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Biomedical subjects

J Stevens

Publications and source records attributed to J Stevens.

At least 271 records · Page 15Linked to original sources
PubMed1988

Variation in energy intake during the menstrual cycle: implications for food-intake research.

The relationship between spontaneous energy consumption and menstrual cycle was evaluated in 23 subjects who participated in one of two independent studies. Ad libitum intakes of experimental diets were measured by food weighing and bomb calorimetry for 56 or 42 d. Comparisons were made between each woman's mean energy during the 10 d before and after the onset of menstruation. The significant decline (364 kJ, or 87 kcal) between these two 10-d intervals was smaller than but consistent with findings from previous studies of data from food journals. In a separate analysis with time-series techniques, two distinct periods of elevated intake were identified (during the midluteal and midfollicular phases) that were independent of illness and menstrual symptoms. This pattern of food intake is discussed with reference to normal hormonal fluctuations. These findings confirm that menstrual cycle is a potential confounding variable that should be controlled in research on human food intake.

Adult↗
PubMed1988

Prognostic features of chronic myelomonocytic leukaemia: a modified Bournemouth score gives the best prediction of survival.

We have studied the clinical and laboratory features of 53 cases of chronic myelomonocytic leukaemia (CMML) defined according to the FAB criteria. A granulocyte count of greater than 16 X 10(9)/l or a monocyte count of greater than 2.6 X 10(9)/l correlated with a poorer survival, but the best predictor of poor survival was the modified 'Bournemouth' score in which one point each was allocated for Hb less than 10 g/dl, neutrophils less than 2.5 X 10(9)/l or greater than 16 X 10(9)/l, platelets less than 100 X 10(9)/l and bone marrow blasts greater than 5%. A score of 2 or more was predictive of poor survival (Chi2 = 10.25; P less than 0.001). Those patients with low monocyte and neutrophil counts and a low modified Bournemouth score tended to have a clinical course similar to refractory anaemia (RA) with an indolent course not requiring treatment and long survival whereas those with high monocyte and neutrophil counts and a high modified 'Bournemouth' score have a clinical course resembling that of refractory anaemia with excess of blasts (RAEB).

Aged↗
PubMed1988

Reduction in order turnaround time, telephone calls, and trips to the pharmacy by means of facsimile transceivers.

The facsimile transceiver (FAX) was trialed at Beverly Hospital, Beverly Massachusetts, on the Intensive Care Unit and the Pediatric Floor from March 13 to April 27, 1987. Beverly Hospital is a 233 bed non profit community hospital. The facsimile unit was used to transmit medication orders to the pharmacy over existing telephone lines. The purpose of the trial was to determine the time saved between the writing of the medication order and the arrival of the medication on the nursing unit. This time was considered as medication turnaround time. During the trial period, a total of 1767 medication order sheets were processed via the FAX machine. The results of the trial showed that medication turnaround time has improved by an average of 90 minutes for each order placed. In addition, it was found that a total of 60 phone calls and 14 trips to the pharmacy, per day, were eliminated from both trial units combined. This resulted in an estimated time savings of 6.5 staff hours per day on these two units alone. On a hospital-wide basis, this would result in considerable labor savings for nursing staff on the floors. In addition, supply costs of medication order sheets will be reduced by approximately $3200 per year if the FAX units were used throughout the hospital. As a result of the trial, Beverly Hospital purchased 9 units, at a cost of $17,325 and implemented a hospital-wide policy of sending medication orders to the pharmacy using this equipment. This will result in improved ability of the pharmacy to respond to new orders in a more timely manner, supply cost reductions and improved use of staff.

Costs and Cost Analysis↗
PubMed1988

Effect of fiber supplements on the apparent absorption of pharmacological doses of riboflavin.

The effect of dietary fiber from wheat bran and psyllium gum on the apparent absorption of riboflavin was studied in 12 healthy women. The test fiber was consumed in crackers that contained approximately 7.5 gm fiber from psyllium gum, wheat bran, or a combination of the two sources. Each subject was given a riboflavin load test after consuming one of the three different fiber supplements or a control supplement that contained 1.3 gm fiber. Fractional urine collections were made for 24 hours, and riboflavin was measured by fluorometric techniques. The psyllium gum and combination supplements reduced the 24-hour apparent absorption of riboflavin from 31.8% to 25.4% and 26.1%, respectively (p less than .01). No effect of the wheat bran supplement on riboflavin was detected.

Absorption↗
PubMed1988

Comparison of the effects of psyllium and wheat bran on gastrointestinal transit time and stool characteristics.

Gastrointestinal transit time, frequency of defecation, stool weight, and stool consistency were studied in 12 subjects who were each given fiber supplements containing wheat bran, psyllium gum, a combination of wheat bran and psyllium gum, or a low-fiber control for 2 weeks. Gastrointestinal transit time was measured using four different markers: plastic pellets, chromium mordanted bran, cobalt-ethylenediamine-tetraacetic acid, and terbium oxide. The wet weight and dry weight of stools were measured, and a questionnaire accessed subjects' perceptions of the consistency of their stools. Fiber supplementation decreased transit time and increased the daily number of defecations and the wet weight and dry weight of stools. Bran had a greater effect on transit time than psyllium. Psyllium had a greater effect on the amount of water found in the stools and the total stool weight. On the days that stools were passed, 50% of the daily stool ratings were scored as "hard" when subjects received the control supplement. Less than 10% of the ratings were scored as "hard" when subjects received the high-fiber supplements. The type of marker used did not significantly affect the transit time measured.

Adult↗
PubMed1988

Does dietary fiber affect food intake and body weight?

The effect of dietary fiber on energy intake or body weight has been the subject of numerous clinical studies. Critical examination of the studies shows that many have methodological problems that limit their usefulness. Problems include the absence of a placebo treatment, confounding with time, inadequate measurement of food intake, very low doses of fiber, inappropriately short treatment and observation periods, and multiple changes in the diet. The reviewed evidence indicates that supplementation with wheat bran has no effect on energy intake or body weight; however, other types of fiber may have an effect. Four studies showed that fiber supplementation resulted in a 0.2 to 0.4 kg/week greater weight loss in the treatment than in the control subjects. One study showed a decrease of 1,071 kcal/week in a subject's spontaneous intake. None of the studies reviewed followed subjects for longer than 3 months.

Body Weight↗
PubMed1987

Myxoedema presenting with chiasmal compression: resolution after thyroxine replacement.

A 60-year-old woman presented with deteriorating vision. A computed tomography (CT) scan showed pituitary enlargement with chiasmal compression. Serum prolactin levels were normal but assessment of thyroid function showed a serum thyroxine level of 25 nmol/l (normal range 76-160 nmol/l) and a thyroid-stimulating hormone (TSH) level of 60 mU/l (normal range 0.5-5.0 mU/l). After 8 weeks of thyroxine replacement therapy (0.05 mg daily increasing to 0.1 mg daily after 3 weeks) the visual defects had resolved, serum TSH had fallen to 0.7 mU/l, and the CT scan showed pronounced reduction in the size of the pituitary gland. Measurement of TSH as well as prolactin is essential in all patients with pituitary enlargement, to avoid unnecessary pituitary surgery.

Female↗
PubMed1987

Effect of psyllium gum and wheat bran on spontaneous energy intake.

Energy intake, fecal energy output, and gastrointestinal symptoms were measured in 12 females who consumed either approximately 23 g/d supplementary fiber or a 4 g/d fiber control. Fiber supplements were crackers containing psyllium gum, wheat bran, or a combination of the two fiber sources. After 1 wk on the control cracker, subjects consumed the three high-fiber crackers and the control cracker for 2-wk periods in a balanced design. Gum and combination supplements gave increased bloating and flatulence. Increase in abdominal pain was reported with gum supplement. Mean daily fecal energy was 96 kcal/d with control crackers and was increased by 63 kcal with high-fiber crackers. Gum and combination supplements significantly decreased intake of digestible energy by 153 and 115 kcal/d, respectively. This suppression was not dependent upon fiber intolerance. Wheat bran supplement had no effect on energy intake.

Adult↗
PubMed1987

Mean transit time measurement by analysis of a single stool after ingestion of multicolored plastic pellets.

Mean transit time (MTT) was measured in 12 females and served as a standard to evaluate the validity of different methods of estimating transit by analysis of a single stool (SST). Each subject consumed three different fiber supplements and a low-fiber control for 14-d periods. On days 4-8 of each period, subjects were given 20 plastic pallets, which varied in color each day. SST was calculated using from two to five sets of colored pellets and different criteria for designation of the stool to be analyzed were compared. Results indicate that the following modifications in the SST method originally proposed by Cummings and Wiggins will result in improved prediction of MTT: 1) Increase the days of dosing from 3 to 6.2) Collect for study the first stool passed 3 h after the last dosing. 3) Include all pellets identified in the selected stool in the SST calculation.

Defecation↗
PubMed1987

Unusual cranial and abdominal computed tomographic (CT) scan appearances in a case of systemic lupus erythematosus (SLE).

A 35 year old woman presented with headache and fever. Computed brain tomography showed diffuse low attenuation in the cerebral white matter. Several months later, serological tests for systemic lupus erythematosus (SLE) became positive. In spite of immunosuppressive therapy she relapsed after six months of treatment, presenting with abdominal symptoms and signs. On this occasion an abdominal CT scan showed distended and oedematous loops of bowel attributed to an underlying vasculitis. This case illustrates novel CT scan appearances in two systems involved in SLE.

Adult↗
PubMed1987

Prediction of survival in patients with femoral neck fractures.

A prospective study of factors which might help to predict mortality in patients with intracapsular fractures of the femoral neck has been undertaken. A multivariate analysis technique was used to analyse the collected data, and it was found that mental ability was the most significant variable; this factor had the greatest effect on outcome.

Aged↗