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Biomedical subjects

K B Keller

Publications and source records attributed to K B Keller.

14 recordsLinked to original sources
PubMed2001

Herbal or complementary medicine: fact or fiction?

Although herbal medications have been used in medical therapy since the dawn of civilization, they have not undergone careful scientific assessment. Some herbal derivations are exceptional and have become standard therapy in cardiovascular disease; eg, digitalis, reserpine, and aspirin. The high prevalence of herbal use around the world and in the United States today may have a negative impact on patient care when herbal preparations are used in combination with medications ordered by healthcare providers who are not advised of the patient's use of herbs. Healthcare providers need to be familiar with all herbal medications in order to prevent potentially serious reactions between conventional and herbal medications. They should be asking patients about herbal use when first obtaining a medical history. Patients who use alternative therapies do not tell their healthcare providers about such use.

Aged↗
PubMed2000

Gender differences in acute coronary events.

The most frequent cause of death among women in the United States is coronary heart disease, which claims 200,000 lives a year. The prognosis with either medical or surgical therapy is worse in females than in males. The following significant gender differences have been observed and reported: (1) the rate of early death following acute myocardial infarction is greater in women, (2) the difference between sexes remains whether or not thrombolytic therapy is used, and (3) the hospital mortality rate following coronary angioplasty, atherectomy, or bypass surgery is greater in females. The reasons for these gender differences are not clearly understood. Nevertheless, awareness of the higher morbidity and mortality in women dictates the need for early detection and more aggressive therapy of the risk factors. However, diabetes mellitus and essential hypertension are 2 well-established major risk factors for coronary disease and stroke that are more prevalent in the female gender. These 2 risk factors are cumulative and require more intensive and aggressive therapy to prevent acute vascular events, and therefore early detection is mandatory.

Aged↗
PubMed1998

Coronary artery disease--ignored in women or inherently more lethal in women?

The leading cause of death in women is cardiovascular disease. The major cardiovascular risk factors have a greater impact on women. The prognosis for women with CAD is worse than for men. Women frequently present with symptoms of heart disease at a much later age and have a greater frequency of atypical chest pain. Noninvasive testing is less reliable in women. Do these facts indicate that CAD is inherently a more lethal disease in women? Or is CAD, as some would suggest, traditionally ignored in women? Stay tuned!

Adult↗
PubMed1996

Smoking: a burden to patient and society.

Smoking prevalence had been steadily decreasing in the United States until 1993 when the rate stabilized. In 1993 there were 46 million adult smokers, which represented 25% of adults aged 18 years and older. Between 1983 and 1993, smoking prevalence among white men declined from 34% to 27% and from 41% to 32% in black men. Smoking prevalence among women declined from 30% to 27%. Currently, smoking prevalence is still higher for men than women, 28% and 23% respectively. More than 70% of adults began their daily habit of smoking by the age of 18 years. The frequency of this habit is highest among Native Americans/Native Alaskans (39%) compared with that of other ethnic groups. It is interesting that smoking prevalence is highest among men who are high-school dropouts (42%). Our role as healthcare providers is clear. We must protect our patients and society from the consequences of smoking. But healthcare professionals must first lead by example. Although the frequency of smokers is decreasing in this segment of society, it was still 18% for RNs and 27% for licensed practical nurses in 1991. Among physicians, the frequency of smokers has decreased from 19% in 1976 to 3% in 1991. With respect to effects on human health and the costs of tobacco use, our direction, responsibility, and duty to our patients and society are very clear.

Adult↗
PubMed1994

Q and non-Q wave myocardial infarctions.

Previously, the classification of MI into transmural and subendocardial types has been based on the presence or absence of abnormal Q waves. The pathologic anatomy of necrosis in MI does not necessarily correspond to these ECG criteria. Thus, it is more appropriate to describe myocardial infarcts as Q wave or non-Q wave infarcts. The importance of this classification is underscored by their clinical and pathologic differences and the tendency for more serious prognosis in the non-Q wave infarcts. It should be noted that in Q wave infarcts the volume of necrosis is usually greater than that in non-Q wave infarcts.

Electrocardiography↗
PubMed1991

Interventional coronary therapy in the elderly.

Advancing age is associated with significantly greater mortality and morbidity in the elderly undergoing coronary artery bypass grafting or PTCA. Nevertheless, successful bypass surgery or PTCA in the elderly has significant benefits (i.e., relief of angina or increase in longevity) that exceed that of the United States population matched for age and gender. Continued improvement in skills in cardiac surgery and PTCA correlated significantly with a progressively better prognosis in the young as well as the elderly.

Age Factors↗
PubMed1991

Myocardial infarction in the young adult.

CAD in young male adults below the age of 40 years has generally been found to be associated with the usual risk factors associated with CAD. In a lesser number of young adults, MIs may be related to cocaine use. Sympathomimetic effects and increase in myocardial oxygen demand are factors considered responsible for acute MI in cocaine-abusing patients. In young adults who are asymptomatic following an acute MI and who are able to pass treadmill exercise stress tests at levels of Bruce stage 4 have been shown to have normal coronary arteriograms. Thus this subset should not require routine coronary angiograms following an acute MI.

Adult↗