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Biomedical subjects

J D Mitchell

Publications and source records attributed to J D Mitchell.

At least 19 recordsLinked to original sources
PubMed1992

Breath hydrogen excretion in healthy premature infants.

Breath hydrogen excretion during the neonatal period was studied on 84 occasions in 44 well premature infants of 27-37 weeks gestational age who all received lactose-containing feeds. Only one of 15 infants studied during the first 24 h excreted hydrogen. Thereafter, the proportion of infants excreting hydrogen increased daily. From day 5 onwards all the infants studied were found to be excreting hydrogen. The concentration and the volume of hydrogen exhaled by infants ranged from 10-230 parts/10(6) and 2.6-107 microL/min, respectively. Breath hydrogen excretion was variable and showed no relationship to birthweight, gestation period, volume of feed or the time of last feed through there was an increase with the age of the infant. Breath hydrogen excretion appears to be a normal phenomenon in premature infants and is probably related to gut colonization with lactose fermenting organisms.

Aging↗
PubMed1992

Differentiation of coeliac disease and other malabsorption diseases using specific serum antigliadin IgG subclass profiles and IgA1 levels.

The differential diagnostic potential of serum gliadin-specific IgG subclass antibodies was assessed by comparing the antigliadin IgG1, 2, 3, 4 profile at different stages of coeliac disease with that of gastro-intestinal infection and also conditions associated with increased intestinal permeability. The IgG subclass profile of untreated coeliac disease was found to be the same as in healthy controls (IgG1 approximately IgG2 > IgG3 > IgG4), with only the magnitude of the individual subclass responses being increased in coeliac patients. Coeliac adults and children on gluten-free diets had different antigliadin IgG subclass profiles with IgG2 being elevated. Increased intestinal permeability or recent gastro-intestinal infection did not alter the antigliadin subclass profile from that observed in healthy individuals. Assessment of the diagnostic potential of antigliadin IgA1 and IgG1-4 measurements in screening for coeliac disease demonstrated that measurement of subclasses of gliadin-specific IgA and IgG was less sensitive and specific compared with the combined use of total antigliadin IgA and IgG. Therefore it is suggested that IgG subclasses should not be used for routine screening for coeliac disease.

Adolescent↗
PubMed1992

Neuropathy in chronic obstructive pulmonary disease: a multicentre electrophysiological and clinical study.

The incidence and type of neuropathy in patients with chronic obstructive pulmonary disease (COPD) were assessed. In a selected group of 89 patients, abnormal nerve conduction studies were found in 44%. Electrophysiological signs of a generalized peripheral neuropathy were found in 5-18%, depending on diagnostic criteria. Lesions which were thought to be due to compression or other forms of trauma were present in a further 24%. In the patients with peripheral neuropathy, the changes were distally predominant, affected mainly sensory fibres, and were consistent with an axonal type of neuropathy. There was a significant correlation between age and the incidence of peripheral neuropathy. Electrophysiological evidence of neuropathy was three times as common as clinical evidence. Much of the variation in the reported incidence of neuropathy in COPD is probably due to imprecise diagnostic criteria.

Adult↗
PubMed1992

Acute Helicobacter pylori infection in an infant, associated with gastric ulceration and serological evidence of intra-familial transmission.

Reports of the clinical picture and laboratory findings associated with naturally acquired acute H. pylori infection are rare and, although family studies have suggested person-to-person transmission, there have been no accounts of serologically proven intra-familial spread. This report describes the clinical and histological features associated with acute H. pylori infection in an infant and includes serological evidence for the possible transmission of this organism within his direct family. The infant, who presented with acute vomiting and severe haemetemesis, was found on endoscopy to have two shallow ulcers in the gastric antrum. Evidence of H. pylori infection was provided by the urease test, histology, and serology, the latter two tests showing the infection to be acute. Serologically, the patient's mother was shown to have an established H. pylori infection prior to her son, his twin brother to have acquired the infection shortly before the patient, and his father to have become infected some 63 days after the patient. Information on the acute presentation of H. pylori in children and evidence of the spread of H. pylori within family members is presented.

Acute Disease↗
PubMed1991

A reliable screening test for coeliac disease: enzyme-linked immunosorbent assay to detect anti-gliadin antibodies in serum.

A simple, rapid, highly reproducible enzyme-linked immunosorbent assay detecting anti-gliadin antibodies in serum to screen for coeliac disease (CD) is described. By combining the results of anti-gliadin IgA and IgG determinations the overall sensitivity of the assay was found to be 100% and the specificity 96% for children and 99% for adults. Significantly elevated antigliadin IgA and IgG antibodies were detected in all 20 children and all 25 adults with untreated CD. False positive results were found in 1/79 histologically normal control and 5/86 disease control children, while for adults false positive rates were 0/74 and 1/34 for the healthy and disease control groups, respectively. Anti-gliadin IgA and IgG was measured in serum samples from 52 coeliac patients (11 children and 41 adults) treated with a gluten-free diet (GFD). Each of the children and 28 of the adults who followed a strict GFD had significantly lower IgA and IgG levels than untreated CD patients. The serum anti-gliadin IgA and IgG levels of the 13 adults not complying with a GFD were similar to those found for untreated CD patients. This assay is recommended as a screening test for CD as well as a tool for follow-up of treated patients.

Adolescent↗
PubMed1991

Manganese, selenium and other trace elements in spinal cord, liver and bone in motor neurone disease.

Trace element levels were measured by neutron activation analysis in spinal cord, liver and bone of 7 control patients dying of non-neurological disease and 15 patients dying of motor neurone disease (MND). The concentration of selenium was significantly elevated in the cervical cord, liver and bone in the MND group. Although spinal cord manganese levels were increased at both the cervical and thoracic levels, the hepatic concentration was reduced in the MND patients. These findings are discussed in relation to current understanding of the pathogenesis of MND.

Adult↗
PubMed1990

Amyotrophic lateral sclerosis in Lancashire and South Cumbria, England, 1976-1986. A geographical study.

An attempt was made to identify all patients presenting with amyotrophic lateral sclerosis (ALS) during a 10-year period in Lancashire and South Cumbria, England. An analysis of their place of residence was made using the postal code. This was used to allocate each patient to an electoral ward. Using such small areal units, it was found that more cases of ALS had arisen than would have been expected by chance in several wards during the study period. Although the actual number of wards showing this effect was probably not increased, the significance levels suggest that the disease may not show a random geographical distribution. No evidence of clustering of year of birth was found. These findings indicate the need for further work seeking geographical clusters of ALS and are discussed in relation to current etiological hypotheses of the disease.

Adult↗
PubMed1990

The relationship between alexithymia and abnormal illness behavior.

The relationship between abnormal illness behavior, measured by the illness Behavior Questionnaire and alexithymia, measured by the Toronto Alexithymia Scale, was studied in four cohorts of subjects. The two measures overlap in that the more alexithymic subjects endorsed more disease conviction, hypochondriacal concern, affective inhibition, affective disturbance, and irritability. Denial was not related to alexithymia, which supports the construct validity of alexithymia. Regression models developed for the four cohorts that consisted of psychiatric outpatients, psychiatric inpatients, medically ill patients and controls differed to suggest that alexithymia state phenomena interact with trait characteristics.

Adult↗
PubMed1990

Human botulism.

The survival of Clostridium botulinum spores in improperly processed foods varies considerably with pH and temperature. The greatest risk arises from commercial or home-prepared condiments, vegetables, non-acid fruits and preserved raw fish. Clinical problems with botulism arise from the rapidity of development, unexpected manifestations involving the autonomic nervous system, including paralytic ileus, gastric dilatation and hypotension, and the need to ensure ventilation.

Botulinum Antitoxin↗
PubMed1989

Visual function in multiple sclerosis.

126 patients with multiple sclerosis and normal visual acuity were submitted to a battery of tests of visual function. The investigation included visual evoked potential, contrast sensitivity by three methods, and a segment of the Farnsworth-Munsell 100 Hue test. 22 of the patients gave a history of unilateral acute optic neuritis and in these the abnormalities were greater in degree. Contrast sensitivity emerged as the most useful test and was abnormal in 92.2% of eyes. Visual evoked potential was delayed in 35.6% and colour vision was abnormal in less than a third. In general, contrast sensitivity was depressed at all frequencies and most of the abnormalities could be identified by testing at a single frequency of 4 cycles/degree.

Acute Disease↗
PubMed1989

Effect of bladder filling on embryo transfer.

We have investigated a claim that bladder filling, by straightening an anteverted uterus into line with the vagina, might facilitate embryo transfer through the cervix after in vitro fertilization. In a randomized controlled trail in 66 women with and 76 without a filled bladder, we found no significant differences in difficulties encountered at embryo transfer or in the chance of pregnancy.

Adult↗
PubMed1989

Arrhythmogenic right ventricular dysplasia in a child with congenital enteropeptidase deficiency and hypogammaglobulinaemia.

A case of arrhythmogenic right ventricular dysplasia in a 10 year old girl is described which provides some evidence for an inherited aetiology of this unusual form of heart disease. The parents of this child were first cousins, thus increasing the possibility of inherited disorders in their offspring. She had been known from infancy to have the rare disorder of congenital deficiency of intestinal enteropeptidase, and low serum immunoglobulins G and A. An untyped adenovirus was grown from a myocardial biopsy taken early in the course of her cardiac disease. However, it is unlikely that this virus was a major factor in the aetiology of her cardiac disease. Both the cardiac and intestinal diseases are now commonly believed to result from hereditary factors, and this report provides further support for this view.

Agammaglobulinemia↗
PubMed1987

Explanation and management of neurological disability.

Patients are often told of the diagnosis of a neurological disability in less than ideal circumstances such that they may not fully comprehend it. Clinicians must be able to sense when the patient's understanding is imperfect even if superficially he or she appears to take in what has been said and its implications. A programme of further counselling is often required to follow this up. A critical look at current procedures will show how these problems arise. It is suggested that improvements in the care of neurologically disabled patients would follow from improved communication between the many agencies that the concerned in their care and from providing books and other material explaining disability and its treatment. A logical development would be for disabled living centres to be established adjacent to existing neuroscience units.

Communication↗