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Biomedical subjects

L B Gardner

Publications and source records attributed to L B Gardner.

At least 37 records · Page 2Linked to original sources
PubMed1988

Effects of low- and high-repetition resistive training on lipoprotein-lipid profiles.

Thirty-seven healthy untrained males (age = 21 +/- 1 yr; range = 19 to 35 yr) were studied to determine the effects of 10 wk of low- and high-repetition resistive training on lipoprotein-lipid profiles. Subjects were assigned to 1 of 3 groups: a low-repetition group (N = 15) that trained using 4 to 6 repetitions maximum or a high-repetition group (N = 14) that used 14 to 16 repetitions maximum in their training or to an inactive control group (N = 8). The number of sets was adjusted to equalize workloads. Muscular strength increased significantly in both training groups as indicated by the increase in the one-repetition maximum test (P less than 0.05). VO2max, body weight, and percent body fat did not change in either of these groups. However, fat-free weight increased significantly in both training groups (both P less than 0.05). The low-repetition training program resulted in no significant changes in the plasma concentrations of triglycerides (104 +/- 15 vs 89 +/- 8), total cholesterol (150 +/- 7 vs 141 +/- 6), high-density lipoprotein (HDL)-cholesterol (40 +/- 1 vs 41 +/- 2), and HDL2-cholesterol (7 +/- 1 vs 7 +/- 1). A similar pattern was observed for the high-repetition group ([i.e., no significant changes in the concentrations of triglycerides (87 +/- 10 vs 89 +/- 8), total cholesterol (148 +/- 6 vs 162 +/- 6), HDL-cholesterol (40 +/-2 vs 40 +/- 2), and HDL2-cholesterol (6 +/- vs 1 vs 7 +/- 2)]. All lipid values were expressed in milligrams per deciliter (mean +/- SE).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Clinical value of the creatinine clearance before the administration of chemotherapy with cisplatin.

The creatinine clearance was calculated in standard fashion from a timed urine specimen (measured creatinine clearance [MCC]) and from a previously published formula (estimated creatinine clearance [ECC]), in 55 instances, in 19 consecutive patients who were admitted to the hospital for treatment with cisplatin. Using creatinine excretion as an index of completeness of urine collection, there were 19 (35%) inaccurate collections. The correlation between creatinine clearances calculated by both methods was excellent (r = 0.684, P less than .001) and improved when inaccurate collections were excluded (r = 0.922, P less than 0.001). A discrepancy between the two methods of 25% or more was found in 19 collections. Using data from patients with two or more collections to test whether or not the two methods produced equally variable results, indicated that the MCC is a more variable, less reliable method than the ECC. In eight of 55 urine collections, the results of MCC were not used as a guide to chemotherapy and, in an additional 16 should have not been used because of inaccuracy in the urine collection. These results suggest that the creatinine clearance as calculated by an alternative method (ECC) should replace the use of MCC when assessment of the renal function is needed before the administration of nephrotoxic agents.

Adult↗
PubMed1987

Attribute frequency and misclassification bias.

Allowances for potential misclassification bias were performed for three epidemiologic studies. Although the error rates were assumed to be identical for the three studies, there were differences in the degree and even in the direction of the bias. It is shown that they are the result of differences in the true frequencies of the misclassified attributes in these studies. In this regard, the relation of misclassification bias to predictive value is described. Misclassification bias is highly dependent upon the interactions between error rates and the true frequencies of attributes. In general, relative risk estimates are more subject to substantial bias from disease misclassification when cohort studies have very low disease frequencies. Odds ratio estimates are more likely to be substantially biased from exposure misclassification when case-control studies have either very high or very low exposure frequencies. Attribute frequency is an important determinant of bias from misclassification.

Epidemiologic Methods↗
PubMed1985

Decision to adopt new medical technology: a case study of thrombolytic therapy.

New medical technologies are adopted by practising physicians at varying rates. Thrombolytic therapy is an example of a technological advance that many physicians have seemed reluctant to employ. A random sample of board certified internists was surveyed by mail to study factors that influence decisions to use thrombolytic agents. Variables important in predicting use were identified by discriminant analysis. In general users and non-users had similar assumptions about the risks and benefits of this technology. Among the important predictor variables were a perception of having patients suitable for treatment, availability of the agents and self-rating of knowledge about this therapy. Among questions related to type of practice and education, only subspecialization and textbook reading were important discriminators. These results suggest that decisions to adopt new technologies do not follow simply from risk-benefit assessments.

Adult↗
PubMed1984

Serum folate and vitamin B12 levels in patients with small cell lung cancer.

Serum folate and vitamin B12 levels were evaluated in 80 patients with small cell lung cancer at diagnosis and during therapy over a 30-week period. Approximately one half of the patients were randomized to receive hyperalimentation. Folate and vitamin B12 intake was adequate without parenteral nutrition in these cancer patients. Serum folate and Vitamin B12 levels did not correlate with disease extent. At the initiation of therapy, serum folate declined with increasing weight loss. During therapy, the intake of folate was adequate to maintain a normal serum folate despite marked weight loss.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Cocaine-packet ingestion. Diagnosis, management, and natural history.

We treated 50 patients who ingested packets of cocaine and developed a protocol for conservative medical management. Of the 50 patients, only 3 required emergency surgery. Surgery was precipitated by signs and symptoms of bowel obstruction in all cases. Six patients chose elective surgery. The rest of the patients passed the packets without signs of cocaine toxicity or other complications. This finding is in contrast to that of previous reports. Asymptomatic patients who have ingested packets of cocaine can be safely observed and managed conservatively.

Adult↗
PubMed1982

A description of a means of improving ambulatory care in a large municipal teaching hospital: a new role for nurse practitioners.

We describe a nurse practitioner program that has improved ambulatory care in a large municipal teaching hospital. The significant feature of this program is an expanded role for nurse practitioners in the follow-up of patients with complicated illnesses. Benefits of this program include improved continuity of care and an easing of the house staff's service burden. Similar use of nurse practitioners at other municipal teaching hospitals would be a useful approach to problems in quality of care and continuity of care.

Florida↗
PubMed1981

An index predicting relapse and need for hospitalization in patients with acute bronchial asthma.

In an attempt to define guidelines for the assessment of acute asthma, we evaluated 205 patients who presented to the emergency room for treatment of asthma. Of the 205, 120 were successfully treated and discharged from the emergency room, 45 were hospitalized, and 40 were treated and discharged from the emergency room but had relapses within 10 days. A predictive index using a combination of presenting factors was developed: pulse rate greater than or equal to 120 per minute, respiratory rate greater than or equal to 30 per minute, pulsus paradoxus greater than or equal to 18 mm Hg, peak expiratory flow rate less than or equal to 120 liters per minute, moderate to severe dyspnea, accessory-muscle use, and wheezing. The index ranged from 0 to 7, increasing with the severity of symptoms. The index scores of the relapse group (4.9 +/- 1.0) and the admitted group (5.1 +/- 1.0) were both significantly different (p less than 0.001) from that of the successfully treated group (1.6 +/- 1.2). An index of 4 or higher was 95 per cent accurate in predicting the risk of relapse and 96 per cent accurate in predicting the need for hospitalization.

Acute Disease↗
PubMed1980

Metabolic responses of Zucker fatty and lean rats fed carbohydrate diets ad libitum or in meals.

In order to study the metabolic effects of dietary sucrose on Zucker rats, young male fatty and lean rats were fed ad libitum or in meals (2 hours/day) for 4 weeks. Diets contained 54% carbohydrate as either sucrose, invert sugar or cooked cornstarch. A genotype effect (fatty versus lean) occurred with the activities of liver and adipose tissue lipogenic enzymes, relative total fat pad size and soluble adipose tissue protein levels in both ad libitum- and meal-fed rats, whereas a genotype effect occurred with food intake and relative liver size only in meal-fed rats and with body weight gain only in ad libitum-fed rats. The significance of diet effects varied with genotype and feeding pattern. The sucrose effect (sucrose versus starch) occurred with food efficiency and body weight gain, activities of liver lipogenic and gluconeogenic enzymes, relative liver size, relative total fat pad size and soluble adipose tissue protein levels in both ad libitum- and meal-fed rats, and with adipose lipogenic enzyme activities in meal-fed rats. The disaccharide effect (sucrose versus invert sugar) occurred with the activities of liver lipogenic enzymes, relative total fat pad size and soluble adipose tissue protein levels in ad libitum-fed rats and was greater in lean than in fatty rats. The data demonstrate that the Zucker fatty and lean rat can be used as sensitive models to study differential effects of dietary carbohydrate.

Adipose Tissue↗
PubMed1979

Isocaloric exchange of dietary starch and sucrose in humans. II. Effect on fasting blood insulin, glucose, and glucagon and on insulin and glucose response to a sucrose load.

Ten men and nine women ages 35 to 55 consumed two diets for 6 weeks each in a cross-over design. The diets were composed of identical natural foods and 30% of the calories as either sucrose or wheat starch. Carbohydrate, fat, and protein supplied 43, 42, and 15% of the calories, respectively. Of the calories 10% was eaten at breakfast (7:00 to 8:30 AM) and 90% at dinner (4:30 to 6:30 PM). Inital body weights were essentially maintained. Fasting serum insulin and glucose levels were significantly higher with the sucrose than with the starch diet. The insulin response and the insulin:glucose ratios after a sucrose load (2 g/kg body weight) were greater after the subjects consumed the sucrose diet. Sucrose feeding produced increases in fasting serum insulin, the insulin:glucose ratio and the insulin response to a sucrose load that were of greater magnitude in a subgroup of nine subjects classified as potentially carbohydrate-sensitive than in normal subjects. Glucose response to a sucrose load and fasting serum glucagon did not differ significantly with diet. Fasting insulin and glucose showed significant increases as a function of time on diet. These results indicate that sucrose feeding produces undersirable changes in several of the parameters associated with glucose tolerance.

Adult↗
PubMed1978

Effect of glucagon infusion on the renal clearance of amylase relative to creatinine.

Recent data seem to support a tubular defect as the mechanism of the elevated renal clearance of amylase relative to creatinine in acute pancreatitis. Glucagon has been proposed by some to be an important factor in this phenomenon. To examine the role of glucagon as this "tubular dysfunction factor", we investigated the effect of intravenously infused glucagon on the fractional excretion of amylase and the tubular handling of a low molecular weight protein, beta2 microglobulin, in normal, healthy volunteers. At glucagon levels far in excess of those seen in pancreatitis, the clearance ratio of beta2 microglobulin relative to creatinine increased, whereas the clearance ratio of amylase relative to creatinine did not increase above the normal range. The dissociation between beta2 microglobulin clearance and amylase clearance allows one to question the theory that tubular dysfunction is the mechanism of the elevated renal clearance of amylase relative to creatinine in acute pancreatitis. Glucagon does not appear to be the sole factor responsible for the elevation of renal clearance of amylase relative to creatinine in acute pancreatitis.

Adult↗
PubMed1977

Natural history of lactic acidosis after grand-mal seizures. A model for the study of an anion-gap acidosis not associated with hyperkalemia.

To define the time course of the metabolic acidosis that follows a single grand-mal seizure, we obtained serial blood samples from eight consecutive patients. Immediately after a seizure, the mean (+/- S.E.M.) venous lactate concentration was 12.7 +/- 1.0 meq per liter, the mean carbon dioxide content 17.1 +/- 1.1 mmol per liter, and the mean arterial pH 7.14 +/- 0.06. Sixty minutes later their values were 6.6 +/- 0.7 meq per liter (P less than 0.005), 23.6 +/- 1.1 mmol per liter (P less than 0.005) and 7.38 +/- 0.04 (P less than 0.005) respectively. The spontaneous resolution of the acidosis was due, in large part, to the metabolism of lactate and to the concomitant removal of hydrogen ion. There was no change in the serum potassium concentration, despite the development of a severe systemic acidemia and the subsequent return to normal of the pH. We suggest that the patient with seizures may serve as a unique model of lactic acidosis.

Acetates↗
PubMed1977

A strain specific increase in blood glycerol level of the carbohydrate-sensitive BHE rat.

A strain-specific, elevated serum free glycerol has been found in stock diet fed, carbohydrate-sensitive, hyperlipemic BHE rats. This suggests that considerably more peripheral lipolysis is taking place in the nonfasting BHE rat than in its Wistar counterpart. This observation further suggests that the BHE rat may exhibit metabolic changes in the fed state that are similar to those found in normal fasting rats. Individual, serum free glycerol levels were not correlated with individual serum insulin values. In the nonfasted BHE rats, serum free glycerol concentrations were found to be sufficiently high to initiate gluconeogenesis or to contribute to a maximal rate of triglyceride synthesis.

Animals↗