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Biomedical subjects

L Kramer

Publications and source records attributed to L Kramer.

At least 145 records · Page 8Linked to original sources
PubMed1985

Disseminated aspergillosis and pacemaker endocarditis.

Clinical and pathologic findings in a 65-year old woman with fever of unknown origin are described in this report. Generalized aspergillosis with endocarditis was demonstrated at autopsy. The patient had no recognized risk factors for the development of fungal infection. A functional transvenous pacemaker lead, inserted 2 years previously, was completely encased in a large infected thrombus and may have been the initial site of infection. Septicemia and endocarditis are rare but well-described complications of cardiac pacing, and should be considered in the differential diagnosis of fever of unknown origin in patients with pacemakers.

Aged↗
PubMed1984

Effect of calcium on phosphorus metabolism in man.

The effect of calcium on phosphorus metabolism was studied in adult males by determining phosphorus and calcium balances during three calcium intakes of approximately 200, 800, and 2000 mg/day. Each of these calcium intakes were given during two intake levels of phosphorus of approximately 800 and 2000 mg/day. In all studies, the addition of different amounts of calcium led to a significant decrease of the urinary phosphorus, a significant increase of the stool phosphorus, and significant improvement of the phosphorus balance irrespective of the phosphorus intake. Only in one study in which the calcium intake was increased from 230 to 831 mg/day during the high phosphorus intake of approximately 2000 mg/day were these changes not significant. During all calcium intakes, the decrease in urinary phosphorus was greater than the increase in stool phosphorus irrespective of the phosphorus intake. The apparent absorption of phosphorus decreased on increasing the calcium intake. The calcium balance was not adversely affected by increasing the phosphorus intake to 2000 mg/day during any of the calcium intakes.

Adult↗
PubMed1984

Effect of calcium and phosphorus on zinc metabolism in man.

Calcium and phosphorus have been shown to inhibit the availability of zinc for absorption in animal studies, but limited information is available on this subject in man. In the present study, the effect of both calcium and phosphorus on zinc metabolism was investigated in adult men by determining metabolic balances of zinc during three intake levels of calcium of 200, 800, and 2000 mg/day, and during two intake levels of phosphorus of 800 and 2000 mg/day. The analyzed dietary zinc intake was normal and was kept constant throughout all study phases. Increasing the calcium intake from 200 mg to two higher intake levels up to 2000 mg/day did not significantly change the urinary or fecal zinc excretions or the zinc balance. Also, increasing the phosphorus intake from 800 to a high intake of 2000 mg/day did not have any effect. The simultaneous use of the high calcium and high phosphorus intake also had no effect on zinc excretions and on the zinc balance.

Adult↗
PubMed1984

Calcium requirements in humans. Report of original data and a review.

Presently submitted and previously available data indicate that the recommended calcium requirement of 800 mg/day is inadequate for a large segment of the population, particularly the elderly. With an intake of 800 mg of calcium/day, calcium balance was only slightly positive, without consideration of dermal losses or other risk factors that may play a role in calcium bioavailability and calcium retention. A calcium intake of 1000-1200 mg/day is preferable, as calcium balance increased significantly when calcium intake was increased from 800 to 1200 mg/day; there was no further improvement in calcium balance on higher calcium intakes, up to 2300 mg/day.

Adaptation, Physiological↗
PubMed1984

Fluoride therapy in metabolic bone disease.

Multiple forms of treatment are used for osteoporosis, Paget's disease of the bone, and osteogenesis imperfecta. Because of the effect of fluoride (F) on bone, these bone conditions may benefit from F therapy. In the present study, the metabolic effects of two dose levels of F (20 and 45 mg, given as sodium fluoride) were studied on calcium (Ca) and F metabolism in patients with osteoporosis, whereas the effect of the 45-mg dose was studied in patients with Paget's disease. In patients with osteoporosis, the retention of F increased with increasing F intake, indicating F deposition in bone. However, only the 45-mg dose decreased urinary Ca excretion. F did not decrease fecal Ca excretion, indicating that the intestinal absorption of Ca did not improve during F therapy. This was confirmed in 47Ca absorption studies. The duration of F therapy was 3 months, utilizing the 45-mg dose. Clinically, the patients experienced relief of bone pain, and the onset of this change coincided with the decrease in urinary Ca. The 3-month course of treatment was sufficient for alleviation of clinical symptoms for many months and even years. In patients with Paget's disease, F supplements decreased urinary Ca and also resulted in relief of bone pain. F therapy for osteogenesis imperfecta resulted in decreased fracture incidence.

Calcium↗
PubMed1983

Further studies of the effect of a high protein diet as meat on calcium metabolism.

Previous studies in this Unit have shown that a high protein intake, given as meat, did not induce hypercalciuria, except for the initial and temporary increase in two subjects. In the present investigation the long-term effect of a high meat diet on calcium metabolism was studied for 78 to 132 days in four adult males and the short-term effect for 18 to 30 days in three subjects. Calcium and phosphorus balances and calcium absorption studies, using 47Ca as the tracer, were carried out. During the long-term high meat intake and during the short-term high meat studies, there was no significant change of the urinary or fecal calcium nor of the calcium balance. There was also no significant change of the intestinal absorption of calcium during the high meat intake. These long- and short-term studies have confirmed our previous results that a high protein intake, given as meat, does not lead to hypercalciuria and does not induce calcium loss.

Adult↗
PubMed1982

Effect of small doses of aluminum-containing antacids on calcium and phosphorus metabolism.

The effect of small doses of four commercially available aluminum-containing antacids on calcium and phosphorus metabolism was investigated in adult males in 20 studies. During the use of these doses of antacids, urinary and fecal calcium increased significantly during a low calcium intake averaging 252 mg/day, and the calcium balances became distinctly more negative. There was a reversal of the normal pattern of phosphorus excretions, namely, the fecal phosphorus was high and the urinary phosphorus was low. During a normal calcium intake of 800 mg/day, these doses of antacids did not result in significant changes of the calcium excretions or balance. Despite the decrease in net intestinal absorption of calcium, the average 47Ca absorption remained unchanged, irrespective of the type and dose of antacid used. In three patients who received large therapeutic doses of antacids, 240 to 450 ml/day, the changes of calcium and phosphorus metabolism were intensified.

Adult↗
PubMed1981

Disturbances in prosody. A right-hemisphere contribution to language.

In addition to grammar and semantics, prosody constitutes a third element of speech. Modulations of prosody can produce alterations in the meaning and affective tone of spoken language. Previous studies have suggested that right-hemisphere lesions may selectively disrupt a patient's ability to interpret and express the affective component of prosody. On the other hand, this study shows that the effect of right-hemisphere damage on prosody is more widespread. Thus, when discrimination, repetition, and spontaneous production of nonemotional prosody were tested in nine patients with right-sided brain injuries and ten control subjects without brain damage, the patients were found to be significantly worse than the control subjects in their ability to distinguish and express prosodic features that provide phonemic or emphatic information. These results suggest that right-hemisphere damage may affect prosody in a more general manner than was previously assumed.

Adult↗
PubMed1981

Zinc and mineral content of weight reducing diets.

The zinc content of four commonly used weight reduction diets and of three constant diets used for weight reduction in a Metabolic Research Unit was determined by atomic absorption spectroscopy. The diets were also analyzed for other elements, namely, for nitrogen, calcium, phosphorus, magnesium, and iron. The four commonly used weight reduction diets and two of the metabolic diets contained approximately 1000 cal, while one metabolic diet contained 600 cal. The zinc content of the diets correlated with the type but not with the amount of protein used because proteins of high biological value may have a low zinc content. There was no correlation between the zinc and calorie content of the diets. Although the protein content of two equicaloric diets was normal and similar, the zinc content differed by a factor of 2. Conversely, when the dietary protein was increased the dietary zinc content remained low, half of that of the RDA. Even when the diet contained only 600 cal the zinc intake was still approximately 75% of the RDA. The phosphorus and magnesium content correlated with the dietary protein. These studies have shown that the adequacy of the zinc and iron content of weight reduction diets depends on the type of protein used, however, there is no apparent correlation between the zinc and iron content of individual protein-containing foods.

Calcium, Dietary↗
PubMed1980

Effect of aluminum hydroxide on fluoride metabolism.

Aluminum inhibits intestinal absorption of fluoride in animals but little information is available about man. To determine whether and to what extent aluminum affects fluoride absorption in man, effects of aluminum hydroxide on fluoride metabolism were studied under controlled dietary conditions. Relatively small amounts of aluminum hydroxide were used (30 ml three times daily, containing a total of 1.8 gm aluminum, were given for several weeks). Fluoride balances were determined in control studies and during the intake of aluminum hydroxide. The fluoride intake was the fluoride content of the diet and the drinking water. Two studies were also carried out on a high-fluoride intake. The use of aluminum hydroxide was associated with an increase in fecal fluoride excretion and a decrease in net absorption of fluoride regardless of the intake fluoride, calcium, phosphorus, or magnesium. Urinary fluoride decreased during aluminum hydroxide ingestion. Our studies show that relatively small amounts of aluminum hydroxide inhibit intestinal absorption of fluoride in man.

Aged↗
PubMed1980

Effect of calcium, phosphorus, magnesium, and aluminum on fluoride metabolism in man.

The studies of the interaction of fluoride with minerals in man have shown that: 1. in contrast to observations made in animals, the high intake of calcium, phosphorus, and magnesium in amounts that can be used in humans did not inhibit the intestinal absorption of fluoride in man; 2. the lack of effect of added calcium, given in divided doses, on the intestinal absorption of fluoride has relevance for the use of a high calcium intake during fluoride therapy for osteoporosis; 3. aluminum as the hydroxide, commonly used as an antacid in clinical medicine, significantly decreases the intestinal absorption of fluoride. This inhibitory effect, in conjunction with the known effects of aluminum-containing antacids in causing calcium loss as a consequence of phosphorus depletion, may contribute to the development of skeletal demineralization.

Adult↗
PubMed1980

Fluoride metabolism in patients with chronic renal failure.

Studies of fluoride metabolism were carried out in patients with chronic renal failure by determining fluoride balances for several weeks. The fluoride intake was due to the analyzed fluoride content of the diet and of the drinking water. The effect of aluminum hydroxide on fluoride metabolism was investigated because this antacid is commonly used therapeutically for these patients. Studies have shown that urinary fluoride excretion in patients with chronic renal failure was significantly lower than that in patients with normal renal function, resulting in a signicantly higher retention of fluoride. Although the fecal fluoride excretion in patients with chronic renal failure was slightly but significantly increased, this change did not compensate for the decrease of the urinary fluoride excretion. The intake of aluminum hydroxide resulted in a significant increase of fecal fluoride excretion and in a significant decrease of net absorption and retention of fluoride in patients with chronic renal failure.

Aged↗