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Biomedical subjects

K Sanders

Publications and source records attributed to K Sanders.

At least 37 records · Page 2Linked to original sources
PubMed1996

Substance abuse and dependence in physicians: the Missouri Physicians' Health Program.

Substance abuse and dependence (alcohol and drugs) are behavioral disorders and treatable medical diseases. There is growing concern in the medical community for physicians impaired by these diseases. The Missouri Physicians' Health Program has been established to help impaired physicians return to healthy personal and professional lives. This confidential voluntary program of early referral, intervention, treatment, monitoring, and advocacy has been highly successful. The average recovery rate in this study of 146 participants was 94%.

Female↗
PubMed1994

The effect of dietary fat level and quality on plasma lipoprotein lipids and plasma fatty acids in normocholesterolemic subjects.

This study examined the effect on the plasma lipids and plasma phospholipid and cholesteryl ester fatty acids of changing froma typical western diet to a very low fat (VLF) vegetarian diet containing one egg/day. The effect of the addition of saturated, monounsaturated or polyunsaturated fat (PUFA) to the VLF diet was also examined. Three groups of 10 subjects (6 women, 4 men) were fed the VLF diet (10% energy as fat) for two weeks, and then in the next two weeks the dietary fat in each group was increased by 10% energy/week using butter, olive oil or safflower oil. The fat replaced dietary carbohydrate. The VLF diet reduced both the low density lipoprotein (LDL)- and high density lipoprotein (HDL)-cholesterol levels; addition of the monounsaturated fats and PUFA increased the HDL-cholesterol levels, whereas butter increased the cholesterol levels in both the LDL- and HDL-fractions. The VLF diet led to significant reductions in the proportion of linoleic acid (18:2 omega 6) and eicosapentaenoic acid (20:5 omega 3) and to increases in palmitoleic (16:1), eicosatrienoic (20:3 omega 6) and arachidonic acids (20:4 omega 6) in both phospholipids and cholesteryl esters. Addition of butter reversed the changes seen on the VLF diet, with the exception of 16:1, which remained elevated. Addition of olive oil resulted in a significant rise in the proportion of 18:1 and significant decreases in all omega 3 PUFA except 22:6 compared with the usual diet. The addition of safflower oil resulted in significant increases in 18:2 and 20:4 omega 6 and significant decreases in 18:1, 20:5 omega 3 and 22:5 omega 3. These results indicate that the reduction of saturated fat content of the diet (< 6% dietary energy), either by reducing the total fat content of the diet or by exchanging saturated fat with unsaturated fat, reduced the total plasma cholesterol levels by approximately 12% in normocholesterolemic subjects. Although the VLF vegetarian diet reduced both LDL- and HDL-cholesterol levels, the long-term effects of VLF diets are unlikely to be deleterious since populations which habitually consume these diets have low rates of coronary heart disease. The addition of safflower oil or olive oil to a VLF diet produced favorable changes in the lipoprotein lipid profile compared with the addition of butter. The VLF diets and diets rich in butter, olive oil or safflower oil had different effects on the 20 carbon eicosanoid precursor fatty acids in the plasma.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1994

Pain relief and clinical improvement temporally related to the use of pentoxifylline in a patient with documented cholesterol emboli--a case report.

A sixty-six-year-old man with known severe atherosclerosis was admitted with painful feet and nonblanching purpuric lesions of his toes. He had undergone cardiac catheterization and coronary artery bypass five and three months, respectively, prior to admission. Initial treatment included: stopping the patient's lisinopril, increasing his nifedipine dose, and adding pentoxifylline 400 mg po tid. Within twenty-four hours pain was markedly decreased. Skin biopsy confirmed a diagnosis of cholesterol embolism. Pentoxifylline was stopped and intravenous heparin therapy was initiated. Within twenty-four hours, pain returned. Nitrol paste applied to the top of each foot had no effect. After forty-eight hours, pentoxifylline was restarted. Once again, pain relief was noted within twenty-four hours, and after forty-eight hours both feet were visibly improved. Heparin and analgesics were discontinued. On the ninth hospital day, the patient was able to walk and was discharged to home. The innocuous nature of the intervention combined with the prompt nature of the therapeutic response support a short trial of pentoxifylline in patients with cholesterol emboli who are not responding to other therapy.

Aged↗
PubMed1994

Substance abuse and dependence in physicians: an overview of the effects of alcohol and drug abuse.

Substance abuse and dependence (alcohol and drugs) are behavioral disorders and treatable medical diseases. Early intervention followed by appropriate treatment can often help return physicians to healthy personal and professional lives. Current scientific evidence suggests the prevalence of substance abuse or dependence among the medical profession over a lifetime is approximately 10-15%, slightly in excess of the general population. The initiation of intervention is critical and ultimately may be lifesaving.

Alcoholism↗
PubMed1994

The impaired physician, Part II: Missouri State Physicians Health Program.

Missouri Physicians Health Program (MPHP) was established to help impaired physicians return to healthy personal and professional lives. One percent of Missouri physicians will suffer some sort of impairment; ie: substance abuse, or dependency of drugs or alcohol within a year. This is a confidential voluntary program. This program of early referral, intervention, treatment and monitoring advocacy has been highly successful. The average recovery rate in this study of 75 participants was 92%.

Female↗
PubMed1993

Differential utilization of eicosapentaenoic acid and docosahexaenoic acid in human plasma.

It has recently been shown that the omega 3 fatty acid status in humans can be predicted by the concentration of eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids in plasma phospholipids [Bjerve, K.S., Brubakk, A.M., Fougner, K.J., Johnsen, H., Midjthell, K., and Vik, T. (1993) Am. J. Clin. Nutr., in press]. In countries with low intake of omega 3 fatty acids, the level of EPA in plasma phospholipids is often only about one-fifth the concentration of DHA. The purpose of this study was to investigate whether this difference in the concentration of these two fatty acids was due to a selective loss of EPA relative to DHA or to a lower dietary intake of EPA. Seven female volunteers ingested four grams of MaxEPA daily for 2 wk and in the following 4 wk they ate a diet almost completely devoid of the long-chain omega 3 fatty acids. The concentrations of the omega 3 fatty acids in the plasma cholesteryl esters, triglycerides and phospholipids and the high density lipoprotein phospholipids were examined at weekly intervals throughout the study. There was a more rapid rise in the concentration of EPA than in DHA levels in the supplementation period in all lipid fractions, but there was a disproportionate rise in DHA relative to EPA in the plasma lipids compared with the ratio in the supplement. In the depletion phase there was a rapid disappearance of EPA from all fractions, such that pre-trial levels were reached by one week post-supplementation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Comparison of ketorolac and opioid analgesics in postoperative ACL reconstruction outpatient pain control.

Pain control is an important postoperative consideration with any surgical procedure. Technological and procedural improvements have contributed to the reduction in both the degree of surgical difficulty and the postsurgical complications associated with intricate surgeries. As a result, certain surgeries have potential for being performed on an outpatient basis, dependent upon appropriate pain-management regimens and the degree of potential for postoperative complications. Arthroscopic anterior cruciate ligament (ACL) reconstruction is a common procedure. Because of the reduction in invasiveness that arthroscopy provides, outpatient surgery is now routinely employed for ACL patients. The arguments against ACL outpatient surgery have included the reluctance to use ambulatory, indwelling, intravenous pain-pump delivery systems for opioid pain medication. The purpose of this study was to determine the efficacy of a ketorolac tromethamine used for the management of the postoperative pain produced as a result of outpatient ACL reconstruction. When the ketorolac pain management regimen is compared in this setting with meperidine or morphine, pain control is as good as, or in some cases better than, either of the opioid drugs. Additionally, the adverse side effects associated with opioid drugs are significantly reduced at a substantially lower direct cost to the patient.

Adolescent↗
PubMed1991

Endothelin inhibits fluid and bicarbonate transport in part by reducing Na+/K+ ATPase activity in the rat proximal straight tubule.

The effects of endothelin on fluid and bicarbonate absorption and Na+/K+ ATPase activity in the proximal straight tubule were investigated. During the control period, fluid absorption was 0.59 +/- 0.03 nL/mm.min when tubules were perfused at 4.76 nL/mm.min. After treatment with 10(-9) M endothelin, fluid absorption fell to 0.36 +/- 0.06 nL/mm.min when perfused at a similar flow rate. During the control period, bicarbonate absorption was 67.9 +/- 3.6 pmol/mm.min. After treatment with endothelin, it fell to 42.8 +/- 4.3 pmol/mm.min, an inhibition of 38%. To test whether inhibition of fluid and bicarbonate absorption was due to suppression of Na+/K+ ATPase activity, the effect of endothelin on pump activity was investigated. In control tubules, Na+/K+ ATPase activity was 85 +/- 5 pmol/mm.min. In endothelin-treated tubules, Na+/K+ ATPase activity was 68 +/- 4 pmol/mm.min, a reduction of 20%. From these data, it was concluded that endothelin inhibits fluid and bicarbonate transport in the proximal tubule and that this inhibition is in part due to suppression of Na+/K+ ATPase activity.

Animals↗
PubMed1990

Ethanol diffuses across the gastric muscle wall.

Ethanol inhibits the electrical and mechanical activities of gastric smooth muscle, but only at concentrations higher than can be provided by serum delivery. We speculated that the ethanol concentration in the gastric wall may exceed plasma levels by direct diffusion across the mucosa and through the muscle layers. A model of acute ethanol ingestion was created by partitioning the stomachs of three dogs with a surgical stapling device and instilling carbon 14 (14C)-labeled ethanol into the proximal segments. The flux of ethanol was traced by counting 14C in serial sections of the gastric wall. A mucosa-to-serosa gradient of 14C activity was established. The data indicate that direct diffusion from the mucosal surface will produce dramatically higher concentrations of ethanol in gastric muscle than would be anticipated from serum levels alone.

Animals↗
PubMed1988

Mean platelet volume and size distribution and their sensitivity to agonists in patients with coronary artery disease and congestive heart failure.

Mean platelet volume was related to platelet count in patients with myocardial infarction (n = 55) and patients with congestive heart failure (n = 9). 18 patients with acute myocardial infarction were tested at admission and 4-7 days later, together with 13 patients with chronic stable angina and 10 patients with chest pain which was not related to coronary artery disease. In citrated blood a relative reduced frequency of large platelets (greater than 13 fl) occurred in patients with acute myocardial infarction at admission but was not seen during recovery or in patients with chronic stable angina. This suggests consumption of large platelets at time of thrombus formation. No relation was found between plasma catecholamine levels and mean platelet volumes. Effects of serotonine, adrenaline and CGP 28392, a calcium agonist, on platelet volume distributions were determined. Sensitivity of platelets to adrenaline was increased in patients with acute myocardial infarction on admission and reduced 4-7 days later, while in patients with congestive heart failure reactivity to both serotonine and adrenaline were reduced. This indicates a fast down-regulation during the early recovery phase of myocardial infarction and chronically in congestive heart failure.

Adult↗
PubMed1987

Management of a recalcitrant periprosthetic fluid collection.

Axillofemoral bypass grafts have been in common use for more than 20 years in the treatment of severe aortoiliac occlusive disease in poor-risk patients. A persistent periprosthetic fluid collection is an unusual complication of this procedure. We describe a technique by which a tense periprosthetic collection was kept successfully decompressed by the construction of a "window" from the cavity to the peritoneum. In our hands it proved to be safely and easily performed with the patient given local anesthetics; no morbidity occurred.

Abdominal Muscles↗
PubMed1986

Idiopathic lingual mandibular bone "depression".

A case of Stafne's idiopathic lingual bone depression is described. This occurred in the classical position below the mandibular molars. On surgical exploration, the defect was found to contain a lymph node rather than the more usual salivary tissue. This may throw some light on the possible etiology of this condition.

Adult↗
PubMed1986

Enhancement in the adhesion of tumor cells to endothelial cells by decreased cholesterol synthesis.

Adhesive interactions between tumor cells and the endothelial cells are presumed to be an obligatory step in the metastatic process. Using an in vitro model, we have examined the role of endothelial lipids in the regulation of this interaction. The cholesterol levels of bovine aorta endothelial cell monolayers were inhibited by the addition of compactin, 25-hydroxycholesterol, or 7-ketocholesterol. Metastatic B16 melanoma cells prelabeled with 14C-amino acid mixture were then deposited on this monolayer as a suspension and, at various time intervals, the number of cells adhering to the monolayer was determined. The results indicated that inhibition of cellular cholesterol caused enhancement in cell adhesion. On the other hand, perturbations of the glycosylation in the endothelial cells were without any effect on cell adhesion. The presence of cholesterol dispersion in the growth medium partially reversed the enhancement in cell adhesion caused by the cholesterol inhibitors. Growth in the presence of retinol or dexamethasone (1 microM) also caused enhancement in the adhesiveness of the tumor cells to endothelial cells, possibly because of their effects on cholesterol synthesis. Procaine, a local anesthetic which is known to increase membrane fluidity, also increased the tumor cell-endothelial interaction, suggesting that the membrane fluidity plays an important role in the regulation of cell adhesion.

Animals↗