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Biomedical subjects

R L Ferrer

Publications and source records attributed to R L Ferrer.

7 recordsLinked to original sources
PubMed2004

Variations in health status within and between socioeconomic strata.

OBJECTIVES: To analyse the variability in health status within as well as between socioeconomic groups. What is the range of individual variability in the health effects of socioeconomic status? Is the adverse effect of lower socioeconomic status uniform across the entire distribution of health status? DESIGN: Nationally representative telephone survey of the US population in 1996. SETTING: 60 US metropolitan and rural areas. PARTICIPANTS: 47 076 adult respondents to the community tracking study. MAIN OUTCOME MEASURES: Self rated physical and mental health status, measured by the Short Form-12 instrument. RESULTS: There is considerable variability in self rated health within socioeconomic strata and that variability increases in a step-wise fashion at each lower stratum of income. Most of the increased variability is accounted for by changes in the middle and lower (10th, 25th, and 50th centiles) rather than the upper (75th and 90th) portions of the distribution. A resilient subgroup of lower socioeconomic status people seems to maintain excellent self rated health throughout life, while a more vulnerable lower socioeconomic status group experiences rapid deterioration in health status as people reach middle age. CONCLUSIONS: Within the population level social structuring of health there are differences in individual resilience and vulnerability that are amenable to further exploration and potential modification.

Adolescent↗
PubMed2001

Effect of exogenous cholecystokinin and secretin on pancreatic secretion of insulin and glucagon in rats: in vivo model without hepatic filter.

In order to study the effect of cholecystokinin and secretin on the endocrine function of the pancreas, we have developed an experimental model that we have applied to a total of 30 anesthetized rats stimulated with physiological or supraphysiological doses of cholecystokinin and secretin administered intravenously by continuous infusion. Our results show that the serum insulin concentration increases after the supramaximum dose of cholecystokinin is infused, while that of glucagon increases after the maximum dose of this hormone. In case of secretin, the serum glucagon level increases after the supramaximum dose, while that of insulin is not affected by any dose. We conclude that after infusion of physiological doses of cholecystokinin, the pancreatic secretion of glucagon is modified but not that of insulin, while secretin has no effect on the endocrine pancreatic secretion of either insulin or glucagon upon the same conditions.

Animals↗
PubMed2000

Management of mild chronic hypertension during pregnancy: a review.

OBJECTIVE: To conduct a systematic review of evidence relating to management of mild chronic hypertension during pregnancy, including associated risks, benefits, and harms of treatment with antihypertensive agents, nonpharmacologic measures, and aspirin and benefits of various monitoring strategies. DATA SOURCES: Using four broad search strategies, we searched English and non-English-language citations in 16 electronic databases from their inception to February 1999 and consulted relevant textbooks, references, and experts. STUDY SELECTION: Reviewers screened 6228 abstracts and found 215 articles that met multiple prespecified patient selection, study population, and design criteria. TABULATION, INTEGRATION, AND RESULTS: Forty-six studies consistently showed that chronic hypertension triples the risk for perinatal mortality (odds ratio [OR] 3.4; 95% confidence interval [CI] 3.0, 3.7) and doubles the risk for placental abruption (OR 2.1; 95% CI 1.1, 3.9). Thirteen small, randomized controlled trials had inadequate power to rule in or rule out moderate-to-large (20%-50%) benefits of antihypertensive treatment. Possible adverse effects were fetal renal failure when angiotensin-converting enzyme inhibitors are used in the second or third trimester and growth restriction when atenolol is used early in pregnancy. Trials showed that aspirin neither reduces nor increases perinatal and maternal morbidity, but they did not rule out possible small-to moderate beneficial or adverse effects. No studies provide guidance on benefits or consequences of various nonpharmacologic therapies or monitoring strategies. CONCLUSION: Mild chronic hypertension is associated with increased maternal and fetal risks. Beneficial treatment and monitoring regimens are not clear, but some treatments, such as angiotensin-converting enzyme inhibitors, are best avoided.

Abruptio Placentae↗
PubMed1998

Graphical methods for detecting bias in meta-analysis.

The trustworthiness of meta-analysis, a set of techniques used to quantitatively combine results from different studies, has recently been questioned. Problems with meta-analysis stem from bias in selecting studies to include in a meta-analysis and from combining study results when it is inappropriate to do so. Simple graphical techniques address these problems but are infrequently applied. Funnel plots display the relationship of effect size versus sample size and help determine whether there is likely to have been selection bias in including studies in the meta-analysis. The L'Abbé plot displays the outcomes in both the treatment and control groups of included studies and helps to decide whether the studies are too heterogeneous to appropriately combine into a single measure of effect.

Bias↗