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Biomedical subjects

I Hessov

Publications and source records attributed to I Hessov.

At least 37 records · Page 2Linked to original sources

Effects of short-chain fatty acids on in vitro bacterial growth of Bacteroides fragilis and Escherichia coli.

Short-chain fatty acids (SCFA) are produced in the large bowel of nonruminant mammals by bacterial anaerobic fermentation. The aim of the present study was to investigate the effects of SCFA on the in vitro growth of Bacteroides fragilis and Escherichia coli. B. fragilis and E. coli isolated from fresh human clinical samples and a reference strain for each species were incubated in a meat infusion broth with increasing amounts of SCFA and grown under anaerobic conditions at a temperature of 37 degrees C. Bacterial growth was estimated by spectrophotometry. Rate of growth was calculated from the logarithmic growth phase. SCFA, in concentrations normally found in the human colon, had a significant (p<0.01) inhibitory effect of the in vitro growth rate for E. coli, while they were without effect on the in vitro growth rate of B. fragilis. It may be concluded that under in vitro conditions SCFA had growth-inhibitory effects on E. coli, while they had no effect on B. fragilis.

Bacteroides fragilis↗

Treatment of rheumatoid arthritis with a peptide diet: a randomized, controlled trial.

Elemental diets provide food in its simplest formulation and have been used in the treatment of rheumatoid arthritis (RA) and other chronic inflammatory diseases. Such a diet is supposed to be less antigenic to the human immune system than normal food. The aim of this study was to evaluate the clinical effect of an artificial peptide diet as a temporary supplement to conventional treatment. Patients with active RA were single-blindly randomized either to a liquid elemental peptide-diet for four weeks or to continuation of the usual food (control group). In the diet group all normal foods were renounced. Thirty patients were included and followed for six months. The outcome measurements were pain intensity, morning stiffness, HAQ-score, number of swollen joints, joint tenderness, erythrocyte sedimentation rate, and patient's global assessment of health. Two of the fifteen patients assigned to the diet dropped out. The diet resulted in a transient but statistically significant improvement in the average level of pain (P = 0.02), in HAQ-score (P=0.03), and a significant reduction in Body Mass Index (P=0.001). Only one patient in the diet group had a clear remission. Side-effects were frequent but compliance good. The study showed that the peptide diet can improve some subjective and objective disease parameters. Due to the low remission ratio the peptide diet is not a treatment of choice in unselected RA-patients. but the peptide diet might be beneficial to a subset of RA-patients, e.g. patients where foods aggravate disease activity.

Adult↗

Perioperative oral nutrition.

Much attention has been paid to perioperative intravenous nutrition and postoperative enteral nutrition but the literature concerning perioperative oral nutrition is sparse. This review will draw attention to new ideas about preoperative feeding instead of overnight fasting, it will show that immediate postoperative oral nutrition is tolerated in significant amounts, that liquid supplements may be given routinely after elective surgery, and that it is worth giving dietary advice to malnourished patients on discharge from hospital.

Administration, Oral↗

Components of variance when assessing the reproducibility of body composition measurements using bio-impedance and the Hologic QDR-2000 DXA scanner.

This study evaluated the reproducibility of measuring lean tissue mass (LTM), fat mass(FM(DXA)), bone mineral content (BMC) and density (BMD) with a Hologic QDR-2000 DXA scanner, and both fat free mass (FFM(bio)) and fat mass (FM(bio)) with an impedance meter. Furthermore, the study aimed to assess whether sheets and pillows significantly altered the DXA results. Fifty-one healthy volunteers aged 20-61 years were examined before and after repositioning (n = 20), removal of the sheets (n = 10), addition of two foam pillows (n = 11) or a regular pillow (n = 10). One to 7 days later a re-examination was performed (n = 35). Eight surgical patients were also scanned twice 1-7 days apart. The day to day coefficients of variation were about 1% for most measurements, though more than 2% for FM(DXA), and FM(bio). For total tissue mass, LTM, and BMC there was a significant biological day to day variance whereas for the other measurements the day to day variation could be accounted for by just measurement variance. Pillows systematically changed the estimates of bone mineral and soft tissue, but sheets did not.

Journal Article↗

Dietary supplementation at home improves the regain of lean body mass after surgery.

Little is known about nutritional intake after discharge though it takes months to regain preoperative weight after gastrointestinal surgery. We studied whether a 4-mo intervention with dietary advice and protein-rich supplements would increase nutritional intake and gain in lean body mass (LBM) in patients who had undergone gastrointestinal surgery. Patients admitted for gastrointestinal surgery were randomized at discharge to serve as control patients (n = 47) or to receive intervention (n = 40). One month after discharge, the control patients had a nutritional intake (3-d diet record) comparable with the intake of the general population that did not increase further. During the 4 m, the intervention patients had an increased intake of protein (+22%) and energy (+16%), and an enhanced gain of LBM after 2 mo (control 0.8 kg versus intervention 2.1 kg; P = 0.009). After the 4-mo intervention, both LBM and fat were gained (control 1.7 kg LBM and 0.2 kg fat versus intervention 3.1 kg LBM and 1.5 kg fat; LBM: P = 0.029 and fat: P = 0.056). At discharge patients should increase protein intake to 1.5 g.kg-1.d-1 for 2 mo, e.g., by taking protein-rich liquid supplements.

Age Factors↗

Primary hyperparathyroidism: biochemical markers and bone mineral density at multiple skeletal sites in Danish patients.

Biochemical bone markers and bone mineral density (BMD) in spine, hip, and forearm were measured, before surgery, in 30 patients with mild to moderate primary hyperparathyroidism (PHP) (25 women and 5 men; mean age 54 +/- 12 years, range 26-73 years) and compared with normal controls. A group of 291 healthy adults (181 women and 110 men) served as controls for BMD. A smaller group of 30 normal individuals (25 women and 5 men; mean age 54 +/- 12 years; range 26-74 years) were used as matched normal controls. Parameters of bone formation (s-osteocalcin, s-alkaline phosphatase activity, and s-bone isoenzyme alkaline phosphatase activity) and bone resorption (s-type-1 collagen telopeptide) were considerably increased in patients with PHP compared with normal controls (p < 0.01 for all parameters). BMD was found to be reduced in the hip (trochanteric: 95.1 +/- 14.7% of expected, p < 0.05; intertrochanteric: 95.2 +/- 13.8% of expected, p < 0.05), and the forearm (proximal: 93.3 +/- 12.2% of expected, p < 0.05; mid: 91.8 +/- 11.6% of expected, p < 0.001; distal: 90.7 +/- 13.1% of expected, p < 0.001). Spine BMD was found significantly reduced in premenopausal (87.8 +/- 7.6% of expected, p < 0.05) but not in postmenopausal patients, and although normal women showed a decrease in spinal BMD with increasing age this was not found in the PHP women. Forearm BMD was reduced in both pre- and postmenopausal patients (distal forearm: 86.7 +/- 12.2% of expected, p < 0.05; 87.6 +/- 12.1% of expected, p < 0.01, respectively). It was concluded that Danish patients with mild or moderate PHP have only small reductions in BMD. The bone loss is mainly found in the appendicular skeleton.

Adult↗

Randomization to nutritional intervention at home did not improve postoperative function, fatigue or well-being.

BACKGROUND: Postoperative fatigue and deterioration in functional capacity have been correlated to postoperative weight loss. This suggested that nutritional support to enhance the regain of weight might improve upon the convalescence. METHODS: Patients were allocated randomly at discharge to standard management or to dietary advice and protein-rich supplements for 4 months. The convalescence of 32 patients admitted electively for colorectal surgery and of 21 operated on for acute obstruction or severe peritonitis was studied. RESULTS: The intervention substantially increased protein intake, gain in body-weight and lean body mass, especially in the legs as shown by dual-energy X-ray absorptiometry. Changes in work capacity, hand grip and pinching strength, fatigue and quality of life were similar in patients in control and intervention groups and had returned to preoperative values 1-2 months after operation, although fatigue was increased at 2-3 months. CONCLUSIONS: This study did not support the hypothesis that changes in weight were important for the changes in function and fatigue in patients with small to moderate weight loss.

Body Composition↗

Nutrition in short-bowel syndrome.

Short-bowel syndrome is a state of severe malabsorption secondary to extensive bowel resection. The most common reasons for extensive bowel resection are Crohn's disease and mesenteric infarction. The pathophysiological consequences depend on extent and site of resection, integrity and adaptation of the remaining bowel, and secondary effects on other organs. Most extensively bowel resected patients can be adequately nourished by mouth, especially since they develop compensatory hyperphagia. For patients with colon in function a high-carbohydrate low-fat diet is beneficial compared to a diet with a normal fat content, because it results in decreased diarrhoea, decreased faecal mineral losses, and increased energy assimilation. The relative amount of dietary fat does not influence stool mass or energy assimilation in jejunostomy patients. Patients with jejunostomy have a high faecal output of water, sodium, and divalent cations, and they often need permanent parenteral supply of saline as well as calcium and magnesium if their small intestinal remnant is < 200 cm and parenteral nutritional support if they retain < 100 cm small bowel. In contrast, 50 cm of the jejunum often suffices for adequate oral nutrition if most of the colon is preserved. The majority of patients needing long-term intravenous supply are trained to administer parenteral nutrition at home (HPN). Most patients on HPN obtain a good or fair quality of life with hospital readmissions corresponding to an average of 10% of the HPN duration and an overall HPN related mortality of about 4%.

Animals↗

Transmural trophic effect of short chain fatty acid infusions on atrophic, defunctioned rat colon.

PURPOSE: This study was designed to investigate and quantify trophic alterations in the defunctioned, atrophic rat colon after short chain fatty acid (SCFA) treatment was administered in a clinically relevant way. METHODS: Diverting colostomy with exclusion of distal colon was performed on adult female rats (58), and treatment was started four weeks later. Enemas of either a SCFA solution of sodium-acetate, sodium-propionate and sodium-butyrate (concentration, 780 mM), or isotonic saline (placebo) were instilled through the anus into the defunctioned colon. This was done twice daily for 7 or 14 days before death. RESULTS: After SCFA instillation for 14 days, the colonic wet weight was 18 percent higher compared with placebo (P < 0.01), and there was a similarly significant difference in dry weight (P < 0.05). Using stereologic assessment to determine the histologic composition of defunctioned colon, we found significant increases among SCFA-treated rats in the weight of the mucose (P < 0.05), the submucosa (P < 0.05), and the muscularis propria (P < 0.05) and a 30 percent increase in the mucosal surface area compared with placebo-treated in the mucosal surface area compared with placebo-treated rats (P < 0.05). Measurements of breaking strength and hydroxyproline content showed no differences between treatment groups. CONCLUSIONS: SCFA enemas have a transmural trophic effect and preserve mucosal surface area of defunctioned and atrophic colon in rats.

Acetates↗

Recovery of inulin from Jerusalem artichoke (Helianthus tuberosus L.) in the small intestine of man.

The recovery of inulin, a naturally occurring beta (2-->1)-fructan isolated from Jerusalem artichoke (Helianthus tuberosus L.), in the small intestine of man was studied in ileostomy subjects. The ileostomists were given a low-dietary-fibre diet based on white wheat bread and virtually free of inulin, and the same diet with the addition of 10 g and 30 g inulin product respectively, and the recovery and mean transit time (MTT) of inulin were estimated by tracking inulin in ileal effluent. The recovery of inulin was approximately 87% at both ingestion levels. MTT was 4.9 (SE 0.6) h at an intake of 10 g inulin product decreasing to 3.4 (SE 0.3) h at an intake of 30 g inulin product. A significant change in the fructose:glucose ratio of inulin from ingestion (4.1) to recovery in ileal effluent (4.5-4.7) and a lower recovery of the glucose residue than of the fructose residue of inulin indicate that the low-molecular-weight inulins are more sensitive to hydrolysis than the high-molecular-weight fragments. The loss of inulin during passage through the small intestine is presumably due to hydrolysis by either acids or enzymes and to microbial degradation by the microflora permanently colonizing the distal small intestine. The concentrations of lactic acid (LA) and short-chain fatty acids (SCFA) in frequently collected ileal effluents on the control day were approximately 6 nmol/l and approximately 55 mmol/l respectively. During periods with inulin ingestion the concentration of LA increased to 18-26 mmol/l (P < 0.052), while the concentration of SCFA ran converse and decreased to 18-32 mmol/l (P < 0.023). The osmotic loads (68 and 204 mosmol/l) associated with the ingestion of inulin product caused minor malabsorption of low-molecular-weight sugars.

Adult↗

Trophic effects of different enteral diets in the rat intestine.

The trophic effect of 4 commercial diets compared to chow was studied in 50 rats. The 4 commercial diets were: a free amino acid diet, a diet based on soy protein hydrolysate and two diets based on intact protein with and without extra fibre added. Bowel weight, mucosa weight and DNA content were measured after 7 days of treatment. The enteral formula based on a soy protein hydrolysate had a significant growth stimulating effect on the proximal small bowel compared to rat chow. In the ileum and in the colon all diets without fibre supplementation caused significantly lower bowel weights than rat chow.

Journal Article↗

Primary hyperparathyroidism: iliac crest trabecular bone volume, structure, remodeling, and balance evaluated by histomorphometric methods.

Iliac bone biopsies from 69 patients (48 females, 21 males; median age 58 years; range 17-79 years) with primary hyperparathyroidism (PHP) were examined, and static histomorphometric parameters compared to 30 age- and sex-matched normal controls. The control group for the dynamic parameters constituted 20 sex-matched younger normal controls. Fractional volume of trabecular bone was normal, but the trabeculae were thinner (p less than 0.05) in PHP. The structural parameters marrow space star volume, intertrabecular distance, and mean trabecular plate density were not significantly different in PHP patients compared to normal controls, but the age-related increase, for females, in marrow space star volume and decrease, for both sexes, in mean plate density observed in the controls were not noticed in the PHP group. Trabecular bone remodeling was found significantly increased in the PHP patients reflected by increased extension of eroded (p less than 0.001), osteoid (p less than 0.001), and labeled surfaces (p less than 0.05). The activation frequency was increased by approximately 50% (p less than 0.001). Neither PHP patients nor controls showed age-related decrease in trabecular thickness, and accordingly in both groups the bone balance per remodeling cycle was very close to and not significantly different from zero. Normal postmenopausal women (age greater than or equal to 50 yr) had lower trabecular bone volume (p less than 0.001) and higher intertrabecular distance than normal pre-menopausal women (age less than 50 yr).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Hemithyroidectomy. A consecutive series of 100 patients].

Treatment of isolated, scintigraphically cold thyroid nodules in the thyroid gland by means of hemithyroidectomy ensures that, in patients with thyroid carcinoma, it is possible subsequently to carry out total thyroidectomy by means of an intervention limited to the contralateral surgically intact side. The object of the present investigation to assess whether this therapeutic strategy was rational and safe. Hemithyroidectomy was carried out in 67 patients on account of a "cold nodule" while the remaining 33 patients were submitted to operation on other indications. Out of the 67 patients, one (2%) had a papillary carcinoma, 53 (79%) had follicular adenomata, 12 (18%) had nodular goitre and one (2%) had Hashimoto's thyroiditis. In the entire material, one case (1%) of permanent hypocalcaemia was encountered. None of the patients developed paresis of the recurrent laryngeal nerve. Reoperation proved necessary in one patient (1%) on account of postoperative heamorrhage. It is concluded that hemithyroidectomy is a rational primary method of treatment in cases with suspected malignant disease in the thyroid gland. Non-neoplastic conditions may be excluded with reasonable certainty by preoperative clinical assessment and thyroid scintigraphy and ultrasound scanning. The intervention is safe and every thyroid surgeon should be capable of performing the operation.

Adult↗