Publications by authors named "Gloria L Klein"
Context: According to the carbohydrate-insulin model of obesity, an elevated insulin-to-glucagon ratio in response to a high-carbohydrate diet directs metabolic fuels toward storage, resulting in lower circulating energy.
Objective: To determine differences in total circulating energy post-meal related to dietary carbohydrate.
Design: Ancillary study within the Framingham State Food Study.
Background: Longer-term feeding studies suggest that a low-carbohydrate diet increases energy expenditure, consistent with the carbohydrate-insulin model of obesity. However, the validity of methodology utilized in these studies, involving doubly labeled water (DLW), has been questioned.
Objective: The aim of this study was to determine whether dietary energy requirement for weight-loss maintenance is higher on a low- compared with high-carbohydrate diet.
Objective: To determine the effects of diets varying in carbohydrate to fat ratio on total energy expenditure.
Design: Randomized trial.
Setting: Multicenter collaboration at US two sites, August 2014 to May 2017.
A research team from Boston Children's Hospital and Harvard Medical School conducted a community-based feeding study in collaboration with Framingham State University (FSU) and Sodexo, the food service contractor at FSU. The study was a randomized controlled trial, implemented on the FSU campus. For the final year of the study, a satellite feeding site was established at Assabet Valley Regional Technical High School.
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- The study investigates the long-term effects of different carbohydrate-to-fat ratios in diets on maintaining weight loss among individuals who are overweight or obese after an initial weight loss period.
- 164 participants aged 18 to 65 were randomly assigned to one of three controlled diets (high-carb, moderate-carb, low-carb) for 20 weeks, following a standardized weight loss phase.
- Primary outcomes measured included total energy expenditure and secondary outcomes involved resting energy, physical activity, chronic disease risk, and metabolism-related factors to understand how the diet ratio affected weight maintenance.
Article Synopsis
- Aortic-root dissection is a serious complication in Marfan's syndrome, and this study compares the effectiveness of losartan and atenolol for slowing aortic-root enlargement in affected children and young adults.* -
- The randomized trial involved 608 participants aged 6 months to 25 years and measured changes in aortic-root dimensions over 3 years, finding no significant differences between the two treatment groups.* -
- The results indicated that both medications reduced aortic-root size relative to body surface area, but there were no significant differences in surgery, dissection, or death rates between the losartan and atenolol groups.*
Background: The Pediatric Heart Network designed a clinical trial to compare aortic root growth and other short-term cardiovascular outcomes in children and young adults with Marfan syndrome randomized to receive atenolol or losartan. We report here the characteristics of the screened population and enrolled subjects.
Methods And Results: Between 2007 and 2011, 21 clinical sites randomized 608 subjects, aged 6 months to 25 years who met the original Ghent criteria and had a body surface area-adjusted aortic root diameter z-score >3.
Background: Mitral regurgitation is the most common indication for reoperation in children following repair of atrioventricular septal defect (AVSD). We hypothesized that angiotensin-converting enzyme inhibitor therapy would decrease the severity of mitral regurgitation and limit left ventricular volume overload in children following AVSD repair.
Methods: The Pediatric Heart Network designed a placebo-controlled randomized trial of enalapril in this population.
Background: Surgical and perioperative improvements permit earlier repair of partial and transitional atrioventricular septal defects (AVSD). We sought to describe contemporary outcomes in a multicenter cohort.
Methods: We studied 87 patients undergoing primary biventricular repair of partial or transitional AVSD between June 2004 and February 2006 across seven North American centers.
Objective: To describe common associated symptoms within the 10 days before diagnosis in subjects enrolled in the Pediatric Heart Network's trial of steroid therapy in Kawasaki disease (KD).
Study Design: Patients with acute KD were enrolled between days 4 and 10 of illness at 8 centers between 2002 and 2004. We defined common associated symptoms as those occurring in >or=10% of patients.
Objective: Because late diagnosis of Kawasaki disease increases the risk for coronary artery abnormalities, we explored the prevalence of and possible risk factors for delayed diagnosis by using the database of the Pediatric Heart Network trial of corticosteroid treatment for Kawasaki disease.
Methods: We collected sociodemographic and clinical data at presentation for all patients who were treated for presumed Kawasaki disease at 8 centers (7 in the United States, 1 in Canada). Delayed diagnosis was evaluated by total number of illness days to diagnosis and by the percentage of patients who were treated after day 10 of illness.
Background: Cardiovascular disease, including aortic root dilation, dissection, and rupture, is the leading cause of mortality in patients with Marfan syndrome (MFS). The maximal aortic root diameter at the sinuses of Valsalva is considered the best predictor of adverse cardiovascular outcome. Although advances in therapy have improved life expectancy, affected individuals continue to suffer cardiovascular morbidity and mortality.
View Article and Find Full Text PDFBackground: Treatment of acute Kawasaki disease with intravenous immune globulin and aspirin reduces the risk of coronary-artery abnormalities and systemic inflammation, but despite intravenous immune globulin therapy, coronary-artery abnormalities develop in some children. Studies have suggested that primary corticosteroid therapy might be beneficial and that adverse events are infrequent with short-term use.
Methods: We conducted a multicenter, randomized, double-blind, placebo-controlled trial to determine whether the addition of intravenous methylprednisolone to conventional primary therapy for Kawasaki disease reduces the risk of coronary-artery abnormalities.