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Biomedical subjects

H C Seftel

Publications and source records attributed to H C Seftel.

At least 109 records · Page 6Linked to original sources
PubMed1978

Intravenous fat tolerance in obese Africans with varying grades of carbohydrate tolerance.

An intravenous fat tolerance test (IVFTT) was performed and fasting plasma lipid values determined in 12 healthy normal weight, 18 obese non-diabetic, 9 obese chemical diabetic and 10 obese symptomatic diabetic African subjects. Their insulin responses to an oral glucose load were also determined. Mean plasma triglyceride levels were similar in the normal weight and obese non-diabetic groups but were significantly raised in the two diabetic groups, being highest in the symptomatic diabetics. The fractional removal-rate of an intravenous injection of the fat emulsion Intralipid was significantly less in each of the obese diabetic groups compared with the normal weight or obese non-diabetic group. There was a significant negative correlation in all but the symptomatic diabetic group between the fasting triglyceride level and the rate constants for the IVFTT. These results suggest that the rate of triglyceride clearance is an important determinant of the basal plasma triglyceride concentration in urban African subjects.

Adult↗
PubMed1977

Immunological studies of eosinophilic gastro-enteritis and treatment with disodium cromoglycate and beclomethasone dipropionate.

A 45-year-old woman with intestinal malabsorption due to eosinophilic gastro-enteritis was found to have markedly fluctuating total serum IgE levels with a positive intradermal skin test and a positive radio-allergosorbent test to milk antigen. No organ-specific or non-organ-specific auto-antibodies were detected in the patient's serum, and her complement profile was normal. Low doses of disodium cromoglycate failed to improve intestinal absorption, whereas a 16-day course of a corticosteroid, beclomethasone dipropionate 3 mg daily, improved D-xylose and carotene absorption without suppressing the hypothalamic-pituitary-adrenal axis.

Beclomethasone↗
PubMed1977

Luteinizing hormone-releasing hormone and serum growth hormone in insulin-dependent diabetes.

Growth hormone (GH) responses were studied in 26 insulin-dependent diabetics after the intravenous administration of 100 microgram of synthetic luteinizing hormone-releasing hormone (LH-RH). Although the mean basal GH concentration was significantly higher than that of 20 matched non-diabetic controls, no significant increment occurred after the LH-RH injection. (The controls also showed no rise in GH.) It seems that the GH hypersecretion of insulin-requiring diabetics does not, as is frequently noted in acromegaly, respond to the injection of LH-RH.

Adolescent↗
PubMed1977

Comparison of clofibrate with halofenate in diabetics with hyperlipidaemia.

In a double-blind, randomized study which lasted 48 weeks the effects of clofibrate and halofenate were compared in maturity-onset diabetics with hyperlipidaemia. With the use of both clofibrate and halofenate serum cholesterol values were lowered only slightly. Both agents significantly reduced triglyceride values, but the decreases were modest and transient. Both drugs significantly lowered serum urate values, although the effect of halofenate was distinctly greater. Halofenate, but not clofibrate, had a considerable hypoglycaemic effect on the patients, most of whom were also receiving oral antidiabetic medicines. The drugs produced a number of clinical and biochemical adverse reactions, and in about 20% of all patients the trial had to be discontinued prematurely. The management of hyperlipidaemia in maturity-onset diabetics is briefly discussed, and it is concluded that neither clofibrate nor halofenate is to be recommended.

Aged↗
PubMed1977

Diseases in urban and rural Black populations.

Diseases of urban and rural Blacks in South Africa are reviewed. In rural Blacks the major problems are infection and malnutrition. Other important disorders include cancer of the oesophagus, liver and cervix, and rheumatic heart disease and cardiomyopathy. The diseases in urban Blacks are those of a population in transition. Characterised by all gradations of socioeconomic development, from the relatively primitive to the completely westernised, these people exhibit a correspondingly wide and varied range of disease embracing the afflictions of rural dwellers and the new diseases of the city. Whereas the prevalence of some of the former, such as infection and malnutrition, is declining, they still constitute a considerable problem in urban Blacks. More important is the increasingly serious impact of the new disorders, which may be divided into two groups: (a) a large range and variety of alcohol-related disorders with serious effects at the social, economic, psychological and physical levels; and (b) most, if not all, of the diseases encountered in western populations. Some of these, such as obesity and hypertension, have not only attained epidemic proportions among urban Blacks, but their prevalence may actually have exceeded that among Whites. Other conditions, such as coronary heart disease, gout, gallstones and colonic cancer, which emerged later, are relatively uncommon or rare. A plea is made for much greater epidemiological research. This is necessary in order to obtain reliable knowledge of the prevalence of disease, to determine the best ways of applying present knowledge with existing and future resources, and to obtain knowledge regarding both old and new diseases of which the pathogenesis is still obscure.

Adult↗
PubMed1976

Coagulation studies in long-term survivors after renal allograft transplantation.

Screening coagulation studies were carried out on 69 long-term survivors who had received renal allografts. Fibrinogen levels were significantly raised in this group. Factor VIII activity was increased in 7 of the 11 patients studied. Six long-term survivors of renal allografts demonstrated arterial thrombotic phenomena. The onset of the thrombotic episode occurred at a relatively young age. It is considered that the hypercoagulable state may contribute to the observed increased tendency towards arterial thrombotic phenomena.

Adolescent↗
PubMed1976

Hyperlipidaemia in renal transplant patients.

The prevalence, nature and possible aetiology of post-transplantation hyperlipidaemia were studied in 94 renal allograft recipients. Sixty-five per cent of the group had hypercholesterolaemia or hypertriglyceridaemia, and types IIb and IV were the commonest forms of hyperlipoproteinaemia encountered. The pathogenesis of post-transplantation hyperlipidaemia is complex. Hypertriglyceridaemia was maximal in the first year after transplantation and could be correlated with high corticosteroid dosage during this period. Thereafter hypertriglyceridaemia was less marked and was related to obesity, corbohydrate intolerance and basal insulin levels. Mean cholesterol levels were elevated throughout the post-transplantation period, varied little and could not be related to corticosteroid dosage, body weight, carbohydrate intolerance, basal insulin levels or renal dysfunction.

Adolescent↗
PubMed1976

Clinical aspects of monocomponent insulins in the treatment of diabetes.

Conventional insulins, even if recrystallised many times, are found to contain several peptides on gel electrophoresis and are immunogenic. Antibody formation, insulin allergy, fat atrophy, fat hypertrophy and insulin bumps are thought to be largely caused by the impurities rather than by the insulin itself. 'Monocomponent' insulin has recently been prepared in the laboratories of Novo industries Ltd. Theoretically, this insulin should not cause the above complications. A combined clinical trial of monocomponent insulin has been carried out in Johannesburg and Cape Town on 24 patients with diabetes of diverse aetiology, who required insulin. The results of the trial may be summarised as follows: Monocomponent insulin appears to be very effective in patients with insulin allergy, adipopathy, and possibily in some patients in whom diabetes is not controlled with large doses of insulin. The monocomponent insulins deteriorate on storage at room temperature and yield monodesamido insulin. This de-amidation may be associated with persistent circulating antibodies to insulin and pro-insulin and with failure to reduce insulin requirements, but does not interfere with improvement in allergy or adipopathy. Long-standing diabetic patients, who are qell controlled with conventional insulin, are unlikely to gain therapeutic benefit from monocomponent insulin, and may even deteriorate or lose smooth metabolic control.

Adolescent↗
PubMed1976

Some metabolic relationships in young patients with ischemic heart disease.

The interrelationships between body weight, insulin secretion and serum lipids were studied in 40 young white patients (mean age 37 years) with established ischemic heart disease (IHD), living in Johannesburg. None was severely obese, hypertensive or overtly diabetic. In general, strong positive correlations were found between body weight and insulin concentrations and between insulin levels and fasting serum triglycerides. However, insulin levels were relatively low in 4 patients with marked hypertriglyceridemia (above 350 mg/dl). These data are consistent with the postulate that insulin promotes (hepatic) triglyceride synthesis, but when there is gross hypertriglyceridemia peripheral triglyceride clearance becomes defective. Insignificant correlations were observed between body weight and serum lipids and between cholesterol and other metabolic variables. We conclude that there is a sequential link between increasing body weight, insulin secretion and triglyceride levels in young patients with IHD, but that cholesterolemia is independent of this axis.

Adult↗
PubMed1976

Prevalence of hepatitis B surface antigen and antibody in white and black patients with diabetes mellitus.

The prevalence of hepatitis B surface antigen (HBSAg) and antibody (anti-HBS) was determined in 531 white and 519 black diabetic outpatients and in appropriate white and black control populations. There was no difference between the prevalence of either HBSAg or anti-HBS in either the white or black diabetics and that in the white and black controls. These findings make it unlikely that the vast majority of patients with diabetes mellitus have either an increased susceptibility to infection by the hepatitis B virus or an impaired ability to clear the virus once they are infected.

Adolescent↗
PubMed1975

Metabolic bone disease in the elderly. Biochemical studies in three different racial groups living in South Africa.

In an attempt to detect biochemical evidence of metabolic bone disease in the aged, we measured plasma parathyroid hormone (PTH) concentrations, in addition to plasma calcium, phosphorus, alkaline phosphatase and creatinine levels, in elderly White, Black and Indian women. All three ethnic groups demonstrated raised mean PTH concentrations. The Black patients, however, showed the greatest mean PTH elevation and the lowest plasma calcium level. Increased PTH secretion in elderly females may reflect either an age-related decline in renal function or subclinical osteomalacia. Elderly Black women seem particularly susceptible to the latter disorder, probably because of dietary and environmental factors.

Black or African American↗