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Biomedical subjects

W P Stephenson

Publications and source records attributed to W P Stephenson.

9 recordsLinked to original sources

Expanded clinical evaluation of lovastatin (EXCEL) study results. II. Assessment of the human lens after 48 weeks of treatment with lovastatin.

The crystalline lenses of hypercholesterolemic patients were assessed before and after 48 weeks of treatment with lovastatin or placebo to determine the effect of lovastatin on the human lens. Patients were given a biomicroscopic (slit-lamp) examination of the lens, and a previously validated, standardized classification system was used to describe the findings. A total of 8,245 patients were randomly assigned in equal numbers to treatment with placebo or lovastatin 20 or 40 mg once or twice daily in this double-blind, parallel-group study. Statistical analyses of the distribution of cortical, nuclear and subcapsular opacities at 48 weeks, adjusted for age and presence of an opacity at baseline, showed no significant differences (p less than 0.01) between the placebo and lovastatin-treated groups. Visual acuity assessments at week 48 were also not found to have significantly different distributions among treatment groups. Moreover, no significant differences were found among the groups in the frequencies of greater than or equal to 2-line worsening in visual acuity with concurrent progression in lenticular opacity, cataract extraction, or any spontaneously reported adverse ophthalmologic experience. No evidence was found for an effect of lovastatin on the human lens after 48 weeks of treatment.

Adolescent

Incidence and outcome of surgery for benign prostatic hyperplasia among residents of Rochester, Minnesota: 1980-87. A population-based study.

The incidence and outcome of surgery for benign prostatic hyperplasia (BPH) was studied in Rochester, Minnesota, during the period 1980-1987. Three hundred thirty Rochester men without a diagnosis of prostate or bladder cancer underwent prostatectomy for BPH for the first time. Mean and median ages were both seventy (range: 46-95). The incidence of initial prostatectomy for BPH among men forty-five years of age and older age-adjusted to the 1980 U.S. white male population was 642 cases per 100,000 persons per year (py). Among the 330 men undergoing initial prostatectomy for BPH, 14 (4.2%) had serious intraoperative complications, 32 (9.7%) were rehospitalized for urologic complications within thirty days of surgery, and 13 (3.9%) had other serious complications within thirty days after surgery, including 1 death (surgical mortality 0.3%). Forty-five patients (14%) required blood transfusions within thirty days of surgery. The likelihood of reoperation within six years of the initial surgery was 15.1 percent (95% CI 9.7, 20.6). Short- and long-term postoperative mortality was not statistically significantly different than expected based on age- and sex-specific mortality statistics for Rochester, Minnesota.

Aged

Benign prostatic hyperplasia: a population-based study.

To evaluate the incidence and outcome of initial surgery for benign prostatic hyperplasia (BPH) and to clarify the natural occurrence and progression of such urologic diseases, two studies have been conducted in a free-living population in Rochester, MN. The first followed 330 men who had not been diagnosed with prostate or bladder cancer at the time of prostatectomy. All surgery subjects were area residents and between 46 and 95 years of age (mean age 70 years). Among the operated subjects, 14 (4.2%) had serious intraoperative complications, 32 (9.7%) were rehospitalized for urologic complications within 30 days after surgery, and 13 (3.9%) experienced other serious complications in that same time period. Blood transfusions within 30 days of surgery were necessary in 45 patients (14%). The risk of reoperation within 6 years of the initial surgery was calculated at 15.1% (95% CI: 9.7, 20.6). On the basis of age- and sex-specific mortality statistics for Rochester, short- and long-term postoperative mortality was not statistically significantly different from that expected. Results of the second study are not yet available. This population-based evaluation of the natural history of urologic disease is expected to clarify the relative utility of various treatment options and provide a useful perspective on the management of BPH.

Aged

Effects on blood pressure of a decrease in sodium use in institutional food preparation: the Exeter-Andover Project.

To judge the effect on blood pressure, sodium intake of students at two boarding high schools was reduced by 15-20% through changes in food purchasing and in preparation practices in the schools' kitchens. Students were not asked to change their usual eating habits. Each school served alternately as the control or intervention school for one school year. Blood pressure was monitored among 341 subjects during control years and 309 subjects during intervention years. Analysis of blood pressure differences between early in the school year and near the end of the school year, with adjustment for sex and initial blood pressure, showed the effect of the dietary intervention to be -1.7 mmHg for systolic (95% CI = -0.6, -2.9, p = 0.003) and -1.5 mmHg for diastolic pressure (95% CI = -0.6, -2.5, p = 0.002). Such modest and easily attainable changes in sodium intake, if maintained, could have a significant effect on the future risk of essential hypertension among young people.

Adolescent

The role of epsilon-aminocaproic acid in reducing bleeding after cardiac operation: a double-blind randomized study.

Sixty patients scheduled for elective coronary artery bypass graft operations were randomly assigned to receive epsilon-aminocaproic acid or placebo to test whether antifibrinolytic therapy would decrease postoperative bleeding. A small but significant decrease in bleeding was observed in the treated group without complications resulting from treatment with epsilon-aminocaproic acid.

Aminocaproates

Vitamin B12 levels and age.

Vitamin B12 concentration was determined by radioassay in 179 healthy volunteers between the ages of 20 and 93 years in order to determine whether vitamin B12 levels decline with advancing age. The authors found no statistically significant decline in vitamin B12 levels in older individuals, nor a difference between males and females. A review of previous reports identifies potential reasons for controversy regarding the normal concentration of vitamin B12 in the elderly.

Adult

Pharyngeal carriage rates of Haemophilus influenzae, type b and non-b, and prevalence of ampicillin-resistant Haemophilus influenzae among healthy day-care children in central Massachusetts.

Pharyngeal swabs were obtained from 832 children less than 14 years of age attending day-care centers and family day-care homes in central Massachusetts during a seven-week period beginning March 1, 1982. Colonization rates for Haemophilus influenzae and for H. influenzae type b were 60.7% and 15.1%, respectively. Nonwhite children were more likely to be carriers of non-b H. influenzae than white children (62.9% vs. 47.8%, p less than 0.025). Children in day care for more than six months were more likely to be carriers of non-b H. influenzae than children in day care for six months or less (52.9% vs. 45.5%, p less than 0.05). There was no association between colonization rates and age, sex, type of day-care setting, number of siblings, number sharing a bedroom, history of otitis media, or history of antibiotic use. The prevalence of ampicillin-resistant H. influenzae was 6.3% among all children and 10.3% among carriers of H. influenzae. The prevalence of ampicillin resistance was significantly higher among type b carriers than among carriers of other types (15.1% vs. 8.3%, p less than 0.05). Children who had taken ampicillin or amoxicillin within the past three months were much more likely to be colonized with ampicillin-resistant H. influenzae than were children who had not taken these antibiotics (13.5% vs. 4.8%, p less than 0.0005). These observations have important clinical implications for the management of children with H. influenzae disease.

Adolescent