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Biomedical subjects

C R Pennington

Publications and source records attributed to C R Pennington.

At least 73 records · Page 4Linked to original sources
PubMed1981

Fluctuations of serum bile acid concentrations during the menstrual cycle.

Fasting primary bile acid conjugates were measured in 44 women by radioimmunoassay methods. Bile acid values were significantly greater in the 21 women who were in the first half of the menstrual cycle than in the 23 women in whom blood was sampled during the second half of the cycle. Similar measurements were made at weekly intervals after menstruation in five subjects; increased values were observed in the first week. It is concluded that serum bile acid values fluctuate during the menstrual cycle.

Adult↗
PubMed1980

Acute diarrhoea in the elderly.

One hundred consecutive patients admitted to hospital because of acute diarrhoea are described. The commonest causes of diarrhoea were found to be faecal impaction, infection and drugs, although in a third of the cases no cause was found. Faecal impaction was significantly more common in those living alone or in institutions than in those living with their families. The study suggests that the elderly population is very intolerant of the symptom of diarrhoea, and a case is made for the provision of facilities for more efficient assessment and treatment.

Acute Disease↗
PubMed1980

Pseudohyperkalaemia and infectious mononucleosis.

Pseudohyperkalaemia is described from a patient with infectious mononucleosis. The in vitro release of potassium was associated with clotting and all the blood cells may have been involved.

Adolescent↗
PubMed1980

Pseudomembranous colitis.

Nine patients with pseudomembranous colitis (PMC) are described. Eight patients received prior therapy with antibiotics. Pyrexia and polymorph leukocytosis were common features. Six relapses occurred in four of the six patients who were treated with vancomycin. Two patients who did not receive vancomycin died.

Aged↗
PubMed1979

Measurement of serum primary bile acid ratio by gas liquid chromatography and radioimmunoassay.

The application of a sensitive gas liquid chromatography (GLC) assay has enabled patients in different diagnostic groups to be differentiated on the basis of the ratio of the primary bile acids, cholic: chenodeoxycholic acid. Because this method is unsuitable for a routine clinical laboratory, the primary bile acid ratio (PBR) is determined by radioimmunoassay techniques (RIA), and the results were compared with GLC analysis. RIA provided comparable results in control subjects and patients with large-duct obstruction, but significantly higher PBR values were found in cirrhotic subjects.

Animals↗
PubMed1978

Serum bile acids in hepatobiliary disease.

We review the estimation of total and individual serum bile acids to detect the presence and nature of hepatobiliary disease. The different methods for measuring serum bile acids are discussed.

Bile Acids and Salts↗
PubMed1978

Serum bile acids in patients with hyperlipidaemia.

Individual serum bile acids were analysed by an improved gas liquid chromatography method in 12 patients with primary hyperlipidaemia. Total serum bile acid concentrations were raised in 10 subjects. Ursodeoxycholic acid was found in all 12 patients. It was present in significantly greater concentrations, accounted for a greater proportion of the total serum bile acids, and occurred more frequently than in patients with various forms of hepatobiliary disease. Patients with hyperlipidaemia had proportionately less deoxycholic acid than controls but more than patients with liver disease. There was proportionately less chenodeoxycholic acid in patients with hypercholesterolaemia, in whom the primary bile acid ratio was raised.

Bile Acids and Salts↗
PubMed1978

Fasting and postprandial serum bile acid concentrations in normal persons using an improved GLC method.

An improved GLC method was employed to study individual serum bile acids in 14 control subjects after a 12-hour fast followed by a standard fatty meal. Peripheral venous blood samples were obtained at 15-min intervals for up to 2 h in 7 subjects, and 4 h in 2 subjects. The fasting total bile acids, and cholic:chenodeozycholic acid ratio fell within a narrow range. The total bile acids and chenodeoxycholic acid increased significantly within 30 min of the meal, to reach peak values within 75-120 min. The extent of the increase was variable, and the range of values increased progressively after the meal.

Bile Acids and Salts↗
PubMed1978

Serum bile acids in patients with viral hepatitis.

Total and individual serum bile acid concentrations were studied in 18 patients with viral hepatitis. The initial high values returned to the normal range at approximately the same time as the conventional liver function tests. Chenodeoxycholic acid was the predominant bile acid initially, but cholic acid predominated as the disease resolved. All patients had proportionately less doexycholic acid than controls. It is concluded that the measurement of serum bile acid does not provide added information of value in the management of patients with viral hepatitis.

Bile Acids and Salts↗
PubMed1977

An ultrastructural study of osmiophilia in the human rectum.

Rectal biopsies from subjects with a normal rectum and from patients with various forms of inflammatory bowel disease were studied by the prolonged osmication technique. No consistent ultrastructural differences were observed between these groups, but there were striking differences between individual epithelial cells in the same biopsy and between the epithelium and the cells of the lamina propria. The Golgi apparatus was demonstrated occasionally in the epithelium, often in endothelium. Endoplasmic reticulum, perinuclear cisterna and mitochondria were variably outlined. In plasma cells, there were striking differences in osmiophilia. The underlying mechanism of the different staining patterns is not clear. The findings do not appear to help in the differential diagnosis of inflammatory bowel disease nor to shed any new light on their underlying pathogenic mechanisms.

Cell Membrane↗
PubMed1977

Serum bile acids in the diagnosis of hepatobiliary disease.

The value of serum bile acids (SBA) in the diagnosis of hepatobiliary disease has been investigated. A modified GLC method was used, with an overall coefficient of variation of +/- 11% in the control range. Serum was obtained after a 12 hour fast, and two hours after a fatty meal from 73 patients and 14 control subjects. In controls the total fasting SBA of 2.17 +/- 0.86 mumol/l increased significantly (p less than 0.001) to 3.81 +/- 1.14 mumol/l after a meal. All icteric patients had raised SBA, but in 23 anicteric patients there was no significant difference in the detection of chronic liver disease by fasting SBA, postprandial SBA, AST, or gamma GTP. Compared with controls, serum in patients contained proportionately less deoxycholic acid (p less than 0.001), there was proportionately more cholic acid in extrahepatic obstruction (p less than 0.001), and proportionately more chenodeoxycholic acid in patients with cirrhosis, viral hepatitis, and neoplasia (p less than 0.001). In control subjects, the fasting cholic:chenodeoxycholic acid ratio ranged from 0.5-1.0, and differed significantly (p less than 0.001) from patients with extrahepatic obstruction 0.96-3.6, and cirrhosis 0.1-0.5. It is concluded that serum bile acids measured by sensitive methods can provide useful diagnostic information.

Bile Acids and Salts↗
PubMedDate not supplied

A comparison between oral and nasogastric nutritional supplements in malnourished patients.

There is a common perception that malnutrition is an inevitable manifestation of illness, that oral nutritional supplements are not taken or reduce the consumption of oral diet, and that nasogastric feeding is poorly tolerated. This study assessed the efficacy of supplemental enteral feeding on the nutritional status of malnourished patients, to compare oral supplements (OS) with overnight supplemental nasogastric feeding (NG) on nutritional status and to determine the effect of nutritional supplements on oral diet. Malnourished hospital patients were randomized to one of three groups: control (C), OS, or NG. All patients had access to hospital diet. Supplements were prescribed to meet estimated nutritional needs. Nutritional status was recorded at the start and the end of the feeding period. The total nutritional intake was recorded. Weight gain occurred in 64% of the supplemented patients, whereas 73% of the controls lost weight with mean weight changes of +2.9% OS. +3.3% NG, and -2.5% C. There was no difference in the mean energy intake from food in the three groups. There were no documented complications of OS and three minor complications of NG. Both methods of supplementation allow weight gain without significantly affecting spontaneous oral intake.

Adult↗
PubMedDate not supplied

Potential hazards of excluded bowel and use of parenteral nutrition: a case report.

This case demonstrates that excluded gut may be a reservoir for bacterial translocation and recurrent sepsis. Translocation may contribute to cholestatic hepatitis, and restoration of bowel continuity is fundamental to reversing these pathologic changes. It also emphasizes that parenteral nutrition even when used as interim supportive treatment is not without serious hazard.

Bacteremia↗
PubMedDate not supplied

Assessment of distal tip position of long-term central venous feeding catheters using transesophageal echocardiology.

BACKGROUND: Central vein catheter position is a vital element in promoting longevity and minimizing adverse events associated with long-term parenteral nutrition. Traditionally, position has been verified using a chest radiograph. However, this mode of assessment has limitations as the catheter is placed in a dynamic system subject to forces from changes in posture and diaphragmatic movement. METHODS: We compared the reported position using a chest x-ray compared with assessment using transesophageal echocardiology (TOE) in 9 patients receiving home parenteral nutrition. The x-ray was reported by a radiologist unaware of the study. RESULTS: There were discordant results in 7 of the 9 cases with catheter tip placed in the right atrium or impinging in the tricuspid valve which was not evident from the chest x-ray. TOE offered greater information of catheter tip position and relationship to adjacent anatomy. CONCLUSIONS: Further work is required but this observational study suggests guidelines suggesting the use of a chest radiograph to confirm catheter position may need to be re-assessed.

Catheterization, Central Venous↗