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Biomedical subjects

D Rudman

Publications and source records attributed to D Rudman.

231 records · Page 13Linked to original sources
PubMed1966

Movement of lipids into and out of the blood during hyperlipidemia induced in rabbits by pituitary extract and fraction H.

Rabbits were rendered hyperlipidemic by the subcutaneous injection of an alkaline aqueous extract of mammalian pituitary gland or a partially purified, concentrated fraction derived therefrom, designated Fraction H. Eight hours after the injection of Fraction H, arteriovenous (A-V) differences in plasma triglyceride (TG) were measured across five body areas. A large negative A-V difference in plasma TG was consistently found across the liver (increase in plasma concentration), and a moderate positive A-V difference across the perirenal fat depot (decrease in plasma concentration). Most values obtained across the intestines and mesentery and the leg were positive. Differences across the kidney were mostly small and almost equally divided between positive and negative values. Similar results were obtained 7-12 and 16-18 hr after injection of the pituitary extract. It is concluded that the liver is the principal source of the TG for this kind of hyperlipidemia, and that the plasma TG levels are reduced principally in passage through adipose tissue. A consistent negative A-V difference in plasma free fatty acid concentration (net increase) was found across the kidney 7-12 hr after injection, suggesting that the kidney hydrolyzes its accumulated TG and mobilizes it in the form of free fatty acids.

Animals↗
PubMedDate not supplied

An instrument evaluation framework: description and application to assessments of hand function.

An instrument evaluation framework outlining a process for selecting measurement instruments for use in hand therapy is presented. Each section of the framework--including clinical utility, standardization, purpose, psychometric properties, and patient's perspective--is explained in detail. The framework is applied to four hand function assessments that measure functional limitation, specifically, the Test Evaluant les Membres Supèrieurs des Personnes Agèes (Upper Extremity Performance Evaluation Test for the Elderly; TEMPA), the Jebsen Test of Hand Function, the Smith Hand Function Test, and the Quantitative Test of Upper Extremity Function. The therapists who developed and applied the framework selected the TEMPA as the most appropriate measure for their setting. This framework will assist hand therapists in justifying the selection of measurement instruments and will facilitate a consistent, comprehensive, and critical evaluation approach.

Algorithms↗
PubMedDate not supplied

The relationship of growth hormone to alveolar ridge atrophy in an older male nursing home population.

Alveolar bone development has been shown by other investigators to be sensitive to growth hormone concentration in both humans and rodents. Many elderly people are deficient in growth hormone. The cyclic variation in plasma growth hormone concentration that complicates growth hormone measurement is not seen in the plasma somatomedin C (SmC) concentration. Furthermore, SmC is a dependable indicator of growth hormone secretion. It has been established that an SmC level of 0.24 or less is associated with decreased muscle mass and kidney size. We have investigated the relationship of the alveolar bone/supporting (basal) bone (A/B) ratio to the SmC in an elderly male population. These data suggest that growth hormone secretion is not the sole determinant of alveolar bone retention.

Aged↗
PubMedDate not supplied

The role of protein in nutrition, with particular reference to the composition and use of enteral feeding formulas. A consensus report.

In its proposed classification scheme for reimbursement for enteral feeding formulas, the United States Health Care Financing Administration (HCFA) has neglected to consider the importance of making available formulas of varying protein content. In responding to HCFA's proposal, this consensus report reviews information currently available regarding different protein requirements in healthy, ill, and undernourished adults and elderly individuals. HCFA's reimbursement guidelines should reflect sound medical and nutritional practice rather than influencing it adversely, which its original proposal could do. Clinicians should have at their disposal enteral feeding formulas of varying protein/calorie ratios, especially since the following groups often have higher than average protein requirements relative to calorie requirements: the elderly, individuals with physiologic stress such as infection and injury, and patients with protein-calorie undernutrition.

Adult↗
PubMedDate not supplied

Relation of serum albumin concentration to death rate in nursing home men.

Serum albumin was measured in 126 men (average age 70.6; range 40 to 96) of a Veterans Administration Nursing Home, and was correlated with other items in an extensive clinical data base, including death or survival during the year after the analysis. The reason for institutionalization was chronic neurologic disease or other disabling physical condition in 63 men (group A), and psychiatric disorder in 63 men (group B). In group A, the proportions of men with albumin less than 3.5, 3.5-4.0, and greater than 4.0 g/dl were 6%, 37%, and 57%, respectively. In this group, the serum albumin level was significantly (p less than 0.05) correlated with death rate, hemoglobin, hematocrit, serum cholesterol, and serum lactic dehydrogenase. The death rate in group A during the year after the albumin analysis was 25%. For the patients with albumin level less than 3.5, 3.5-4.0, and greater than 4.0 g/dl, the death rates were 50%, 43%, and 11% respectively (p less than 0.01 for comparison of the former two groups with the latter). The subgroup with albumin 3.5-4.0 g/dl represented only 37% of the men in group A, but accounted for 63% of the group's deaths. In group B, serum albumin level was not significantly correlated with any other clinical variable. Death rate during the year after the albumin analysis was only 2% in group B, and did not correlate with the albumin level. These data indicate that, in nonpsychiatric Nursing Home men, the desirable level for the serum albumin concentration is higher than 3.5 g/dl.

Adult↗
PubMedDate not supplied

Prognostic significance of serum cholesterol in nursing home men.

Serum cholesterol was measured in 129 men (average age 70.6; range 41-96) of a Veterans Administration Nursing Home, and was correlated with other items in an extensive clinical data base. Serum cholesterol was less than 150 mg/dl in 13% of the subjects, and was less than 160 mg/dl in 18%. Cholesterol greater than 280 mg/dl occurred in 8%. Serum cholesterol varied directly (p less than 0.02) with: body weight, serum albumin, serum total protein, serum sodium, ability to walk, and ability to feed oneself; and indirectly (p less than 0.02) with death rate, degree of functional dependence, and serum SGOT and LDH. Nursing home men with cholesterol less than 150 mg/dl had a death rate of 63% during the 14 months after the cholesterol analysis, compared to a death rate of 9% in men with cholesterol greater than 150 mg/dl (p less than 0.05). Death rate during the year after the analysis was 52% if cholesterol was below 160 mg/dl, compared to 7% if it was above this threshold (p less than 0.05).

Adult↗
PubMedDate not supplied

A mortality risk index for men in a Veterans Administration extended care facility.

the purpose of this study was to develop (phase I) and validate (phase II) a mortality prognostic index, based on the annual clinical data base, for the men of this Veterans Administration extended care facility. The study population during phase I consisted of 123 men who were residing in three of the seven wards of the facility in August 1984. Sixty-six of these individuals were institutionalized because of a chronic neurologic (50) or medical (15) disorder ("nonpsychiatric group"). In 57 men, the reason for institutionalization was a chronic psychosis (schizophrenia, 53; manic depressive illness, 4) ("psychiatric group"). During August to October 1984, a comprehensive clinical data base comprising 70 attributes (including diagnoses and drugs) was collected. Deaths were recorded during the next 14 months. Death rate during the 14 months of observation was 33.3% in the nonpsychiatric group, and only 1.7% in the psychiatric group. In the nonpsychiatric men, univariate analysis yielded six attributes significantly correlated with death rate: serum cholesterol level, hematocrit, hemoglobin, midarm muscle circumference, triceps skinfold, and number of morbidity episodes. After serum cholesterol and hematocrit had been entered into a multivariate analysis model, none of the other four attributes contributed significant information about death rate. The multivariate analysis led to a mortality risk index (MRI) for nonpsychiatric patients, MRI = [hematocrit in %] + 10% [serum cholesterol in mg/dl]. As MRI varied from less than 50 to greater than 65, death rate in the nonpsychiatric group varied in parallel from 86-11%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Deranged tyrosine metabolism in cirrhosis.

In normal individuals, the main route for tyrosine degradation is the hepatic pathway tyrosine→4-hydroxyphenylpyruvic acid→homogentisic acid→CO(2). Quantitatively minor pathways, in large part extrahepatic, are: tyrosine→tyramine→octopamine and tyrosine→dopa→catecholamines.In cirrhosis, the main hepatic pathway is blocked to varying degrees at the first three stages. This appears to be due to lack of activity of the enzymes tyrosine transaminase, PHPA oxidase, and HGA oxidase, the first step being rate limiting. Hypertyrosinemia and tyrosine intolerance result.With the main hepatic pathway partially blocked, an abnormally large amount of tyrosine passes into the normally minor extrahepatic pathway leading to the false neurotransmitters tyramine and octopamine. Overproduction of these amines ensues and they accumulate in the body fluid.The false neurotransmitters can displace catecholamines from their storage sites in the peripheral and central nervous system, and thereby disrupt adrenergic processes in arterioles, kidneys, and brain. Their accumulation in cirrhotic patients may play a role in the pathogenesis of hepatic encephalopathy, hepatorenal syndrome, and hyperdynamic circulation.

4-Hydroxyphenylpyruvate Dioxygenase↗