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Biomedical subjects

D Rudman

Publications and source records attributed to D Rudman.

At least 73 records · Page 4Linked to original sources
PubMed1987

Subnormal concentrations of serum selenium and plasma carnitine in chronically tube-fed patients.

Forty-seven tube-fed nursing home patients were investigated with regard to serum or plasma selenium (Se), carnitine, and red blood cell (RBC) glutathione peroxidase (GSH-Px). Thirty-six patients were tube fed with Isocal, and 11 were tube fed with Compleat B, an L-carnitine-containing formula. Eighteen elderly nursing home patients and 10 young adults served as controls. Serum Se and plasma carnitine were lowest (p less than 0.05) in the Isocal patients. In all 36 Isocal subjects, Se was below normal, and in 26% of Isocal patients RBC GSH-Px was also below normal. Free and total carnitine were below normal in most Isocal subjects. All 11 Compleat B patients had subnormal serum Se, but most had normal carnitine concentrations. These data suggest that enteral formulae in nursing homes should contain greater than 100 micrograms Se and on the order of a mmol carnitine/1600 kcal.

Adult↗
PubMed1987

Antecedents of death in the men of a Veterans Administration nursing home.

This study aims to learn whether the annual clinical and laboratory screening of nursing home residents provides significant information about their chance of dying during the following year. In August 1984, a comprehensive clinical data base was compiled for 176 male residents of this VA nursing home. During the next 14 months, 12 men were discharged to other locations and were dropped from the study; among the remaining 166, who comprised the study group of this report, 24 died. The most common immediate causes of death were infections (67%) and cardiac disorders (25%). Twenty of the deaths occurred after transfer to the acute hospital services. Among the 67 items in the clinical data base (including absence or presence of 17 diagnoses and 16 drugs), eight were significantly correlated with death rate. Age and functional impairment were directly related, and inversely related were the following: body weight as percent of ideal, triceps skin fold, hematocrit, hemoglobin, serum albumin, and serum cholesterol. Multivariate analysis showed cholesterol and hematocrit to be the most informative of the eight mortality predictors and to correlate with death independently of age and functional level. Subgroups defined on the basis of combinations of mortality-related attributes differed many fold in their death rates. For example, men with cholesterol less than or equal to 156 mg/dl and hematocrit less than or equal to 41% died at a rate 42 times the rate of men with values above both thresholds. For each mortality-related attribute, death rate varied with the level of the attribute. This relationship extended into the generally accepted "normal ranges" for cholesterol, hematocrit, hemoglobin, and albumin.

Aged↗
PubMed1987

Hyposomatomedinemia in the men of a Veterans Administration Nursing Home: prevalence and correlates.

A previous study found hyposomatomedinemia to be common in the men of this VA Nursing Home. To gain information on the prevalence and correlates of this endocrine characteristic, we have measured plasma somatomedin C (SmC) in 69 Nursing Home men 55-95 years old (group I), and in 37 independent men 56-87 years old attending our geriatric medicine outpatient clinic (group II). In groups I and II, a clinical data base was compiled comprising: blood chemistries, measures of body composition - nutritional state and functional level, diagnoses, medications, and morbidity and mortality during the year after the SmC analysis. The mean +/- SD for SmC was significantly (p less than 0.05) lower in group I (0.35 +/- 0.21 units/ml) than in group II (0.45 +/- 0.13 units/ml). SmC less than 0.25 units/ml, a range consistent with severe growth hormone deficiency, was found almost exclusively in group I (31.8% of men in group I, 3.7% of men in group II). In either group I, or in groups I and II combined, SmC was significantly (p less than 0.05) correlated with body weight as percentage of ideal, midarm muscle circumference (MAMC) as percent of standard, diagnosis of cerebrovascular disease, and plasma testosterone level. Men with SmC values below 0.25 units/ml had significantly (p less than 0.05) lower values for body weight as percentage of ideal, and for MAMC as percentage of standard. Except for cerebrovascular disease, SmC did not correlate significantly (p greater than 0.05) with diagnosis, drugs, morbidity or mortality.

Aged↗
PubMed1987

Relationship between plasma somatomedin C and muscle performance in a geriatric male population.

The purpose of this study was to ascertain if a relationship existed between plasma somatomedin C (SmC) level, as an indicator of growth hormone secretion, and muscle performance. Eighteen community-dwelling men between the ages of 65 and 80 comprised the sample group. Muscle strength, power and endurance were measured isokinetically on the elbow flexors and extensors and on the knee flexors and extensors. No relationship was found between plasma SmC levels and measures of muscle performance (P greater than 0.05). The limitations of this study as well as suggestions for future studies were discussed. Further research is needed to assess the effects of growth hormone on muscle performance.

Aged↗
PubMed1986

Hyponatremia in tube-fed elderly men.

Previous reports have described 5-20% prevalence of hyponatremia in extended care facilities, due largely to drugs or inappropriate antidiuretic hormone secretion. In our 400 bed VA extended care facility, 15 men with organic brain syndrome (Alzheimer's, multi-infarct dementia, anoxic encephalopathy or alcoholism) currently receive Isocal via gastrostomy as the sole source of nutrition. We noted intermittent hyponatremia in about half of these patients, and conducted a chart review to investigate the cause. Mean age was 68 yr (range 46-92); tube feeding duration was 3 mo.-3 yr; 266 Na concentrations were obtained from the charts. Simultaneous with these Na analyses, one of three diets prevailed: (A) mixed foods (3-6 g Na/day) orally before gastrostomy; (B) Isocal supplemented with NaCl to give 2 g Na/day; (C) unsupplemented Isocal providing 1 g Na/day. (B) and (C) had been randomly varied by rotating physicians. Serum Na was directly related to Na intake. On (A), Na was within normal range (135-145 mEq/l) in all men. One patient was hyponatremic during diet (B). During (C), eight patients were hyponatremic. Na was less than 135 mEq/l in 40% of all samples during diet (C) and less than 130 mEq/l in 14%. Changing from diet (A) or (B) to diet (C) caused nearly equivalent declines in Na and Cl; K and HCO-3 were unaffected. No hyponatremic patient took drugs known to cause hyponatremia, or had congestive heart failure, hypoalbuminemia, lipemia or fasting hyperglycemia. At the end of the study, four hyponatremic men were changed from (C) to (B); serum Na became normal in all four patients, without edema or hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1986

Effect of beta h-endorphin on release of insulin by rabbit pancreas in response to four secretagogues: comparison with somatostatin and epinephrine.

Previous work showed beta h-endorphin inhibits glucose-stimulated secretion of insulin by rabbit pancreas slices. This study, also conducted with rabbit pancreas slices, compared the antisecretagogue actions of beta h-endorphin, somatostatin 1-14, and epinephrine versus four secretagogues, glucose, mannose, leucine and potassium chloride. All three antisecretagogues inhibited all four secretagogues. The order of potency of the antisecretagogues varied according to secretagogue. Naloxone antagonized only beta h-endorphin among the three antisecretagogues, and phentolamine antagonized only epinephrine.

Animals↗
PubMed1986

Hyposomatomedinemia in the nursing home patient.

Plasma somatomedin C (SmC) concentration was compared in three groups of men: 58 healthy independent men aged 26 to 45 years; 28 independent men aged 52 to 87 years; and 50 male nursing home residents aged 51 to 95 years. Somatomedin C (mean +/- SE) was 0.73 +/- .04 U/mL, 0.41 +/- .03 U/mL, and 0.33 +/- .03 U/mL in these three groups, respectively (P less than .05 for the differences between all three groups). Somatomedin C less than 0.25 U/mL, a range consistent with severe growth hormone deficiency in children, occurred in 0% of the independent younger men, in 15% of the independent elderly, and in 37% of the nursing home men. Somatomedin C was inversely correlated with age in the independent elderly, but the excess of hyposomatomedinemia in the nursing home men was not explained by age.

Adult↗
PubMed1985

Plasma concentrations of transsulfuration pathway products during nasoenteral and intravenous hyperalimentation of malnourished patients.

We have monitored the plasma concentrations of products of the transsulfuration pathway in 11 undernourished noncirrhotic patients, and in 10 cachectic cirrhotic subjects, before and during nasoenteral nutrition with Vivonex (Norwich-Eaton Pharmaceuticals, Norwich, NY) or total parenteral nutrition (TPN) with FreAmine III (American McGaw, Irvine, CA). In the cirrhotic cases eating a mixed diet, levels of taurine, cysteine, plasma glutathione, and free choline were subnormal. During nasoenteral hyperalimentation, methionine was elevated while cysteine, glutathione, and free choline levels remained depressed. During TPN, levels of taurine, cysteine, protein-bound cysteine, glutathione, free choline, and phosphatidyl choline were depressed and methionine was elevated. In the noncirrhotic cases eating a mixed diet, only the free choline concentration was low. During nasoenteral hyperalimentation, the plasma levels of both free choline and total carnitine were depressed. During TPN, plasma levels of cystine, protein-bound cysteine, total carnitine, free choline, and phosphatidyl choline were subnormal. These data suggest that biosynthesis of several products of the transsulfuration pathway may be inadequate in both cirrhotic and noncirrhotic patients during TPN with FreAmine III.

Adolescent↗
PubMed1985

The short child with subnormal plasma somatomedin C.

In 59 male and 59 female healthy children of average stature between 7 and 10 yr old, the normal range of plasma somatomedin C was investigated. The 95% tolerance limits narrowed progressively when the child's plasma somatomedin C status was described by the mean of one, two, three, or four determinations at 6-wk intervals. The 95% tolerance limits were therefore based on the mean of four determinations. In 97 children, age 7 to 10, below the 3.0 percentile in height, 44 had an average plasma somatomedin C below the 2.5 percentile. Among these hyposomatomedinemic short children, 19 were partially or totally deficient in growth hormone, 20 had normal immunoreactive growth hormone responses to dopa, glucagon, and sleep (nongrowth hormone deficient), and five had borderline provocative tests. Both growth hormone deficient and nongrowth hormone deficient children showed significant linear growth responses to 6-month courses of human growth hormone (0.16 to 0.70 unit/kg/wk). The responses of the latter group were 50 to 90% as great as those of the former.

Child↗
PubMed1985

Heterogeneity of growth hormone in the nocturnal serum of children.

The nocturnal serum of 13 nongrowth hormone deficient, hyposomatomedinemic short children and of 12 normal children of average height was analyzed by both polyclonal and biclonal radioimmunoassays. The biclonal/polyclonal ratio for immunochemical grade human growth hormone was 1.0, but for the nocturnal sera in both groups, this ratio was significantly less than 1.0 (range 0.5-1.2, average 0.7-0.8). The ratio did not differ significantly between the two groups of children.

Adolescent↗
PubMed1984

Comparative study of serum human growth hormone measurement with NB2 lymphoma cell bioassay, IM-9 receptor modulation assay, and radioimmunoassay in children with disorders of growth.

The biological activity of GH in serum from 10 adult volunteers, 6 children with normal stature, and 26 children with growth retardation was assessed using the Nb2 rat lymphoma cell bioassay and the IM-9 human lymphocyte receptor modulation assay. The bioassay/RIA ratios for both bioassays varied widely but the range of ratios found in the normal stature adults and children was not different than that found in the group of children with growth retardation, which included 4 children with a presumptive diagnosis of bioinactive GH. We conclude that the use of these two bioassays is a valid approach to the assessment of the bioactivity of the circulating molecular forms of GH and that a large number of children with disorders of growth can be screened to identify patients with bioinactive GH.

Adolescent↗
PubMed1984

Plasma cysteine, cystine, and glutathione in cirrhosis.

Plasma contains three forms of cyst(e)ine: cysteine, cystine, and protein-bound cysteine. The former is a thiol and the latter two are disulfides. The levels of all three types of cyst(e)ine, as well as the cysteinyl tripeptide glutathione, were measured in the plasma of 14 normal and 10 cirrhotic individuals. All subjects ate mixed foods. Some cirrhotic patients were studied during nasogastric hyperalimentation with Vivonex (Norwich Eaton Pharmaceuticals, Norwich, N.Y.) as well as during total parenteral nutrition with FreAmine III (American McGaw, Irvine, Calif.); neither formula contains cyst(e)ine. Regardless of the nature of the diet, cirrhotic patients had significantly subnormal values for cysteine, glutathione, and albumin. In addition, the following significant changes were found to be diet-dependent: (a) elevated methionine during Vivonex, (b) subnormal taurine during mixed foods and total parenteral nutrition, (c) depressed protein-bound cysteine during total parenteral nutrition, (d) depressed cyst(e)ine thiol/disulfide ratio during mixed foods, and (e) depressed total thiol during Vivonex and total parenteral nutrition. The data indicate multiple abnormalities in sulfur metabolism in cirrhosis.

Adult↗