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Biomedical subjects

J Mann

Publications and source records attributed to J Mann.

At least 109 records · Page 6Linked to original sources
PubMed1998

Dignity and Health: The UDHR's Revolutionary First Article.

The modern human rights revolution emerges boldly from the first article of the Universal Declaration of Human Rights. Given the care lavished upon each word and phrase in the course of its elaboration, the syntax which places dignity before rights merits consideration. Dignity is clearly of vital individual and societal importance - individuals and societies spend considerable energy in the daily effort to protect, enhance and sustain their dignity. Dignity seems to flow from two components, one internal ("how I see myself") and the other external ("how others see me"). The impact on health for people living in an environment characterized by repetitive, severe and sustained violations of individual and collective dignity is likely to be substantial. It is increasingly evident that violations of dignity are pervasive events with potentially devastating negative effects on physical, mental and social well-being.

Journal Article↗
PubMed1998

The effect of pretwisting the ACL autograft on knee laxity.

This study was undertaken to determine whether pretwisting the bone-patellar tendon-bone autograft during primary anterior cruciate ligament (ACL) reconstruction had any effect on knee laxity. Patients were assigned to have twisted or nontwisted autografts based on the date of ACL reconstruction. The control group was comprised of 60 patients without graft twist, and the twist group was comprised of 60 patients who had 90 degrees of external twist applied to the graft prior to tibial fixation to reproduce the anatomic external twist of the native ACL. The average patient age was 28.8 years for the control group and 28.3 years for the twist group. Males accounted for 68% of the control patients and 73% of the twist patients. Meniscal tears were present in 45% of control and 52% of twist patients. Reconstructions were performed using an endoscopic, single-incision technique with interference screw fixation in the femur. Follow-up examination with KT-2000 arthrometry was performed when patients were within 10% of strength of the uninjured leg by isokinetic testing. KT-2000 testing at 30 lb revealed a mean side-to-side difference for reconstructed versus noninvolved knees of 1.06 for control patients and 1.08 for twist patients. The difference between the two groups was not statistically significant. All but three control and two twist patients had a Lachman and an anterior drawer examination graded as 0 to 1+. This difference also was not statistically significant. There were no clinical failures in either group. Furthermore, there was no statistically significant difference between groups clinically or by arthrometry when comparing tibial fixation with an interference fit screw versus suture fixation to a unicortical post. These results indicate that pretwisting the patellar tendon autograft in ACL reconstruction has no significant short-term effect on knee laxity as determined by instrumented testing or clinical examination.

Adult↗
PubMed1997

Randomised controlled trial of effect of fruit and vegetable consumption on plasma concentrations of lipids and antioxidants.

OBJECTIVES: To determine the extent to which plasma antioxidant concentrations in people with habitual low intake of fruit and vegetables respond to increased intakes of these foods. To examine whether advice to increase fruit and vegetables will result in reduction of concentrations of total and low density lipoprotein cholesterol. DESIGN: Randomised controlled trial in which intervention and control groups were followed up for eight weeks. The intervention group was asked to consume eight servings of fruit and vegetables a day. SETTING: Dunedin, New Zealand. SUBJECTS: Eighty seven subjects with normal lipid concentrations who ate three or fewer servings of fruit and vegetables daily. MAIN OUTCOME MEASURES: Plasma concentrations of vitamin C, retinol, alpha and beta carotene, alpha tocopherol, lipids, and lipoproteins. Dietary intake assessed with diet records over four days. RESULTS: The mean plasma vitamin C, alpha carotene, and beta carotene concentrations increased in parallel with increased dietary intake of fruit and vegetables in the intervention group. Concentrations of retinol, alpha tocopherol, lipids, and lipoproteins remained unchanged despite some increase in dietary vitamin E and a small reduction in saturated fat intake. CONCLUSIONS: Following a recommendation to increase fruit and vegetable consumption produces change in plasma concentrations of vitamin C, alpha carotene, and beta carotene likely to reduce incidence of cancer. More specific dietary advice to modify fat intake may be necessary to reduce the risk of cardiovascular disease mediated by lipoprotein and vitamin E.

Adult↗
PubMed1997

Protein intake and urinary albumin excretion rates in the EURODIAB IDDM Complications Study.

For people with insulin-dependent diabetes mellitus (IDDM) renal disease represents a life-threatening and costly complication. The EURODIAB IDDM Complications Study, a cross-sectional, clinic-based study, was designed to determine the prevalence of renal complications and putative risk factors in stratified samples of European individuals with IDDM. The present study examined the relationship between dietary protein intake and urinary albumin excretion rate (AER). Food intake was assessed centrally by a standardized 3-day dietary record. Urinary AER was determined in a central laboratory from a timed 24-h urine collection. Complete data were available from 2696 persons with IDDM from 30 centres in 16 European countries. In individuals who reported protein consumption less than 20% of total food energy intake, mean AER was below 20 microg/min. In those in whom protein intake constituted more than 20%, mean AER increased, a trend particularly pronounced in individuals with hypertension and/or poor metabolic control. Trends reached statistical significance for intakes of total protein (% of energy, p = 0.01) and animal protein (% of energy, p = 0.02), while no association was seen for vegetable protein (p = 0.83). These findings support the current recommendation for people with diabetes not to exceed a protein intake of 20% of total energy. Monitoring and adjustment of dietary protein appears particularly desirable for individuals with AER exceeding 20 microg/min (approximately 30 mg/24h), especially when arterial pressure is raised and/or diabetic control is poor.

Adolescent↗
PubMed1997

Changing caries prevalence in primary and permanent teeth of children in a Jerusalem neighbourhood.

The objective of the present study was to conduct cross-sectional surveys of caries prevalence in Jerusalem schoolchildren from one geographic region over time (9 years for 6-year-old first graders and 6 years for 9-year-old fourth graders), and to examine possible changes in caries levels. Dental caries was assessed among school children in one Jerusalem neighbourhood, employing the DMFS and dmfs indices, for permanent and primary teeth respectively. One epidemiologist in the team of examiners participated in all stages of the surveys and served as the calibrator. Data indicated a decline among 6-year-old children of mean DMFS scores from 1.64 in 1983, to 0.32 in 1992, and of mean dmfs values from 13.95 to 8.09. Among 9-year-old children, mean DMFS scores declined from 3.50 in 1986 to 2.50 in 1992. The water supply of Jerusalem was optimally fluoridated to 0.9 ppm in 1988, and this is suggested as a contributor to the decline in caries prevalence.

Child↗
PubMed1997

Meal frequency and plasma lipids and lipoproteins.

Epidemiological data suggesting benefits of increased meal frequency on CHD risk and lipid and lipoprotein levels may be flawed because of biases associated with the method of data collection. In normolipidaemic individuals increasing meal frequency from three to six or more meals daily over a period of several weeks appears to be associated with reduced levels of total and LDL-cholesterol, possibly due to reduced cholesterol synthesis or enhancement of reverse cholesterol transport. However, in non-obese individuals with polygenic hyperlipidaemia and non-insulin-dependent diabetes, altered meal frequency does not appear to confer similar benefits. The reasons for the different responses in these groups of subjects is not clear. The reported effects of altered meal frequency on diurnal levels of triacylglycerols and fatty acids are more variable, with benefits being reported principally in association with meal frequencies exceeding those which might be translated into practical recommendations. Present data preclude recommendations concerning meal frequency on the basis of effects on lipids and lipoproteins. Even in healthy individuals amongst whom benefits have been observed, the periods of observation have been relatively short and it is not known whether adaptation occurs. Further research should focus on longer-term studies in healthy individuals as well as hyperinsulinaemic and diabetic subjects. For those individuals choosing to have a large number of small meals each day, it is relevant to emphasize that no untoward effects of increased meal frequency on lipids or lipoproteins have been demonstrated.

Adolescent↗
PubMed1997

Iodine status of New Zealand residents as assessed by urinary iodide excretion and thyroid hormones.

The aims of this study were (1) to compare various measures of I status, and (2) to assess urinary I and thyroid hormone status of residents of two areas of New Zealand where, before the iodization of salt, goitre was endemic due to low soil I. A total of 189 subjects (102 males, eighty-seven females) were recruited from the Dunedin Blood Transfusion Centre, and 144 (sixty-seven males, seventy-seven females) from the Waikato Blood Transfusion Centre between November 1993 and June 1994. Blood was taken for thyroid hormone assays, and subjects collected a fasting overnight urine specimen, a double-voided fasting urine sample, and a complete 24 h specimen for iodide and creatinine analyses. Positive correlations (P < 0.0001) between daily iodide excretion and iodide concentrations in fasting and double-voided fasting urines, identical median values for iodide concentrations in the three samples, and similar numbers of subjects classified as at risk from I deficiency disorders according to the International Committee for the Control of Iodine Deficiency Disorders/World Health Organization categories (World Health Organization, 1994) confirmed indications from earlier studies that fasting urine samples were suitable for population studies. However 24 h urinary iodide excretion remains the recommended measure for individual I status. Waikato residents excreted more iodide in urine and all measures were significantly greater than for Otago residents. However median urinary iodide excretions for both areas (60 and 76 microgram/d for Otago and Waikato respectively) were considerably lower than those reported previously for New Zealand. Thyroid hormone concentrations were within normal ranges. Our findings suggest that I status of New Zealanders may no longer be considered adequate and may once again be approaching levels of intake associated with clinical I deficiency.

Adolescent↗
PubMed1997

Child survivors of suicide: psychosocial characteristics.

OBJECTIVE: To describe psychosocial characteristics of children and young adolescents who experienced the recent suicidal death of a parent or sibling. METHOD: Sixteen families with children aged 5 years to 14 years and who experienced the suicidal death of a relative on average within the year of research assessment were recruited from the community and evaluated with standard research instruments for levels of children's psychiatric symptoms and social adjustment. RESULTS: Child survivors of suicide had a higher rate of internalizing symptoms and poorer school adjustments than a standard community sample. Twenty-five percent of the families had children who reported clinically significant symptoms of depression. Approximately 40% of the families included children who reported at least moderate symptoms of posttraumatic stress. Approximately 31% of families had at least one child who reported suicidal ideation, but no child reported a suicide attempt. Significant associations were identified between psychosocial features of the children and parental psychiatric symptoms and stressful life events. CONCLUSION: Child survivors of suicide are at risk for psychiatric symptoms and social maladjustment which require early identification and preventive intervention to minimize risk for more extensive psychosocial morbidity.

Adolescent↗
PubMed1997

Large scale deletions in the GPC3 gene may account for a minority of cases of Simpson-Golabi-Behmel syndrome.

AIMS OF THE STUDY: To identify the proportion and type of deletions present in the glypican 3 (GPC3) gene in a group of patients with Simpson-Golabi-Behmel syndrome (SGBS). SUBJECTS AND METHODS: PCR analysis using primer pairs which amplify fragments from each of the eight exons of the GPC3 gene was carried out in a series of 18 families with SGBS (approximately half of reported cases). RESULTS: Deletions were detected in only five families (one reported previously). We found deletions in all exons of the gene except exon 3. CONCLUSIONS: Our results suggest that large scale deletions may be less common in SGBS than was originally thought. One patient, with an exon 4 and 5 deletion, lacked the characteristic facial dysmorphic features. This raises the possibility of involvement of GPC3 gene defects in a wider range of overgrowth disorders.

Abnormalities, Multiple↗
PubMed1997

The reasons for tooth loss in geriatric patients attending two surgical clinics in Jerusalem, Israel.

OBJECTIVES: Numerous studies around the world have been conducted in order to understand the reasons for tooth extractions in various age groups. Most studies have dealt with the general adult population but little attention has been paid to the elderly population. In Israel, as in most of the western countries, the elderly population is growing rapidly and thus demands for its dental needs are also increasing. In order to meet the dental requirements of the geriatric population, data on the main reasons of tooth mortality have been collected. DESIGN: Retrospective analysis of reasons for extraction divided into three categories: caries, periodontal disease and "other". SUBJECTS: The files of 302 consecutive elderly patients aged 65-95 years attending for extraction. The cause for tooth extraction was gathered from the written diagnosis described by the operator as well as from radiographs. Setting Two surgical clinics in Jerusalem serving low income residents. Results Results indicated that 30% of the extractions were due to caries, 65% were due to periodontal disease and only 6.4% related to "other" reasons. In both, males and females, periodontal disease was the major cause for tooth loss yet, females exhibited more extractions due to caries than males (35% vs 23% respectively). A relatively high incidence of tooth loss was documented for the 85+ age group. Of the teeth that were extracted, incisors and molars were equally the most frequent (29%) followed by premolars (26%) and canines (17%). Premolars were the teeth most frequently extracted out of the teeth removed due to caries (32%) whereas incisors were the most frequently removed within the group of teeth extracted due to periodontal disease (31%). CONCLUSIONS: The results of this study point to the importance of prevention and treatment of dental diseases, particularly periodontal disease, in adults aged 0 years and above in order to prevent tooth loss in their later years.

Aged↗
PubMed1997

Smoke rising.

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Adolescent↗