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Biomedical subjects

D Heber

Publications and source records attributed to D Heber.

142 records · Page 8Linked to original sources
PubMed1977

Low-dose continuous insulin therapy for diabetic ketoacidosis. Prospective comparison with "conventional" insulin therapy.

Low-dose insulin infusion has recently been used to treat ketoacidosis. We have prospectively compared patients with ketoacidosis either treated with insulin infusion at the rate of 6 units per hour or with high-dose, intermittent subcutaneously administered insulin, with emphasis placed on the hormonal responses. Basal glucagon, cortisol, and growth hormone levels were elevated in both groups. Cortisol and growth hormone levels did not fall with therapy in either group but glucagon levels fell in parallel with glucose levels in both groups. There was no difference in the time taken for glucose levels to fall below 250 mg/100 ml between groups. Whereas both methods of therapy appeared to be equally effective, low-dose infusion had the advantages of ease of administration, a predictable, relatively linear rate of fall of glucose levels, and ability to be stopped abruptly in the event of hypoglycemia.

Blood Glucose↗
PubMed1975

Cholinergic and adrenergic neuroreceptors in urinary tract of female dogs. Evaluation of function with pharmacodynamics.

Our preliminary pharmacodynamic studies on the lower urinary tract of adult female dogs indicate that cholinergic and adrenergic (alpha and beta) neuroreceptors in the urethra appear to coordinate the detrusor and urethral function during micturition. Urethral resistance measured as urethral pressure was easily altered with various pharmacologic agents. However, only bethanechol elicited detrusor response measured as intravesical pressure. The possible clinical usefulness of various drugs is outlined. Our results indicate the therapeutic value of ephedrine sulfate and propranolol in stress urinary incontinence; phenoxybenzamine in neurogenic vesical dysfunction and functional outlet obstruction; phenoxybenzamine plus bethanechol in atonic neurogenic bladder; and imipramine in enuresis.

Adrenergic alpha-Antagonists↗
PubMed1975

Imipramine hydrochloride: pharmacodynamic effects on lower urinary tract of female dogs.

Our study of the pharmacodynamics of imipramine hydrochloride of the female canine lower urinary tract indicates the primary mode of action to be the stimulation of alpha adrenergic neuroreceptors in the bladder neck and urethra. This stimulation results in increased resting urethral pressure, adequate sphincter closure, possibly an increase in the bladder capacity and efficient urinary control. Imipramine had no anticholinergic effect on the bladder and the urethra. It also appears unlikely that in enuretic patients imipramine acts by central augmentation of the adrenergic system. No change was noticed in the intravesical or arterial pressures.

Adrenergic alpha-Agonists↗
PubMedDate not supplied

Hormonal and metabolic abnormalities in the malnourished cancer patient: effects on host-tumor interaction.

Many common metastatic cancers are associated with marked weight loss at the time of diagnosis. Anorexia clearly plays a major role in weight loss in the cancer patient, but cannot explain all of the weight loss noted. Malnourished patients with localized cancers under metabolic ward conditions fail to gain weight when given apparently adequate calories for anabolism, thus suggesting that these patients are hypermetabolic. Increased whole body protein breakdown, increased lipolysis, and increased gluconeogenesis have been repeatedly demonstrated in malnourished cancer patients. Protein and glucose metabolism are closely linked, and both are regulated by a number of the same hormones and metabolites. For example, when increased glucose production in malnourished cancer patients is inhibited pharmacologically, protein catabolism is proportionally decreased. Studies of glucose, growth hormone, cortisol, and insulin secretion following an oral glucose load in well-nourished cancer patients are consistent with insulin resistance but no other hormonal abnormalities. Malnourished cancer patients have elevated levels of growth hormone that are further stimulated by arginine and insulin infusion. No abnormalities of thyroid function were noted in cancer patients. Current studies are underway to determine the mechanisms and effects of progestational steroids and cytokines on both food intake and intermediary lipid metabolism.

Cachexia↗
PubMedDate not supplied

Nutrition in advanced cancer: anorexia as an outcome variable and target of therapy.

The endpoints used as outcome variables in clinical cancer treatment trials, including nutrition intervention studies, should contain items that are meaningful to the patient. Variables to consider are appetite, food intake, physical performance, psychological and social functioning, response to cancer therapies, survival time, nutrition status, associated morbidity, and costs. Ideally, the design and conduct of nutrition trials should be carried out by a multidisciplinary team comprising medical oncologists, physician specialists in nutrition, dietitians, and social scientists. Anorexia has not been a focus of nutrition support trials in the past partly because of the lack of effective strategies to reverse it. Anorexia is one important cause of cancer starvation, and it also causes patient discomfort. This paper describes outcome variables that include patient derived subjective factors such as anorexia, and outlines new strategies to reverse anorexia. Pharmacologic strategies tested to reverse anorexia include corticosteroids, anabolic steroids, cyproheptadine, hydrazine sulfate, cannabinoids, and megestrol acetate. Of these, only the latter has been consistently well tolerated and effective, with significant improvements in appetite and food intake demonstrated in large-scale, randomized, controlled trials involving more than 600 cancer patients. Dose-response studies have demonstrated increasing efficacy with increasing doses of megestrol acetate from 160 to 800 mg/day. Doses in excess of 800 mg/day are not currently recommended. The mechanisms of action of megestrol acetate involve both behavioral and metabolic effects, and its impact on energy expenditure, appetite, body composition, endocrine function, and lipid metabolism is the subject of ongoing research.(ABSTRACT TRUNCATED AT 250 WORDS)

Anorexia↗
PubMedDate not supplied

Livistona extract inhibits angiogenesis and cancer growth.

In a screen for naturally occurring angiogenic inhibitors, we have identified an extract from the seed of the plant Livistona chinensis, which has potent anti-angiogenic and anti-tumor activity. The aqueous extract inhibits the in vitro proliferation of endothelial cells and multiple tumor cell lines including mouse fibrosarcoma and human breast and colon cancer. In mouse experiments, this extract suppresses the growth of the subcutaneous fibrosarcoma tumors. When the seed is separated into different components, the shell including the seed skin appears more potent than the inner kernel in tumor suppression. Our results suggest that the extract from the shell of Livistona chinensis may be a potential supplemental source for cancer treatment.

Angiogenesis Inhibitors↗
PubMedDate not supplied

Reduction of serum estradiol in postmenopausal women given free access to low-fat high-carbohydrate diet.

The short-term effects of a low-fat (less than 10% of cal) high-fiber (35-45 g.1000 kcal-1.day-1) diet on estradiol levels were studied in 13 postmenopausal women under residential conditions with cafeteria food service. During this diet study (mean +/- SE duration 22 +/- 4.6 days), body weight declined from 84.9 +/- 6.4 to 82.3 +/- 6.0 kg (P less than 0.001). Serum cholesterol and low-density and high-density lipoprotein cholesterol also fell significantly, whereas triglycerides remained constant. Serum estradiol fell from 18.1 +/- 3.6 to 9.4 +/- 2.4 pg/ml (P less than 0.05). This study demonstrates that serum estradiol levels are reduced in normal to over-weight postmenopausal women given free access to a low-fat high-fiber diet. Most of these women were in negative caloric balance during the study, suggesting that short-term changes in caloric balance may affect estrogen synthesis in postmenopausal women prior to a large decrease in fat mass.

Adult↗
PubMedDate not supplied

Weight reduction for breast cancer prevention by restriction of dietary fat and calories: rationale, mechanisms and interventions.

A large body of epidemiologic evidence and data drawn from animal feeding studies have led to the feasibility testing of clinical breast cancer prevention trials based on the restriction of dietary fat intake. The animal data strongly suggest that restricting calories as well as fat inhibits breast cancer promotion. Body fat correlates with dietary fat intake in human populations. Obese postmenopausal women have increased levels of circulating bioavailable estrogen capable of promoting breast cancer growth. We propose that restriction of dietary fat intake will decrease total calorie intake and result in a loss of body fat in postmenopausal women. This loss of fat will decrease estrogen production from adrenal androgens and increase bioavailable estrogen, leading to decreased promotion of estrogen-dependent breast tumors. Intervention programs targeted at weight reduction via restriction of calories, reduction of dietary fat and increased physical activity are logical, practical and measurable strategies for reducing the risk of breast cancer in women at moderate to increased risk. Failure to account for variations in adherence to a restricted-fat diet in past feasibility studies has cast doubt on the hypothesis that restricting dietary fat intake can be utilized to reduce the risk of breast cancer. Current studies examining nutritional, hormonal and physiologic data in conjunction with evidence of adherence to dietary and lifestyle change will likely clarify the hormonal and physiologic effects of this potential nutritional strategy for breast cancer prevention.

Animals↗