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Biomedical subjects

P R Erve

Publications and source records attributed to P R Erve.

At least 19 recordsLinked 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↗
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

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↗
PubMed1978

Endotoxin-challenged monkeys and rats.

Studies in our laboratory with both the monkey and the rat showed that, after three hours of endotoxemia, there was a significant decrease in the number of circulating platelets, total hemolytic complement (CH 50 units), and blood serotonin (5-HT) levels. Administration of dexamethasone sodium phosphate in the clinical dose range at the time of endotoxin challenge significantly attenuated the decrease in blood 5-HT levels when compared to the untreated groups in both the monkey and the rat experiments. In the monkey, CH 50 units remained at a higher level when dexamethasone was administered; however, the difference between the treated and untreated groups was not statistically significant. The number of circulating white blood cells and platelets did not appear to be significantly altered by corticosteroid treatment. It is suggested that glucocorticoids may interfere with lipopolysaccharide-induced alterations in complement components or factors regulating hemostasis that influence platelet 5-HT release.

Animals↗
PubMed1976

Glucocorticoid effect on hepatic carbohydrate metabolism in the endotoxin-shocked monkey.

This study investigated the effect of glucocorticoid treatment on survival, on hepatic carbohydrate metabolism, and on levels of hepatic adenine nucleotides in the endotoxin-shocked monkey. Dexamethasone sodium phosphate (DMP) administered either at the time of endotoxin challenge or up to 90 minutes afterward significantly increased the survival rates. Endotoxin administered alone caused profound hypoglycemia and lactic-acidemia, which were alleviated by the administration of DMP. Endotoxin administered alone significantly decreased the hepatic levels of glucose-6-phosphate, fructose-6-phosphate, phospho-enolpyruvate, adenosine triphosphate, adenosine diphosphate, and glycogen; and it significantly increased the hepatic levels of fructose-1,6-diphosphate, lactate, and adenosine mono-phosphate. The administration of DMP at the time of endotoxin challenge maintained the levels of all these metabolites at or near the control levels.

Adenosine Diphosphate↗
PubMed1975

Glucocorticoid and antibiotic effect on experimental gram-negative bacteremic shock.

This study was designed to answer the three following questions: (1) Are glucocorticoids as protective in Gram-negative bacteremic shock as they are in endotoxic shock? (2) Is there any difference in efficacy between a bacteriostatic and a bactericidal antibiotic in bacteremic shock? (3) Does the combination of glucocorticoid with antibiotic potentiate the individual protective effects of both? Bacteremia was induced in male Sprague-Dawley rats by a single intravenous injection of viable Escherichia coli. The results showed that dexamethasone sodium phosphate alone afforded significant protection against Gram-negative bacteremic shock up to eight hours after challenge. The choice of a bactericidal vs a bacteriostatic antibiotic did not influence the survival rates in this study. The survival rate was maximal when dexamethasone was used with both ampicillin sodium and gentamicin sulfate.

Ampicillin↗
PubMed1975

Biochemical monitoring of the surgical patient.

The need for prognostic and biochemical monitors of cellular function becomes increasingly evident with the further elucidation of the metabolic pattern secondary to disease. Thus far studies have shown that lactic acid may be one of these biochemical parameters. Investigations are now in the process of defining other biochemical indicators of cellular dysfunction.

Alkaline Phosphatase↗