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Biomedical subjects

R H Behrens

Publications and source records attributed to R H Behrens.

At least 19 recordsLinked to original sources
PubMed1992

Impact of zinc supplementation on intestinal permeability in Bangladeshi children with acute diarrhoea and persistent diarrhoea syndrome.

Zinc has been shown to enhance intestinal mucosal repair in patients suffering from acrodermatitis enteropathica; but the impact on mucosal integrity during acute (AD) or persistent (PD) diarrhoea is unknown. One hundred eleven children with AD and 190 with PD aged between 3 and 24 months received, randomly and blind to the investigators, either an elemental zinc supplement of 5 mg/kg body wt/day or placebo in multivitamin syrup for 2 weeks while intestinal permeability and, biochemical and anthropometric markers were serially monitored. The permeability test was administered as an oral dose of 5 g lactulose/l g mannitol in a 20-ml solution followed by a 5-h urine collection. The ratio of the urinary probe sugars was correlated to clinical, biochemical, and microbiological parameters. At presentation, lactulose excretion was increased and mannitol excretion decreased in both AD and PD as compared with age-matched asymptomatic children. The lactulose/mannitol ratio (L/M) was higher in subjects with mucosal invasive pathogens (rotavirus and enteropathogenic Escherichia coli) compared with children excreting Vibrio cholera and enterotoxigenic E. coli. Two-week zinc supplementation significantly reduced lactulose excretion in both AD and PD, whereas the change in mannitol excretion and L/M was similar between study groups in both studies. Changes in lactulose excretion were significantly influenced by zinc supplementation in children with E. coli, Shigella sp., and Campylobacter jejuni stool isolates. The greatest reduction in total lactulose excretion was seen in supplemented children who on presentation were lighter (wt/age less than 80%), thinner (wt/ht less than 85%), and undernourished [middle upper arm circumference (MUAC) less than 12.5 cm] or with hypozincaemia (less than 14 mumol/L).(ABSTRACT TRUNCATED AT 250 WORDS)

Acrodermatitis↗
PubMed1991

Cholera.

Explore the source record for details and available documents.

Cholera↗
PubMed1991

Measurement of acute phase proteins for assessing severity of Plasmodium falciparum malaria.

Seventeen adult patients with acute Plasmodium falciparum malaria, admitted to the Hospital for Tropical Diseases, were studied. Serial measurements of the serum concentration of C-reactive protein, serum amyloid A protein, and percentage parasitaemia were determined, together with initial measurement of serum electrolytes, liver function, haemoglobin, white cell and platelet counts. Initial C-reactive protein and serum amyloid A concentrations were increased (C-reactive protein mean 49.0 mg/l serum amyloid A 28 mg/l) falling towards the normal range by the seventh day of treatment. There was a significant correlation between the pretreatment parasite count and clinical and laboratory markers of inflammation. C-reactive protein and serum amyloid A concentrations correlated inversely with the serum sodium. These results indicate that measurement of acute phase reactants such as C-reactive protein and serum amyloid A may prove valuable in assessing the severity of P falciparum malaria, and in following the response to antimalarial treatment.

Acute Disease↗
PubMed1991

Evaluation of a computerized field data collection system for health surveys.

A customized field data collection system (FDCS) has been developed for a hand-held computer to collect and check questionnaire data. The data quality, preparation time, and user acceptability of the system were evaluated during a malaria morbidity survey in Bakau, the Gambia. Eight field-workers collected data with either the FDCS or on paper questionnaire forms in alternate weeks over a 6-week period. Significantly fewer item errors occurred with the FDCS, and by the end of the survey period interview times were significantly less with the FDCS than with the paper and pencil questionnaire. Advanced appropriate technology may have a useful role in providing accurate and rapid information, particularly in overcoming bottlenecks in data processing, and in obviating the need for costly expertise and equipment. In developing countries this could help to improve the quality of data on health care.

Data Collection↗
PubMed1990

Automated enzymatic assays for the determination of intestinal permeability probes in urine. 1. Lactulose and lactose.

Lactulose is becoming the disaccharide of choice in the dual sugar assessment of passive permeability of the small intestinal mucosa. However its more widespread use is hampered by current analytical methods which are tedious and time consuming. An automated spectrophotometric technique for the assay of this sugar in urine is presented in which lactulose is linked by a series of enzyme reactions to the equimolar production of NADPH. In addition to lactulose, the procedure also gives accurate values for lactose, glucose and fructose in the urine sample. The assay has been shown to be highly specific for lactulose and lactose and was not affected by high concentrations of other sugars or other urinary constituents. Within assay and between assay precision were similar with the coefficient of variation for both sugars in the range 0.4-1.6%. The technique represents a significant improvement in time, simplicity and precision on existing methods of analysis.

Disaccharides↗
PubMed1987

Factors affecting the integrity of the intestinal mucosa of Gambian children.

The interrelationship between diarrhea, malnutrition, and small bowel integrity was investigated prospectively in 68 Gambian infants aged 0-18 mo. Profiles of growth and morbidity were recorded for 8 mo. Each month intestinal permeability was measured by the differential uptake of orally administered lactulose (L) and mannitol (M). In well infants the mean L:M ratio was 0.42 (range 0.11-1.42). This ratio was increased slightly for underweight (60-80% wt for age) infants (mean 0.52) but considerably for those with marasmus (less than 60% wt for age) (mean 1.3, p less than 0.001), for those with acute or chronic diarrhea (mean 1.0 and 2.85, respectively; p less than 0.001), or with measles (mean 1.4, p less than 0.001). Sequential studies of ward patients with malnutrition and diarrhea showed a rapid fall in L:M ratios with resolution of diarrhea. These studies suggest that damage to the small intestine may play an important part in the development of infant malnutrition in The Gambia.

Carbohydrate Metabolism↗
PubMed1987

Radionuclide tests for the assessment of intestinal permeability.

14C labelled-D-mannitol and aquo (ethylene-diaminetriacetoacetic acid) 51chromium (III) (51Cr EDTA) have been evaluated as markers of intestinal permeability in twenty-four healthy control subjects, sixteen patients with recently diagnosed coeliac disease and twenty subjects with coeliac disease in remission on a gluten-free diet. The percentage excretion of 14C mannitol in urine collected for 6 h was significantly less in patients with coeliac disease (mean 6.7%) than controls (mean 13.5%). Conversely the excretion of 51Cr EDTA was significantly greater in patients with coeliac disease (mean 1.23%) compared with controls (mean 0.28%). The mean ratio of the percentage excretion of 51Cr to the percentage excretion of 14C was 0.29 in patients with untreated coeliac disease compared with 0.023 for healthy control subjects (P less than 0.001). Patients with untreated coeliac disease were clearly separated from control subjects by use of the 51Cr EDTA: 14C mannitol ratio but not by the excretion of independent markers.

Adult↗
PubMed1986

Protein losing enteropathy associated with Nippostrongylus brasiliensis infestation and its impact on albumin homoeostasis in rats fed two levels of dietary protein.

Alterations in plasma albumin concentration and gastrointestinal permeability have been investigated in rats infected with the nematode Nippostrongylus brasiliensis and fed adequate or low protein diets. Infection caused only minor changes in growth and food consumption of well nourished rats but resulted in significant reductions in those fed the low protein diet. Animals in both dietary groups were able to mount an immune response beyond day 10 post-infection (p.i.) which caused expulsion of the parasites, but this was less effective in rats fed the low protein food. Uninfected rats fed the low protein diet had significantly lower plasma albumin concentrations than their well nourished counterparts. Animals of both dietary groups showed a progressive reduction in plasma albumin concentration as the infection developed but values returned towards normal as the parasites were expelled. The reduction in plasma albumin concentration was closely associated with increases in gastrointestinal leakage of plasma protein but losses were far greater in the protein deficiency animals. Beyond day 10 p.i. protein loss decreased in both dietary groups and by day 21 p.i. had returned to normal in well nourished animals but not those fed the low protein diet. Intestinal permeability measured by the lactulose:mannitol ratio technique gave similar results to the protein loss data. Permeability increased as the infection progressed then fell as the worms were expelled but remained above control values in infected protein deficient animals. Overall, animals fed the low protein diet were more severely affected by the parasite than were their well fed counterparts.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗