Biomedical subjects

I B Nyulasi

Publications and source records attributed to I B Nyulasi.

4 recordsLinked to original sources

PubMed2005

Reduced bone density in cystic fibrosis: DeltaF508 mutation is an independent risk factor.

The aim of this cross-sectional study was to determine the prevalence and identify determinants of reduced bone mineral density (BMD) in adults with cystic fibrosis (CF). Adults (88) with CF (mean+/-SD age 29.9+/-7.7 yrs; forced expiratory volume in one second (FEV1) 58.2+/-21.5% of the predicted value) were studied. BMD at the lumbar spine (LS) and femoral neck (FN) and body composition were measured using dual-energy X-ray absorptiometry. Blood and urine were analysed for hormones, bone turnover markers, and the cytokines tumour necrosis factor-alpha, and interleukin-6 and -1beta. FEV1 (% pred); CF genotype; malnutrition; history of growth, development or weight gain delays; and corticosteroid use were analysed. BMD Z-scores were -0.58+/-1.30 (mean+/-SD) at the LS and -0.24+/-1.19 at the FN. Z-scores of <-2.0 were found in 17% of subjects. Subjects who were homozygous or heterozygous for the DeltaF508 mutation exhibited significantly lower Z-scores than those with no DeltaF508 allele. Multiple linear regression showed that the DeltaF508 genotype and male sex were independently associated with lower BMD at both sites. Other factors also independently associated with lower BMD included malnutrition, lower 25-hydroxyvitamin D level, lower fat-free mass and lower FEV1 (% pred). In conclusion, reduced bone mineral density in cystic fibrosis is associated with a number of factors, including DeltaF508 genotype, male sex, greater lung disease severity and malnutrition.

Adult↗

PubMed1999

Bone loss at the proximal femur and reduced lean mass following liver transplantation: a longitudinal study.

The longevity of recipients of liver transplant may be compromised by spinal osteoporosis and vertebral fractures. However, femoral neck fractures are associated with a higher morbidity and mortality than spine fractures. As there is little information on bone loss at this clinically important site of fracture, the aim of this study was to determine whether accelerated bone loss occurs at the proximal femur following transplantation. Bone mineral density and body composition were measured at the femoral neck, lumbar spine and total body, using dual x-ray absorptiometry in 22 men and 19 women, age 46 +/- 1.4 y (mean +/- SEM) before and at a mean of 19 mo after surgery (range 3-44). Results were expressed in absolute terms (g/cm2) and as a z score. Before transplantation, z scores for bone mineral density were reduced at the femoral neck (-0.47 +/- 0.21 SD), trochanter (-0.56 +/- 0.19 SD), Ward's triangle (-0.35 +/- 0.14 SD), lumbar spine (-0.76 +/- 0.13 SD), and total body (-0.78 +/- 0.15 SD) (all P < 0.01 to < 0.001). Following transplantation, bone mineral density decreased by 8.0 +/- 1.7% at the femoral neck (P < or = 0.01) and by 2.0 +/- 1.2% at the lumbar spine (P < or = 0.05). Total weight increased by 12.2 +/- 2.3%, lean mass decreased by 5.7 +/- 1.4%, while fat mass increased from 24.1 +/- 2.0% to 35.1 +/- 1.8% (all P < or = 0.001). Patients with end-stage liver disease have reduced bone mineral density. Liver transplantation is associated with a rapid decrease in bone mineral density at the proximal femur, further increasing fracture risk and a reduction in lean (muscle) mass, which may also predispose to falls. Prophylactic therapy to prevent further bone loss should be considered in patients after liver transplantation.

Absorptiometry, Photon↗

PubMed1996

Assessment of the effect of increased dietary fibre intake on bowel function in patients with spinal cord injury.

It is common for constipation to occur following severe spinal cord injury (SCI). Although a bowel management program including a high fibre diet is an integral part of rehabilitation, the effect of a high fibre diet on large bowel function in SCI has not been examined. The aims of this study were to assess the nutrient intake of SCI patients, to determine baseline transit time, stool weight and evacuation time and to assess the effect of addition of bran on large bowel function. Eleven subjects, aged 32 +/- 10.5 years participated in the study. The level of injury ranged from C4 to T12; only one patient had an incomplete injury. Baseline mean energy intake was 7823 +/- 1443 kJ/d, protein intake 93 +/- 21 g/d, carbohydrate intake 209 +/- 39 g/d and mean dietary fibre intake 25 +/- 8 g/d. Mean baseline stool weight was 128 +/- 55 g/d and bowel evacuation time was 13 +/- 7.4 min/d. Three subjects who consumed < 18 g dietary fibre/d had low stool weights of 60-70 g/d and two had very delayed transit times that were too slow to enable quantitation. Mean mouth to anus transit time was 51.3 +/- 31.2 h, mean colonic transit time 28.2 +/- 3.5 h, right colonic transit time 5.9 +/- 4.5 h, left colonic transit time 14.5 +/- 5.2 h and rectosigmoid colonic transit time 7.9 +/- 5.6 h. Following the addition of bran, dietary fibre intake significantly increased from 25 g/d to 31 g/d (P < 0.001). However, the mean colonic transit time increased from 28.2 h to 42.2 h (P < 0.05) and rectosigmoid colon transit time increased from 7.9 to 23.3 h (P < 0.02). Stool weight, mouth to anus, left and right colon transit time and evacuation time did not change significantly. Results of this study suggest that increasing dietary fibre in SCI patients does not have the same effect on bowel function as has been previously demonstrated in individuals with 'normally functioning' bowels. Indeed the effect may be the opposite to that desired. This preliminary study highlights the need for further research to examine the optimal level of dietary fibre intake in SCI patients.

Adult↗

PubMed1984

Methods of introducing nasoenteric feeding. A prospective randomized study.

In 50 patients requiring enteral nutritional support, a nasogastric feeding regimen with an isotonic, polymeric solution was introduced either by the slow, conventional four-day method or by a more rapid one. The incidences of symptoms associated with either introduction protocol were compared. As many as 82% of patients showed no sign of intolerance, whatever the method used. Of the remainder, four developed symptoms that might have been associated with the treatment. Only one of these patients had been subjected to the fast introduction protocol. It is concluded that undiluted isotonic lactose-free nasoenteric solutions can be safely introduced rapidly to meet energy requirements earlier.

Enteral Nutrition↗