Search PubMed⌕ Search

Biomedical subjects

A M Tomkins

Publications and source records attributed to A M Tomkins.

At least 19 recordsLinked to original sources
PubMed1992

Intensity of reinfection with Ascaris lumbricoides and its implications for parasite control.

Intestinal helminths are among the most common and widespread of human infections. Because it is typical to find that most worms are aggregated in a few potential hosts it has been suggested that some individuals are predisposed to heavy infections and that morbidity could be controlled by the treatment of heavily infected individuals only. We have studied the prevalence and intensity of reinfection with the intestinal nematode Ascaris lumbricoides among people living in Dhaka, Bangladesh. 880 people were treated with pyrantel pamoate three times at six month intervals, and on each occasion they collected all their stools for 48 h after treatment. Worms expelled by each subject were counted and weighed. The prevalence of infection at round 1 of treatment was 89% and the mean burden was 18.5 worms. Reinfection was rapid and at rounds 2 and 3 the prevalence was 82% and 80%, respectively, with mean burdens of 14.0 and 11.5 worms. The intensity of reinfection was not random: more subjects than expected became heavily reinfected (greater than or equal to 15 worms) and more subjects than expected remained lightly infected (less than or equal to 14 worms) (p less than 0.001). Worms were highly aggregated at each round of treatment but although just over 10% of all subjects were heavily infected at each and every round of treatment, over 60% of all subjects were heavily infected at least once. The findings show that some individuals seem to be susceptible to heavy infection whereas others are not, that deworming has a greater effect on the intensity of infection than on the prevalence, and that mass chemotherapy is likely to be a more effective means to control morbidity than is selective treatment of heavily infected individuals only.

Adolescent↗
PubMed1992

Raised resting energy expenditure in Parkinson's disease and its relationship to muscle rigidity.

1. Resting energy expenditure was measured, by indirect calorimetry, in 12 patients with Parkinson's disease and in eight healthy age-matched control subjects. In the patients with Parkinson's disease measurements were made in both the untreated state and after an injection of the dopamine agonist apomorphine (treated state). In each state muscle rigidity was recorded. 2. Resting energy expenditure was higher in patients with Parkinson's disease in both the treated and untreated states than in the control subjects. Of the patients with Parkinson's disease, seven showed no difference in resting energy expenditure between the two treatment states, whereas four showed markedly increased resting energy expenditure in the untreated state. The change in resting energy expenditure in the untreated state, as compared with the treated state, was significantly related to the development of muscle rigidity in the untreated state. 3. In Parkinson's disease, even in optimally treated patients, resting energy expenditure is raised and this may contribute to the weight loss seen in this disease. Severe muscle rigidity occurring during untreated periods results in a further increase in resting energy expenditure.

Apomorphine↗
PubMed1992

Impact of zinc supplementation on intestinal permeability in Bangladeshi children with acute diarrhoea and persistent diarrhoea syndrome.

Zinc has been shown to enhance intestinal mucosal repair in patients suffering from acrodermatitis enteropathica; but the impact on mucosal integrity during acute (AD) or persistent (PD) diarrhoea is unknown. One hundred eleven children with AD and 190 with PD aged between 3 and 24 months received, randomly and blind to the investigators, either an elemental zinc supplement of 5 mg/kg body wt/day or placebo in multivitamin syrup for 2 weeks while intestinal permeability and, biochemical and anthropometric markers were serially monitored. The permeability test was administered as an oral dose of 5 g lactulose/l g mannitol in a 20-ml solution followed by a 5-h urine collection. The ratio of the urinary probe sugars was correlated to clinical, biochemical, and microbiological parameters. At presentation, lactulose excretion was increased and mannitol excretion decreased in both AD and PD as compared with age-matched asymptomatic children. The lactulose/mannitol ratio (L/M) was higher in subjects with mucosal invasive pathogens (rotavirus and enteropathogenic Escherichia coli) compared with children excreting Vibrio cholera and enterotoxigenic E. coli. Two-week zinc supplementation significantly reduced lactulose excretion in both AD and PD, whereas the change in mannitol excretion and L/M was similar between study groups in both studies. Changes in lactulose excretion were significantly influenced by zinc supplementation in children with E. coli, Shigella sp., and Campylobacter jejuni stool isolates. The greatest reduction in total lactulose excretion was seen in supplemented children who on presentation were lighter (wt/age less than 80%), thinner (wt/ht less than 85%), and undernourished [middle upper arm circumference (MUAC) less than 12.5 cm] or with hypozincaemia (less than 14 mumol/L).(ABSTRACT TRUNCATED AT 250 WORDS)

Acrodermatitis↗
PubMed1979

The effect of starvation on the rate of protein synthesis in rat liver and small intestine.

1. A method is described that allows for measurement of protein synthesis in liver and intestine in the rat. By injecting a massive amount of [14C]leucine (100 mumol/100 g body wt.) an attempt has been made to over come problems of precursor specific radioactivity and problems arising from the breakdown of labelled protein that are encountered when tracer amounts of amino acids are used. 2. Starvation for 2 days resulted in decline in the rate of total liver protein synthesis from 87%/day to 62%/day. 3. In jejunal mucosa the rate of protein synthesis was 136%/day. This declined to 105%/day after 2 days of starvation.

Animals↗
PubMed1978

Water supply and nutritional status in rural northern Nigeria.

A high incidence of protein energy malnutrition (PEM) was found in a community survey of preschool children in rural northern Nigeria among whom gastro-enteritis is common. Wasting (less than 80% Weight/Height) was more common (37.9%) among those with scanty, unprotected water supplies than in those with copious protected water (10.2%) whereas the incidence of stunting (less than 90% Height/Age)) was similar. Severe coliform contaminatin of all water sources was demonstrable. Even higher numbers of coliforms in foods sampled suggests that other factors related to water supply may be more important than water purity in the genesis of the PEM/gastro-enteritis complex.

Body Height↗
PubMed1978

Bacterial colonization of jejunal mucosa in giardiasis.

Nine of 14 cases of giardiasis and severe malabsorption were found to have numerous bacteria adjacent to the mucosa and within luminal fluid samples from the upper jejunum. Three species of enterobacteria (Klebsiella pneumoniae, Enterobacter cloacae and E. hafniae) were cultured from eight patients and from only one were Bacteroides isolated. Enterobacteria were not cultured from seven of eight patients who had giardiasis but only mild malabsorption (of xylose only) nor from seven patients without malabsorption. Intestinal colonization by enterobacteria may make an important contribution to the development of malabsorption in patients with giardiasis.

Enterobacteriaceae↗
PubMed1978

Assessment of early and delayed responses in vitamin B12 absorption during antibiotic therapy in tropical malabsorption.

1. Vitamin B12 absorption was measured in 18 patients with tropical malabsorption. 2. Absorption was particularly impaired in patients with severe mucosal lesions. 3. Sequential measurements with 57Co- and 58Co-labelled vitamin B12 were made before and 48 h after the start of tetracycline therapy. A rapid improvement (on average 22% increase in absorption) occurred in four of six patients with marked mucosal lesions. Further improvement occurred in four of five patients measured after 4 weeks' tetracycline, including the two who failed to improve initially. 4. These rapid changes in vitamin B12 absorption after antibiotics occur too early to be due to mucosal recovery and suggest that bacterial metabolism is an important factor in the malabsorption in these patients.

Adult↗
PubMed1978

Quantitative histology in giardiasis.

The Weibel graticule was used to assess quantitatively histological changes in proximal jejunal mucosal biopsies from patients with Giardia lamblia infections. Most had malabsorption. A group of patients who had mild abdominal symptoms but no intestinal infection and normal absorption were the controls. There were significant differences in mean surface area (SA) measurements between patients with giardiasis and severe malabsorption and controls (P less than 0.001) and infected patients with normal absorption (P less than 0.05). SA measurements correlated significantly with D-xylose excretion results (r = 0.55; P less than 0.01) and daily facal fat output (r = -0.61; P less than 0.001). Significant correlations between duration of symptoms and SA measurements (r = 0.43; P less than 0.05) and D-xylose excretion (r = 0.43; P less than 0.05) in giardiasis suggest that histological and functional impairment are maximal soon after infection and resolve in time. Treatment with metronidazole or mepacrine was associated with a significant increase in SA (P less than 0.05) in patients with severe malabsorption but there was little change in SA in a similar group of patients who received tetracycline. The Weibel graticule was found to be useful in assessing the severity of histological changes and in following changes after treatment.

Dietary Fats↗
PubMed1977

Giardiasis.

Explore the source record for details and available documents.

Feces↗
PubMed1977

Giardiasis: clinical and therapeutic aspects.

Malabsorption was present in 29 of 40 symptomatic patients with giardiasis. Twenty-three had impaired D-xylose absorption; in 20 vitamin B12 absorption was low, and 15 patients had steatorrhoea. More severe malabsorption was associated with more marked histological abnormalities. Metronidazole, 2-0 g as a single daily dose on three successive days, produced a parasitological cure rate of 91%. In contrast, the standard course of mepacrine, 100 mg thrice daily for 10 days, eradicated the parasite in only 63% of patients. Improvements in absorption and jejunal morphology followed anti-giardial treatment. Tetracycline in eight patients failed to eradicate the parasite, intestinal absorption was unaltered, and histological appearances of the jejunal mucosa often deteriorated.

Adult↗
PubMed1977

Quantification of the lymphocytic infiltrate in jejunal epithelium in giardiasis.

The intraepithelial lymphocytes of the jejunal mucosa from patients with giardiasis and from control patients were counted in coded serial sections. Patients with giardiasis and normal intestinal absorption and control patients who had lived and travelled in tropical areas had similar counts, which were higher than those reported for controls from temperate areas. Where giardiasis was accompanied by malabsorption of one substance the mean count was significantly higher than that of controls (P less than 0.02). In those patients with giardiasis and malabsorption of two or three substances the mean count was significantly higher than that of controls (P less than 0.02) and that of patients with giardiasis and normal absorption (P less than 0.05). After treatment, intraepithelial lymphocyte counts declined consistently in patients with malabsorption. An association between raised intraepithelial lymphocyte counts and malabsorption is indicated. The possible significance of this finding is discussed.

Adult↗