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Biomedical subjects

M Wynn

Publications and source records attributed to M Wynn.

At least 19 recordsLinked to original sources
PubMed2001

Reducing waiting lists for hospital admission: community nutrition services reduce the need for hospital beds.

The number of hospital beds needed is greatly increased by the malnutrition of patients before admission and after discharge. Malnourished patients spend longer in hospital and are more likely to die following surgery or other treatment. Extensive studies show that low blood serum albumin, indicating protein deficiency, is a major risk factor for morbidity and mortality among hospital patients. Community food and nutrition services are extending throughout the developed world as part of public health policies. Such services can reduce costs by reducing the need for hospital beds, can reduce waiting lists and save the lives of many hospital patients. Preventive nutrition services can give financial benefits much exceeding costs.

Biomarkers↗
PubMed2000

Low birthweight in electoral wards: a useful health and social indicator at local level.

Greater use of electoral ward data is recommended for the guidance of allocation of resources to reduce low birthweight rates and for the monitoring of the health of communities. Ward data on low birthweight can be used for correlation studies to show the many associations of social, economic and health factors with low birthweight and with each other. A recent government report shows a substantial increase in the prevalence of disability since 1985 which is partly a consequence of an increase in low birthweight and of a deterioration in the nutritional status of an important minority of poor families who are concentrated in inner city wards.

England↗
PubMed2000

New nutrient intake recommendations are needed for childbearing.

British recommendations (DRVs and RNIs) include hardly any increments for pregnancy. British recommendations for protein are likely to cause unsatisfactory birthweight. What is the normal nutrient intake in pregnancy of healthy women? What evidence is there of special requirements for folate, iron, magnesium or iodine? New recommendations for nutrient intakes in pregnancy should be the responsibility of the Food Standards Agency and a survey of the diets of pregnant women is needed.

Diet↗
PubMed1999

Microalbuminuria in ischemic stroke.

OBJECTIVES: To determine (1) the incidence of microalbuminuria in patients with recent ischemic stroke, (2) its relationship to risk factors for stroke, (3) its prevalence in the major subtypes of ischemic stroke, and (4) its potential for identifying patients at increased risk for recurrent stroke, myocardial infarction, or vascular death. DESIGN: Prospective case-control study. SETTING: Outpatient clinics at the medical centers affiliated with the Department of Veterans Affairs and Oregon Health Sciences University in Portland, Ore. PATIENTS: A total of 186 older men and women (median age, 65 years) who were enrolled in a prospective study of risk factors for recurrent stroke, including 97 patients with recent (6-8 weeks) ischemic stroke, 51 with similar clinical risk factors for stroke, including 24 with a history of remote stroke or transient ischemic attack, and 38 community-dwelling volunteers. RESULTS: Microalbuminuria was 3 times more prevalent in patients with recent stroke (29%) than in those with clinical risk factors for stroke (10%), and was undetectable in healthy elderly controls (P<.001). The presence of microalbuminuria in recent stroke as well as in the combined recent and remote stroke or transient ischemic attack group (n = 121) was predicted by diabetes (odds ratio [OR], 8.4; 95% confidence interval [CI], 2.6-27.0; P<.001; serum albumin levels (OR, 0.12; 95% CI, 0.03-0.50; P<.005); age (OR, 1.1; 95% CI, 1.0-1.2; P<.01), and ischemic heart disease (OR, 3.0; 95% CI, 1.0-9.1; P<.05). Among patients with recent stroke the prevalence of microalbuminuria did not differ among major ischemic stroke subtypes, ie, atheroembolic, 23%; cardioembolic, 30%; and lacunar, 33%. During a mean +/- SD of 1.5 +/- 0.9 years of follow-up, 20% of patients with recent stroke, 14% with risk factors for stroke, and 0% of healthy elderly volunteers had vascular end points (P<.004), with events being as frequent in patients with microalbuminuria (32%) as in patients with macroalbuminuria (33%). After controlling for major clinical risk factors, microalbuminuria remained an independently significant predictor of future stroke in the combined recent stroke and remote stroke or transient ischemic attack group (Cox proportional hazard ratio, 4.9; 95% CI, 1.4-17.6; P<.01). CONCLUSIONS: Microalbuminuria is a common finding in patients with cerebrovascular disease and is associated with increased risk for stroke even after correction for the presence of confounding clinical risk factors. These data suggest that microalbuminuria merits further examination as a potentially inexpensive and easily measured marker of increased risk for stroke.

Aged↗
PubMed1998

U.S. Gulf War Veterans: service periods in theater, differential exposures, and persistent unexplained illness. Portland Environmental Hazards Research Centre.

Approximately 80,000 of the 697,000 American men and women who were stationed in SW Asia during the Gulf War (GW) report unexplained illness consisting of symptoms of persistent fatigue, cognitive difficulties, such as mild memory loss, diffuse muscle and joint pain, gastrointestinal symptoms, skin lesions, and respiratory problems, among others. Associations between major symptom groups and periods of deployment in the theater of operations have been sought in a population-based, clinical case-control study of GW veterans resident in the north-western region of the United States. No statistically significant differences were evident in the proportion of cases with unexplained fatigue, cognitive/psychological or musculoskeletal symptoms among veterans present in SW Asia in 3 specific time periods: (a) 8/1/1990-12/31/1990 (which includes Desert Shield), (b) the period surrounding Desert Storm (1/1/1991-3/31/1991), and (c) the (post-combat) period immediately following hostilities (4/1/1991-7/31/1991). There was a trend for all 3 case symptoms to be more common among GW veterans who served in the post-combat period. As numbers in these deployment groups were small, and power to detect differences low, the apparent absence of significant differences in the frequency of major symptom groups among these veterans requires confirmation in a larger study. Deployment for discrete periods in SW Asia is a method to separate distinct constellations of environmental factors; these are useful for analyses of associations among symptoms and exposures given the near-total absence of objective data on chemical and other possible exposures in the theater of operations.

Adult↗
PubMed1998

Fortification of grain products with folate: should Britain follow the American example.

The fortification of all grain products with folate is mandatory in the USA from 1st January 1999. The decision has been prompted by research indicating that the risk of heart disease, cancer, stroke, nervous system disorders, including Alzheimer's disease, and neural tube defects may be reduced by daily intake of folate higher than is currently normal in the American population. There is a debate on the adequacy of the level of folate mandated and on the limiting of fortification to grain products. Furthermore, there have been representations to the US Food and Drug Administration to include B12 in the fortification requirement. Would British health also benefit from such fortification?

Adolescent↗
PubMed1998

The danger of B12 deficiency in the elderly.

Vitamin B12 deficiency damages nerve cells and aggravates nervous system disorders even in the absence of evidence of anaemia. Prevalence of B12 deficiency increases with age especially over 65 and is frequently associated with Alzheimer's disease. Recent American surveys record a higher prevalence of B12 deficiency and of undiagnosed and untreated pernicious anaemia in the elderly than reported earlier. B12 deficiency is also reported to be a risk factor for heart disease, stroke and accelerated ageing.

Aged↗
PubMed1998

Persistent inflammatory response in stroke survivors.

OBJECTIVE: Goals were to determine how long acute-phase markers remain elevated after ischemic stroke and how marker levels relate to stroke risk factors, stroke mechanism, and subsequent vascular events. METHODS: Fibrinogen (FIB), C-reactive protein (CRP), leukocytes (WBC), neutrophils (PMN), interleukin-6, and interleukin-1 receptor antagonist were measured at stroke onset and at 6 weeks, 6 months, and 1 year after enrollment, or until a vascular event occurred in 136 acute ischemic stroke patients, 76 patients with comparable risk factors for stroke, and 48 age-balanced healthy subjects. RESULTS: Multivariate logistic analysis showed that prior stroke and FIB level predicted new events in stroke patients (p < 0.04 for both), whereas congestive heart failure (p < 0.02) and creatinine level (p < 0.006) were predictive in at-risk patients. After controlling for infection, FIB, CRP, and PMN levels at baseline were higher in at-risk but not in stroke patients with recurrent events (p < 0.05 for all). At 1 year, FIB levels remained elevated in event-free stroke survivors compared with levels in the risk and control groups (p < 0.001 for both). FIB also remained higher in stroke survivors who had atheroembolism (AE) compared with non-AE stroke survivors (381+/-72 versus 342+/-78 mg/dL, p < 0.02). Peripheral vascular disease was an independent predictor (p < 0.0001) of longitudinal FIB in stroke survivors. Of note, both WBC and PMN levels were chronically elevated in patients with stroke risk factors and in stroke survivors (p < 0.0001 for both) compared with healthy elderly subjects. CONCLUSIONS: Most acute-phase markers decline gradually after stroke, but FIB remains significantly elevated and is associated with increased risk for recurrent vascular events.

Acute-Phase Proteins↗
PubMed1997

The problem of low birthweight, the cost and possibilities of prevention.

Low birthweight is costly to sufferers and to society. Primary prevention gives benefits exceeding costs, but many plans to prevent low birthweight, for example improvement in antenatal care, have failed because the intervention is too late. Preconception care is generally necessary. Poor maternal nutrition and infection are the major causes of low birthweight.

Central Nervous System Diseases↗
PubMed1996

Can improved diet contribute to the prevention of cataract?

British adults who were disabled by defective vision were estimated to number 1.668 million in 1988. Cataract is a most important cause of disability and blindness. Cataract develops earlier in life in populations with low income and inferior education. Cataract was shown to be associated with riboflavin deficiency in animals in the 1930s and subsequently with deficiencies of amino acids, vitamins and some minerals. In Britain and the U.S.A. there is a substantial spread in the intake of these micronutrients, the antioxidants and B vitamins, which have been shown to have low intakes in patients at higher risk of cataract. But there is little reliable information on the comparative importance of different micronutrients in Britain and longitudinal surveys relating diet to progression of cataract are recommended, which should also include non-nutrient risk factors for cataract such as smoking, medication and industrial chemicals.

Adolescent↗
PubMed1995

Barnett continent intestinal reservoir. Multicenter experience with an alternative to the Brooke ileostomy.

PURPOSE: Since 1988, surgeons at five hospitals have been performing the Barnett continent intestinal reservoir (BCIR). The BCIR includes modifications to the original Kock pouch, designed to reduce the incidence of valve slippage and fistula formation. Principle modifications include an intestinal collar, an isoperistaltic valve, and a lateral pouch design. METHOD: This unique collaborative study includes 510 ulcerative colitis or familial polyposis patients, with a follow-up time from one to five years postoperatively. RESULTS: Ninety-two percent still have functioning reservoirs. Six and one-half percent have had their pouches removed and replaced with conventional Brooke ileostomies. Reoperation rate for major pouch-related complications (other than pouch removal) was 12.8 percent. These complications included slipped valve (6.3 percent), valve fistulas (4.5 percent), and pouch fistulas (6.3 percent). Several questions were administered to patients whose responses revealed a significant improvement in general quality of life, state of mind, and overall health. CONCLUSIONS: The BCIR represents a successful alternative to patients with a conventional Brooke ileostomy or those who are not candidates for the ileal pouch-anal anastomosis.

Adenomatous Polyposis Coli↗
PubMed1994

Slimming and fertility.

Severe reducing diets cause low levels of progesterone, slowing down follicular growth, inhibiting the surge of luteinising hormone (LH) and preventing ovulation. If less severe, slimming may depresses hormone levels by producing too small a corpus luteum and may result in a miscarriage. A reducing diet over a longer period may also affect fertility. Women planning pregnancy should be advised on the regularity as well as the adequacy of meals during the preconception period. A woman's nutritional status may be adequate for fertility but inadequate to produce a baby in the optimum birthweight range. There is a recovery period from amenorrhoea when it is wise not to conceive.

Diet, Reducing↗
PubMed1991

Structural characterization of heme sites in spinach cytochrome b6f complexes: a resonance Raman study.

Resonance Raman spectra of cytochrome b6f complexes isolated from spinach chloroplasts have been obtained. Selective resonance enhancements and partial reductions of the complex by redox mediators were used to isolate and identify the contributions of heme b6 and heme f sites to the observed spectra. Corresponding spectra for turnip cytochrome f have also been obtained. Power-dependent photoreduction was observed in cytochrome f of the complex as well as in the isolated cytochrome f during the course of the Raman experiments.

Cytochromes↗
PubMed1988

Nutrition around conception and the prevention of low birthweight.

About 80 per cent of perinatal deaths are associated with low birthweight. Mothers' prepregnancy weight for height is correlated with birthweight, but this is only a crude indication of the close connection between low birthweight and maternal consumption of energy, protein and a range of other nutrients before and around the time of conception. Diet influences follicular growth before ovulation and thus affects ovulatory maturation and the number and quality of ova produced. Immediately after fertilisation diet affects the rate at which ova proceed to first and subsequent cleavages and therefore the size of the subsequent fetus. Diet acts not only directly on follicular and embryonic growth but indirectly by affecting gonadotropin secretion. The endocrine system is sensitive to blood concentrations of amino acids and some vitamins and minerals. Gonadotropin secretion is also depressed by smoking, and by some drugs, poisons and diseases, which may as a result also affect birthweight.

Animals↗