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C Mews

Publications and source records attributed to C Mews.

5 recordsLinked to original sources
PubMed1999

Pancreatic enzyme replacement therapy in cystic fibrosis: Australian guidelines. Pediatric Gastroenterological Society and the Dietitians Association of Australia.

Pancreatic enzyme replacement therapy (PERT) is a major factor associated with achieving optimum growth and nutritional status in cystic fibrosis (CF) patients with pancreatic insufficiency and consequent malabsorption. Currently in Australian CF clinics policies for the usage of PERT vary considerably. This paper highlights the current issues related to fat absorption and use of PERT in CF. It also provides evidence to support the recommendation of a PERT dose based on a standard ratio of lipase units per gram of dietary fat consumed for individual patients. A consistent approach to PERT doses will facilitate identification of patients whose PERT intake increases their risk of fibrosing colonopathy and for whom gastroenterological review is warranted. Recent reports indicate that PERT intake can be reduced with a secondary improvement in growth and nutrition status as a consequence of increased dietetic input. These Australian guidelines for the judicious use of PERT in CF should lead not only to a refinement in nutritional management of patients with CF but should also facilitate an improvement in compliance with therapy due to sophistication in patient education materials. The Australian guidelines for the use of PERT in CF if correctly applied, will also provide patients and their families with a better understanding of the relationship between PERT and nutritional status.

Adolescent↗
PubMed1998

Comparison of radiographic and necropsy findings of lung lesions in calves after challenge exposure with Pasteurella multocida.

OBJECTIVES: To test suitability of radiographic evaluation of lung lesions as a substitute for lung lesion scores derived by examination at necropsy in challenge-exposure models of bovine pneumonia. ANIMALS: 10 calves selected by body weight from 20 multiple-source male Holstein calves approximately 1 to 2 months old enrolled in a Pasteurella multocida challenge-exposure study. PROCEDURE: Calves were paired on the basis of weight and randomly assigned within pairs to vaccine or control (saline solution) group. By use of deep tracheal cannulation, calves were challenge exposed with a culture of virulent P multocida, observed for 10 days, euthanatized, and necropsied, and the lungs were scored for pneumonic lesions. Radiographic views of the lung fields of the calves were taken before challenge exposure and before necropsy and were evaluated for alveolar disease by a veterinary radiologist. Lung lesion scores were compared with radiographic evaluations. RESULTS: There was a strong and significant correlation (R2 = 0.91, P < 0.001) between results of the evaluation of postchallenge-exposure radiographs and necropsy results. There also was also strong and significant correlation (R2 = 0.90, P < 0.001) between evaluation of the prechallenge-exposure radiographs and necropsy results. CONCLUSIONS: Radiographic evaluation of lung lesions correlates well with lung lesions found at necropsy. The findings emphasize the need for caution in interpreting the results of challenge-exposure studies of bovine respiratory tract disease in which small numbers of calves are studied.

Animals↗
PubMed1996

Hepatitis C genotypes in Australian haemophilia patients.

BACKGROUND: Differences in the hepatitis C virus (HCV) genotype influence the severity of HCV related liver disease and response to interferon therapy. HCV infection is frequent in Australian haemophilia patients who have been exposed repeatedly to multiple HCV genotypes through non HCV virally inactivated clotting factor concentrates. The distribution of the various HCV genotypes in Australian haemophilia patients is unknown. AIM: To examine the HCV genotype distribution and clinical features of HCV associated liver disease in Australian haemophilia patients. METHODS: Forty patients with bleeding disorders who were known to be both HCV antibody and polymerase chain reaction (PCR) positive were evaluated by direct sequencing of the PCR products for the HCV genotype. RESULTS: Genotype 1 was found in 65% of patients (26/40), type 2 in 5% (2/40) and type 3 in 30% (12/40). No genotypes 4 to 6 were found. There was no association between the HCV genotype and the severity of haemophilia, alanine transaminase levels, or the presence of portal hypertension. Unlike European, Asian and American studies where the majority of type 1 infection is subclass 1b, in Australian haemophilia patients it is subclass 1a (73%-19/26) which may have a better prognosis and response to interferon. CONCLUSIONS: Despite patients with haemophilia being exposed to multiple HCV genotypes, it appears that there is no selection advantage of one genotype over another. Australian haemophilia patients with HCV have a different genotype distribution to that reported in other countries and care should be observed in interpreting non Australian studies concerning HCV.

Adolescent↗
PubMed1994

Cholestasis in infancy.

It is imperative that serum bilirubin fractionation be performed in any infant whose jaundice is prolonged to identify the infant who has cholestasis. Conjugated hyperbilirubinemia always is pathologic, and a well-organized and expedient diagnostic evaluation should be undertaken to identify those conditions that are treatable medically or surgically if they are recognized early. The complications of prolonged cholestasis need to be recognized and the appropriate medical therapy instituted to allow patients to maximize their growth potential, avoid the problems of nutrient deficiencies, and maintain a reasonable quality of life. Hepatic transplantation now offers the opportunity for long-term survival for infants whose liver disorders previously were fatal.

Causality↗