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Biomedical subjects

M J World

Publications and source records attributed to M J World.

25 records · Page 2Linked to original sources
PubMed1987

Palmitoyl-catechin for alcoholic liver disease: results of a three-month clinical trial.

A prospective randomized double-blind trial of 3-palmitoyl-(+)-catechin at a dose of 1500 mg daily (500 mg t.d.s.) for 3 months vs placebo has failed to demonstrate statistically significant clinical, biochemical or histological benefit in patients with biopsy-proven alcoholic liver disease. Nevertheless, this trial has confirmed the beneficial effect of a reduction in the rate of alcohol consumption on alcoholic liver disease. Apart from clinical evidence of a higher rate of alcohol consumption by patients receiving the active drug during the trial, no adverse side-effects were identified and for this reason, it is suggested that a further trial should be considered with the daily dosage so far used in man (20 mg/kg) increased toward that (100 mg/kg) employed with benefit in animal experiments.

Alcohol Drinking↗
PubMed1985

Alcoholic malnutrition and the small intestine.

Malnutrition is common in chronic alcoholics, although its severity may depend on the social characteristics of the patient group under study and their severity of alcohol dependence. General malnutrition is often reflected in body weight loss, mainly of adipose and muscle tissue. This loss of nutritional reserves is partly due to inadequate protein intake in the face of continued alcohol ingestion. However, there is also evidence that ethanol is relatively ineffective as a source of calories, in spite of its high theoretical calorific value. An increased metabolic rate and tissue oxygen consumption following alcohol ingestion, without parallel increases in phosphate bond energy production or anabolic processes demonstrate the poor value of ethanol as an alternative calorie source to carbohydrate, fat or protein. This situation of nutritional imbalance is often compounded in chronic alcoholics by the effects that ethanol has on gastrointestinal function. These include increased mucosal permeability which may lead to 'leakage' of nutrients from the blood to the gut lumen, increased gut motility with increased transit times, and impaired salt and water absorption. Alcohol inhibits absorption of vitamins and nutrients by active transport processes, an effect that may be crucial in precipitating specific nutrient deficiencies (e.g. thiamine) in the alcoholic, in addition to the role of reduced dietary intake of vitamins and minerals in alcoholics that also contributes to such deficiency states. The end result may be severe functional impairment and tissue damage in other organs, notably the liver and the brain, as a consequence of specific vitamin and nutrient deficiencies arising in chronic alcoholics by these mechanisms.

Adenosine Triphosphate↗
PubMed1984

(+)-Cyanidanol-3 for alcoholic liver disease: results of a six-month clinical trial.

A prospective randomized double-blind trial of (+)-cyanidanol-3 at a dose of 2 g daily (500 mg qds) for six months versus placebo has failed to demonstrate statistically significant clinical, biochemical or histological benefit in patients with biopsy-proven alcoholic liver disease although certain trends were identified. The group receiving the active drug tended to drink more both before and during the trial and had mean serum aspartate aminotransferase (AsT) and gamma-glutamyltranspeptidase (gamma-GT) levels which were higher on admission to the trial. After the fourth week of treatment, the mean serum levels of these enzymes remained consistently lower in the group receiving the active drug. In order to reproduce the beneficial effects of the drug observed in the rat, it is suggested that further trials be conducted with the dosage so far used in man (ca. 20-40 mg/kg daily) increased toward that successfully employed in animal experiments (200 mg/kg daily).

Alcohol Drinking↗
PubMed1984

Differential effect of chronic alcohol intake and poor nutrition on body weight and fat stores.

A six-months out-patient study of chronic alcoholics with undecompensated liver disease has shown a statistically significant inverse correlation between the change in mean corpuscular volume and the change in body weight (r = -0.4, P less than 0.01). A fall in body weight over this period was the best clinical indicator of apparently continuing alcohol abuse. Previous anthropometric studies have indicated that reduced adipose tissue is one cause of lower body weights in such patients. To determine whether this is due to the effects of alcohol or of poor nutrition, the epididymal fat pad weights of rats following 28 days administration of alcohol (36% of total calories) as part of a nutritionally adequate liquid diet were compared with those of pair-fed controls initially matched for body weight. At the end of the experiment, body weight gain was the same in both groups but the mean weight of the fat pads of alcohol-fed animals (371.7 mg +/- 60.0 mg SD) all of which developed hepatic steatosis was 29% greater than that of pair-fed controls (288.7 mg +/- 42.4 mg). This difference was statistically significant (P less than 0.025). This study shows that alcohol intake per se does not prevent an increase in body weight or fat even if hepatic steatosis is induced and that loss of adipose tissue in chronic alcoholics who continue to drink is probably due to simultaneous inadequate nutritional intake.

Adipose Tissue↗
PubMed1976

Variables discriminating between cryptogenic glomerular lesions in adults with the nephrotic syndrome.

A univariate analysis of individual clinical and biochemical values of adult patients with cryptogenic nephrotic syndrome has shown that significant differences exist between patients with proliferative glomerulonephritis, 'minimal change' nephritis and membranous nephropathy. For any given adult patient with the condition, the most likely clinical diagnosis is proliferative disease and the next, minimal change. These two diagnoses together account for most cases. The best clinical discriminants between them are the systolic blood pressure and plasma cholesterol concentration. If the systolic pressure is greater than 145 mm Hg proliferative disease is more likely, but if the cholesterol is greater than 530 mgm/100ml, a minimal change lesion is more likely. A scattergram for combining these variables in clinical practice is given, showing a zone of uncertainty where renal biopsy would be indicated. Although single variables do not permit discrimination between membranous nephropathy and the other two groups, it is suggested that analytical techniques where combinations of variables are used may be helpful, and should be developed.

Adolescent↗
PubMedDate not supplied

Side effects of mefloquine prophylaxis for malaria: an independent randomized controlled trial.

A prospective randomized double-'blind' trial was undertaken during a military exercise in East Africa to determine whether there was a significant difference in the incidence of side effects experienced by soldiers taking mefloquine 250 mg weekly compared with those taking chloroquine 300 mg weekly and proguanil 200 mg daily as chemoprophylaxis for malaria. Subject to their informed voluntary consent, male soldiers who were not aviators were included in the study. Identical questionnaires were completed voluntarily at the end of 2 and 8 weeks. Symptoms were classified by nature into-'all', 'neuropsychological', 'enteric' and 'other', and by severity into 'severe' and 'very severe'. The proportions of respondents experiencing side effects were compared to seek statistically significant differences between the chemoprophylactic groups. Questionnaire 1 was completed after 2 weeks by 183 of 317 subjects (58%) randomly assigned mefloquine and by 176 of 307 subjects (57%) randomly assigned chloroquine-proguanil. The incidence of putative side effects was not significantly different between the groups (71/183 vs. 70/176), odds ratio 0.96 (95% confidence interval [CI] 0.63 to 1.47). Questionnaire 2 was completed after 8 weeks by 145 of 317 subjects (46%) randomly assigned mefloquine and by 142 of 307 subjects (46%) randomly assigned chloroquine-proguanil. The incidence of putative side effects was still not significantly different between the groups (95/145 vs. 103/142), odds ratio 0.72 (95% CI 0.43 to 1.19). None of the subjects developed a serious neuropsychological reaction. Among respondents, 12.8% and 38% admitted lack of full compliance at 2 and 8 weeks, respectively. Exclusion of these subjects during a secondary analysis did not affect the results. None of the subjects developed malaria in the 12 months following return to the UK. Subject to the limitations of a response rate that was smaller than desired and the fact that the study was conducted in fit male military personnel, these results support evidence which indicates that mefloquine is no more toxic than chloroquine-proguanil.

Africa, Eastern↗