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Biomedical subjects

D C Heimburger

Publications and source records attributed to D C Heimburger.

At least 37 records · Page 2Linked to original sources
PubMed1994

Antioxidant status, erythrocyte fatty acids, and mortality from cardiovascular disease and Keshan disease in China.

OBJECTIVE: Various measures of antioxidant status were investigated in relation to mortality from cardiovascular disease (CVD: coronary heart disease, hypertensive heart disease, and stroke) and Keshan disease. DESIGN: Ecological study. SETTING: Sixty-five largely rural counties in the People's Republic of China. SUBJECTS: One hundred subjects in each county randomly selected from two communes (6500 subjects). INTERVENTIONS: Antioxidants, antioxidant enzymes, and pro-oxidants were measured from sex- and commune-specific pooled blood samples in each county. Fatty acid content of red blood cells was measured. Mortality rates were determined from a national mortality survey. RESULTS: In univariate analysis most correlations between measures of antioxidant status and mortality rates from CVD were not statistically significant, although plasma ascorbic acid, beta-carotene and retinol were consistently inversely associated with CVD mortality rates. There were significant negative associations between plasma ascorbic acid and mortality from stroke (r = -0.38, P < 0.01), and plasma selenium and mortality from Keshan disease (r = -0.32, P < 0.05). There was a significant positive association between plasma copper and mortality from hypertensive heart disease (r = 0.32, P < 0.05). Data previously reported from this population demonstrated an inverse association between red blood cell monounsaturated fatty acids and mortality from CVD, and a direct association between red blood cell polyunsaturated fatty acids and mortality from CVD. CONCLUSIONS: Mortality from CVD and Keshan disease is associated with the fatty acid content of red blood cells and some measures of antioxidant status in blood. It is postulated that the associations between fatty acids and CVD may be related to the different susceptibilities of the respective fatty acids, contained in low-density lipoprotein, to oxidation.

Adolescent↗
PubMed1993

Biennial survey of physician clinical-nutrition training programs.

This is the fourth survey of physician clinical-nutrition training programs. As in previous reports, current fellowship training programs were identified, descriptive information obtained, and program content surveyed. In addition, a questionnaire developed by the American Board of Nutrition Committee on Fellowship Training Programs was used to determine the degree of emphasis given to content in the areas of basic nutrition science, clinical applications, and research training. Among the 38 programs identified, uniform ratings of importance were found in all major topic areas. There was also uniformity in most subtopics, with minor exceptions. As expected, in the area of nutrition in the life cycle, pediatric training programs emphasized infancy and childhood whereas medical-surgical programs emphasized adulthood and aging. Alcoholism was emphasized in medical-surgical training programs whereas cystic fibrosis and inborn errors of metabolism were emphasized in pediatric programs. Nutrition in burn patients received minor emphasis in all programs. The overall uniformity of curricular content in training programs confirms the contention that clinical nutrition has a defined clinical scope and should be considered for establishment as a recognized subspecialty in American medicine.

Education↗
PubMed1992

Localized deficiencies of folic acid in aerodigestive tissues.

The notion that requirements for folic acid may be higher in some tissues than others, resulting in localized deficiencies in spite of blood levels in the normal range was first suggested by the observation of megaloblastic changes in the cervical epithelium that responded to folate supplementation. Theoretically, such deficiencies may arise from elevated folate turnover in response to rapid tissue proliferation or repair; inactivation or alteration of its function by external agents such as tobacco, alcohol, or drugs; or altered metabolism or tissue uptake caused by an inborn error. Marginal dietary intake could aggravate these effects on cells at risk. Evidence for the possible existence of localized folate deficiencies in the aerodigestive tract includes lower circulating folate levels in smokers as compared with nonsmokers; yet lower circulating levels in smokers with bronchial metaplasia; lower folate levels in scrapings of the buccal mucosa of smokers than non-smokers; apparent improvement in bronchial atypical metaplasia in smokers supplemented with folic acid; lower erythrocyte folate levels and higher prevalence of cellular features compatible with folate deficiency in geographic areas and individuals in South Africa at high risk for esophageal cancer; and a trend toward a lower prevalence of colonic dysplasia in ulcerative colitis patients who use folic acid supplements. These observations, as well as animal and in vitro studies, also suggest that folate deficiency may be co-carcinogenic. Further research in this area will be aided by the development of animal models of localized folate deficiency and of methodologies capable of measuring folate levels in minute quantities of tissues and exfoliated cells.

Colitis, Ulcerative↗
PubMed1992

A meal conference format to teach ambulatory nutrition concepts.

Third-year medical students participated in a program using a meal conference approach to teach ambulatory nutrition concepts called "Building Better Health Through Nutrition." The series of three interactive presentations was given during the required family medicine clerkship. A pretest and posttest were used to measure acquisition of nutrition knowledge. There was a statistically significant (P less than 0.05) average increase in posttest compared to pretest scores. Seventy percent of students rated the meal conference approach as "effective" or "very effective" and 76% stated that the series expanded their knowledge of nutrition's role in clinical medicine. We conclude that the meal conference format is an effective way to teach nutrition during the clinical years in medical school.

Ambulatory Care↗
PubMed1992

Ten-year survival of a Broviac catheter.

We report a patient with regional enteritis and short bowel syndrome who has been treated with home parenteral nutrition for 19 years, during 10 of which he used a single Broviac central venous catheter. The catheter finally required replacement because of progressive lumen occlusion, which was presumed to be caused by thrombosis. At the time of replacement, the catheter was found to be friable and embedded in a hard sheath that made it adherent to the wall of the internal jugular vein and prevented complete removal. At some time during the ensuing 16 months, the retained fragment embolized asymptomatically to the pulmonary artery. During the first 2 months after the placement of a new Hickman catheter, progressive flow resistance developed, probably because of calcium phosphate precipitation, although no change had been made in the parenteral formulation. It resolved immediately upon the instillation of hydrochloric acid into the catheter.

Adult↗
PubMed1988

Improvement in bronchial squamous metaplasia in smokers treated with folate and vitamin B12. Report of a preliminary randomized, double-blind intervention trial.

To test whether changes in folate and vitamin B12 nutrition modify the severity of potentially premalignant lesions identified by cytology in sputum samples of smokers, we conducted a randomized, controlled prospective intervention trial in smokers with bronchial squamous metaplasia. Seventy-three men with a history of 20 or more pack-years of cigarette smoking who had metaplasia on one or more sputum samples were stratified according to smoking level and randomly assigned to four months' treatment with either placebo or 10 mg of folate plus 500 micrograms of hydroxocobalamin. Direct cytological comparison of the two groups after four months showed significantly greater reduction of atypia in the supplemented group. This provides preliminary evidence that atypical bronchial squamous metaplasia may be reduced by supplementation with folate and vitamin B12. However, the significance of these findings is tempered by substantial spontaneous variation in sputum cytologies, the small study population, the short duration of the trial, and the supraphysiological doses of folate and B12 used. The results should not be construed as pointing to a potential way of preventing lung cancer in individuals who continue to smoke or as supporting self-medication with large doses of folate or B12 by smokers.

Bronchi↗
PubMed1987

Folate conjugase activity in the plasma and tumors of breast-cancer patients.

The activity of folate conjugase (pteroylpolyglutamate hydrolase, EC 3.4.22.12) was measured in plasma from normal subjects and patients with breast cancer using pteroylglutamyl-gamma-glutamyl-gamma-(U14C) glutamate as the substrate. Conjugase assays also were performed on samples of breast-tumor tissue, normal breast, and fibroadenoma. When assayed at pH 4.5 and 7.4, mean plasma conjugase activity was significantly (p less than 0.05) elevated in a group of patients with anatomically proven metastatic disease (n = 21) when compared with control subjects (n = 12) and a group of patients (n = 13) with no clinical evidence of disease after mastectomies. Mean plasma conjugase activity assayed at pH 4.5 also was significantly higher in the metastatic disease group when compared with breast cancer patients before mastectomy (n = 9) and fibroadenoma patients before biopsy (n = 3). The specific activity of tissue conjugase assayed at pH 4.5 was significantly higher (p less than or equal to 0.05) in infiltrating ductal carcinoma than in normal adjacent breast tissue according to the Wilcoxon test for paired samples (n = 10).

Adenofibroma↗
PubMed1983

An innovation in nutrition education: development of a national nutrition test-item bank.

A NNTIB prototype has been developed and implemented at the University of Alabama in Birmingham School of Medicine. The further development of the Bank as a shared national resource was considered at a workshop carried out in conjunction with the 1983 ASCN meeting. Through this forum it was confirmed that the concept of a NNTIB is both valid and viable, receiving the support of a variety of nutrition educators and the endorsement of the ASCN Committee on Nutrition Education. The general recommendations of the workshop participants were that a modification of the test-item bank prototype be used as the model for the development of a national bank. A key recommendation was the development of a committee to oversee the acceptance and review of test items included in the NNTIB. Recognizing that the major constraints in the development of a national bank are likely to be logistical, mechanical, and fiscal, it is our belief that each of the limitations could be overcome if the Bank were adopted by a parent society with a long-term commitment to its continued support and development. After such support has been identified and pilot trials have been carried out, the implications of the NNTIB for advances in the field of nutrition go well beyond improved quality of testing materials and extend into the critical area of the establishment of standards of nutrition education and certification of competency. The development of the NNTIB offers a challenge to nutrition educators, national nutrition organizations, and interested governmental agencies for their involvement and support.

Congresses as Topic↗