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Biomedical subjects

V Rose

Publications and source records attributed to V Rose.

At least 37 records · Page 2Linked to original sources
PubMed1996

Treatment of familial hypercholesterolemia in children and adolescents: effect of lovastatin. Canadian Lovastatin in Children Study Group.

OBJECTIVE: Familial hypercholesterolemia (FH), an inherited autosomal dominant disorder of lipoprotein metabolism, is associated with premature atherosclerosis. The recommended pediatric therapy consists of dietary intervention and, when necessary, treatment with bile acid-binding resins. However, compliance has been poor in many children. Therefore, our objectives were to determine the efficacy, safety, and tolerance of the short-term use of lovastatin, a 3-hydroxy 3-methylglutaryl coenzyme A reductase inhibitor, in the control of severe FH in a male pediatric population and to evaluate the dose-response relationship. METHODS: Sixty-nine male patients with FH 12.9 +/- 2.4 years of age (mean +/- SD) participated in this multicenter, randomized, double-blind trial. After a 4-week placebo period, the patients were allocated to four treatment groups (lovastatin 10, 20, 30, 40 mg/d) for 8 weeks. Plasma lipid and apolipoprotein (Apo) concentrations were measured every 2 weeks. Clinical and laboratory evidence of adverse events was monitored periodically throughout the study. RESULTS: All lovastatin doses reduced total cholesterol (-17% to -29%), low density lipoprotein cholesterol (-21% to -36%), and ApoB (-19% to -28%) concentrations. A dose-response relationship was seen, and between-group comparisons showed that results were significantly improved up to a dose of 30 mg/d. We observed a 7% increase in high-density lipoprotein cholesterol and a 4% increase in ApoA1 concentrations. The medication was well tolerated by all patients. No serious clinical adverse experience was reported. Lovastatin increased aspartate aminotransferase concentrations, but there was no evidence of a dose-response relationship, and no value exceeded two times the upper limit of normal. No significant change in alanine aminotransferase was observed. Three patients had marked (more than three times the upper limit of normal) asymptomatic elevations in their creatine kinase values, which returned spontaneously to normal, and no action was required regarding the drug.

Adolescent↗
PubMed1995

Evaluation of the cytokine response in Kawasaki disease.

Intracellular cytokines interleukin 6, tumor necrosis factor (TNF) alpha and TNF-beta were studied in peripheral blood mononuclear cells of patients with Kawasaki disease during the acute, subacute and convalescent stages of the disease utilizing cytokine-specific monoclonal antibodies and indirect immunofluorescence. Intracellular cytokines TNF-alpha and -beta were present only during the acute stage before initiation of therapy and not in the subacute or convalescent phase. Intracellular interleukin 6 was seen in both the acute phase and, in small numbers of patients, in the subacute stage of the illness. Overall 15 of 25 (60%) patients produced at least one intracellular cytokine. In the acute stage both monocyte and lymphocyte cytokines were detected intracellularly, TNF-alpha and TNF-beta in 58% of patients whereas interleukin 6 was seen in only 16%. This study provides evidence to support the involvement of activated mononuclear cells, both T cells and monocytes and their secreted soluble products, cytokines, in the pathogenesis of Kawasaki disease.

Acute Disease↗
PubMed1994

Health education for parents with special needs.

Working with families with communication and learning difficulties can require health visiting skills other than those taught on the formal health visitor training course, writes Val Rose. She describes how she approached the problems of one such family with a new-born baby, and the resulting design of a simple feed calculator and communication card which enabled parents and professionals to ensure the baby was being adequately nourished.

Adult↗
PubMed1993

Elevated plasma lipoprotein(a) associated with abnormal stress thallium scans in children with familial hypercholesterolemia.

Plasma lipoprotein(a) (Lp(a)) concentrations are associated with an increased risk of coronary artery disease in adults with familial hypercholesterolemia (FH). We hypothesized that Lp(a) concentrations in children with FH were higher among those with myocardial ischemia on stress thallium scans and among those with a family history of premature coronary artery disease. Twenty-nine asymptomatic heterozygotes with FH (range 9 to 23 years) and 7 homozygotes (range 4 to 13 years) were evaluated with clinical assessment, lipoprotein measurement and stress thallium scans. Compared with subjects with normal stress thallium scans, mean Lp(a) was significantly higher in homozygotes with stress thallium abnormalities (79 +/- 18 vs 15 +/- 5.5 mg/dl, p = 0.03), and tended to be higher in heterozygotes with stress thallium abnormalities (39 +/- 12 vs 20 +/- 4.2 mg/dl, p = 0.10). Lp(a) tended to be higher in heterozygotes with a family history of premature coronary artery disease (30 +/- 6.4 vs 14 +/- 4.1 mg/dl, p = 0.12). It is concluded that Lp(a) is higher in hypercholesterolemic children who have abnormal stress thallium scans. Lp(a) may be useful in assessing coronary artery disease risk in children with FH.

Adolescent↗
PubMed1993

Use of organic solvents and potential worker exposure in the motor vehicle manufacturing industry.

This survey was designed to assist with planning epidemiologic studies of the effects of solvent exposure among motor vehicle manufacturing workers. The objectives were to identify subgroups of workers with solvent exposure, and to evaluate the availability of data for a job-exposure matrix (JEM). Of 65 plants selected, 31 (48%) participated. Participant plants represent all production activities initially included in the survey, and employ 97,655 hourly workers. About 14% of these workers use organic solvents (direct exposure), and 19% work in the proximity of solvent-using operations (indirect exposure). However, only 3% have direct exposure, and 6% have indirect exposure to large-volume (> or = 100 gallons/month)/high-frequency (hourly)-use solvents. The highest solvent exposure prevalence occurs in plants manufacturing engines and power train components and in metal degreasing/cleaning and painting tasks, and entails exposure to petroleum fractions, aromatic hydrocarbons, alcohols, and ketones. A JEM can be developed using plant records on job titles, work histories, production scheduling, and plant engineering, and using the corporate computerized personnel and industrial hygiene databases. However, information on solvent use and on exposure is adequate only for recent time periods.

Automobiles↗
PubMed1993

Inter-rater agreement in the assessment of solvent exposure at a car assembly plant.

This study investigated the feasibility and the reproducibility of a retrospective assessment of solvent exposure in the painting operations of a car assembly plant. Five industrial hygienists (the raters) reviewed summary documents on plant operations and solvent exposure levels, developed from plant records and interviews. The raters independently reviewed 695 department-job-year combinations compiled from 29 work histories and used semi-quantitative scores to rate solvent exposure. Inter-rater agreement was evaluated by computing the percent concordance index and the intraclass correlation coefficient (rI). There was discordance among raters, a large proportion of which pertained to low exposure levels (1-5 ppm). The computation of the rI is sensitive to the distribution of exposure levels. A low rI can be observed for a rare exposure even if the percent concordance is high. Inter-rater agreement was good for cumulative exposure scores computed for frequent exposures: coatings (rI = 0.67), aromatic hydrocarbons (rI = 0.66), and petroleum distillates (rI = 0.62).

Automobiles↗
PubMed1992

Detection of silent coronary artery disease in adolescents and young adults with familial hypercholesterolemia by single-photon emission computed tomography thallium-201 scanning.

Familial hypercholesterolemia (FH), a genetic disease characterized by increased levels of total and low-density lipoprotein cholesterol in the blood, results in a markedly increased incidence of atherosclerosis and coronary artery disease in homozygotes and to a lesser extent in heterozygotes. The purpose of this study was to detect the presence of myocardial ischemia, particularly in heterozygotes, with stress single-photon emission computed tomography thallium-201 scanning and to determine if there were any differentiating variables between heterozygotes with normal and abnormal thallium-201 scans. Fifty-four patients (mean age 16 years; range 8 to 24) with FH were analyzed (4 homozygotes and 50 heterozygotes). Eleven heterozygotes and 3 homozygotes had abnormal thallium-201 scans. Family history, lipid profile, age and sex of heterozygotes with FH did not predict the presence of myocardial ischemia. The mean total cholesterol level in heterozygotes with normal thallium-201 scans was 7.68 +/- 2.29 mmol/liter (297 mg/dl), which was not significantly different from that in heterozygotes with abnormal scans (7.63 +/- 1.07 mmol/liter [295 mg/dl]; p = 0.91). The coronary angiography of 1 homozygote who had an abnormal thallium-201 scan demonstrated a 50% stenosis of the left anterior descending artery. Aggressive, repetitive plasma exchange was then instituted. The 11 heterozygotes with abnormal thallium-201 scans underwent more rigorous dietary and drug therapy. It is concluded that myocardial ischemia with stress in heterozygotes with FH can occur at a young age and that thallium-201 scanning should be performed early as a screening test and to guide patient management.

Adolescent↗
PubMed1992

Outcome of coronary artery aneurysms after Kawasaki disease.

From 1974 through 1991, a total of 583 children with Kawasaki disease were seen at the Hospital for Sick Children, in Toronto, of whom 80 (13.7%) had coronary artery involvement. There were 55 boys and 25 girls, whose mean age at onset was 2.9 +/- 2.5 years, followed for a mean period of 4.0 +/- 3.6 years. Giant aneurysms (maximum diameter > or = 8 mm) were found in 22 children, moderate-sized aneurysms (> or = 4 to < 8 mm) in 44, and dilation lesions (< 4 mm) in 14. Myocardial infarction occurred in 9 (1.5%), all of whom had giant aneurysms. The persistence rate for aneurysms was 72% at 1 year and 41% at 5 years of follow-up. In multivariate analysis, the regression of an aneurysm was significantly related to the severity of coronary artery lesions, initial treatment, and gender. Although > 80% of small or moderate-sized aneurysms regressed within 5 years, giant aneurysms did not regress during the follow-up period. In patients who received immune globulin therapy, coronary lesions tended to resolve more rapidly than in those treated with salicylate therapy alone, because 91% of the lesions in the former were small or moderate. These findings suggest that the severity of coronary artery involvement during the initial stages of Kawasaki disease influences the regression of these lesions, and that immune globulin treatment may improve outcome by reducing the incidence of severe lesions.

Adolescent↗
PubMed1992

Understanding motor neurone disease.

Understanding of neurological disorders has improved in recent years, enhancing nursing involvement in this area of care The nurses' role as the key worker within a multidisciplinary team identifies their management skills. Nursing care of people with motor neurone disease centres upon

Activities of Daily Living↗
PubMed1991

Expression of ventricular myosin subunits in the atria of children with congenital heart malformations.

The presence of ventricular myosin light chains in the atria of children with congenital heart disease was demonstrated by two-dimensional polyacrylamide gel electrophoresis, peptide mapping, and Western blot analysis. Ventricular myosin light chains were present in 27% of biopsies from 91 children with different forms of congenital heart disease. Perimembranous ventricular septal defects and tetralogy of Fallot were associated with the presence of ventricular myosin light chains in 50% of patients. The presence of ventricular myosin light chains in these atria did not correlate with pressure or volume overload. Analysis of myosin heavy chain isotype in the same biopsies by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, peptide mapping, and Western blot analysis indicated that there was no detectable expression of ventricular myosin heavy chain (beta-subunit), suggesting that the genes for the myosin heavy chains and light chains are not expressed coordinately.

Blood Pressure↗
PubMed1991

Indian summer.

Health visitor, Val Rose, won a Florence Nightingale memorial fund scholarship to travel to the Navajo Indian reservation in north America. The health problems of the Navajo are similar to those affecting the traveller population on her own caseload, forced by changing circumstances and legislation to settle on local authority sites in England. Here she describes some of the health problems arising from the settlement of nomadic people.

Arizona↗