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Biomedical subjects

J Wishart

Publications and source records attributed to J Wishart.

At least 37 records · Page 2Linked to original sources
PubMed1990

Relationship between forearm and vertebral mineral density in postmenopausal women with primary hyperparathyroidism.

Vertebral and forearm mineral density of 28 postmenopausal women with mild primary hyperparathyroidism was measured and compared with expected values on the basis of age and years since menopause. In these patients we found that the bone deficit in the distal forearm was greater than in the spine, and 8 patients had already suffered one or more peripheral fractures. This suggests that postmenopausal women with mild, asymptomatic hypercalcemia of primary hyperparathyroidism are likely to be relatively more predisposed to peripheral than vertebral fractures, which is clear evidence of the need for treatment to prevent bone loss in these patients.

Aged↗
PubMed1990

Treatment of postmenopausal hyperparathyroidism with norethindrone. Long-term effects on forearm mineral content.

In 15 postmenopausal women with mild primary hyperparathyroidism, the long-term effect of norethindrone therapy (5 mg/d) on forearm bone mineral content (FMC) was evaluated. The FMC rose from 810 +/- 39 (SEM) mg/cm at baseline to 841 +/- 41 mg/cm after 2 years of treatment, representing a mean bone mineral gain of 1.9% per year. The majority of this bone gain occurred during the first 6 months of treatment. The rate of increase in FMC in the first 6 months was +3.71 +/- 0.12 mg/cm per month compared with -0.35 +/- 0.51 mg/cm per month during the second year. Fat-corrected FMC was measured to determine whether the bone gain was real or reflected a decrease in fat mass. There was a similar rise in fat-corrected FMC (from 885 +/- 36 mg/cm at baseline to 909 +/- 39 mg/cm at 2 years). The difference between fat-corrected and uncorrected FMC, however, decreased slightly on norethindrone treatment (from 75.2 +/- 11.9 mg/cm at baseline to 67.8 +/- 11.8 mg/cm at 12 months), indicating a reduction in the subcutaneous fat layer. We conclude that norethindrone therapy in postmenopausal women with mild primary hyperparathyroidism produces a gain in bone mass that is sustained for at least 2 years.

Absorptiometry, Photon↗
PubMed1989

Relationships between gastric emptying of solid and caloric liquid meals and alcohol absorption.

The effects of three variations in meal composition (a solid and a liquid meal consumed together, a liquid meal consumed alone, and a liquid meal consumed 90 min after a solid meal) on the rates and patterns of solid and liquid gastric emptying were examined in 13 volunteers. By including alcohol (0.5 g/kg body wt) in the liquid meal, the relationship between alcohol absorption and gastric emptying was also assessed. The lag phase and the initial emptying phase of the solid meal were prolonged (P less than 0.001) when the liquid meal was consumed with the solid meal, compared with when the liquid meal was consumed 90 min after the solid meal. In this latter situation, consumption of the liquid meal caused the cessation of emptying of solid food, and this second lag phase was followed by a slower (P less than 0.001) than initial emptying phase. Gastric emptying of the liquid meal was slower (P less than 0.005) when solid food was present and was slowest (P less than 0.05) when liquid was consumed 90 min after the solid meal. Alcohol absorption was fastest (P less than 0.05) when the liquid meal was consumed alone and slower (P less than 0.01) when alcohol was consumed with or after the solid meal. For all three meals there was a close correlation (r greater than or equal to 0.91; P less than 0.001) between alcohol absorption and liquid emptying. We conclude that gastric emptying of liquid may be influenced by solid food and that the rate and pattern of solid emptying may be modified by the presence of liquid.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Gastric and oesophageal emptying in obesity.

Gastric and oesophageal emptying were evaluated in 31 obese patients and 31 control subjects. A double-isotope technique was used to measure gastric emptying of a mixed solid/liquid meal, and oesophageal emptying was measured as the time taken for a bolus of the solid meal to enter the stomach. Gastric emptying of the solid (p less than 0.001) and the liquid (p less than 0.02) meal and oesophageal emptying (p less than 0.001) were delayed in the obese patients compared with the control subjects. There were no significant relationships among gastric emptying, oesophageal emptying, and upper gastrointestinal symptoms in the obese patients alone, but in the total group of 62 subjects there were significant correlations between body mass index and both gastric (r = 0.44, p less than 0.01) and oesophageal (r = 0.45, p less than 0.001) emptying. These results indicate that delayed gastric and oesophageal emptying occurs frequently in obesity and that these abnormalities relate to body weight.

Adolescent↗
PubMed1988

Biochemical effects of calcium supplementation in postmenopausal osteoporosis.

Although calcium supplements are widely used in the treatment of osteoporosis their beneficial effect is not conclusively established. The biochemical effects of a calcium supplement (1 g/d) given for between 6 and 36 months were studied in 20 postmenopausal osteoporotic women who had normal calcium absorption. The mean fasting urinary hydroxyproline/creatinine ratio decreased from 0.024 +/- 0.002 to 0.016 +/- 0.001 (P less than 0.005) indicating a significant reduction in bone resorption. The mean plasma alkaline phosphatase fell from 85 +/- 4 U/l to 73 +/- 3 U/l (P less than 0.005), probably representing a secondary reduction in bone formation following the inhibition of bone resorption. There was no significant change in calcium absorption. These results support the concept that calcium supplementation is useful in the treatment of postmenopausal osteoporosis.

Alkaline Phosphatase↗
PubMed1987

The relation of forearm mineral density to peripheral fractures in postmenopausal women.

Forearm bone mineral density was measured in 557 postmenopausal women from whom a history of fractures was also obtained. Known cases of osteoporosis were excluded. The mean age of the subjects was 59 years. Ninety-eight of the subjects had sustained a fracture since the menopause and 37 had done so before the menopause. There had been 188 fractures in all. The mean bone density was significantly lower in the subjects who had experienced a fracture than in those who had not experienced a fracture; this was also true of subjects who had suffered a fracture before the menopause. The lowest bone densities were observed in subjects who had suffered forearm fractures, followed by those who had suffered fractures of the rib, ankle and foot. The mean bone density in subjects with more than one fracture was significantly lower than in those with only one fracture. The difference in bone density between subjects with and without a history of fractures was most significant in the younger subjects and became progressively less significant with age. The estimated relative fracture risk was 3.1 in the group with the lowest bone densities and zero in the group with the highest bone densities.

Female↗
PubMed1987

The effect of an oral calcium load on plasma ionized calcium and parathyroid hormone concentrations in osteoporotic postmenopausal women.

Plasma ionized calcium (IC) and parathyroid hormone (PTH) concentrations were measured in 31 osteoporotic postmenopausal women at hourly intervals for 5 hours after a 1 g oral calcium load. Fifteen subjects had normal radiocalcium absorption and 16 subjects were malabsorbers of calcium. IC rose and PTH fell after the calcium load in both groups with a plateau at 3-4 hours, and the rise in IC was greater (P less than 0.01) in the normal absorbers. There was a nonsignificant trend for the fall in PTH to be greater in the normal absorbers. In the group as a whole the mean increase in IC (above baseline) at 4 hours was directly related to calcium absorption (P less than 0.025) and the mean change in PTH was inversely related to calcium absorption (P less than 0.05). These results demonstrate that in subjects with postmenopausal osteoporosis the responses of IC and PTH to an oral calcium load are a function of calcium absorptive status.

Administration, Oral↗
PubMed1987

Gastric and esophageal emptying in dystrophia myotonica. Effect of metoclopramide.

Gastric and esophageal emptying were measured using scintigraphic techniques in 16 patients with dystrophia myotonica and in 22 normal volunteers. Gastric emptying of a solid meal was slower than the normal range (defined as the mean +/- two standard deviations obtained in the normal volunteers) in 15 of the 16 patients, and gastric emptying of the liquid meal was slower than the normal range in 10 of the patients. Esophageal emptying was also markedly delayed in patients, with 15 of 16 patients having an emptying time longer than the normal range. There was no relationship between gastrointestinal symptoms, or the severity of the peripheral (skeletal) muscle weakness, and either gastric or esophageal emptying. Oral administration of metoclopramide resulted in a significant improvement in gastric emptying of the solid meal and a nonsignificant trend toward more rapid liquid emptying, but no change in esophageal emptying. These results indicate that there is a very high prevalence of gastric and esophageal smooth muscle dysfunction in dystrophia myotonica and that gastroparesis is likely to be a treatable cause of morbidity in this disease.

Adult↗
PubMed1987

Effect of cisapride on gastric and esophageal emptying in insulin-dependent diabetes mellitus.

The effects of cisapride on gastric emptying, esophageal emptying, gastrointestinal symptoms, and glycemic control were evaluated in 20 insulin-dependent diabetics who had delayed gastric emptying of the solid or liquid component of a meal, or both. A double-isotope technique was used to measure gastric emptying, and esophageal emptying was measured as the time for a bolus of the solid meal to enter the stomach. On 2 days each patient received cisapride (20 mg) or placebo orally, 60 min before an esophageal and gastric emptying test. A third gastric and esophageal emptying test was performed after each patient had orally taken 10 mg of cisapride or placebo q.i.d. for 4 wk. Single-dose cisapride increased esophageal emptying (p less than 0.01) and both solid and liquid gastric emptying (p less than 0.001). The response to cisapride was most marked in patients with the greatest delay in esophageal and gastric emptying (p less than 0.05). After administration of cisapride for 4 wk, gastric emptying of solid and liquid were faster (p less than 0.001), but esophageal emptying was not significantly different from the placebo test. Upper gastrointestinal symptoms were less after cisapride (p less than 0.05), whereas there was no change on placebo (p greater than 0.2). Plasma glucose and glycosylated hemoglobin concentrations were not different after cisapride compared with placebo. These results indicate that single-dose cisapride increases esophageal emptying in insulin-dependent diabetics and that chronic administration of cisapride is effective in the treatment of diabetic gastroparesis.

Adult↗
PubMed1987

Effects of cisapride on gastric and esophageal emptying in progressive systemic sclerosis.

The effects of cisapride on gastric emptying, esophageal emptying, and gastrointestinal symptoms were evaluated in 8 patients with progressive systemic sclerosis who had delayed gastric emptying of the solid or liquid component of a meal, or both. A double-isotope technique was used to measure gastric emptying, and esophageal emptying was measured as the time for a bolus of the solid meal to enter the stomach. Gastrointestinal symptoms were assessed by a questionnaire. On 2 days each patient received cisapride (10 mg) or placebo intravenously, 5 min before an esophageal and gastric emptying test. After these 2 days each subject took cisapride (10 mg q.i.d., p.o.) for 1 mo. Cisapride improved solid and liquid gastric emptying (p less than 0.001), but had no significant effect on esophageal emptying (p less than 0.1). Upper gastrointestinal symptoms were reduced after cisapride (p less than 0.001), and no side effects were reported. These results indicate that gastroparesis is a treatable cause of morbidity in progressive systemic sclerosis.

Adult↗
PubMed1987

Lactose and calcium absorption in postmenopausal osteoporosis.

The prevalence of lactase deficiency and the relationship between lactose and calcium malabsorption in postmenopausal osteoporosis has been assessed in 46 subjects. Malabsorption of lactose occurred in 25 (54%) of the subjects and was associated with a significantly lower milk intake. Malabsorption of calcium occurred in 11 (44%) of the lactase-deficient subjects and in 11 (52%) of normal lactose absorbers. There was no relationship between lactose and calcium malabsorption. Vertebral and forearm mineral densities were not significantly different between normal lactose absorbers and lactase-deficient subjects.

Aged↗
PubMed1987

Treatment of postmenopausal hyperparathyroidism with norethindrone. Effects on biochemistry and forearm mineral density.

The effects of norethindrone (5 mg daily) on biochemical variables and forearm mineral density were assessed in 20 postmenopausal women with mild primary hyperparathyroidism. Norethindrone produced a significant fall in plasma calcium levels and the fasting urinary calcium-creatinine and hydroxyproline-creatinine ratios after three months of treatment. There was no change in the plasma parathyroid hormone concentrations. The forearm mineral density before treatment was low in 16 of the 20 patients and there was a significant increase in forearm mineral density after norethindrone treatment. No side effects were reported. We conclude that norethindrone is an effective treatment for mild hyperparathyroidism in postmenopausal women.

Aged↗
PubMed1984

Cell hydration in the normally grown, the premature and the low weight for gestational age infant.

Total body water (TBW), extracellular volume (ECV) and intracellular water (ICW) were measured in a cross-sectional study of 107 infants up to four weeks after birth. Three groups of infants were selected for study: (1) mature normally grown infants, (2) mature low weight for gestational age (LWGA) infants and (3) premature normally grown infants. In the normal mature infants there was no significant change in TBW during the first 6 days after birth but there was a small but significant (P less than 0.02) redistribution of extracellular water into the cells by the sixth postnatal day. This suggests that the normal weight loss in infants after birth is due to a relative starvation rather than cell dehydration. In the LWGA infants, TBW levels were higher than normal and ICW significantly increased. This index of cell mass further increased throughout the 14-day period studied (P less than 0.01) and was the highest of all groups studied. It is argued that the changes are due to cytoplasmic growth. Premature babies (mean weight approximately 2000 g and greater than 30 weeks gestation) had higher TBW values than their mature normally grown counterparts. Hyponatraemia was infrequent and no shift of water into cells was detected. All groups of infants revealed loss of ECV over the first two weeks and in premature infants the loss was commensurate with that of TBW.

Body Water↗
PubMed1982

Hydration in the first 24 h of postnatal life in normal infants born vaginally or by caesarean section.

A total of 65 infants, 48 born vaginally and 17 by segment caesarean section, were studied prior to labour for extracellular volume (ECV) (corrected bromide space) and total body water (TBW) (deuterium space) during the first 24 h of postnatal life. The infants were mature and growth retardation excluded. A 'heel stick' blood sample was taken for micro determination of Br and urine for 2H2O concentration. ECV varied from 343 +/- 27 ml/kg at 6 h to 358 +/- 21 ml/kg at 24 h and TBW was 75.5 +/- 3.4% of body weight. Contrary to current opinion, neither TBW nor cell hydration differed in infants born by caesarean section compared with those born vaginally. Such modern methodology to study infant body hydration and the critical assessment of growth and maturity demonstrates that hydration during the first 24 h of life is relatively stable and is not affected by the mode of delivery.

Birth Weight↗
PubMed1981

Systemic treatment of Darier's disease with an oral retinoic acid derivative Ro 10-9359 Tigason.

In an open trial, seven patients with Darier's disease took part in a three month study to evaluate the effect of a new oral synthetic retinoid. Ro 10-9359 (Tigason). The usual dose was 50 mg daily. At two-week intervals, lesions were graded with respect to their nature, erythema, keratosis, and percent of body surface area involved. All but one patient, were markedly improved on the drug, and showed a marked preference for the retinoid above other treatments. No patients withdrew because of side-effects but all suffered dry lips. Other side-effects were mild or moderate and well tolerated. It is concluded that Tigason is effective in Darier's disease.

Administration, Oral↗