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Biomedical subjects

J Dwyer

Publications and source records attributed to J Dwyer.

At least 109 records · Page 6Linked to original sources

The metabolism of estradiol; oral compared to intravenous administration.

We administered [6,7-3H]estradiol p.o. and [4-14C]estradiol i.v. simultaneously to 5 women 22-35 years of age. Fourteen blood samples were collected over 480 min, and all urine was collected for 96 h. The blood samples were analyzed for radioactivity as estradiol, estrone, estrone-sulfate and estradiol glucuronide. The urine samples were analyzed for radioactivity as the glucuronide and pH 1 hydrolyzable conjugates of estradiol, estrone, estriol, 16 alpha-hydroxy-estrone, 2-hydroxy-estrone, 2-hydroxy-estradiol, 2-methoxy-estradiol and 2-methoxy-estrone. The major circulating estrogen, after either estradiol, p.o. or i.v. administration, was estrone sulfate; approximately 50% of estradiol administered by either route being converted to and measured as estrone sulfate in the blood. Following oral administration about twice as much estradiol was converted to and measured as estradiol glucuronide in the blood as after i.v. administration. Of the estradiol administered p.o., only 10% was absorbed into the blood as estradiol the rest being metabolized prior to absorption. After estradiol, p.o., the major radioactive compounds in the urine were the glucuronides of estrone and estradiol, but after estradiol, i.v., the conjugates of estrone, estradiol and estriol were present to about the same extent as the conjugates of the 2-oxygenated compounds. Following p.o., considerable metabolism of estradiol administration occurs in the splanchnic tissue, much of it in the intestinal wall.

Administration, Oral↗

Towards microbiological quality assurance in radiation sterilization processing: the limiting case model applied to a microbial population having a distribution of radiation responses.

A limiting case model, developed earlier to provide a conservative estimate of the proportion of non-sterile items (P) in an irradiated population of items contaminated with micro-organisms of a single type, has been extended to include items having organisms of different types. Estimates of P are compared with exact values derived on purely theoretical grounds and with values obtained by computer simulation of microbiological inactivation on items.

Bacteria↗

Salt substitutes and medicinal potassium sources: risks and benefits.

The purpose of this investigation was to gather and summarize currently available product information on salt substitutes, low-sodium products, and medicinal potassium supplements. A review of the literature identified both risks (e.g., hyperkalemia) and benefits (e.g., changing sodium:potassium ratios, and low-cost substitutes for medicinal potassium replacement) resulting from the use of salt substitutes. Risks and benefits are related to individual patient conditions and treatment plans. Nutritionists and physicians must be aware of the medicinal and dietary potassium sources and be able to educate patients in the proper use of the products. Lists of medicinal and dietary sources of potassium are provided to aid health professionals in determining appropriate potassium equivalents. Case reports from the literature of patients developing hyperkalemia secondary to the use of salt substitutes are summarized. Regular monitoring of serum potassium levels is necessary to achieve and maintain normal values.

Adult↗

Acid/alkaline ash diets: time for assessment and change.

The purpose of this article is to review critically the assumptions made to predict the effects of different diets on the pH of urine by calculations from food tables and lists of acid or alkaline ash in foods. Acid/alkaline ash calculations were completed for 7 days' worth of omnivore, lacto-ovo, and vegan diets. The vegetarian diets were significantly more alkaline than the omnivore diets, and the vegan diets were more alkaline than lacto-ovo vegetarian diets. The article discusses the history of the acid/alkaline ash concept, assumptions underlying it, mechanisms by which urine is acidified, how the acid/alkaline ash content of diets is calculated from food tables, difficulties arising in acid/ash calculations, and their validity in predicting urine pH. The authors conclude that while diet does influence the pH of urine, present calculation methods are time consuming, imprecise, and do not permit quantitative prediction of urine pH. Better methods for calculating the effects of diet on acid-base balance are needed.

Acid-Base Equilibrium↗

Lethal delayed radiation necrosis of the brain as a complication of radiotherapy for cancer in the head and neck.

Necrosis of the brain following irradiation of tumors adjacent to the cranial cavity is an insidious and often fatal complication. Three patients with this complication are reported. Recognition of the condition is often delayed due to the long time interval between irradiation and manifestation of first symptoms. Accurate shielding and limitation of irradiation to the brain may prevent this problem.

Aged↗

Caveat emptor: assessing needs, evaluating computer options.

A variety of services and microcomputer programs are available for providing the dietitian with a mechanized diet-analysis system for calculating nutrients from food records or recipes. They differ widely in the content of their data bases, cost, ease of use, reporting of results, flexibility, and other features. The characteristics of seven programs available by mail order from diet-analysis service vendors and five microcomputer programs were compared. The results of analysis of a one-day food record using various systems and coding by three different operators were compared. Differences by both system and operator were apparent. Nutritionists need to recognize that for some programs the reliability and the validity of data are uncertain. When making purchasing decisions for nonresearch applications, the nutritionist is advised to compare systems and services and to consider carefully whether mechanized diet analysis is of sufficient benefit in the delivery of high-quality nutrition care to offset its cost. The dietitian who chooses to use computerized diet analysis has a responsibility for making sure that reported results are reasonable and for interpreting results to other health professionals and to patients.

Computers↗

High incidence of hypogammaglobulinemia in infants with diarrhea.

Examination of 136 children who were referred to the Pediatric Gastroenterology Clinic at Yale-New Haven Hospital for chronic or severe diarrhea between 1977 and 1981 revealed that 31 patients (22.8%) had serum immunoglobulin levels below the 5th percentile for age. Twenty-four of these 31 patients (77.4%) had normal or near normal serum immunoglobulin levels by their third birthday and most could therefore be classified under the heading "transient hypogammaglobulinemia of infancy," an unexpected finding, as this condition has previously been thought to be rare; only 27 patients with this disorder were reported prior to 1978. While the basic cause of the defect is unknown, it has been linked to a slower than normal maturation of the neonate's ability to secrete immunoglobulins. Comparison of our patients with hypogammaglobulinemia and those with chronic diarrhea but normal immunoglobulins revealed that the former group are younger at presentation (mean, 8.2 months) and at the onset of their diarrhea (3.1 months); the figures for patients without hypogammaglobulinemia were 18.2 and 8.2 months, respectively. Males and females were equally affected, and the diarrhea, which was responsive to a hypoallergenic diet, resolved by 3 years of age as did the hypogammaglobulinemia in nearly all cases. While the etiology of the diarrhea remains obscure, significant problems outside the gastrointestinal tract did not occur. Circumstantial evidence suggests that the most likely cause for the failure of production of IgG, and to a lesser extent IgA antibody, in infants seen with diarrhea may result from a failure of maturation of T cell helper systems rather than any intrinsic defect in the B cell system itself.

B-Lymphocytes↗

Estimation of oxygen uptake from heart rate response to undersea work.

The efficacy of using a diver's heart rate (HR) response to work performed formed in the open sea to estimate the oxygen uptake (VO2) and work stress by general and depth-specific regression equations was examined in six scuba divers. A diver-carried data recording system and an underwater gas sampler were used to obtain measures of physiological responses to work in the ocean. The HR and VO2 were measured during dry cycling at 1 ATA, and during moderate to very heavy work fin-swimming against an ergometer at 2, 3, and 4 ATA. Underwater VO2 and HR at 2-4 ATA ranged from 1.41 to 3.89 liters/min (39%-89% VO2max observed on land) and 105-180 beats/min, respectively. Individual data points at three work levels at 1-4 ATA were used to compute correlation coefficients (r) and regression equations. Only one significant difference in regression slopes was found (1 ATA vs. 4 ATA), but large differences in intercept were observed in each comparison. From 1 ATA to 4 ATA r decreased from 0.78 to 0.53 while the standard error of VO2 estimated from HR (Syx) increased from 0.229 to 0.582 liters O2. The regression equation for dry exercise (1 ATA) underestimated VO2 over most of the work range by 0.4 to 0.9 liters/min or 11% to 25% of VO2max. The accuracy of estimating VO2 from cardiac response by general (1 ATA) or depth-specific regression equations is insufficient to justify their use in research or diver monitoring systems. Attempts to estimate VO2 from pulmonary ventilation (VE) gave similar results with more differences between slopes among the conditions. These observations and those of other investigators support the idea that underwater work loads and stress cannot be estimated or evaluated by simple HR measurements that are made during diving operations and interpreted in terms of sea-level standards.

Adult↗

Nutritional support during pregnancy and lactation.

Needs for virtually all nutrients increase during pregnancy and lactation but those for iron are the most difficult to meet from a normal diet. During pregnancy, nutritional objectives include helping the woman to increase the quality of her diet in protective nutrients as well as energy to meet the elevated needs of gestation, ensuring satisfactory weight gain patterns, prescribing iron and possible folic acid supplements, ensuring that intakes of alcohol, drugs, and other potentially harmful substances are moderate, preparing her for feeding the infant, and coping with any special diet-related problems that may arise. These issues and the management of edema, high blood pressure, and diabetes mellitus are discussed. Prenatal preparations for lactation and diet during lactation are also discussed. Specific objectives of nutritional education on lactation include helping the mother to make the decision to breast or bottle feed, taking steps to prepare her nipples if this is necessary and planning her diet. Dietary adjustments are discussed and a food guide presented. Iron supplements for ther lactating mother and iron, vitamin D, and fluoride supplements for the infant are recommended.

Diet↗

Chronic ear infection in the immunodeficient patient.

In the immunodeficient patient, surgery for chronic ear disease is often unsuccessful. Early recognition of the immune deficiency is of paramount importance in minimizing bacterial infection within the postoperative surgical field. The intravenous administration of immunoglobulins via plasma transfusions, intramuscular injections of gamma-globulin, and the selective use of immunoglobulin applied directly to the healing wound seem useful in achieving beneficial surgical results by containment of infection.

Adult↗

Regulation of acetylcholine receptor phosphorylation by calcium and calmodulin.

Acetylcholine receptor-enriched membranes prepared from frozen electric organ of Torpedo californica by differential centrifugation and density step gradient centrifugation were assayed for endogenous phosphorylation in the absence and presence of calmodulin and calcium. Each of the membrane fractions exhibited a 3- to 6-fold stimulation of endogenous phosphorylation by calcium and calmodulin. Both calcium and calmodulin were needed for maximal stimulation although calcium alone afforded a small, reproducible stimulation of endogenous phosphorylation. In the presence of fluoride, a phosphatase inhibitor, the calmodulin plus calcium stimulation was increased an additional 3-fold. The phosphorylation reaction was rapid, and maximal phosphorylation was achieved in 2 min. Stimulation of phosphorylation by calcium and calmodulin was completely inhibited by 25 microM trifluoperazine; at 50 microM it inhibited basal phosphorylation by 60%, suggesting that most of the basal phosphorylation may be due to the endogenous calmodulin present in our membrane preparation. NaDodSO4/polyacrylamide gel electrophoresis revealed that at least three of the phosphorylated species (both in the presence and in the absence of calcium and calmodulin) correspond to subunits of the purified acetylcholine receptor from T. californica (i.e., 65,000, 58,000, and 50,000 daltons) which are the beta, gamma, and delta subunits of the receptor.

Animals↗