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Biomedical subjects

R K Elswick

Publications and source records attributed to R K Elswick.

42 records · Page 3Linked to original sources
PubMedDate not supplied

The effect of supplemental dietary fat on plasma cholesterol levels in lovastatin-treated hypercholesterolemic patients.

STUDY OBJECTIVE: A validation study was conducted first to test assumptions about the effect of saturated and unsaturated dietary fat supplements. The second study was conducted to determine the effect on blood cholesterol levels of saturated and unsaturated fat supplements in patients who followed a low-fat diet and were administered lovastatin. DESIGN: Randomized, crossover design, with three periods in the first study and four in the second study, each lasting 6 weeks. SETTING: Cholesterol Research Center. PATIENTS: The first study evaluated adults with total cholesterol levels between 200 and 280 mg/dl (5.172 and 7.241 mmol/L). The second study included adults with low-density lipoprotein (LDL) cholesterol levels above 160 mg/dl (4.138 mmol/L). INTERVENTIONS: Fat supplements with either coconut or canola oil were delivered to patients in oatmeal-raisin cookies. MEASUREMENTS AND MAIN RESULTS: In the validation study, patients' mean prerandomization total cholesterol level of 222 mg/dl was reduced to 213 mg/dl with canola oil and increased to 233 mg/dl with coconut oil cookies (p = 0.0038). In the second study the mean prerandomization total cholesterol level of 214 mg/dl was decreased to 199 mg/dl with canola oil and to 208 mg/dl with coconut oil cookies (p = 0.2342). The LDL cholesterol levels changed in a similar fashion in both studies. CONCLUSIONS: Changes in total and LDL cholesterol levels in the validation study were expected based on established effects of saturated and unsaturated fatty acids, but changes in these levels in lovastatin-cookie study were not expected. They could have occurred because lovastatin reversed the effect of saturated fats and enhanced the effect of unsaturated fats. Alternatively, they may have been due to enhanced bioavailability of lovastatin when administered with a high-fat diet. These findings must be confirmed.

Adult↗
PubMedDate not supplied

Duration of action of a single, early oral application of chlorhexidine on oral microbial flora in mechanically ventilated patients: a pilot study.

OBJECTIVE: The purpose of this study was to describe the effect of an early post-intubation oral application of chlorhexidine gluconate on oral microbial flora and ventilator-associated pneumonia. METHODS: Thirty-four intubated patients were randomly assigned to chlorhexidine gluconate by spray or swab or to control group. Oral cultures were done at study admission, 12, 24, 48, and 72 hours, whereas the Clinical Pulmonary Infection Score (CPIS) was documented at study admission, 48, and 72 hours. RESULTS: Reductions in oral culture scores (less growth) were only found in the treatment groups (swab and spray); no reduction was found in the control group. There was a trend for fewer positive cultures in the combined treatment groups. The mean CPIS for the control group increased to a level indicating pneumonia (4.7 to 6.6), whereas the CPIS for the treatment group increased only slightly (5.17 to 5.57). CONCLUSIONS: Trends in the data suggest that use of chlorhexidine gluconate in the early post-intubation period may mitigate or delay the development of ventilator-associated pneumonia.

Adult↗
PubMedDate not supplied

Coronary heart disease risks and lifestyle behaviors in persons with HIV infection.

Metabolic complications such as HIV-associated lipodystrophy syndrome are common in patients with HIV-1 infection who are taking highly active antiretroviral therapy. HIV-associated lipodystrophy syndrome is characterized by dyslipidemia, fat redistribution, and altered glucose metabolism; however, there has been little study of relationships between these risk factors for coronary heart disease (CHD) and lifestyle risks. The aims of this study were to (a) describe the physical activity levels, nutrition habits, and smoking behaviors of persons with HIV-1 infection; (b) describe their CHD risks and estimate 10-year risk for CHD outcomes; and (c) examine the relationship between potentially modifiable lifestyle behaviors and risk factors for atherosclerotic cardiovascular disease in persons with HIV-1 infection receiving highly active antiretroviral therapy. Variables included lipid profile and other metabolic indices, body fat distribution, body mass index, blood pressure, and lifestyle behaviors (physical activity, dietary habits, smoking). A cross-sectional design and convenience sampling (n = 95) was used. Participants had multiple modifiable risk factors: 20% had a 10-year risk of 10% or higher of developing CHD. Results underscore the need for health promotion interventions to target lifestyle risks in persons with HIV-1 infection taking highly active retroviral therapy.

Adult↗
PubMedDate not supplied

Perinatal substance abusers: factors influencing treatment retention.

This study investigated the association between two demographic and two psychological variables and treatment retention for 65 perinatal substance abusers. Subjects who lived in the community while attending day treatment were 6.125 times more likely to drp out than subjects who lived in a program-operated shelter (p < .0001). An interaction was found for pregnancy status and antisocial personality disorder (p < .0478). Subjects who were both pregnant and antisocial were 4.876 times more likely to remain in treatment than those who were neither pregnant nor antisocial. Degree of "treatment resistance," measured by the MMPI Negative Treatment Indicators (TRT) Scale, did not predict dropout. These findings indicate that supportive housing can play an important role in preventing dropout for perinatal substance abusers. Additionally, pregnancy may present a "window" of opportunity for treating a hard to reach population, drug abusing women with comorbid ASP.

Adult↗
PubMedDate not supplied

Influence of functional, urological, and environmental characteristics on urinary incontinence in community-dwelling older women.

The purpose of this study was to explore the relationships of functional, urological, and environmental characteristics to the frequency of urinary incontinence in 131 community-dwelling older women. Subjects with detrusor instability with or without concomitant genuine stress incontinence had significantly more impaired physical functioning, slower gait speeds, smaller bladder capacities, and less ability to delay voiding than subjects with genuine stress incontinence alone. Age, distance to toilet used most, and toilet-gait speed explained 17% of the variance in incontinence severity. Younger age, slower mobility, and a shorter distance to reach the toilet were associated with a higher frequency of incontinence. Physical functional status and urological characteristics, including urodynamic diagnosis, did not predict incontinence severity. These findings confirm, in part, the commonly held assumption that mobility and the environment influence urinary incontinence.

Activities of Daily Living↗