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Biomedical subjects

K Brownell

Publications and source records attributed to K Brownell.

6 recordsLinked to original sources

Acetylcholine receptor antibodies in myasthenia gravis are associated with greater risk of diabetes and thyroid disease.

OBJECTIVE: Myasthenia gravis (MG) may be associated with the presence of acetylcholine receptor antibodies (AChRAb) [seropositive MG (SPMG)] or their absence [seronegative MG (SNMG)]. Along with features of MG, the presence of the AChRAb may relate to the existence of other immune-mediated diseases. We sought to determine the association of SPMG with other potential autoimmune diseases. METHODS: A retrospective evaluation of prospectively identified MG patients at a tertiary care center was performed, with patients separated into SPMG and SNMG. Prevalence of other immune-mediated disorders, as well as the epidemiology, sensitivity of diagnostic testing, and thymic pathology, was contrasted between both patient groups. RESULTS: Of the 109 MG patients identified, 66% were SPMG. SPMG was associated with a greater likelihood of significant repetitive stimulation decrement, the presence of either thymoma or thymic hyperplasia, and the presence of thyroid disease. In addition, all patients with a diagnosis of diabetes, concurrent with MG, were found to be SPMG. CONCLUSIONS: AChRAb and SPMG impart not only a distinctive clinical and electrophysiological phenotype of MG, but are also associated with the heightened presence of endocrinological disease.

Adolescent↗

Stress may add bite to appetite in women: a laboratory study of stress-induced cortisol and eating behavior.

To date, there are few known predictors of stress-induced eating. The purpose of this study was to identify whether physiological and psychological variables are related to eating after stress. Specifically, we hypothesized that high cortisol reactivity in response to stress may lead to eating after stress, given the relations between cortisol with both psychological stress and mechanisms affecting hunger. To test this, we exposed fifty-nine healthy pre-menopausal women to both a stress session and a control session on different days. High cortisol reactors consumed more calories on the stress day compared to low reactors, but ate similar amounts on the control day. In terms of taste preferences, high reactors ate significantly more sweet food across days. Increases in negative mood in response to the stressors were also significantly related to greater food consumption. These results suggest that psychophysiological response to stress may influence subsequent eating behavior. Over time, these alterations could impact both weight and health.

Adult↗

Body weight change, all-cause mortality, and cause-specific mortality in the Multiple Risk Factor Intervention Trial.

OBJECTIVE: To evaluate the relation between weight variability and death in high-risk, middle-aged men participating in the Multiple Risk Factor Intervention Trial (MRFIT). DESIGN: Cohort study with 3.8 years of follow-up. SETTING: Multicenter, collaborative, primary prevention trial conducted at 22 clinical centers in the United States. PARTICIPANTS: Men (n = 10,529) who were 35 to 57 years old at baseline and who were in the upper 10% to 15% of risk for coronary heart disease because of smoking, high blood pressure, and elevated cholesterol level. Participants were seen at least annually for 6 to 7 years for medical evaluations in study clinical centers. MEASUREMENTS: Death from cardiovascular disease (228 deaths) and from all causes (380 deaths). RESULTS: The primary measure of weight variability was the intrapersonal standard deviation of weight (ISD), which was calculated from measured weights obtained at clinic visits during a 6- to 7-year period. All-cause death rates per 1000 person-years of follow-up across ISD quartiles were 8.28, 8.25, 10.57, and 11.07 from the first to fourth quartiles, respectively. After adjusting for baseline risk factors associated with weight change, the relative risk for all-cause mortality in the fourth compared with the first quartile was 1.64 (95% CI, 1.21 to 2.23). Cardiovascular death and ISD showed a similar pattern. The association between weight change and death was not observed in the heaviest men. CONCLUSION: Greater weight variability was associated with a greater risk for cardiovascular disease and all-cause mortality in some types of high-risk men.

Adult↗

Plasma fenfluramine levels, weight loss and side effects: a failure to find a relationship.

Thirty-six women were treated for 16 weeks with fenfluramine and behavior therapy. There was a strong correlation between drug dosage and plasma levels of fenfluramine. In contrast to two previous reports, however, there was no correlation between plasma levels of fenfluramine and its metabolite norfenfluramine and weight loss, nor was there any correlation between these levels and side effects. If weight loss is not related to drug levels, as suggested by this report, there is no merit in increasing drug levels to tolerance as is the current practice; modest dosage to produce modest drug levels is indicated.

Adult↗

Congenital cervical spinal atrophy.

Three children presented at birth with axial hypotonia and symmetrical flaccid paresis limited to the upper extremities, and involving proximal and distal muscle groups. At birth, palmar flexion creases were poorly developed, and the hand muscles were atrophic. These clinical features, the muscle biopsy findings, and the nonprogressive course, suggest a vascular insult to the cervical spinal cord during gestation. The term, congenital cervical spinal atrophy seems most descriptive of these features.

Child↗