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Biomedical subjects

M Underwood

Publications and source records attributed to M Underwood.

17 recordsLinked to original sources
PubMed1996

Prevalence of gastroesophageal reflux symptoms in asthma.

STUDY OBJECTIVE: To determine the prevalences of symptomatic gastroesophageal reflux (GER), reflux-associated respiratory symptoms (RARS), and reflux-associated beta-agonist inhaler use in asthmatics. DESIGN: Questionnaire-based, cross-sectional analytic survey. SETTING: Outpatient asthma and clinical research clinics attached to the University of Calgary tertiary care centre and two family practices. PATIENTS: Asthma group consisted of 109 patients referred to an outpatient asthma clinic. First control group consisted of 68 patients visiting their family physicians. Second control group consisted of 67 patients with thyroid disease, hypercholesterolemia, or diabetes participating in drug trials. RESULTS: Among the asthmatics, 77%, 55%, and 24% experienced heartburn, regurgitation, and swallowing difficulties, respectively. Symptoms were less prevalent in the control groups. At least one antireflux medication was required by 37% of asthmatics (p < 0.001, vs controls). None of the asthma medications were associated with an increased likelihood of symptomatic GER. In the week prior to completing the questionnaire, 41% of the asthmatics noted RARS, including cough, dyspnea, and wheeze and 28% used their inhalers while experiencing GER symptoms. Inhaler use correlated with the severity of heartburn (r = 0.28, p < 0.05) and regurgitation (r = 0.40, p < 0.05) CONCLUSIONS: The questionnaire demonstrated a greater prevalence of GER symptoms, RARS, and reflux-associated inhaler use in asthmatics. This excessive inhaler use may explain how GER indirectly causes asthma to worsen.

Adult↗
PubMed1995

C-erbB-2 gene amplification: a molecular marker in recurrent bladder tumors?

C-erbB-2 gene amplification and protein overexpression have been implicated as prognostic markers for patients with recurrent progressive bladder tumors. This event has been investigated as a potential diagnostic indicator in archival samples of transitional cell carcinoma of the bladder. Two hundred thirty-six bladder tumors from 89 patients with recurrent disease (mean follow-up, 4 years), 20 tumors from patients with no evidence of bladder tumor recurrence (mean follow-up, 7 years) and 10 normal bladder controls (patients with no history of transitional cell carcinoma) were studied. A differential PCR was used to provide a semiquantitative estimate of C-erbB-2 gene amplification. Protein overexpression was assessed immunohistochemically. Sixteen of 89 patients with recurrent disease had evidence of C-erbB-2 gene amplification. No C-erbB-2 gene amplification was seen in the nonrecurrent tumors or normal bladder controls. Of the 89 patients with recurrent bladder tumors, 43 had evidence of progressive disease, and of these, 14 patients exhibited C-erbB-2 gene amplification, indicating a strong association with gene amplification and progressive disease (P < 0.0005). Gene amplification in these patients was seen only after disease progression had occurred. Protein overexpression was seen in 50% of patients with recurrent and 45% of patients with nonrecurrent disease. No protein overexpression was seen in normal controls. Protein overexpression could not be linked to disease progression. C-erbB-2 gene amplification and protein overexpression were of predictive value in multivariate analysis for overall bladder cancer death; however stage and grade remained the most important independent prognostic variables. C-erbB-2 gene amplification and protein overexpression were of no value as independent markers for the prediction of disease recurrence or progression. It appears from these results that the role of C-erbB-2 as a diagnostic marker may far outweigh its usefulness as a prognostic indicator.

Aged↗
PubMed1993

Balance improvements in older women: effects of exercise training.

BACKGROUND AND PURPOSE: Loss of lower-extremity strength increases the risk of falls in older persons. The purpose of this study was to test the hypothesis that a vigorous program of lower-extremity strengthening, walking, and postural control exercises would improve the single-stance balance of healthy older women and lower their risk of falls and fall-associated injuries. SUBJECTS: From a total of 38 respondents, 21 women were randomly assigned to either a treatment group (combined training, n = 12) or a control group (flexibility training, n = 9). The subjects ranged in age from 62 to 75 years (mean = 68, SD = 3.5). METHODS: A randomized control trial compared the effects of two exercise programs on static balance. The combined training group exercised three times per week on knee extension and sitting leg press machines, walked briskly for 20 minutes, and performed postural control exercises, which included simple tai chi movements. The flexibility training group performed postural control exercises weekly. Measurements of balance were obtained on a force platform in double and single stance, at baseline and following 6 months of exercise training. RESULTS: Double-stance measurements were unchanged after training. The mean displacement of the center of pressure in single stance improved 17% in the combined training group and did not change in the flexibility training group. A repeated-measures analysis of variance revealed that the difference in improvement between the combined training and flexibility training groups was not significant. DISCUSSION AND CONCLUSION: This is the first intervention trial to demonstrate improvements in single-stance postural sway in older women with exercise training. Additional studies with more subjects will be needed to determine whether a combined training program of resistance training, walking, and postural exercises can improve balance more than a program of postural control exercises alone.

Accidental Falls↗
PubMed1993

Exercise to improve gait velocity in older persons.

The effect of 12 weeks of resistance and balance training on strength and gait measures in older persons was tested in a randomized control trial. Thirty-one residents of two life-care communities volunteered (mean age, 82.1 years). The exercise group (E) trained three times per week, performing resistance training to fatigue for knee extension, hip abduction, ankle dorsiflexion, hip extension, and knee flexion, and postural control exercises. The control group (C) met weekly for flexibility exercises performed sitting in a chair. The exercise group achieved significant improvements in muscle strength and gait velocity (p < .05). Knee extension one maximum repetition increased 32% (24% to 40%, 95% confidence interval [CI]), from 55 +/- to 72 +/- 4N.m. Isokinetic knee extension torque increased 25% (3% to 47%) from 40 +/- 5 to 50 +/- 5N.m at 120 degrees s-1. Usual gait velocity increased 8% (3% to 13%) in E from 1.04 +/- .07 to 1.12 +/- .06m/s. There was a trend of improvement in maximal gait speed 4% (0 to 8%) from 1.43 +/- 0.1 to 1.49 +/- 0.1m/s, p = 0.054. Gait and strength measures in C were unchanged. A short-term exercise program that trained strength and balance achieved a clinically significant improvement in gait velocity.

Aged↗
PubMed1992

The older driver. Clinical assessment and injury prevention.

Continued increases in the number of older drivers during the next several decades will increase the importance of medical, ethical, and health policy issues related to driving privileges. Physicians have a critical role in examining patients for driving competence and in screening for impairments that increase the risk of motor vehicle injuries. Both age-related and disease-related factors may affect driving ability in older adults. Research related to the impact of chronic diseases, medications, visual problems, and various neurologic disorders should provide guidance to clinicians in the assessment of driving ability. Performance-based functional assessment, including the use of driving simulators and road tests, may provide information that is useful in the evaluation and rehabilitation of possibly impaired older drivers. Further research related to human, vehicular, and environmental factors and the development of intervention strategies for prevention of crashes and crash-related injuries will reduce the risk of injury and death in older adults.

Accidents, Traffic↗
PubMed1992

The aftermath of youth suicide--providing postvention services for the school and community.

Suicide is one of the leading causes of death in adolescence. Due to the risk of contagion and maladaptive coping responses in the aftermath of suicide, clinicians have responded by developing postvention services. Based on a considerable amount of experience in this field, target groups of individuals have been identified to receive such assistance. These groups include school administrators, staff, students, families, and community members at large. In addition, it has become clear that the local media response to suicide is of critical importance, and that school administrators and local mental health officials should work effectively with reporters so that news stories do not contribute to suicide contagion.

Adaptation, Psychological↗
PubMed1991

Adductor pollicis. The missing interosseous.

This paper highlights the many similarities between the adductor pollicis and the palmar interossei. In particular it compares their anatomy, innervation and function. It suggests that adductor pollicis should be considered as the first palmar interosseous and that this view simplifies the teaching of hand anatomy and the tests of ulnar nerve function. Further support for the view that adductor pollicis is the thenar counterpart of the second, third and fourth palmar interossei is gained from studies of the literature on hand evolution, in particular published details of fossil records and dissection of primate hands.

Animals↗
PubMed1991

The impact of curriculum-based suicide prevention programs for teenagers.

The impact of three school-based suicide prevention programs was assessed by comparing attitudes and knowledge of 758 9th and 10th graders with those of 680 control pupils, matched on age, ethnicity, and socioeconomic status at the school level, who did not receive the programs. Evaluations were conducted before exposure to the programs and again 1 month later. A large majority of students knew and subscribed to some of the more important program goals before exposure to the program. There was little evidence of program impact among the minority that did not. Most students were interested by the programs, and positive reactions were more common among female and minority students.

Adolescent↗
PubMed1990

Adolescent suicide attempters. Response to suicide-prevention programs.

As part of a controlled evaluation of three suicide-prevention curricula delivered to 1438 ninth- and 10th-grade students, 63 adolescents were identified as having made a suicide attempt. Their attitudes about suicide and help seeking were compared with those of 910 nonattempters drawn from the same population. Reaction to the prevention program was assessed by comparing the responses of the 35 attempters exposed to the programs with responses of 524 exposed nonattempters. The impact of the programs was assessed by comparing 35 exposed attempters with 28 attempters from a control group. Self-identified attempters were less likely to endorse views consistent with the curricula at baseline, but there was little evidence that the programs were successful in influencing these views. There was some evidence that previous attempters were more upset by the programs than their nonattempter peers. The prevalence of suicide attempts as defined in this study by self-report was higher than that reported in studies using interview techniques.

Adolescent↗
PubMed1989

Glutathione metabolism at the blood-cerebrospinal fluid barrier.

Glutathione metabolism and transport in the choroid plexus were probed by determining the effects of administration to rats of several compounds (buthionine sulfoximine, L-2-oxothiazolidine-4-carboxylate, L-(alpha 5,5S)-alpha-amino-3-chloro-4,5-dihydro-5-isoxazole acetic acid, gamma-glutamyl alanine, and glutathione monoethyl ester) on the levels of glutathione and cysteine in the cerebrospinal fluid. The findings indicate that glutathione is actively metabolized in the choroid plexus by pathways similar to those in kidney and other tissues. The level of glutathione in the cerebrospinal fluid can be decreased or increased by giving compounds that do not, under similar conditions, appreciably alter total brain levels of glutathione. Glutathione monoethyl ester is effectively transported into the cerebrospinal fluid.

Animals↗
PubMed1989

Enhanced withdrawal of polychlorinated biphenyls: a comparison of colestipol, mineral oil, propylene glycol, and petroleum jelly with or without restricted feeding.

Meat type chickens were fed a commercial mixture of polychlorinated biphenyl (PCB), Aroclor 1254, at 10 ppm for 14 days, then treated for 21 days to hasten the withdrawal of PCB with either mineral oil (MO), petroleum jelly (PJ), propylene glycol (PG), or colestipol (CO) at 5% of the diet, or at 10% of the diet when restricted to 50% of control intake (50% FR). Whole carcass analyses for PCB revealed that MO + 50% FR reduced PCB to 1.91 mg/bird, or 32% of the body burden (5.96 mg) in nontreated chickens previously fed PCB, whereas those restricted in feed intake by 50% (50% FR) had almost no change (6.44 mg/bird) in body burdens. The PJ, PG, and CO in combination with 50% FR reduced body burdens of PCB to 47, 57, and 77%, respectively, of the control value. When treated with MO, PJ, PG, or CO alone (no 50% FR), chickens had body burdens reduced to only 67 to 90% of control, depending on th compound. Thus, feed restriction was necessary for the MO and PJ to have their greatest effect. Carcass lipid values and body weight gains were markedly reduced by the feed restriction. The CO reduced carcass lipid in nonrestricted chickens by 30%.

Animal Feed↗
PubMed1986

Inactivation of rat hepatic cytochrome P-450 by spironolactone.

Administration of antimineralocorticoid spironolactone (SPL) to rats results in modest destruction of hepatic cytochrome P-450 with parallel loss of heme. This process is accentuated by pretreatment with dexamethasone (DEX), an inducer of cytochrome P-450p and is associated with marked functional loss of cytochrome P-450p-dependent hydroxylases. Cytochrome P-450 destruction may be replicated in vitro when microsomes from DEX-pretreated rats are incubated with SPL and NADPH and is impaired when these rats are given triacetyloleandomycin, an inhibitor of cytochrome P-450p. In vitro SPL-mediated cytochrome P-450 destruction is accompanied by a loss of heme, which appears to be converted to reactive intermediates which covalently bind to microsomes or are converted to polar metabolites.

Animals↗