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Biomedical subjects

E Harju

Publications and source records attributed to E Harju.

At least 37 records · Page 2Linked to original sources
PubMed1988

Nutritional state after colon interposition for benign oesophageal disease.

The nutritional state of 32 patients after (mean 66 months) colon interposition due to benign oesophageal disease was examined. Forty-four per cent of the patients had depleted iron stores (low serum ferritin concentration). Serum iron and blood haemoglobin concentrations were lower (P less than 0.001) in those with low than in those with normal serum ferritin concentration (115 +/- 12 g/l and 15 +/- 5 mumol/l vs 135 +/- 12 g/l and 23 +/- 9 mumol/l). Most very low blood haemoglobin concentrations (less than 110 g/l) were found in patients with depleted iron stores. Eighteen patients had serum albumin concentrations slightly below (35-39 g/l) the normal range, and two other patients had values less than 35 g/l. The patients had less dietary iron (13 +/- 6 mg/d) than age- and sex-matched controls (19 +/- 7 mg/d), but the intake of patients with depleted iron stores (12 +/- 5 mg/d) was similar to that of patients with normal iron stores (14 +/- 6 mg/d). Symptoms and/or the replacement of colon graft anti- or isoperistaltically did not have any significant association with the nutritional status, only slightly reduced blood haemoglobin and serum albumin concentration were found among the symptomatic patients and the patients with an antiperistaltic graft. Iron therapy and protein supplements, eg, from milk, egg, soy and meat, are recommended as the dietary treatment. To improve the nutritional status a short intra-abdominal colon graft loop anastomosed to the proximal stomach instead of long loop with an antral anastomosis of the present patients is suggested.

Adolescent↗
PubMed1987

Dietary habits of patients with regurgitation after colon interposition.

The dietary habits after colon interposition following oesophagectomy in patients without symptoms (n = 8), with regurgitation (n = 22) and in sex- and age-matched healthy controls (n = 20) were studied by a 7-day diary method. The patients ate smaller meals (1080 +/- 90 kJ versus 1810 +/- 151 for the controls, P less than 0.01), more frequently during the day (eight versus five in the controls). Solid and sour foods were preferred, especially by those with regurgitation, compared with controls. The asymptomatic patients consumed more milk and coffee and less cheese, sour milk, meat, fish, eggs, tea and orange juice than the patients with regurgitation. Vegetable fats and medium chain triglycerides were consumed in negligible amounts. The patients with regurgitation had more fluids separately from meals than the asymptomatic patients. The results suggest that intake of vitamin supplements and replacement of animal fats by vegetable fats may be useful in these patients. Much of the dietary difficulties after colon interposition might be the result of the intra-abdominal colon graft loop anastomosed to the antrum; a short graft with a more proximal anastomosis to the lesser curvature merits study in this context.

Body Weight↗
PubMed1987

The protective effect of nutrients against stress induced gastric ulcers in the rat.

The first part of the study consisted of 110 rats in 11 groups with ten rats in each. Nine of the groups were fed nutrient solutions of different compositions, antacid and sucralfate through orogastric tube during induction of stress ulcer by restraint and a cold ambient temperature. One group served as a control group and received no feeding and the 11th group was given cimetidine intraperitoneally. The extensiveness of the stress effect was estimated in each group by the number of rats with ulcer as percentage, the mean number of ulcers in each rat, the mean distribution of ulcers of different sizes, the mean total of mucosal damage in each rat and the contribution of ulcers of a different size to the total mucosal damage. The results showed that cimetidine is an effective protector against stress ulcer. Guar gum, Intralipid (fat emulsion), egg protein and 30 per cent glucose are slightly weaker protectors than cimetidine but much stronger than 10 per cent glucose wheat flour and distilled water. Sucralfate increased the susceptibility to stress ulcer. The second part of the study consisted of 86 rats. It showed, that guar gum increased the healing rate of stress ulcers. During a 30 hour treatment period after four hours of stress, the rats fed guar gum (n = 30) showed a lower (p less than 0.001) number of ulcers than the control rats fed normal rat food (n = 26) or immediately after the four hours of stress (n = 30). The mechanisms suggested for ulcer prevention and increased ulcer healing rate found herein may be due to reduced acidity, increased local mucosal supply of energy and mechanical protection.

Animal Nutritional Physiological Phenomena↗
PubMed1987

Postprandial hyperglycemia after different carbohydrates in patients with total gastrectomy.

Eating related difficulties and symptoms and postprandial serum glucose levels were studied in 11 patients (44 to 70 years old) five to 48 months after total gastrectomy and Roux-en-Y reconstruction for carcinoma of the stomach with no signs of metastasis or residual tumor. Three tests were used. The first contained 150 milliliters of 50 per cent glucose alone, the second had 150 milliliters of 50 per cent glucose with 5 grams of guar gum (viscose dietary fiber) and the third was a vegetable meal containing 75 grams of glucose. All of the patients with total gastrectomy had eating related symptoms, such as dumping and difficulties with the large volume of a meal. They had to eat small meals and the most usually experienced postprandial symptoms were abdominal pain, nausea and faintness. The postprandial serum glucose level was highest after drinking glucose alone and the lowest after eating the vegetable meal (as the highest 9.4 +/- 2.0 and 6.2 +/- 1.6 millimole per liter, respectively, 50 minutes postprandially, p less than 0.01). Hyperglycemia was associated with nausea, sweating, faintness, reduction of blood pressure and increase of pulse rate. The large volume of the vegetable meal produced difficulties (dysphagia and abdominal distension) in eating for everyone except one patient. Guar gum eaten with glucose reduced the postprandial hyperglycemia near to the level found after the vegetable meal. Also, the symptoms experienced after glucose with guar gum reduced from that after glucose alone, five patients became symptomless. Four of these five patients have supplemented guar gum regularly for several months into their daily meals with the result of reduction of the postprandial subjective symptoms. The dose has been adjusted individually from 2 to 7 grams of guar gum three times daily. Loose stools and diarrhea may occur at the beginning. These are avoided by a gradual increase of the dose during an adaptation period of two weeks. Sometimes glucose with guar gum may result in hypoglycemia with prolonged symptoms after immediate hyperglycemia. It is concluded that guar gum gives a possibility to avoid the symptoms related to a large volume of a meal and to reduce those produced by a high glucose content of a meal in patients after total gastrectomy. Guar gum also works in practical prolonged use when the dose is estimated from postprandial symptoms.

Adult↗
PubMed1986

Gastric polyposis and malignancy.

Gastric malignancies developed in 15 patients with gastric polyps (seven men, eight women; mean age 66 +/- 8.8 years) during a 14-year follow-up of 170 patients (8.8 per cent). The polyps were hyperplastic in 90 per cent of the patients, adenomas in 8.2 per cent and leiomyomas in 1.8 per cent. During follow-up 4.7 per cent of the patients had both adenomas and hyperplastic polyps. Ten patients developed adenocarcinoma, two lymphoma, one lymphoid sarcoma, one carcinoid tumour and one severe dysplasia. The incidence of malignancy was sevenfold higher than expected (P less than 0.01). There is an associated but lower risk of malignancy in stomachs with hyperplastic polyps than with adenomas; 2 of the 15 stomachs with adenomas and 3 of the 142 hyperplastic polyps showed later malignancy (P less than 0.001). Before the diagnosis of malignancy 1.1 +/- 1.4 (0-4) gastroscopies were done and 12 +/- 19 (0-48) months had elapsed since the first examination and detection of polyps, whereas the mean number of gastroscopies and length of follow-up period in all patients with polyps was 1.9 +/- 0.9 (0-10) and 68 +/- 35 (0-156) months, respectively. Eleven patients had a stage I malignancy and four had a stage IV tumour. The survival rate of the eight patients with malignancy found at the first examination was better (6/8) than for those diagnosed during the follow-up period (3/7) (P less than 0.01; chi2 test). The results show the high risk of malignancy in stomach polyps, adenomas or hyperplasia, and stress the importance of careful and repeated examination of these patients.

Adenoma↗
PubMed1986

Dietary and supplementary intake of nutrients by patients with gastrointestinal diseases.

The dietary and supplementary intake of food, energy, and nutrients were examined in 54 patients after various gastrointestinal operations and in 33 patients with gastritis, peptic ulcer, or undefined abdominal pain. Forty-six of the operated and 21 of the nonoperated patients had to avoid certain foods (p less than 0.001, chi 2-test), mainly milk, beans, cabbage and other vegetables, bread, and fried foods. Only a few patients got discomfort from coffee, fatty foods, and meat. The intake of energy was at the level of light physical work. The dietary intake of iron, vitamin A, and niacin did not reach the level of the recommended daily allowance (RDA). One-half of the patients used vitamins and supplements, which increased their intake over the level of RDA. It is important to inform patients before operations about the possibility of persistent abdominal symptoms after the operation.

Abdomen↗
PubMed1986

A high amount of branched chain amino acids did not change favourable plasma albumin and protein concentrations during 48 hours post-laparotomy infusion--an experimental study in the rabbit.

The changes in plasma albumin and protein concentration during 48 hours post-laparotomy infusion of saline, 10% glucose alone and in combination with low (18%) and high (25%) concentration of branched chain amino acid solutions were investigated in the rabbit. During 24-hours post-laparotomy infusion of a solution with a low concentration of branched chain amino acids together with 10% glucose, the plasma albumin concentration decreases (15%) less than during infusion of a solution with a high concentration of branched chain amino acids together with 10% glucose (24%), saline (21%) or 10% glucose alone (23%). The amount of decrease in plasma albumin concentration 48 hours after laparotomy was independent of the four solution regimen used (between 20 to 23%). There is no favourable effect on plasma albumin and protein concentration from the use of high amounts of branched chain amino acids in 48 hours post-laparotomy infusion, whereas 24 hours infusion of a low concentration of branched chain amino acids is recommended.

Amino Acids, Branched-Chain↗
PubMed1986

Ascorbic acid does not augment the restoration effect of iron treatment for empty iron stores in patients after gastrointestinal surgery.

The effect of a 6-week combined treatment with ferrous sulfate (80 mg Fe++ three times daily) and ascorbic acid (75 mg three times daily) on the empty iron stores in 20 patients after gastrointestinal surgery was examined from changes of serum ferritin. One group of 20 patients with similar clinical characteristics served as controls. The treatment replaced the empty iron stores. Since mean serum ferritin concentrations increased from 9 +/- 8 to 29 +/- 11 micrograms/l (P less than 0.001) in males and from 8 +/- 8 to 26 +/- 10 micrograms/l (P less than 0.001) in the females. Also blood hemoglobin and serum iron concentrations increased significantly (P less than 0.01). Among the controls there were no marked changes in serum ferritin, blood hemoglobin or serum iron concentrations. However, the increase of serum ferritin caused by this combined treatment was similar with that caused previously by pure ferrous sulfate treatment. Thus, it is considered that the combined treatment with ferrous sulfate (80 mg Fe++ three times daily) and ascorbic acid (75 mg three times daily) restores the empty iron stores in patients after gastrointestinal surgery, but that the increase is not augmented by the ascorbic acid. Thus, a pure iron therapy is recommended to fill up the empty iron stores in these patients.

Adult↗
PubMed1986

Infusion of amino acids decreases the hyperglycaemic effect of per- and postoperative glucose infusion: an experimental study in the rabbit.

The effects on blood glucose concentration of 10% glucose with amino acid solution at low (18%) and high (25%) concentration of branched chain amino acids were studied, two days after laparotomy in fasted rabbits. During the whole study period, saline infusion was associated with normoglycaemia. Among the other infusion combinations peroperative infusion of amino acid solution high in branched chain amino acids with 10% glucose was the least hyperglycaemic. An amino acid solution low in branched chain amino acids with 10% glucose had the lowest hyperglycaemic effect 24 hours postoperatively. After 48 hours an infusion of 10% glucose produced the weakest hyperglycaemia. In preoperatively and 24 hours postoperatively 10% glucose was more hyperglycaemic than 10% glucose with the two amino acid solutions. After 24 and 48 hours, infusion of 10% glucose with amino acids high in branched chain amino acids was more hyperglycaemic than 10% glucose with amino acids low in branched chain amino acids.

Amino Acids↗
PubMed1986

Independence of postprandial serum gastrin concentrations on gastric emptying rate in healthy subjects.

Changes in serum gastrin concentration after ingestion of meals containing 5 g of guar gum or 5 g wheat flour were studied in 15 healthy subjects for up to 120 minutes postprandially. The results showed that the postprandial gastrin response was independent of changes in gastric emptying rate. A two-fold increase in serum gastrin concentration prevailed for 60 to 90 minutes postprandially. In addition, was serum gastrin concentration was independent of the amount of food in the stomach.

Adult↗
PubMed1986

Gastrointestinal symptoms after colon interposition.

To assess gastrointestinal symptoms after colon interposition, 12 patients with colon interposition for malign disease and 33 for benign esophageal disease were interviewed. A 7-day diary, including time of eating and gastrointestinal symptoms experienced by patients during and between meals, was kept by every patient. The observations of the interview and diary were compared. No patient had swallowing difficulties or heartburn. All could also eat solid foods; 24% had no gastrointestinal gastrointestinal symptoms during follow-up. Regurgitation, vomiting, and dumping symptoms were common, being observed in 22, 31, and 18% of the cases. There were no differences with these symptoms between patients with anti- or isoperistaltic colon grafts. The information from interviews agrees with the information recorded in the diaries. We conclude that various degree reflux symptoms are common after colon interposition, being experienced by almost half of the patients.

Adolescent↗
PubMed1985

Complications of subclavian vein catheters in patients with high enterocutaneous fistulas.

Complications of subclavian catheters in 17 consecutive patients with high enterocutaneous fistulas were studied. Fifteen patients had drainage surgery and total parenteral nutrition was given to all patients via a subclavian catheter for 27 +/- 20 days and in total 75 catheters were used for 1044 days. One patient needed on average 5.0 +/- 2.2 catheters and one catheter was in place 12.3 +/- 9.7 days. Bacterial cultures were positive in two and candida cultures in one catheter. Three patients died due to sepsis, but only one had a minor complication transient skin infection around the catheter. The frequency of complications decreased when the number of catheters in each patient increased. Minor complications were common.

Adult↗
PubMed1985

High incidence of low serum vitamin D concentration in patients with hip fracture.

The study of 82 consecutive hip fracture patients (22 males and 60 females) and 185 various controls showed that low serum 25-OH-vitamin D3 (25-OD-D3) concentration was common in the hip fracture patients, who in addition were old, incapable of independent daily life, had poor dietary habits, reduced nutritional status, and spent insufficient time in sunlight. The most usual mechanisms of trauma were minor indoor falls. Osteoporosis was common and associated with low 25-OH-D3. Hypocalcemia was more common in hip fracture patients than in controls. Increased serum alkaline phosphatase was not a specific feature in hip fracture patients. The results suggest that vitamin D supplementation is indicated in elderly disabled people.

Adult↗
PubMed1985

Increase of body iron stores estimated by the increase of serum ferritin concentration during a treatment of 200 mg Fe++ daily after gastrointestinal surgery.

A 6-week iron therapy of 200 mg Fe++ daily was given to 13 men and 12 women who had previously undergone various kinds of common gastrointestinal surgery and who had empty iron stores estimated from low serum ferritin concentration. The results were compared with those of a control group corresponding to the study group in respect of sex, number of patients, primary disease, previous operation, empty iron stores (serum ferritin), blood hemoglobin, serum iron, sedimentation rate, blood leukocytes, serum transferrin, folate and vitamin B12. The iron therapy restored the lack of body iron, for the serum ferritin concentrations increased from 12 +/- 7 to 30 +/- 11 micrograms/l (p less than 0.001) in the men and from 10 +/- 6 to 30 +/- 12 micrograms/l (p less than 0.001) in the women, whereas the corresponding changes in the control group were from 10 +/- 9 to 11 +/- 8 micrograms/l and from 11 +/- 8 to 13 +/- 11 micrograms/l in the men and women, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗