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Biomedical subjects

S H Goodnight

Publications and source records attributed to S H Goodnight.

At least 37 records · Page 2Linked to original sources
PubMed1993

The effects of n-3 fatty acids on atherosclerosis and the vascular response to injury.

The potentially beneficial effects of dietary fatty acids on vascular disease continues to generate intense clinical and investigative interest throughout the world. In particular, attention has focused on the highly unsaturated n-3 fatty acids found in marine and certain plant oils in the prevention of atherosclerosis and thrombosis. This article will review the impact of these fatty acids on vascular disease in epidemiologic studies, in animal models of atherosclerosis and vascular injury, and in human clinical trials of restenosis following angioplasty. Some of the more specific cellular effects of n-3 fatty acids will also be discussed. The data accumulated in the last 15 years suggest that additional prospective clinical trials of n-3 fatty acids in the prevention or treatment of vascular disease are warranted in humans.

Animals↗
PubMed1992

Inherited hypercoagulable states: questions and controversies.

Inherited hypercoagulable states such as protein C, protein S, and antithrombin III deficiencies account for 15% to 20% of recurrent thromboembolic episodes. A common risk profile is associated with these disorders and guides the use of laboratory screening. The use of anticoagulants in inherited hypercoagulable states varies with a patient's personal and familial history of thrombosis. Special consideration is given to the need for anticoagulants perioperatively and during pregnancy.

Blood Coagulation Disorders↗
PubMed1991

Food use and health effects of soybean and sunflower oils.

This review provides a scientific assessment of current knowledge of health effects of soybean oil (SBO) and sunflower oil (SFO). SBO and SFO both contain high levels of polyunsaturated fatty acids (PUFA) (60.8 and 69%, respectively), with a PUFA:saturated fat ratio of 4.0 for SBO and 6.4 for SFO. SFO contains 69% C18:2n-6 and less than 0.1% C18:3n-3, while SBO contains 54% C18:2n-6 and 7.2% C18:3n-3. Thus, SFO and SBO each provide adequate amounts of C18:2n-6, but of the two, SBO provides C18:3n-3 with a C18:2n-6:C18:3n-3 ratio of 7.1. Epidemiological evidence has suggested an inverse relationship between the consumption of diets high in vegetable fat and blood pressure, although clinical findings have been inconclusive. Recent dietary guidelines suggest the desirability of decreasing consumption of total and saturated fat and cholesterol, an objective that can be achieved by substituting such oils as SFO and SBO for animal fats. Such changes have consistently resulted in decreased total and low-density-lipoprotein cholesterol, which is thought to be favorable with respect to decreasing risk of cardiovascular disease. Also, decreases in high-density-lipoprotein cholesterol have raised some concern. Use of vegetable oils such as SFO and SBO increases C18:2n-6, decreases C20:4n-6, and slightly elevated C20:5n-3 and C22:6n-3 in platelets, changes that slightly inhibit platelet generation of thromboxane and ex vivo aggregation. Whether chronic use of these oils will effectively block thrombosis at sites of vascular injury, inhibit pathologic platelet vascular interactions associated with atherosclerosis, or reduce the incidence of acute vascular occlusion in the coronary or cerebral circulation is uncertain. Linoleic acid is needed for normal immune response, and essential fatty acid (EFA) deficiency impairs B and T cell-mediated responses. SBO and SFO can provide adequate linoleic acid for maintenance of the immune response. Excess linoleic acid has supported tumor growth in animals, an effect not verified by data from diverse human studies of risk, incidence, or progression of cancers of the breast and colon. Areas yet to be investigated include the differential effects of n-6- and n-3-containing oil on tumor development in humans and whether shorter-chain n-3 PUFA of plant origin such as found in SBO will modulate these actions of linoleic acid, as has been shown for the longer-chain n-3 PUFA of marine oils.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1990

Evaluation of the safety, recovery, half-life, and clinical efficacy of antithrombin III (human) in patients with hereditary antithrombin III deficiency. Cooperative Study Group.

Antithrombin III (Human) (AT III) was administered to 18 patients with documented hereditary AT III deficiency. In eight patients with no ongoing clinical symptoms of thrombosis, the percent increase per unit AT III infused per kilogram of body weight ranged from 1.56% to 2.74%, and the half-life from 43.3 to 77.0 hours. No significant difference was noted between patients receiving and those not receiving coumarin therapy. In clinically ill patients, the in vivo recovery was significantly lower and ranged from 0.64% to 1.90% increase per unit AT III infused/kg. Efficacy of AT III was evaluated in 13 patients for the prevention or treatment of thrombosis. AT III was efficacious as assessed by the absence of thrombotic complications after surgery and/or parturition, and the nonextension and nonrecurrence of thrombosis in patients exhibiting an acute thrombotic episode. No side effects were noted. Follow-up studies indicated no hepatitis B seroconversion and no alanine aminotransferase elevations in patients who were not transfused with other blood products.

Adult↗
PubMed1990

Fish oils in hypertriglyceridemia: a dose-response study.

The effects of three supplemental doses of fish oil on plasma lipids, lipoproteins, and bleeding times were studied in ten hypertriglyceridemic patients. After a 3-wk baseline period each patient was given 15, 25, or 40 mL fish oil/d (containing 4.5, 7.5, and 12 g n-3 fatty acids) for three successive 6-wk periods, each separated by a 4-wk period of no supplementation. Plasma cholesterol concentrations decreased from 7.40 mmol/L to 6.35, 6.55, and 6.40 mmol/L with increasing doses of fish oil (p less than 0.01 vs baseline for each). Plasma triglyceride concentrations decreased from 6.10 mmol/L to 2.90, 2.80, and 2.35 mmol/L (p less than 0.01 vs baseline for each). Low-density-lipoprotein cholesterol concentrations increased significantly (by 23% and 28%) with the two higher doses, respectively. Bleeding times increased only with the largest dose. The lowest dose was the most hypolipidemic per gram n-3 fatty acids.

Adult↗
PubMed1989

Neurological disease associated with antiphospholipid antibodies.

The Hemostasis and Thrombosis Laboratory at the Oregon Health Sciences University identified 80 patients with significantly elevated anticardiolipin antibody (ACLA) levels. We reviewed all of their available medical records and found that 25 of these patients had associated neurological symptoms or disorders. These symptoms and disorders could be grouped into four distinct clinical patterns comprising encephalopathy, multiple cerebral infarctions, migraine-like headaches, and visual abnormalities including amaurosis fugax and ischemic optic neuropathy. Cerebral ischemia best explained these neurological dysfunctions. There was no correlation between the presence or absence of neurological disease and ACLA levels, but ACLA levels were higher in patients with encephalopathy than in others with neurological involvement (p less than 0.05). How neurological dysfunction and the presence of these antiphospholipid antibodies are related remains to be clarified. Nevertheless, in patients with unexplained cerebral ischemia, establishing the presence of ACLA may have prognostic and therapeutic importance. In particular, acute immunosuppressive therapy and plasmapheresis may be useful in patients with acute ischemic encephalopathy.

Adult↗
PubMed1989

Topical dimethylsulfoxide may prevent tissue damage from anthracycline extravasation.

The optimal management of anthracycline extravasation remains unclear. Traditional topical measures to reduce local tissue damage, including corticosteroids, sodium bicarbonate, and ice applications, have not consistently demonstrated beneficial effects. This report describes our experience with four adult patients who suffered anthracycline extravasation and were treated with a regimen of ice, local glucocorticoid injection, and dimethylsulfoxide (DMSO) 55%-99% applied topically every 2-4 h after extravasation for a minimum of 3 days. In all four cases, pain and erythema resolved within 2 days; in no case did tissue necrosis or skin ulceration occur. Topical DMSO is a safe, inexpensive agent that appears to reduce the risk of anthracycline-induced tissue damage. Further studies are needed to determine the optimal dose and schedule of DMSO application and to assess its efficacy in extravasation injuries from other vesicants.

Administration, Topical↗
PubMed1989

The vascular effects of omega-3 fatty acids.

Much has been learned in the past two decades about the impact of omega-3 fatty acids on human biology. These distinctive fatty acids are derived principally from marine sources such as fish and fish oil. They are rapidly incorporated into cell membranes after their ingestion in the diet and subsequently may alter a myriad of cellular functions. For example, eicosapentaenoic acid and docosahexaenoic acid may inhibit the synthesis of several prostaglandins and leukotrienes, as well as reduce the cellular production of cytokines or growth factors such as interleukin-1 or platelet-derived growth factor. Some of these functional changes found after fish-oil ingestion may have therapeutic implications in the treatment of human disease. Studies are now underway to investigate the effect of fish-oil preparations or more-purified omega-3 fatty acids on arterial injury, thrombosis or atherosclerosis, as well as to study their effects in certain inflammatory or cutaneous disorders, such as psoriasis. This paper will review the current body of research on marine oils and will focus specifically on the effects of omega-3 fatty acids in vascular biology and associated disease states. The potential toxicity of these fatty acids will be discussed, as well as current indications (or lack of them) for their therapeutic use in humans.

Animals↗
PubMed1988

Effects of dietary fish oil and omega-3 fatty acids on platelets and blood vessels.

Our understanding of the effects of fish oil and the omega-3 fatty acids on platelet and vascular composition and function has increased substantially in the last decade. It is clear that the omega-3 fatty acids found in marine oils may be incorporated into the cell membranes of platelets and endothelial cells and that they may alter the synthesis of prostaglandins. Platelet function is modestly inhibited, and platelet and vascular interactions appear to be modified in humans. It is far too early to advocate widespread prophylactic or therapeutic use of dietary fish oils to prevent or reduce atherosclerotic cardiovascular disease. Additional studies are needed, especially in respect to the prevention or regression of atherosclerosis, inhibition of arterial thrombosis, and long-term toxicity.

Animals↗
PubMed1987

An unusual syndrome of a devastating noninflammatory vasculopathy associated with anticardiolipin antibodies: report of two cases.

We describe 2 patients with marked elevations of anticardiolipin antibodies who developed multiple-organ disease characterized by a noninflammatory vasculopathy. Their cases were remarkable for the fulminant nature of their thrombotic diathesis, which was heralded by a prominent livedo reticularis of the extremities. Both patients had a serologic profile and salivary gland biopsy findings that were consistent with a diagnosis of primary Sjögren's syndrome.

Adult↗
PubMed1985

Reduced prostacyclin survival after fasting-induced elevation of plasma free fatty acids.

The anti-thrombotic effect of prostacyclin (PGI2) may be determined not only by its synthetic rate but also by its subsequent survival in blood. After its release from the vascular wall, prostacyclin binds to plasma albumin which stabilizes the molecule and prolongs its inhibitory effects on platelets. In vitro studies have shown that free fatty acids compete for the same albumin binding sites and may therefore displace PGI2 and substantially shorten its survival. To see if this competition could also occur in vivo, we produced a three-fold rise of plasma free fatty acid concentrations in ten normal volunteers by four days of fasting, which led to a significant reduction in prostacyclin survival as measured by a functional assay based on inhibition of ADP-induced platelet aggregation. The shortening of prostacyclin survival was associated with evidence of increased platelet reactivity as measured by the circulating platelet aggregate ratio test. Diseases that produce marked elevations of free fatty acids such as acute myocardial infarction may also lead to shortened PGI2 survival with potentiation of platelet mediated thrombosis.

Adult↗
PubMed1985

Long-term follow-up of hemophiliacs with lymphocytopenia or thrombocytopenia.

Immunologic abnormalities resembling those seen in patients with the acquired immunodeficiency syndrome (AIDS) are frequently observed in multitransfused but otherwise healthy individuals with hemophilia. To determine whether there was clinical or laboratory evidence to suggest an abnormality of immunoregulation in persons with hemophilia before the recognition of AIDS, we examined data collected by the Hemophilia Study Group from 1975 to 1979 on 1,551 patients with factor VIII deficiency. The prevalence of lymphocytopenia and thrombocytopenia in patients over 5 years of age on entry was found to be 9.3% (94/1,013) and 5.0% (26/518), respectively. These rates were significantly different from a normal population (P less than .00001 and less than .0003). No cases meeting the definition of AIDS were noted during the study. However, on follow-up in 1984 of a cohort of 79 patients with thrombocytopenia or lymphocytopenia on two or more occasions during the study, eight patients (10%) with AIDS-related abnormalities, including idiopathic thrombocytopenic purpura, non-Hodgkin's lymphoma, generalized lymphadenopathy, and oral moniliasis without obvious cause were identified. Of the 79 patients, liver disease accounted for five of the ten deaths (12.6% mortality) observed during a minimum follow-up of five years after detection of cytopenia. Only one death was attributed to bleeding in the absence of liver disease. We conclude that (a) the frequency of lymphocytopenia and thrombocytopenia was increased in multitransfused factor VIII-deficient hemophiliacs before the advent of AIDS, and (b) persistent lymphocytopenia and thrombocytopenia appear to be strongly associated with liver disease, which was the leading cause of death in a cohort of hemophiliacs followed five or more years.

Acute Kidney Injury↗