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Biomedical subjects

I Cobden

Publications and source records attributed to I Cobden.

At least 37 records · Page 2Linked to original sources
PubMed1987

Effect of ethanol challenge on serum glycoproteins in alcoholic and non-alcoholic liver disease.

The effects of acute ethanol challenge on serum glycoprotein concentrations in man were studied. Serum levels of haptoglobin, alpha-2-macroglobulin and pre-albumin were measured fasting and 6 hr after oral ethanol 0.75 g/kg body weight in 8 healthy controls, 13 patients with alcoholic liver disease and 13 with non-alcoholic-related liver damage, both patient groups being further subdivided into those with and without cirrhosis. Basal levels of haptoglobin were significantly higher in non-cirrhotic alcoholics than controls and pre-albumin levels were lower in non-alcohol-related cirrhotic liver disease. In response to ethanol challenge, no consistent change was observed in any group, nor was there any significant difference between groups. There was, however, a significant correlation (r = 0.53, P less than 0.005) between the percentage changes in haptoglobin and alpha-2-macroglobulin. In 16 subjects (2 controls, 8 alcoholics and 6 non-alcoholics) blood levels of ethanol and acetaldehyde were measured serially: there was no relationship between the peak or mean concentration and the glycoprotein response. This study does not substantiate other reports which claimed to be able to predict the severity and reversibility of alcoholic liver disease on the basis of the serum glycoprotein response to ethanol: ethanol challenge with measurement of serum glycoproteins cannot substitute for proper histological assessment.

Acetaldehyde↗
PubMed1986

A biphasic illness associated with acute hepatitis A virus infection.

Four patients are described with serologically proven hepatitis A (HAV) infection. In each patient there was a bimodal course to the illness--clinically and biochemically--with complete remission between the two phases of the illness. Other possible causes except NANB for a second hepatitic illness were excluded.

Adolescent↗
PubMed1986

Hepatocellular carcinoma in north-east England: importance of hepatitis B infection and ex-tropical military service.

Over a four-year period 40 patients of local origin, with primary hepatocellular carcinoma were seen at a regional referral centre. Twenty-nine patients had histological evidence of underlying cirrhosis and these patients were predominantly male (25/29) and elderly (mean age 66 years). Serological evidence of hepatitis B virus (HBV) infection was found in 11 (38 per cent) of the cirrhotic group. Of the 25 males with cirrhosis, 13 (52 per cent) were known to have seen military service in the tropics and of these eight had serum HBV markers. The non-cirrhotic group was younger (mean age 55 years) and the sex distribution was nearly equal (six male, five female). Two patients (19 per cent) had hepatitis B markers including one of the two men in this group who had served in the tropics. One patient with no serum HBV markers had integrated HBV-DNA sequences in the cellular DNA of her tumour. These observations confirm the association of primary hepatocellular carcinoma with hepatitis B virus and suggest that a significant proportion of patients of United Kingdom origin acquired their susceptibility as a result of military service in the tropics. There is presumably a substantial cohort of ex-service men at risk of developing primary hepatocellular carcinoma.

Adult↗
PubMed1985

Cellobiose/mannitol test: physiological properties of probe molecules and influence of extraneous factors.

The influence of gastric emptying, intestinal transit, renal and hepatic function, and variations in the timing of urine collections, on the cellobiose/mannitol test of intestinal permeability has been studied. None of these extraneous factors influences the cellobiose/mannitol recovery ratio, and there is only a modest effect of renal function on urinary mannitol recovery. Cellobiose is almost totally recovered in the urine within 10 h of intravenous injection, whilst mannitol is less completely recovered, perhaps due to hepatic metabolism. The simultaneous administration of two probe molecules in the cellobiose/mannitol test, and the use of a ratio to express results, thus achieves the desired object of minimising the effect of extraneous factors on the test result. The cellobiose/mannitol test is therefore not subject to the limitations of previous tests of intestinal permeability using orally administered probe molecules, and is widely applicable as a screening test for coeliac disease.

Celiac Disease↗
PubMed1985

Captopril in the hepatorenal syndrome.

Five patients with hepatorenal syndrome were treated with the orally active angiotensin-converting enzyme inhibitor captopril (25 or 50 mg 6 hourly) for up to 48 hours. Only one patient showed a significant increase in urinary sodium concentration (from less than 10 to 70 mmol/liter), but without associated diuresis; renal function continued to deteriorate in all patients with persistent oliguria and rising serum creatinine. The outcome was uniformly fatal. These results suggest that in the hepatorenal syndrome, captopril in standard dosage is without benefit, and provide further evidence that the changes in the renin-angiotensin system are probably secondary to reduced renal perfusion from some other cause.

Adult↗
PubMed1984

Gallstones presenting as mental and physical debility in the elderly.

Within 1 year six elderly patients (aged 80-89 years) were admitted because of non-specific deterioration in mental or physical well-being. In no instance was hepatobiliary disease suspected at the time of hospital admission. One patient presented with intermittent confusion only. The other five were referred with "falls" or having "gone off legs", with malaise, confusion, or incontinence. All had raised alkaline phosphatase levels of 159-1230 IU/l, which led to investigation of the biliary tree. At endoscopic retrograde cholangiopancreatography all were shown to have biliary disease (three common duct stones, one gallbladder calculus, one an abscess, and one a widely dilated common bileduct ). With appropriate treatment (endoscopic sphincterotomy for two, surgery for two, and antibiotics alone for two), all showed a gratifying return of mobility and mental function. Biliary disease is a treatable cause of chronic ill health in the elderly and should be excluded, even in the absence of "classical" symptoms, when there is abnormal liver function.

Aged↗
PubMed1983

Gastrointestinal transit of liquids.

A simple, non-invasive technique has been established for the simultaneous measurement of stomach emptying and the small bowel transit of a liquid meal. The rate of gastric emptying (T1/2) was measured in 21 normal subjects by using a gamma camera and computer to observe emptying of 200 ml of water to which 200 muCi 99Tcm - diethylene tetramene pentacetic acid chelate was added. By adding lactulose to the drink and measuring breath hydrogen (H2) concentration, small bowel transit time (Ta) was simultaneously estimated. There was no significant correlation (r = 0.26, P greater than 0.2) between T1/2 and Ta or between T1/2 and the shape of the breath H2 evolution curve. However, the shape of the breath H2 curve did seem to be affected by Ta. The technique should prove useful for the study of gastrointestinal motility in disease states.

Disaccharides↗
PubMed1982

Controlled trial of terlipressin ('Glypressin') versus vasopressin in the early treatment of oesophageal varices.

In a randomised controlled trial the effect of intermittent bolus injection of triglycyl lysine vasopressin (terlipressin 'Glypressin') (2 mg that 6-hourly), an analogue of vasopressin, was compared with that of a constant peripheral intravenous infusion of vasopressin (0.4 units/Min) in the initial management of bleeding oesophageal varices in nineteen patients. Failure of vasopressin therapy was defined as continued bleeding of sufficient severity to necessitate the passage of a Sengstaken tube. Bleeding was controlled in 70% of patients treated with glypressin but in only 9% of patients given vasopressin. The glypressin group required significantly less blood after randomisation than the vasopressin group. Because of its efficacy, lack of side-effects, and ease of administration, glypressin appears to be valuable in the management of bleeding varices.

Adult↗