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Biomedical subjects

M Watkinson

Publications and source records attributed to M Watkinson.

At least 37 records · Page 2Linked to original sources
PubMed1985

Zinc and acute tropical ulcers in Gambian children and adolescents.

28 Gambian children and adolescents with acute tropical leg ulcers entered a double blind trial of oral zinc supplements as an adjunct to standard treatment. Analysis of the area healing of the ulcers resulted in a mathematical expression which showed that for each subject re-epithelialization reduced the ulcer radius at a constant healing rate (k). k was derived from the equation At = pi X (r - k X t)2, where At = residual ulcer area at time "t", r = initial ulcer radius and t = time from start of treatment. In the zinc treated group k was 0.55 +/- 0.39 mm/day, and 0.51 +/- 0.25 mm/day in the placebo group. The initial low plasma zinc of 6.5 +/- 1.9 mumol/L in the ulcerated subjects was not significantly lower than that of 7.5 +/- 3.6 mumol/L in the nonulcerated controls. Oral zinc supplements significantly elevated plasma zinc concentrations by 5.8 +/- 4.8 mumol/L compared to the placebo group's change of 0.4 +/- 2.0 mumol/L (p less than 0.001). Plasma alkaline phosphatase activities and fatty acid profiles did not change with zinc supplementation. Thus unequivocal clinical and biochemical evidence of zinc deficiency in these ulcerated subjects was not established, despite changes in plasma zinc. This study does not indicate any role for zinc supplementation in the management of acute tropical ulcers.

Adolescent↗
PubMed1984

Breast-milk antimicrobial factors of rural Gambian mothers. II. Influence of season and prevalence of infection.

The effects of season and variations in the prevalence of infectious disease on the concentrations and daily production of breast-milk immunoproteins were studied in 152 rural Gambian mothers and their children up to 26 months post-partum. IgA, IgG, IgM, C3, C4, lactoferrin, lysozyme and secretory component concentrations and breast-milk volumes were measured longitudinally over a six month period which encompassed dry and rainy seasons. No increase in the production of any immunoprotein was observed at the time of maximum prevalence of serious infectious diseases, especially diarrhoea, in the children. Enhanced secretion of certain immunoproteins was noted in mothers of children aged 9-18 months at the beginning of the rainy season. There was some evidence that this may have been associated with skin sepsis, particularly impetigo, in the children. The production of most immunoproteins fell during the rainy season. This was not the result of declining maternal food intakes as similar decreases were seen for women receiving a dietary supplement.

Bacterial Infections↗
PubMed1984

Efficacy of a food supplement in correcting riboflavin deficiency in pregnant Gambian women.

Pregnant women living in rural Gambian villages, whose natural riboflavin intake is about 0.5 mg/d, have abnormal biochemical riboflavin status and signs of clinical deficiency. A vitamin-fortified food supplement given in one village which increased the riboflavin intake to about 1.3 mg/d was followed by a substantial improvement in biochemical status, although seasonally-related variations in status somewhat complicated the picture. It was calculated that the amount of riboflavin needed to satisfy the requirement, for normal biochemical status, of the majority of pregnant women throughout pregnancy and throughout the year, is about 2.6 mg/d. Clinical signs associated with riboflavin deficiency, especially atrophic lingual papillae, showed significantly reduced incidence in the supplemented, compared with an unsupplemented, village. Cord blood values of the activation coefficient of erythrocyte glutathione reductase were in the abnormal range for 84 per cent of infants before introduction of the supplement, but were abnormal for only one of 12 infants after its introduction. Thus even a suboptimal maternal riboflavin intake of about 1.3 mg/d appears to be sufficient to prevent biochemical deficiency in cord blood, and to reduce considerably the incidence of clinical deficiency signs during pregnancy.

Adult↗
PubMed1983

Plasmodial pigmentation of placenta and outcome of pregnancy in West African mothers.

In a region where falciparum malaria is endemic and where pregnant women traditionally receive only curative treatment for parasitaemias and no chemoprophylaxis 65 placental biopsy specimens were examined histologically for malaria pigment. Twenty seven placentas had pigment, but parasitaemias had been diagnosed antenatally in only 12 of these women despite their frequent attendance at antenatal and other clinics. The incidence of parasitaemia in pregnant primigravidas was 17.7%, seven times greater than that in lactating primiparous mothers; pregnant primigravidas also had the highest incidence (67%) of pigmented placentas. First born babies with pigmented placentas had a mean (SD) birth weight of 2580 (260) g, significantly less than the 3150 (400) g of unaffected first babies. All babies weighing less than 2500 g at birth had pigmented placentas. Pigmentation was associated with parasitaemias in the second half of pregnancy, and, although some recovery from early parasitaemias may occur, the fetoplacental unit is inadequately protected by curative treatment alone. Chemoprophylaxis currently remains the procedure of choice.

Birth Weight↗
PubMed1983

Diabetic nursing.

Explore the source record for details and available documents.

Diabetes Mellitus↗
PubMed1983

Prenatal dietary supplementation of African women and birth-weight.

Gambian women, who show marked seasonal fluctuations in energy balance, were offered a dietary supplement during pregnancy. This resulted in a net energy increment of 431 kcal/day. In the wet season, when the women were normally in marked negative energy balance due to food shortages and a high agricultural work load, the supplementation improved birth-weight by a mean of 224 g and reduced the incidence of low-birth-weight babies (less than 2.5 kg) from 28.2% to 4.7%. In the dry season, when the women were previously in positive energy balance despite an energy intake of only 60% of the recommended dietary allowance, the supplement had no beneficial effect on birth outcome. This threshold effect indicates the need to identify truly at-risk groups for prenatal supplementation programmes in developing countries.

Birth Weight↗
PubMed1983

Dietary supplementation of lactating Gambian women. I. Effect on breast-milk volume and quality.

In order to test whether lactational capacity can be improved by dietary interventions, a nutritionally balanced supplement was provided under carefully controlled conditions to 130 nursing mothers in Keneba, The Gambia over 12 months. Maternal mean energy intake (+/- s.e.) increased from 1568 +/- 15 kcal/d (6.56 +/- 0.06 MJ/d) to 2291 +/- 14 kcal/d (9.59 +/- 0.06 MJ/d). Protein intake was in excess of the WHO/FAO recommended intake after supplementation and serious deficits of riboflavin, vitamin A, vitamin C and calcium were rectified. The supplement had no effect on breast-milk volume, compared with retrospective controls, at any stage of lactation or in any season of the year. There was no selective effect on women with poor milk outputs. The average milk protein concentration was slightly improved over the entire period of lactation (+ 6.6 per cent, P less than 0.01), but the total energy content was unchanged since an increase in breast-milk fat concentration (+ 7.9 per cent, n.s.) was offset by a decrease in the milk lactose concentration (- 7.6 per cent, P less than 0.01). Breast milk vitamin content was improved for those vitamins for which the supplement provided a significant proportion of the recommended dietary intake.

Adult↗
PubMed1983

Dietary supplementation of lactating Gambian women. II. Effect on maternal health, nutritional status and biochemistry.

The effect of a high-energy dietary supplement provided under carefully controlled conditions to 130 lactating Gambian women was assessed with respect to changes in maternal health, nutritional status and biochemistry. The supplement resulted in a net increase in energy intake of 723 kcal/d (3.03 MJ/d) and corrected deficits in the intake of protein, riboflavin, vitamin A, vitamin C and calcium. Supplemented women complained of fewer health problems when attending postnatal clinics (P less than 0.001). In particular the incidence of gastrointestinal problems was lower (P less than 0.001). The supplement caused a net body weight gain of only 1.8 kg averaged over a year, and women still lost weight during the farming season. Fasting serum levels of non-esterified fatty acids were increased and of glucose were decreased by the supplement. Plasma concentrations of prolactin, cortisol, insulin and T3 were found to be decreased after supplementation at one or more points during lactation, but growth hormone values remained unchanged. It is suggested that these changes reflect a relaxation from a state of high metabolic efficiency and that much of the additional energy derived from the supplement was simply wasted through a decreased efficiency in the women.

Adult↗
PubMed1982

The impact of domiciliary glucose electrolyte solution on diarrhoeal prevalence and growth in children under five years of age in a rural West African village.

In a rural West African village with an easily accessible clinic, the provision of glucose electrolyte solution in the home for the early treatment of acute childhood diarrhoea significantly reduced the incidence of attacks lasting more than two days and the amount of diarrhoea reported to the clinic. In a study lasting one year this did not significantly affect the nutritional status of the children when compared to the control group which had access to the clinic. The group receiving domiciliary glucose electrolyte solution reported significantly more brief attacks with low stool frequencies: they did not use the solution selectively. The strategy of providing domicilary glucose electrolyte solutions needs to be carefully assessed in those communities with local clinics.

Child, Preschool↗
PubMed1982

Riboflavin requirements of lactating Gambian women: a controlled supplementation trial.

As part of a study to determine the minimum allowance of riboflavin which is adequate for lactating women in a rural African environment, 60 subjects living in two Gambian villages were given either 2 mg riboflavin or a placebo daily on a double-blind basis for 12 wk. Their riboflavin intake from dietary sources was about 0.5 mg/day. In the supplemented group, the mean activation coefficient (AC) of erythrocyte glutathione reductase fell from 1.62 to 1.19 within 3 wk, and 90% had mean AC's below 1.3 throughout supplementation, whereas the placebo group maintained mean AC's between 1.6 and 1.9. Clinical signs associated with riboflavin deficiency improved more rapidly in the supplemented group; their breast milk riboflavin levels increased, and their infants' AC's were reduced, compared with those of the placebo group. After withdrawal of the supplement, the maternal and infants' AC's rose toward those of the placebo group. Thus a total riboflavin intake of about 2.5 mg/day during lactation is sufficient to maintain normal biochemical status in most Gambian women.

Adult↗
PubMed1981

Delayed onset of weanling diarrhoea associated with high breast milk intake.

In a West African community where breast feeding was practised universally for 18 to 24 months infants with the higher breast milk intakes were given supplementary foods later than others. Although 66% of infants had diarrhoea before the introduction of these foods, it was generally mild and only 12% suffered diarrhoea-induced weight loss in this pre-weaning period. By the end of infancy, all children had had diarrhoea and 89% had suffered weight loss in one or more attacks. As the bulk of diarrhoeal morbidity occurred after weaning had started, children with the higher breast milk intakes tended to be older before losing weight with diarrhoea. By one year, children with a higher than average breast milk intake and with no diarrhoea-induced weight loss in the first half of infancy weighed an average of 1 kg more than those with low breast milk intakes and early weight loss with diarrhoea. Interventions which improve or maintain maternal lactation performance should not only increase the nutrient intake of an infant, but also delay the almost inevitable weight loss of weanling diarrhoea.

Age Factors↗
PubMed1981

Riboflavin status in Gambian pregnant and lactating women and its implications for Recommended Dietary Allowances.

Riboflavin status by the erythrocyte glutathione reductase (NAD(P)H2:glutathione oxidoreductase EC1.6.4.2) test, and dietary riboflavin intake, were measured in 156 pregnant and lactating women in Keneba, a rural Gambian village, and in 59 pregnant and lactating women in Cambridge, England. The Keneba women were studied longitudinally, for up to 19 months. In Keneba, where the mean daily riboflavin intake was 0.5 mg, the mean erythrocyte glutathione reductase activation coefficient was 1.78 and there was a marked deterioration of biochemical status near parturition. In Cambridge, where the mean intake was 2.3 mg/day, the mean activation coefficient was 1.19. A vitamin fortified diet supplement, given to lactating women in Keneba for 8 months, raised their mean riboflavin intake for 0.5 to 1.5 mg/day and reduced the mean activation coefficient to 1.42. It is therefore likely that an intake even greater than the current United Kingdom or United States recommended daily amounts would be needed to achieve biochemical 'normality' in these women.

Adolescent↗
PubMed1980

Dietary supplementation of Gambian nursing mothers and lactational performance.

A dietary supplement, resulting in a mean net increase in energy intake of over 700 kcal/day, was supplied to all nursing mothers in a West African village for 12 months. The supplement produced a slight initial improvement in maternal body weight and subcutaneous fat stores but did not increase breast-milk output or fat content.

Body Weight↗