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Biomedical subjects

M A Stokes

Publications and source records attributed to M A Stokes.

At least 37 records · Page 2Linked to original sources
PubMed1993

Surgery for Crohn's disease.

In the last 12 years, 72 operations have been performed on 41 patients for Crohn's disease in this hospital. The patients were predominantly young (mean age 32 yrs) and there were more females than males. 28 had ileocolic disease, three small intestinal, two pan-enteric and eight colonic. Pain (in 76%), diarrhoea (56%) and weight loss (66%) were the main presenting symptoms. Diarrhoea occurred in all those with colonic disease, but in only 43% of those with ileocolic disease. A right hemicolectomy (28 patients), colonic resection (12) and small intestinal resection (9) were the commonest operations. There were no deaths. 22 patients had a total of 26 complications after surgery, eight necessitating further surgery. The mean post-operative stay was 15 days, being lowest in those with ileocolic disease. 19 patients have required only one operation, with a mean follow-up of 5.3 years. These patients also had significantly less complications (p < 0.05). Half of the patients requiring surgery for Crohn's disease have done very well. The other half require many operations and have a substantial morbidity.

Adolescent↗
PubMed1992

Crohn's disease and nutrition.

Malnutrition was included by Crohn as one of the features of the new disease he described. Most patients with Crohn's disease are malnourished even if their disease is not active. Nutritional factors may be implicated in the aetiology of the disease, but this remains unproven. The role of nutritional support and therapy is discussed and it is suggested that improving the patient's nutritional status may have a primary therapeutic as well as a supportive role in the treatment of the disease.

Adolescent↗
PubMed1991

Home parenteral nutrition at Auckland Hospital.

This paper reports the results of home parenteral nutrition (HPN) from Auckland Hospital. In the last two and a half years, six patients have gone home from hospital on HPN. Four are still on it, after periods of from one to 30 months. There has been one death and one patient who developed catheter sepsis. Quality of life on HPN has in general been very good. Body composition studies performed on these patients have shown that a normal body composition can be maintained while on HPN.

Adult↗
PubMed1991

Papaveretum infusions in infants under 6 months of age.

The effectiveness of a continuous low dose papaveretum infusion for the relief of postoperative pain was assessed in 29 infants aged 1-6 months nursed on the infant surgical ward following major abdominal surgery. Trained nursing staff were able to adjust the dosage within prescribed guidelines and satisfactory analgesia was obtained with a regimen which delivered up to 0.0375 mg/kg/hour, approximately half the dose recommended in children older than 12 months. There was one case of clinically significant respiratory depression.

Female↗
PubMed1991

Antoine Lavoisier and the study of respiration: 200 years old.

Antoine Lavoisier has been called the father of modern chemistry. From a medical point of view, he introduced the study of respiration and metabolism and so founded biochemistry. With his experiments, our knowledge of how the body works made immense strides forward. Two hundred years ago, he wrote his last authentic and untouched account of his views on respiration, in a letter to Joseph Black in Edinburgh. This opportunity has been taken to briefly review this work and the life of a man who did much to improve our understanding of ourselves.

Chemistry↗
PubMed1991

Long-term changes in body composition after pancreatoduodenectomy.

Body protein and fat stores were measured in four long-term survivors both before Whipple's procedure for malignancy at the ampulla of Vater and at a mean of 40 months (range 20-64 months) later. The results were compared with predicted well values. At follow-up patients also underwent dietary assessment and measurement of faecal fat losses. A dietary intake of mean (s.d) of 2690 (733) kcal per day and 85 (21) g protein per day met the patients' requirements. There was notable steatorrhoea (faecal fat 28 (21) g per day) but faecal protein losses were normal. Before surgery, body-weight was significantly lower than well-weight (P less than 0.0005), three patients having body fat stores lower than predicted well values. After surgery, body-weight and protein stores did not change significantly but fat stores fell in each patient (P less than 0.04). A curative Whipple's procedure prevents further weight loss in ampullary malignancy but weight gain does not occur because of steatorrhoea, perhaps a result of the accompanying truncal vagotomy.

Adenoma, Islet Cell↗
PubMed1990

Dietary management of the patient with massive enterectomy.

We present two cases who required massive enterectomy and who represent different points in the spectrum of this disease. We discuss their management from a nutritional stand-point and show details of energy uptake and expenditure for one of our patients. This describes our approach to this problem, and we hope it will be of use to others when dealing with patients following massive enterectomy.

Adaptation, Physiological↗
PubMed1990

One hundred operations for Crohn's disease.

One hundred operations for Crohn's disease have been reviewed. The 100 procedures were performed on 54 patients. Thirty-four patients had had a single operation, and 20 patients had had the other 66 operations. The patients were classified into four categories: small intestinal disease (n = 17), jejuno-ileocolic (n = 7), colonic (n = 5) and classical ileocolic (n = 25). These categories had differing disease severity, symptomatology and re-operation rates. The distribution of the disease in Northern New Zealand seems similar to that elsewhere. Whereas a small number of patients may have a large number of complications and recurrences and a prolonged stay in hospital, the majority of patients can have safe and effective surgery for Crohn's disease. This is particularly true for patients with ileocolic disease and who have a limited ileocolic resection.

Adolescent↗
PubMed1988

A study of the genesis of colic.

To investigate local events in the gut as well as the location and duration of discomfort associated with colic, mild phasic pain was induced by balloon distension and bolus injection of normal saline at various sites in the gut of 1 normal volunteer and 12 patients with gut disorders. Intraluminal pressures were recorded. Pain was experienced only when a rise in baseline pressure occurred in a segment of gut at least 6 cm and up to 32 cm long. Painful segmental pressure rises were often low compared with non-painful localised pressure rises. Induced phasic pain had all the characteristics of colic, usually lasted less than a minute in both small and large intestine, and while frequently beginning paracentrally, tended to spread across the midline with increasing severity.

Colic↗
PubMed1988

Home parenteral nutrition: a review of 100 patient years of treatment in 76 consecutive cases.

Over the last 10 years, the Nutrition Unit at Hope Hospital has trained and looked after 76 patients on home parenteral nutrition for a total of 100 patient years. Although 40 per cent of patients have required home parenteral nutrition for 6 months or less one patient has been on treatment for 7 years. The quality of life measured on a 4 point scale was good for the majority of patients. Sepsis and superior vena caval thrombosis are the main problems encountered. Overall mortality rate was 18 per cent and the sepsis rate was 0.14 episodes per patient per year. Home parenteral nutrition is an effective and safe treatment of intestinal failure.

Adolescent↗
PubMed1988

How do patients with Crohn's disease fare on home parenteral nutrition?

The United Kingdom and Ireland Register of Home Parenteral Nutrition (HPN) contains details on 237 cases treated between 1977 and 1987. One hundred courses of HPN were given to 89 patients for complications of Crohn's disease. Six registering centers provided 87 percent of the courses of treatment. The short-bowel syndrome was a factor in 60 patients, fistulas in 29 patients, and exacerbation of the disease in 41 patients. Thirty patients had more than one complication. The age distribution of patients with Crohn's disease was the same as for all HPN patients. Nine patients have died and eight have ceased HPN because of complications from the treatment. Fifty two percent of the patients had no complications. Patients with Crohn's disease on HPN had a significantly better lifestyle than the group as a whole (P less than .05) and had lower sepsis and complication rates (P less than .01 and 0.001, respectively). The 60 Crohn's patients with short-bowel syndrome spent a significantly longer time on HPN than Crohn's patients overall (P less than .05). Only 15 of these have been able to cease treatment and resume enteral feeding, compared with 23 of the other 40 patients who were able to resume enteral nutrition after a median of three months. Analysis of the authors' group of 35 patients included in the 100 showed that the only nutritional parameters of use in monitoring the patients' well-being were weight and serum albumin. Eighty percent of the patients with Crohn's disease who were treated by HPN have either successfully resumed enteral feeding or are successfully managing their own HPN. HPN is a safe and effective treatment for patients with acute or chronic intestinal failure from Crohn's disease.

Adolescent↗
PubMed1988

Effects of noise on speech production: acoustic and perceptual analyses.

Acoustical analyses were carried out on a set of utterances produced by two male speakers talking in quiet and in 80, 90, and 100 dB SPL of masking noise. In addition to replicating previous studies demonstrating increases in amplitude, duration, and vocal pitch while talking in noise, these analyses also found reliable differences in the formant frequencies and short-term spectra of vowels. Perceptual experiments were also conducted to assess the intelligibility of utterances produced in quiet and in noise when they were presented at equal S/N ratios for identification. In each experiment, utterances originally produced in noise were found to be more intelligible than utterances produced in the quiet. The results of the acoustic analyses showed clear and consistent differences in the acoustic-phonetic characteristics of speech produced in quiet versus noisy environments. Moreover, these accounts differences produced reliable effects on intelligibility. The findings are discussed in terms of: (1) the nature of the acoustic changes that taken place when speakers produce speech under adverse conditions such as noise, psychological stress, or high cognitive load: (2) the role of training and feedback in controlling and modifying a talker's speech to improve performance of current speech recognizers; and (3) the development of robust algorithms for recognition of speech in noise.

Adult↗
PubMed1988

Direct measurement of the poliovirus RNA polymerase error frequency in vitro.

The fidelity of RNA replication by the poliovirus-RNA-dependent RNA polymerase was examined by copying homopolymeric RNA templates in vitro. The poliovirus RNA polymerase was extensively purified and used to copy poly(A), poly(C), or poly(I) templates with equimolar concentrations of noncomplementary and complementary ribonucleotides. The error frequency was expressed as the amount of a noncomplementary nucleotide incorporated divided by the total amount of complementary and noncomplementary nucleotide incorporated. The polymerase error frequencies were very high and ranged from 7 x 10(-4) to 5.4 x 10(-3), depending on the specific reaction conditions. There were no significant differences among the error frequencies obtained with different noncomplementary nucleotide substrates on a given template or between the values determined on two different templates for a specific noncomplementary substrate. The activity of the polymerase on poly(U) and poly(G) was too low to measure error frequencies on these templates. A fivefold increase in the error frequency was observed when the reaction conditions were changed from 3.0 mM Mg2+ (pH 7.0) to 7.0 mM Mg2+ (pH 8.0). This increase in the error frequency correlates with an eightfold increase in the elongation rate that was observed under the same conditions in a previous study.

Nucleotidases↗