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Biomedical subjects

M Cosgrove

Publications and source records attributed to M Cosgrove.

At least 19 recordsLinked to original sources
PubMed2002

Randomized double-blind controlled trial on the effects on iron status in the first year between a no added iron and standard infant formula received for three months.

UNLABELLED: Recent research has not only questioned the necessity of iron supplementation in human milk substitutes prior to weaning, but also suggested some potential adverse effects. This study investigated the hypothesis that infant formula need not contain added iron in the first 3 mo. Healthy term infants were recruited into a double-blind controlled trial and randomized to receive either a new no added iron formula (New; <0.1 mg Fe 100 ml(-1)) or a standard formula (Standard; 0.5 mg Fe 100 ml(-1)) for the first 3 mo of life. A breastfed reference group was also studied. Iron status was assessed at 3 and 12 mo from heel-prick capillary blood samples evaluated by full blood-count analysis, including reticulocytes and serum ferritin. In total, 149 infants were entered (51 New, 49 Standard, 49 breastfed) with no differences between the groups in gender distribution, birthweight, gestation or numbers completing the study. There were no significant differences between the principal outcome measures: mean values for haemoglobin, mean cell volume and ferritin, between the two formula-fed groups, and the proportion with a haemoglobin level <11 g dl(-1) or ferritin <10 microg l(-1) did not differ. CONCLUSION: The use of a "no added iron" infant formula in place of an iron-fortified formula during the first 3 mo of life did not clinically affect iron status at 3 and 12 mo of age. The universal supplementation of formulae with iron during this initial period needs further consideration.

Breast Feeding↗
PubMed1998

Perinatal and infant nutrition. Nucleotides.

Nucleotides (NT) are ubiquitous intracellular compounds of crucial importance to cellular function and metabolism. Much recent interest has focused on NT as components of the non-protein nitrogen fraction of human milk. NT supplementation of infant formula has now been introduced in several countries. Biological effects of NT have been reported in several fields. Dietary NT have been shown to have important effects on several components of the immune system: they may enhance intestinal absorption of iron; they affect lipoprotein and long-chain polyunsaturated fatty acid metabolism; they may alter intestinal flora; and they have been demonstrated to have trophic effects on the intestinal mucosa and liver in several experimental situations. Clinical studies have shown NT supplementation of infant formula reduces the incidence of diarrheal episodes among socioeconomically deprived infants, and enhances catch-up growth in infants born small for gestational age. Further work will continue to try to identify other clinical situations in which NT may have a beneficial role.

Animals↗
PubMed1998

Gastro-oesophageal reflux in children.

Disordered motility of the gastrointestinal tract in children is usually manifest as gastro-oesophageal reflux disease. Reflux is common in infants but usually resolves spontaneously with time. If severe enough to merit investigation, 24-hour ambulant oesophageal pH monitoring is the most widely used investigation, though it does have disadvantages. Upper gastrointestinal endoscopy and biopsy may be required to diagnose oesophagitis. Treatment follows a step-wise approach, progressing from positioning and feed-thickening in infants, through to pharmacological management with prokinetic agents and/or acid-suppression, and surgery for a very small proportion of children whose symptoms do not respond to optimal medical therapy.

Child↗
PubMed1997

The technetium white cell scan as an initial imaging investigation for evaluating suspected childhood inflammatory bowel disease.

BACKGROUND: The technetium white cell scan (WCS) may be a useful investigation for patients with inflammatory bowel disease (IBD). In a retrospective study we assessed the use of the WCS as an initial imaging investigation in evaluating children with suspected IBD. METHODS: Over a 3-year period, 60 WCS were performed on 55 patients (25 boys, median age 12.1 years, age range 1.5-18 years) with known or suspected IBD. There were two clinical groups: those with previously diagnosed IBD (histologically and radiologically) and in clinical relapse (13 patients), and newly presenting patients with suspected IBD (42 patients). RESULTS: Eighteen scans were performed on the 13 patients presenting with relapse. Seventeen were positive and one patient, subsequently shown to have an inactive stricture, had a negative scan. Seven of the 42 newly presenting patients had abnormal scans, confirmed to be due to IBD by a combination of histology and barium examinations. Of the remaining 35 scans, three were abnormal and 32 were normal. None of these patients were subsequently proven to have IBD. These results show that in detecting active IBD, a positive WCS has a 100% sensitivity (24/24) and a 91% specificity (32/35) in the diagnosis of IBD. CONCLUSIONS: Our results show that the WCS is very useful as an initial imaging investigation in evaluating patients with suspected IBD to select patients for further investigation.

Adolescent↗
PubMed1997

Experience of percutaneous endoscopic gastrostomy in children with Crohn's disease.

Enternal nutrition is an important mode of treatment for Crohn's disease in children. Percutaneous endoscopic gastrostomy has been little used, even through it can facilitate the administration of an unpalatable elemental diet to an anorexic, undernourished patients. Its use is reported in 10 children with Crohn's disease. The gastrostomy was found to be more acceptable than a nasogastric tube and was associated with only minor complications. As a consequence of improved delivery of enteral nutrition, in the year after the insertion of the gastrostomy there was a reduction in prednisolone dosage in all patients, with six patients being able to stop prednisolone completely. The SD score for height also improved significantly. It is suggested that percutaneous endoscopic gastrostomy is both useful and safe in the management of Crohn's disease in children, particularly when compliance with an elemental diet is likely to be poor.

Adolescent↗
PubMed1997

Faecal chymotrypsin in small for gestational age infants: effects of nucleotides and breast feeding.

The effect of diet on pancreatic exocrine function, measured by faecal chymotrypsin activity (FCA), was studied longitudinally in three groups of small for gestational age (SGA) infants in the first six months of life. The three groups comprised breastfed infants (group B), those randomly allocated to receive a standard infant formula (group S), or the same formula supplemented with nucleotides (group N). The three groups did not differ in their birthweight or gestational age. Nucleotide supplementation of infant formula improves catchup growth in SGA infants but whether this is due to effects on the gastrointestinal mucosa or the exocrine pancreas is not known. There were no differences in FCA at study entry but by one month group B had significantly lower values than the other groups, and this was maintained at 2, 4, and 6 months. Groups N and S did not differ significantly at any time point. Nucleotide supplementation of infant formula does not influence pancreatic exocrine function and its effect on growth is unlikely, therefore, to be mediated through the pancreas. This study shows that breast feeding is associated with lower FCA which may be related to the lower protein content of human milk. Reliable interpretation of FCA in young infants requires information about their diet.

Bottle Feeding↗
PubMed1996

The epidemiology of paediatric inflammatory bowel disease.

A retrospective study of the incidence and prevalence of paediatric inflammatory bowel disease over an 11 year period was undertaken in South Glamorgan. Over this time the incidence of Crohn's disease more than doubled from 1.30 cases per 100,000 childhood population per year in the period 1983-1988, to 3.11 cases per 100,000 population per year in the period 1989-1993. In contrast, the incidence of ulcerative colitis remained the same throughout the study period at 0.71 per 100,000 per year. In 1993 the prevalence of Crohn's disease in the childhood population was 16.6 per 100,000 and of ulcerative colitis, 3.42 per 100,000.

Adolescent↗
PubMed1996

Nucleotide supplementation and the growth of term small for gestational age infants.

A double blind randomised controlled trial in small for gestational age (SGA) infants, whose intestinal mucosa was shown to be functionally impaired as a result of intrauterine undernutrition, was carried out to investigate the hypothesis that nucleotide supplementation of a milk formula could improve catchup growth. Anthropometric data were collected on 74 infants, 39 randomly allocated to the nucleotide supplemented group (group N) and 35 to a standard formula group (group S). From study entry to 2 months of age, infants in group N had significantly higher mean rates of weight gain (106.3 compared with 94.7 g/kg baseline weight/week) and length gain (21.8 v 19.7 mm/m baseline length/week). Over the whole six months for which the trial formula was provided group N had significantly higher mean rates of gain of weight (80.1 compared with 71.8 g/kg baseline weight/week), length (16.2 compared with 15.0 mm/m baseline length/week), and head circumference (11.8 compared with 10.8 mm/m baseline head circumference/week). Catchup growth in SGA infants is therefore improved by nucleotide supplementation of infant formula.

Anthropometry↗
PubMed1991

Co-expression of four intermediate filament subclasses in childhood glial neoplasms.

Immunohistochemical analysis of intermediate filament (IF) proteins was performed on frozen sections of 16 childhood glial tumors using a library of 10 antigen-specific IF protein directed monoclonal antibodies (MoABs) and a four-step biotin-streptavidin-alkaline phosphatase conjugated antigen detection immunocytochemical technique. Human glial fibrillary acidic protein (GFAP) and vimentin were expressed in all brain tumors. High molecular weight (200 kDa) neurofilament (NF-H) protein was expressed in 15 out of 16 tumors; medium molecular weight (160 kDa) neurofilament (NF-M) in seven out of 16 tumors; and low molecular weight (68 kDa) neurofilament (NF-L) in five out of 16. Positive acidic keratin reactivity was found in five out of 16 tumors using MoAB AE1. Expression of a keratin pair was detected with MoAB AE2 in five out of 16 tumors. A second keratin pair in 14 out of 16 glial tumors was demonstrated with MoAB AE3. Immunostaining with AE5 defined the expression of another basic keratin (64 kDa) in nine out of 16 glial tumors. Finally, in 14 out of 16 astrocytomas an individual 51 kDa acidic keratin (detected with MoAB AE8) was expressed. Glial tumor cells contain cell lineage specific and nonspecific IF proteins in the following IF pattern: AE3+, AE8+, GFAP+, vimentin+, and NF-H+. The heterogenous composition of these cytoskeletal IF proteins in childhood glial tumors may reflect a direct stage dependent correlation with their neoplastic transformation.

Adolescent↗
PubMed1990

Rapid anti-epileptic drug assay.

The usefulness of rapid anti-epileptic drug assay in a paediatric neurology clinic was assessed. Compared with a method in which results were not available for seven to 10 days, there was an increased likelihood that levels would be within the target range, particularly for carbamazepine. Increased parental discussion, and therefore involvement with dosage, was possible. Management of children receiving phenytoin was more efficient and non-compliance could be dealt with immediately. When anti-epileptic drug levels are measured, rapid assay, with results available while the patient is still in the clinic, should be a standard facility.

Anticonvulsants↗
PubMed1990

Health-related expenditure patterns in selected migrant groups: data from the Australian Household Expenditure Survey, 1984.

Australians born in Italy, Greece and East and South East Asia all have substantially lower mortality levels than those born in Australia, the British Isles or Holland and Germany. Using data from the 1984 Household Expenditure Survey, the health-related consumption expenditure of these six groups was compared (excluding expenditure on medical care). The heterogeneity of household types was largely removed by confining attention to married couple households with dependent children. The two groups with mortality levels comparable to those of the Australian-born (British Isles and Holland/Germany) also shared a similar pattern of consumption expenditures. There was a tendency (not always fully consistent), for the low mortality groups to spend more on fruits, vegetables, cereal products and fish and substantially less on alcohol. Patterns that might be 'unexpected' in low mortality groups are the (presumptively) substantial expenditures on tobacco among males (especially in the Greek group) and the substantial expenditures on red meat in all three groups. Analysis of available data sets such as this can provide useful descriptions of the distribution of health-influencing behaviour in our population.

Adolescent↗
PubMed1989

Detection of human papillomavirus DNA in fine-needle aspirations of metastatic squamous-cell carcinoma of the uterine cervix using the polymerase chain reaction.

Routinely processed fine-needle aspirations of metastatic squamous-cell carcinoma (SCC) were analyzed for human papillomavirus type 16 (HPV-16) using the polymerase chain reaction (PCR), an in vitro DNA amplification method. HPV-16 DNA was detected in five of seven (71%) metastases from SCC of the uterine cervix. In two cases in which the primary tumor was available for comparison, the HPV-16 DNA content of the primary tumor and of the metastasis was identical. HPV-16 was not found in a metastatic SCC from the lung or in a metastatic nasopharyngeal SCC. These findings demonstrate that HPV-16 DNA sequences can be readily detected in routinely processed fine-needle aspirations using the polymerase chain reaction. The finding of HPV-16 DNA in a metastasis may serve to direct a search for a primary site of origin.

Adolescent↗
PubMed1989

Intermediate filament expression in astrocytic neoplasms.

Immunohistochemical analysis of 30 paraffin-embedded astrocytic neoplasms was performed to correlate the expression of intermediate filament proteins with histologic subtype. Each tumor was studied with monoclonal antibodies to keratin, vimentin, desmin, 200-kd neurofilament protein, and glial fibrillary acidic protein (GFAP). Immunoreactivity with the anti-keratin monoclonal antibodies AE1 and AE3 was demonstrated in 24 cases (80%) including 4 of 6 (66%) well-differentiated astrocytomas (WDAs), 10 of 12 (83%) anaplastic astrocytomas (ANAs), and 10 of 12 (83%) glioblastomas multiforme (GBMs). These cases were further studied with the monoclonal antikeratin antibodies 34 beta E12 and 34 beta H11. Of the 24 AE1/AE3-positive cases, 14 (58%) reacted with 34 beta E12. None of the cases was reactive with 34 beta H11. Vimentin expression was demonstrated in 24 cases (80%), including 2 of 6 (33%) WDAs, 11 of 12 (92%) ANAs, and 11 of 12 (92%) GBMs. Coexpression of keratin and vimentin was observed in 20 cases (67%), including 2 of 6 WDAs, 9 of 12 (75%) ANAs, and 9 of 12 (75%) GBMs. Immunoreactivity with GFAP antibody was present in all 30 (100%) cases, but none of the tumors was reactive with antibodies to desmin or 200-kd neurofilament protein. These findings demonstrate that expression of both keratin and vimentin intermediate filaments is common in astrocytic neoplasms regardless of histologic grade.

Astrocytoma↗