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Biomedical subjects

B F Walker

Publications and source records attributed to B F Walker.

At least 73 records · Page 4Linked to original sources

Obesity in indigent elderly rural African women: effects on hypertension, hyperlipidaemia and hyperglycaemia.

To learn more of the sequelae of obesity in South African elderly rural indigent black women (aged 58-85 years), studies were made on 40 women with BMI greater than or equal to 30, and on 50 non-obese women with BMI of 25 or less, all in outward good health. In the two groups, hypertension (greater than or equal to 160/95 mm Hg) was present in 9 and 5 women (22% and 10%), hypercholesterolaemia (greater than or equal to 5.2 mmol/l) in 28 and 26 women (70% and 52%), hypertriglyceridaemia (greater than or equal to 1.8 mmol/l) in 20 and 16 (50% and 32%), and hyperglycaemia (greater than or equal to 6.7 mmol/l) in 8 and 7 women (20% and 14%). Differences between the obese and non-obese attained significance with blood pressure and serum lipids (P less than 0.01), although not with blood glucose. Both groups were habituated to a low fat high fibre diet. In this context, obesity appeared less evocative of adverse sequelae than prevails in a white population. However, for appropriate validation, longitudinal studies are required.

Aged↗

Serum albumin levels in elderly rural Africans.

Reports on white populations indicate an inverse relationship between serum albumin level and total death rate, also death rates from cardiovascular diseases (CHD) and cancer. Among rural African blacks, CHD is absent, and diet-related cancers rare, so that albumin levels in the elderly would be expected to be elevated. Studies on 50 men and 50 women, representative elderly rural blacks, revealed mean values to be high, 47.6 +/- 4.9 g/l and 48.2 +/- 4.2 g/l. Levels were not significantly associated with Body Mass Index, blood pressure, serum cholesterol level, nor blood glucose level. Hence, in the setting described, even elevated levels of these variables appear less noxious to health than is the case in white populations, since such levels are consistent with low mortality from the diseases mentioned. Explanation of the relationship between serum albumin and life expectancy is unknown. Longitudinal studies are necessary to clarify the situation.

Aged↗

Obesity in black women in Soweto, South Africa: minimal effects on hypertension, hyperlipidaemia and hyperglycaemia.

Studies were made on 50 South African urban black obese women aged 25-40 years, with Body Mass Index (BMI) (Kg/m2) of 29.5 or more, and on 50 non-obese women with BMI of 25 or less. In the two groups, mean triceps skinfolds were 25.5mm and 17.8mm, respectively. Hypertension (greater than or equal to 160/95mm Hg) was present in 6 and 4 women (12% and 8%), hypercholesterolaemia (greater than or equal to 5.2mmol/l) in 5 and 3 women (10% and 6%), hypertriglyceridaemia (greater than or equal to 1.8mmol/l) in 5 and 3 (10% and 6%), and hyperglycaemia (greater than or equal to 7.8mmol/l) in 2 and 1 women (4% and 2%). One or more adverse sequelae were present in 11 (22%) obese and in 9 (18%) of non-obese women, proportions not significantly different. Dietarily, mean daily intakes were--Kcals 2273 and 2240, protein 73g and 70g (12.9% and 12.5% energy), fat 65g and 67g (25.7% and 26.9% energy), carbohydrate 349g and 330g (61.4% and 60.5% energy), and dietary fibre, 12g and 13g. In this low socioeconomic and low fat dietary context, obesity in the black women studied was not specifically evocative of deleterious sequelae of obesity.

Adult↗

Fetal intestinal obstruction: necessity for percutaneous umbilical blood sampling to assess the severity of Rh sensitization.

Investigation into the severity of hemolytic disease due to Rh isoimmunization may be complicated by concurrent amniotic fluid contamination with bile. We have presented a case in which a prenatal sonogram showed evidence of fetal intestinal obstruction, which was subsequently confirmed postpartum by exploratory laparotomy. Since intrauterine regurgitation of bile occurs with intestinal obstruction distal to the papilla of Vater, percutaneous umbilical blood sampling is necessary to discern the presence and severity of hemolytic disease as indicated by an abnormal spectrophotometric absorption pattern.

Adult↗

Wheal and flare responses to opioids in humans.

Certain opioids release histamine from cutaneous mast cells to produce local wheal and flare responses and adverse hemodynamic effects. In vivo responses to opioids suggest that cutaneous responses result from the interaction of opioids with opioid receptors on human mast cells. There are no data evaluating or comparing the opioids currently used in anesthesia. Volunteers were injected intradermally with different opioids as well as with naloxone and antihistamines to evaluate their effects on cutaneous mast cell reactivity and cutaneous vascular responses. Fentanyl and morphine produced concentration-dependent wheal and flare responses in the range of 5 X 10(-6) M to 1.5 X 10(-3) M. Volunteers were then tested intradermally with different opioids and histamine at a 5 X 10(-4) M concentration to determine their relative cutaneous effects. Morphine, meperidine, fentanyl, and sufentanil produced both wheal and flare responses that were significantly greater than those due to saline (P less than 0.05). Naloxone, alfentanil, and nalbuphine did not produce significant wheal or flare responses. Butorphenol was followed by a significant wheal but no flare. Naloxone attentuated cutaneous wheal and flare responses to fentanyl and the flare response to morphine. Intradermal antihistamines (diphenhydramine and cimetidine) produced significant wheal and flare responses. Electron micrographs of biopsies from fentanyl-induced wheals demonstrated normal mast cell architecture with no evidence of mast cell degranulation. Opioid effects on wheal and flare responses and mast cell degranulation appear independent of opioid analgesic potency. Opioids produce cutaneous vascular responses dependent on both histamine release from mast cells and direct effects on the vasculature.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Cutaneous↗

Growth of South African Indian schoolchildren in different social classes.

The height and weight of 4594 Indian schoolchildren aged 6 to 17 years, in Durban, South Africa, were measured at schools selected by inspectors as representative of upper, intermediate, and lower socio-economic populations. Significant superiority, anthropometrically, prevailed at all ages in upper compared with lower or poor-class children, but tended to lessen at 17 years. In the affluent group, in the age period studied the proportions under the 5th percentile of USA NCHS reference values were--concerning height-for-age 4.7% to 22.0% of boys and 5.0% to 20.7% of girls; and concerning weight-for-age, 20.3% to 45.0% of boys and 9.3% to 37.7% of girls. In the affluent group, at full growth at 17 years, means of height and weight were highly significantly lower, namely, roughly by 7cm and 10kg, compared with respective mean values given in USA reference values. Hence, in Indian schoolchildren a genetic factor, and not dietary inadequacy, appears primarily responsible for both slower post-pubertal growth and lower ultimate height attainment.

Adolescent↗

Appendicitis in Soweto, South Africa: traditional healers and hospitalization.

Appendicitis is near absent in rural blacks in Africa, and even in urban areas it remains very uncommon. Since the disease is new, and, moreover, potentially dangerous, a study was made of the antecedent history of 97 patients with proven appendicitis. Information was acquired concerning visits, and treatments and history, of (1) 34 patients who went first to traditional healers, and (2) 63 patients who sought orthodox medical attention. Of healers' treatments, none was beneficial; patients were ultimately directed, or decided to go to the hospital. Throughout Africa, traditional healers are held in high esteem and very extensively patronized. Accordingly, in both rural and in urban areas, concerted endeavours must be made by health authorities to promote recognition by healers of those diseases, acute or malignant, for which patients should be told to seek immediate medical attention.

Adolescent↗

Low frequency of adverse sequelae of obesity in South African rural black women.

In a series of 210 black women aged 25-45 years in a village in Eastern Transvaal, South Africa, 40 (19.0%) were obese, having a Body Mass Index (kg/m2) of 30 or more. Mean triceps skinfold was 23.5 mm; in 10 (25%) it was 25 mm or more) Hypertension (greater than or equal to 160/95 mm Hg) was present in 3 women (7.5%), hyperglycaemia (greater than or equal to 7.8 mmol/l) in 1 (2.5%), hypercholesterolaemia (greater than or equal to 5.2 mmol/l) in 3 (7.5%), and hypertriglyceridaemia (greater than or equal to 1.8 mmol/l) in 3 (7.5%). Dietarily, mean intake of energy was 2260 kcals, protein 73 g (12.9% energy), fat 55 g (20.8% energy), and carbohydrate 369 g (65.3%). In this context, of low fat, low animal food intakes, together with high physical activity, one or more of the adverse sequelae enumerated were present in 5 women (12.5%). Accordingly, in 35 women (87.5%), their obesity could be regarded as "healthy" obesity.

Adult↗