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Biomedical subjects

R Hanley

Publications and source records attributed to R Hanley.

6 recordsLinked to original sources
PubMed2001

Troglitazone improves ovulation and hirsutism in the polycystic ovary syndrome: a multicenter, double blind, placebo-controlled trial.

We hypothesized that the administration of troglitazone, an insulin-sensitizing agent of the thiazolidinedione class, would improve the ovulatory dysfunction, hirsutism, hyperandrogenemia, and hyperinsulinemia of polycystic ovary syndrome (PCOS) patients. Four hundred and ten premenopausal women with PCOS in a multicenter, double blind trial were randomly assigned to 44 weeks of treatment with placebo (PBO) or troglitazone [150 mg/day (TGZ-150), 300 mg/day (TGZ-300), or 600 mg/day (TGZ-600)]. We compared changes in ovulatory function (by monitoring the urinary level of pregnanediol-3-glucuronide daily), hirsutism (by a modified Ferriman-Gallwey scoring method), hormonal levels (total and free testosterone, androstenedione, sex hormone-binding globulin, LH, FSH, and the LH/FSH ratio), and measures of glycemic parameters (fasting levels of glucose, insulin, hemoglobin A(1c), and the glucose and insulin areas under the curve during an oral glucose challenge) among study groups. Of the 410 patients recruited, 305 (74.4%) met evaluability criteria and were included in the analyses. The patients' baseline characteristics were similar across all treatment arms. Ovulatory rates were significantly greater for patients receiving TGZ-300 and TGZ-600 than for those receiving PBO (0.42 and 0.58 vs. 0.32; P < 0.05 and 0.0001, respectively). Of PCOS patients treated with TGZ-600, 57% ovulated over 50% of the time compared with 12% of placebo-treated patients. There was a significant decrease in the Ferriman-Gallwey score with TGZ-600 compared with PBO (0.22 +/- 0.53 vs. -2.21 +/- 0.49; P < 0.05, respectively). Free testosterone decreased and sex hormone-binding globulin increased in a dose-related fashion with troglitazone treatment, and all three troglitazone treatment groups were significantly different from placebo. Nearly all glycemic parameters showed dose-related decreases with troglitazone treatment. The total number and severity of adverse events (including elevations in liver enzymes) and the proportion of patients withdrawn from the study due to the development of adverse effects were similar between treatment groups. Troglitazone improves the ovulatory dysfunction, hirsutism, hyperandrogenemia, and insulin resistance of PCOS in a dose-related fashion, with a minimum of adverse effects.

Adult↗
PubMed1992

Regulation of the renal Na(+)-H+ exchanger by calcium calmodulin-dependent multifunctional protein kinase II.

Prior studies indicate that cAMP-dependent protein kinase (PKA) and calcium calmodulin-dependent multifunctional protein kinase II (CaM-KII) inhibit Na(+)-H+ exchanger as assayed in octyl glucoside solubilized rabbit renal brush border membrane proteins reconstituted into artificial lipid vesicles. An anion exchange chromatography fraction of these proteins which elutes between 0.2 and 0.4 M NaCl (Fraction B), however, fails to demonstrate regulation of the transporter by PKA. The present studies examine regulation of the Na(+)-H+ exchanger by CaM-KII using Fraction B proteins. As compared to the initial total protein extract, Fraction B demonstrated increased Na(+)-H+ exchange activity. CaM-KII inhibited the Na(+)-H+ exchanger in Fraction B by 38.2 +/- 10.6% in an ATP and calmodulin-dependent manner. The results of the present studies suggest that CaM-KII-mediated inhibition of the Na(+)-H+ exchanger involves the phosphorylation of different polypeptides than those mediating the inhibition of this transporter by PKA.

Adenosine Triphosphate↗
PubMed1982

Five-year experience of a community outreach program for the elderly.

The authors report on more than 2,000 impaired elderly people who were referred to a geriatric outreach program during its first 5 years of operation. These patients were referred by a wide variety of professionals and private citizens, who were usually concerned about the person's ability to care for himself or herself or about psychiatric symptoms. The most common diagnosis was dementing illness (21% of the patients), followed by depression (13%). Intervention usually involved making appropriate plans based on an accurate diagnosis, often including coordinating the services of other agencies. A follow-up of 100 patients showed that most of the patients who were still living had maintained their independence.

Aged↗
PubMed1982

Coexistence of cognitive impairment and depression in geriatric outpatients.

The authors diagnosed depression in 20 (23%) of 88 cognitively impaired geriatric outpatients. Three (20%) of these patients had depression only, and 17 (85%) had depression superimposed on an underlying dementia. The rate of coexisting depression decreased significantly with greater severity of the cognitive impairment: 9 (33%) of 27 mildly impaired patients were depressed, compared with 8 (23%) of 35 moderately impaired and 3 (12%) of 26 severely impaired patients. There was a nonsignificant trend for cognitively impaired women to be more likely to be depressed than for similarly impaired men. The authors conclude that although depression must be differentiated from dementia, it is equally important to consider the possibility that the diagnoses coexist.

Aged↗