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Biomedical subjects

R Dodds

Publications and source records attributed to R Dodds.

At least 19 recordsLinked to original sources
PubMed1992

Protein intake and blood glucose as modulators of GFR in hyperfiltering diabetic patients.

Glomerular hyperfiltration has been claimed to be a risk factor for the development of diabetic nephropathy. Protein intake and hyperglycemia can both increase GFR in diabetic and normal subjects. Our study was designed to explore the relative importance of short-term changes in protein intake and glycemia on the modulation of renal hemodynamics in insulin-dependent diabetic (IDDM) patients with and without glomerular hyperfiltration. The renal hemodynamic response to a protein challenge was studied in eight hyperfiltering (HF) and eight normofiltering (NF) patients after a three week period of low or normal protein diet (LPD, NPD), each study being conducted twice, in random order, under conditions of prevailing hyperglycemia (H) and euglycemia (E). In HF patients GFR failed to increase significantly in response to protein challenge during NPD under conditions of either H or E (Baseline vs. 2 hr H: 151 +/- 4 vs. 155 +/- 6, NS; E 147 +/- 4 vs. 157 +/- 7 ml/min/1.73 m2, NS). A more normal response was restored following LPD with GFR increasing in all but one patient after challenge during H and in all patients during E (Baseline vs. 2 hr H: 130 +/- 7 vs. 145 +/- 8, P less than 0.07; E: 127 +/- 7 vs. 143 +/- 7 ml/min/1.73 m2, P less than 0.01). Changes in RPF paralleled the changes in GFR and filtration fraction remained stable under all study conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

The ability of deaf students to understand text. A comparison of the perceptions of teachers and students.

Sixteen deaf high school students and nine of their teachers, two deaf and seven hearing, were interviewed for their perceptions of the interest and difficulty of three types of text. Students read and retold the texts and reported on their use of metacognitive strategies and comprehension monitoring and assessment. In this paper, we compare the perceptions of the teachers and students. The teachers in this study underestimated the extent to which their students could comprehend independently, often based on insubstantial evidence. The text perceived to be most difficult by both teachers and students was also considered the most interesting to students, but not to teachers. This text also fostered the greatest use of a variety of metacognitive strategies, suggesting that difficult materials should not be avoided or simplified for deaf students.

Adolescent↗
PubMed1990

Renal, metabolic and hormonal responses to ingestion of animal and vegetable proteins.

Renal and hormonal responses were studied in a group of healthy individuals fed, in random order, for three weeks, a vegetable protein diet (N = 10), an animal protein diet (N = 10), or an animal protein diet supplemented with fiber (N = 7), all containing the same amount of total protein (chronic study). In seven additional subjects the acute renal, metabolic and hormonal response to ingestion of a meat or soya load of equivalent total protein content was investigated (acute study). In the chronic study GRF, RPF and fractional clearance of albumin and IgG were significantly higher on the animal than the vegetable protein diets (GFR: 121 +/- 4 vs. 111 +/- 4 ml/min/1.73 m2, P less than 0.001; RPF: 634 +/- 29 vs. 559 +/- 26 ml/min/1.73 m2, P less than 0.001; theta alb: 19.5 +/- 3.1 vs. 10.2 +/- 1.6 x 10(-7), P less than 0.01; theta IgG: 11.6 +/- 3.1 vs. 7.5 +/- 1.7 x 10(-7), P less than 0.05). Renal vascular resistance was lower on the animal than vegetable protein diet (82 +/- 5 vs. 97 +/- 5 mmHg/min/liter; P less than 0.001). Fiber supplementation to APD did not have any effect on the renal variables measured which were indistinguishable from APD. In the acute study, GFR and RPF both rose significantly by approximately 16% (P less than 0.005) and approximately 14% (P less than 0.05), respectively, after the meat load, while RVR fell by approximately 12% (P less than 0.05). There were no significant changes in these parameters following the soya load.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Myopic and nonmyopic aphakic retinal detachment: time interval and location of breaks.

Of 471 retinal detachments occurring in aphakic patients after undergoing intracapsular cataract extraction, we reviewed 318 eyes with uncomplicated aphakia (no vitreous loss). Myopic eyes had equatorial breaks 38% of the time versus 19% for nonmyopic eyes. The time interval between aphakia and detachment was shorter for myopic than for nonmyopic eyes. Our results showed a significant incidence of: (1) equatorial breaks in myopic eyes versus nonmyopic eyes (P less than 0.005), and (2) earlier detachments for myopic eyes versus nonmyopic eyes (P less than 0.005). The presence of equatorial breaks seemed to be associated with earlier retinal detachments.

Aphakia, Postcataract↗
PubMed1988

Protein restriction, blood pressure and the progression of diabetic nephropathy.

Diabetic nephropathy is the long-term complication of diabetes responsible for the greatest increased mortality. Clinical nephropathy is characterised by a triad consisting of persistent proteinuria (total urinary protein greater than 0.5 g/24 h), rising arterial pressure and declining renal function. The role of treatment of raised blood pressure and the influence of dietary protein restriction on the established progressive phase of the disease are discussed. Subclinical elevations of urinary albumin excretion rates (greater than 30 micrograms/min; microalbuminuria), glomerular hyperfiltration and marginal elevations of arterial pressure are early markers of later clinical nephropathy which appear to respond to strict blood glucose control, blood pressure treatment and lowered dietary protein intake. Recent evidence to suggest that an inherited predisposition to raised arterial pressure may confer the susceptibility to diabetic nephropathy is presented.

Blood Pressure↗
PubMed1987

Effect of protein restriction in insulin dependent diabetics at risk of nephropathy.

Persistent proteinuria is strongly associated with increased mortality in insulin dependent diabetes, and risk of this condition can be predicted many years in advance by subclinical increases in albumin excretion rate (microalbuminuria). Eight normotensive insulin dependent diabetics with microalbuminuria who had overnight albumin excretion rates of between 15 and 200 micrograms/min underwent a three week randomised crossover study of their normal protein diet (median 92 (range 55-117) g/day) and a low protein diet (47 (38-57) g/day). Both diets were isoenergetic, and the low protein diet was supplemented with calcium and phosphate. Median overnight albumin excretion rate fell from 23.0 (15.0-170.1) micrograms/min during the normal diet to 15.4 (4.1-97.8) micrograms/min during the low protein diet. No consistent change was found in urinary excretion of beta 2 microglobulin during the two diets. The reduction in albumin excretion rate was accompanied by a significant fall in median glomerular filtration rate and fractional renal clearance of albumin. Kidney volume remained unchanged. There were no significant changes in glycaemic control or arterial blood pressure. In these few patients restriction of dietary protein had a beneficial effect on microalbuminuria, independent of changes in glucose concentrations and arterial blood pressure.

Adolescent↗
PubMed1987

Changes in renal function in response to protein restricted diet in type 1 (insulin-dependent) diabetic patients.

Glomerular filtration rate, renal plasma flow and urinary albumin excretion rate were measured during insulin-induced euglycaemia in 12 male Type 1 (insulin-dependent) diabetic patients after a 3-week period of low protein diet (45 g/day) or a similar period on unchanged conventional diet (103 g/day). No changes in glycaemic control, indicated by home blood glucose profiles and serum fructosamine concentration, or in arterial pressure, were noted on either diet. On low protein diet, glomerular filtration rate was lower (p less than 0.001) in all patients, but there was no difference in renal plasma flow between low protein diet and normal protein diet; filtration fraction fell significantly on low protein diet (p less than 0.001). Fractional clearance of albumin was also lower (p less than 0.05) on low protein diet. This study suggests that reduction of dietary protein induces, independently of changes in plasma glucose and arterial pressure, modifications in glomerular filtration rate, filtration fraction and fractional clearance of albumin, which may be associated with a beneficial effect on the evolution of diabetic renal disease.

Adult↗
PubMed1987

Effect of protein-restricted diet on renal response to a meat meal in humans.

To study the influence of preceding dietary protein intake on the renal response to a protein meal we examined renal hemodynamic and excretory responses to a meat meal in six normal human subjects either taking their normal-protein diet (NPD, 75 +/- 5 g/day) or after 3 wk of a low-protein diet (LPD, 43 +/- 3 g/day; P less than 0.005). Glomerular filtration rate (GFR) was lower on LPD than on NPD (107 +/- 7 vs. 124 +/- 5 ml X min-1 X 1.73 M-2, respectively; P less than 0.01), as was renal plasma flow (RPF) (NPD, 666 +/- 44; LPD, 605 +/- 43 ml X min-1 X 1.73 M-2; P less than 0.05). Filtration fraction (FF) was not different (NPD, 0.19 +/- 0.01; LPD, 0.18 +/- 0.01). Urinary excretion of albumin was also lower after LPD than NPD (2.1 +/- 0.5 vs. 4.2 +/- 0.8 micrograms/min; P less than 0.05). After an 80-g protein meat meal, GFR rose to a ceiling significantly higher on NPD than on LPD (132 +/- 4.8 vs. 120 +/- 5.2 ml X min-1 X 1.73 M-2; P less than 0.02), even though the percent changes were greater on LPD than on NPD (12.7 +/- 3.3 vs. 6.6 +/- 1.5%, respectively; P less than 0.05). There was a rise in RPF that was entirely attributable to a fall in renal vascular resistance, and FF did not change. On both diets, oral protein loading produced a 200-300% increase in the urinary excretion and fractional clearance of albumin and IgG, but failed to alter that of beta 2-microglobulin.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Hypertriglyceridemia and lipid inclusions in a case of Philadelphia chromosome-positive, acute nonlymphocytic leukemia.

We report a case of a 71-year-old female patient with an unusual morphological variant of Philadelphia chromosome-positive, acute nonlymphocytic leukemia. The myeloblasts exhibited an extreme degree of lipid vacuolization and the serum exhibited hyperlipidemia. The initial serum triglyceride level was 756 mg/dL. There were 26,000 white blood cells per cubic millimeter with 19% myeloblasts. The bone marrow contained greater than 80% myeloblasts that were myeloperoxidase- and chloracetate esterase-positive and typed positive for OKM1 and Leu 1 myeloid cellular markers. At remission, the lipid inclusions disappeared and the serum triglyceride levels returned to normal. Both abnormalities recurred at relapse. The cause of the hyperlipidemia and lipid inclusions was most likely an acquired hyperlipoproteinemia and secondary absorption of lipids into the malignant cells.

Acute Disease↗
PubMed1985

Bilateral and massive lipoidal infiltration of the cornea (secondary lipoidal degeneration).

A 41-year-old white man presented with bilateral white infiltration of the cornea from limbus to limbus. Extensive examination revealed no manifestations of disorders of lipid metabolism and the patient gave no history of previous ocular disease. VDRL and other serological tests were negative. The corneal button removed by penetrating keratoplasty from the right eye was studied by light microscopy, histochemistry and electron microscopy. The light microscopic appearance was consistent with lipoidal degeneration of the cornea associated with stromal vascularization and chronic keratitis, more likely a secondary lipoidal degeneration. Cholesterol clefts were seen in all levels of the stroma focally surrounded by a foreign body giant cell reaction. Lipid vacuoles were observed in extracellular and intracellular locations within histiocytes and fibroblasts in vascularized and inflammed areas. Lipid stains disclosed cholesterol crystals, neutral fats, and phospholipids.

Adult↗
PubMed1985

Heparin and dihydroergotamine prophylaxis against thrombo-embolism after hip arthroplasty.

A prospective study involving 500 consecutive patients undergoing hip replacement was performed to find out whether a combination of heparin and dihydroergotamine was effective in preventing postoperative fatal and non-fatal emboli. Deep-vein thrombosis was demonstrated in 131 cases (26.2%), in 99 of whom thrombi were confined to the ipsilateral (operated) limb and in 13 to the contralateral limb; 19 patients developed bilateral thrombi. Nine patients (1.8%) died during the first four weeks after operation, before they were discharged from hospital; in one, major emboli were demonstrated in the right pulmonary artery. Three of the 500 patients developed non-fatal pulmonary emboli. Excessive bleeding occurred in 21 (4.2%) and in 19 of these prophylaxis was discontinued. Wound haematomas developed in 25 patients (5.0%); only six required evacuation but in none of these six did deep infection occur while in hospital; in three patients, however, the wound haematoma prolonged the stay in hospital. Thus the combination of heparin and dihydroergotamine proved an effective prophylaxis against pulmonary embolism in patients undergoing total hip replacement. The risk of bleeding complications is wholly acceptable when balanced against the advantages of the therapy.

Aged↗