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Biomedical subjects

P Singer

Publications and source records attributed to P Singer.

288 records · Page 16Linked to original sources
PubMedDate not supplied

Effect of nutritional state of brain-dead organ donor on transplantation.

OBJECTIVE: We describe the effect of the metabolic and nutritional modifications caused by severe illness or injury in brain-dead organ donors on transplant organ function. Malnutrition is frequently found in brain-dead organ donors and nutrients may interfere with different organ functions. METHODS: Literature was obtained from MEDLINE using the key words organ donation, brain death, transplantation, nutrition, fish oil, amino acids. RESULTS: In the liver, infusion of large quantities of dextrose can restore glycogen reserves but may induce hyperglycemia and a hyperosmolar hepatic state. Feeding improves protein synthesis in hepatocytes, and fat (fish oil) administration in particular increases the hepatic energy and adenosine triphosphate content. Amino acids have a significant effect on regenerating hepatic tissue when given with fat and glucose. In the heart, free fatty acids administered during reperfusion improve cardiac functional recovery, and administration of propofol, a general anesthetic agent enriched with fatty acids, have protective effects on ischemia-and-reperfusion injury. Glutamine also can induce graft protection during ischemia-and-reperfusion injury. Renal function is improved by fish oil supplementation. In addition, effective renal plasma flow, glomerular filtration rate, and renal blood flow are increased, apparently by a reduction in thromboxane B2 production. Glycine or alanine can protect renal tubules from stress injury. CONCLUSION: Nutrition plays an important role in the modulation of organ function after transplantation.

Amino Acids↗
PubMedDate not supplied

Postprandial hyperinsulinemia in patients with mild essential hypertension.

Glucose tolerance tests and diurnal profiles of glucose, insulin, free fatty acids, serum triglycerides, total and high-density lipoprotein cholesterol levels were performed in 8 male patients with mild essential hypertension as well as in 20 normotensive subjects. Although glucose tolerance and postprandial glucose levels appeared equal in both groups, the insulin response after a glucose load and after each meal was significantly increased in hypertensive subjects as compared with the controls (p less than 0.01). The levels of free fatty acids were higher in the postabsorptive phase of patients with hypertension in comparison to normotensive subjects, but decreased markedly when plasma insulin levels rose after meals. In both subject groups serum triglyceride levels showed the typical postprandial increase. Total and high-density lipoprotein cholesterol levels showed neither diurnal variations nor differences between hypertensive subjects and normotensive controls. Postprandial hyperinsulinemia in patients with mild essential hypertension possibly may provoke lipid accumulation in the arterial wall and therefore may be a relevant risk factor for atherosclerosis in these subjects.

Adult↗
PubMedDate not supplied

Risks and benefits of home parenteral nutrition in the acquired immunodeficiency syndrome.

The gastrointestinal tract is a major target of the human immunodeficiency virus. Many AIDS patients have weight loss and/or diarrhea. Parenteral nutrition can be used to treat malnutrition associated with malabsorption. We reviewed retrospectively the clinical course of 22 patients with AIDS and weight loss greater than 10% who received home parenteral nutrition (HPN) for 56.2 patient-months. Mean weight loss was 21.4%, mean duration of HPN 2.55 months, mean age 37.4 years. Fifteen patients gained weight, six stabilized and two continued to lose weight. Nine patients returned to previous activity. Five died. The rates of catheter-related sepsis, complications, and metabolic disturbances were 0.12, 0.25, and 0.12/100 catheter days, respectively, results identical to those reported in other patient populations where HPN is commonly applied. We found that HPN induced weight gain and clinical improvement in most patients without higher risks of sepsis than in patients with malignancies.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Clinical and immunologic effects of lipid-based parenteral nutrition in AIDS.

The effect of lipid-based parenteral nutrition was assessed in eight patients with AIDS and weight loss of 10% or greater. All patients received home parenteral nutrition consisting of a lipid-based system with 50% of nonprotein calories given as fat. Measurements were made of body weight, serum albumin, and immune function as assessed by mitogen responses, P24 antigen levels and T-cell counts. Over a period of 2 months, weight gain and improved well-being were noted in all patients. An improved in vitro lymphocyte mitogenic response to phytohemagglutinin and to concanavalin A was also noted. No change in T-cell subsets was observed. Viral cultures and P24 serum levels also remained unchanged. Lipid-based parenteral nutrition is safe and probably efficacious in AIDS.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Medical school, psychosocial attitudes, and gender.

A scale measuring empathy and a scale measuring attitudes toward social issues and human relations in health care were administered to medical students when they were applicants to medical school and again midway through their third year. Students in their third year exhibited less positive and/or more negative attitudes compared to their scores as applicants. The changes were largest in areas relating to social issues, such as government involvement in health care, and least in areas relating to human relations, such as the role of social factors as determinants of a patient's health or illness. There were few differences between women and men on these scales. These data suggest that attitudes toward the interpersonal aspect of patient care may be less severely affected by the medical school experience than previously expected, and that the medical school experience does not affect women's attitudes differently than it does men's.

Attitude↗
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To do or not to do?

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Animal Experimentation↗
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[Hematotoxicity of thiamphenicol. Report of two cases of acute erythroblastopenia (author's transl)].

Thiamphenicol is known to produce two hematological side effects: a decrease in blood cell count concerning mainly red blood cells; in this case regression is observed after withdrawal of the drug; the frequency of this side effect appears to be higher than that observed after chloramphenicol administration. Severe and sometimes fatal pancytopenia is rare and related to primary bone marrow failure; its incidence seems to be increased by high dosages, long-term or repeated administration, interaction with other hematotoxic drug administration, renal failure, elderly or immune suppression.

Acute Disease↗