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Biomedical subjects

S R Newmark

Publications and source records attributed to S R Newmark.

At least 19 recordsLinked to original sources
PubMed1994

Thyrotoxicosis-induced congestive heart failure in an urban hospital.

Thyrotoxicosis has been associated with several cardiac complications, including atrial fibrillation (AF), functional cardiomyopathy, and congestive heart failure (CHF). Thyrotoxicosis-induced CHF has been considered an unusual complication of thyrotoxicosis, occurring generally in older patients. To determine the nature and frequency of this complication of thyrotoxicosis in an adult, hospitalized population, the authors consecutively evaluated all admissions to a 535-bed urban hospital during a 14-month period. Admitted during the study period were 177 individuals with a principal diagnosis of AF and 21 individuals with a principal diagnosis of thyrotoxicosis. Eleven of these individuals had concomitant AF and thyrotoxicosis, which was 6% of the AF group. Of these 11 patients, 5 had clinically apparent CHF without evidence of other organic heart disease (Group A) and 6 had only AF without clinical CHF (Group B). The 5 patients with CHF had a significantly lower mean age (36) than the 6 with thyrotoxicosis and AF only (P < 0.03). Echocardiography revealed Group A to have a mean of 2.8 cardiac chambers enlarged compared with a mean of 1 in Group B (P < 0.008). Four of the five patients with CHF had normal left ventricular function. Mean levels of serum thyroxine, albumin, hematocrit, left ventricular percent shortening, and left atrial diameter were similar in groups A and B. Based on the authors' data, thyrotoxicosis-induced CHF is not as rare a complication of thyrotoxicosis in young individuals as reported previously. Thyrotoxicosis-induced CHF most commonly has a dilated cardiomyopathy and high output failure.

Adult↗
PubMed1984

Metabolic profiles in patients with acute neurosurgical injuries.

Twenty-seven patients with acute neurosurgical injuries were compared with 23 patients with neurosurgical and multisystem injuries and 10 patients with multi-system injuries without neurosurgical injuries. Patients with isolated acute neurosurgical injuries did not demonstrate a hypermetabolic state with increased loss of nitrogen and decreased circulating levels of albumin, prealbumin, and retinol-binding protein when compared to multisystem-injured patients. Patients with demonstrated hypermetabolism on day 1 were supported with parenteral nutrition which decreased their protein losses and stabilized other metabolic variables such as calcium and phosphorus. It is concluded that patients with neurosurgical and other multisystem injuries require close metabolic monitoring. Early institution of metabolic support in hypercatabolic patients may prevent clinically significant depletion states.

Adult↗
PubMed1982

Immunologic status in severe obesity.

Aspects of humoral, secretory and cell-mediated immunologic status were studied in a group of 22 adults with severe, uncomplicated obesity. Normal concentrations of serum immunoglobulins (IgG, IgA, IgM, IgD) and complement components (C3, C4) were found. Levels of secretory IgA and lysozyme in the tears of obese patients did not differ from normal weight controls. The obese individuals had circulating sub-populations of T and B lymphocytes which were the same as controls. No effect of obesity was detected on the response of lymphocytes to stimulation in vitro with polyclonal T and B cell mitogens. All but two of the obese patients responded to one or more of the recall skin test antigens employed. We conclude that severe overweight alone, uncomplicated by diabetes or hyperlipidemia, is not associated with significant immunologic dysfunction.

Adult↗
PubMed1982

Prevalence of gallstones in obese Caucasian American women.

Although the association between gallstones and obesity is well known, no attempt has been made to quantitate the increased risk for gallstone formation associated with moderate obesity commonly seen in clinical practice. To determine the prevalence of both asymptomatic and symptomatic gallstones, screening oral cholecystograms were combined with prior documented history in 249 consecutive obese Caucasian women aged 20-59 yr who were seeking treatment for obesity in an out-patient clinic. To ascertain the relative risk of moderate obesity for gallstone formation, the results were compared with a control group of 60 consecutive women who were undergoing screening health examinations in the same clinic. Both groups were without gastrointestinal symptoms. Gallstone prevalence averaged 31 percent among obese women compared to 10 percent in the control group. Sixty percent of gallstones in the combined 20-29 yr age group were asymptomatic. However, among all patients with gallstone disease 59 percent had symptomatic disease evidence by prior cholecystectomy. Moderate obesity imposes at least a three-fold risk of gallstone disease in Caucasian women.

Adult↗
PubMed1981

Nutritional support in an inpatient rehabilitation unit.

Twenty-four patients with protein-calorie malnutrition were treated with intensive dietary support to improve nutritional status. Sixteen patients were able to ingest a mean of 1,945kcal and 77gm protein per 24 hours. Eight patients were unable to consume sufficient protein (11 gm) and kcal (311 gm) per 24 hours; these patients were treated with enteral tube feeding. Patients supported on tube feeding increased serum albumin levels by 0.5gm/100ml and were eventually able to consume 2,170kcal and 87gm of protein per 24-hour period after tube feeding was discontinued. Treatment of patients with protein-calorie malnutrition may require a multiple-modality nutritional support system in a rehabilitation unit.

Humans↗
PubMed1981

Nutritional assessment in a rehabilitation unit.

Forty-nine consecutive patient admissions to a rehabilitation unit were evaluated by a nutritional assessment team. Measured parameters included serum albumin, height, weight, 24-hour protein and calorie intake, and response to 4 antigens (purified protein derivative, streptokinase/streptodornase, trichophyton, candida) administered by intradermal injections. Patients were classified normal (albumin greater than or equal to 3.5 gm%, positive skin tests, normal weight), Kwashiorkor (albumin less than 3.5gm%, anergic skin tests, no weight loss), marasmus (albumin greater than or equal to 3.5gm%, anergic skin tests, weight loss greater than 101lb (4.54kg) or obesity (greater than 130% ideal body weight). Protein-calories malnutrition (marasmus or kwashiorkor) was found in 34 (67%) of the patients. Only 15 patients (33%) satisfied criteria for normal nutritional status at the time of admission. Four subjects satisfied the criteria for both obesity and kwashiorkor. Because of the increased morbidity and mortality associated with protein-calorie malnutrition, all patients admitted to a rehabilitation unit should have a nutritional assessment. If the assessment demonstrates malnutrition, a program of metabolic support should be initiated to increase protein levels and restore immune competence.

Adolescent↗