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Biomedical subjects

J H Sadler

Publications and source records attributed to J H Sadler.

At least 37 records · Page 2Linked to original sources
PubMed1997

Measuring and improving the health status of end stage renal disease patients.

This highlight reports on recent efforts to develop and promote health status measurement instruments for use in dialysis units that treat end-stage renal disease (ESRD) patients, most of whom are covered for all medical services under Medicare. Readers interested in a more detailed discussion of instruments, including associated data collection and data processing aspects, should consult a recently published account, with its extensive references, of four instruments currently being used in dialysis units (Rettig et al., 1997). Those interested in early reports of the clinical utility of such instruments should consult the following references (Kurtin et al., 1992; Meyer et al., 1994; and DeOreo, 1997).

Health Status Indicators↗
PubMed1994

Measuring, managing, and improving quality in the end-stage renal disease treatment setting: committee statement.

The Institute of Medicine (IOM) committee that organized the conference reported in this issue of the journal on assessing quality of care and quality of life, wishes to emphasize that it regards the task of measuring quality as one that can be approached systematically, albeit with caution. Outcomes of end-stage renal disease (ESRD) care by dialysis and transplantation (and variations of outcomes among treatment units) and related processes of care need to be measured in ways useful to clinicians. In addition to clinical measures of outcome, the committee also favored giving greater attention to functional outcomes and health-related quality of life. The interest in maintaining and improving quality in the treatment setting reflects an underlying need to encourage its systematic assessment on a sustained basis, with appropriate weight devoted to practical issues.

Humans↗
PubMed1992

Influence of circulating insulin-like growth factor-I compared with that of intrarenal insulin-like growth factor-I on proximal nephron receptor density in rats.

1. We examined the effects of dietary protein manipulations in partially nephrectomized (one and one-third nephrectomy) and normal rats to gain perspective on the relative importance of circulating versus intrarenal (collecting tubule) insulin-like growth factor-I in the control of proximal nephron receptor density. In addition, we studied the factors that influence liver insulin-like growth factor-I secretion in partially nephrectomized rats. 2. Dietary protein restriction (6% versus 40%) lowered circulating levels of insulin and insulin-like growth factor-I in both normal and partially nephrectomized rats up to 3 weeks after institution of the diets; however, growth hormone levels were little changed. Reduced renal mass stimulated intrarenal production of insulin-like growth factor-I regardless of the diet. 3. Scatchard analysis revealed that the density of insulin-like growth factor-I receptors on glomerular and proximal tubule basolateral membranes increased when circulating levels of insulin-like growth factor-I were diminished, despite raised levels of intrarenal insulin-like growth factor-I, in partially nephrectomized rats. 4. Circulating insulin-like growth factor-I, rather than the tissue level, plays the dominant role in the control of proximal nephron receptor density under physiological conditions. Insulin, but not growth hormone, may play a role in liver insulin-like growth factor-I secretion in partially nephrectomized rats during dietary manipulations.

Animals↗
PubMed1987

Hepatitis B surface antigenemia in a chronic hemodialysis program: lack of influence on morbidity and mortality.

One hundred one patients established on chronic hemodialysis on January 1, 1978, were retrospectively evaluated over the ensuing 8-year period to determine the effect of hepatitis B surface antigenemia on morbidity and mortality. Sixty-four patients remained HBsAg-negative after reaching end-stage renal disease; 30 were transiently or persistently HBsAg-positive; seven patients were excluded from study because of insufficient data. The HBsAg-positive and HBsAg-negative patients did not differ with respect to age, sex, race, or etiology of renal disease. There were no differences between the positive and negative groups in terms of death rates (50% v 34.4%, P = not significant), causes of death, hospitalizations (1.5 v 1.2/patient/yr), or hospitalized days (18.0 v 11.8 patient/yr). Only mild liver enzyme elevation (SGOT) was observed at the time of conversion in 13 patients with enzyme abnormalities who seroconverted after beginning hemodialysis (mean SGOT 255 micron/mL). No patient had persistent liver enzyme elevation over the 8-year period. These data suggest that chronic hepatitis B surface antigenemia is not, in itself, associated with increased morbidity or mortality in a chronic hemodialysis population.

Adult↗