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Biomedical subjects

R Ness

Publications and source records attributed to R Ness.

33 records · Page 2Linked to original sources
PubMed1990

Common major gene inheritance of extreme overweight.

We studied 3925 individuals in 961 families to determine the mode of inheritance of overweight. As an index of overweight, we examined body mass index. Our analyses indicate that the most likely genetic model for susceptibility to overweight included moderate polygenic inheritance (34% of variance resulting from many genes with small effects) and common (21% frequency) recessively expressed major genes (a few genes with large effects on the individuals who possess them). Standard statistical criteria for accepting both polygenic and major gene inheritance were met, including tests of Mendelian transmission. These results suggest that recessive major gene inheritance of overweight may be common and that homozygosity for overweight susceptibility alleles often results in overweight. Clinical, biologic, and empirical observations all suggest genetic heterogeneity, that is, more than one predisposing gene.

Adult↗
PubMed1990

Childhood onset (age less than 10) obesity has high familial risk.

We assessed risk for obesity in 1743 first-degree relatives (parents and siblings) of 566 obese patients at three sites in the USA and one in Argentina. Onset of obesity prior to adulthood, and especially by age 10, significantly increased relative risk (2.14) for obesity in adult first-degree relatives. This increase in risk was consistent across four different patient samples from two different countries. Higher levels of obesity in patients were also associated with increased familial risk. Age of onset of obesity may be used to select obese adults with high genetic loading--an approach that should facilitate the identification of specific genes for human obesity. The enhanced ability to identify persons at high genetic risk for obesity provided by this study should increase the effectiveness of efforts to prevent obesity.

Adolescent↗
PubMed1989

Likelihood of contact with AIDS patients as a factor in medical students' residency selections.

Results from the National Resident Matching Program for the years 1980, 1983, and 1987 were used to examine changes over time in the matches of U.S. medical students to residencies in cities with high concentrations of patients with acquired immunodeficiency syndrome (AIDS) and to specialties in which the care of AIDS patients was most concentrated. Medical students seeking postgraduate training in categorical surgery residency programs were less likely to be matched with programs located in areas where the numbers of reported AIDS cases were high in 1987 as compared with the "pre-AIDS" years of 1980 or 1983. This trend was more pronounced for students from medical schools located in cities with high numbers of AIDS cases. There was a decline in matches to residencies in categorical internal medicine nationally, regardless of location; this decline was also greater among the students coming from medical schools in cities with high numbers of AIDS cases. The authors discuss the implications for medical educators of declines in matches to specialties in which the care of AIDS patients is most concentrated. The imperfect nature of available measures of students' exposure to AIDS patients makes the data of this study preliminary, and further studies are being undertaken. However, the finding of significant effects in spite of the imprecision of some measures suggests that future work will confirm the results of this study.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Two new rating scales for opiate withdrawal.

Two new rating scales for measuring the signs and symptoms of opiate withdrawal are presented. The Subjective Opiate Withdrawal Scale (SOWS) contains 16 symptoms whose intensity the patient rates on a scale of 0 (not at all) to 4 (extremely). The Objective Opiate Withdrawal Scale (OOWS) contains 13 physically observable signs, rated present or absent, based on a timed period of observation of the patient by a rater. Opiate abusers admitted to a detoxification ward had significantly higher scores on the SOWS and OOWS before receiving methadone as compared to after receiving methadone for 2 days. Opiate abusers seeking treatment were challenged either with placebo or with 0.4 mg naloxone. Postchallenge SOWS and OOWS scores were significantly higher than prechallenge scores in the naloxone but not the placebo group. We have demonstrated good interrater reliability for the OOWS and good intrasubject reliability over time for both scales in controls and in patients on a methadone maintenance program. These scales are demonstrated to be valid and reliable indicators of the severity of the opiate withdrawal syndrome over a wide range of common signs and symptoms.

Adult↗
PubMed1984

Chronic hemodialysis in end-stage lupus nephritis: changes of clinical and serological activities.

The available data on the clinical and serological activities of systemic lupus erythematosus (SLE) in dialysis patients with end-stage lupus nephritis are limited. The clinical and serological parameters in 12 such patients prior to, at the onset of, and an average of 31 months after the institution of hemodialysis were retrospectively compared. One of the patients died of cardiopulmonary arrest within 1 week after institution of hemodialysis. All patients were clinically and serologically active prior to the onset of end-stage renal disease (ESRD). With the onset of ESRD, 2 of the 10 patients exhibited complete clinical and serological remission, and 2 patients showed clinical remission with persistent serological activity. After an average of 31 months on dialysis, the number of patients in total remission rose to 4 of 11, and the number of clinically inactive but serologically active patients was 1 of 11. Significant clinical and serological activities persisted in 6 of the 11 dialysis patients, requiring low dose steroid therapy in 3. The authors conclude that the clinical and serological activities of SLE decrease with the onset of ESRD and the institution of dialysis, leading to complete or partial remission in the majority of patients.

Adult↗
PubMed1984

Association of beta hydroxybutyric acidosis with isoniazid intoxication.

Acute metabolic acidosis associated with accumulation of lactate has been previously reported in isoniazid (INH) intoxication. To our knowledge, association of INH toxicity with beta-hydroxybutyric acidosis has not been demonstrated previously. The present report documents the occurrence of beta-hydroxybutyric acidosis in patients with INH intoxication. The reason for the lack of previous reports of this association is not clear, although failure to measure plasma beta-hydroxybutyrate levels in previous studies is a likely possibility. Our patients received intravenous sodium bicarbonate, anticonvulsants and dialysis which resulted in complete reversal of metabolic acidosis and other manifestations of INH toxicity.

3-Hydroxybutyric Acid↗
PubMed1981

Femoral neuropathy: a complication of renal transplantation.

Femoral neuropathy occurred in 3 patients after renal transplantation. This appeared to be due to compression of the femoral nerve by medial and inferior blades of the self-retaining retractors used during renal transplantation surgery. The condition resulted in weakness of quadriceps muscles, loss of patellar reflex, and sensory deficit on the side of transplantation surgery. The rate of recovery from neurologic deficits appeared to depend on the level of transplant renal function.

Adult↗
PubMed1979

Bicarbonate-buffered peritoneal dialysis. An effective adjunct in the treatment of lactic acidosis.

Severe lactic acidosis is associated with poor prognosis. Usually, the patient is treated with massive amounts of intravenous sodium bicarbonate, which in itself carries many undesirable consequences such as fluid overload and hypernatremia. We have successfully used peritoneal dialysis with a bicarbonate-buffered dialysate in the management of severe acidosis. Bicarbonate-buffered peritoneal dialysis provided an unlimited supply of physiologic buffer over a prolonged period without causing hypervolemia or hypernatremia. Furthermore, significant amounts of lactate were removed by dialysis. We, therefore, recommend the use of bicarbonate-buffered peritoneal dialysis as an adjunct in the treatment of severe lactic acidosis.

Acidosis↗
PubMed1978

Control of bleeding from cannulation sites with topical thrombin in dialyzed patients.

Topical thrombin was applied to the cannulation sites during and after withdrawal of the needles. The duration of bleeding was reduced by 50% compared to the control period in patients with various internal arteriovenous communications undergoing maintenance hemodialysis treatment. Accordingly, use of topical thrombin appears effective in saving patients and staffs time, minimizing the blood loss in these anemic patients, and preventing the possible injurious effect of prolonged compression of vascular access to accomplish hemostasis.

Catheterization↗
PubMed1978

Dialysability of theophylline.

We have shown that theophylline is highly dialysable with an average dialysis clearance of 76 ml/min approaching 63% of urea clearance with hemodialysis. Implications include dose adjustment during dialysis and efficacy of dialytic technique in the treatment of theophylline intoxication.

Blood Glucose↗
PubMedDate not supplied

Changes of coagulation factors IX, VIII, VII, X, and V in nephrotic syndrome.

Plasma procoagulant activities of factors IX, VIII, VII, IX, and V were determined in 21 adult patients with nephrotic syndrome of diverse etiologies. The studies were performed during the initial presentation and prior to institution of any therapy. Procoagulant activities of all these coagulation factors were found to be markedly elevated in a majority of the tested patients. Elevated factor VIII and factor V plasma procoagulant activities demonstrated in this study are in agreement with earlier investigations. None of our patients exhibited acquired factor IX deficiency, a publicized complication of nephrotic syndrome. Instead, the prevalent abnormality was increased plasma factor IX activity in these patients. Our results also suggest that previously reported increased combined factor VII-X activity in nephrotic syndrome is due to elevation of both factor VII and factor X activities.

Adult↗