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Biomedical subjects

R H Clark

Publications and source records attributed to R H Clark.

82 records · Page 5Linked to original sources
PubMed1983

Noninvasive localization of urinary tract infection: clinical investigations and experience.

Previously we evaluated new methods to localize the source of bacteriuria in monkeys with experimental urinary tract infection. A high level of diagnostic accuracy was obtained with studies of antibody coating of urinary bacteria by immunofluorescence, 131iodine hippuran quantitative scintillation camera studies with the patient in the hydropenic state and 67gallium citrate scintiphotos. We identified unique patterns that differentiated cystitis, ureteritis, pyelonephritis and renal or perinephric abscess. Herein we review our clinical experience with these combined techniques in 40 patients and correlate the degree of accuracy of these studies with that of standard radiographic examinations. In 20 patients diagnostic studies also were compared to the findings of split ureteral urine cultures or bacteriologic culture of renal tissue obtained from surgical specimens or autopsy. The use of the quantitative scintillation camera studies done with the patient in a state of controlled hydropenia increased clearly the level of diagnostic sensitivity in demonstrating the source of a urinary tract infection compared to urine culture and excretory urography alone. In patients with an abnormal 131iodine hippuran study the performance of 67gallium renal imaging on the same day usually provided information that allowed specific localization of the source and extent of an infection. Both studies must be performed with a high degree of resolution over the renal areas and then must be interpreted carefully to ensure accuracy. Study of antibody coating of urinary bacteria was helpful in suggesting the presence or absence of upper urinary tract disease but was less sensitive and accurate than the combined radionuclide studies.

Abscess↗
PubMed1977

Staff characteristics associated with likeableness on an adolescent treatment unit.

Personality characteristics including subtest scores from the 16 Personality Factor Questionnaire (16 PF), California Personality Inventory, and Tennessee Self-concept Scale were related to the rated likeableness of staff members of an adolescent treatment unit. Likeableness was assessed by students participating in the treatment program. Correlated were likeableness of staff members and staff members' self-esteem, responsiblity, social awareness, and lack of acquiescent response tendencies.

Adolescent↗
PubMed1976

Racial similarity and adult modeling of uncooperative behavior.

To test the hypothesis that modeling is enhanced when Ss and models are of the same race, black and white attendants at a southern mental hospital were exposed to either a black or white model who refused to volunteer for a series of future studies. Although the white model more effectively induced refusal behavior by both races of Ss, no interaction effect was found between race of model and race of S, which refutes the hypothesis.

Adult↗
PubMedDate not supplied

Nutritional treatment for acquired immunodeficiency virus-associated wasting using beta-hydroxy beta-methylbutyrate, glutamine, and arginine: a randomized, double-blind, placebo-controlled study.

BACKGROUND: The current study was designed to examine whether a combination of three nutrients, consisting of beta-hydroxy-beta-methylbutyrate (HMB), a metabolite of leucine, L-glutamine (Gln) and L-arginine (Arg), each of which has been previously shown to slow muscle proteolysis, could synergistically alter the course of muscle wasting in patients with established acquired immunodeficiency syndrome (AIDS). METHODS: Sixty-eight human immunodeficiency virus (HIV)-infected patients with a documented weight loss of at least 5% in the previous 3 months were recruited from the HIV clinic at Nassau County Medical Center. The subjects were randomly assigned in a double-blind fashion to receive either placebo containing maltodextrin or the nutrient mixture (HMB/Arg/Gln) containing 3 g HMB, 14 g L-glutamine, and 14 g L-arginine given in two divided doses daily for 8 weeks. Body weights (BW) were recorded weekly and lean body mass (LBM) and fat mass (FM) were measured by air displacement plethysmography and by a single computerized tomography (CT) slice through the thigh at 0, 4, and 8 weeks. RESULTS: Forty-three subjects completed the 8-week protocol, (placebo, n = 21; HMB/Arg/Gln, n = 22). At 8 weeks, the subjects consuming the HMB/Arg/Gln mixture gained 3.0 +/- 0.5 kg of BW while those supplemented with the placebo gained 0.37 +/- 0.84 kg (p = .009). The BW gain in the HMB/Arg/Gln-treated subjects was predominantly LBM (2.55 +/- 0.75 kg) compared with the placebo-supplemented subjects who lost lean mass (-0.70 +/- 0.69 kg, p = .003). No significant change in FM gain was observed (0.43 +/- 0.83 kg for the group receiving HMB/Arg/Gln and 1.07 +/- 0.64 kg for the group receiving the placebo, p > .20). Similar percentage changes in muscle mass and fat mass were observed with CT scans. Immune status was also improved as evident by an increase in CD3 and CD8 cells and a decrease in the HIV viral load with HMB/Arg/Gln supplementation. CONCLUSIONS: The data indicate that the HMB/Arg/Gln mixture can markedly alter the course of lean tissue loss in patients with AIDS-associated wasting.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Supplementation with a combination of beta-hydroxy-beta-methylbutyrate (HMB), arginine, and glutamine is safe and could improve hematological parameters.

BACKGROUND: Combining the amino acids arginine and glutamine with the leucine metabolite beta-hydroxy-beta-methylbutyrate (HMB) has been shown to reverse lean tissue loss in cancer and acquired immunodeficiency syndrome (AIDS) patients. Although each of these nutrients has been shown to be safe, the safety of this mixture has not been reported. Three double-blind studies examined the safety of the combination of HMB, arginine and glutamine on blood chemistries, hematology, emotional profile, and adverse events. METHODS: Study 1 was conducted in healthy adult males (n = 34), study 2 was in HIV patients with AIDS-associated weight loss (n = 43), and study 3 was in cancer patients with wasting (n = 32). Volunteers were assigned to either a placebo or a mixture of 3 g HMB, 14 g arginine, and 14 g glutamine per day. RESULTS: Across the 3 studies, HMB, arginine, and glutamine supplementation was not associated with any adverse indicators of health. The only significant changes noted were positive indicators of health status. HMB, arginine, and glutamine supplementation was associated with an improvement in emotional profile (p = .05), a decreased feeling of weakness (p = .03), and increased red blood cells, hemoglobin, hematocrit, lymphocytes, and eosinophils (p < .05) when compared with placebo-supplemented subjects. Blood creatinine levels were not changed. However, blood urea nitrogen increased (p = .01) with HMB, arginine, and glutamine supplementation, which was possibly caused by the additional nitrogen consumed or to the fact that ureagenesis is influenced by arginine and glutamine supplementation. CONCLUSION: These results show that HMB, arginine, and glutamine can be safely used to treat muscle wasting associated with AIDS and cancer.

3-Hydroxybutyric Acid↗
PubMedDate not supplied

High frequency ventilation--the relationship between ventilator design and clinical strategy in the treatment of hyaline membrane disease and its complications: a brief review.

Progress in the application of techniques of HFV to clinical settings has been hampered by a lack of comparative data. Ventilator design and/or strategy place clear limitations on the effective and safe use of these devices. There is a definite need to develop clear therapeutic goals for HFV, to define the operating characteristics and limitations of each device, and to develop effective and safe strategies for their use in various clinical settings. Only then can adequate controlled clinical trials be performed and the role of these techniques be firmly established.

Cardiac Output↗