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Biomedical subjects

R B Fraser

Publications and source records attributed to R B Fraser.

At least 37 records · Page 2Linked to original sources
PubMed1995

A study exploring midwives' education in, knowledge of and attitudes to nutrition in pregnancy.

OBJECTIVE: to explore midwives' education in, knowledge of and attitudes to nutrition in pregnancy. DESIGN: survey using questionnaire and interview schedule. PARTICIPANTS: a randomly selected sample of 77 Registered Midwives. SETTING: one English regional health authority. MEASUREMENTS AND FINDINGS: qualitative and quantitative data collection methods. Midwife teachers were responsible for 95% of teaching in nutrition. 86% of midwives had received no education in nutrition following qualification. 46% of midwives achieved a poor score in nutrition knowledge. Considerable numbers of midwives felt unprepared to offer dietary advice to women from ethnic minority groups (36%), vegetarians (66%) and to women with pre-existing medical conditions (41%). KEY CONCLUSION: midwives require more education in nutrition both during basic education and following qualification. IMPLICATIONS FOR EDUCATION PRACTICE: nutritional issues should be included in continuing education programmes available to qualified midwives.

Female↗
PubMed1992

Evidence that the insulin resistance of pregnancy may not involve a post-receptor defect in human adipocytes.

Insulin binding and the capacity of insulin to stimulate the conversion of glucose to carbon dioxide and lipid, and to activate the protein tyrosine kinase associated with the insulin receptor have been investigated in adipocytes isolated from pregnant and non-pregnant women. Insulin binding and the conversion of glucose to lipid were the same for both groups. However, conversion of glucose to CO2 was higher in the non-pregnant group due to an elevated basal activity, and the increase produced by insulin was similar in both groups. The tyrosine kinase activity of the isolated receptor preparations was higher in the pregnant group due to an increase in the basal non-insulin dependent activity, and the increase produced by insulin was similar in both groups. These findings show the in vitro insulin responsiveness of isolated adipocytes is similar for both groups, and suggests that the in vivo insulin resistance of late pregnancy, as far as adipose tissue is concerned, is not due to any inherent defect in insulin action at the receptor or post-receptor level. In vivo insulin resistance may result from an increased level of circulating insulin antagonists.

Adipose Tissue↗
PubMed1992

Cord insulin and C-peptide--distribution in an unselected population.

OBJECTIVE: To assess the distribution of cord blood insulin in an unselected population, and examine its relation to birthweight centiles. SETTING: District General Hospital in Nottinghamshire. SUBJECTS: 209 unselected singleton births. MEAN OUTCOME MEASURE: Cord blood insulin; cord blood C-peptide; birthweight centiles. RESULTS: Hyperinsulinaemic babies (greater than 97th centile for cord insulin) were found at all birthweight centiles. 15% of high birthweight babies were hyperinsulinaemic. For low birthweight babies, the distribution of cord insulin/C-peptide was skewed indicating a high number of low values. Hypoinsulinaemic babies were present up to the 50th centile for birthweight. CONCLUSIONS: Abnormalities of fetal insulinisation may be found in babies of all birthweights.

Birth Weight↗
PubMed1990

An expert system for the nutritional management of the critically ill.

While there have been considerable advances in the last several years in the nutritional management of the critically ill, these improvements are not always recognized in intensive care environments. In this paper we describe the development and testing of an expert system, NUTRITIONAL ADVISOR, which would be be an aid in providing nutritional assessment and support of critically ill patients. We discuss various approaches to treating time-varying data in the knowledge base in order to provide a recommended level of nutritional support which varies smoothly from day to day.

Critical Care↗
PubMed1990

Intra-operative pulmonary embolism. Detection by pulse oximetry.

A case is presented of a 49-year-old patient who had a pulmonary embolism during ovarian cystectomy. The only evidence of its occurrence was a sudden, marked reduction in arterial oxygen saturation as detected by a pulse oximeter. The diagnosis was confirmed 24 hours later by a chest radiograph and a ventilation perfusion scan. Anticoagulant treatment was instituted.

Female↗
PubMed1989

Oxytocin infusion during second stage of labour in primiparous women using epidural analgesia: a randomised double blind placebo controlled trial.

OBJECTIVE: To determine whether the high rate of forceps delivery associated with the use of epidural analgesia could be reduced through giving an intravenous infusion of oxytocin during the second stage of labour. DESIGN: A randomised, double blind, placebo controlled trial. SETTING: Delivery suites in three hospitals. SUBJECTS: 226 Primiparous women with adequate epidural analgesia in whom full dilatation of the cervix had been achieved without prior stimulation with oxytocin. INTERVENTION: An infusion of oxytocin or placebo starting at the diagnosis of full cervical dilatation at an initial dose rate of 2 mU/min increasing to a maximum of 16 mU/min. MAIN OUTCOME MEASURES: The outcome of labour was assessed in terms of the duration of the second stage, mode of delivery, fetal condition at birth, postpartum blood loss, and the incidence of perineal trauma. RESULTS: Treatment with oxytocin was associated with a shorter second stage (p = 0.01), a reduction in the number of non-rotational forceps deliveries (p = 0.03), and less perineal trauma (p = 0.03) but was not associated with any reduction in the number of rotational forceps deliveries performed for malposition of the occiput. No adverse effects on fetal condition at birth or in the early puerperium were seen in association with the use of oxytocin. CONCLUSIONS: The use of an oxytocin infusion may reduce the high rate of operative delivery associated with epidural analgesia provided that the fetal occiput is in an anterior position at the onset of the second stage of labour but within the dose range studied does not seem to correct malposition of the fetal occiput.

Adolescent↗
PubMed1988

Insulin sensitivity in third trimester pregnancy. A randomized study of dietary effects.

The metabolic effects of three diets were investigated in a randomized study in 15 non-pregnant women and 14 pregnant women in the third trimester; all the women were of normal weight. After 2-week periods of habituation to each diet, metabolic profiles were performed on standardized intakes. Diet 1 contained 40% of energy as carbohydrate and 10 g dietary fibre representing typical Western intakes. Diet 2 contained 40% energy as carbohydrate and 52 g dietary fibre and diet 3 contained 60% of energy as carbohydrate and 84 g dietary fibre, representing typical developing world intakes. No deterioration in glucose homeostasis in pregnancy was seen on any of the three diets in contrast to previous work. On diet 1 there was a loss of insulin sensitivity in pregnancy, but not on diets 2 and 3. The loss of insulin sensitivity which is typical of Western women in the third trimester of pregnancy and is considered to be physiological, may be a diet-induced artefact.

3-Hydroxybutyric Acid↗
PubMed1988

Preparation of "histocomposites" for direct immunohistochemical screening of monoclonal antibodies.

Screening and selection of hybrids producing relevant antibodies in monoclonal technology usually rely on rapid and sensitive adsorption assays of the ELISA type. To identify clones producing antibodies with unexpected specificities direct immunohistological screening may be applied, but this is both tedious and expensive. Histocomposites made from a number of tissue types permit testing of supernatants at the required early stage after fusion. The multiple antigenic specificities displayed in such test specimens ensure detection of a broad range of antibodies. A simple method for production of the histocomposites is described.

Animals↗
PubMed1985

Glycosylated haemoglobin in normal pregnancy: a longitudinal study with two independent methods.

Twenty-one women completed a longitudinal study of glycosylated haemoglobin in normal pregnancy. Glycosylated haemoglobin levels were measured using two independent techniques (ion-exchange column and colorimetric). Concurrent serial oral glucose tolerance tests (75-g glucose load) and erythrocyte indices were obtained. Changes in mean glycosylated haemoglobin were similar with both techniques with a nadir at 17 weeks, a peak at delivery (p less than 0.002 versus 17 weeks) and a fall post-partum. Glycosylated haemoglobin levels in abnormal pregnancies, e.g. diabetic, should be interpreted in the knowledge of these physiological changes.

Adolescent↗
PubMed1985

Acinar structure and function in canine pancreatic autografts with duct drainage into the urinary bladder.

Autotransplants of pancreas in 8 dogs, with exocrine drainage into the urinary bladder, were stimulated in vivo with cholecystokinin-pancreozymin (CCK-PZ). Transplant biopsies, when compared with 6 normal pancreases, showed normal acinar structure by light and electron microscopy 13-18 months after initial surgery; 2 transplants with sutures unintentionally transecting ducts were fibrosed and had duct obstruction. After in vivo stimulation, the normal-appearing transplants produced a 7-fold increase in urinary amylase, and quantitative electron microscopy showed a 50% reduction in mature zymogen granules; there were no intracellular organelle abnormalities prior or subsequent to stimulation. Fibrosed transplants produced lesser urinary amylase both prior to and after stimulation. In vitro stimulation of grafts with normal structure increased amylase secretion from 1.5-2.1-fold. In vitro dose-response showed a maximum at 10(-9)M cholecystokinin-octopeptide (CCK-OP) in transplant and control. The in vivo stimulation is more responsive and may be useful for clinical monitoring of graft survival. In vivo stimulation occurred after induced urinary tract infection; because no pancreatitis ensued, a regimen of trophic stimulation by CCK-PZ was not contraindicated. The bladder tolerated exocrine drainage with no significant change, and bladder infection did not adversely affect the transplant. The islets appeared normal in the transplants by light and qualitative electron microscopic observation; fasting blood glucose and insulin values were normal during the 12-18-month follow-up. Bladder drainage of segmental grafts of pancreas provides a preparation with intact acinar-islet relationships; the present observations suggest that this may permit longer islet survival in the absence of acinar destruction and subsequent fibrosis.

Amylases↗
PubMed1985

New method of respiratory gas analysis: light spectrometer.

A multigas concentration analyzer particularly suited for respiratory gas analysis has been developed using a new principle based on the measurement of the intensity of light emitted by excited atoms or ions in a direct current glow discharge. This glow discharge spectral emission gas analyzer (GDSEA), or light spectrometer, simultaneously measures O2, N2, CO2, He, and N2O gas concentrations with a 0-90% response time of 100 ms and a sample rate of less than 20 ml/min in a short gas sample line configuration. Mole accuracy and resolution of the GDSEA using a short sample line were determined in the laboratory to be +/- 0.15 to +/- 0.7% and 0.02-0.05%, respectively. In the clinical setting a comparative evaluation was made with a mass spectrometer in a long sample line, computerized, multibed, respiratory monitoring system. Results indicate a close agreement between the two instruments with differences in mixed inspiratory or expiratory O2 and CO2 concentrations of less than 2% and of derived variables, such as O2 consumption, CO2 production, and respiratory exchange ratio, of less than 5%.

Gases↗