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Biomedical subjects

G F Russell

Publications and source records attributed to G F Russell.

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

Weight gain and reproductive function: ultrasonographic and endocrine features in anorexia nervosa.

Pelvic ultrasonographic measurements and reproductive hormone levels in 36 patients with anorexia nervosa were followed as they gained weight during inpatient treatment. In 24 patients who were severely malnourished (69% of premorbid weight) the ovaries were small and amorphous and the levels of LH, FSH and oestradiol were very low. Weight gain led to the appearance of multifollicular ovaries when levels of LH and oestradiol remained low but FSH levels had increased resulting in an LH:FSH ratio of less than 1. The emergence of a dominant follicle in 19 patients after weight gain (to 97% of premorbid weight) was accompanied by an increase in uterine area and associated with increased levels of LH and oestradiol and an LH:FSH ratio greater than 2. Among these patients with a dominant follicle at peak weight, 11 menstruated within a month of discharge. The weight at which normal ovarian morphology returned was related to premorbid weight (P less than 0.002) whereas body mass index (BMI) was poorly related. Our findings suggest that pelvic ultrasonography is probably the best indicator of the weight required for full endocrine recovery and offers advantages over sequential hormonal measurements, and is valuable in the management of patients with anorexia nervosa.

Adolescent↗
PubMed1988

Physical complications in anorexia nervosa. Haematological and neuromuscular changes in 12 patients.

Of twelve patients consecutively admitted to the Maudsley Hospital Eating Disorders Unit, four had neuromuscular abnormality, eight haematological abnormality, and four no abnormality. All those having neuromuscular signs had concomitant haematological dysfunction. Vomiting, and food restriction with vegetarianism, appeared more likely to lead to complications than either food restriction alone or laxative abuse. The physical status of severely underweight patients admitted for refeeding needs to be carefully monitored.

Adolescent↗
PubMed1988

A controlled trial of d-fenfluramine in bulimia nervosa.

A double-blind, placebo-controlled trial of d-fenfluramine in bulimia nervosa was undertaken in order to assess its efficacy in controlling bulimic behavior and relieving more general symptoms. A high proportion of the patients evaluated were reluctant to enter the drug trial in spite of the offer of additional supportive psychotherapy and counselling on dietary control. Moreover, 17 out of the 42 enrolled patients withdrew halfway through the 12 week trial. Were it not for this high rate of defaulting, there might be clearer support for the efficacy of d-fenfluramine in reducing the frequency of overeating and self-induced vomiting in these bulimic patients. An unexpected finding was that among the noncompleters, those on d-fenfluramine had experienced relief of their bulimic symptoms. The persistence of depressive symptoms and features of the eating disorder probably contributed to the noncompleters leaving the trial. Reassuring findings were the absence of weight loss and serious unwanted effects from d-fenfluramine. By itself, d-fenfluramine did not benefit some of the patients with severe bulimia nervosa, but it may yet prove a useful adjunct to psychological treatments.

Adolescent↗
PubMed1987

An evaluation of family therapy in anorexia nervosa and bulimia nervosa.

A controlled trial comparing family therapy with individual supportive therapy in anorexia nervosa and bulimia nervosa was undertaken. Eighty patients (57 with anorexia nervosa; 23 with bulimia nervosa) were first admitted to a specialized unit to restore their weight to normal. Before discharge, they were randomly allocated to family therapy or the control treatment (individual supportive therapy). After one year of psychological treatment, they were reassessed, using body weight, menstrual function, and ratings on the Morgan and Russell scales. Family therapy was found to be more effective than individual therapy in patients whose illness was not chronic and had begun before the age of 19 years. A more tentative finding was the greater value of individual supportive therapy in older patients. To our knowledge, this is the first controlled trial of family therapy in anorexia nervosa and clarifies the specific indications for this treatment.

Adolescent↗
PubMed1986

Osteopaenia of the lumbar spine and femoral neck in anorexia nervosa.

The bone density in the spine, femoral neck and radius in 31 outpatients with anorexia nervosa (AN) was measured by photon absorptiometry and compared with 31 age matched controls. In all bone sites measured the patients with anorexia nervosa had reduced bone mineral density (spine- control 0.91 + .10 gHA/cm2, AN 0.75 + .09 gHA/cm2; femur- control 0.87 + .09 gHA/cm2, AN 0.67 + .07 gHA/cm2; radius-control 0.41 + .04 gHA/cm2, AN 0.38 + 0.9 gHA/cm2). The mean difference between the groups was greatest in the femoral neck at 0.21 gHA/cm2 (95% CI 0.18-.024 p less than 0.001) and least at the radius 0.04 gHA/cm2 (95% CI 0.02-0.06, p less than 0.05), the lumbar spine was intermediate with a mean difference of 0.16 gHA/cm2 (95% CI 0.12-0.2 p less than 0.001). Femoral and spinal bone mineral density was positively correlated with body mass and negatively correlated with duration of amenorrhoea. Three of these patients had vertebral crush fractures which suggests that this diminution in bone density is of clinical significance.

Adolescent↗
PubMed1985

Anorexia nervosa and the adrenal: the effect of weight gain.

Cortisol (F) and dehydroepiandrosterone (DHA) were measured following each 5 kg gain in weight in a group of 16 patients with anorexia nervosa admitted to hospital for refeeding. The mean percentage of standard weight on admission was 65% and that on discharge was 92%. Basal plasma cortisol fell gradually throughout the inpatient period, the correlation coefficient of the regression line relating percentage of standard weight to plasma cortisol in all patients was -0.559 (p less than 0.001). Adrenal androgen production, however, increased with weight gain and the correlation coefficient of the regression line of androgen production against percentage of standard weight was +0.303 (p less than 0.01). The DHA/F ratio increased with weight gain. This suggests that weight gain in the patient with anorexia nervosa could be associated with increased activity in the adrenal 17,20-lyase enzymes and a decrease in the activity of the 3-beta hydroxysteroid dehydrogenase. The possibility that these adrenal enzyme changes are controlled by pituitary proopiocortin peptides [the putative cortical androgen stimulating hormone (CASH)] is discussed as is the relationship between normal adrenarche and the weight related changes in adrenal function in anorexia nervosa.

Adolescent↗
PubMed1985

Neuropathy and myopathy in two patients with anorexia and bulimia nervosa.

Two adolescent patients with eating disorders and severe weight loss presented with neuromyopathy. The first was female and had a twenty months' history of bulimia nervosa with weight loss and episodic gorging and vomiting. The second was male with a two-year history of anorexia nervosa characterised by vegetarianism and increasing food restriction. Both had severe wasting and asymmetrical weakness of proximal limb muscles. The first patient deteriorated on refeeding and became temporarily paralysed. Both had a purpuric rash and haematological abnormalities. They made a complete recovery on a mixed diet: vitamin supplements were given to the first but not to the second patient.

Adolescent↗
PubMed1985

Suppression of eating by fenfluramine in patients with bulimia nervosa.

Fifteen patients with bulimia nervosa received fenfluramine (60 mg po) or placebo under double-blind, randomly ordered conditions. Two hours later food was presented. Significantly less food was eaten after fenfluramine and the quantity eaten was inversely correlated with serum fenfluramine levels. Significantly fewer patients reported bulimic symptoms during the test after fenfluramine, but no significant effect was demonstrated after leaving the ward. Fenfluramine caused drowsiness but did not reduce hunger ratings. Similarly, eating failed to reduce hunger ratings normally in the patients. These findings suggest that in patients with bulimia nervosa, hunger is reported abnormally and eating is suppressed by fenfluramine. Bulimic symptoms were probably reduced by fenfluramine, which may prove to be a useful treatment for bulimia nervosa.

Adolescent↗
PubMed1985

Anorexia nervosa, parental 'expressed emotion' and dropping out of treatment.

The number of dropouts from a long-term treatment study of patients with anorexia nervosa (AN) and bulimia nervosa (BN) was substantial. A variety of social, clinical, parental, and treatment factors were examined for their association with early termination of treatment by the patient or the family. Parents' expressed emotion' (EE) (particularly critical comments), BN, and the type of therapy offered (family or individual) were found to interact in some manner to result in dropping out. Some other aspects of parents' EE were also examined, including a comparison of scores in parental pairs; EE was found to be influenced by social class, and there were significant associations with the patient's symptomatology and social adjustment. There was a strong relationship between mothers' and fathers' scores in parental pairs.

Adult↗
PubMed1984

The influence of 1-(N-L-tryptophan)-1-deoxy-D-fructose [Fru-Trp] and its N-nitrosated analogue [NO-Fru-Trp] on the viability and intracellular synthetic activity (DNA, RNA, and protein synthesis) of HeLa S3-carcinoma cells.

Exposing HeLa S3 cells at 37 degrees C to varied concentrations of, respectively, Fru-Trp (0.1 microM - 1 mM), NO-Fru-Trp (0.1 microM - 1 mM), and NaNO2 (0.6 microM - 6 mM) for varied periods of time (1 - 36 hr) does neither affect their viability (trypan blue dye exclusion test) nor capability to synthesize RNA or protein but is of considerable influence on DNA synthesis in the case of NO-Fru-Trp and NaNO2, but not in the case of Fru-Trp which continues to be ineffective. None of the three compounds tested is of significant influence on cell number. Both NO-Fru-Trp and NaNO2 stimulate DNA synthesis: a maximum of activity [( 3H] thymidine incorporation) exists at the 24 hr time point of incubation, with NO-Fru-Trp, for instance, generating a 2.5-fold increase (over control) at 1 mM concentration in the medium while NaNO2, at comparable concentration, increases DNA synthesis by a factor of 1.6 over control. The increase in DNA synthesis is not due to stimulatory influences on (semi-conservative) DNA replication but represents DNA repair. This was verified by keeping the cells under conditions that prevent normal (semi-conservative) replication but permit repair ("unscheduled DNA synthesis"). Two major routes are suggested by which NO-Fru-Trp could impart DNA damage and, thus, assume mutagenic properties.

Cell Count↗
PubMed1984

Anorexia nervosa: a study of 34 twin pairs and one set of triplets.

In a collaborative study between St George's and the Maudsley Hospitals, 34 pairs of twins and one set of triplets were identified in which the proband had anorexia nervosa. The diagnosis was based on standard criteria and zygosity was established by blood group analysis or by use of the physical resemblance questionnaire. In the 30 female twin pairs, 9/16 of the monozygotic (MZ) and 1/14 of the dizygotic (DZ) pairs were concordant for anorexia nervosa. Three of the non-anorexia co-twins had other psychiatric illnesses, and two had minor eating disorders. None of the male co-twins had anorexia nervosa.

Adult↗