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Biomedical subjects

T D Bolin

Publications and source records attributed to T D Bolin.

At least 55 records · Page 3Linked to original sources
PubMed1995

Bacteriologic analysis of mucosal biopsy specimens for detecting small-intestinal bacterial overgrowth.

BACKGROUND: Although culture of luminal secretions is regarded as the most accurate diagnostic test for small-intestinal bacterial overgrowth, obtaining an aspirate is often difficult owing to the sparseness of luminal secretions present at the time of aspiration. Obtaining a mucosal biopsy specimen for bacteriologic analysis would overcome this problem. METHODS: Culture of small-intestinal and gastric aspirates and unwashed small-intestinal mucosal specimens was performed in 51 adult subjects investigated for small-intestinal overgrowth. RESULTS: Highly significant (r = 0.85-0.90; p < 0.0005) correlations were found between viable bacterial counts in small-intestinal luminal secretions and biopsy specimens. Small-intestinal bacterial overgrowth was present in 60.8% of subjects. When specimens weighing 4.0-84.0 mg were suspended in diluent, total aerobic and/or anaerobic bacterial counts > or = 10(2) CFU/ml were found to have 90.3% sensitivity and 100% specificity for small-intestinal bacterial overgrowth. CONCLUSION: Culture of an unwashed small-intestinal mucosal biopsy specimen is a useful alternative to culture of a small-intestinal aspirate for detecting subjects with small-intestinal bacterial overgrowth, especially when luminal secretions are scanty at the time of aspiration.

Adult↗
PubMed1995

Malnutrition in the developing and developed world: is small intestinal bacterial colonization important?

Malnutrition is a major problem on a global basis and will continue if current world population trends persist. Small intestinal bacterial colonization may contribute to malnutrition in populations whose dietary intake is marginal, such as those in developing countries and many elderly in the developed world. This review focuses on the evidence for small intestinal bacterial colonization in these subjects and briefly revises current thinking on the pathogenesis and diagnosis of this condition.

Bacteria↗
PubMed1995

Factors influencing the 1-g 14C-D-xylose breath test for bacterial overgrowth.

OBJECTIVES: To document the sensitivity of the 1-g 14C-D-xylose breath test for bacterial overgrowth and to investigate luminal and nonluminal factors that may influence breath 14CO2 levels and impact on the clinical utility of this test. METHODS: Thirty-five adult subjects were investigated for bacterial overgrowth by culture of gastric and small intestinal aspirates and by a 1-g 14C-D-xylose breath test. Body weight, gastroduodenal pH and the in vitro capability of overgrowth flora to ferment D-xylose were assessed. Serial breath 14CO2 levels were also recorded before and after the resolution of malabsorption in a subject with celiac disease to determine the importance of postabsorptive metabolism of this substrate. RESULTS: Gastric and small intestinal bacterial overgrowth were present in 19/35 (54.3%) and 21/35 (60.0%) subjects, respectively. The positivity rate of culture of aspirate exceeded that of the 1-g 14C-D-xylose breath test. Endogenous CO2 production independently influenced breath 14CO2 levels. After excluding this influence, sensitivity of the 1-g 14C-D-xylose breath test for gastric bacterial overgrowth or small intestinal bacterial overgrowth was poor, even when overgrowth with specific "marker organisms" was considered. Poor sensitivity could not be explained by unfavorable luminal pH. Overgrowth flora were proven capable of in vitro D-xylose fermentation in 81.8% of subjects. Systemic and/or colonic metabolism of 1-g 14C-D-xylose appear to be important factors influencing results of the 1-g 14C-D-xylose breath test, especially in partial gastrectomy subjects. CONCLUSIONS: The 1-g 14C-D-xylose breath test is not a suitable alternative to culture of aspirate for the investigation of subjects for bacterial overgrowth.

Aged↗
PubMed1995

An appraisal of a 'string test' for the detection of small bowel bacterial overgrowth.

The efficacy of a string test for the detection of small bowel bacterial overgrowth (SBBO) was determined by comparison with a sterile endoscopic method for sampling small bowel secretions in 15 subjects investigated for SBBO. Clinical value was found to be limited by poor sensitivity, specificity and positive predictive value. The string test is not an adequate substitute for oro-duodenal intubation for the detection of SBBO.

Adult↗
PubMed1994

A prospective study on defecation frequency, stool weight, and consistency.

It has been commonly believed that children in developing countries pass stools that are very different from those of developed countries. A community based study on defecation frequency, stool weight, and consistency was conducted in a cohort of 300 Myanmar (Burmese) children aged 1 to 4 years. Most (80.3%) children opened their bowels daily and none passed more than three stools a day. The mean (SD) defecation frequency was 6.98 (1.94) times a week and total stool weight was 596 (221) g a week. The majority (61%) of children passed soft stools. At all ages, there was no significant difference in the defecation frequency, stool weight, and consistency between boys and girls, those on adult style diet and those partially weaned, and between age groups.

Aging↗
PubMed1992

Dyspepsia.

Explore the source record for details and available documents.

Dyspepsia↗
PubMed1992

Comparison of an in vitro faecal hydrogen test with the lactulose breath test: assessment of in vivo hydrogen-producing capability in Burmese village children.

In the assessment of carbohydrate malabsorption, it is important to determine if patients with a flat breath hydrogen (H2) response to an absorbable carbohydrate challenge are capable of producing H2. We compared the reliability of a rapid faecal incubation system with the lactulose breath test to assess in vivo H2 production in 64 children. Overall, 70% of subjects were in vivo H2-producers, with breath H2 peaks greater than 10 parts per million within 3 h of ingesting 10 g of the non-absorbable disaccharide lactulose. Faecal specimens from the 64 children had a mean (SE) pH of 5.0 (0.077). Faecal homogenates were incubated with lactulose at both the initially measured faecal pH and at neutral pH. In predicting a normal in vivo H2-producing ability (sensitivity), the faecal H2 test was correct in only 22% (faecal pH) to 44% (pH7) of cases. In predicting an abnormal lactulose breath test result (specificity), faecal homogenate analysis was correct in 53% of cases, at both faecal and neutral pH. These findings indicate that the faecal hydrogen test is unsuitable as a screening test for in vivo H2 production.

Breath Tests↗
PubMed1992

Absorption of carbohydrate from rice in Ascaris lumbricoides infected Burmese village children.

With the objective of determining the relationship between ascariasis and carbohydrate absorption from rice, breath hydrogen tests (BHT's) were performed in two study populations of Burmese village children. Using a rice test meal, breath hydrogen peaks greater than 10 ppm above baseline within 4 hours (indicating rice malabsorption) were seen in 24 out of 55 (44 per cent) Ascaris lumbricoides infected children and 3 out of 18 (17 per cent) non-infected children (age 18-59 months). In another ascaris endemic village 139 children (age 36-108 months) underwent a rice meal BHT. Seventy children had been regularly dewormed for 2 years (single dose levamisole 50 mg every 3 months) whilst 69 children had been dewormed once in 2 years, 6 weeks before breath testing. Regularly dewormed children showed a lower prevalence of rice malabsorption (33 per cent) compared to the control group (54 per cent) (P < 0.05). These findings suggest that malabsorption of carbohydrate from rice can occur during Ascaris lumbricoides infection in children.

Animals↗
PubMed1992

In vitro hydrogen production by enteric bacteria cultured from children with small bowel bacterial overgrowth.

Lactulose breath hydrogen test and Enterotest string test were carried out simultaneously on 19 children 3-5 years old. Bacteria isolated from the jejunal fluid in upper small intestines of these children were incubated with lactulose at neutral pH. Anaerobes were present in all but one child, and in 15 children they were present in numbers greater than 5 log10 organisms per ml. Most of these bacteria did not produce hydrogen in vitro. Hydrogen production (greater than 100 ppm) was observed with the following bacteria: Bacteroides (5%), clostridia (8%), anaerobic corynebacteria (5%), Escherichia coli (67%), Lactobacillus (8%), Staphylococcus (8%), and Streptococcus (9%). The following bacteria did not produce hydrogen in vitro: Actinobacter, Actinomyces, anaerobic cocci, Bifidobacterium, Fusobacterium, micrococci, Neisseria, Sarcina, and Veillonella. This study suggests that in the diagnosis of small bowel bacterial overgrowth using lactulose breath hydrogen test, it is important to consider that patients with a flat breath hydrogen response to a carbohydrate challenge during the first 60 min may be infected with enteric bacteria which are not capable of producing H2.

Bacteria↗
PubMed1992

Epidemiology of small bowel bacterial overgrowth and rice carbohydrate malabsorption in Burmese (Myanmar) village children.

Breath hydrogen tests were performed after a rice meal (3 g of cooked rice/kg of body weight, equivalent to 1 g of carbohydrate/kg of body weight) on 256 village children (age range 1-59 months) who were known hydrogen (H2) producers. Anthropometric measurements were made every three months and growth rates were calculated. A breath H2 excretion pattern that suggested small bowel bacterial overgrowth (SBBO), which was recognized as a transient maximum level of 10 ppm or more at 20-, 40-, or 60-min breath samples following the rice meal, was present in 53 (20.7%) children, and was more frequent in children 36-47 and 48-59 months old. This breath H2 excretion pattern was detected in 48 (33.3%) of 144 children who were rice malabsorbers (greater than 10 ppm H2 above baseline values in one of the breath samples taken between 90 and 240 min), and in only five (4.5%) of 112 rice absorbers. Children who had SBBO had a high relative risk (10.7) of being rice malabsorbers. Rice malabsorbers have a high relative risk (59.7) of having faltered growth, accompanied by a large etiologic fraction (94%). This same risk (6.68) and an etiologic fraction of 62% exist in children with untreated SBBO. These findings emphasize the need for interventions aimed at reducing the prevalence of SBBO or similar conditions as detected by the breath H2 excretion pattern to prevent rice malabsorption and growth faltering.

Bacteria↗
PubMed1991

A pattern of breath hydrogen excretion suggesting small bowel bacterial overgrowth in Burmese village children.

Breath hydrogen tests (BHTs) were performed on 340 Burmese village children aged 1-59 months. Normalization (correction of breath H2 values to a constant mean O2 level) eliminated the variations in H2 levels due to sleep, storage temperature, or duration of storage. After a 10 g lactulose test meal, 145 (42.6%) children produced less than 10 ppm H2 above basal values (non-H2 producers). Of 195 H2 producers, a pattern of breath hydrogen excretion suggesting small bowel bacterial overgrowth (SBBO)--recognized as a transient peak at the 20, 40, or 60 min breath samples following the lactulose test meal and distinguishable from the later colonic peak--was observed in 53 (27.2%), being significantly more frequent in male children, and exhibiting an age-prevalence pattern similar to that of acute childhood diarrhea in these villages. Diarrhea did not alter the state of H2 production (non-H2 producers remain non-H2 producers, and H2 producers remain H2 producers) although the magnitude of peak breath H2 changed.

Breath Tests↗
PubMed1990

Effect of short-term intermittent antibiotic treatment on growth of Burmese (Myanmar) village children.

To test the hypothesis that subclinical enteric infection (such as bacterial overgrowth), rice malabsorption, and growth faltering are causally linked, a field trial of low-dose, short-term, intermittent antibiotic treatment was carried out in 142 hydrogen-producing (by lactulose breath hydrogen test) Burmese village children aged 6-59 months. The children were randomly allocated treatment with metronidazole (20 mg/kg or 5 mg/kg daily), amoxycillin (25 mg/kg daily), or placebo given 1 week per month for 6 months. A cooked rice meal breath hydrogen test was done to classify the children as rice absorbers (RA) or rice malabsorbers (RM) before treatment and monthly on the day before each cycle of treatment. There were no differences between the treatment groups, so they were considered together. Factorial analysis showed that antibiotic treatment did not significantly affect the proportion of RM children. The only significant difference between antibiotic-treated and placebo-treated children's growth was in the subgroup of RM children aged 36-47 months; the antibiotic-treated children had significantly greater linear growth. In other age groups antibiotic treatment had no effect on growth.

Age Factors↗
PubMed1990

Absorption of carbohydrate from rice in Burmese village children and adults.

Breath-hydrogen tests (BHTs) were performed on 310 Burmese village children aged 1-59 mo. After a 10-g lactulose test meal, 94 (30.3%) children produced less than 10 ppm H2 above basal values (nonhydrogen producers). Of 216 hydrogen producers, 210 were tested after a cooked rice meal (3 g cooked rice/kg body wt, equivalent to 1 g carbohydrate/kg body wt) with the BHT. Hydrogen peaks greater than or equal to 10 ppm above baseline concentrations were produced by 133 (66.5%) children who were defined as rice malabsorbers. Forty-three percent to 62% of children were less than or equal to -3 SD of the National Center of Health Statistics (NCHS) median weight-for-age and length-for-age and less than -2 SD of the NCHS median weight-for-length. There were no differences between rice absorbers (peak hydrogen less than 10 ppm above baseline) and rice malabsorbers in the allometric indices (the Ehrenberg index and the Dugdale index) of weight-for-length. Rice-carbohydrate malabsorption was also detected by BHTs in 26.7% of 86 school children (aged 5-15 y), 38.5% of 39 young adults (aged 15-39 y), and 50% of 34 older adults (aged 40-70 y).

Adolescent↗
PubMed1990

Malabsorption of carbohydrate from rice and child growth: a longitudinal study with the breath-hydrogen test in Burmese village children.

Breath-hydrogen tests were performed after a rice meal (3 g cooked rice/kg body wt, equivalent to 1 g carbohydrate/kg body wt) at monthly intervals for 6 mo on 75 village children aged 1-59 mo who were known hydrogen producers. The overall rate for rice-carbohydrate malabsorption was 46.7% (range 37.3-56.0%). Anthropometric measurements were made every 3 mo and growth rates were calculated. Forty-six percent to 59% of children were less than or equal to -3 SD of the National Center for Health Statistics (NCHS) median weight-for-age and length-for-age and less than -2 SD of the NCHS median weight-for-length. Rice malabsorbers (ie, those with hydrogen peaks greater than or equal to 10 ppm above baseline concentrations) in the age groups 36-47 mo and 48-59 mo had statistically significant diminished growth expressed as percent gain in length per annum per child (p less than 0.02). Thus, rice malabsorbers had a deficit in linear growth of 2.7 cm/y (range 2.5-2.9 cm/y) for children aged 36-47 mo old and 1.9 cm/y (range 1.7-2.1 cm/y) for children aged 48-59 mo.

Analysis of Variance↗
PubMed1989

Sucralfate maintenance therapy in duodenal ulcer disease. A review.

There are a large number of patients with chronic duodenal ulcer disease who warrant long-term maintenance therapy to diminish the risk of recurrence and thereby the risk of further complications such as gastrointestinal bleeding. The efficacy of sucralfate has been compared with both placebo and histamine (H2)-receptor antagonists and sucralfate in a dose of 1 g twice a day or 2 g taken at night. It is a safe and effective medication in preventing duodenal ulcer recurrence. However, duodenal ulcer relapse rates always exceed 20 percent and frequently approach 50 percent, whether the therapy be H2-receptor antagonists or sucralfate, and the use of dosages that are half the healing dose seems irrational. It would therefore seem reasonable to continue maintenance therapy at the healing dose, whatever medication is used. Any increased costs for drugs should be outweighed by savings in indirect costs.

Clinical Trials as Topic↗
PubMed1989

Human rectosigmoid electromyography: a new approach and some pitfalls.

A method has been developed to record directly myoelectrical activity from the smooth muscle of the colon of intact subjects using pairs of intramuscular wires. Discrete bursts of myoelectrical activity occurred at 4-20 per min. A small interelectrode distance in this method allows contamination of colonic myoelectrical activity by the electromyogram of skeletal muscle to be excluded. This artefact has not been considered in previous recordings of 'colonic' activity.

Adult↗