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Biomedical subjects

P Bowen

Publications and source records attributed to P Bowen.

At least 19 recordsLinked to original sources

Common risk factors in adolescent suicide attempters revisited.

The principle risk factors for suicide attempts in adolescents discussed in the literature are examined on the basis of data from a study carried out at the Geneva University Hospitals. 148 adolescents aged between 15 and 19 years form the sample. The results concerning mental disorders at the time of the suicide attempt confirm the clear predominance of affective disorder as well as the elevated frequency of comorbidity. Other main risk factors include suicidal behavior in family members and among acquaintances, poor state of health, poor integration into school or professional life, as well as sexual abuse.

Adolescent↗

Human serum carotenoid concentrations are related to physiologic and lifestyle factors.

We examined the concentrations of five carotenoids in the serum and diet of a population-based sample of 400 individuals to determine what physiologic and lifestyle factors were related to serum carotenoid concentrations, how these relationships differed among the carotenoids, and if these relationships reflected differences in carotenoid intake. Lower serum concentrations of alpha-carotene, beta-carotene, beta-cryptoxanthin, and lutein+zeaxanthin generally were associated with male gender, smoking, younger age, lower non-HDL cholesterol, greater ethanol consumption and higher body mass index. Serum lycopene generally was not related to these factors, but lower lycopene levels were associated with older age and lower non-HDL cholesterol. Only the hydrocarbon carotenoids (alpha- and beta-carotene and lycopene) were directly associated with HDL cholesterol. The associations of some factors (gender, age, smoking, and ethanol intake) with serum carotenoids were similar to the associations of these factors with levels in the diet, indicating that serum carotenoids may reflect the influence of these factors on carotenoid intake. Consistent with this notion, correlations between serum and dietary carotenoids did not differ between smokers and nonsmokers. Other factors (HDL and non-HDL cholesterol and body mass index) associated with carotenoids in the serum were not associated with carotenoid intake, indicating that physiologic conditions that affect the absorption, storage, and utilization of carotenoids may influence these associations. These physiologic and behavioral correlates of carotenoids could explain or modify associations of carotenoids with chronic diseases.

Aged↗

Serum antioxidants and age-related macular degeneration in a population-based case-control study.

OBJECTIVE: To investigate relationships between levels of tocopherols and carotenoids in the serum and age-related macular degeneration (ARMD). DESIGN: A nested case-control study within a population-based cohort. PARTICIPANTS: Cases included a sample of subjects with retinal pigment abnormalities with the presence of soft drusen (n = 127) or with late ARMD (geographic atrophy [n = 9]) or neovascular and exudative macular degeneration (n = 31). An equal number of controls (167 pairs) were selected from among participants in the Beaver Dam Eye Study. The controls had no photographic evidence of soft drusen, retinal pigment abnormalities, or late ARMD and were matched with cases for age, sex, and current smoking status. DATA COLLECTION: Presence and severity of ARMD were determined from masked grading of fundus photographs obtained from 1988 to 1990. Levels of individual carotenoids and tocopherols were determined in serum collected at the same time. RESULTS: Average levels of individual carotenoids were similar in cases and controls. Average levels of vitamin E (alpha-tocopherol) were lower in people with exudative macular degeneration (P = .03). However, the difference was no longer statistically significant after controlling for levels of cholesterol in the serum. Persons with levels of lycopene, the most abundant carotenoid in the serum, in the lowest quintile were twice as likely to have ARMD. Levels of the carotenoids that compose macular pigment (lutein with zeaxanthin) in the serum were unrelated to ARMD. CONCLUSIONS: Very low levels of one (lycopene) but not other dietary carotenoids or tocopherols were related to ARMD. Lower levels of vitamin E in subjects with exudative macular degeneration compared with controls may be explained by lower levels of serum lipids.

Adult↗

Serum carotenoids and tocopherols and severity of nuclear and cortical opacities.

PURPOSE: To determine whether higher levels of individual carotenoids and tocopherols in the serum are related to less severe nuclear and cortical opacities within the general population. METHODS: Levels of individual carotenoids and tocopherols in the serum were determined in 400 randomly selected persons aged 50 to 84 years participating in the Nutritional Factors in Eye Disease Study of Beaver Dam, Wisconsin. Severity of nuclear and cortical opacities was assessed from lens slit lamp and retroillumination photographs taken at the same time. Relationships between serum levels of nutrients and prevalence of these opacities were evaluated using logistic regression analysis accounting for known possible confounders. RESULTS: Higher levels of individual or total carotenoids or alpha-tocopherol in the serum were not associated with less severe nuclear or cortical opacities overall. However, associations differed between men and women and within specific population subgroups. A significant trend for lower odds for either type of opacity with increasing levels of beta-carotene in the serum was observed in men. For nuclear sclerosis, this protective association with beta-carotene was found in younger but not older men. Higher levels of three other carotenoids (alpha-carotene, beta-cryptoxanthin, and lutein) in serum were significantly related to lower odds for nuclear sclerosis only in men who smoked. In contrast to these inverse associations observed in some subgroups, higher levels of some carotenoids and alpha-tocopherol often were directly associated with nuclear sclerosis, particularly in women. CONCLUSIONS: Higher levels of carotenoids and tocopherols are not consistently associated with less severe opacities in the general population.

Aged↗

Body iron stores and risk of colonic neoplasia.

BACKGROUND: Body iron stores and dietary iron intake have both been shown to be positively associated with subsequent risk of colon cancer. This finding comes from a cohort study involving 14,000 men, but the positive association occurred in only 12 cases. PURPOSE: We performed a case-control study of 264 men and 98 women to test for an association between serum ferritin levels and the presence of adenoma of the colon that would be independent of other known risk factors. METHODS: Serum ferritin levels were determined in this study from sera, frozen at -80 degrees C for 5-8 years, that had been originally obtained between 1984-1987 at the Walter Reed Army Medical Center from adult male and postmenopausal female patients undergoing routine colonoscopic examination and previously enrolled in a case-control study that assessed the potential dietary and environmental risk factors for colonic neoplasia. The presence of fecal occult blood in the stool or the suggestion of colonic polyps seen on barium enema defined eligibility for the study. Patients with known preexisting colonic disease were excluded. Eligible patients had their blood drawn and serum prepared. Following colonoscopy and histologic review, the patients were classified into three groups: normal (without neoplastic disease), 159 subjects; adenoma, 145 subjects; and colon cancer, 29 subjects. Body iron stores were determined by measuring serum ferritin levels by a competitive-binding radiometric immunoassay. Ferritin levels categorized into quintiles for adenoma were defined. Crude and adjusted odds ratios (ORadj) with 95% confidence intervals (CIs) for cancer and adenoma related to ferritin were calculated, controlling for known or suspected risk factors including sex, age, race, body mass index, family history, tobacco use, and alcohol consumption. RESULTS: Statistically significant associations of adenoma risk were seen in the third ([ORadj] = 3.8; 95% CI = 1.5-9.5) and fourth (ORadj = 5.1; 95% CI = 2.0-12.7) quintiles of ferritin relative to the first quintile, for smoking history (ORadj = 2.4; 95% CI = 1.3-4.3), for male sex (ORadj = 1.9; 95% CI = 1.0-3.7), and for family history of polyps or cancer (ORadj = 1.8; 95% CI = 1.0-3.4). From a second set of analyses that excluded 36 patients with serum ferritin of greater than or equal to 399 ng/mL, the greatest effect of ferritin on adenoma risk by anatomic subsite was seen in the right colon. CONCLUSION: The apparent dose-response for serum ferritin level and adenoma risk suggest that exposure to iron may be related to adenoma formation.

Adenoma↗

Assessment of the intestinal retention of beta-carotene in humans.

OBJECTIVE: Assessment of the intestinal absorption of beta-carotene (BC) in humans as well as plasma clearance of BC has been difficult. We have used the total gut washout method (TGWM) to assess BC retention during transit through the intestine, as well as the effect that different diets and age have on BC retention. METHODS: HPLC was used to quantitate fecal and serum BC concentrations from young and elderly subjects who had undergone the TGWM to remove all intestinal contents prior to ingesting BC or placebo with or without a meal. Meals contained different combinations of calories and fat. RESULTS: In subjects receiving no meal, 83% of ingested BC was recovered in rectal effluent collected within 24 hours post-BC administration. The quantity of BC in feces of individuals receiving meals was 49-71%. There was no significant change in serum concentrations of other carotenoids or retinoids following consumption of BC with any of the different meals. Interestingly, both diet and age influenced the efficiency of BC absorption. An increase in dietary fat content resulted in an higher serum BC concentration in young subjects within 8 and at 24 hours post BC administration, whereas a higher caloric content resulted in a decrease in serum BC concentration in older subjects within 8 hours of BC administration. CONCLUSION: Results indicate that the TGWM provides an accurate means for assessing the intestinal retention of BC in humans.

Adolescent↗

Alzheimer's disease. Research turned into reality.

A needs assessment revealed that a majority of home care workers feel the need for more education on Alzheimer's disease if they are taking care of such individuals. One program in Canada addressed this hole in the home care basket with a seven-module training course, which prepares its workers for the difficult task of caring for persons with AD when no one else is there.

Aged↗

beta-Carotene supplementation results in an increased serum and colonic mucosal concentration of beta-carotene and a decrease in alpha-tocopherol concentration in patients with colonic neoplasia.

The aim of this study was to evaluate the colonic mucosal beta-carotene (BC) concentration following supplementation with BC and to determine if an increase in BC concentration influences vitamin E (alpha-tocopherol) status. The concentration of BC and alpha-tocopherol was assessed in serum and colonic tissue obtained from subjects with a history of colonic polyps or resected cancer (Dukes A, B1, or B2). Serum and mucosal biopsy samples were obtained prior to and following 3 months daily p.o. supplementation with 30 mg of BC or placebo. The concentration of BC was significantly increased in serum and colonic mucosa from both polyp and cancer subjects following supplementation as compared to presupplementation values and values from subjects receiving a placebo. The concentration of alpha-tocopherol in serum from cancer subjects was significantly decreased in samples obtained at the end of 3 months of BC supplementation as compared to placebo-matched controls. In BC-supplemented polyp subjects the tissue concentration of alpha-tocopherol was also significantly decreased relative to presupplementation values. The results indicate that BC supplementation does result in a significant accumulation of BC in the colonic mucosa but that the alpha-tocopherol concentration in both serum and colonic tissue may be compromised by an increased intake of BC. The mechanism for the decrease in alpha-tocopherol in conjunction with the increase in BC will require further study in order to develop strategies which will prevent vitamin E deficiency in BC-supplemented individuals.

Adult↗

Pulmonary pentane excretion increases with age in healthy subjects.

Excessive lipid peroxidation occurs in various diseases. However, even in health low levels of lipid peroxidation can be detected by measuring the pulmonary excretion of pentane. Lipid peroxidation has been postulated to be one of the causes of the ageing process. In order to test whether pentane excretion is related to age, we measured breath pentane in 47 healthy subjects (ages 21-79). We also measured serum levels of the antioxidants tocopherol, retinol, lycopene, beta carotene, ascorbate and zinc. We found that pentane excretion significantly (P < 0.05, r = 0.32) increased with age. Of the six antioxidants measured, only lycopene decreased significantly (P < 0.05, r = -0.47) with age, however, this decline did not statistically correlate with pentane excretion. The remaining five antioxidants either remained stable or increased over the age range studied. We conclude that lipid peroxidation, as assessed by pentane excretion, increases with advancing age but that this increase is independent of dietary antioxidant levels.

Adult↗

Beta-carotene decreases markers of lipid peroxidation in healthy volunteers.

We previously showed that daily intake of beta-carotene, a nontoxic antioxidant, reduces lipid peroxidation as assessed by serum lipid peroxide levels. An alternative method to detect lipid peroxidation is the measurement of pentane in breath. Pentane is a five-carbon hydrocarbon that is released when an omega-6 unsaturated fatty acid undergoes peroxidation. The aim of this study was to see whether graded doses of beta-carotene would affect breath pentane excretion in normal subjects placed on a carotenoid-free liquid diet for two weeks. The subjects were then repleted with either 15 (n = 7) or 120 mg (n = 8) of beta-carotene daily for four weeks while continuing the same diet. Serum beta-carotene and breath pentane were measured before and after beta-carotene refeeding. Lipid peroxidation, as assessed by gas-chromatographic measurement of breath pentane, was significantly (p < 0.05) reduced by daily supplements of 120 mg beta-carotene (from 3.7 +/- 0.9 to 2.2 +/- 1.4 nmol/l). However, the decline in pentane exhalation observed with the 15-mg beta-carotene dose did not achieve statistical significance (p = 0.13).

Adult↗

Undernutrition and vitamin A deficiency in the Department of Linguère, Louga Region of Sénégal.

Anthropometric measurements were taken on 281 toddlers (24-48 mo old) in Linguère, Sénégal, to determine the prevalence of undernutrition. Blood samples collected from 271 of the toddlers were analyzed for retinol and carotenoids by HPLC. According to the National Center for Health Statistics reference values 30.2% of the population was undernourished. Serum retinol values were below the lower limit of the normal range in 71.5% of the children; 7.4% of this group had concentrations < 0.35 mumol/L, placing them at risk for xerophthalmia. Only 3% of the population had serum retinol values > or = 1.0 mumol/L. Serum carotenoids were low (< 0.70 mumol/L) in 55% of the children. Retinol-binding protein values were low and measurable concentrations of retinyl palmitate were detectable in only 17% of the children. Undernutrition and poor vitamin A status were found to exist at a concentration that would endanger health.

Anthropometry↗

Maintenance of lower proportions of (n - 6) eicosanoid precursors in phospholipids of human plasma in response to added dietary (n - 3) fatty acids.

Competition between the (n - 3) and (n - 6) types of highly unsaturated fatty acids can diminish the abundance of (n - 6) eicosanoid precursors in a tissue, which in turn can diminish the intensity of tissue responses that are mediated by (n - 6) eicosanoids. The mixture of 20- and 22-carbon highly unsaturated fatty acids maintained in the phospholipids of human plasma is related to the dietary intake of 18:2 (n - 6) and 18:3 (n - 3) by empirical hyperbolic equations in a manner very similar to the relationship reported for laboratory rats (Lands, W.E.M., Morris, A. and Libelt, B. (1990) Lipids 25, 505-516). Analytical results from volunteers ingesting self-selected diets showed an inter-individual variance for the proportion of (n - 6) eicosanoid precursors in the fatty acids of plasma phospholipids of about 5%, but the variance among multiple samples taken from the same individual throughout the day was less (about 3%), closer to the experimental variance of the analytical procedure (about 1%). The reproducibility of the results makes it likely that analysis of fatty-acid composition of plasma lipids from individuals will prove useful in estimating the diet-related tendency for severe thrombotic, arthritic or other disorders that are mediated by (n - 6) eicosanoids. Additional constants and terms were included in the equations to account for the effects of 20- and 22-carbon highly unsaturated (n - 3) fatty acids in the diet. A lower constant for the 20- and 22-carbon (n - 3) fatty acids compared to that for the 18-carbon (n - 3) fatty acid in decreasing the ability of dietary 18:2 (n - 6) to maintain 20:4 (n - 6) in tissue lipids confirmed the greater competitive effectiveness of the more highly unsaturated n - 3 fatty acids in the elongation/desaturation process. Also, a lower constant for direct incorporation of 20-carbon fatty acids of the n - 6 vs. the n - 3 type indicated a greater competitive effectiveness of 20:4 (n - 6) relative to 20:5 (n - 3) in reesterification after release from tissue lipids. The equations may be used in reverse to estimate the dietary intakes of the (n - 3) and (n - 6) fatty acids by using the composition of the fatty acids that had been maintained in plasma lipids.

Aged↗

Oral diet does not alter pulmonary pentane or ethane excretion in healthy subjects.

Ethane and pentane are alkanes that are excreted through the lungs to a small degree in healthy subjects. These gasses are produced from the peroxidation of unsaturated fats which are found both in body tissues and in foods. These gasses are excreted in larger amounts by patients with increased production of reactive oxygen metabolites, including those with inflammation or ischemia. Thus, detection of these gasses in excessive quantities is considered evidence for lipid peroxidation. However, the effects of dietary factors on these measurements have not been defined. To define the effects of eating on the pulmonary excretion of these alkanes, 29 healthy subjects were fed a standardized liquid diet (1060 kcal, 12.9 g linoleic acid and 385 mg linolenic acid) after an overnight fast. Breath alkanes were measured at 0, 1, 3, and 6 hours. All subjects had normal vitamin E (1.11 + 0.26 mg/dl), retinol (64 +/- 14 micrograms/dl), beta carotene (27 +/- 21 micrograms/dl), lycopene (23 +/- 12 micrograms/dl) and zinc (81.9 +/- 13.5 micrograms/dl) levels. No statistically significant changes in either alkane were noted relative to the fasting level. We conclude that oral diet does not alter pulmonary ethane or pentane excretion in healthy subjects.

Adult↗

Preparing for expansion in Canadian home care.

Through its universal health care system, Canada has conducted three care assessment studies in Canadian provinces. Although covering divergent topics, all point to a national need: more training for paraprofessionals to provide high-quality care.

Acquired Immunodeficiency Syndrome↗

Trembling chin--a report of this inheritable dominant character in a four-generation Canadian family.

Trembling chin is an unusual, benign, dominant trait. We describe the condition in a four-generation Canadian family. Investigations, which included E.E.G., electromyograph and facial nerve conductance studies on affected and unaffected individuals, were normal. Premature hearing loss, present in all affected members of this family over age 50, strongly suggests an association of trembling chin with otosclerosis. The merits of early diagnosis and preventive treatment for otosclerosis in persons affected by trembling chin are discussed.

Canada↗

The Alberta Hereditary Diseases Program: a regional model for delivery of genetic services.

Genetic counselling and related services are generally provided at major university medical centres because they are very specialized. The need for rurally based genetic services prompted the inclusion of an outreached program in the Alberta Hereditary Diseases Program (AHDP), which was established in 1979; the AHDP was designed to provide services to the entire province through two regional centres and seven outreach clinics. There is a community health nurse in almost every health unit whose duties are either totally or partially devoted to the AHDP; thus, genetic help and information are as close as a rural health unit. The AHDP is designed to provide complete clinical (diagnostic, counselling and some management) services and laboratory (cytogenetic, biochemical and molecular) services for genetic disorders. In addition, the program emphasizes education and publishes a quarterly bulletin, which is sent free of charge to all physicians, hospitals, public health units, social service units, major radio and television stations, newspapers and public libraries and to selected individuals and groups in Alberta.

Alberta↗

Determining the origins and the structural aberrations of small marker chromosomes in two cases of 45,X/46,X, + mar by use of chromosome-specific DNA probes.

A 17-year-old girl (S.M.) and a 13-year-old girl (C.L.) both with Ullrich-Turner syndrome (UTS) were found to have 45,X/46,X, + mar mosaicism. The marker chromosomes in both patients were very small in size. In S.M. the marker chromosome was present in 80% of phytohemagglutinin-stimulated lymphocytes, 28% of skin fibroblasts, and 11-20% of gonadal fibroblasts. In C.L., the small marker chromosome was found in 50% of stimulated lymphocytes. S.M. is of normal height, but C.L. is short. Molecular hybridization with a number of Y-specific DNA probes demonstrated their presence in S.M. but absence in C.L. In situ hybridization with Y-specific and X-centromere-specific DNA probes confirmed the Y origin of the marker chromosome in S.M. and the X origin of the minute chromosome in C.L. Biotinylated centromere and telomere probes were also used for in situ hybridization to show the presence of centromeric and telomeric sequences in the Y-marker chromosome, suggesting that the deletion of this marker chromosome is interstitial.

Adolescent↗