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Biomedical subjects

C C Hamilton

Publications and source records attributed to C C Hamilton.

10 recordsLinked to original sources
PubMed1997

A phase III double-blind randomised study of rectal sucralfate suspension in the prevention of acute radiation proctitis.

BACKGROUND AND PURPOSE: A limited number of studies have suggested that oral sucralfate reduces the acute and late gastro-intestinal side-effects of pelvic radiotherapy and sucralfate enemas ameliorate symptoms of chronic proctitis. Sucralfate may act via local bFGF at the mucosal level in promoting angiogenesis and reducing epithelial associated microvascular injury. This multi-institutional study was designed to test the hypothesis that sucralfate given as an enema would have a significant protective effect against acute radiation induced rectal injury by direct application to the mucosa. MATERIALS AND METHODS: Eighty-six patients having radiotherapy for localised carcinoma of the prostate were randomised in a double-blind placebo-controlled study to receive either 15 ml of placebo suspension or 3 g of sucralfate in 15 ml suspension, given as a once daily enema during and for 2 weeks following radiotherapy. Assessment was based on the EORTC/RTOG acute toxicity criteria and a patient self-assessment diary. RESULTS: There was no significant difference between placebo and sucralfate for peak incidences of EORTC/RTOG proctitis. For the placebo and sucralfate arms 95 and 88% (difference 7 +/- 11%) suffered some degree of proctitis, with 71 and 61% (difference 10 +/- 19%) reaching grade 2, respectively. The median period to onset of grade 2 proctitis was 33.5 and 36 days, with the median duration being 9.5 and 15 days, respectively, again these difference being non-significant. Thirty-five and 37% of patients rated the effect of radiotherapy on bowel habit as 'a lot' with a moderate or severe effect on normal daily living in 52 and 49%, respectively. CONCLUSION: This study suggests that sucralfate given as a once daily enema does not substantially reduce the incidence of symptoms associated with acute radiation proctitis and its routine clinical use cannot be recommended. This cohort of patients will be followed to determine if any difference develops in relation to late toxicity.

Acute Disease↗
PubMed1996

Surveying potential sites for a rural decentralized allied health education program.

Allied health education programs which are decentralized into medically underserved communities increase the likelihood that graduates will practice within these regions. However, assessing potential sites for decentralized allied health education programs is often done haphazardly, if at all. The University of Kentucky Physician Assistant Program obtained grant funds to develop and administer a survey to assess potential sites for establishing a rural baccalaureate-level physician assistant (PA) program. This article describes the written survey, how it was administered, and the preliminary survey results. The survey assessed academic, medical, and community resources and commitment to support a decentralized program. The survey instrument and assessment procedure were useful for evaluating, ranking, and comparing the sites. Although the survey was designed to meet PA education and training needs, components of the survey are applicable to any allied health education program wishing to evaluate potential sites for didactic and clinical training of students.

Community-Institutional Relations↗
PubMed1994

Haemodialysis during cardiopulmonary bypass using a haemofilter.

The decision to employ haemofiltration and/or haemodialysis is based on various criteria depending on institutional protocol. Cardiac surgical patients, especially those with renal failure, often require fluid and electrolyte intervention. In the past haemodialysis patients were closely monitored and often delayed for surgery depending on their electrolyte status. Operative technique was changed to accommodate the impending sequelae of cardioplegic solutions, blood transfusions and fluid administration. Although haemofiltration has been used successfully in the management of hypervolaemia and anaemia due to haemodilution, the rate of uraemic toxins and solute removal may not be adequate. The use of haemodialysis helps in the treatment of these difficult and often unpredictable cases. The type of dialysate and method of administration has simplied the technique of haemodialysis, during CPB, allowing effective solute and toxin removal while being able to control the amount of fluid removed.

Cardiopulmonary Bypass↗
PubMed1994

Food-containing hypocaloric diets are as effective as liquid-supplement diets for obese individuals with NIDDM.

OBJECTIVE: This study was designed to determine if food-containing hypocaloric diets are as effective as liquid-supplement diets in promoting weight loss for obese individuals with non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS: Forty NIDDM subjects with body mass indexes (BMIs) of 30-40 kg/m2 were randomized to one of two 800-kcal diets for 12 weeks. Group A received liquid supplement only, and group B received supplement plus an evening meal. Both groups received an intensive behavioral education program. RESULTS: Weight loss and improvements in glycemic, blood lipid, and blood pressure parameters were similar for the two groups. Weight loss averaged 15.7 kg for the entire group. The need for insulin, anti-diabetes, and anti-hypertensive medication decreased significantly. No serious side effects were observed. CONCLUSIONS: Both food-containing and supplement diets providing 800 kcal a day effectively promote weight loss for obese individuals with NIDDM.

Body Mass Index↗
PubMed1992

Weight loss and 2-y follow-up for 80 morbidly obese patients treated with intensive very-low-calorie diet and an education program.

Eighty morbidly obese individuals consecutively enrolled in a comprehensive very-low-calorie diet (VLCD) program were evaluated. Patients' mean initial body mass index was 45.5 kg/m2 and they lost 35.3 kg in 26 wk. Serum total cholesterol, low-density-lipoprotein cholesterol, and triglycerides decreased by 15.0%, 17.0%, and 14%, respectively. Systolic and diastolic blood pressure decreased by 8.7% and 10.0%, respectively. The 46 individuals completing 2-y follow-up were maintaining 48.0 +/- 7.6% (means +/- SE) of their weight loss. Morbidly obese persons lost substantial amounts of weight using a comprehensive VLCD program, reduced risk factors associated with obesity, and had encouraging long-term results, with 48% of weight loss maintained at 2 y of follow-up.

Adult↗
PubMed1992

Fiber and weight management.

Fiber is the portion of plant cells not digested in the human small intestine. Benefits of fiber consumption have been documented in treatment of obesity and obesity-related risk factors. In the last century carbohydrate intake and, thus, fiber intake have declined in the U.S. diet at the same time obesity has increased. Higher fiber intake can be achieved by adding high fiber foods or supplements to the diet. A combination of water soluble and water insoluble fiber sources offer the greatest health and weight control benefits. A high fiber weight-reducing diet is most beneficial as part of a lifestyle modification program for weight management.

Body Weight↗
PubMed1992

Benefits and risks of an intensive very-low-calorie diet program for severe obesity.

Comprehensive very-low-calorie diet (VLCD) programs are the preferred treatment for selected obese individuals. They combine energy intakes of 400-800 kcal/day with medical monitoring and intensive lifestyle education. Typical VLCD patients have median body mass indexes of 36 kg/m2 and have median ages of 40 years. About 70% are female. Commonly associated medical problems include hypertension in 50%, hyperlipidemia in 41%, and diabetes mellitus or glucose intolerance in 14%. Typical weight loss with VLCD is around 21 kg in 16 wk. Reductions of 8-13% in blood pressure, 5-15% in serum total cholesterol, 5-20% in low-density lipoprotein-cholesterol, 15-50% in triglycerides, and decreases in blood glucose and glycohemoglobin in diabetic individuals accompany weight loss. VLCD-associated side effects can be managed medically without discontinuing treatment. Lifestyle education promotes long-term weight maintenance of approximately 56% 2 yr after VLCD treatment. Weight losses using comprehensive VLCDs allow moderately to morbidly obese persons to achieve greater benefits than other nonsurgical treatments and should be considered before opting for surgical treatment.

Diet, Reducing↗
PubMed1990

Oat-bran cereal lowers serum total and LDL cholesterol in hypercholesterolemic men.

Oat bran lowers serum lipid concentrations in healthy and hyperlipidemic subjects. To determine the effects of a ready-to-eat oat-bran cereal on lipid concentrations, we fed control (corn flakes) and oat-bran cereal diets for 2 wk to 12 men with undesirably high serum total-cholesterol concentrations. Subjects were randomly assigned to one of the two diets upon admission to the metabolic ward. After completing the first diet, subjects completed 2 wk on the alternate diet. Intakes of carbohydrate, protein, fat, and cholesterol were virtually identical on the two diets. The oat-bran cereal provided 25 g oat bran/d. The oat-bran cereal diet compared with the corn flakes diet lowered serum total-cholesterol and serum LDL-cholesterol concentrations significantly by 5.4% (p less than 0.05) and 8.5% (p less than 0.025), respectively. Final body weights on each of the diets were similar. Ready-to-eat oat-bran cereal provides a practical means to incorporate soluble fiber into the diet to lower serum cholesterol.

Aged↗
PubMedDate not supplied

Management of obesity in diabetes mellitus.

A primary goal of treatment in obese individuals with NIDDM is weight loss and maintenance. Obesity is a precipitating factor for the development of NIDDM in individuals who are genetically at risk. A variety of weight-loss regimens are available to match the specific needs and lifestyles of individuals. Hypocaloric high-fiber diets have been found to be effective in achieving weight loss, as well as aiding in glycemic and lipid control. Very low calorie diets, administered under medical supervision, are useful for obese NIDDM patients with 18-55 kilograms of weight to lose. Lifestyle education appears to be an important element of any successful weight loss program.

Diabetes Mellitus, Type 2↗