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Biomedical subjects

J C Wells

Publications and source records attributed to J C Wells.

At least 55 records · Page 3Linked to original sources
PubMed1996

Total energy expenditure and body composition in early infancy.

UNLABELLED: In adults greater energy expenditure, primarily on physical activity, is associated with greater leanness. Such an association has proved more difficult to demonstrate in infants, partly due to the difficulty of measuring fatness and free living energy expenditure in this age group. Stable isotope techniques now make such investigations more viable. OBJECTIVE: The relationship between body composition and energy expenditure was investigated in 12 week infants. METHODS: Total energy expenditure and fat mass were estimated using the doubly labelled water technique. SUBJECTS: 92 normal healthy infants. RESULTS: Fat mass was correlated with both triceps and subscapular skinfold thicknesses (p < 0.001). After controlling for body size, age was a significant predictor of fat mass (p = 0.003), whereas total energy expenditure was not (p = 0.463). CONCLUSIONS: The cross sectional link between activity level and fatness in young infants, reported previously, does not persist when energy expenditure is considered.

Aging↗
PubMed1996

Lesion characteristics and depressed mood in the stroke data bank study.

This study examined the relationship between post-stroke lesion size and location and depressed mood by using data from the multicenter National Stroke Data Bank. For in patients with first-ever cerebral infarction, lesions were characterized by location and size from CT scans. Forty-seven (24%) of the 193 patients studied were depressed. In the complete sample, neither lesion size nor location was associated with depression. However, among patients with comparable small-sized lesions (n = 124), depression was more frequent among those with left hemisphere stroke than those with right hemisphere stroke (31% vs. 16%; P = 0.04). Among patients with larger lesions, brain edema was common and may have obscured lateralized findings. Different biogenic amine neurotransmitter responses to right and left hemisphere brain injury may underlie this mood asymmetry.

Aged↗
PubMed1996

The relationship between components of infant energy expenditure and childhood body fatness.

OBJECTIVE: To investigate whether any component of infant energy expenditure is related to fatness in early childhood, and whether infant fatness is related to childhood variables. DESIGN: Longitudinal investigation of infants studied at 12 weeks and followed up at 2.5 to 3.5 years of age. SUBJECTS: 30 healthy full-term infants selected from the general population. MEASUREMENTS: Sleeping metabolic rate, total energy expenditure, anthropometry and behaviour at 12 weeks; anthropometry, body composition and behaviour in follow-up. RESULTS: Energy expenditure at 12 weeks (minimal metabolism, total energy expenditure, energy expended on physical activity, behaviour) showed no relationship with later fatness. Infant fatness (skinfold thicknesses and percentage fat) showed in contrast a strong relationship with childhood fatness. Infant fatness also predicted childhood behaviour. CONCLUSIONS: These data do not support the theory that reduced energy expenditure in early infancy is related to later fatness. However, infant fatness influences both later fatness and activity patterns.

Adipose Tissue↗
PubMed1996

Measurement of nutritional status using conventional anthropometry and D2O in Sarawak, Malaysia.

OBJECTIVE: To evaluate the effect of different methods (plateau or back extrapolation) of calculating total body water (TBW) from deuterium dilution in an environment characterised by high water turnover. The back extrapolation model is assumed to be more accurate when water turnover is high. DESIGN: Cross-sectional study with measurement of body composition by deuterium dilution and conventional anthropometry. SETTING: Rural Sarawak, Malaysia. SUBJECTS: 24 adults of the Iban population. RESULTS: TBW was significantly different by method of calculation (P < 0.0001), and mean fat free mass was lower by 1.3 kg using the back extrapolation technique, equivalent to a mean 3.1 (s.d. 0.8)% reduction. The same 1.3 kg difference was equivalent to a mean 16.6 (s.d. 12.3)% increase in fat mass using the back extrapolation technique. Back extrapolation values were used in subsequent analyses. Percentage fat correlated significantly with BMI and skinfold thicknesses in females, but only with BMI in males. Fat mass was significantly correlated with skinfolds and BMI in both sexes. Fat free mass was correlated with BMI in both sexes. CONCLUSIONS: The back extrapolation method produced values for fat mass that differed substantially from those obtained by the plateau method. The difference between calculation methods could be lessened by using saliva samples in place of urine. Back extrapolation values for body fat correlated well with anthropometric measurements in females, less well in males. This difference is due to characteristics of the study population.

Adult↗
PubMed1995

Correction for environmental water influx in measurement of milk volume intake by deuterium turnover in infants.

Measurement of milk volume intake (MVI) in infants is a useful tool for assessing nutritional intake. Current measurement techniques include test-weighting, weighting formula-bottles, and calculation of MVI from water turnover estimated isotopically. Test-weighing of breast-fed infants may disturb normal feeding behaviour and thus influence intake. Calculation of MVI from water turnover is a non-invasive measurement method and can be applied to all infants whether breast-fed or formula-fed. The method requires correction for environmental water influx (EWI) which constitutes non-oral water intake. EWI has previously been investigated only in premature or malnourished infants. The correction factor for EWI was calculated by comparing MVI obtained from weighing formula-bottles and measured isotopically in 21 formula-fed infants at 12 weeks of age. The mean correction factor, by which total water intake should be adjusted to obtain oral water intake, was 0.937 (S.E. 0.017). The proportion of water intake derived from non-oral sources was therefore 6.3%.

Deuterium↗
PubMed1995

Parental body composition and infant energy expenditure.

It has been suggested that infants born to overweight parents are at risk of becoming overweight because of reduced total energy expenditure (TEE). We therefore examined the relationship between infant TEE and parental nutritional status as assessed by body mass index (BMI) in a large sample of healthy infants. TEE was measured by the doubly labeled water method in 124 infants at 12 wk of age. Sleeping metabolic rate (SMR) was measured by indirect calorimetry in 70 of these infants. Indexes of physical activity were calculated as TEE/SMR and TEE-SMR. No aspect of infant energy expenditure was found to be related to parental BMI. Moreover, there was no difference between TEE of two subsets of infants born to parents with high and low BMIs. We therefore find no evidence for parental body composition being associated with reduced infant energy expenditure at 12 wk of age.

Adult↗
PubMed1995

Association between trigeminal neuralgia and multiple sclerosis: role of magnetic resonance imaging.

Seven consecutive patients with multiple sclerosis and trigeminal neuralgia were investigated with MRI to determine the occurrence of a lesion which would account for the patients' pain. Two patients had bilateral symptoms. In the patients with unilateral trigeminal neuralgia vascular compression of the nerve by an artery at the root entry zone on the symptomatic side was confirmed in three patients and an epidermoid tumour distorting the nerve on the symptomatic side was identified in one patient. A demyelinating plaque was identified in only one patient, affecting the trigeminal nerve at the root entry zone at the pons. In those with bilateral symptoms neurovascular compression was identified on both sides in one patient and on one side only in the remaining patient. Microvascular decompression cured the pain in two patients with neurovascular compression. The variable aetiology of trigeminal neuralgia is stressed even in patients with coexistent neurological conditions such as multiple sclerosis, which can cause trigeminal neuralgia independent of other causes.

Adult↗
PubMed1995

Sleeping metabolic rate and body size in 12-week-old infants.

OBJECTIVE: Sleeping metabolic rate (SMR) is influenced by body size and body composition. In order to be able to compare SMR between individuals and groups, the best way to remove the effect of body size and body composition was sought. DESIGN: A cohort of 50 infants was studied at 12 weeks. SMR was measured by indirect calorimetry, and body size and body composition by anthropometry and a stable isotope technique. Regression analysis was used to calculate the best way to remove the effect of body size and body composition on SMR. RESULTS: Regression analysis showed that SMR was adjusted for body weight and fat-free mass by raising body weight to the power 0.41, and by raising fat-free mass to the power 0.44. When SMR was at its minimum level, the optimum powers were 0.41 for body weight and 0.45 for fat-free mass. CONCLUSIONS: SMR can be adjusted for body weight, or fat-free mass thereby taking both body size and body composition into account, by expressing SMR in terms of weight or fat free mass raised to powers close to 0.50.

Body Composition↗
PubMed1995

The effect of diet and sex on sleeping metabolic rate in 12-week-old infants.

OBJECTIVE: Sleeping metabolic rate (SMR) in 12-week-old infants was adjusted for body size and body composition and then compared between the sexes and between breast-fed and formula-fed infants. DESIGN: A cohort of 50 infants was studied at 12 weeks. SMR was measured by indirect calorimetry, and body size and body composition by anthropometry and a stable isotope technique. The effects of body size and body composition on SMR were removed to permit comparison between groups. RESULTS: Mass independent SMR differed between the diet groups when expressed in terms of body weight, but this difference could be explained by differences in fat free mass. The SMR of male infants was 386 +/- 31 kcal/d, and that of female infants was 341 +/- 31 kcal/d: P < 0.0001. The sexes differed whether body weight or fat-free mass was considered. Multiple regression analysis showed that the effect of sex was stronger than that of diet. CONCLUSIONS: There is a relationship between SMR and infant sex and diet even after body size has been taken into account. The relationship could be explained by body composition for diet but not for sex. These differences are equivalent to differences in heat production and may have significance for infant health.

Body Composition↗
PubMed1994

Adjusting milk intake for body size in early infancy.

Energy intake and expenditure are related to body size and body composition and therefore must be taken into consideration when comparing individuals. Previous work has typically expressed energy metabolism variables per kilogram body weight or per kilogram fat-free mass. However this may not remove the effect of body size entirely. In infancy milk volume intake is usually expressed in a similar manner which may not be entirely appropriate. The most appropriate method of expressing milk volume intake relative to body weight and fat-free mass was investigated in 20 normal breast-fed infants at 6 weeks of age. Regression analysis revealed that the relationship between milk intake and body weight could be adjusted for by expressing milk intake per kg0.68, and that the relationship between milk intake and fat-free mass could be adjusted for by expressing milk intake per kg0.54. These values are not significantly different to 0.50 which is the square root of body weight. It is suggested that in studies of energy metabolism in infancy the expression of milk intake per kg0.50 should be used as the most appropriate adjustment for removing the influence of body size upon milk intake, in the first few months of life.

Body Constitution↗
PubMed1994

Risk factors for the incidence of social phobia as determined by the Diagnostic Interview Schedule in a population-based study.

The Diagnostic Interview Schedule was used to identify 89 incident social phobia cases in wave 2 household subjects from 9437 at risk persons age 18 or older as part of the Epidemiologic Catchment Area study. Crude annual incidence of Diagnostic Interview Schedule/DSM-III social phobia was estimated at 9 per 1000 population per year. Onset of social phobia was associated with low education, never having been married and female gender. First onsets occurred throughout the life course of this adult sample. Nervousness, headache, panic spells, palpitations, other phobias, binge pattern of alcohol consumption, dysthymia and schizophrenic symptoms were also predictive of social phobia onset. There was no difference in predictive factors when "primary" social phobia (without premorbid panic) was analyzed separately.

Adolescent↗
PubMed1994

Calculation of total body water in infancy.

OBJECTIVE: Total body water can be calculated using stable isotopes by two alternative approaches known as the plateau method and the back extrapolation method. These methods treat the isotopic data in different ways and consequently do not necessarily produce identical values for total body water. Total body water was therefore calculated using both methods using two different tracers, 2H and 18O. DESIGN: A cohort of infants was studied at three ages in the first year of life, and the two methods and two tracers compared at each age. RESULTS: The plateau method was found to produce values for total body water greater than those obtained by the back extrapolation method at all three ages using both isotopes (P < 0.01 in all cases). CONCLUSIONS: This difference is due to the different time points at which total body water is calculated. Back extrapolation values correspond more closely to values of total body water obtained by alternative techniques.

Age Factors↗
PubMed1993

Patterns of infant weight gain in developing countries.

Data relating to weight of infants from 23 developing countries and two western industrialized populations taken from the literature were compared. Growth in the developing countries was extremely variable, but was poor compared to western standards such that by 12 months of age mean weight in all 23 populations was below the NCHS 50th percentile (P < 0.001) and in 11 populations mean weight was below the 10th percentile. Birth weight was not related to growth increment in the first 3 months. Multiple regression analysis showed birth weight and growth increments in the first four 3-month periods post-partum to be highly significantly related to weight at 12 months (P < 0.0001 in all cases). Growth increment in the first 3 months had the greatest effect out of these variables; the effect of the other four variables was similar. These patterns demonstrate the variable impact of environmental factors on growth in the first year of life.

Age Factors↗
PubMed1992

Paradoxical pain.

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Colonic Neoplasms↗
PubMed1992

Discriminant validity of a reduced set of Mini-Mental State Examination items for dementia and Alzheimer's disease.

Linear discriminant analysis was used to construct a series of discriminant functions including subsets of demographic variables and Mini-Mental State Examination item responses for a case series and a population sample. A 9-item discriminant function including the variables for time orientation, recall, calculation, copying a figure, age, writing, 3-step command, naming, and race distinguished demented subjects from community controls with 91% sensitivity and 88% specificity. The same discriminant function classified Alzheimer's disease patients and controls with 96% sensitivity and 98% specificity. This discriminant function has been cross-validated as a potential screening instrument for Alzheimer's disease in a community-based sample.

Aged↗
PubMed1991

Pain clinics and pain clinic treatments.

Chronic pain is multi-factorial, and consequently a multidisciplinary approach is essential for its proper management. Pain Clinics may treat acute pain, chronic pain and cancer pain, and need to differentiate between these different conditions. Careful diagnosis and assessment is essential, including history, examination, questionnaires and relevant investigations. A variety of treatments exist to manage chronic pain, some of which have already been discussed in this issue. Treatments may be summarized as drugs, surgical (including nerve blocks), stimulation techniques, psychological techniques and general or physical measures. If a Pain Relief Unit has the ability to provide all of these types of treatment, then it can manage any type of pain, with the ability to relieve pain and improve quality of life greatly in a significant number of sufferers.

Chronic Disease↗