Ethnic differences in infant health.
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Birth Weight↗
Biomedical subjects
M Pearson
Publications and source records attributed to M Pearson.
Elemental diet in the management of Crohn's disease during pregnancy.
Four patients with Crohn's disease were treated with an elemental diet during pregnancy. Two had active disease and two also had symptoms of small intestinal obstruction. All went into a clinical remission within a few days of starting treatment. Treatment periods varied from two to four weeks, and were followed by elemental diet as a supplement to normal food in two patients. At term, all delivered a healthy infant. These patients indicate that elemental diet is a safe form of treatment for Crohn's disease during pregnancy and may be considered as an alternative to conventional drug treatments which carry a theoretical risk of teratogenesis.
Adult↗
Low anthropometric indices in elderly females with fractured neck of femur.
Anthropometric measurements were made in 3 groups of elderly females (1) with fractured neck of femur, (2) those admitted to acute medical and geriatric wards, and (3) healthy women in the community. Mid-arm circumference was different in the three groups with mean values of 22.8 +/- 0.21 cm, 25.9 +/- 0.41 cm and 28.6 +/- 0.27 cm respectively; (p < 0.001 for all comparisons). Triceps skinfold thickness was 24.7 +/- 0.70 mm in the healthy elderly but only 13.0 +/- 0.59 mm in the fracture group (p < 0.001). Fractured femur patients are therefore thinner than both healthy controls and unselected elderly female medical in-patients. These differences are most apparent in anthropometric indices dependent on body fat and this may be significant in terms of the aetiology of fractured femur.
Journal Article↗
A small-scale controlled environment chamber for the investigation of the effects of pollutant gases on plants growing at cool or sub-zero temperature.
A new, small-scale controlled environment plant growth chamber is described, which permits accurately controlled temperatures from ambient (c. 20 degrees C) down to -5 degrees C in the day or -15 degrees C at night. The system also allows controlled injection of pollutant gases. The chamber is based on a modified commercial chest freezer with temperature control achieved through by-passing the cooling coils in the inner walls of the freezer. This by-pass is controlled by a BBC microcomputer which gives nominal temperature control to 0.1 degrees C over definable diurnal temperature profiles. Photoperiod is also controlled by the microcomputer. The chamber forms a virtually closed system to which pollutant gases are added by injection from low concentration cylinders, regulated using mass flow controllers. The accuracy with which pollutant concentrations are controlled is increased by filtration of the air-stream after passing over the experimental plants: i.e. a 'single-pass' system is adopted. In operation air temperatures across the chambers are controlled to within 1-1.5 degrees C of the pre-set value over the range 25 to -10 degrees C. Leaf temperatures are 2.5-3.0 degrees C above air temperatures during the day, with a total energy input of c. 180 Wm(-2) from two 400 W metal halide lamps. The lamps provide a photon fluence rate of 270+/-30 micromol quanta PAR m(-2) s(-1) at plant height. During the dark, leaf temperatures deviate less than 1.0 degrees C from air temperature. Soil temperatures are controlled separately from air temperature and are held above zero at all times. To date, fumigation, with NO(2) and SO(2) has been confined to the daytime. At pre-set concentrations of 20 nl litre(-1) variations during fumigation were less than 2.0-2.5 nl litre(-1) and 0.5 nl litre(-1), respectively.
Journal Article↗
High resolution computed tomography of Pneumocystis carinii pneumonia in AIDS.
High resolution computed tomography (CT) was performed on 11 homosexual men with the Acquired Immune Deficiency Syndrome (AIDS). All had bronchoscopically proven Pneumocystis carinii pneumonia (PCP). Six patients were re-scanned following treatment and symptomatic recovery. All the scans were abnormal, most showing fine diffuse bilateral alveolar consolidation with bronchial wall thickening, despite having a normal or near-normal chest radiograph in three cases. A variety of unexpected changes such as peripheral consolidation only, upper or lower zone predominance, unilaterality, bronchial dilatation, cystic air spaces and sub-pleural sparing were also seen. Following therapy, resolution of CT changes was shown to be incomplete despite clinical recovery, and whilst all the cases showed a reduction in alveolar consolidation, other findings such as new interstitial shadowing, peripheral predominance, and persistent cystic changes were observed, suggesting the healing process to be complex. Whilst the changes of PCP and its progression following treatment are well described on the plain chest radiograph, this is the first specific documentation of its appearances on narrow section CT, and its response to therapy. The usefulness of high resolution CT scanning to show early infection with PCP in the face of a normal chest radiograph is discussed, and the wide variety of CT changes occurring once the disease is established is emphasized.
Acquired Immunodeficiency Syndrome↗
Aspects of protein metabolism after elective surgery in patients receiving constant nutritional support.
1. The present study was designed in an attempt to resolve conflicting views currently in the literature relating to the effect of surgery on various aspects of protein metabolism. 2. Sequential post-operative (2, 4 and 6 days) changes in whole-body protein turnover, forearm arteriovenous difference of plasma amino acids, glucose, lactate and free fatty acids, muscle concentration of free amino acids, RNA and protein, urinary nitrogen and 3-methylhistidine, plasma concentrations of insulin, cortisol and growth hormone, and resting metabolic rate, were measured in six patients undergoing uncomplicated elective total abdominal hysterectomy. 3. All patients received a constant daily diet, either orally or intravenously, based on 0.1 g of nitrogen/kg and an energy content of 1.1 times the resting metabolic rate for 7 days before and 6 days after surgery. 4. Whole-body protein turnover, synthesis and breakdown increased significantly 2 days after surgery (P less than 0.05) and returned towards pre-operative levels thereafter. 5. Forearm release of branched-chain amino acids and alanine, and efflux of glucose and lactate, were enhanced 4 days after surgery (P less than 0.05). Muscle glutamine and alanine concentrations were decreased on the fourth and sixth days after surgery (P less than 0.05). The RNA/protein ratio (indicating the capacity for protein synthesis) was unaltered. 6. A significant increase in urinary nitrogen and 3-methylhistidine was observed on days 3 and 4 after surgery (P less than 0.05). Thereafter, these parameters remained elevated, although failing to reach statistical significance.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Ten years' experience with an elemental diet in the management of Crohn's disease.
The immediate and longterm outcome of treating patients with acute Crohn's disease with an elemental diet was studied retrospectively. Successful diet induced remission was achieved in 96 of 113 patients (85%) regardless of age, sex, site or severity of disease, or associated complications of strictures, fistula, or perianal disease. Treatment was unsuccessful in 17 patients (15%), but there were no features at the outset of treatment that distinguished these patients from those who had successful remission. The longterm outcome of treatment was assessed over a five year period by analysis of life tables and survival curves. Twenty two per cent of the patients relapsed within six months of treatment and thereafter the annual relapse rate was 8-10%. Patients with disease complicated by fistula or perianal involvement had early relapse, approaching 100% for the latter. A further retrospective comparison of longterm outcome of diet v steroid induced remissions showed no significant difference in the relapse rates between the two groups at one, three, and five years.
Adolescent↗
Self-consciousness, self-esteem and depression of gifted school children.
38 gifted students from north central school districts were administered the Coopersmith Self-esteem Inventory--Short Form, the Self-consciousness Scale, and the Children's Depression Inventory. The gifted students' mean score on depression was below the cut-off and so did not indicate depression while their mean score on self-esteem was within average range. The Pearson correlation for self-esteem and lie scores was significant and positive, indicating, if the lie scores are high, the self-esteem scores tend to be high. The General Self-consciousness mean was low; students spend time examining their own behavior and thought. The Private Self-consciousness mean was low and suggests, however, these students tend to avoid thinking about themselves and are not so overly concerned with self-examination that this interferes with everyday function. On Public Self-consciousness a borderline low mean score allows the inference that these students display little concern about how others will react to them in social settings, how they appear to others, that is, they show some insensitivity associated with high self-confidence. The mean on Social Anxiety was within the normal limits.
Child↗
Directions for a new decade.
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Hospital Auxiliaries↗
Is CT scanning essential in the pre-operative assessment of lung cancer?
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Health Services↗
Maternal translocation (9;18) with two abnormal offspring each with different chromosome derivatives.
We report a phenotypically normal woman with an apparently balanced reciprocal translocation between chromosomes 9 and 18 [46,XX,t(9;18)(p22;p11.2)], giving rise to unbalanced chromosome complements in two of her children, each of whom received a different derivative chromosome. The proband's karyotype is 46,XY,-18,+der(18), t(9;18)(p22;p11.2)mat, which results in a duplication of the distal portion of the short arm of chromosome 9 with a concomitant deletion of much of the short arm of chromosome 18. The karyotype of the proband's brother is 46, XY,-9,+der(9),t(9;18)(p22;p11.2)mat, which results in a deletion of the distal short arm of chromosome 9 and a duplication of most of the short arm of chromosome 18. The phenotype of each child is significantly different from that of his sib and is not consistent with any previously reported chromosome abnormality.
Child↗
Inpatient-outpatient randomized comparison of Cambridge diet versus milk diet in 17 obese women over 24 weeks.
Twenty-two obese women were recruited for a prospective cross-over trial of the effects of either the Cambridge Diet (CD) or 1200 ml milk with iron and vitamin supplements (milk) during a three-week inpatient study, then 20 weeks as outpatients, then a final week as inpatients. Five dropped out, leaving eight who took initially milk and then CD and nine who took CD and then milk. Within each diet group five women had their jaws wired together during the outpatient phase. The four groups (CD/milk, with/without jaw wiring) were initially well matched for age, height, weight and resting metabolic rate (RMR). There was no significant difference (by unpaired t test) between the groups during the initial inpatient phase in rate of weight loss, or N loss/kg weight loss, but patients on CD during days 13-22 had a greater daily N loss than those on milk (2.08 vs 0.28 g N/day, P = 0.02). When the change in weight loss, N loss and N/kg weight loss on changing diet within a patient group was compared by paired t test the patients changing from milk to CD showed no significant change, but patients changing from CD to milk showed a reduced rate of weight loss (0.36-0.23 kg/day; P = 0.012), a reduced N loss (2.02-0.28 g N/day; P = 0.0013) and reduced loss of N/kg (6.26 to 1.02 g N/kg; P = 0.025). During the outpatient phase weight loss was not significantly related to the diet, but patients with jaws wired lost more weight than those without jaw wiring (0.151 vs 0.077 kg/day; P = 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
What does distance matter? Leprosy control in West Nepal.
One of the major planks of leprosy control strategies is that distance from established treatment centres deters leprosy cases from seeking treatment. The integration of leprosy care with locally available primary health care services is therefore a common feature of leprosy control programmes. Within these guidelines, a National Leprosy Control Programme was established in Nepal in 1975, with intensive case-finding surveys and the provision of leprosy care in government basic health posts. A study of one district, Lamjung, in West Nepal suggests that far from being a deterrent, distance afforded welcome anonymity for leprosy cases anxious to disguise their diagnosis and thereby avoid the social ostracism which could result. Cases from ethnic groups in which the stigma of leprosy was high travelled farther for treatment. Gender differences in distance travelled suggest that women's mobility was restricted, but the local availability of care did not increase attendance for regular treatment. It is suggested that this was more the result of poor quality of care than fear of being known locally as a leprosy case.
Ethnicity↗
Muscle strength in the triceps surae and objectively measured customary walking activity in men and women over 65 years of age.
1. Objective measurements of the maximal voluntary strength of triceps surae and the amount and speed of customary walking have been made in 56 men and 66 women aged over 65 years, who were living independently. 2. Strength was measured using a dynamometer based upon a hydraulic system (Bourdon tube). Walking was assessed, for amount using a mechanical accelerometer (pedometer) over a week, and for speed using a self-paced test for normal walking over 100 m on the level. The reliability and validity of these methods has been described. 3. The men were significantly stronger (1128 +/- 206 vs 873 +/- 177 N) even after adjustment for body weight; their amount of walking was similar to that of women, but they walked significantly faster (4.8 +/- 0.6 vs 4.2 +/- 0.6 km/h). Men were significantly more active in leisure pursuits (as assessed by questionnaire). 4. Significant associations between strength and chosen normal walking speed were found for both sexes (r = 0.41, P less than 0.001 for men and r = 0.36, P less than 0.01 for women). The amount of walking (daily stepscore as a mean from 7 consecutive days recorded) was significantly but less strongly correlated with strength (r = 0.30, P less than 0.05) in the men only. 5. Multiple regression analysis showed that in men neither age nor amount of walking had any further effect in addition to speed, but in women age had an additional effect (multiple R = 0.48). 6. An association has been demonstrated which raises the possibility of reversing loss of muscle strength through increased daily activity.
Aged↗
Self-help in primary care: preliminary findings of a study in Liverpool.
Self-help groups are an important, but often neglected, resource in primary care. This paper reports the preliminary findings of a study of the origins and natural history of self-help groups in Liverpool, and considers the role for general practitioners in mobilizing resources to facilitate community participation in health through this diverse, and informal, sector of the health care system.
England↗
Asymptomatic uterine retroversion at 36 weeks' gestation.
Approximately 11-19% of pregnancies begin in a retroverted uterus. If spontaneous displacement does not occur, fundal impaction may be manifest by 14-16 weeks. We present a report of persistent retroversion discovered at 36 weeks' gestation. A "pelvic mass" was misdiagnosed as posterior sacculation of the uterine wall. We include a review of the literature with regard to incidence, complications, and management of this sometimes confusing condition.
Adult↗
Significance of elevated MB isoenzyme with normal creatine kinase in acute myocardial infarction.
The significance of elevated levels of the MB isomer of creatine kinase (CK-MB) when creatine kinase (CK) level is normal was studied in 400 patients with suspected acute myocardial infarction (AMI). In 350 patients both CK and CK-MB were elevated (group 1), in 21 only CK-MB was elevated (group 2), in 24 neither enzyme was elevated (group 3) and in 5 only CK was elevated (group 4). In 57% of patients in group 2 the CK level was doubled, with a characteristic enzyme curve, within the normal range, suggesting that an increase in CK had been missed because arbitrary definitions of "normal" were used. The median CK increase (60 IU/liter) in group 2 was greater than that in group 3 (23 IU/liter) (p less than 0.001). Patients in group 1 with small AMIs had a relative increase in CK similar to that in group 2. However, patients in group 2 had a lower baseline CK level so that peak CK did not become abnormally high despite a 5-fold increase in some patients. In patients in group 1 with small AMIs, CK was elevated in fewer samples than CK-MB. If only 2 samples were obtained in all patients, elevation of CK levels would have been missed in 63 group 1 patients, erroneously increasing the number of patients in group 2 fourfold (to 84 of 400, or 21%, instead of 21 of 400, or only 5%). Conversely, if patients in group 2 with a doubling of CK are excluded, the prevalence of elevated CK-MB with normal CK would be only 9 of 400 (2%).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
A cross-sectional cost/benefit audit in a hospital obesity clinic.
A cross-sectional survey was made of the 25 men and 127 women attending a hospital obesity clinic over a period of 6 weeks. Among the men the mean (+/- s.d.) age was 37 (+/- 14) years, weight 115.2 (+/- 25.4) kg, height 1.70 (+/- 0.09) m, and Quetelet's index 39.6 (+/- 6.4) kg/m2. Among the women the corresponding values were 41 (+/- 15) years, 102.2 (+/- 22.3) kg, 1.60 (+/- 0.07) m, and 40.3 (+/- 9.2) kg/m2. The most common reasons for wishing to lose weight among both men and women was to improve appearance, shortness of breath and pain in weight-bearing joints. About one-third of the patients tested had raised fasting plasma triglyceride levels. Only one had tests indicating hypothyroidism, and two were hyperthyroid. None of these characteristics predicted how long the patient would continue to attend the clinic. Weight loss was calculated according to the duration of attendance at the clinic, and the method of treatment. Two men and 15 women were treated by jaw-wiring, and the remainder by dietary advice alone. No anorectic or thermogenic drugs were used. Among men treated by diet alone the mean weight loss after 1-3 months, 4-6 months, 7-12 months and greater than or equal to 13 months attendance was 5.0 +/- 6.2 kg, 12.4 +/- 11.0 kg, 12.4 +/- 10.2 kg and 13.0 +/- 5.2 kg respectively. Two men treated by jaw-wiring had lost 23.9 and 57.9 kg.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗