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Biomedical subjects

A Prentice

Publications and source records attributed to A Prentice.

At least 91 records · Page 5Linked to original sources

Vascular endothelial growth factor (VEGF) concentrations are elevated in peritoneal fluid of women with endometriosis.

Active endometriosis is characterized by hypervascularization both within and surrounding the implant; therefore the presence of angiogenic factors in the peritoneal environment would be of great importance. Vascular endothelial growth factor (VEGF) is a potent angiogenic factor involved in both physiological and pathological angiogenesis. We sought to determine if VEGF was present in the peritoneal fluid of women with and without endometriosis, and to establish if differences exist between these groups. VEGF was present in all patients sampled. The fluid from patients with endometriosis contained significantly greater amounts of VEGF than controls. Cyclic variations in VEGF concentration were seen in fluid from patients with endometriosis, the VEGF concentration in proliferative phase being significantly higher than in the secretory phase. The concentration of VEGF in this fluid was also significantly higher than that found in the proliferative and secretory phases of women without endometriosis. No cyclic variations in VEGF were seen in the control group. We suggest that elevated levels of VEGF in the peritoneal fluid of patients with endometriosis may be critical in the pathogenesis of endometriosis.

Adult↗

Statutory and voluntary sector palliative care in the community setting: National Health Service professionals' perceptions of the interface.

Following the rapid service development brought about by the hospice movement, specialist palliative care services are involved with up to 50% of all patients dying with cancer in the United Kingdom, although the primary health care team remains the main provider of community based palliative care. This paper discusses findings from a survey of palliative care provision in the south west of England, and describes the perceptions of the primary care team (general practitioners and district nurses) about the interface between themselves and voluntary sector specialist palliative care providers (hospice in-patient units, hospice home care nurses and other charitably funded specialist palliative care nurses). The voluntary sector services are run with a mixture of funding from charitable sources (public donations, legacies, charitable trust moneys), and statutory funding (grants and recurrent contracts from central government, district health commissions, and local health care trust). The interview and questionnaire data suggest that the voluntary sector services are perceived variably as substituting, supplementing, complementing and duplicating the services provided by the primary care team. Drawing attention to these dimensions and the ambivalence sometimes felt by general practitioners and district nurses could provide a means of negotiating consensus on appropriate professional tasks and facilitating interprofessional practice in what is increasingly a mixed economy of statutory and voluntary funded health care.

Attitude of Health Personnel↗

Maternal obesity increases congenital malformations.

There has been growing evidence that maternal obesity is associated with an increased risk of congenital malformations, particularly of neural tube defects. Two new studies confirm this relationship and indicate that it is independent of possible covariant confounders such as maternal age, socioeconomic status, education, smoking, and vitamin intake, including folic acid. There is a suggestion that folic acid loses its protective benefit in overweight and obese mothers. These new findings add to a long list of obstetric morbidities, and show a steep gradient with increasing maternal fatness and point to the urgent need to prevent excess weight gain in young women.

Adolescent↗

The bone mineral content of weight-bearing bones is influenced by the ratio of sitting to standing height in elderly Gambian women.

Body size is an important predictor of bone mineral content (BMC) at various anatomical sites but the influence of relative body proportions on BMC has previously been little studied. Using single- and dual-photon absorptiometry, we measured BMC at the distal and midshaft of the radius, the neck of femur, and the lumbar spine in 190 rural West African women aged 45-84 years. After regression adjustment for age, bone width and weight, sitting height and standing height were not separate significant determinants of BMC, except at the lumbar spine (standing height, p < 0.05). However, the ratio of sitting:standing height was a significant determinant of BMC at the neck of femur and lumbar spine, but not the midshaft or distal radius. The fact that sitting:standing height ratio is a positive predictor for BMC at hip and lumbar spine may reflect a higher peak bone mass or selective conservation of mineral in weight-bearing bones in subjects with a proportionately longer torso. We do not know whether the relationship is racially determined but we recommend that this simple combination of measurements be used in further studies in subjects of all races.

Age Factors↗

Calcium requirements of lactating Gambian mothers: effects of a calcium supplement on breast-milk calcium concentration, maternal bone mineral content, and urinary calcium excretion.

The calcium requirement for prolonged lactation was investigated in a randomized supplementation study of Gambian mothers consuming a low-calcium diet (7.1 mmol/d, or 283 mg/d). Sixty women were studied from 10 d to 78 wk of lactation, receiving calcium or placebo for the first 12 mo. The supplement increased average calcium intake by 17.9 mmol/d (714 mg/d). Supplementation had no effect on breast-milk calcium concentration or on maternal bone mineral content. Urinary calcium output was higher in supplemented than in unsupplemented mothers by 1.18 mmol/d (47 mg/d), P < or = 0.005. Longitudinal changes in urinary calcium output and bone mineral content made a substantial contribution to calcium requirements for lactation. This study suggests that, in women with low calcium intakes, there is no direct benefit from increasing calcium intake during lactation, and that physiological mechanisms operate to furnish calcium for breast-milk production.

Adolescent↗

Effect of calcium supplements and stage of lactation on the calcium absorption efficiency of lactating women accustomed to low calcium intakes.

The effect of calcium intake on the calcium absorption efficiency from 100 mL cow milk was measured in lactating Gambian mothers habituated to a low-calcium diet [mean intake 7.08 mmol (283 mg)/d], and compared with UK lactating mothers consuming high-calcium diets [mean intake 29.2 mmol (1168 mg)/d] by using a double stable-isotope technique (oral 44Ca and intravenous 42Ca). In a double-blind trial starting 9 d postpartum, Gambian mothers were given a calcium supplement [17.85 mmol (714 mg)/d] or placebo for 12 mo. At 3 and 12 mo postpartum, mean (+/- SEM) calcium absorption from isotopically enriched milk was 52.3 +/- 3.1% (n = 25) and 47.2 +/- 4.8% (n = 24) in the unsupplemented Gambian mothers and 48.8 +/- 2.8% (n = 28) and 42.9 +/- 3.7% (n = 24) in the supplemented mothers, respectively. There was no effect of supplementation or stage of lactation on the efficiency of calcium absorption. At 3 mo postpartum the UK mothers absorbed 32.2 +/- 3.8% of the isotopically enriched calcium added to milk, which was significantly less than that of the Gambian mothers (P < 0.01).

Absorption↗

Osteoporosis in severe congenital neutropenia treated with granulocyte colony-stimulating factor.

Recombinant human granulocyte colony-stimulating factor (G-CSF) has substantially improved life expectancy for children with severe congenital neutropenia (SCN). Severe osteoporosis, reported in this population, may relate to the disease process, or be a therapeutic side-effect. This report details bone loss, quantitated absorptiometrically and histomorphometrically, in a child with SCN and vertebral collapse, and the positive response to anabolic steroid and bisphosphonate therapy.

Anabolic Agents↗

Rate of radial bone mineral accretion in healthy children.

Radial bone width and mineral content were measured in 392 healthy Cambridge children aged 6-12 years from a cohort of 420 children studied 2 years previously. The typical rate of bone mineral accretion was 0.044 g/cm/year for boys across the whole age range and 0.042 g/cm/year for girls up to a mean age of 9 years, rising rapidly thereafter in association with changes in body size. The factors best predicting bone mineral accretion rate were mean bone mineral content, mean height, height velocity, weight velocity and bone width velocity. After adjusting for anthropometry, age did not contribute to the model. These are the first available longitudinal reference data for the rate of radial bone mineral accretion in healthy children.

Anthropometry↗

Calcium intakes and bone densities of lactating women and breast-fed infants in The Gambia.

The calcium required for breast-milk production and infant growth can be a substantial proportion of dietary intakes especially in regions of the world were calcium consumption is low. Insufficient calcium supply might lead to maternal bone loss, reduced breast-milk calcium secretion and impaired infant bone growth. However, changes in calcium absorption and excretion may be sufficient to allow these requirements to be met without affecting maternal or infant health. A limited number of studies have investigated changes in maternal bone mineral, absorption, excretion and metabolism during lactation but few have addressed whether any changes are influenced by calcium intakes. Ongoing detailed research by the MRC Dunn Nutrition Unit in a rural area of The Gambia amongst mothers and infants with habitually low calcium intakes will provide valuable information about calcium needs during lactation and growth.

Bone Density↗