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Biomedical subjects

A M Woolfson

Publications and source records attributed to A M Woolfson.

At least 19 recordsLinked to original sources
PubMed1989

Elective nutritional support after major surgery: a prospective randomised trial.

We investigated the possibility that morbidity and mortality might be reduced by giving seven days elective intravenous nutrition after major thoraco-abdominal procedures and total cystectomy. In a prospective parallel randomised double-blind comparison with a standard post-operative fluid regimen, intravenous nutrition had no effect on morbidity, mortality or duration of hospital stay in a group of 122 sequentially recruited patients. This was not due to poor comparability of the patient groups or to failure to give the prescribed treatment. A policy to give post-operative intravenous nutrition routinely to such patients is not likely to prove cost effective. There may be certain patients who might benefit, but we were unable to identify them with a simple pre-operative assessment.

Journal Article↗
PubMed1985

Intravenous feeding--a review of aspects of current practice.

This review summarises the present state of knowledge of energy and nitrogen requirements of hospital patients requiring intravenous feeding. It also addresses electrolyte, inorganic element and vitamin intakes, and examines possible differences in requirements in some special circumstances. It is concluded that most of the patients could be fed using one of a small number of standard regimens.

Journal Article↗
PubMed1984

The effect of different carbohydrate intakes on body weight and nitrogen balance during nasogastric feeding after faciomaxillary surgery.

In order to assess the effects on body composition of different carbohydrate intakes when nitrogen supply is constant and adequate (9 g/day), we gave either no carbohydrate, sufficient to avoid ketosis (100 g) or at least enough to satisfy energy needs (600 g) to a group of six patients after major faciomaxillary surgery. Each patient was given the different feeds for 3-day periods in a randomised, cross over design. 100 g carbohydrate was effective in avoiding negative nitrogen balance, but weight loss was only prevented when 600 g was used. Differences in water balance suggest that mobilisation and repletion of body glycogen (with associated water) probably account for most of these differences in body weight changes.

Journal Article↗
PubMed1983

Calcium excretion (CaE) in metastatic breast cancer.

In 51 women with metastatic breast cancer calcium excretion per litre of glomerular filtrate (CaE) values were persistently higher in those with bone secondaries than in those with only soft tissue involvement despite a normal range of serum calcium in both groups. Measurement of CaE in 8 further patients who were severely hypercalcaemic as a result of their advanced breast cancer revealed the degree to which calcium resorption from bone secondaries and renal dysfunction contributed to the hypercalcaemia. Thus, in patients with breast cancer, CaE provides a reliable indicator of early changes of calcium homeostasis. It may provide an objective indication of progression of bone secondaries and also has important therapeutic implications in established hypercalcaemia.

Bone Neoplasms↗
PubMed1982

Do we need thyroid follow-up registers? A cost-effective study.

Patients who had received radioiodine treatment for hyperthyroidism were followed up by two different methods. 576 patients (group 1) were followed up conventionally by their general practitioners and as hospital outpatients. 609 similarly treated patients (group 2) were followed up by a computer-assisted system, the Scottish Automated Follow-up Register (S.A.F.U.R.). Follow-up in the two groups were compared on the basis of cost-effectiveness. On average, patients were seen for follow-up about once every 8 months if in group 1 and every 14 1/2 months in group 2. The overall cost of follow-up and treatment for group 2 patients was less than 60% of that for group 1 patients. A central follow-up register is reliable and cost-effective, particularly so when patients are dispersed over a wide area.

Cost-Benefit Analysis↗
PubMed1981

The effect of intravenous therapy during labour on maternal and cord serum sodium levels.

A total of 113 women in labour were studied prospectively to determine the relation between maternal and cord serum sodium levels and the effect of intravenous infusions of glucose solutions and oxytocin during labour on the mother and infant. Maternal and cord sodium levels were correlated, with no systematic difference between the two, which is consistent with passive diffusion of sodium across the placenta. Glucose infusions and oxytocin caused statistically significant depression of maternal and cord serum sodium levels, but with the quantities used this did not adversely affect the mothers or infants. It is recommended that caution should be exercised in prescribing intravenous therapy during labour and, if more than 500 ml of fluid is required, sodium should be included.

Female↗
PubMed1980

Control of blood glucose during nutritional support in ill patients.

The traditional "Sliding Scale" is an inefficient and unreliable way of controlling blood glucose levels in ill patients receiving nutritional support in the Intensive Care Unit. In these patients, it is necessary to reassess insulin requirements frequently in the light of changing clinical circumstances. A significant improvement in control can be achieved by using a dynamic scale of instructions for changing the insulin dose rather than one of arbitrary dose levels. This scale adapts to any changes that occur without needing to be rewritten. It avoids confusion due to a proliferation of prescription charts, and has been readily accepted by nursing staff.

Blood Glucose↗
PubMed1980

Carrier detection in Duchenne muscular dystrophy.

Serum creatine kinase, myoglobin, and percentage lymphocyte capping was determined in ten patients with Duchenne muscular dystrophy, 12 carriers (nine definite and three probable), 16 other female relatives, and eight normal controls. There was no detectable difference in lymphocyte capping ability between any of these clinical groups. Significant myoglobinaemia was present in all the affected males, but the difference in levels between carriers and controls suggested that this test has no advantage over creatine kinase estimations in carrier detection.

Creatine Kinase↗
PubMed1979

Insulin to inhibit protein catabolism after injury.

Using patients with varying degrees of trauma as their own controls we compared three isocaloric regimens in three-day crossover studies; 9.4 g of nitrogen as l-amino acids was also given daily. The urea production rate was used as an index of protein breakdown. We found that in catabolic patients, insulin and glucose produced a strikingly greater inhibition of protein breakdown that glucose alone, and that glucose alone was marginally more protein sparing than a regimen containing mainly fat (intralipid and sorbitol). These differences were not seen in noncatabolic patients (urea production rate less than 15 g daily). In the catabolic patients (urea production rate greater than 15 g daily) the protein-sparing effect of insulin was proportional to the initial urea production rate. We therefore concluded that insulin has important protein-sparing effects in severely ill traumatized patients, but little effect when there is no increased catabolic rate.

Blood Glucose↗