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Biomedical subjects

A A Haffejee

Publications and source records attributed to A A Haffejee.

At least 55 records · Page 3Linked to original sources
PubMed1985

Nutritional parameters in urban and rural Zulus.

Anthropometric, biochemical and haematological nutritional parameters were measured in 103 (65 men, 38 women) Durban Zulu adults (urban) and 109 (41 men, 68 women) Tugela Ferry Zulu adults (rural). Men conformed to an ideal weight for height whereas women were 18% overweight in Tugela Ferry and 30% so in Durban. Mean arm muscle circumference in men was between the 10th and 20th centiles. Other nutritional parameters were similar to those accepted internationally as normal. In particular the serum albumin level was normal in both urban and rural Zulus. There was little change in the parameters with age except that hand grip as measured by dynamometry fell with age (P less than 0,05). Serum albumin levels fell with age in women (P less than 0,01) but not in men. Nine mothers of babies suffering from kwashiorkor showed normal nutritional profiles.

Adolescent↗
PubMed1985

Nutritional assessment by hand grip dynamometry.

Hand grip dynamometry was studied in 109 normally nourished and 26 malnourished patients. The grip strength was 37,5 +/- 9,9 kg/m2 in normal men, 30,5 +/- 14,4 kg/m2 in men with carcinoma of the oesophagus (starvation-adapted) and 22,0 +/- 9,2 kg/m2 in catabolic men (P less than 0,001). Normal women had a grip strength of 31,6 +/- 7,5 kg/m2 compared with 22,3 +/- 7,0 in catabolic women (P = 0,083). Hand grip dynamometry fell with age (r = 0,69 men; r = 0,57 women), although the correlation was only statistically significant in women (P less than 0,05). There was a strong correlation between right and left hand grip (r = 0,84 men; r = 0,86 women), but hand grip did not correlate well with other indices of nutritional status. Although hand grip dynamometry is a quick, easy and reproducible test, and grip strength is reduced in malnutrition, it cannot replace other tests of nutritional status.

Adolescent↗
PubMed1985

Total parenteral nutrition by peripheral venous infusion in patients with oesophageal carcinoma.

The safety and efficacy of pre-operative intravenous feeding using a peripheral venous infusion technique was evaluated in 15 black patients with oesophageal carcinoma. Energy requirements were based on individual energy expenditure at rest calculated from oxygen consumption and the respiratory quotient. Patients received 7 600 non-protein kJ and 9,4 g nitrogen daily for 14 days. Although no measurable improvements in nutritional status were noted after intravenous feeding, peripheral venous alimentation using the dual energy system proved an effective method of preventing progressive weight loss and depletion of the lean body cell mass. The infusion technique was safe and without serious metabolic or infectious complications. Total parenteral nutrition by peripheral venous infusion is a viable alternative to the central venous approach in patients with oesophageal carcinoma when their clinical and metabolic status demands early establishment of a positive nitrogen balance.

Adult↗
PubMed1984

Total parenteral nutrition with the '3-litre bag': effect of fat emulsion on amino acid kinetics and nitrogen balance in patients with intestinal fistulae.

Three metabolically stable patients, receiving total parenteral nutrition as part of their management for post-surgical intestinal fistulae, were studied over a 16-d period in order to assess the effect of two different energy sources on protein metabolism. Nutrient intake was kept constant throughout except for the energy source: for half the time the patients received glucose alone, for the other half glucose plus fat emulsion (3:1 mixture). Amino acid metabolism, as indicated by rates of leucine turnover, was measured by constant infusion of [1-14C]-leucine for 24 h at the end of each of two 8-d periods. The rates of protein synthesis in the three patients (means of two measurements) were 5.15, 2.45 and 3.8 g/kg/d. No significant difference in nitrogen balance, plasma amino acid concentrations or amino acid kinetic rates could be detected whether energy was supplied as glucose alone or glucose plus fat. The extra expense of supplying energy as fat does not seem justified when total parenteral nutrition is given to stable patients for periods of up to 8 d.

Aged↗
PubMed1983

Retrosternal gastric bypass for the palliative treatment of unresectable oesophageal carcinoma. A simple technique.

A simple and effective technique of retrosternal gastric bypass of the excluded oesophagus for the palliative treatment of unresectable carcinoma of the upper thoracic oesophagus is described. It was used in 60 patients, of whom 5 (8,3%) died. Postoperative morbidity was considerable, complications including chest infection in 20 patients (33,3%), wound infection in 8 (13,3%) and anastomotic leakage in 5 (8,3%); the latter caused 2 deaths. All of the patients who survived the operation were able to swallow solid food and saliva satisfactorily.

Adult↗
PubMed1983

Continuous ambulatory peritoneal dialysis in the physically disabled.

Continuous ambulatory peritoneal dialysis (CAPD) has been increasingly used as maintenance home dialysis by patients in end-stage chronic renal failure since it was first described in 1976. The procedure is hazardous in the physically disabled and blind and in non-compliant patients. This paper describes 2 patients, one with rheumatoid arthritis and the other with Volkmann's ischaemic contracture of the left forearm, who are able to carry out CAPD successfully with the aid of bioengineering.

Adolescent↗
PubMed1983

Total parenteral nutrition--progress with the 3-litre bag.

Recently a disposable 3-litre plastic bag in which the 24-hour nutrient requirements for total parenteral nutrition can be mixed to provide a single solution was introduced to South Africa. We report our initial experience with the 3-litre bag (379 'catheter days'), comparing it with the conventional multiple-bottle system (267 days) in a series of 10 patients. The 3-litre bag system proved easier to administer and also reduced nursing supervision, improved metabolic control and reduced complications. In particular, the control of blood sugar levels in glucose-intolerant patients was significantly better. The 3-litre bag appears to be a major advance in the field of parenteral nutrition, resulting in improved patient care and management.

Evaluation Studies as Topic↗
PubMed1983

Nutritional support of the hospitalized patient. Part II. Clinical indications.

The first part of this review dealt with the background, methodology and techniques of nutritional support. As a significant proportion of hospitalized patients suffer from various forms of unrecognized and untreated malnutrition, nutritional support is essential for the maintenance of body mass and function until specific treatment is able to influence the course of disease. The following review highlights various medical and surgical conditions in which nutritional support, in particular total parenteral nutrition, has been advocated in adult patients. Nutritional repletion as a therapeutic modality is still in its infancy, and consequently its true role in patient management is still undergoing evaluation.

Acute Kidney Injury↗
PubMed1983

E-rosette inhibition and tumour recurrence in early breast cancer.

The relationship of serum blocking activity and susceptibility to tumour recurrence using E-rosette inhibition by normal allogenic lymphocytes was evaluated before and after operation in 20 patients with early breast cancer. Preoperative serum inhibition levels did not predict recurrent tumour. The mean postoperative inhibition in patient with recurrence was significantly greater than in those without recurrence. Postoperative testing only in a group of 124 patients showed that the development of local tumour recurrence was preceded by significantly greater inhibition of E-rosetting than occurred in patients without recurrence. The application of a threshold level of serum inhibition of 15 per cent distinguishes patients who are unlikely to develop tumour recurrence over a 4-year follow-up period. Serial measurements of serum inhibition at 6-monthly intervals over 2 years did not add to the predictive value of this test.

Breast Neoplasms↗
PubMed1983

Pulsion intubation v. restrosternal gastric bypass for palliation of unresectable carcinoma of the upper thoracic oesophagus.

The optimum method of restoring the ability to swallow in patients with oesophageal carcinoma remains controversial. This prospective randomized study evaluates the palliative potential of pulsion intubation v. retrosternal gastric bypass of the excluded oesophagus in 106 patients with unresectable carcinoma; 55 patients were intubated and 51 patients treated by gastric bypass. The operative mortality and morbidity, palliation of dysphagia and postoperative nutritional status were compared in the 2 groups. Intubation resulted in 3 deaths (5.5 per cent) and gastric bypass in 4 deaths (7.8 per cent). Intubation was complicated by chest infection in 13 patients (24 per cent) but complications related to the procedure occurred in only 5 patients and included tube migration (2), respiratory obstruction (1), bleeding (2) and oesophageal perforation (1). Gastric bypass was complicated by chest infection in 14 patients (27 per cent), but procedure-related complications were common and included pneumothorax (3), wound infection (6), subphrenic abscess (2), anastomotic leak (5) and purulent neck discharge (3). Palliation of dysphagia was achieved in 93 per cent of patients following intubation and 92 per cent of patients following bypass. Nutritional status improved more rapidly following bypass. Nutritional status improved more rapidly following intubation. Pulsion intubation is the preferred palliative procedure because of fewer complications and a lesser degree of postoperative catabolism.

Adult↗
PubMed1981

Inhibition of mitogen-induced lymphocyte proliferation by autologous serum in oesophageal carcinoma.

The reactivity of lymphocytes from patients with oesophageal carcinoma in response to mitogenic stimulation with phytohaemagglutinin was assessed in four culture systems in an attempt to demonstrate an inhibitory effect of cancer serum on lymphocyte transformation. The metaphase index (number of cells at metaphase/1000 live cells) was used to determine lymphocyte reactivity of patients and controls in the presence of: (a) autologous plasma; (b) pooled AB serum; (c) pooled plasma from patients with oesophageal cancer, and (d) fetal calf serum. The division of lymphocytes from cancer patients was significantly depressed in the presence of autologous plasma (p<0,001) when compared with division of lymphocytes of control subjects. No significant difference was evident in pooled AB serum, homologous cancer plasma or fetal calf serum. The depressed lymphocyte reactivity in cancer patients appears to be related to a serum inhibitory factor.

Cells, Cultured↗