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Biomedical subjects

F L Iber

Publications and source records attributed to F L Iber.

139 records · Page 8Linked to original sources
PubMedDate not supplied

Metabolic bone disease in alcoholic cirrhosis: a comparison of the effect of vitamin D2, 25-hydroxyvitamin D, or supportive treatment.

In a study of 56 alcoholics with liver cirrhosis, 18 (32%) had decreased bone density and low levels of serum 25-hydroxyvitamin D (25-OH-D) (less than 20 ng per ml). To compare the efficacy of vitamin D2 and 25-OH-D treatment in correcting the metabolic bone disease in alcoholic cirrhosis, the 18 patients were randomized in the following manner, in groups of six patients each: Group 1, control (received no supplemental vitamin D treatment); Group 2, given vitamin D2 (50,000 IU p.o.) two to three times weekly, and Group 3, treated with 25-OH-D (20 to 50 mg p.o.) daily as required to attain normal serum 25-OH-D levels. The study period lasted 6 to 12 months (mean, 10.7 months). Initial histomorphometric study of transiliac bone biopsy with double tetracycline labeling in nine patients in whom biopsy was feasible showed only osteoporosis without evidence of osteomalacia. By the end of the study, serum 25-OH-D levels in the control group (Group 1) raised slightly while showing marked improvement in Groups 2 and 3. Bone density results remained unchanged in control patients but demonstrated a significant increase in both treatment groups. Vitamin D2 and 25-OH-D were equally effective in increasing bone density measurements. Posttreatment biopsies were performed in three patients of Group 2 and two patients of Group 3. While the histomorphometric results in Group 3 were not conclusive, in Group 2 improvement in static measures of bone remodeling was noted. Osteoporosis is the usual form of bone disease in alcoholic cirrhosis and a response to either vitamin D2 or 25-OH-D treatment is suggested.

25-Hydroxyvitamin D 2↗
PubMedDate not supplied

The effect of bumetanide on the serum disappearance of warfarin sodium.

Ten normal subjects were given 0.8 mg/kg warfarin orally, and daily blood samples were taken for one week to test for prothrombin activity and warfarin levels, the latter determined specifically by a high-performance liquid chromatography method. Bumetanide at a dose of 1 mg/day was then administered for 14 days. A second dose of warfarin was given on the eighth day of bumetanide administration. The curves showing disappearance of warfarin from the blood were identical before and during bumetanide administration. The prothrombin times were similar in both studies. It is concluded that bumetanide does not influence anticoagulant activity or its duration when warfarin and bumetanide are given simultaneously.

Adult↗
PubMedDate not supplied

Bumetanide in refractory ascites of cirrhosis of the liver: a comparison with furosemide.

Bumetanide and furosemide were compared in the treatment of resistant ascites in patients with liver disease of alcoholic origin. In a prospective randomized trial, no significant difference was found in the ability of these two agents to promote natriuresis or diuresis. The duration of action was 12 hours for bumetanide and 6 hours for furosemide, but this difference was of no clinical significance.

Adult↗
PubMedDate not supplied

Influence of alcohol on the pharmacokinetics of diazepam controlled-release formulation in healthy volunteers.

Twelve normal volunteers were empanelled in an open-label, three-way crossover study to evaluate the influence of alcohol on the pharmacokinetics of controlled-release diazepam capsules. Each volunteer received one 15-mg diazepam controlled-release capsule alone, concomitantly with alcohol or followed by alcohol 2 hours later. The mean plasma concentration-time profiles following both alcohol treatments were superimposable on the profile from the control. The mean plateau concentrations were observed to endure from 2 through 12 hours in all cases. The mean +/- S.D. areas under the plasma concentration-time curves from time zero to infinity were similar indicating no difference in the extent of absorption of diazepam in the presence of alcohol. The harmonic mean elimination half-lives were also similar. Overall, the pharmacokinetics and the release properties of controlled-release diazepam capsule were not influenced by alcohol in normal volunteers.

Adult↗
PubMedDate not supplied

Intraluminal fungal colonization of gastrostomy tubes.

Percutaneous endoscopic gastrostomy tubes are frequently colonized with fungal and bacterial organisms. This has not been previously reported. In our sample of 10 patients, nine percutaneous endoscopic gastrostomy tubes were colonized with fungi. This occurred as early as 1 week after placement. Candida tropicalis was isolated in five patients. It is hypothesized that a variety of fungi use components of the gastrostomy tube polymer, such as polymer additives, which contribute to the structural deterioration of the tube.

Aged↗
PubMedDate not supplied

Evaluation of complications during and after conscious sedation for endoscopy using pulse oximetry.

All events prolonging an endoscopic procedure or recovery, or requiring a medication or an intervention, were analyzed from a consecutive sample of 508 patients receiving conscious sedation. Although 102 events were identified (20%), 33 of these (7%) were major. These included four episodes of apnea and four patients with a prompt and sustained fall in oxygenation during the procedure; 19 additional patients had a decrease to less than 89% in oxygen saturation in the 30 minutes after the completion of the procedure. The patients with observed events had significantly more major illnesses, a higher fraction older than 70 years, and a higher fraction of endoscopic retrograde cholangiopancreatography than those without events (p < 0.05) but had a similar dose of sedative medications, mean age, and fraction of colonoscopies.

Age Factors↗
PubMedDate not supplied

The Duffy blood system and alcoholic liver disease in Baltimore black patients.

Determination of the Duffy antigen status was made in a group of Baltimore patients with alcoholic liver disease. A parallel group of patients with chronic alcoholism but who did not show evidence of liver impairment was studied in a similar manner. An association between the presence of a positive Duffy antigen and alcoholic liver disease could not be demonstrated.

Alcoholism↗
PubMedDate not supplied

Oral Candida colonizes the stomach and gastrostomy feeding tubes.

The lumen of gastrostomy tubes is frequently colonized with Candida. To investigate the source of this contamination, 20 consecutive malnourished patients undergoing placement of a percutaneous endoscopic gastrostomy tube and ten ambulatory controls having routine upper endoscopy performed had both their oral cavity and gastric antrum swabbed and cultured. Percutaneous endoscopic gastrostomy tube recipients who after several weeks were still under our care (9 of 20) had the lumen of their tubes cultured. Fungi were isolated from the stomach in 13 (65%) of 20 patients undergoing percutaneous endoscopic gastrostomy tube placement but in only 1 of 10 ambulatory patients (p < .01). The species isolated from the oral cavity, the stomach, and later the gastrostomy tube were identical in most cases. We conclude that gastrostomy tubes are probably colonized by oral organisms that have made their way into the stomach.

Aged↗
PubMedDate not supplied

Alcoholism and associated malnutrition in the elderly.

Although most free-living people over age 55 yr use alcohol occasionally, both the fraction of people drinking and the magnitude of individual alcohol consumption decrease with every decade of age. Overall, approximately 5% of drinkers over age 55 yr use alcohol at excessive levels, i.e., sufficient to interfere with health or social functioning. As age increases, the fraction of drinkers with alcohol-caused central nervous system disease and cirrhosis increases, indicating increased sensitivity to alcohol injury. Beyond age 70 yr, new-onset alcoholism is more common than long-standing alcoholism. Malnutrition in the elderly alcoholic person is rare; it usually is caused by multiple factors, including alcohol displacing nutrient-rich diet factors, disease, limited availability of food, or altered metabolism increasing nutrient requirement. The recognition of alcohol and malnutrition problems in the elderly is more difficult than in younger people.

Aged↗