PubMed Health⌕ Search

Biomedical subjects

T Rhodes

Publications and source records attributed to T Rhodes.

At least 37 records · Page 2Linked to original sources
PubMed1999

Evaluation of a long-chain polyunsaturated fatty acid supplemented formula on growth, tolerance, and plasma lipids in preterm infants up to 48 weeks postconceptional age.

BACKGROUND: The last trimester of pregnancy is a period of rapid accretion of long-chain polyunsaturated fatty acids, both in the central nervous system and the body as a whole. Human milk contains these fatty acids, whereas some preterm infant formulas do not. Infants fed formulas without these fatty acids have lower plasma and erythrocyte concentrations than infants fed human milk. Preclinical and clinical studies have demonstrated that single-cell sources (algal and fungal) of long-chain polyunsaturated fatty acids are bioavailable. A balanced addition of fatty acids from these oils to preterm formula results in blood fatty acid concentrations in low birth weight infants comparable to those of infants fed human milk. METHODS: In the present study the growth, acceptance (overall incidence of discontinuation, reasons for discontinuation, overall incidence and type of individual adverse events), and plasma fatty acid concentrations were compared in three groups of infants fed a long-chain polyunsaturated fatty acid-supplemented preterm infant formula, an unsupplemented control formula, or human milk. The study was prospective, double-blind (formula groups only), and randomized (formula groups only). Two hundred eighty-eight infants were enrolled (supplemented formula group, n = 77; control formula group, n = 78; human milk group, n = 133). RESULTS: Anthropometric measurements at enrollment, at first day of full oral feeding, and at both 40 and 48 weeks postconceptional age did not differ between the formula groups, whereas the human milk-fed group initially grew at a lower rate. The incidence of severe adverse events was rare and not significantly different between formula groups. The groups fed either human milk or supplemented formula had long-chain polyunsaturated fatty acid concentrations higher than those in the control formula group. CONCLUSIONS: The results of this study demonstrate the safety and efficacy of a preterm formula supplemented with long-chain polyunsaturated fatty acids from single-cell oils.

Aging↗
PubMed1999

Association of health-related quality of life and benign prostatic enlargement.

OBJECTIVE: To investigate the association of benign prostatic enlargement and health-related quality of life (HRQoL) assessed by validated questionnaires. METHOD: Randomly selected men (n = 471) aged 40-79 years from Olmsted County, Minn. (USA) without prior prostate surgery or prostate cancer had a full urologic workup, including transrectal ultrasonography, in addition to completing questionnaires soliciting information about urinary symptom frequency, bother, degree of interference with daily activities and other measures of HRQoL. RESULTS: Disease-specific HRQoL was worse in older men, and men with more severe symptoms. Age-adjusted mean scores for symptom severity, bother and activity interference were about 50% worse for men with enlarged prostates (volume > 40 cm3). After adjusting for age, men with enlarged prostates were nearly 3 times (95% CI 1.6, 5.1) as likely to have moderate to severe symptoms, and about twice as likely to have bother (odds ratio 2.4; 95% CI 1.3, 4.2) or activity interference (odds ratio 1.8; 95% CI 1. 0, 3.2) relative to men with smaller prostates. CONCLUSION: HRQoL measures are worse in men who are older and, after adjusting for age, in men with increased urinary symptom frequency and enlarged prostate. The broader spectrum of patients provided by the community-based random sampling allows elucidation of these important relationships.

Adult↗
PubMed1999

Longitudinal prostate growth rates during 5 years in randomly selected community men 40 to 79 years old.

PURPOSE: We estimate the rate of prostate growth in randomly selected healthy community dwelling men. MATERIALS AND METHODS: Prostate volume in an age stratified random sample of 631 white male residents of Olmsted County, Minnesota 40 to 79 years old without prior prostate surgery or prostate cancer was measured up to 4 times by transrectal ultrasound during a followup period of almost 7 years. RESULTS: Estimated prostate growth rates increased with increasing age. However, the estimated average annual change was 1.6% across all age groups. Estimated prostate growth rates were high depending on baseline prostate volume with higher growth rates for men with larger prostates. CONCLUSIONS: While there is wide variability in prostate growth rates on an individual level, prostate volume appears to increase steadily at about 1.6% per year in randomly selected community men.

Adult↗
PubMed1999

Treatment for benign prostatic hyperplasia among community dwelling men: the Olmsted County study of urinary symptoms and health status.

PURPOSE: We describe treatments for benign prostatic hyperplasia (BPH) among men participating in the Olmsted County study of urinary symptoms and health status among men during 10,000 person-years of followup. MATERIALS AND METHODS: A cohort of 2,115 men 40 to 79 years old was randomly selected from an enumeration of the Olmsted County, Minnesota population (55% response rate). Participants completed a previously validated baseline questionnaire to assess symptom severity and voided into a portable urometer. A 25% random subsample underwent transrectal sonographic imaging of the prostate to determine prostate volume and measurement of serum prostate specific antigen. Followup included retrospective review of community medical records and completion of a biennial questionnaire to determine the occurrence of medical and surgical treatment for BPH in the subsequent 6 years. RESULTS: During more than 10,000 person-years of followup 167 men were treated, yielding an overall incidence of 16.0/1,000 person-years. There was a strong age related increase in risk of any treatment from 3.3/1,000 person-years for men 40 to 49 years old to more than 30/1,000 person-years for those 70 years old or older. Men with moderate to severe symptoms (American Urological Association symptom index greater than 7), depressed peak urinary flow rates (less than 12 ml. per second), enlarged prostate (greater than 30 ml.) or elevated serum prostate specific antigen (1.4 ng./ml. or greater) had about 4 times the risk of BPH treatment than those who did not. After adjustment for all measures simultaneously an enlarged prostate (hazard ratio 2.3, 95% confidence interval [CI] 1.1, 4.7), depressed peak flow rate (hazard ratio 2.7, 95% CI 1.4, 5.3) and moderate to severe symptoms (hazard ratio 5.3, 95% CI 2.5, 11.1) at baseline each independently predicted subsequent treatment. CONCLUSIONS: While repeat contact and availability of urological measurements during the study period may have influenced treatment decisions in this cohort, the data demonstrate that treatment is common in elderly men with nearly 1 in 4 receiving treatment in the eighth decade of life. Furthermore, these data suggest that men with moderate to severe lower urinary tract symptoms, impaired flow rates or enlarged prostates are more likely to undergo treatment, with increases in risk of similar magnitude to those associated with adverse outcomes, such as acute urinary retention.

Adult↗
PubMed1998

Health-related quality of life associated with lower urinary tract symptoms in four countries.

OBJECTIVES: To describe health-related quality of life (HRQL) associated with lower urinary tract symptoms (LUTS) assessed by validated questionnaires in four countries. METHODS: More than 6000 men, recruited by using community- or population-based sampling in four countries, completed questionnaires soliciting information about urinary symptom frequency, bother, degree of interference with daily activities, and other measures of HRQL. RESULTS: In all countries, disease-specific HRQL worsened with increasing age. Adjusting for age, most disease-specific HRQL measures were significantly worse with increasing symptom severity. The correlation between symptoms and HRQL was strongest in countries with higher prevalence of symptoms, such as Japan or the United States, and less pronounced in countries with lower prevalence (France, Scotland), possibly reflecting the lower variability in scores. CONCLUSIONS: HRQL measures are worse in older men, and increased urinary symptom severity is associated with worse disease-specific HRQL in all countries, despite potential cross-cultural differences in disease prevalence, medication use, perceptions, or willingness to report symptoms or worse HRQL. This cross-cultural consistency suggests that an assessment of symptom bother or interference with daily activities may be useful in patient evaluation.

Adult↗
PubMed1998

Prevalence of a physician-assigned diagnosis of prostatitis: the Olmsted County Study of Urinary Symptoms and Health Status Among Men.

OBJECTIVES: To describe the occurrence of a physician-assigned diagnosis of prostatitis in a community-based cohort. METHODS: A sampling frame of all Olmsted County, Minnesota, male residents was used to randomly select a cohort of men between 40 and 79 years old by January 1, 1990, to participate in a longitudinal study of lower urinary tract symptoms. The 2115 participants (response rate 55%) completed a previously validated self-administered questionnaire that assessed the prevalence of lower urinary tract symptoms, including a history of prostatitis. Subsequently, all inpatient and outpatient community medical records of participants were reviewed retrospectively for a physician-assigned diagnosis of prostatitis from the date of initiation of the medical record through the date of the last follow-up. RESULTS: The overall prevalence rate of a physician-assigned diagnosis of prostatitis was 9%. Men identified with the diagnosis of "prostatitis" had symptoms of dysuria and frequency and rectal, perineal, suprapubic, and lower back pain. Among men with a previous diagnosis of prostatitis, the cumulative probability of subsequent episodes of prostatitis was much higher (20%, 38%, and 50% among men 40, 60, and 80 years old, respectively). CONCLUSIONS: These findings indicate that the community-based prevalence of a physician-assigned diagnosis of prostatitis is high, of similar magnitude to that of ischemic heart disease and diabetes. Furthermore, once a man has an initial episode of prostatitis, he is more likely to suffer chronic episodes than men without a diagnosis. Although the pathologic mechanisms underlying these diagnoses are not certain, these data provide a first step toward understanding how frequently the diagnosis occurs in the community.

Adult↗
PubMed1998

Drug users' sexual relationships and the social organisation of risk: the sexual relationship as a site of risk management.

Research on "risk behaviour" in the time of AIDS has emphasised how social relationships influence individuals' responses to risk. Yet the social relationship remains an under-utilised unit of analysis in risk behaviour research. Drawing on qualitative research with illicit drug users in London, this paper illustrates how drug users' sexual relationships act as key sites of risk management in individuals' drug use and everyday lifestyles. First, while recent research has almost exclusively focused on the dangers of disease transmission, our findings show that drug users perceived their sexual relationships as influencing a variety of risks associated with heroin and other opioid drugs. Here, two types of relationships--"gear" and "straight" relationships--were perceived to be particularly important. Second, while research has tended to focus on drug and health risks as an outcome of relationships, drug users' accounts emphasise that managing risks to their relationships is an important facet of everyday risk management made complicated by drug use. It is argued that risk is a product of social interactions, and that the sexual relationship is an important site of risk management in this process. Future interventions should target drug users' sexual relationships as agents of risk management and behaviour change.

Adult↗
PubMed1998

'Unsafe protected sex': qualitative insights on measures of sexual risk.

To describe forms of unsafe protected sex (vaginal or anal intercourse where condoms are used unsafely) among a sample of drug users in London, data are drawn from a qualitative study of the sexual and drug taking lifestyles of opioid and stimulant users. Depth one-to-one interviews (n = 96) elicited detailed descriptions from interviewees of their sexual behaviour, including the last occasions they had protected and unprotected sex. Analysis of these accounts identified the phenomenon of 'unsafe protected sex' (UPS). Three forms of UPS were identified: (1) Condoms for ejaculation only. This is where a condom was used for penetrative sex, but only when ejaculation was imminent. In these situations, the perceived function of the condom related more to the prevention of unwanted pregnancy than the prevention of HIV/STDs. (2) Condoms after limited unprotected penetration. This is where sexual partners commenced unprotected penetration but used a condom soon after. Participants tended to see such unprotected penetration as a coerced or collaborative transgression from their usual safer sexual practices. (3) Condom failure. This is where condoms split or came off during penetration. This was sometimes only discovered after ejaculation and withdrawal, and was invariably perceived by participants to have been unsafe. The likelihood of condom failure may be increased in penetrative sex prolonged through the use of drugs. Findings point to the possibility that surveys of sexual risk behaviour underestimate levels of unprotected and unsafe sex. A broader and more sophisticated definition of 'sexual risk behaviour' is required with regard to condom use, one which incorporates UPS. If some forms of UPS are perceived to be 'safer sex', future interventions need to highlight the STD transmission risks associated with this activity. Also, some people may view UPS as a transgression towards unsafe behaviour, and this may be proffered as a rationalization for not using condoms at all.

Adolescent↗
PubMed1998

Safety, tolerance and pharmacokinetics of a humanized monoclonal antibody to respiratory syncytial virus in premature infants and infants with bronchopulmonary dysplasia. MEDI-493 Study Group.

BACKGROUND: Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract infection in infants. MEDI-493 (palivizumab) is a humanized monoclonal antibody to the fusion protein of RSV and is active in animal models for prevention of pulmonary RSV replication. OBJECTIVE: To describe the safety, tolerance, immunogenicity and pharmacokinetics of repeat intravenous doses of MEDI-493 in premature infants or infants with bronchopulmonary dysplasia. DESIGN: Phase I/II multicenter, randomized, double blind, placebo-controlled, dose escalation trial. PATIENT POPULATION: Infants born prematurely (< or = 35 weeks of gestation) who were < or = 6 months of age and infants with bronchopulmonary dysplasia who were < or = 24 months of age were eligible for study participation. STUDY AGENTS: Participants received 3, 10 or 15 mg/kg MEDI-493 or 0.9% saline intravenously every 30 days for up to five doses. RESULTS: MEDI-493 was safe and well-tolerated and did not induce a specific anti-MEDI-493 response. The mean half-life of 20 days was comparable with that of other immunoglobulin G preparations. Mean trough serum concentrations 30 days after Infusion 1 were 6.8, 36.1 and 60.6 microg/ml for the 3-, 10- and 15-mg/kg dose groups, respectively. After Infusion 2 the trough concentrations were 11.9, 45.2 and 70.7 microg/ml. After subsequent doses the mean trough values ranged from 14 to 18 microg/ml in those given 3 mg/kg and were > 40 microg/ml for patients who received 10 or 15 mg/kg MEDI-493 (46 to 72 microg/ml and 88 to 96 microg/ml, respectively). CONCLUSIONS: MEDI-493 was safe and well-tolerated in this high risk pediatric population. Mean serum concentrations of MEDI-493 that have been shown to produce a 2-log reduction in pulmonary RSV titer in cotton rats were maintained when 10 or 15 mg/kg MEDI-493 was given every 30 days to pediatric patients at high risk for serious RSV disease. Monthly doses of 15 mg/kg maintained concentrations of > 40 microg/ml for the majority of patients.

Antibodies, Monoclonal↗
PubMed1998

Prevalence of male pattern hair loss in 18-49 year old men.

BACKGROUND: Previous studies investigating the prevalence of male pattern hair loss (MPHL) typically used biased samples of men recruited from clinical populations which may limit generalizability of findings to broader populations. OBJECTIVE: To obtain an updated and improved estimate of the occurrence of MPHL in healthy men residing in the community. METHODS: Community-based sample of healthy men aged 18-49 years participated in a study investigating the effects of MPHL. Participants completed a brief questionnaire self reporting degree of hair loss, general health-related quality of life (HRQL) and hair-loss-specific measures. A trained observer also rated each participant using standardized classification for MPHL. RESULTS: The proportion of men with moderate to extensive hair loss (type III or greater) was 42%. The proportion of men with moderate to extensive hair loss increased with increasing age, ranging from 16% for men 18-29 years of age to 53% of men 40-49. Twelve percent of the men were classified as having predominantly frontal baldness (type A variants). CONCLUSIONS: MPHL, especially frontal baldness, may be more common than previously reported.

Adolescent↗
PubMed1998

Urinary incontinence in a community-based cohort: prevalence and healthcare-seeking.

OBJECTIVE: To estimate the prevalence of urinary incontinence and to assess care-seeking behavior for urinary symptoms among community-dwelling people. DESIGN: A community-based cross-sectional study. SETTING: Randomly selected men and women from Olmsted County, Minnesota. PARTICIPANTS: Two cohorts, one comprised of both men (n = 778) and women (n = 762) 50 years of age or older and a second comprised of men aged 40 years or older (n = 2150). MEASUREMENTS: Participants completed questionnaires assessing urinary incontinence in the previous 12 months, the number of days leaked, the amount leaked, and healthcare-seeking measures for urinary symptoms. RESULTS: In the first cohort, the prevalence of incontinence was 24% in men and 49% in women; 29% of men and 13% of women with incontinence had sought care for urinary symptoms. Urinary incontinence was more strongly associated with care-seeking measures for urinary symptoms in men (Odds Ratio (OR) = 4.3, 95% Confidence Interval (CI) = 2.4, 8.0) than in women (OR = 2.1, 95% CI = 1.2, 3.9). Moderate or severe urinary incontinence was associated significantly with care-seeking for urinary symptoms (OR = 10.5, 95% CI = 5.6, 19.8). In the second cohort, the prevalence of urinary incontinence was 17.3%; 8.5% of men with incontinence had sought care for urinary symptoms. Men with incontinence were 1.2 times (95% CI = .8, 1.9) as likely to seek care for urinary symptoms as men without incontinence. CONCLUSION: Our findings indicate that although urinary incontinence is relatively common in the community, care-seeking for urinary symptoms among persons with urinary incontinence is low, particularly among women, for whom the prevalence exceeds 40% between the ages of 50 and 70 years. These findings suggest that strategies to promote care-seeking for incontinence need to be investigated and employed in the community.

Adult↗
PubMed1998

Effects of self-perceived hair loss in a community sample of men.

BACKGROUND: Few studies have quantified the psychosocial effects of hair loss using standardized instruments in men not seeking treatment for hair loss. OBJECTIVE: Examine self-perception of hair loss and its effects on men from the community. METHODS: Men 18-50 years of age recruited without regard to hair loss, from households near Dayton, Ohio, completed a questionnaire assessing self-perception of hair loss, satisfaction with hair appearance, hair-loss-specific effects and general health status. RESULTS: Men with greater hair loss had more bother, concern about getting older, perceived noticeability to others and greater dissatisfaction with their hair appearance than men with less hair loss. These effects decreased with age for men with hair loss, but regardless of age, perceived noticeability of hair loss increased monotonically with degree of hair loss. CONCLUSIONS: Men with greater hair loss report more negative effects due to their hair loss across all age groups, but the effects were more pronounced in younger men.

Adolescent↗
PubMed1997

Association between cigarette smoking and prostatism in a Japanese community.

BACKGROUND: The purpose of this study was to examine the association between cigarette smoking and prostatism among Japanese men. METHODS: Male residents of Shimamaki-mura, Japan, aged 40-79 years old (n = 286), completed a self-administered questionnaire that included the international prostate symptom score (IPSS). A detailed cigarette smoking history was also obtained. All men had a transrectal ultrasonographic estimate of prostatic volume and a peak urinary flow rate measurement. RESULTS: Current cigarette smoking was inversely associated with an impaired peak urinary flow rate (< 15 mL/sec) (odd ratio [OR] = 0.39, 95% confidence interval [CI] = 0.18, 0.84), and with moderate to severe symptoms (IPSS > 7) (OR = 0.84, 95% CI = 0.48, 1.49), but was not significantly associated with prostatic volume. Smokers of 1 to 1.4 packs a day were less likely and smokers of less than a pack a day or 1.5 or more packs a day were more likely to have moderate to severe symptoms and a greater prostatic volume. CONCLUSION: These findings suggest that cigarette smoking may have a protective effect on prostatism at certain smoking intensities, but no effect or a deleterious effect at other intensities.

Adult↗
PubMed1997

Natural history of prostatism: risk factors for acute urinary retention.

PURPOSE: We determined the occurrence of and risk factors for acute urinary retention in the community setting. MATERIALS AND METHODS: A cohort of 2,115 men 40 to 79 years old was randomly selected from an enumeration of the Olmsted County, Minnesota population (55% response rate). Participants completed a previously validated baseline questionnaire that assessed symptom severity, and voided into a portable urometer to measure peak urinary flow rates. A 25% random subsample underwent transrectal sonographic imaging of the prostate to determine prostate volume. Followup was performed through a retrospective review of community medical records to determine the occurrence of acute urinary retention in the subsequent 4 years. RESULTS: During the 8,344 person-years of followup 57 men had a first episode of acute urinary retention (incidence 6.8/1,000 person-years, 95% confidence interval [CI] 5.2, 8.9). Among men with no to mild symptoms (American Urological Association symptom index score 7 or less) the incidence of acute urinary retention increased from 2.6/1,000 person-years among men 40 to 49 years old to 9.3/1,000 person-years among men 70 to 79 years old. By contrast, rates increased from 3.0/1,000 person-years for men 40 to 49 years old to 34.7/1,000 person-years among men 70 to 79 years old among men with moderate to severe symptoms (American Urological Association symptom index score greater than 7). Men with depressed peak urinary flow rate (less than 12 ml. per second) were at 4 times the risk of acute urinary retention compared with men with urinary flow rates greater than 12 ml. per second (95% CI 2.3, 6.6). Men with an enlarged prostate (greater than 30 ml.) experienced a 3-fold increase in risk (95% CI 1.0, 9.0, p = 0.04). CONCLUSIONS: Lower urinary tract symptoms, depressed peak urinary flow rates, enlarged prostates and older age are associated with an increased risk of acute urinary retention in community dwelling men. These findings may help to identify men at increased risk of acute urinary retention in whom closer evaluation may be warranted.

Acute Disease↗
PubMed1997

Natural history of prostatism: impaired health states in men with lower urinary tract symptoms.

PURPOSE: Lower urinary tract symptoms are reported to have a significant impact on quality of life. However, the impact on specific aspects of health status is not clear. We evaluated the association between lower urinary tract symptoms, and physical and mental aspects of health using community based data from a cross-sectional component of a prospective cohort study. MATERIALS AND METHODS: A total of 2,133 men 41 to 84 years old who were randomly selected from the Olmsted County, Minnesota population completed the 36-item health status questionnaire and a previously validated questionnaire assessing urinary symptoms. Eight domains, measured on a scale of 0 to 100, were used to assess general health status. Men were classified as having an impaired health status if they scored less than 75 points on the scale. Symptom severity (none, mild, moderate or severe) was measured from responses to the urinary symptom questionnaire. RESULTS: The results demonstrated a cross-sectional decrease in mean health status scores for all 8 domains across levels of increasing urinary symptom severity. The strongest associations between health status scores and urinary symptoms (severe versus none) were observed for role limitation due to physical problems (odds ratio 15.7, 95% confidence interval 6.6 to 37.0), energy/fatigue (odds ratio 9.2, 95% confidence interval 4.7 to 18.1), role limitation due to emotional problems (odds ratio 8.7, 95% confidence interval 4.1 to 18.2) and general perception of health (odds ratio 7.2, 95% confidence interval 3.8 to 13.4). For these 4 dimensions men with mild urinary symptoms were also significantly more likely to have an impaired health status. Adjustment for age and co-morbidity did not alter the results. CONCLUSIONS: These findings suggest that urinary symptoms have a multidimensional association with physical and mental aspects of health. Although lower urinary tract symptoms may be the cause of an impaired health status, men with impaired health conditions may be more sensitive to prevalent urinary symptoms and more likely to report them. While the casual nature of this association has not been ascertained, these results may help to identify appropriate health dimensions to assess in patients with lower urinary tract symptoms.

Adult↗
PubMed1997

Correlation between prostate size estimated by digital rectal examination and measured by transrectal ultrasound.

OBJECTIVES: To correlate prostate size estimates performed by single or multiple examiners through digital rectal examination (DRE) with volume measured by transrectal ultrasound (TRUS) and to propose measures for predicting prostate volume using DRE estimates in clinical settings. METHODS: Data from four sources were analyzed: (1) the Olmsted County community study of 397 patients examined by a single urology nurse, with TRUS measurements done by multiple examiners; (2) a community study in Stirling, Scotland, involving 480 patients with DRE and TRUS performed by one urologist; (3) baseline data from the Veterans Affairs Cooperative Study No. 359 in 1222 patients with DRE and TRUS measurements by multiple personnel at 31 centers; and (4) a clinical series of 100 men with DRE and TRUS by a single urologist. RESULTS: DRE estimates and TRUS volumes were significantly correlated (r = 0.4 to 0.9), but prostate size was underestimated by 25% to 55% for men with a prostate volume over 40 mL, depending on the study, with greater variability for studies involving multiple examiners. In one study that assessed prostate dimensions by DRE, posterior surface area (SA) correlated with overall TRUS volume (r = 0.4). According to receiver operating characteristic curves, SA showed a 70% and 76% chance of correctly identifying men with prostate volume greater than 30 or 40 mL, respectively; those with larger prostates were best distinguished by SA greater than 7 cm2 (sensitivity greater than 0.74, specificity greater than 0.50). CONCLUSIONS: DRE underestimates prostate size, particularly if TRUS volume is greater than 30 mL. However, DRE estimates may help identify prostates likely to be larger than certain cutpoints by TRUS. Posterior SA may be useful as a preliminary assessment when prostate size is an important predictor of therapeutic response.

Aged↗