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Biomedical subjects

J Mann

Publications and source records attributed to J Mann.

At least 145 records · Page 8Linked to original sources
PubMed1995

Individual variation in plasma cholesterol response to dietary saturated fat.

OBJECTIVE: To determine the extent to which plasma lipid concentrations of individuals are consistently sensitive to changes in saturated fats; to examine whether groups that consistently have large or small responses can be defined; and to identify factors which predict response of lipids to dietary change. DESIGN: A double crossover design in which two diets (S, providing 21% energy from saturated fat, and P, providing 10%) were followed for periods of six weeks in the sequence SPSP or PSPS. SETTING: 67 free living subjects, total cholesterol 5.5-7.9 mmol/l. MAIN OUTCOME MEASURES: Relation of cholesterol responses to repeated dietary changes and of potential predictors and cholesterol response. RESULTS: Similar average changes in cholesterol mask a wide range of individual responses. Response was not related to compliance. In all participants the change in cholesterol observed when the nature of dietary fat was changed on the two crossovers was correlated (r = 0.31, P = 0.01); the degree of correlation between the two sets of responses was greater in the 46 consistent responders than in the 21 variable responders (r = 0.71 v r = 0.21). Mean differences in cholesterol between diet S and diet P during the two crossovers were 1.16 (SD 0.35) mmol/l and 0.95 (0.26) mmol/l for consistent hyperresponders and 0.18 (0.26) mmol/l and 0.18 (0.25) mmol/l for consistent minimal responders. In consistent responders, changes in total cholesterol in response to increasing saturated fats correlated with baseline cholesteryl ester transfer activity (r = 0.32, P = 0.03); total cholesterol (r = 0.37, P = 0.01); triglycerides (r = 0.30, P = 0.04); and apolipoprotein B (r = 0.54, P = 0.01). CONCLUSIONS: There is a degree of consistency in cholesterol response to instructions to change dietary fat which is not explained by dietary compliance, and there are groups of consistent hyperresponders and minimal responders within a population of hypercholesterolaemic individuals. Several factors predicting response have been identified. These results have relevance to dietary approaches aimed at reducing the lipoprotein mediated risk of coronary heart disease.

Adult↗
PubMed1995

Re-inventing WHO.

Explore the source record for details and available documents.

Global Health↗
PubMed1995

Dilated cardiomyopathy is associated with an increase in the type I/type III collagen ratio: a quantitative assessment.

OBJECTIVES: The aim of this study was to quantify total collagen and the type I/type III collagen ratio and their localization in hearts with dilated cardiomyopathy. BACKGROUND: Patients with dilated cardiomyopathy have an increase in intramyocardial fibrillar collagen. Types I and III are the main constituents and have different physical properties that may affect cardiac compliance. METHODS: Nineteen hearts with dilated cardiomyopathy were studied (17 cardiac explants, 2 hearts obtained at autopsy) and compared with reference hearts. Total collagen was determined by hydroxyproline analysis. Collagen types I and III were analyzed using the cyanogen bromide method and immunohistochemical analysis followed by microdensitophotometric quantification. Localization of collagen types I and III was established at the light and electron microscopic levels. Immunoelectron microscopy provided information regarding their localization. RESULTS: Total collagen and the collagen type I/type III ratio were increased in hearts with dilated cardiomyopathy (p < 0.05). Electron microscopy showed a diffuse increase in collagen fibrils in the endomysium; the perimysium showed an inhomogeneous increase. Collagen fibrils were thicker, and fibrous long-spacing collagen occurred in the endomysium. Immunoelectron microscopic findings confirmed an increase in type I collagen. CONCLUSIONS: Hearts with dilated cardiomyopathy have a statistically significant increase in the collagen type I/type III ratio. The changes occur in the endomysium and perimysium, although with differences in distribution. These changes in intramyocardial collagen may be clinically relevant because they may affect cardiac rigidity and, therefore, eventually may render the heart less compliant. Further studies are needed to evaluate at what point in the course of the disease these changes appear.

Adolescent↗
PubMed1995

As good as anyone: antenatal shared care at an inner Sydney hospital.

An exploratory survey design was used to assess satisfaction with antenatal care over a two-month period of women giving birth in an inner Sydney teaching hospital. Patients received obstetric services from private obstetricians, midwives, the hospital outpatient clinic, or 'shared care' between general practitioners and the outpatient clinic or birth centre. Insurance status and demographic information were collected across all groups. Shared care patients gave reasons why they chose that model of antenatal service. Ten per cent of women in the sample received shared care. Shared care patients were equally as satisfied as those in other modes of care in all but one factor--promptness of service (in which private obstetricians received higher ratings). They also judged shared care to have the advantages of being convenient, personal, and culturally appropriate. Significantly more patients in the shared care group were born overseas and they were less likely to hold private insurance. This paper discusses the results of the current study in the context of the Australian literature, explores some issues surrounding satisfaction research, and suggests further research arising from this work.

Australia↗
PubMed1995

Variables affecting denture satisfaction in Israeli elderly: a one year follow-up.

The purpose of this study was to investigate patient satisfaction with complete dentures after one year of use and several potential mitigating factors in Israeli elderly. Eight-four patients who were 54 years of age or older and who were rehabilitated with complete dentures were recalled for examination 12-15 months later; 84.5% (n = 70) were interviewed and reexamined by calibrated examiners who judged all prostheses to be clinically acceptable. The mean age of participants was 71.90 years and two-thirds were females. Over 73% reported that they wore their dentures "always." Nearly 79% indicated that they were pleased with their denture appearance. Difficulties were reported by 28.2%, while 46.5% reported difficulties with chewing. Chewing problems were significantly related to swallowing problems (P < .001); food enjoyment "as much now as you did five years ago" (P < 0.001); difficulties speaking (P < 0.05); and "having sores under your dentures" (P < 0.01) which affected 28.2% of the survey group. Married elderly expressed higher satisfaction with denture comfort as compared to "single" patients, and patients suffering from any systemic chronic diseases were more dissatisfied with appearance. A summary satisfaction scale of 7 items was constructed (Cronbach alpha reliability 0.6834) and logistic regression performed to identify key model variables for overall satisfaction. Stat sign findings included: 1) immigration year; 2) neurological or psychological disorder; and 3) age. The model correctly classified 92.75%. Findings suggest that a variety of factors may influence denture satisfaction. Gathering detailed information by means of a questionnaire before new denture fabrication may be an important tool for the dentist in predicting and consequently enhancing patient satisfaction with complete dentures.

Adult↗
PubMed1995

Emergency appendicectomy and meat consumption in the UK.

STUDY OBJECTIVE: To compare the rates of reported emergency appendicectomies in a cohort study of vegetarians and non-vegetarians by participants' history of meat consumption. DESIGN: This was a prospective cohort study in which participants were asked about their lifetime history of meat consumption/avoidance and, separately, whether they had had an appendicectomy. Appendicectomy was described as either "emergency" or "non-emergency" according to details supplied by the participant. SETTING: The United Kingdom. PARTICIPANTS: These comprised more than 11000 people, of whom 4852 (44%) completed both an appendicectomy form and a dietary questionnaire giving details of their lifetime history of meat consumption. MAIN RESULTS: The percentage who reported an emergency appendicectomy was higher among lifelong meat eaters (10.7%) than either lifelong non-meat eaters (7.8%) or those who had stopped eating meat (8.0%); and the operations were performed at an earlier age in this first group (mean values 18.9, 26.0, and 19.6 years respectively). The overall age adjusted emergency participants who did not eat mean with those who ate meat was 0.47 (95% confidence interval 0.35, 0.65). CONCLUSION: The results suggests that people who do not eat meat have a 50% lower risk of requiring an emergency appendicectomy than those who do. The data do not, however, allow the reliable testing of other hypotheses, so meat consumption may simply be a marker for another dietary, lifestyle, or socioeconomic factor.

Aged↗
PubMed1995

Uncompensated care: hospitals' responses to fiscal pressures.

This Data Watch examines the impact of hospital competition, the Medicare prospective payment system (PPS), and Medi-Cal selective contracting on the provision of uncompensated care by private hospitals in California during 1980-1989. It finds that hospitals subject to more intense competition and greater fiscal pressure from Medicare and Medi-Cal reduced their provision of uncompensated care relative to hospitals facing less pressure from these sources. We estimate that had hospitals not been subjected to increasing price competition from growth of managed care plans and financial tightening in public programs, they would have provided 36 percent more uncompensated care than was actually provided in 1989.

California↗
PubMed1995

Trans fatty acids: a cause for concern?

The recommendation to reduce total and saturated fat is incorporated into the dietary guidelines for the general population in many western countries. In addition, dietary modification to reduce substantially the intake of saturated fats is a cornerstone of treatment in the hyperlipidaemias. Concern has recently been expressed regarding possible deleterious effects of trans isomers of unsaturated fatty acids on the lipoprotein profiles of both normo and hypercholesterolaemic persons. This review seeks to examine recent research in this area with a view to considering possible changes in the present dietary recommendations.

Coronary Disease↗
PubMed1995

Periodontal treatment needs and oral hygiene among Ethiopian immigrants.

Periodontal disease studies in developing countries over the past four decades indicate periodontitis to be a major problem, even in populations with relatively low caries rates. The aim of this study was to document levels of periodontal treatment needs, as well as oral hygiene levels for a large sample covering all ages of an Ethiopian Jewish population recently immigrated into Israel. Over 800 subjects from the total of 15,000 Ethiopians who immigrated were examined utilising the PTNS Index and the OHI-S Index. Results indicate that all the examined population was in need of oral hygiene instruction. Almost 80 per cent are in need of scaling and approximately 20 per cent are in need of more complex treatment such as surgery. Significant differences were found according to age. This could be attributed to the high OHI-S scores, ranging from 2.53 at age 0-12 to 4.82 at the 51+ age group, with a mean Debris Index of 2.12 for the total population. It is suggested that this population should be exposed immediately to preventive and treatment programmes to improve oral hygiene and decrease needs for future, costly periodontal treatment.

Adolescent↗
PubMed1995

Effects of coconut oil, butter, and safflower oil on lipids and lipoproteins in persons with moderately elevated cholesterol levels.

The physiological effects of coconut oil, butter, and safflower oil on lipids and lipoproteins have been compared in moderately hypercholesterolemic individuals. Twenty eight participants (13 men, 15 women) followed three 6-week experimental diets of similar macronutrient distribution with the different test fats providing 50% total dietary fat. Total cholesterol and low density lipoprotein cholesterol were significantly higher (P < 0.001) on the diet containing butter [6.8 +/- 0.9, 4.5 +/- 0.8 mmol/l] (mean +/- SD), respectively than on the coconut oil diet (6.4 +/- 0.8; 4.2 +/- 0.7 mmol/l) when levels were significantly higher (P < 0.01) than on the safflower diet (6.1 +/- 0.8; 3.9 +/- 0.7 mmol/l). Findings with regard to the other measures of lipids and lipoproteins were less consistent. Apolipoprotein A-I was significantly higher on coconut oil (157 +/- 17 mg/dl) and on butter (141 +/- 23 mg/dl) than on safflower oil (132 +/- 22 mg/dl). Apolipoprotein B was also higher on butter (86 +/- 20 mg/dl) and coconut oil (91 +/- 32 mg/dl) than on safflower oil (77 +/- 19 mg/dl). However gender differences were apparent. In the group as a whole, high density lipoprotein did not differ significantly on the three diets whereas levels in women on the butter and coconut oil diet were significantly higher than on the safflower oil diet. Triacylglycerol was higher on the butter diet than on the safflower and coconut oil diets but the difference only reached statistical significance in women. Cholesteryl ester transfer activity was significantly higher on butter than safflower oil in the group as a whole and in women.(ABSTRACT TRUNCATED AT 250 WORDS)

Butter↗
PubMed1995

The global AIDS pandemic. Toward a new vision of health.

The AIDS pandemic has not been brought under control in any community or nation as its impact continues to worsen. The program-based strategy developed in the mid-1980s was important in placing AIDS on national and global agendas. From the laboratory and healthcare facilities will come many answers to the AIDS pandemic, some opening new prospects for effective prevention and care. The global fight against AIDS has now reached a critical stage in which complacency and loss of direction threaten the opportunity to effectively curb the course of the pandemic, mitigate its impact, and stimulate the emergence of a modern concept of health and society.

AIDS Vaccines↗