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Biomedical subjects

K A Rickard

Publications and source records attributed to K A Rickard.

At least 109 records · Page 6Linked to original sources
PubMed1983

Effectiveness of central parenteral nutrition versus peripheral parenteral nutrition plus enteral nutrition in reversing protein-energy malnutrition in children with advanced neuroblastoma and Wilms' tumor: a prospective randomized study.

The effectiveness of central parenteral nutrition (CPN) versus peripheral parenteral nutrition (PPN) plus enteral nutrition in reversing protein-energy malnutrition was evaluated in 19 children (nine CPN, 10 PPN) with advanced neuroblastoma or Wilms' tumor. Weekly dietary, anthropometric, and biochemical measurements were compared for 15 patients (eight CPN, seven PPN) who completed more than 25 days of nutrition support. The groups had similar mean energy and protein intakes (CPN: 95 +/- 5% of healthy children, 2.5 +/- 0.3 g/kg; PPN: 102 +/- 5% of healthy children, 2.9 +/- 0.3 g/kg). Increases in weight (p less than 0.001), subscapular skinfold thickness (p less than 0.001), albumin (p less than 0.05), and transferrin (p less than 0.05) for the first 28 days were significant and did not differ between groups. Fever, sepsis, elevated SGOT, and severe anemia occurred with both CPN and PPN. PPN resulted in subcutaneous infiltrations and more psychological trauma. PPN with enteral nutrition seems most appropriate for short term intravenous nutrition support or as a temporary substitute for CPN; CPN is preferred for long-term support.

Body Weight↗
PubMed1983

An analysis of peripheral blood burst forming units-erythroid in the polycythaemic states.

Peripheral blood burst forming units-erythroid (BFU-E) were measured by the plasma clot cell culture technique in patients with the various subtypes of polycythaemia and compared to normal. 10 patients with active polycythaemia rubra vera (PRV) were found to have a mean BFU-E level of 48 +/- 15.8 (SEM) per 5 X 10(5) cultured cells which was significantly different from normals (4 +/- 1.1, P less than 0.02), patients with controlled PRV (7 +/- 1.6, P less than 0.025), secondary polycythaemia (1 +/- 0.3, P less than 0.015) and relative polycythaemia (0, P less than 0.015). Burst forming units were found to fall to normal levels in patients with PRV with appropriate disease control and then to rise again in patients untreated for more than 18 months. Clinical aspects. Measurement of BFU-E levels from the peripheral blood could provide a useful adjunct from an accessible source in the differential diagnosis of polycythaemia as well as being of use in serial monitoring of patients with PRV.

Bloodletting↗
PubMed1983

In vitro clonogenic assays in selective neutropenia.

Granulocyte-monocyte colony forming cell (GM-CFC) concentration and the proportion of GM-CFC in DNA synthesis (S) were determined in 43 patients with varying degrees of selective neutropenia, including 5 patients who were normal extremes (2.0-2.5 x 10(9) neutrophils/1), to study the diagnostic and prognostic significance of clonogenic assays and to determine the response of the committed myeloid stem cell to neutropenia. The proportion of GM-CFC in S proved to be a more useful parameter than the GM-CFC concentration. 75% of the patients with greater than 60% GM-CFC in S returned to normal within 1 month. Patients with less than 20% GM-CFC in S had at least a 10 times greater incidence of developing a malignant or autoimmune disease than the other 28 patients. The 11 patients with 41-51% in GM-CFC in S had greater than 1 x 10(9) neutrophils/1 and no significant clinical problems but all have remained mildly neutropenic for a long period. An indirect relationship existed between the degree of neutropenia and the proportion of GM-CFC in S (r = -0.70).

Adult↗
PubMed1983

Immunoradiometric assay of plasma lactoferrin.

The concentration of lactoferrin, a non-heme iron binding glycoprotein, was determined in more than 1500 EDTA plasma samples by a 2-site solid phase immunoradiometric assay to assess the significance of lactoferrin in plasma and to investigate applications for this assay. The use of commercially available antibody and antigen and a relatively short assay time make this assay more suitable for use in routine clinical laboratories than previous methods. A normal range of 250-750 micrograms/l was established. There was a correlation between plasma lactoferrin concentration and the circulating blood neutrophil count in most patients except those with splenomegaly, post-splenectomy and undergoing intensive chemotherapy. Patients with gross splenomegaly usually had an increased and post-splenectomy patients a decreased lactoferrin/neutrophil ratio indicating a respective increase and decrease in the marginated pool. In patients with acute leukemia after chemotherapy or transplantation plasma lactoferrin levels increased 1 to 5 d before blood neutrophil counts rose. As plasma lactoferrin seems to be derived from neutrophils, its concentration is probably related to the size of the total blood granulocyte pool. Calculation of the lactoferrin/neutrophil ratio demonstrated variations in the size of the bone marrow reserve and the marginated neutrophil pool.

Humans↗
PubMed1983

Feeding practices of the very low-birth-weight infant within the first year.

Information summarized from early feeding practices of VLBW infants (1,500 gm. or less at birth) identified three prevalent practices which potentially could result in compromised nutrition for these babies: (1) Cereals were introduced at an early age. Feeding cereals before infants are developmentally ready may decrease formula intake or result in a forced feeding situation. (b) Two percent and skim milk were fed to approximately 50% of these infants within their first year of life. Feeding calorically dilute milk may reduce energy intake, as well as compromise the intake of essential fatty acids. (c) Whole cow's milk was introduced to some VLBW infants at an early age. The feeding of cow's milk to young infants without appropriate supplementation may predispose these infants to significant nutritional deficiencies and imbalances. Any one of these feeding practices could affect an infant's nutrient intake. If all three are encountered in the same baby, growth may be adversely affected. Whether increased attention to appropriate feeding practices during the first year of life would result in a more favorable growth outcome for VLBW infants is not known.

Adolescent↗
PubMed1983

Growth outcome of the very low-birth-weight infant at one year.

Growth patterns of weight, length, and OFC complete through 12 months corrected age were determined for 122 VLBW infants who weighed 1,500 gm. or less and were 35 weeks or less gestational age at birth. Significant differences in growth were apparent when infants were grouped according to sex and appropriateness of intrauterine growth. When the mean values of each group were compared, the female AGA infants demonstrated growth at higher percentiles (NCHS term infant norms) for all three growth parameters (weight, length, and OFC). AGA male, SGA male, and SGA female infants all grew similarly, at lower percentiles for weight and length, when compared with the same norms. Growth in OFC was closest to term infant norms in all subgroups of infants. (formula; see text) Appropriateness of weight for length was determined for each of the infants at one year corrected age. The majority of the babies, regardless of subgroup, achieved weights and lengths greater than the 5th percentile and with normal weights for lengths. At 12 months corrected age, 30% remained below the 5th percentile in weight, 21% below the 5th percentile in length, and 14% below the 5th percentile in OFC. Eighteen infants (15%) demonstrated a disproportionately low weight for length (less than the 5th percentile).

Adolescent↗
PubMed1982

Hepatitis and haemophilia therapy in Australia.

243 Australian haemophiliacs have been studied retrospectively over 4 1/2 years to assess the effect of treatment products on liver function and to determine the frequency of hepatitis-B markers in these patients. Commercial blood products are not used in Australia, and the patients were treated with products of blood from unpaid donors screened for hepatitis B surface antigen. Cryoprecipitate was the major treatment product, and only small amounts of factor VIII and IX concentrates were used. Despite the use of blood products obtained from entirely voluntary blood donors and the frequent use of single-donor packs of cryoprecipitate, markers of viral hepatitis were common in these haemophiliacs. Antibody to hepatitis B surface antigen was detected in 63% of the patients, and there were 66 cases of non-A, non-B hepatitis during the study. 29 of these episodes persisted for longer than 6 months. 13 patients (5.4%) had hepatitis B during the study; 2 patients remained HBsAg-positive for longer than 6 months. Abnormal serum aminotransferase levels were found in 34% of the patients; in 8% of patients these abnormalities persisted for more than 6 months.

Adolescent↗
PubMed1982

Contact activation by ellagic acid - the concept of soluble activator disputed.

Concentrated, true solutions of ellagic acid (EA) prepared by pH reduction had only a small effect on contact activation initially. However when the EA formed a fine microcrystalline dispersion there was concurrent development of contact activity with turbidity. The dependence of contact activity on EA concentration was found to be a log-log relationship. After relatively low speed centrifugation contact activity-promoting material was decreased from supernatant layers at all concentrations. These findings suggest that EA is not effective as a contact activator when in true solution, but is active only when present as a solid.

Benzopyrans↗
PubMed1982

Formulas and human milk for premature infants: a review and update.

New methods of feeding low-birth-weight infants have been developed as a result of improved knowledge concerning the nutritional requirements of the premature infant. Breast milk may offer certain nutritional and non-nutritional advantages for immature babies. Preterm milk is theoretically more appropriate than term or pooled mature breast milk. However, some nutrients may be inadequate to support intrauterine rates of growth in small premature infants. New formulas specifically designed for preterm babies appear to be safe and to promote improved weight gain, fat absorption, bone mineralization, and nitrogen retention. Nutritional needs of growing preterm infants are better met by preamture formulas than by formulas designed for term babies.

Cystine↗
PubMed1982

Nutritional outcome of 207 very low-birth-weight infants in an intensive care unit.

Growth and feeding outcomes during the first weeks of life were prospectively evaluated in 207 critically ill, very low-birth-weight (VLBW) infants (birth weight less than 1,500 gm). Maximal weight loss occurrd by day 9, averaging 13 percent of birth weight, while birth weight was regained by day 18. Energy intake during initial weight gain (19 gm. per day) averaged 100 kcal per kilogram. Feeding and growth outcome were highly correlated (p of less than 0.001) with severity of illness but were not significantly related to sex, birth weight, or appropriateness of weight for gestational age.

Female↗
PubMed1981

Aortic and mitral valve replacement in a patient with severe haemophilia A.

A forty-nine year old man with severe Haemophilia A developed left ventricular failure as a complication of valvular heart disease. On November 26th, 1979, open heart surgery was performed and both the aortic and mitral valves were replaced with porcine heterografts. Replacement therapy in the form of Factor VIII concentrates maintained the Factor VIII coagulant level at 100% until ten days post-operatively and a total dose of 116,600 units were given. The patient described is the first haemophiliac to undergo open heart surgery in Australia and the first reported case in the world to have had a successful double valve graft. With the current availability of factor VIII concentrates, elective surgical procedures are being performed more frequently. Such procedures require careful pre-operative planning and post-operative monitoring of replacement therapy to ensure satisfactory haemostasis. Although haemostatic defects may occur after open heart surgery, this case report illustrates that the haemostatic problems of open heart surgery and haemophilia can be prevented by pre-operative planning and meticulous post-operative monitoring of replacement therapy.

Aortic Valve↗