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PubMed2000

Estrogen replacement therapy in a man with congenital aromatase deficiency: effects of different doses of transdermal estradiol on bone mineral density and hormonal parameters.

The effects of different doses of transdermal estradiol (TE) on bone mineral density (BMD) in a man with aromatase deficiency were evaluated. The study protocol was divided in the following four phases: phase 1, before estradiol treatment; phase 2, 50 microg TE twice weekly for 6 months; phase 3, 25 microg TE twice weekly for 9 months; and phase 4, 12.5 microg TE twice weekly for 9 months. X-rays of hands, legs, and pelvis were performed, and BMD of the lumbar spine, hormonal parameters (LH, FSH, testosterone, and estradiol), and markers of bone turnover were determined during each phase. BMD in phase 1 was 0.933 g/cm2 and increased to 1.051 and 1.173 g/cm2 after 4 and 7 months of TE, respectively. In phase 3, BMD reached the maximum value (1.275 g/cm2). In phase 4, BMD decreased to 1.180 g/cm2 and was 1.029 g/cm2 at the end of the study protocol. A bilateral necrosis of femoral heads was also detected by x-ray films. In phase 1 serum testosterone was in the normal range, whereas serum estradiol was undetectable. During the 24-month period of treatment with TE (phases 2-4), estradiol was directly related to the amount of TE, whereas LH was inversely related to estradiol serum levels. Estradiol and gonadotropins reached optimal values only in phase 3, when FSH also was near normal; serum testosterone concentrations were normal in phases 3 and 4. This study confirms the role of estrogens in achieving and maintaining bone mineral content in the human male, providing further clinical tools useful in the management of bone loss in aromatase deficiency in the male. We suggest that the adequate substitutive dose of TE for maintaining both bone mass and normal estradiol serum levels in adult men with aromatase deficiency may be 25 microg twice weekly (0.47 microg/kg weekly).

Administration, Cutaneous↗
PubMed1996

Haemodynamic changes in the small intestine correlate to migrating motor complex in humans.

OBJECTIVE: To evaluate local intestinal blood flow and its relationship to fasting gut motility in humans. DESIGN AND METHODS: Regional laser Doppler flowmetry (LDF) was carried out for 8 h in 14 tasted volunteers. LDF measured as perfusion units (PU) was performed using two single-fibre microprobes attached to a small intestinal manometry tube, which monitored migrating motor complexes (MMCs). Luminal pressures of small intestine were registered in analogue and digital recordings. RESULTS: During phase 1 of MMC, PU values of 65 (33-95) and 37 (20-100) in proximal and distal duodenum were measured. During phase 2, PU values increased by 17% and 38%, respectively (each P < 0.001). At phase 3 of MMC, corresponding PU values increased by 363% and 443% (each P < 0.001) and remained at high levels until termination of phase 3. During phase 3 there was aboral propagation of LDF activity. Computerized recordings allowed detailed analysis of relationships between LDF pattern and luminal pressures. At pressures below 48 (42-54) mmHg, individual LDF cycles and contraction cycles were phase displaced at 180 degrees, indicating low perfusion during contractions. When pressures exceeded 48 (42-54) mmHg, a decrease in PU was registered and the cycling pattern of LDF was abolished. Then, as luminal pressure decreased below 33 (25-41) mmHg, PU increased by 246%. CONCLUSION: Our findings show a relationship between fasting motility and blood flow in the human gut, in which the blood flow exhibited a pattern similar to phase 1, 2 and 3 of the MMC.

Adult↗
PubMed2001

Evaluation of a pushrim-activated, power-assisted wheelchair.

OBJECTIVE: To evaluate a novel pushrim-activated, power-assisted wheelchair (PAPAW) for compliance with wheelchair standards, metabolic energy cost during propulsion, and ergonomics during selected activities of daily living (ADLs). DESIGN: A 3-phase study, the second and third of which were repeated-measures designs. SETTING: A rehabilitation engineering center within a Veterans Affairs medical center. PATIENTS: Eleven full-time, community-dwelling, manual wheelchair users (4 women, 6 men) with spinal cord injuries or multiple sclerosis. INTERVENTIONS: Phase 1: Compliance testing, with a test dummy, in accordance with the wheelchair standards of the American National Standards Institute and the Rehabilitation Engineering and Assistive Technology Society of North America. Phase 2: Metabolic energy consumption testing-at 2 speeds and 3 resistance levels-in subjects' manual wheelchair and the PAPAW. Phase 3: Evaluation of ability to perform ADLs and ergonomics of the PAPAW compared with the subjects personal wheelchair. MAIN OUTCOME MEASURES: Phase 1: The PAPAW's static stability, static strength, impact strength, fatigue strength, environmental response, obstacle climbing ability, range, maximum speed, and braking distance. Phase 2: Subjects' oxygen consumption per minute, minute ventilation, and heart rate during different speeds and workloads with a PAPAW and their own wheelchairs. Phase 3: Subject ratings of perceived comfort and basic ergonomics while performing selected ADLs. Completion time, stroke frequency, and heart rate during each ADL. RESULTS: Phase 1: The PAPAW was found to be in compliance with wheelchair standards. Phase 2: With the PAPAW, the user had a significantly lower oxygen consumption (&Vdot;O(2)mL/min: p <.0001; &Vdot;O(2)mL/kg x min: p <.0001) and heart rate (p <.0001) when compared with a manual wheelchair at different speeds. Phase 3: The PAPAW had a significantly higher mean ergonomic evaluation (p <.01) than the subjects' personal wheelchairs. The results of comparing the ratings of the car transfer between the PAPAW and the subjects' personal wheelchair showed a significant difference in the task of taking the wheels off (p <.001) and putting the wheels back on (p =.001), with the PAPAW receiving lower ratings. CONCLUSION: This study indicated that the PAPAW is compliant with wheelchair standards, reduces the energy demand placed on the user during propulsion, and that subjects rated its ergonomics favorably when compared with their personal wheelchair. PAPAWs may provide manual wheelchairs with a less physiologically stressful means of mobility with few adaptations to the vehicle or home environment.

Adult↗
PubMedDate not supplied

The effect of early treatment at the initial stage 3 moderate phase of retinopathy of prematurity on severe retinal changes.

PURPOSE: To compare the outcome of early treatment at the initial stage 3 moderate phase of retinopathy of prematurity (ROP) with that at prethreshold ROP. METHODS: The outcome of treatment of 117 very-low-birth-weight infants was reviewed. Sixty-eight infants underwent their first treatment at prethreshold ROP (group A). The other 49 infants underwent their first treatment at the initial stage 3 moderate phase of ROP (pre-prethreshold ROP) (group B). The first treatment was performed by laser photocoagulation or cryotherapy. Eleven clinical variables were included in the evaluation of the two groups. The outcome of treatment of the two groups was compared as favorable or unfavorable. Logistic regression analysis was performed to assess the relation between each independent variable and an unfavorable outcome. RESULTS: The extent of contiguous stage 3 moderate ROP and that of cumulative stage 3 moderate ROP were significantly smaller in group B. There were nine unfavorable outcomes in group A, but none in group B. Logistic regression analysis showed that the extent of cumulative stage 3 moderate ROP and the presence of zone 1 retinopathy were major predictive factors for unfavorable outcome in the treatment of very-low-birth-weight infants. CONCLUSION: Early treatment at the initial stage 3 moderate phase of ROP decreases the occurrence of severe retinal changes.

Cryotherapy↗
PubMed2004

The effect of environmental manipulation on behavior, salivary cortisol, and growth of piglets weaned at 14 days of age.

Environmental enrichment can be a useful tool to reduce belly nosing behaviors in early weaned piglets. The aim of this study was to assess the effect of environmental enrichment on behavior, salivary cortisol, and productivity of piglets weaned at 14 days of age. The study assigned 112 piglets (line Camborough 22 of PIC) into 2 treatments, control and enriched, and observed them for 192 hr in 3 periods: 14 to 28 days of age (Phase 1), 28 to 42 days of age (Phase 2), and 42 to 54 days of age (Phase 3). The study obtained saliva samples in each phase from 56 piglets selected randomly from each group for cortisol determination. Comparisons between both treatments and phases included the following: proportion of time belly nosing, latency of approaching a person, average levels of salivary cortisol, and daily weight gain. Belly nosing was higher and latency of approaching a person lower in the control group than in the enriched one (p < .05 and p < .01). Belly nosing was lower in Phase 3 (p < .05); latency of approaching a person was higher in Phase 1 with respect to Phase 2, and this was higher with respect to Phase 3 (p < .01). There were no differences in salivary cortisol levels between treatments or phases. Weight gain was higher in the enriched group (p < .001). Environmental enrichment in piglets weaned at 14 days of age resulted in a reduced proportion of time nosing, reduced latency of response to humans, and better growth than piglets in barren environments.

Animal Husbandry↗
PubMed2000

Do adaptive changes in metabolic rate favor weight regain in weight-reduced individuals? An examination of the set-point theory.

BACKGROUND: Obese persons generally regain lost weight, suggesting that adaptive metabolic changes favor return to a preset weight. OBJECTIVE: Our objective was to determine whether adaptive changes in resting metabolic rate (RMR) and thyroid hormones occur in weight-reduced persons, predisposing them to long-term weight gain. DESIGN: Twenty-four overweight, postmenopausal women were studied at a clinical research center in four 10-d study phases: the overweight state (phase 1, energy balance; phase 2, 3350 kJ/d) and after reduction to a normal-weight state (phase 3, 3350 kJ/d; phase 4, energy balance). Weight-reduced women were matched with 24 never-overweight control subjects. After each study phase, assessments included RMR (by indirect calorimetry), body composition (by hydrostatic weighing), serum triiodothyronine (T(3)), and reverse T(3) (rT(3)). Body weight was measured 4 y later, without intervention. RESULTS: Body composition-adjusted RMR and T(3):rT(3) fell during acute (phase 2) and chronic (phase 3) energy restriction (P: < 0.01), but returned to baseline in the normal-weight, energy-balanced state (phase 4; mean weight loss: 12.9 +/- 2.0 kg). RMR among weight-reduced women (4771 +/- 414 kJ/d) was not significantly different from that in control subjects (4955 +/- 414 kJ/d; P: = 0.14), and lower RMR did not predict greater 4-y weight regain (r = 0.27, NS). CONCLUSIONS: Energy restriction produces a transient hypothyroid-hypometabolic state that normalizes on return to energy-balanced conditions. Failure to establish energy balance after weight loss gives the misleading impression that weight-reduced persons are energy conservative and predisposed to weight regain. Our findings do not provide evidence in support of adaptive metabolic changes as an explanation for the tendency of weight-reduced persons to regain weight.

Aged↗
PubMed1997

Field evaluation of rapid HIV serologic tests for screening and confirming HIV-1 infection in Honduras.

OBJECTIVE: To determine the ability of simple, rapid tests to identify HIV-1 antibody-positive specimens in field settings using the World Health Organization's (WHO) alternative testing strategies. DESIGN: Three-phase evaluation of simple, rapid assays using banked specimens and prospectively collected serum specimens at regional hospitals and rural clinics. METHODS: Seven test (Retrocell, Genie, HIVCHEK, SUDS HIV-1, Testpack, Serodia HIV-1, and HIV-1/2 RTD) were evaluated and results compared with standard enzyme immunoassay (EIA) and Western blot results (phase 1). Further evaluation consisted of prospective testing of routine specimens at regional (phase 2; n = 900) and rural, peripheral laboratories (phase 3; n = 1266) throughout Honduras with selected assays. RESULTS: Sensitivity and specificity were calculated for each assay and combination of assays for each phase to evaluate the effectiveness of the WHO alternative testing strategies. All tests in all phases were > 99% sensitive after correcting for technical errors, with two exceptions (SUDS, phase 1; HIVCHEK, phase 3). In phase 3, where the testing algorithm was diagnostic, several combinations of assays were 100% sensitive and specific using WHO strategy II or III. For the Honduras Ministry of Health, the combination of Retrocell and Genie was found to be equally sensitive, more specific (no indeterminate results), and less expensive than EIA/Western blot. CONCLUSION: Combinations of rapid, simple HIV antibody assays provide sensitivity and specificity performance comparable to EIA/Western blot. Application of these combinations in the WHO alternative testing strategies provides an inexpensive and effective method of determining HIV status. Assay combinations using these strategies can be easily performed in small, rural laboratories and have been implemented in routine HIV screening in Honduras.

AIDS Serodiagnosis↗
PubMed2001

Respiratory health effects from exposure to carbon black: results of the phase 2 and 3 cross sectional studies in the European carbon black manufacturing industry.

OBJECTIVES: To assess respiratory morbidity over several cross sectional phases in the European carbon black manufacturing industry. METHODS: Participants completed an amended (and translated) MRC respiratory morbidity questionnaire with additional questions on previous exposures, job history, etc, and spirometry traces in each phase. Concurrent with the health outcome measures, personal exposure to inhalable dust was measured. RESULTS: Percentage participation rose from 90% in phase 2 (19 factories) to 95% in phase 3 (16 factories). Exposure dropped slightly between the 2 and 3 phases; as did the prevalence of reporting symptoms. Percentage of predicted lung function volumes exceeded 100% for forced expired volume in 1 second (FEV(1)) and forced vital capacity (FVC), whereas forced mid-expiratory flow (FEF(25%-75%)) and FEV(1)/FVC ratio were below 100% in both phases. The multiple linear and logistic regressions showed that carbon black had a significant effect on lung function and on most respiratory symptoms, respectively. CONCLUSION: Both current and cumulative exposure to carbon black have a deleterious effect on respiratory morbidity. Due to the drop in exposure between phases 2 and 3, recent exposures seem to have less of an impact on the respiratory morbidity in the workers in phase 3 than those in phase 2.

Air Pollutants, Occupational↗
PubMed1987

Oxygen toxicity in the premature baboon with hyaline membrane disease.

Immaturity, pulmonary barotrauma, and oxygen toxicity have been implicated in the pathogenesis of bronchopulmonary dysplasia (BPD). Although the physiologic and biochemical consequences of oxygen toxicity have been described in newborn and adult animals, there have been no controlled observations in prematures. We compared the physiologic and morphologic effects of prolonged hyperoxia with those of clinically appropriate oxygen in premature baboons with hyaline membrane disease (HMD) supported with conventional positive pressure ventilation and continuous distending airway pressure (PPV/PEEP). Twenty-one premature baboons were delivered at 140 days gestation, intubated and resuscitated, and supported with PPV/PEEP and standard NICU techniques for 11 days. The FIO2, PaO2, PaCO2, pHa, ventilator and airway pressures, and blood pressure were intermittently measured and recorded. The physiologic observations could be divided into 3 distinct phases. During Phase 1 (0 to 42 h) there were no significant intergroup differences, and (a/A)PO2 and IO2 (oxygenation index; (a/A)PO2/Paw) remained stable. In Phase 2 (43 to 96 h) there was a rapid improvement in (a/A)PO2 and IO2 in both groups, but the response in the hyperoxic animals was significantly dampened. During Phase 3 (97 to 264 h) there was continued improvement in the "prn" animals, which contrasted with progressive deterioration in those exposed to FIO2 1.0. Five of 11 "prn" and 3 of 10 FIO2 1.0 baboons developed air leaks during Phase 1 or early Phase 2. Four of 10 of the hyperoxic animals died after the late onset of air leak. Pathologic changes of BPD were found in all FIO2 1.0 animals surviving more than 6 days but in none of the "prn" long-term survivors.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Long-term effects of mass screening for neuroblastoma in infancy.

Eighty-four neuroblastoma patients were treated at the Department of Pediatrics, Kyoto Prefectural University of Medicine, during the 27 years from 1962 to 1988. They were divided into three groups: 35 cases in phase 1, the 12 years before mass screening from 1962 to 1974; 22 in phase 2, the 8 years after the onset of mass screening by a qualitative vanillylmandelic acid (VMA) test from 1974 to 1982; and 27 in phase 3, the recent 6 years from 1983 to 1988, after the introduction of mass screening by quantitative assay for VMA and homovanillic acid using high performance liquid chromatography. The clinical findings of these patients were compared for each phase. In Kyoto, the number of annual neuroblastoma cases diagnosed under 1 year of age increased from 0.58 in phase 1 to 1.50 in phase 2 and 3.17 in phase 3. The number of cases over 2 years of age decreased from 2.00 in phase 1 to 0.88 in phase 2 and 1.00 in phase 3. Survival rates increased from 17.1% (six of 35) in phase 1 to 54.5% (12 of 22) in phase 2 and 85.2% (23 of 27) in phase 3. The annual number of neuroblastoma deaths decreased from 2.42 in phase 1 to 1.25 in phase 2 and 0.67 in phase 3. Mass screening for neuroblastoma in infancy has increased the long-term survival rates of neuroblastoma cases treated at this hospital.

Adrenal Gland Neoplasms↗
PubMed2001

Observation of Andreev surface bound states in the 3-K phase region of Sr2RuO4.

The tunneling spectrum of the superconducting phase with Tc approximately 3.0 K has been measured in the Ru-embedded region of Sr2RuO4 using cleaved junctions. A sharp zero-bias conductance peak (ZBCP) has been observed below 3 K. All characteristics of this ZBCP suggest that it originates from Andreev surface bound states, indicating that the pairing in the 3-K phase is also non- s-wave. Below the bulk Tc of Sr2RuO4 (approximately 1.5 K), a crossover from sharp to bell-shaped ZBCP was found. This supports the theory that there is a phase transition in the 3-K phase region near the bulk Tc.

Journal Article↗
PubMed1998

Effects of short-term calcium depletion and repletion on biochemical markers of bone turnover in young adult women.

The skeletal responses to calcium depletion and repletion in rodents have been well characterized, but those in humans are poorly understood. The present study sought to evaluate the effects of short term dietary calcium depletion and repletion on biochemical markers of bone turnover in 15 young Caucasian women (age, 21-30 yr). The study contained 3 phases: 1) 5 days of a regular diet containing more than 800 mg/day calcium to establish baseline values (baseline phase), 2) 22 days of a restricted diet containing less than 300 mg/day calcium (depletion phase), and 3) 7 days of a normal diet containing more than 800 mg/day calcium (repletion phase). Serum and urine samples were obtained from each subject during the baseline phase; on the first, second, and last days of the depletion phase; and on the third and last days of the repletion phase. Serum levels of calcium, PTH, 1,25-dihydroxyvitamin D3, osteocalcin, and C-terminal type I procollagen peptide (PICP) and urinary levels of calcium and deoxypyridinoline were determined. Serum and urinary calcium levels were significantly reduced, and serum PTH and 1,25-dihydroxyvitamin D3 levels were markedly increased during depletion. These changes were completely reversed after 1 week of repletion. Depletion also rapidly and significantly increased the urinary deoxypyridinoline level, indicating increased bone resorption. The increase also returned rapidly to baseline upon repletion. Calcium depletion had contrasting effects on bone formation markers; whereas depletion significantly reduced the serum PICP level, it significantly increased serum osteocalcin level. Past histomorphometric studies in rodents indicated that the number of mature but inactive osteoblasts was increased during depletion despite an inhibition of bone formation. Thus, it is speculated that although the reduction in serum PICP reflected the depletion-associated inhibition of bone formation, the increase in serum osteocalcin could represent this depletion-related increase in osteoblast number. During repletion, serum osteocalcin remained elevated above baseline. PICP recovered from its depressed level and increased above baseline, a finding consistent with past histomorphometric findings of increased bone formation during repletion. In summary, this study confirms that 1) a short calcium depletion period produces calcium stress in young women, which leads to rapid stimulation of bone resorption and inhibition of bone formation; and 2) a subsequent calcium repletion period could lead to a compensatory increase in bone formation. In conclusion, the skeletal responses to calcium depletion/ repletion in young women may be similar to those in rodents.

Adult↗
PubMed1989

Improvement of diastolic function after reversal of left ventricular hypertrophy induced by long-term antihypertensive treatment with tertatolol.

In 15 previously untreated hypertensive subjects with left ventricular (LV) hypertrophy who responded favorably (supine blood pressure less than or equal to 140/90 mm Hg) to antihypertensive treatment with a nonselective beta-blocking agent, tertatolol, the effects of reversal of LV hypertrophy on systolic and diastolic function were assessed. Patients underwent echocardiographic and radionuclide studies in control conditions (phase 1), after 1 month of blood pressure normalization (phase 2), after reversal of LV hypertrophy or at least a 20% reduction of LV mass compared to basal value (phase 3) and finally, after a 1-month washout (phase 4). In phase 2, blood pressure (130 +/- 2/85 +/- 1 vs 148 +/- 4/104 +/- 1 mm Hg) and heart rate (59 +/- 1 vs 76 +/- 2 beats/min) decreased (both p less than 0.01); LV mass remained unchanged. There were improvements in peak filling rate (end-diastolic volume/s) (2.4 +/- 0.1 vs 2.0 +/- 0.1), ejection fraction (65 +/- 1 vs 61 +/- 1%) and their ratio (stroke counts/s) (3.7 +/- 0.2 vs 3.2 +/- 0.1) (all p less than 0.05). In phase 3, blood pressure and heart rate were unchanged and reversal of LV hypertrophy was accompanied by a further increase in peak filling rate (2.9 +/- 0.1), ejection fraction (69 +/- 1%) and their ratio (4.1 +/- 0.1) compared to phase 2 (all p less than 0.01). Finally, in phase 4 blood pressure and heart rate returned to the basal value, but peak filling rate (2.7 +/- 0.1) and ejection fraction (65 +/- 1%), although reduced compared to phase 3, were still higher than phase 1.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Enrollment of racial/ethnic minorities in NIAID-funded networks of HIV vaccine trials in the United States, 1988 to 2002.

OBJECTIVE: The purpose of this study was to analyze enrollment of racial/ethnic minorities in Phase I and Phase II HIV vaccine trials in the U.S. conducted by National Institute of Allergy and Infectious Diseases (NIAID)-funded networks from 1988 to 2002. METHODS: A centralized database was searched for all NIAID-funded networks of HIV vaccine trial enrollment data in the U.S. from 1988 through 2002. The authors reviewed data from Phase I or Phase II preventive HIV vaccine trials that included HIV-1 uninfected participants at low to moderate or high risk for HIV infection based on self-reported risk behaviors. Of 66 identified trials, 55 (52 Phase I, 3 Phase II) met selection criteria and were used for analyses. Investigators extracted data on participant demographics using statistical software. RESULTS: A total of 3,731 volunteers enrolled in U.S. NIAID-funded network HIV vaccine trials from 1988 to 2002. Racial/ethnic minority participants represented 17% of the overall enrollment. By pooling data across all NIAID-funded networks from 1988 to 2002, the proportion of racial/ethnic minority participants was significantly greater (Fisher's exact test p-value < 0.001) in Phase II trials (278/1,061 or 26%) than in Phase I trials (347/2,670 or 13%). By generalized estimating equations, the proportion of minorities in Phase I trials increased over time (p = 0.017), indicating a significant increase in racial/ethnic minority participants from 1988 to 2002. CONCLUSIONS: There has been a gradual increase in racial/ethnic minority participation in NIAID-funded network HIV vaccine trials in the U.S. since 1988. In the light of recent efficacy trial results, it is essential to continue to increase the enrollment of diverse populations in HIV vaccine research.

AIDS Vaccines↗
PubMed1998

Actions of the 5-hydroxytryptamine 1 receptor agonist sumatriptan on interdigestive gastrointestinal motility in man.

BACKGROUND: Pharmacological studies of the enteric nervous system have shown the presence of several subtypes of 5-hydroxytryptamine (5HT) receptor, which might be involved in control of the migrating motor complex. AIMS: To study the effect of sumatriptan, an agonist of enteric neuronal 5HT1p receptors, on interdigestive motility in man. SUBJECTS AND METHODS: In 12 healthy subjects, interdigestive motility was recorded manometrically in the upper gastrointestinal tract. In seven subjects blood samples were drawn every 15 minutes for radioimmunoassay of motilin and somatostatin. After two phase 3s of the migrating motor complex, 6 mg of sumatriptan was administered subcutaneously. Recording continued until two more phase 3s had occurred. RESULTS: Sumatriptan induced a premature phase 3 in the jejunum after a median of 10 (8) minutes. The duration of the migrating motor complex cycle was shortened at the expense of phase 2. After sumatriptan, plasma somatostatin concentrations were reduced and gastric phase 3s were suppressed, although median motilin concentrations and the occurrence of plasma motilin peaks were not affected. Phase 3s of the migrating motor complex preceding sumatriptan were associated with motilin peaks, while phase 3s after sumatriptan were not. Furthermore, pretreatment with sumatriptan prevented the induction of a gastric phase 3 by the motilin agonist erythromycin. CONCLUSIONS: Administration of the 5HT1P receptor agonist sumatriptan induces a premature intestinal phase 3, suppresses gastric phase 3s, prevents induction of a gastric phase 3 by erythromycin, and reduces plasma somatostatin concentrations.

Adult↗
PubMed1989

Gestational evolution of small intestine motility in preterm and term infants.

Continuous perfusion manometry was performed in 31 preterm and term infants to assess the influence of gestational age on small intestinal motility. Gestational ages ranged from 27 to 42 weeks. All 8 term infants had interdigestive cycles that included all three phases. Only 4 of 23 preterm infants had complete interdigestive cycles. The remaining 19 preterm infants had only periods of motor quiescence and nonpropagating contractions. In term infants the interdigestive cycle was significantly shorter and the amplitude of phase 3 activity was significantly greater (p less than 0.01); velocity and duration of phase 3 activity were similar in both groups of infants. Rhythmic nonpropagating activity, or clusters, made up more than 60% of the phase 2 activity in both term and preterm infants. Although clusters did not propagate across three or more leads, approximately 25% of cluster activity was propagated across two leads. The duration of total cluster activity was similar for all gestational ages, but the frequency of clusters decreased and the mean duration of individual clusters increased with gestational age (both p less than 0.01). The amplitude of individual pressure peaks in clusters and phase 3 increased significantly with gestational age (p less than 0.03 and p less than 0.01, respectively). The motility index also increased with gestational age (p less than 0.02). We conclude that small intestinal motility is more immature in preterm infants than in term infants. Furthermore, cluster activity, which increases in duration and amplitude with gestational age, may be an immature form of phase 3 activity. These data and techniques will provide neonatologists with a direct way of tracking preterm intestinal motor function to provide more appropriate enteral nutrition.

Enteral Nutrition↗
PubMed2004

Biological predictors of change in functioning in the Whitehall II study.

PURPOSE: To examine whether risk factors for CHD are related to change in functioning independent of the presence or development of disease. METHODS: Longitudinal follow up of 4768 men and 2034 women civil servants from 20 London-based departments with complete data for the SF-36, biological variables, and BMI and health related behaviors. Data are used from two phases of the Whitehall II study, phase 3 (1991-1993) and phase 4 (1995) with an interval of 36 months. Weight, height, fasting insulin, 2-hour post load glucose, total and HDL-cholesterol, fibrinogen, von Willebrand factor, diastolic and systolic blood pressure, and waist hip ratio were measured at phase 3. Demographic and socio-economic information, health related behaviors, and the SF-36 were obtained at both phases by questionnaire. RESULTS: Waist hip ratio, fasting insulin, triglycerides, and HDL-cholesterol were associated with a decline in physical functioning in the total cohort and when those with poor health at baseline were removed from the analyses. Principal component analysis revealed that these variables clustered with total cholesterol and may represent insulin resistance. The biological variables had a cumulative effect on decline in physical functioning such that those with poor waist hip ratio, fasting insulin, triglycerides, and HDL-cholesterol was two times greater than those without. This relationship was independent of exercise, smoking, and alcohol intake which explained only 17% and 5.4% of the association in men and women, respectively. CONCLUSIONS: A number of biological variables, which may represent insulin resistance, are associated with decline in physical functioning in men and women independent of prevalent ill health or health related behaviors.

Body Mass Index↗