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Biomedical subjects

K F Michaelsen

Publications and source records attributed to K F Michaelsen.

At least 19 recordsLinked to original sources
PubMed2000

Bone mass after allogeneic BMT for childhood leukaemia or lymphoma.

The bone mass was measured by dual energy X-ray absorptiometry in 25 survivors of childhood leukaemia or lymphoma (21 with ALL) who had received TBI and allogeneic BMT a median of 8 years ago (range 4-13). Results were compared with local data on 463 healthy controls and 95 survivors of childhood ALL treated without BMT. Adjusted for sex and age, the mean whole-body bone mineral content (BMC) and bone mineral areal density were significantly less than in healthy controls (0.8 and 0.5 s.d. less than predicted). The reduced BMC was caused by a significantly reduced height for age, whereas bone area for height and BMC for bone area were similar to controls. Less bone mass tended to be related to additional cranial irradiation and age above 20 years at follow-up. Controlled for this, the whole-body bone mass seemed to be unrelated to previous chemotherapy and endocrine status at follow-up and tended to be only marginally less in BMT patients than in ALL survivors treated without BMT. In conclusion, 8 years after allogeneic BMT for childhood leukaemia or lymphoma, the whole-body bone mass was only slightly reduced and the size-adjusted bone mass (BMC for bone area) was normal. Bone Marrow Transplantation (2000) 25, 191-196.

Adolescent↗
PubMed2000

Diet and bone mineral content at term in premature infants.

Premature infants are at risk of developing metabolic bone disease mainly because of low calcium and phosphorus intake. We have examined the effect of different mineral supplements on bone mineral content at term in 127 premature infants with gestational age <32 wk in a double-blinded randomized trial. We used either phosphate supplementation of human milk as recommended by the European Society of Pediatric Gastroenterology and Nutrition or fortified supplementation with protein, calcium, and phosphorus or preterm formula as recommended by the American Academy of Pediatrics. The intervention period was from 1 week old until 36 wk of gestational age, and the infants were fed approximately 200 mL x kg(-1) x d(-1). Bone mineral content was measured at term by dual-energy x-ray absorptiometry scan. Surprisingly, neither phosphate, fortifier, nor preterm formula supplementation had any significant effect on bone mineral content at term compared with infants fed their own mother's milk only. There was a tendency to higher total bone mineral content in infants fed preterm formula compared with infants fed their own mother's milk only (p = 0.05), but when the bone mineral content was corrected for the size of the infant, there was no difference (p = 0.68). Infants fed preterm formula had a significantly higher weight at term compared with infants fed their own mother's milk only (p = 0.02), but did not differ significantly in length or head circumference. In a regression analysis, the amount of supplemented phosphorus was significantly associated with weight at term (p = 0.008). We conclude that when feeding 200 mL x kg(-1) x d(-1), mineral supplementation of human milk or use of preterm formula does not significantly improve bone mineralization outcome at term.

Absorptiometry, Photon↗
PubMed1999

[The AD-drops can be replaced by D-drops].

Since 1932, when vitamin A and D supplementation, in the form of cod liver oil, was introduced in Sweden, rickets has been a rare diagnosis among Swedish infants. In 1978, the National Board of Health and Welfare issued recommendations of daily supplementation with 300 micrograms (1000 IU) of vitamin A and 10 micrograms (400 IU) of vitamin D. This has recently been under review by the Paediatric Committee on Nutrition and Health, of the Swedish Paediatric Association and the National Food Administration, who concluded that there is no reason to retain vitamin A supplementation, but that vitamin D supplementation should continue to be recommended at the same daily dose (400 IU).

Child, Preschool↗
PubMed1999

[Recommendations for prevention of iron deficiency. Delay cow's milk intake as a beverage to infants until 10-12 months of age!].

Breast-feeding is to be encouraged during the first six months of life. Iron deficiency is extremely rare in exclusively breast-fed infants during this period. Any cow-milk based formula used should be iron-fortified. During the second half of infancy, the iron content of weaning foods is important in preventing iron deficiency. Indeed, owing to the low iron content of dairy products, it is hard to compose a weaning diet sufficiently rich in iron to meet the demands of rapidly growing infants, if it is to include substantial amounts of cow milk, sour milk or yoghurt. Accordingly, the Paediatric Committee on Nutrition and Health, of the Swedish Paediatric Association and the National Food Administration, recommend delaying the introduction of cow's milk and cow-milk products until the infant is 10-12 months of age. Until then, breast-feeding, and the use of iron-fortified formula or gruel with modified protein and sodium content are encouraged; iron-fortified porridges of softer consistency can be prepared to circumvent the need of extra fluids, or porridge can be served with breast milk or iron-fortified formula; small amounts of milk may be used for cooking purposes.

Animals↗
PubMed1999

Percutaneous endoscopic gastrostomy in children with cancer.

We reviewed the clinical course of 32 children with cancer who received nutrition through a feeding tube placed percutaneously during gastroscopy (PEG). Their median age was 5.1 y (75%, range: 1.8-13.7 y, min: 3.5 mo) when the PEG was done 0.7-23 mo after diagnosis (median: 1.8 mo, 75%; range: 0.9-8 mo). Five of the children underwent bone marrow transplantation with the gastrostomy in place. There was a significant (p = 0.0001) decrease in the median weight-for-age SDS of 0.55 (75%, range: -1.18-0.28) from the time of diagnosis to placement of the gastrostomy. Twenty-two percent of the children had neutrophils < 0.5 x 10(9)l at the time of placement. There were no major postoperative complications. Seventy-two percent of the patients experienced a total of 55 minor and transient complications including leakage of gastric juice (n = 29), superficial wound infections (n = 23), mechanical problems (n = 2), or bleeding (n = 1). There were no documented cases of bacteraemia. Twelve of the wound infections (52%) arose during neutropenic episodes. Two tubes were replaced due to mechanical problems. There was a median increase in weight SDS of 0.3 (75%, range: -0.6-1.1) from the time of placing the gastrostomy to the end of follow-up (p = 0.054). Nutrition via gastrostomy in children with cancer has several advantages. It is rarely associated with more than minor complications, it is cosmetically more acceptable than the nasogastric tube and it improves nutrition at far lower cost than parenteral nutrition. In selected cases in which bone marrow transplantation or intensive treatment protocols are planned, we suggest that a gastrostomy should be considered before malnutrition develops.

Adolescent↗
PubMed1999

Screening of probiotic activities of forty-seven strains of Lactobacillus spp. by in vitro techniques and evaluation of the colonization ability of five selected strains in humans.

The probiotic potential of 47 selected strains of Lactobacillus spp. was investigated. The strains were examined for resistance to pH 2.5 and 0.3% oxgall, adhesion to Caco-2 cells, and antimicrobial activities against enteric pathogenic bacteria in model systems. From the results obtained in vitro, five strains, Lactobacillus rhamnosus 19070-2, L. reuteri DSM 12246, L. rhamnosus LGG, L. delbrueckii subsp. lactis CHCC 2329, and L. casei subsp. alactus CHCC 3137, were selected for in vivo studies. The daily consumption by 12 healthy volunteers of two doses of 10(10) freeze-dried bacteria of the selected strains for 18 days was followed by a washout period of 17 days. Fecal samples were taken at days 0 and 18 and during the washout period at days 5 and 11. Lactobacillus isolates were initially identified by API 50CHL and internal transcribed spacer PCR, and their identities were confirmed by restriction enzyme analysis in combination with pulsed-field gel electrophoresis. Among the tested strains, L. rhamnosus 19070-2, L. reuteri DSM 12246, and L. rhamnosus LGG were identified most frequently in fecal samples; they were found in 10, 8, and 7 of the 12 samples tested during the intervention period, respectively, whereas reisolations were less frequent in the washout period. The bacteria were reisolated in concentrations from 10(5) to 10(8) cells/g of feces. Survival and reisolation of the bacteria in vivo appeared to be linked to pH tolerance, adhesion, and antimicrobial properties in vitro.

Administration, Oral↗
PubMed1999

Whole body bone mineral accretion in healthy children and adolescents.

Data on accretion in bone size and bone mineral content (BMC) are needed to evaluate bone mineralisation during childhood. Whole body bone mineral content (BMC) and bone area (BA) were determined by dual energy x ray absorptiometry (Hologic 1000/W) with a one year interval in healthy girls (n = 192) and boys (n = 140) aged 6-19 years. Annual accretion in BMC (DeltaBMC (g/year)) and BA (DeltaBA (cm2/year)) according to sex and pubertal stages were calculated. DeltaBA and DeltaBMC were highly significantly associated with pubertal stages in girls and boys. Centile curves for DeltaBA and DeltaBMC according to sex and age were constructed using the LMS method. Peak DeltaBA and DeltaBMC values were reached earlier in girls (12.3 and 12.5 years, respectively) than in boys (13.4 and 14. 2 years, respectively). The DeltaBA peak was dissociated in time from the DeltaBMC peak, indicating that increase in bone size occurs before increase in bone mineral content. Assuming that 32.2% of BMC consist of calcium, the median (90th centile) annual bone calcium accretion in pubertal stage III was 220 mg/day (302) and 317 mg/day (386) for girls and boys, respectively. To obtain an average bone calcium accretion, a high calcium absorption is needed during puberty. This may have implications for dietary calcium requirements at this time.

Absorptiometry, Photon↗
PubMed1999

Bone mineral status in 134 patients with cystic fibrosis.

AIM: To investigate bone mineral status in patients with cystic fibrosis (CF). PATIENTS AND METHODS: Whole body bone mineral content (BMC), projected bone area, and bone mineral density (BMD) were determined by dual energy x ray absorptiometry in 134 patients with CF and compared with 396 healthy controls. RESULTS: In patients </= 19 years of age, BMD for age was normal in boys and marginally reduced in girls, whereas BMC for age was significantly reduced in both sexes. Height for age and bone area for height were significantly reduced, indicating "short" and "narrow" bones, whereas BMC for bone area was increased, indicating increased size corrected BMC. In patients > 19 years of age, BMD and BMC for age were significantly reduced. CONCLUSION: Short and narrow bones were the main reasons for reduced BMC for age in patients </= 19 years of age, indicating that treatment to prevent osteoporosis in younger patients should be directed at increasing bone size, whereas conventional treatment with calcium and vitamin D supplementation alone might not be as effective. Because of the significant decrease in BMD and BMC in adult patients, we fear that these patients may develop osteoporotic fractures prematurely.

Absorptiometry, Photon↗
PubMed1999

Degree of fatness after treatment for acute lymphoblastic leukemia in childhood.

Excessive fatness is considered a frequent late complication of treatment for childhood acute lymphoblastic leukemia. Most previous studies, however, were based on body mass index (BMI) rather than more direct fat mass measurements. We studied 95 survivors of childhood acute lymphoblastic leukemia a median of 11 yr (range, 3-23 yr) after diagnosis. BMI values at diagnosis, at cessation of therapy, yearly thereafter for up to 10 yr, and at follow-up were compared with French reference values. Whole body percent fat was measured at follow-up by dual energy x-ray absorptiometry and compared with data from 463 local controls. Adjusted for sex and age, the mean BMI increased significantly during therapy and remained largely unchanged thereafter. At follow-up, BMI did not differ significantly between patients and local controls. On the other hand, the whole body percent fat was significantly increased (mean observed/predicted value, 21.8/19.0%; P < 0.0002). Twenty-five patients (26%) had a percent fat above the 90th percentile of the reference values, which indicates excessive fatness. Adjusted for sex and age, a higher percent fat was related to cranial irradiation or GH insufficiency, but not to sex, the cumulative doses of anthracyclines or corticosteroids, or the type of corticosteroid used. BMI was a poor measure of body fatness.

Absorptiometry, Photon↗
PubMed1999

Schistosoma japonicum infection and serum and tissue concentrations of retinol and zinc in pigs.

The effects of Schistosoma japonicum infection on the concentrations of zinc in serum, liver, spleen and muscle and on the concentrations of retinol in serum and liver were studied in 48 pigs. Twenty-four of the pigs were each infected by intramuscular inoculation with 2000 cercariae of S. japonicum in medium and the rest were similarly inoculated with parasite-free medium, as controls. On each of weeks 4, 11, 17 and 24 post-inoculation (PI), 12 pigs (six of which were infected) were killed. Tissue samples were collected at necropsy. Blood samples were taken prior to infection and at necropsy from all pigs, and bi-weekly from the pigs killed 24 weeks post-infection. In an analysis of variance in which serum retinol was the dependent variable, the interaction infection x time was found to be significant (P = 0.009). The main reason for this significance was that the concentration of retinol in the sera collected from infected pigs at necropsy at 11 weeks PI was significantly lower than in the control pigs killed at the same time (P = 0.02). Although, overall, infection led to higher zinc concentrations in the liver (P = 0.04) and spleen tissue (P = 0.01), it had no apparent effect on liver retinol, muscle zinc or serum zinc. However, among the pigs which were tested bi-weekly, serum zinc was consistently lower in the infected pigs than in the controls (P = 0.01). The transient declines seen in the concentrations of retinol and zinc in sera from the infected pigs were not accompanied by similar changes in the tissue concentrations, and may reflect an acute-phase response to infection. Schistosoma japonicum infection in pigs is considered a useful model of S. japonicum infection (and probably also of S. mansoni infection) in humans. Similar effects, if they occur in the human infections, may lead to misclassification of vitamin-A and zinc status in endemic populations if this status is based on serum retinol and serum zinc.

Animals↗
PubMed1998

[The sociopsychological importance of food in hospital. Evaluation of a new meal system in a children's cancer ward].

Malnutrition of patients in hospitals is a subject that is fairly well described in the medical literature, but less attention has been paid to the social significance of food in hospitals. This article describes a study of the social and psychological impact of the introduction of a new meal delivery system in a children's cancer ward. A traditional centralized meal system was replaced by a staffed local kitchen. The evaluation involved questionnaires to the children, parents and staff members; qualitative, indepth, semi-structured interviews with subgroups; observations of meals. Children, staff and parents greatly preferred the new meal system, which changed the significance of food and meals in the hospital: from an arena of conflict and problems to one with a greatly enhanced social status. The article underlines that it is important to integrate socio-psychological and nutritional aspects of food and eating if malnutrition in hospitals is to be overcome.

Child↗
PubMed1998

Complementary feeding: a global perspective.

The growth of children in developing countries often declines with the introduction of complementary foods around the age of 6 mo and continues to decline up to 18 mo. These growth deficits are accompanied by delayed development and increased morbidity and mortality. The main cause is nutritionally inadequate and often contaminated complementary foods that typically consist of a cereal-based porridge, with little vegetables and no animal products. Such a diet is bulky, has a low nutrient density and a high content of antinutrients. Promotion of traditional household technologies such as germination and fermentation may be affordable measures to improve the complementary foods. Germination serves to reduce the bulkiness and thus increase the energy and nutrient density. Fermentation leads to hydrolysis of antinutrient phytates and hence increased bioavailability of minerals, and may also have beneficial effects on susceptibility to diarrhea. Alternative strategies include addition of vitamin C-rich foods and meat that enhance absorption of minerals, or direct enrichment of energy and nutrients by addition of animal products, such as fat, fish, meat or milk, vegetables or fruits, or a micronutrient mix.

Aging↗
PubMed1998

Geophagy, iron status and anaemia among primary school children in Western Kenya.

As part of a cross-sectional study among 156 primary school children (median age 13 years, range 10-18) in Western Kenya, geophagy was assessed through interviews. 114 (73.1%) of these children reported eating soil daily. Haemoglobin levels were determined in all 156 children and serum ferritin concentrations in 135. The mean haemoglobin (Hb) concentration was 12.7 g/dl, and median ferritin concentration 27.2 microg/l. Both the proportion of anaemic (Hb < 11.0 g/dl) and of iron-depleted (ferritin < 12 microg/l) children was significantly higher among the geophageous children than among the nongeophageous (9.6% vs. 0% anaemia; P = 0.037; 18.4% vs. 5.4% iron depletion; P = 0.046). Serum ferritin and haemoglobin concentrations were not correlated (r = 0. 13 5; P = 0. 100). Multiple regression analysis showed that geophagy, hookworm eggs per gram faeces and malaria parasite counts per microl blood were independent predictors of serum ferritin, when controlling for other helminth infections, age and sex, and socio-economic and educational background of the children's families and family size (y = 36.038-11.247(geophagy) -- 0.010(hookworm epg) + 0.001(malaria parasite counts); R2 = 0.17). Multiple regression analysis with haemoglobin as dependent variable and the same independent variables did not reveal any significant predictors. Analysis of the soil eaten by the children revealed a mean HCl-extractable iron content of 168.9 mg/kg (SD 44.9). Based on the data on the amounts eaten daily and this mean iron content, soil could provide on average 4.7 mg iron to a geophageous child (interquartile range 2.1-7.1 mg), which is equivalent to 32% of the Recommended Nutrient Intake (RNI) for girls (interquartile range 14-48%) or 42% of the RNI for boys (interquartile range 19-63%). Iron depletion and anaemia are associated with geophagy, but only serum ferritin concentrations were shown to be dependent upon geophagy in the regression model. From the cross-sectional data no inference about causality can be made. To clarify the possible causal relationships involved, longitudinal studies and iron-supplementation intervention studies are needed.

Adolescent↗
PubMed1998

Influence of weight, age and puberty on bone size and bone mineral content in healthy children and adolescents.

The biology of bone mineralization during growth is important for peak bone mass. The aim of the study was to examine how body size, age and puberty influence bone size and bone mineral density. Whole body bone area (BA) and bone mineral content (BMC) were examined by dual-energy X-ray absorptiometry (Hologic 1000/W) in healthy girls (n = 201) and boys (n = 142) aged 5-19 y. The influence of height, weight, age and puberty on bone mineralization was examined by multiple regression. Main determinants of BA were height and weight. Bone width, approximated by BA corrected for height, increased highly significantly with weight and depended weakly significantly on pubertal stage. Main determinants of BMC were BA, height, age and pubertal stages. Bone mineral density, approximated by BMC corrected for BA and height, depended on age and pubertal stage, but not on weight. Thus skeletal size is mainly determined by body size, while bone density is determined by age and pubertal stage.

Absorptiometry, Photon↗