers. Each volunteer received two modified hyperinsulinemic glucose clamps. One morning, plasma glucose was held constant at euglycemic levels (4.9 mM) for 95 min, and another morning, it was lowered over 35 min and then held constant at hypoglycemic levels (3.4 mM) for 60 min. A battery of psychomotor tests and a questionnaire assessing hypoglycemic symptoms were administered before and repeated during the last 30 min of each clamp. The questionnaire and three selected psychomotor tests were also administered repetitively during the 1st h of each clamp. During the hypoglycemic studies, a rise was seen in plasma epinephrine and pancreatic polypeptide at 45 min. An increase in symptom scores was first recorded at 50 min during the hypoglycemic studies [median 4 (range 0-13) vs. 2 (5-6), P less than .05]. Performance was impaired on two psychomotor tests included in the battery. One was the trail making test on fine motor performance (-19.3 +/- 4.2 targets/min, mean +/- SE vs. 1.2 +/- 4.8 targets/min, P less than .05), and the other was the digit-symbol substitution (DSS) test on information processing and memory (18 +/- 3 vs. 29 +/- 4 symbols/min, P less than .03). Of the tests administered during the 1st h, performance was impaired on the DSS. This impairment became significant at 45 min (14 +/- 4 vs. 22 +/- 4 symbols/min, P less than .005). In conclusion, mild hypoglycemia selectively impairs psychomotor performance in healthy volunteers but not before the onset of glucose counterregulation and warning symptoms.

Adult↗
PubMed1988

Pulmonary involvement in ulcerative colitis.

Pulmonary involvement in ulcerative colitis usually presents as a rapidly progressive cough with copious amounts of sputum. Although it is rare, distressing symptoms may be relieved by inhaled steroids in 50-60% of cases. Three case reports are presented along with a review of the features of 28 other cases.

Adult↗
PubMed1988

Serum concentrations of trypsin-like immunoreactivity and pancreatic isoamylase in insulin dependent diabetic patients.

Serum trypsin-like immunoreactivity and pancreatic isoamylase were measured in 302 insulin-dependent diabetic patients (166 men) using radioimmunoassay for the former and a photocolorimetric method for the latter. There was a significant correlation between the two enzymes (r = 0.67, p less than 0.0001) with lower concentrations of both trypsin-like immunoreactivity (208.8 micrograms/L) and pancreatic isoamylase (67.5 U/L) in diabetic patients as compared to controls (p less than 0.0001). Using multiple regression analysis, a statistically significant association was only apparent between enzyme concentrations and age at onset of diabetes (r = 0.31, p less than 0.0001). The results suggest that impaired exocrine pancreatic function may occur in an appreciable proportion of diabetic patients and also that a primary insult to the exocrine pancreas occurring at the time of endocrine injury may be a contributory factor.

Adolescent↗
PubMed1988

Depression in medical in-patients.

Between one-fifth and one-third of patients hospitalized on general medicine wards experience significant depressive symptoms during their hospitalization. This study employed 71 general medical in-patients and examined the relative association of illness/hospitalization characteristics, patient characteristics and environmental characteristics with in-patient medical depression. Multiple regression results indicated that in-patient medical depression was related to pre-hospitalization depression and social functioning, patient perception of physician supportiveness and patient perception of illness-related life-disruption. None of the objective illness/hospitalization variables related to depression while in the hospital. These results are interpreted with regard to several current theories in medical psychology including a life-stress model emphasizing the ability of prior disorder to predict subsequent disorder, a social interaction model focusing on the effects of physicians' supportive behaviour on patients' emotional adjustment in the hospital, and models of illness that stress cognitive appraisal in determining illness-related mood and behaviour.

Adolescent↗