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Biomedical subjects

S A Collins

Publications and source records attributed to S A Collins.

8 recordsLinked to original sources

Cardiovascular disease morbidity in an Iowa law enforcement cohort, compared with the general Iowa population.

It remains uncertain if law enforcement officers experience an elevated cardiovascular disease morbidity and, if so, whether their profession contributes to this incidence. Consequently, the self-reported incidence of cardiovascular disease (CVD) (coronary heart disease, myocardial infarction, stroke, coronary artery bypass graft surgery, angioplasty) and CVD risk factors (age, diabetes, elevated body mass index (> or = 27.8 kg.m-2), hypercholesterolemia, hypertension, tobacco use) in 232 male retirees, > or = 55 years of age, from the Iowa Department of Public Safety were compared with 817 male Iowans of similar age. CVD incidence was higher in the law enforcement officers than the general population (31.5% vs 18.4%, P < 0.001). Using multiple logistic regression, factors found to be associated with CVD included the law enforcement profession (odds ratio [OR] = 2.34; 95% confidence interval [95% CI] = 1.5-3.6), hypercholesterolemia (OR = 2.37; 95% CI = 1.7-3.3); diabetes (OR = 2.22; 95% CI = 1.4-3.6), hypertension (OR = 1.79; 95% CI = 1.3-2.5), tobacco use (OR = 1.67; 95% CI = 1.07-2.6), and age (OR = 1.06; 95% CI = 1.03-1.08). These results suggest that employment as a law enforcement officer is associated with an increased cardiovascular disease morbidity and this relationship persists after considering several conventional risk factors.

Aged↗

A randomized, double-blind, placebo-controlled study of luteal phase dydrogesterone (Duphaston) in women with minimal to mild endometriosis.

OBJECTIVE: To compare dydrogesterone with placebos in the treatment of minimal to mild endometriosis. DESIGN: Prospective, double-blind, randomized study. SETTING: Three Obstetrics and Gynaecology Departments in the United Kingdom. PATIENTS: Sixty-two premenopausal women with complaints of pain (n = 12) and infertility with or without pain (n = 50) with minimal to mild endometriosis diagnosed at laparoscopy. Thirty-nine women had a laparoscopy after treatment and 56 women were followed up 12 months after treatment. INTERVENTIONS: Two high doses of dydrogesterone (either 40 or 60 mg) or a placebo, which was given for 12 days, beginning 2 days after the LH surge for a treatment period of 6 months. MAIN OUTCOME MEASURES: Change between before and after treatment endometriosis scores, pregnancy rates (PRs), and pain. RESULTS: Treatment with dydrogesterone did not alter the natural history of endometriosis or PRs when compared with placebo. Pain was reduced significantly during treatment with 60 mg dydrogesterone and this improvement still was evident at 12-month follow-up. CONCLUSION: Luteal phase dydrogesterone reduces pain associated with endometriosis.

Adult↗

Chronic tissue expansion.

BACKGROUND: Chronic tissue expansion is an extremely useful addition to the dermatologic surgeon's skills. OBJECTIVE: To review chronic tissue expansion. METHODS: The relevant literature is summarized. Two case histories are presented as examples of the utility of chronic tissue expansion. RESULTS: The history of tissue expansion is briefly reviewed. Indications pertinent to the practice of dermatologic surgery are discussed. The devices themselves are described, as well as new experimental advances. The general procedure for utilizing tissue expanders is outlined, as well as relevant histologic changes that occur in expanded skin. Both common and rare complications are covered, with attention to prevention. CONCLUSION: Chronic tissue expansion provides an excellent means for obtaining extra tissue for cosmetic and reconstructive surgery.

Aged↗

Fluvoxamine: an open pilot study in moderately obese female patients suffering from atypical eating disorders and episodes of bingeing.

The results of a small pilot study using Fluvoxamine (Faverin) in the treatment of non-vomiting bingeing female patients and women with bulimia nervosa is presented. Ten non-vomiting subjects and six with bulimia nervosa were treated on an open basis with Fluvoxamine 100-200 mg daily. Assessment was made using established questionnaires for severity of eating disorder and abnormality of mood. Five non-vomiting patients and three with bulimia nervosa completed the study. Non-vomiters showed a significant weight loss; a significant reduction in number of binges; a significant reduction in the scores on the BITE and the EAT; and a significant reduction in anxiety. Those with bulimia nervosa had a significant reduction in hunger and a reduction in depression which tended towards significance. Firm conclusions cannot be drawn from this study as it is an open pilot study of a small number of women. However, the results indicate that Fluvoxamine may have a role in the treatment of eating disorders where bingeing is a prominent symptom and that further research would be valuable. Comments are also made on the usefulness of various questionnaires designed to assess eating disorders.

Adolescent↗

A first study to compare two dosages of dydrogesterone in opposing the 50 mg oestradiol implant.

Thirty post-menopausal, non-hysterectomised women received a 50 mg oestradiol implant subcutaneously and either 10 mg or 20 mg dydrogesterone daily for 14 days every 28 days for 6 months. Endometrial biopsies were taken during the initial oestrogen-only phase and again during the final progestogen phase. Of the ten initial samples which were adequate for histological diagnosis, nine showed proliferative and one non-secretory endometrium. Of the 28 samples obtained at the end of the study during the progestogen phase, all except one showed satisfactory conversion, irrespective of dose. Acceptable bleeding patterns were seen in both dosage groups. Tolerance was good and no patient discontinued treatment. This study has shown that both 10 mg and 20 mg dydrogesterone for 14 days are potent enough to oppose the proliferative effects of the 50 mg oestradiol implant. In view of the wide inter-patient variation in endometrial response to progestogens, it appears appropriate to choose the dosage of dydrogesterone on the basis of cycle control and tolerability, whilst being able to maintain confidence in endometrial protection.

Biopsy↗

Phosphorylation of the alpha-subunit of (Na+ + K+)-ATPase by carbachol in tissue slices and the role of phosphoproteins in stimulus-secretion coupling.

This study examined the changes in protein phosphorylation in response to cholinergic (muscarinic) stimulation of salivary secretion in the rat submandibular gland. Carbachol stimulation was associated with phosphorylation in a number of protein bands as detected by sodium dodecyl sulfate (SDS) polyacrylamide gel electrophoresis and autoradiography. The molecular masses (Mr) of two proteins, in which the amount of phosphorylation more than doubled in response to carbachol, were 22,000 and 96,000. The Mr 96,000 protein precipitated at 120,000 X g while most of the Mr 22,000 protein remained in the supernatant at this speed. The effect of carbachol on the phosphorylation of the Mr 22,000 and 96,000 proteins was blocked by atropine, indicating that the cholinergic receptor involved is muscarinic. The time course of phosphorylation of the Mr 22,000 protein consisted of a rapid increase in phosphorylation within the first min of carbachol stimulation. This increased phosphorylation persisted for less than 1 min. The increased phosphorylation of the Mr 96,000 protein also occurred within the first min but it persisted for at least 10 min. However, removal of the muscarinic agonist, carbachol, resulted in the rapid dephosphorylation of this protein. When the plasma membranes were purified, the Mr 96,000 protein was phosphorylated by ATP in the presence of Na+ and Mg2+. It was dephosphorylated by K+. This proves that the Mr 96,000 dalton protein is the alpha-subunit of the (Na+ + K+)-ATPase.

Animals↗

The epidermal nevus syndrome: case report and review.

A 33-year-old woman had multiple basal cell epitheliomas complicating a large, unilateral nevus sebaceus. Other unilateral epidermal nevi and a contralateral pigmentary nevoid disorder were noted on cutaneous examination. There were signs of skeletal, neurologic, and vascular involvement. This patient illustrates the unpredictable features of the epidermal nevus syndrome and the importance of close follow-up to manage attendant complications.

Adult↗

Five exhibitionists and a method of treatment.

Five consecutive patients referred to a psychosexual clinic are described to illustrate the diversity of aetiology and pathology, and the need for a range of treatment techniques. Three patients responded to a cognitive-behavioural therapy which is described, and one to antidepressive drug treatment.

Adult↗