PubMed Health⌕ Search

Biomedical subjects

J Saini

Publications and source records attributed to J Saini.

33 records · Page 2Linked to original sources
PubMed1992

Lack of diurnal rhythm in plasma atrial natriuretic peptide.

The occurrence of a circadian rhythm in the concentration of circulating atrial natriuretic peptide (ANP) is not clearly established. To investigate diurnal changes, plasma levels of ANP were measured at 10-min intervals for 24 hours in six normal volunteers. The subjects were studied once during a normal sleep-wake cycle and once during a cycle with a shifted sleep period. They received continuous enteral nutrition from 8 hours preceding the experiment until the end of the experiment, throughout this time the subjects remained in a supine position. The mean ANP levels did not differ significantly between the sleep periods and the periods spent awake in either of the protocols, which provides evidence of a lack of a sleep-related influence of ANP. A significant linearity of the mean ANP profile was observed, smoothing out the transient and randomly occurring fluctuations in individual ANP concentration. These results lead to the conclusion that ANP secretion is neither under the control of endogenous circadian rhythmicity nor is it affected by sleep-regulatory mechanisms.

Adult↗
PubMed1992

Management of the oral and maxillofacial surgery patient with end-stage renal disease.

Chronic renal failure (CRF) is the consequence of a multitude of diseases that cause permanent destruction of the nephron. Concurrent with renal failure are a host of changes affecting the homeostatic functioning of the individual. This report outlines the pathophysiology of CRF and highlights its effects on surgical manipulation of the oral and maxillofacial region in this patient population. In addition, some of the common physical findings and alterations in blood chemistries frequently observed in these patients are discussed.

Bleeding Time↗
PubMed1992

Nocturnal plasma thyrotropin variations are related to slow-wave sleep.

The thyrotropin (TSH) nycthemeral pattern is known to be strongly influenced by sleep, but previous studies have failed to demonstrate any link between sleep structure and TSH variations. Using 10-min blood sampling, nocturnal TSH profiles were analysed in 24 young healthy subjects during normal sleep. Six of the subjects then underwent a partial sleep deprivation experiment, sleep was permitted from 03.00 hours to 07.00 hours. Descending slopes of TSH values were observed for the first 20 minutes of SWS episodes, whereas no significant trend was found for other sleep stages. During the period of sleep deprivation, nocturnal TSH levels increased and then declined immediately after sleep onset; however, the association between SWS and descending TSH slopes persisted. This temporal concordance suggests that some particular mechanisms associated with SWS may modulate TSH release, or conversely that increasing TSH levels prevent the occurrence of SWS.

Journal Article↗
PubMed1990

Growth hormone and prolactin response to rehydration during exercise: effect of water and carbohydrate solutions.

The effect of progressive rehydration with either water or a carbohydrate solution on the plasma growth hormone (GH) and prolactin (PRL) response to exercise was examined together with plasma somatostatin. Five subjects underwent four 3-h experimental sessions at 36 degrees C in which 25-min exercise periods alternated with 5-min rest periods. The sessions were conducted without fluid replacement (DH) or under rehydration with either water or isosmotic carbohydrate solutions AISO (acid) or NISO (neutral). The fluid was given every 10 min after the 1st h of exercise. Plasma GH increased significantly (p less than 0.01) under DH after 2 and 3 h of exercise; this increase was prevented by rehydration with water, AISO and NISO. Plasma glucose was significantly higher following AISO and NISO rehydration compared with DH. This possibly influenced the GH response, but there was no difference between plasma glucose levels under DH and water rehydration at any time. The solutions tended to attenuate the increase in heart rate, rectal temperature and plasma cortisol, suggesting that the lack of GH response under rehydration conditions is a result of decreasing physiological stress levels. The GH response could not be explained by plasma somatostatin, which tended to decline in all sessions. Plasma PRL did not increase in any of the sessions, confirming that exercise without rehydration is a more potent stimulator of GH than of PRL. It is concluded that progressive rehydration with water is sufficient to prevent the exercise-induced increase in plasma GH.

Adult↗
PubMed1990

Nocturnal oscillations of plasma aldosterone in relation to sleep stages.

This study examined the relationship between aldosterone secretion and sleep stages in conjunction with two aldosterone regulating hormone systems, the renin-angiotensin system (RAS) and adrenocorticotropin (ACTH), and also K+. Nocturnal plasma patterns of aldosterone, plasma renin activity (PRA), ACTH and K+ were established in blood collected at 10-min intervals in two groups of 6 subjects. Both groups underwent two 9 hour overnight-studies, consisting of one control night and one experimental night. The first group was maintained on a low Na diet and the other was given a beta-blocker, atenolol. Polygraphic recordings of sleep were scored according to established criteria. For the control night, REM sleep usually began at peak level or in the descending phase of aldosterone oscillations. As previously described, PRA reflected REM-NREM sleep alteration, levels increased in NREM and decreased during REM sleep. ACTH fluctuations did not oscillate with sleep stages, but levels were very seldom in the ascending phase at REM sleep onset. Plasma K+ remained almost constant throughout the night. The relative importance of the ACTH and the RAS on nocturnal aldosterone secretion and the relationship between aldosterone oscillations and sleep stages remained unclear. Modulating renin levels by either consuming a low Na diet or administration of a beta-blocker enabled this relationship to be clarified. The RAS dominated aldosterone secretion when stimulated by a low sodium diet. Aldosterone oscillations then reflected PRA oscillations with a delay of about 20 min and the relationship of aldosterone to sleep stages was dependent on the relationship of PRA with sleep stages.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenocorticotropic Hormone↗
PubMed1990

Blood pressure and dietary intake in a French population sample from three regions.

In order to determine the possible relationship between nutritional factors and blood pressure (BP), a sample of 1128 men of the population living in the three French MONICA centres, Bas-Rhin (BR), Haute-Garonne (HG) and the Urban Community of Lille (UCL), was included in a nutritional survey. Of the sample, 16.2% were taking antihypertensive drugs and 34.1% of the remainder had high BP. Prevalence of high BP was greater in BR and UCL than in HG, the differences persisting after adjustment for body mass index (BMI) and age. BMI and geographic location were the best predictors of high systolic BP (SBP) and diastolic BP (DBP). Age was positively correlated with SBP, but not with DBP. Alcohol intake was the dietary component which had the most consistent relationship with SBP and DBP. However, greater intakes of total fat and of cholesterol were also associated with higher DBP and SBP respectively. A small but significant contribution of sodium chloride to SBP and DBP was also found, whereas no influence of the intake of calcium or of any diary product was observed.

Age Factors↗
PubMed1989

Early parenteral feeding of amino acids.

Serial 24 hour balance studies of nitrogen and energy were carried out over 10 days in two groups of ventilator dependent preterm infants, of comparable weight and gestational age. In one group (n = 10) a parenteral amino acid source (Vamin 9) was started within 24 hours of birth, and in the other group (n = 11) it was not started until 72 hours. The feeding protocol was otherwise identical. The nitrogen intake (286 compared with 21 mg/kg/day), energy intake (188 compared with 151 kJ), and nitrogen retention (120 compared with -133 mg/kg/day), were all significantly higher during the first three days of life in the group in which the amino acid solution was started early. There were no differences by 7-10 days. The early introduction of amino acids improves the early nutritional state of sick preterm infants.

Amino Acids↗
PubMed1989

The sick very low birthweight infant fed by parenteral nutrition: studies of nitrogen and energy.

Nine ventilator-dependent intravenously-fed very low birthweight infants with a mean birthweight of 938 (range 760-1100)g and mean gestation of 27 (range 25-29) weeks were studied provided they continued to receive more than 85 per cent of their nutritional needs intravenously. Metabolic balance studies of nitrogen over 72h were undertaken between 2 and 45d postnatal age. The average number of balances performed on each infant was three. The balances were performed at a mean postconceptional age of 5, 15, 25 and 37d. The data were compared to postconceptional age-matched fetal values and to published data from well enterally-fed infants at equivalent postnatal ages and matched for postconceptional age. There was a steady increase in length, weight and head circumference throughout the study period. The mean (range) nitrogen retention was 340 (229-415) mg/kg/d and was similar to intrauterine accretion after 200d postconceptional age, and comparable to nitrogen retention rates seen in well and enterally-fed premature infants. We conclude that parenteral nutrition can sustain growth and support nitrogen retention in the small preterm infant requiring intensive care.

Anthropometry↗
PubMed1988

The relationship between heart rate, heart rate variability and depression in patients with coronary artery disease.

Seventy-seven patients undergoing elective cardiac catheterization were administered a diagnostic psychiatric interview and their mean heart rates and heart rate variability were determined from the results of a 24 hr ambulatory ECG. The mean heart rate for depressed patients with coronary artery disease (CAD) was significantly higher than for nondepressed CAD patients, independent of the patient's age, smoking status, and beta blocker therapy. Heart rate variability was lower in depressed patients but did not achieve significance. With the exception of smoking, which was more common in depressed patients, there were no significant differences between the depressed and nondepressed patients on any other medical or demographic variable assessed. It is concluded that elevated heart rate may represent increased sympathetic tone in depressed CAD patients, and may help to explain the increased morbidity and mortality reported in these patients.

Arousal↗
PubMed1987

Major depressive disorder in coronary artery disease.

Depression has been reported to be common in patients with coronary artery disease (CAD), using a variety of criteria for the diagnosis of depression. However, many studies have relied solely on the presence of symptoms such as a dysphoric mood and fatigue in making a diagnosis of depression. Both fatigue and dysphoric mood are also associated with medical illnesses, and psychiatric diagnoses based on such nonspecific symptoms may lack the specificity necessary to predict the need for psychiatric treatment. To assess the incidence of depression likely to require and respond to psychiatric treatment, 50 patients documented to have CAD by coronary angiography underwent psychiatric diagnostic interviews. Current research-based criteria (DSM-III) were used to make diagnoses of major depressive disorder. In addition, the applicability of a brief screening inventory the (Beck depression inventory) for detecting the presence of depression in these patients was tested. Nine patients (18%) met criteria (DSM-III) for major depressive episode. Depression was not related to the extent of CAD, age or use of beta blockers. There was a relation between depression and smoking. Only 2 of the 9 depressed patients had been diagnosed previously and were being treated for depression. When a score of greater than or equal to 10 on the Beck depression inventory was used to distinguish patients with depression, it had moderate sensitivity (78%) and specificity (90%) for the identification of depression.

Aged↗
PubMed1987

Prevalence of major depressive disorder in patients receiving beta-blocker therapy versus other medications.

Depression is believed to be a common side effect in patients receiving beta-blocker therapy. However, diagnoses of depression defined by current diagnostic criteria may not be more common in patients receiving beta-blockers than in patients with the same medical disorder receiving other medications. Seventy-seven patients undergoing elective cardiac catheterization for evaluation of chest pain received a semi-structured diagnostic psychiatric interview. Twenty-one percent of the patients receiving beta-blockers and 33 percent of the patients receiving medications other than beta-blockers met the current American Psychiatric Association criteria for major depressive disorder (DSM-III) (p = NS). The mean heart rate and state anxiety scores for patients taking beta-blockers were significantly lower than those measured in patients taking medications other than beta-blockers. No other medical or demographic differences were observed between the two groups. Despite the methodologic limitations of the study, there does not appear to be a difference in the point prevalence of depression between patients receiving beta-blockers and those receiving other medications.

Adrenergic beta-Antagonists↗
PubMed1987

Reversibility of severe left ventricular dysfunction due to doxorubicin cardiotoxicity. Report of three cases.

Doxorubicin is a potent anticancer agent effective in a wide range of malignancies, but its use is limited by dose-dependent late cardiotoxicity. Severe doxorubicin cardiotoxicity has been associated with a poor prognosis and a high mortality rate, and until recently has been thought to be irreversible. We describe the cases of three patients with well-documented severe left ventricular dysfunction due to doxorubicin who had complete clinical recovery with return of cardiac function to normal. Because severe doxorubicin cardiotoxicity is reversible in some patients, aggressive supportive therapy is warranted.

Adult↗
PubMedDate not supplied

Major depressive disorder predicts cardiac events in patients with coronary artery disease.

Fifty-two patients undergoing cardiac catheterization and subsequently found to have significant coronary artery disease (CAD) were given structured psychiatric interviews before catheterization. Nine of these patients met criteria for major depressive disorder. All 52 patients were contacted 12 months after catheterization, and the occurrence of myocardial infarction, angioplasty, coronary bypass surgery and death was determined. Results of the study show that major depressive disorder was the best predictor of these major cardiac events during the 12 months following catheterization. The predictive effect was independent of the severity of CAD, left ventricular ejection fraction, and the presence of smoking. Furthermore, with the exception of smoking, there were no statistically significant differences between those patients with major depressive disorder and the remaining patients on any variable studied. The possible mechanisms relating major depressive disorder to subsequent cardiac events are discussed. It is concluded that major depressive disorder is an important independent risk factor for the occurrence of major cardiac events in patients with CAD.

Angioplasty, Balloon↗
PubMedDate not supplied

Twin very low birth weight infants: a study of nutritional and hormonal status.

Nonidentical twin male infants (twin 1,950 g birth weight, twin 2,970 g) had their nutritional and hormone status studied for up to 59 days. Both infants received parenteral nutrition up to 32 days postnatally; enteral feeding was then established in twin 1; in twin 2 parenteral feeding was recommenced on day 35, for the remainder of the study. Serial 72-hr metabolic balances were performed in both infants at 4, 32, 45, and 56 days postnatally. Insulin-like growth factor I (IGF-I) and growth hormone were assayed on day 2 of each balance. During the course of the study growth was similar in each infant. Overall mean daily energy intakes were 90 kcal/kg/day and 84 kcal/kg/day and percentage nitrogen retention was 62% and 55% in twin 1 and twin 2, respectively. No differences were observed between the two infants in IGF-I or growth hormone. Despite low energy intakes incremental weights were within an acceptable range for both infants.

Energy Intake↗