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Biomedical subjects

A Forbes

Publications and source records attributed to A Forbes.

230 records · Page 13Linked to original sources
PubMedDate not supplied

A simple enzyme-linked immunosorbent assay for sex hormone-binding globulin.

A simple enzyme-linked immunosorbent assay (ELISA) for sex hormone-binding globulin (SHBG) has been developed. Polyclonal antibody raised to SHBG purified to homogeneity was employed. The ELISA, which may be performed in under 4 h, shows no cross-reactivity with other serum proteins, has a sensitivity of less than 1.2 fmol per sample, demonstrates excellent correlation with ligand-binding techniques (r = 0.996; p less than 0.0001), and has intra- and inter-assay coefficients of variation of between 5-9% and 7-11% respectively.

Animals↗
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Micronutrient status in patients receiving home parenteral nutrition.

Administration of home parenteral nutrition (HPN) to patients with intestinal failure requires attention to caloric content of feeds, fluid, electrolyte balance, and micronutrient status. Peripheral blood estimations of vitamins and trace elements may be abnormal, but their clinical significance in relation to deficiency or toxicity states is not always clear. We sought to determine the incidence and nature of clinical micronutrient abnormality in our HPN program. Clinical assessment and case record review of 49 patients actively receiving HPN was undertaken, and, in 32 of these patients, serum micronutrient levels were assayed. Clinical evidence of micronutrient deficiency was identified in 16 patients (33%). Iron deficiency anemia occurred in 14 patients which resolved after iron supplementation in all except 1 patient who had persistent intestinal blood loss. Anemia was precipitated in six patients by identifiable clinical events (acute gastrointestinal disease in five and menorrhagia in one), and in two others folate deficiency coexisted. Biotin deficiency developed in three patients, manifested by dry eyes and angular cheilitis or hair loss. Vitamin A deficiency resulting in visual disturbance developed in one patient who was not receiving multivitamin supplements at that time. Serum levels of zinc, copper, selenium, manganese, vitamin A, and vitamin E were measured in 32 patients. No patient had normal levels of all six micronutrients. Nevertheless, there was no clinical evidence of toxicity or deficiency in any of these patients at the time assays were performed. In conclusion, abnormalities of micronutrient status are common in HPN patients, but serious sequelae appear to be unusual.

Adult↗
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Termite control and other determinants of high body burdens of cyclodiene insecticides.

Breast milk fat concentrations of three cyclodiene insecticides--dieldrin, heptachlor epoxide, and oxychlordane--were measured in 797 primiparous women, and sources of exposure that contributed significantly to high body burdens were investigated. All three distributions were highly skewed to the right, with median concentrations falling between 0.007 and 0.039 mg/kg. Termite control of residence was associated consistently with being in the high-body-burden group for all three compounds, but the association was greatest for heptachlor. Age, socioeconomic status, residential area, smoking, and home use of insecticides were also associated with high body burden of one or more of the compounds, but the odds ratios were lower than those for termite control; the findings were inconsistent for the three compounds. The results for termite control remained statistically significant when we adjusted for the other factors; therefore, termite control of residence is an important risk factor for cyclodiene insecticide absorption.

Adipose Tissue↗
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Hypermanganesemia in long-term intravenous nutrition and chronic liver disease.

BACKGROUND: Hypermanganesemia and cholestatic liver disease are both recognized complications of long-term IV nutrition. Manganese is primarily excreted in bile, and recent studies have indicated that manganese toxicity may play a role in the pathogenesis of IV nutrition-associated cholestasis. METHODS: Whole blood and plasma manganese concentrations were measured in patients receiving long-term home IV nutrition (HIN, n = 30). Whole blood manganese concentrations also were measured in patients with chronic liver disease (CLD, n = 10) and control subjects (n = 10). RESULTS: Whole blood manganese concentrations of all CLD patients were within the reference interval (73 to 210 nmol/L) and were not different from those of the control group (151 +/- 44 nmol/L, CLD vs 155 +/- 35 nmol/L, control; not significant), despite the presence of cholestasis. In contrast, whole blood manganese concentration was increased (>210 nmol/L) in 26 patients, and plasma manganese concentration increased (>23 nmol/L) in 23 of the patients receiving HIN. None of the patients exhibited neurologic signs of manganese toxicity. There was no correlation between whole blood manganese concentrations and markers of cholestasis, IV manganese intake, or duration of HIN. However, plasma manganese concentration correlated both with average weekly IV manganese intake (r = .44, p = .02) and with gamma-glutamyl transferase (r = .43, p = .02) and alkaline phosphatase activities (r = .55, p = .003). CONCLUSIONS: Cholestatic liver disease does not appear to contribute to increased whole blood manganese concentrations in patients not receiving HIN. Plasma manganese concentrations in patients receiving HIN reflect recent manganese exposure and impaired excretion where cholestasis is present. The lack of relationship between plasma and whole blood manganese concentrations suggests that factors other than manganese intake and excretion affect intracellular concentrations.

Adult↗
PubMedDate not supplied

Comparison between patella cartilage volume and radiological assessment of the patellofemoral joint.

OBJECTIVES: There is no information on how patella cartilage relates to the radiological grade of individual features of patellofemoral osteoarthritis (osteophytes or joint space narrowing) which have been used in most epidemiological and clinical studies. In this study we compared patella cartilage volume as measured by magnetic resonance imaging (MRI) with radiological assessment of the patellofemoral joint. METHODS: 157 subjects with specific features of patellofemoral osteoarthritis (osteophytes and joint space narrowing) ranging from grade 0-3 were examined (age 62 +/- 10 years, 62% female). Each subject had skyline and lateral patellofemoral radiographs performed. Patella cartilage volume was determined by processing images acquired in the sagittal plane using T1-weighted fat saturated MRI at an independent work station. RESULTS: Grade of joint space narrowing (JSN) as measured on skyline and lateral patellofemoral radiographs was inversely associated with patella cartilage volume. After adjusting for age, gender and body mass index, for every increase in grade of skyline JSN (0-3), the patella cartilage volume was reduced by 411 mm3. For every increase in lateral patellofemoral JSN grade (0-3), the adjusted patella cartilage volume was reduced by 125 mm3. The relationship was stronger for patella cartilage volume and skyline JSN (r = -0.54, p < 0.001) than for lateral patellofemoral JSN (r = -0.16, p = 0.015). There was no significant association between patella cartilage volume and osteophytes measured on skyline or lateral radiographs. CONCLUSIONS: There is a significant negative association between patella cartilage volume and JSN, but not osteophytes. This association was strongest for the skyline rather than lateral radiographs. Longitudinal studies will be needed to determine the role of patella cartilage measurement in assessing progression of patellofemoral osteoarthritis.

Age Factors↗
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Foetal steroid binding protein and malignancy.

Foetal steroid binding protein (FSBP) is a normal constituent of adult human serum; in vivo it appears to influence the degree of steroid binding to albumin rather than acting primarily as a high affinity saturable binding protein. Serum levels are elevated in patients with parenchymal liver disease, hepatic malignancy and in those with non-metastatic breast cancer. That FSBP is protective against the development of breast carcinoma is however supported by a comparison of healthy women from racial groups at differing risk of this malignancy in which higher levels are found in those at lower risk. This hypothesis and the possible links between FSBP and primary hepatocellular carcinoma are further examined.

Breast Neoplasms↗
PubMedDate not supplied

Health care: international comparisons.

A conference held at the College in July 1994 examined the wide range of health care systems employed around the world and their varying responses to the combined pressures of demographic change and increasing patient expectations in the face of anticipated unsustainable increases in financial demand. The meeting, which was planned by Professor Roger Williams, was jointly sponsored by the College, the NHS Management Executive, Glaxo Holdings plc, the Nuffield Provincial Hospitals Trust and the Kohn Foundation.

Delivery of Health Care↗
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New directions.

Explore the source record for details and available documents.

Health Care Reform↗