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D Tweedle

Publications and source records attributed to D Tweedle.

10 recordsLinked to original sources
PubMed1977

Intravenous glucose, aminoacids, and fat in the postoperative period. A controlled evaluation of each substrate.

The metabolic effects of hypocaloric (2-51 MJ), equicalorific quantities of intravenous glucose, crystalline aminoacids, and soyabean emulsion were comapred with those of fasting in 4 groups of male patients (closely matched for age, weight, and fat-free mass) on the day of vagotomy and pylorplasty and on the fast 3 postoperative day. Patients given glucose alone excreted less nitrogen than the fasting patients but nitrogen sparing was greatest in the group given aminoacids alone. There was no evidence of any nitrogen sparing when intravenous fat was the source of energy. There was no difference in blood glucose, free fatty acids, and insulin concentrations among the groups. Ketone-body concentrations rose in the fasting and fat-fed groups but remained low in the groups who received glucose or aminoacids. This study indicates that, in the short term, the increased preservation of protein achieved by the infusion of aminoacids compared with that produced by the traditional infusion of glucose does not warrant the extra cost involved.

Adult↗
PubMed1977

Hypothyroidism following partial thyroidectomy for thyrotoxicosis and its relationship to thyroid remnant size.

One hundred and twenty-two patients were reviewed 1-7 years after partial thyroidectomy for thyrotoxicosis by two surgeons who had left thyroid remnants of different size. There was no significant difference in the prevalence of hypothyroidism or in the serum levels of thyroxine, tri-iodothyronine or thyroid-stimulating hormone between the two groups of patients. The overall prevalence of hypothyroidism was 16 per cent.

Adult↗
PubMed1977

The effect of surgical operation on venous plasma free amino acids.

The effects of abdominal operation on the antecubital vein plasma amino acid concentration were examined. With four groups, each containing ten patients, factors such as severity of surgical operation, anesthesia, and postoperative nutrition were examined. Immediately after operation there is a fall in the plasma concentrations of most amino acids; the nonessential amino acids (glutamate, proline, glycine, alanine, histidine, and arginine) continue to fall during the 2 postoperative days, whereas the essential amino acids (isoleucine, leucine, phenylalanine, and lysine, with tyrosine) are at higher concentration at 48 hours than immediately after operation. Comparison of a group of patients undergoing an operation of moderate severity (vagotomy and pyloroplasty or cholecystectomy) with those having the more severe procedure of resection of aortic aneurysm with Dacron graft replacement suggests that these general changes in amino acid concentrations do not appear to be due to the severity of the operation, although cystine levels were lower, and phenylalanine levels were higher, in the graft-replacement group. The changes did not appear to be the result of anesthesia. Increasing the postoperative glucose intake was associated with higher plasma alanine and lower methionine levels. It is suggested that, in surgical patients, cystine and tyrosine may become essential amino acids and rises in phenylalanine and methionine indicate transient liver dysfunction. The data give support to the view that a high calorie intake after operation has a beneficial effect.

Abdomen↗