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Biomedical subjects

G C Cook

Publications and source records attributed to G C Cook.

At least 109 records · Page 6Linked to original sources
PubMed1979

Gut hormones in tropical malabsorption.

Concentrations of various gut hormones were measured after a test breakfast in eight patients with severe tropical malabsorption and 12 controls. The patients with tropical malabsorption had greatly raised basal plasma motilin and enteroglucagon concentrations, but their postprandial release of both gastric inhibitory polypeptide and insulin was significantly reduced. The pattern of gut hormone release differed from that found in coeliac disease. The measurement of gut hormones, each of which has a specific site and function, thus throws new light on the pathophysiology of tropical malabsorption and may suggest approaches of treatment.

Adult↗
PubMed1979

Training of doctors and delivery of health care in developing countries.

In the past two decades, the training of doctors in developing countries has become confused with the delivery of health care. There should be a balance in the financial aid directed to rural and to urban areas; at present rural areas receive too much. The urban hospital, and especially the national teaching hospital, where most of the teaching, care of the seriously sick, and research are done, is in decline. In the training of doctors, the vital clinical approach, oriented towards the individual patient, is losing ground.

Curriculum↗
PubMed1979

Acute bowing fracture of the fibula in an adult.

Acute traumatic bowing of bone has only recently been recognized. Although most of these unusual fractures have been described in the pediatric forearm, bowing fractures of other juvenile long bones have also been reported. The authors describe a case of an acute bowing fracture of the fibula in a young adult.

Adult↗
PubMed1979

The D-xylose absorption test in different ethnic groups.

Fifty-nine hospital in-patients in England, Saudi Arabia and Zambia had 5-h urinary xylose measured after a 25 g oral load; in 47 of them blood xylose concentration at 90 min. was measured. All of them came from an urban environment and none had significant organic disease. Exactly similar methods were used in each country; the investigator was the same in all of them. Mean xylose excretion was very similar in the English, Asians and Africans. The high incidence of abnormal xylose absorption tests in indigenous populations in tropical countries is due to environmental factors; it does not have a genetic basis.

Adolescent↗
PubMed1978

Delayed small-intestinal transit in tropical malabsorption.

The time of breath hydrogen appearance (T) after oral lactulose was determined in 98 patients in London who had been to the tropics. Fifty-six controls from three different ethnic groups had no evidence of gastrointestinal disease; 23 had tropical malabsorption, which was severe in 10; and 19 had chronic diarrhoea without malabsorption. Mean T was significantly delayed in patients with tropical malabsorption compared with controls, indicating that their mouth-caecum transit rate was abnormally slow. In six patients with tropical malabsorption who were reinvestigated after treatment a fall in the value for T seemed to parallel clinical improvement. Three patients with diarrhoea due to chronic colonic disease had delayed T. Patients with tropical malabsorption have bacterial colonisation of the small intestine, which is important in the pathogenesis of the disease. Bacterial overgrowth, which sometimes occurs after infective diarrhoea in the tropics and gives rise to tropical sprue, is a result of stasis.

Administration, Oral↗
PubMed1978

Breath hydrogen concentrations after oral lactose and lactulose in tropical malabsorption and adult hypolactasia.

Thirty-six hospital in-patients in London had breath-hydrogen concentrations measured after 50 g lactose were given orally; in 23 or them serial blood glucose concentrations were also estimated. Eight had tropical malabsorption (TM), 14 were Europeans with no detectable disease (normal group) and 14 who also had no detectable disease, were from ethnic groups known to have a very high incidence of genetically determined adult hypolactasia (hl). In 21 of them breath-hydrogen concentrations were also measured after 33.5 g of lactulose were given orally. There was a good inverse correlation between breath-hydrogen production and blood-glucose rise after lactose. Correlations between the first appearance of hydrogen (T) and the area under the hydrogen curve between 0 and 120 min (A) were inversely significant both for lactose and lactulose. Mean T was earlier and mean A greater for lactose compared with lactulose. Correlation between individual values for A after lactase and after lactulose was significant. Indirect measurements of lactase are of no value in either detecting or assessing the severity of TM; that is largely due to the very high incidence of HL in individuals exposed to that disease.

Adult↗
PubMed1977

Effect of systemic bacterial infection on absorption rates of L-histidine and glycylglycine from the human jejunum in vivo.

Jejunal absorption rates of L-histidine (from a 100 mmole/liter solution) and glycylglycine (from a 50 mmole/liter solution) were determined with a souble-lumen tube perfusion system in vivo in 12 Zambian African men; six had acute bacterial pneumonia (infection group) and six had no clinical evidence of a bacterial infection (control group). With this experimental design the mean rate of histidine absorption was significantly higher in the infection compared with the control group, but mean rates for glycine absorption from glycylglycine were not significantly different. During the glycylglycine infusions, the luminal disappearance rate of the intact peptide was significantly greater than the total glycine absorption rate. The correlation between individual histidine and glycylglycine absorption rates was significant. That is probably because after intracellular hydrolysis and efflux to the lumen, some glycylglycine is reabsorbed as free glycine by the amino-acid transfer mechanism, and the rate of that has previously been shown to be increased in subjects with systemic bacterial infections.

Adolescent↗
PubMed1977

Rates and mechanisms of glucose, galactose, and xylose absorption in man in vivo.

Jejunal absorption-rates of glucose, galactose, and xylose were determined consecutively, using a double-lumen tube perfusion technique, in 6 Arab subjects in vivo; perfusion solutions contained 200 mmol/l of each monosaccharide. Mean xylose absorption rate was significantly lower than that for glucose (P less than 0.001) and galactose (P less than 0.001). In order to investigate evidence that glucose and xylose share the same jejunal transfer mechanism, their absorption-rates when given alone and together, at high concentrations, were determined in 6 other Arabs; perfusion solutions contained (1) 200 mmol/l glucose, (2) 100 mmol/l xylose, and (3) 200 mmol/l glucose + 100 mmol/l xylose. Rates of glucose and xylose absorption were not significantly influenced by the other monosaccharide. This study does not therefore confirm existence of a common transfer mechanism. A significant correlation between absorption rate of glucose and weight of xylose excreted after a 25 g oral load (P less than 0.05) was demonstrated.

Adolescent↗
PubMed1977

Effect of systemic infection and raised serum Ig-G concentration on the D-xylose test.

Urinary d-xylose excretion during five hours after a 25 gm. oral load was determined in 47 Zambian African patients; some had systemic infections. Serum albumin, total globulin and gamma-globulin concentrations were determined in all and immunoglobulins Ig-G, Ig-A, Ig-M and Ig-D in 36 of them. An inverse association between weight of xylose excreted and serum gamma-globulin (P less than 0.02) and Ig-G (P less than 0.002) concentrations was significant. Taken together with previous observations, those results indicate reduced xylose absorption in the presence of systemic infection. The mechanism of the association is unknown but seems likely to have a nutritional importance; systemic infections must be eradicated if the nutritional status of rural Africans is to be improved.

Adolescent↗