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Biomedical subjects

K Moles

Publications and source records attributed to K Moles.

8 recordsLinked to original sources
PubMed1996

Zinc supplementation is associated with improved neurologic recovery rate and visceral protein levels of patients with severe closed head injury.

Sixty-eight patients were entered into a randomized, prospective, double-blinded controlled trial of supplemental zinc versus standard zinc therapy to study the effects of zinc supplementation on neurologic recovery and nutritional/metabolic status after severe closed head injury. One month after injury, the mortality rates in the standard zinc group and the zinc-supplemented group were 26 and 12%, respectively. Glasgow Coma Scale (GCS) scores of the zinc-supplemented group exceeded the adjusted mean GCS score of the standard group at day 28 (p = 0.03). Mean motor GCS score levels of the zinc-supplemented group were significantly higher on days 15 and 21 than those of the control group (p = 0.005, p = 0.02). This trend continued on day 28 of the study (p = 0.09). The groups did not differ in serum zinc concentration, weight, energy expenditure, or total urinary nitrogen excretion after hospital admission. Mean 24-h urine zinc levels were significantly higher in the zinc-supplemented group at days 2 (p = 0.0001) and 10 (p = 0.01) after injury. Mean serum prealbumin concentrations were significantly higher in the zinc-supplemented group (p = 0.003) at 3 weeks after injury. A similar pattern was found for mean serum retinol binding protein level (p = 0.01). A significantly larger number of patients in the standard zinc group had craniotomies for evacuation of hematoma; thus a bias may have been present. The results of this study indicate that zinc supplementation during the immediate postinjury period is associated with improved rate of neurologic recovery and visceral protein concentrations for patients with severe closed head injury.

Adolescent↗
PubMed1994

Individual and group therapies as constructive continuous experiences.

We began this paper with the conceptualization that individual and group psychotherapies were potentially continuous just as internal and external experiences are co-extensive. We recognized Winnicott's "holding," "regression to dependence," and "The primary maternal preoccupation." In our specific context of individual and group therapies, a state of being, a new construct of one's self can be invented in ways that can overturn the received. Clinician and patient can invent a new state of being and new meaning. For our patient, individual therapy was experienced as impacted space where she could neither be nor invent new meaning with another. "Intimacy" as a problem could not be dealt with in individual work without the risk of decompensation. In group psychotherapy she found no such risks or congestion. Rather, she found space. She was dislodged and group psychotherapy received her by giving her an opportunity to renegotiate who hosts whom. She recognized that group was in the service of the human being and was able to absorb her intolerable conflicts and transfer them without danger to anyone. It was a trusting attitude to the surrounding and was motivated by connectedness toward others. As a result there can be a state of being and the real possibility of thinking as one's own self and for one's self in the midst of others without losing one's newly established self. In a word she could become. Accordingly, our patient was able to work towards amelioration of psychopathological formations and was ready to make appropriate selection for the necessary therapy.

Adult↗
PubMed1992

Marked improvement in parameters of renal osteodystrophy with the use of intraperitoneal calcitriol.

Parenteral administration of Calcitriol is felt to be superior to oral Calcitriol in the treatment of renal osteodystrophy in chronic renal failure patients. We analyzed the results of serum calcium, phosphorus, alkaline phosphatase, and N-terminal parathormone level which are the clinical parameters of renal osteodystrophy in twenty-three chronic peritoneal dialysis patients who received varying dosages of intraperitoneal Calcitriol. The results which were analyzed at the end of one to twenty-three months revealed significant increase in serum calcium and a significant decrease in the values of alkaline phosphatase and N-terminal parathormone level.

Alkaline Phosphatase↗
PubMed1990

Feasibility of in-center staff-assisted cycler dialysis.

Many debilitated elderly patients are not currently considered for peritoneal dialysis because they cannot perform the procedure themselves and they lack adequate back-up support in the family or extended care facility. They often tolerate hemodialysis poorly, and may exhaust their vascular access sites. We have provided intermittent in-center staff-assisted cycler dialysis to two debilitated elderly patients for a total of 12 patient months. Initial peritoneal equilibration tests indicated high solute transport rates in both patients, and led us to evolve a regimen based on frequent cycles. We use a 4 days a week regimen, cycling 12-14 liters during a 7.5 hour period each day. The patients tolerated the treatment well, with improved control of fluid balance and maintenance or improvement in appetite compared to baseline periods of CAPD. Mean pre-treatment BUN is 87 mg/dl. This is 29% higher than during CAPD, and has been stable. The requirement for additional nursing care has been variable but not disruptive of other activities once we established a dedicated space and routine. Current cycler technology permits consideration of in-center cycling as a practical alternative for many patients previously excluded from peritoneal dialysis.

Aged↗
PubMed1989

Cycler dialysis evolution.

Use of automated cycler equipment is currently limited to a fraction of the peritoneal dialysis population. Various technical barriers combined in the past to inhibit its wider application. We have treated forty-seven patients over an eight year period with cycler dialysis, and have observed the evolution of this modality from a treatment of last resort to a first choice therapy for many patients--especially those who work.

Hemodialysis, Home↗
PubMed1986

Comparison of transdermal nitrate and isosorbide dinitrate in chronic stable angina.

The effects of transdermal nitrate (TN) (Transiderm-Nitro TTS, Geigy Pharmaceuticals, one 10 cm2 patch daily) and oral isosorbide dinitrate (ISDN) (Sorbitrate, Stuart Pharmaceuticals, 10 mg three times daily) were compared in a group of 20 patients with chronic stable angina pectoris. Treadmill exercise duration was prolonged from a median time of 365 s to 428 s after ISDN (P less than 0.05), but was unchanged after TN. The difference between the active treatments was not significant. Weekly consumption of glyceryl trinitrate (GTN) increased during treatment with TN from a median value of 5.5 to 6.3 (P less than 0.05). A decrease was observed after ISDN (7.8 to 3.9, P = NS), and the difference between the drugs was significant (P less than 0.01). Systolic arterial pressure was significantly lower during the ISDN than during the TN treatment period in both the supine (135 +/- 5 vs 128 +/- 5 mm Hg; P less than 0.05) and standing positions (134 +/- 5 vs 122 +/- 5 mm Hg; P less than 0.05). No change in weekly attack rate, the degree of ST depression at angina on treadmill testing, or the number of episodes of ST depression recorded during a 24 h period by Holter monitoring was observed after either drug. In this study, an antianginal effect was demonstrated for ISDN but not for TN. It is suggested that the dose of TN may have been inadequate to demonstrate such an effect, and further studies using a higher dose schedule will be required.

Administration, Oral↗