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Biomedical subjects

E M Jepson

Publications and source records attributed to E M Jepson.

7 recordsLinked to original sources

Resolution of right atrial thrombus following anticoagulation.

A man with congestive heart failure, atrial fibrillation and increasing dyspnoea on exertion was shown to have a large right atrial thrombus and multiple pulmonary emboli. The patient was anticoagulated and a subsequent echocardiogram showed that the thrombus was no longer present. This report demonstrates the need for echocardiography in patients presenting with pulmonary emboli and questions the value of anticoagulation in patients with intracavitary thrombi.

Aged

Dietary fiber and blood lipids: reduction of serum cholesterol in type II hyperlipidemia by guar gum.

Guar gum, a storage polysaccharide galactomannan and a form of dietary fiber, was administered to 10 patients with type II a or b hyperlipidemia for 2 weeks. Five grams of gum was given before each of three meals daily, either in a specially prepared soup or mixed with fruit juice or milk. No other deliberate change of diet was made. Three patients had been taking 12 to 16 g/day of cholestyramine for more than 2 years and one had been taking 1000 mg of clofibrate daily. These drugs were continued throughout the trial. Serum cholesterol levels of all 10 patients had been stable for 6 to 18 months before the trial at the start of which the mean level was 345 +/- 15 mg/dl. After 2 weeks of guar gum the mean was 308 +/- 16 mg/dl, a fall of 10.6% (P less than 0.01). Serum triglyceride was not changed significantly. Guar gum, which can be incorporated into foods, merits further study as a potential hypocholesterolemic agent.

Anticholesteremic Agents

Low dose guar in a novel food product: improved metabolic control in non-insulin-dependent diabetes.

Sixteen non-insulin-dependent diabetic patients, mean age 60 years (range 47-69 years) and duration of diabetes 9 years (2-20 years), completed a randomized cross-over study of three 6-week periods separated by 2-week intervals to minimize carry-over effects, in which their usual bread was replaced by either control bread, guar bread (100 g guar/kg wheat flour), or control bread plus a guar granulate. The mean (+/- SEM) intake of guar taken in bread was 7.6 +/- 0.7 g/day (range 3.1-14.3 g/day). The granulate was taken in a dose of 5 g twice daily which provided 8.3 g guar/day. Significant reductions were found in glycosylated haemoglobin after guar bread (11.5 +/- 0.8% to 10.7 +/- 0.8%; p less than 0.02) and after guar granulate (11.2 +/- 0.8% to 10.6 +/- 0.7%; p less than 0.05) compared with control bread. Total cholesterol was also reduced significantly after both guar bread and guar granulate (p less than 0.01, p less than 0.02), the changes being due to LDL-cholesterol. Dietary intakes and body weight did not change. No significant side-effects were reported; 14 subjects found guar bread more palatable than guar granulate but 8 preferred the granulate for its convenience. We conclude that a lower than convential dose of guar can be effective and palatable. The incorporation of guar into food increases its metabolic benefits and palatability.

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