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Biomedical subjects

C F Anderson

Publications and source records attributed to C F Anderson.

At least 91 records · Page 5Linked to original sources

Results of treatment of renal failure by means of home hemodialysis.

Of 630 patients who began hemodialysis treatment for chronic renal failure between 1965 and 1977, 147 successfully completed training for home hemodialysis. Patient compliance was satisfactory, as reflected by the results of monthly blood chemical values, hematocrits, and weight gain between dialysis. Although only 15 patients had previous myocardial infarctions and 4 had had strokes before beginning dialysis, 9 patients subsequently experienced acute myocardial infarctions and 14 had strokes. Of the 45 patients who died while being maintained by hemodialysis, 24 had cardiopulmonary complications and 6 had strokes. Despite such complications, 70 patients were gainfully employed and 32 were active at home or at school, whereas 29 were totally disabled. At last follow-up, 74 remained on home hemodialysis, 53 had functioning renal allografts, and the rest of the patients were being maintained in our dialysis center, had transferred elsewhere, or were being maintained by peritoneal dialysis. The overall estimated 5-year survival rate was 56%, whereas the estimated 5-year survival rate for those maintained by home hemodialysis alone was 52%.

Adolescent↗

Laboratory assessment of nutritional status.

Malnutrition is one of the major causes of increased morbidity and mortality among hospitalized patients. The availability of nutritional therapy for these patients has made clinicians aware of the need for reliable methods of nutritional assessment. A variety of anthropometric, biochemical, and immunologic parameters has been used as indicators of protein-calorie malnutrition. Recently, the concentration of several rapid-turnover visceral proteins (transferrin, thyroxine-binding prealbumin and retinol-binding protein) has been shown to be a very sensitive parameter for indicating both the efficiency of nutritional therapy and conditions of borderline protein intake in apparently healthy children. Likewise, several immunologic parameters (including T cells, delayed hypersensitivity response, and complement components) have been shown to correlate with morbidity, mortality risk, sepsis, and death.

Avitaminosis↗

Continuous ambulatory peritoneal dialysis. Three years' experience at the Mayo Clinic.

From January 1979 through January 1982, 69 patients with end-stage renal failure of various causes were treated by continuous ambulatory peritoneal dialysis. The dialysis was adequate and stable in all except four patients; two of these four became irreversibly uremic, and the other two had inadequate ultrafiltration. Hemoglobin levels increased initially and remained stable in all but two patients. In our experience, metabolic problems included control of secondary hyperparathyroidism, adequate protein nutrition, progressive neuropathy, abnormal lipoprotein profiles, and excessive weight gain. Technical problems included recurrent peritonitis, maintenance of adequate peritoneal access, and development of abdominal hernias. In general, all but two patients remained enthusiastic about this type of therapy despite inherent problems. The long-term potential of continuous ambulatory peritoneal dialysis remains uncertain at this point, but for most patients, adequate short-term treatment by this method is a reasonable alternative to hemodialysis.

Adult↗

The utility of serum albumin values in the nutritional assessment of hospitalized patients.

Nutritional assessment was performed on 47 patients admitted to a nephrology service; renal failure was present in 39 of the 47 patients. Values for serum albumin, total iron binding capacity, arm muscle circumference, triceps skin fold, and percent of ideal body weight for height and sex were determined. The 25 patients who had low serum albumin values at admission stayed in the hospital significantly (P less than 0.025) longer than those who had normal serum albumin values. No other abnormal nutrition-related finding or combination of findings was associated with a significantly (P less than or equal to 0.05) longer hospital stay. Low serum albumin values were also found in 11 of the 15 patients with infection. Low serum albumin values were far and away the most common abnormal nutrition-related findings in these infected patients in addition to the finding significantly (P less than 0.025) associated with a longer hospital stay.

Adult↗

An immunological assessment of patients with anorexia nervosa.

Patients with most forms of protein-calorie malnutrition are typically more susceptible to infection. We studied the immunological consequences of a subgroup of malnourished subjects--nine patients with anorexia nervosa, who typically have a lower incidence of infection. The profiles of the patients with anorexia nervosa deviated from the reported typical profile of significantly depressed cell-mediated immunity in subjects with more common forms of protein-calorie malnutrition, demonstrating normal T-lymphocyte populations and unimpaired proliferative lymphocyte responsiveness to mitogenic stimulation with phytohemagglutinin and concanavalin A. In fact, mitogen responsiveness was significantly elevated above that of controls, and with nutritional repletion, this enhanced responsiveness regressed toward control values. Since impaired cell-mediated immunity has been consistently documented in other malnourished populations, and presumably contributes to their increased propensity toward infection, the maintenance of a relatively intact cell-mediated immune system may be an important factor separating the malnourished anorexia nervosa patient from other protein-calorie malnourished patients.

Adolescent↗

Nutritional assessment of orthopedic patients.

Eighty-two consecutive orthopedic patients were assessed nutritionally at the time of hospital admission and then at 10-day intervals until hospital dismissal. Forty-eight percent of the patients had one or more abnormal findings suggestive of protein-calorie malnutrition. In spite of this prevalence of abnormal findings, only patients with three abnormal findings or a serum albumin concentration of less than 3.5 g/dl had a longer-than-average hospital stay. During hospitalization, abnormal findings developed on only three patients, whereas one or more abnormal nutrition-related findings improved to reach the normal range in six patients.

Adolescent↗

The relationship between the poisson-boltzmann model and the condensation hypothesis: an analysis based on the low salt form of the Donnan coefficient.

Two common models for the interaction of counterions with cylindrical polyions are considered in the context of the Donnan membrane equilibrium. General analytic expressions are obtained from the Poisson-Boltzmann equation for the Donnan coefficient in terms of the potential at the surface of the polyion or the local concentration of unbound ions at the surface. Analysis based on these expressions shows that if, and only if, the polyion charge density exceeds a certain critical value a large local concentration of ions will persist near the polyion surface at low ionic strengths. We therefore conclude that this principal hypothesis of the condensation model is consistent with the characteristics of the Poisson-Boltzmann potential at the surface of the polyion.

Journal Article↗

Relative binding affinities of monovalent cations for double-stranded DNA.

The competition between sodium and various other monovalent cations that bind to helical DNA in aqueous solution has been studied by (23)Na NMR. Variations in the sodium linewidth with the concentration of the other ion have been analyzed with an equation that describes the competitive binding in terms of two parameters: r, the total extent of counterion binding, and D, a measure of the binding affinity of a cation relative to sodium. The concentration dependence of these parameters was found to be minimal. In the absence of a competing cation the constancy of r has been demonstrated over a range of DNA phosphate concentrations (0.0025-0.015 M) and NaCl concentrations (0.003-1.3 M). For the cations investigated the range in D values is small (0.5-0.9), and the relative binding affinities follow the order: NH(4) (+) > Cs(+) > K(+) > Li(+) > Na(+).

Journal Article↗

An evaluation of upper arm measurements used in nutritional assessment.

Triceps skinfold thickness and upper arm circumference (parameters used in assessing protein-calorie malnutrition) were measured on both arms of 91 adult volunteers who fulfilled criteria for absence of disease and conditions affecting nutritional status. For the total study group and subgroups of men only and women only, no significant differences were noted between right and left arm measurements of triceps skinfold thickness, arm circumference, or arm muscle circumference. Median values for significant right-left arm measurement differences were + 1.7 mm for the triceps skinfold thickness of left-handed subjects (P less than 0.05) and + 0.3 cm for the arm circumference of volunteers regularly engaged in predominately right-armed activities (P less than 0.05). Criteria of weight within 15% of "ideal" and nine serum and plasma values within a specified range were fulfilled by 77 subjects, and they comprised the "healthy" subgroup. Left arm median values for healthy men and healthy women differed from a currently accepted standard for each of three anthropometric parameters: triceps skinfold thickness (P less than 0.05), arm circumference (P less than 0.05), and arm muscle circumference (P less than 0.01).

Adult↗

A comparison of triceps skinfold values as measured by the plastic McGaw caliper and the Lange caliper.

The plastic McGaw caliper and the Lange caliper were used to measure the triceps skinfold thickness of both arms of 91 volunteer subjects and of the left arms of 14 obese patients. McGaw caliper values were highly correlated with the Lange caliper values (r = 0.97) but were significantly lower than the Lange caliper values (P less than 0.01). Triceps skinfolds could not be measured by the McGaw caliper on 11 very obese patients, all of whom had Lange triceps skinfold thicknesses greater than 45 mm.

Anthropometry↗

Renal transplantation in patients with diabetes mellitus--revisited.

Sixty-one patients with end-stage renal failure due to diabetic nephropathy received 68 renal allografts from June 1970 to February 1978. Patient and graft survival results equaled those for nondiabetic patients, as reported by the Human Renal Transplant Registry (HRTR). Renal allografts from siblings or pretreated cadaver donors had a significantly longer survival time than did allografts from nonpretreated cadaver donors. It is concluded that renal transplantation with living related and pretreated cadaver donor kidneys continues to be the treatment of choice and is superior to other forms of treatment in the insulin-dependent diabetic patient with end-stage renal disease.

Adult↗

Reversal of deafness after renal transplantation in Alport's syndrome.

Six patients (five men and one woman) with Alport's syndrome underwent successful renal transplantation (four received kidneys from cadaver donors and two received allografts from living, related donors). One patient who had received a cadaver kidney had substantial hearing improvement and the others had stabilization of hearing. Hearing loss in Alport's syndrome is progressive. The reversal of deafness in one of our patients and stabilization in the others made us wonder whether an inherited enzymopathy had been reversed, which then mitigated the deafness.

Adolescent↗

Chronic peritoneal dialysis in juvenile-onset diabetes mellitus: a comparison with hemodialysis.

Fourteen juvenile-onset diabetic patients accepted for renal transplantation and maintained on chronic peritoneal dialysis during a 3-year period were compared with a similar group of 43 patients accepted for renal transplantation and maintained on hemodialysis. The 1-year survival in each group was similar (52% on chronic peritoneal dialysis; 55% on hemodialysis), but there was a striking difference in progressive morbidity. Seven patients on chronic peritoneal dialysis were blind in one or both eyes at the onset, and visual acuity improved in two, including one bilaterally blind patient who achieved 20/35 vision bilaterally; none worsened. In the hemodialysis group, 12 patients were totally blind in one or both eyes and 11 additional patients became blind or had severe deterioration in vision; none improved. Neuropathy progressed in only 1 patient on chronic peritoneal dialysis, whereas it worsened in 17 patients on hemodialysis--9 to the extent that they needed braces or canes or were nonambulatory. All patients on chronic peritoneal dialysis were home trained and were dialyzed at night, with seven being able to work full or part time; virtually none of the patients on hemodialysis were able to work. Chronic peritoneal dialysis was relatively free of technical complication, and no significant difficulty was encountered in diabetic control, in the anephric state, or during abdominal surgery. Chronic peritoneal dialysis appears to have less associated morbidity than does hemodialysis in the treatment of chronic renal failure of juvenile-onset diabetes mellitus.

Adult↗