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Biomedical subjects

S F Abraham

Publications and source records attributed to S F Abraham.

At least 19 recordsLinked to original sources

Reduction of food intake in the ovulatory phase of the menstrual cycle.

Food intake was weighed and recorded daily during one complete menstrual cycle in 18 healthy normally menstruating women. Urinary luteinizing hormone indicated the time of ovulation. Mean daily intakes of energy, macronutrients, and alcohol were calculated for five phases during the menstrual cycle: menses, postmenses, ovulatory, postovulatory, and premenses. Weekly variations were also measured. Energy intake was lowest during the ovulatory phase compared with postovulatory, premenses, and menses phases (p less than 0.05). The maximum difference, 1.36 MJ (324 kcal)/d, occurred between ovulatory and postovulatory phases and was twofold higher than the increase of 0.64 MJ (152 kcal)/d observed at weekends. This reduction of food intake at ovulation has not been previously described in humans. It coincides with the expected peak in circulating estrogen levels and is consistent with the hypothesis in animal models that estrogen is an appetite suppressant.

Adolescent

Vitamin and trace element status of women with disordered eating.

We studied biochemical measures of vitamin B-6, zinc, and copper in a group of 96 women and vitamin A and vitamin E concentrations in 89 women, all suffering from an eating disorder. Twenty-three control subjects were studied. Eating-disorder patients not taking vitamin or mineral supplements had significantly higher plasma concentrations of vitamins A and E than did control subjects (also not taking supplements). No difference was found in indices indicating vitamin B-6 status or in plasma zinc or copper concentrations. Self-induced vomiting was the only significant predictor of upper-quartile vitamin A concentrations. Upper-quartile vitamin B-6 activations (indicating lower vitamin B-6 activity) were significantly predicted only by low actual body weight. These results suggest that supplementation of micronutrient intake needs only to be considered for those eating-disorder patients at low weight and then only with water-soluble vitamins.

Adult

Vitamin and trace element status in premenstrual syndrome.

Nutritional and trace element status as measured by plasma concentrations of magnesium, zinc, retinol (vitamin A), and alpha-tocopherol (vitamin E) and the activities of red cell enzymes dependent on thiamin and pyridoxine (vitamin B-6) were determined in 38 women suffering premenstrual syndrome and in 23 control subjects. Blood samples were collected in the premenstrual and in midfollicular phase. Diagnosis of premenstrual syndrome was based on accepted retrospective criteria and on prospective symptom reports collected over three menstrual cycles. No evidence was found to support the hypothesis that premenstrual symptoms are caused by absolute or relative nutritional deficiencies.

Adult

The psychosexual histories of young women with bulimia.

While it is known that anorexia nervosa patients show a wide range of sexual knowledge, attitudes and practices, the psychosexual histories of bulimia patients have not been studied. In this paper the psychosexual histories of 20 bulimic patients and 20 matched control subjects are presented. Bulimic patients were more likely to experience orgasm with masturbation, were more likely to have experimented with anal intercourse, and were more likely to describe their libido as 'above average.' Control subjects were more likely to experience orgasm during sexual intercourse. Bulimic patients associated high body weights with unattractiveness, and tended to withdraw from social and sexual activity at high weights. In other aspects of their sexual behaviour, and in their attitudes to sexual matters, the two groups were similar.

Adolescent

Hypokalaemia and renal impairment in patients with eating disorders.

The biochemical abnormalities and decreased renal function which developed in two patients suffering from eating disorders are reported. These cases illustrate the need for biochemical screening of patients with eating disorders to determine if significant abnormalities are present and to provide a baseline for future investigations.

Adult

Changes in sodium and uric acid concentrations in plasma during the menstrual cycle.

Hormonal changes during the menstrual cycle are well documented, but many other biochemical variables have not been studied. We find that in the luteal phase of the menstrual cycle the concentrations of sodium and uric acid are significantly lower. The changes may be of significance for the determination of the normal reference interval.

Adult

Eating behaviours among young women.

Disordered eating and weight-control behaviour is becoming increasingly common among adolescent girls. We studied four groups of young women aged between 15 and 27 years (106 school and university students, 50 ballet school students, 22 patients suffering from anorexia nervosa and 44 patients with bulimia). Our results suggest that most young women diet at some time and lose more than three kg in weight; that they may experience episodes of binge eating and "picking" behaviour; and that they wish to be thinner irrespective of their current body weight. Twenty per cent of young women may fulfil the criteria for an eating disorder (bulimia or anorexia nervosa) at some stage, however briefly, and about 7% abuse laxatives or diuretics in order to achieve a fashionably slim figure. We suggest that most young women may pass through a phase of what is currently called disordered eating, and that this is part of normal development and may not necessarily require treatment. The incidence of disordered eating is greater in those young women who are under pressure to maintain a low body weight.

Adolescent

External breast prostheses. A survey of their use by women after mastectomy.

Women who have had a mastectomy for breast cancer have to cope with two major problems: first, that they have cancer, and second, that they have lost their physical appearance. The provision of an appropriate prosthesis can reduce the sense of disfigurement. If women were to obtain the full psychological benefit of wearing a breast prosthesis, they need to be informed about the available breast forms, have an opportunity to choose between them, and to be satisfied with their choice. In this study of 49 women, only 44% had had the opportunity to choose a prosthesis, 28% were dissatisfied with their prostheses, and 17% were still using temporary prostheses.

Aged

How patients describe bulimia or binge eating.

Thirty-two patients who complained of episodes of ravenous overeating which they felt unable to control (bulimia) were asked to describe their behaviour and symptoms. There was considerable variation both between and within individuals, but a number of factors were defined which appeared to be common to all with the complaint. It is difficult to set up strict criteria for the recognition of bulimia, and those that have recently been proposed are criticized in the light of our present findings. Bulimia is usually associated with an excessive concern about body weight. It occurs in patients with anorexia nervosa, in whom it is often a relatively early feature of the illness, but it is also found in subjects of normal weight or obese subjects who have never been emaciated. Episodes of bulimia are usually preceded by dysphoric mood states. The gorging may alleviate the dysphoria temporarily, but many patients later experience negative feelings such as depression and self-depreciation. The ability to induce vomiting after a bulimic episode is a major influence determining the clinical presentation.

Adolescent

Body weight, exercise and menstrual status among ballet dancers in training.

A prospective study of the menstrual pattern and weight changes was made in the first year of training of 29 new female entrants to a professional ballet school. Seventy-nine per cent of the student girls had menstrual disturbances at entry: primary amenorrhoea, four; secondary amenorrhoea, 11; irregular menses, eight. The incidence of secondary amenorrhoea increase substantially by the end of the year (20), but was not associated with any significant change in body weight. Only three students menstruated regularly during the year. Menstrual regularity improved during periods of injury and long vacation and it appears that deterioration of the menstrual pattern during dancing periods was related to strenuous physical exercise rather than to any change in body weight.

Adolescent

Nutritional knowledge questionnaire. Part two.

An easily administered and scored test of nutritional knowledge was published in the previous issue of the Journal (December 27, 1980). The correct answers to the questionnaire are presented here. The questionnaire has been administered to 2175 subjects. The test was shown to have high reliability and criterion validity, discriminating between educational and occupational groups. There was a significant linear relationship between nutritional knowledge score and age. It is suggested that the test may be of value in the assessment of patients requiring dietetic management.

Adolescent

Continuous infusion of luteinizing hormone releasing hormone (LHRH) in patients with anorexia nervosa.

LHRH was administered by continuous 4-hour intravenous infusion to 14 anorexia nervosa patients on a refeeding programme. Infusions were repeated in 7 patients following weight gain and in 4 after a course of bromocriptine. Five healthy female volunteers in the early or mid-follicular phase of the menstrual cycle served as controls. The LH response was diminished in patients at 65% standard weight, but was of progressively increasing magnitude in patients at 80% and 95% standard weight. The pattern of LH response to the 4-hour infusion was suggestive of a deficient stimulation by endogenous LHRH in patients at extremely low weights, and of an impaired oestrogen feedback mechanism in patients at intermediate weights. Bromocriptine enhanced the LH response on one occasion in patient with moderately elevated plasma HPR values, but failed to produce a similar effect when given to 3 patients with normal HPR levels. The mean FSH response did not differ significantly between patients in different weight categories, although those at 65% standard weight had a markedly greater variance of response. Plasma oestradiol values were lower in patients at 65% standard weight than in those at higher weights.

Adolescent