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Biomedical subjects

K M Nelson

Publications and source records attributed to K M Nelson.

65 records · Page 4Linked to original sources
PubMedDate not supplied

Nosocomial transmission of Cryptosporidium in a veterinary hospital.

An outbreak of cryptosporidiosis occurred at a veterinary hospital, involving multiple species, including humans. The index case was an infected dairy calf that presented with diarrhea. Several other cases of cryptosporidial diarrhea subsequently developed during a 1-month period. The key features of this outbreak were the multiple species affected, the increased morbidity in immunocompromised neonates, and the failure of implemented control measures to contain the disease.

Animals↗
PubMedDate not supplied

Effect of insulin on glucose and amino acid uptake by skeletal muscle following burn injury. Studies with 2-deoxyglucose and alpha-aminoisobutyric acid.

Basal and insulin-stimulated uptake of 2-deoxyglucose (2-DG) and alpha-aminoisobutyric acid (AIB) by cells of the intact soleus muscle were studied 3 days after a 3-second scald on one hind limb of the rat. Soleus muscles from the burned and unburned limbs of burned rats, as well as from controls, were incubated with 1 mM [14C]2-DG or 50 micro M [14C] AIB and insulin (0, 1, 1.0, 10.0, or 100.0 mU/ml). Extracellular space was measured with [3H]inulin. Basal uptake of 2-DG and AIB by the cells of the burned limb muscles were 68% (p less than 0.001) and 40% (p less than 0.05), respectively, higher than those of controls. The intracellular concentrations of 2-DG and AIB of burned limb muscles were 112% (p less than 0.01) and 72% (p less than 0.01), respectively, higher than those in control muscles. Corresponding values in soleus muscles from the unburned limb of burned rats did not differ from controls. Addition of insulin increased both the rates of cellular uptake and intracellular concentrations of 2-DG and AIB in control and burned limb muscles but did not significantly affect those of burned limb muscles. It is concluded that thermal injury suppresses the insulin-induced augmentation of 2-DG and AIB uptake by skeletal muscle underlying the burn wound but does not alter the insulin sensitivity of skeletal muscle in the unburned region. Since glucose and amino acid uptakes are stimulated by insulin independently, the cellular mechanism of the burn-induced unresponsiveness to insulin may be located at a site which is common to both processes.

Amino Acids↗
PubMedDate not supplied

Glutamine supplementation of enteral nutrition: impact on whole body protein kinetics and glucose metabolism in critically ill patients.

BACKGROUND: Glutamine-supplemented parenteral nutrition has been reported to attenuate the early postoperative reduction in intracellular glutamine and improve protein synthesis and nitrogen balance. We investigated the effect of an enteral formula or protein and glucose kinetics and nitrogen balance in trauma patients. METHODS: The enteral formula (AlitraQ) provided a mean intake of 0.35 g of glutamine/kg body weight per day to 16 trauma patients and was compared with an isonitrogenous formula that provided a mean of 0.05 g of glutamine/kg body weight per day in 14 trauma patients. After 3 days of feeding, protein kinetics were measured using a 4-hour prime-continuous infusion of L-[1-13C]leucine. Glucose kinetics were measured during the same time interval using prime-continuous infusion of [U-14C]- and [6-3H]glucose. RESULTS: Nitrogen balance was not significantly different in the two groups. There were no significant differences in protein turnover, synthesis, and breakdown between the two groups. There were no significant differences in glucose turnover, oxidation, recycling, and percent of VCO2 from glucose oxidation between the two groups. CONCLUSIONS: Glutamine-enriched enteral formulas are well tolerated by the severely injured patient but provide no additional nutritional advantage compared with standard enteral formulas during the first 3 days of feeding immediately after trauma.

Adult↗
PubMedDate not supplied

Fostering homeless children and their parents too: the emergence of whole-family foster care.

Children should not be placed in out-of-home care simply because their families lack the means to provide for their basic needs, yet this practice continues nationwide. A new program based in St. Paul, MN, gives county social service departments the placement option of whole-family foster care. The target population is adult parents and minor children without stable residences, where the children are at risk of placement in out-of-home care. Although the parents and children may have special needs, there are no safety risks that would necessitate separating children and parents. The program's design is described and policy questions discussed.

Adolescent↗
PubMedDate not supplied

Glucose metabolism in advanced lung cancer patients.

Although it is generally accepted that altered nutrient intake and metabolism are responsible for the progressive loss of body weight observed in most advanced cancer patients, there is still considerable controversy regarding the contributory role of changes in both resting energy expenditure (REE) and glucose metabolism. Several studies suggest increases in both REE and glucose appearance in advanced cancer patients compared with healthy control subjects, whereas others revealed no changes in either metabolic parameter. We measured REE with indirect calorimetry and glucose kinetics with a primed constant infusion of D-[U-14C]glucose and D-[6-3H]glucose over the last 4 h of a 24-h fast in 32 advanced lung cancer patients immediately after diagnosis and before any chemotherapy or radiotherapy and in 19 healthy volunteer subjects. REE for the lung cancer group was not significantly different from that in the control group (1535.8 +/- 78.0 vs. 1670.2 +/- 53.9 kcal/day, respectively, p = 0.151). When REE was expressed as a function of body weight, or lean body mass, no differences between the two groups were observed. The rate of glucose appearance was 9.88 +/- 0.36 mumol.kg-1.min-1 in the cancer patients and 10.15 +/- 0.53 mumol.kg-1.min-1 in control subjects (p = 0.667), of which 50.4 versus 58.2%, respectively, was oxidized. The amount of glucose recycled was 13.54 +/- 1.22% in cancer patients and 15.08 +/- 0.99% in control subjects (p = 0.394). The amount of VCO2 from direct oxidation of glucose was 23.39 +/- 0.74% in cancer patients and 27.45 +/- 1.36% in control subjects (p = 0.006).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

Whole-body protein kinetics in elective surgical patients receiving peptide or amino acid solutions.

We compared the efficacy of two enteral solutions that were isonitrogenous and of identical amino acid composition but differed in that one solution contained only free amino acids whereas the other contained a mixture of free amino acids and peptides. Protein kinetics and nitrogen balance were evaluated in a group of six elective surgical patients. Primed-constant infusion with 15N-glycine was started 24h after gynecologic surgery and sustained over 3 days. During the first postoperative day, patients received enteral 0.45% saline. During postoperative days two and three, the patients received either the free amino acid solution or the mixture of peptides and free amino acids in a crossover design. There were no differences in protein kinetics or nitrogen balance with the two treatments.

Adult↗
PubMedDate not supplied

Drug-related hospital admissions.

To describe the frequency and pattern of drug-related morbidity that results in hospital admission and the extent to which these admissions are avoidable, we prospectively reviewed the charts of 452 consecutive patients admitted to the intensive care unit or internal medicine service of a university-affiliated, county hospital. Of these, 73 (16.2%) were admitted due to drug-related morbidity. Forty patients (54.8%) experienced drug therapy failure, 24 (32.9%) had an adverse reaction, and 9 (12.3%) had overdoses. Thirty-six (49.3%) of these admissions were definitely avoidable. Compared with patients admitted for other reasons, these patients were more likely to report noncompliance with drug therapy (65.8% vs 15.7%, p < 0.0001) and were taking more drugs (p = 0.0037). We conclude that approximately half of drug-related hospital admissions are avoidable. Targeting patients taking several drugs and with a history of noncompliance may reduce this problem.

Adverse Drug Reaction Reporting Systems↗