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Biomedical subjects

Lorna J Gibson

Publications and source records attributed to Lorna J Gibson.

6 recordsLinked to original sources

Lack of evidence on diets for obesity for children: a systematic review.

BACKGROUND: The prevalence of obesity has increased rapidly in most developed countries in the last decades, and this rise is now spreading to developing countries. Childhood obesity is also increasing. The UK government has set a target to halt the rise in childhood obesity by 2010. Dietary recommendations are a central component of any comprehensive weight-loss programme. A low-fat energy-restricted diet is the conventional therapy for obesity, but alternative dietary interventions have been proposed in recent years. METHODS: We conducted a systematic review to assess dietary intervention studies designed to reduce weight in childhood and adolescence. The studies included overweight or obese children or adolescents in which there was a comparison group and change in body weight or BMI was reported. RESULTS: We identified only nine such studies, seven of which were randomized. Six were conducted in the USA, two in Cuba, and one in France. Low-carbohydrate and low-glycaemic-index diets appeared to be at least as effective as energy-restricted low-fat diets for short-term weight loss, but most studies were too small to be informative, and none provided evidence on long-term weight control. CONCLUSIONS: There is a marked mismatch between the public health importance of childhood obesity and the number and quality of the studies conducted so far to assess dietary interventions for weight reduction in childhood and adolescence, and little evidence to support the current recommendation of a low-fat energy-restricted diet. There is an urgent need for well-designed intervention studies of the long-term effectiveness of alternative diets to provide a basis for evidence-based recommendations.

Adolescent↗

Biomechanics of cellular solids.

Materials with a cellular structure are widespread in nature and include wood, cork, plant parenchyma and trabecular bone. Natural cellular materials are often mechanically efficient: the honeycomb-like microstructure of wood, for instance, gives it an exceptionally high performance index for resisting bending and buckling. Here we review the mechanics of a wide range of natural cellular materials and examine their role in lightweight natural sandwich structures (e.g. iris leaves) and natural tubular structures (e.g. plant stems or animal quills). We also describe two examples of engineered biomaterials with a cellular structure, designed to replace or regenerate tissue in the body.

Animals↗

A randomized trial of exemestane after two to three years of tamoxifen therapy in postmenopausal women with primary breast cancer.

BACKGROUND: Tamoxifen, taken for five years, is the standard adjuvant treatment for postmenopausal women with primary, estrogen-receptor-positive breast cancer. Despite this treatment, however, some patients have a relapse. METHODS: We conducted a double-blind, randomized trial to test whether, after two to three years of tamoxifen therapy, switching to exemestane was more effective than continuing tamoxifen therapy for the remainder of the five years of treatment. The primary end point was disease-free survival. RESULTS: Of the 4742 patients enrolled, 2362 were randomly assigned to switch to exemestane, and 2380 to continue to receive tamoxifen. After a median follow-up of 30.6 months, 449 first events (local or metastatic recurrence, contralateral breast cancer, or death) were reported--183 in the exemestane group and 266 in the tamoxifen group. The unadjusted hazard ratio in the exemestane group as compared with the tamoxifen group was 0.68 (95 percent confidence interval, 0.56 to 0.82; P<0.001 by the log-rank test), representing a 32 percent reduction in risk and corresponding to an absolute benefit in terms of disease-free survival of 4.7 percent (95 percent confidence interval, 2.6 to 6.8) at three years after randomization. Overall survival was not significantly different in the two groups, with 93 deaths occurring in the exemestane group and 106 in the tamoxifen group. Severe toxic effects of exemestane were rare. Contralateral breast cancer occurred in 20 patients in the tamoxifen group and 9 in the exemestane group (P=0.04). CONCLUSIONS: Exemestane therapy after two to three years of tamoxifen therapy significantly improved disease-free survival as compared with the standard five years of tamoxifen treatment.

Administration, Oral↗

Fatigue of bovine trabecular bone.

Fatigue loading of bone, from the activities of daily living in the elderly, or from prolonged exercise in the young, can lead to increased risk of fracture. Elderly patients with osteoporosis are particularly prone to fragility fractures of the vertebrae, where load is carried primarily by trabecular bone. In this study, specimens of bovine trabecular bone were loaded in compressive fatigue at four different normalized stresses to one of six maximum strains. The resulting change in modulus and residual strain accumulation were measured over the life of the fatigue test. The number of cycles to reach a given maximum compressive strain increased with decreasing normalized stress. Modulus reduction and specimen residual strain increased with increasing maximum compressive strain, but few differences were observed between specimens loaded to the same maximum strain at different normalized stresses.

Adaptation, Physiological↗

Fatigue microdamage in bovine trabecular bone.

Microdamage, in the form of small cracks, may accumulate in trabecular bone loaded in fatigue. Specimens of bovine trabecular bone were loaded in compressive fatigue at one of four normalized stresses and loading was stopped after the specimens reached one of six maximum strains. Microdamage was identified using a fluorochrome staining technique, and microdamage parameters, including the number of damaged trabeculae and the damaged area fraction, were measured. No microdamage was observed during loading to strains below the yield strain; at higher strains, all microdamage parameters increased with increasing maximum compressive strain. Few significant differences were observed in the type or amount of microdamage accumulation between specimens loaded to the same maximum strain at different normalized stresses; however, more trabecular fractures were observed at high numbers of cycles, which corresponded to low normalized stresses.

Adaptation, Physiological↗

Contractile forces generated by articular chondrocytes in collagen-glycosaminoglycan matrices.

The objective of the study was to directly measure the force of contraction of adult articular chondrocytes and to examine their contractile behavior in collagen-glycosaminoglycan analogs of extracellular matrix by live cell imaging in vitro. The contractile forces generated by passages 2 and 3 adult canine articular chondrocytes were measured using a cell force monitor. The contractile behavior of the cells was also directly imaged as they were cultured in collagen-glycosaminoglycan scaffolds. Passage 2 cells seeded in a collagen-glycosaminoglycan scaffold were capable of generating a force of 0.3 nN/cell. Chondrocytes subcultured through a third passage generated a force twice that level, paralleling the increase in the alpha-smooth muscle actin (SMA) content of the cells as demonstrated by Western blot analysis. Treatment of passage 3 cells with staurosporine reduced the force of contraction by approximately one-half, reflecting the effects of this agent in reducing the SMA content of the cells and disrupting the microfilaments. These values compare with 1 nN previously reported for lapine dermal fibroblasts of passage 5-7, using the same apparatus. Direct live cell imaging documented the contractile behavior of the articular chondrocytes in the collagen-glycosaminoglycan matrix in the time frame in which the force was directly measured in the cell force monitor. This imaging demonstrated how the cells acted individually and in unison to buckle the collagen struts making up the matrix. Adult articular chondrocytes are capable of generating a SMA-enabled force of contraction sufficient to model extracellular matrix molecules.

Animals↗