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Biomedical subjects

T Butler

Publications and source records attributed to T Butler.

At least 19 recordsLinked to original sources
PubMed1992

Nutritional intake, height and weight of 11-12-year-old Northumbrian children in 1990 compared with information obtained in 1980.

There is little age-specific information on changes in dietary intake over time in this country, yet this is valuable in assessing the effectiveness of health education programmes particularly in vulnerable groups such as adolescents. In 1990, 379 children aged 12 years completed two 3 d dietary records. They were interviewed by one dietitian on the day after completion of each diary to verify and enlarge on the information provided and, with the aid of food models, obtain a quantitative record of food intake. Nutrient intake was calculated using computerized food tables. These children attended the same seven Middle schools in Northumberland as 405 children of the same age who recorded their diet using the same method, 10 years previously. Heights and weights were also recorded in both studies in the same manner. Comparing the nutrient intakes in 1990 with 1980, energy intake fell in the boys (to 8.6 MJ) but not in the girls (8.3 MJ). The contribution of fat to energy intake was unchanged at about 40% (about 90 g/d). Likewise, intake of sugars was unchanged at about 22% of energy (about 118 g/d). Calcium intake remained the same in the girls (763 mg/d in 1990) but fell in the boys (786 mg/d in 1990). Iron, vitamin C and unavailable carbohydrate intakes increased in both sexes, and the nutrient density of the diet improved in all sex and social-class groups. However, a social trend evident in 1980 still existed in 1990 with low social groups having the poorest-quality diet. It is concluded that there is little evidence of substantial progress towards improving the diet of adolescents in this country.

Body Height↗
PubMed1992

Risk factors for the development of persistent diarrhoea and malnutrition in Burmese children.

To identify socioeconomic and behavioural risk factors for development of persistent diarrhoea and malnutrition in children, a case-control study was carried out in Burma. Cases were 67 children 1-59 months old hospitalized for diarrhoea lasting > 14 days and complicated by severe malnutrition; for each case, a healthy control child was selected who was age- and sex-matched from the same neighbourhood. Homes of cases and controls were visited for interviews and for direct observation of household child-care practices. Risk factors were catalogued and calculations made for relative risk and etiologic fractions. Risk factors that were associated with persistent diarrhoea and malnutrition included low family income, low education of mothers, unhygienic latrines, flies in the house and on the child, dirty appearance of child and mother, mother not using soap and water when washing child's hands, defaecation of child on floor, breastfeeding on demand, child eating food from floor, not feeding recommended weaning foods, and lack of knowledge by mother about causes of diarrhoea and about foods that prevent malnutrition. These results indicated that persistent diarrhoea and malnutrition in Burma is caused by a complex of several interrelated socioeconomic factors, unsanitary behaviour pertaining to personal hygiene, the practice of demand breastfeeding and lack of certain weaning foods, and low education of mothers who showed less knowledge about causes of diarrhoea and prevention of malnutrition.

Case-Control Studies↗
PubMed1992

Patterns of alcohol consumption in white collar-workers--a cross-sectional and longitudinal study.

A 6-year follow-up of a cohort of male and female white collar workers in whom there was baseline information on alcohol consumption and access to data on sickness absence, promotion and labour turnover, revealed that even moderate alcohol and consumption in this population was associated with social costs for the employer and the employee, particularly in terms of sickness absence. The longitudinal examination of consumption in this study suggests that early intervention in a drinking career may reduce alcohol consumption and consequently avoid years of morbidity and sickness absence, as well as having a favourable influence on promotion prospects and labour turnover.

Adult↗
PubMed1992

A six year longitudinal study of the occupational consequences of drinking over "safe limits" of alcohol.

Although much research has focused on the psychological, social, and economic consequences of heavy problem drinking, there has been far less attention paid to the consequences of "moderate" drinking. This study used a unique opportunity to carry out a six year follow up of a cohort of male and female white collar workers in whom there was baseline information on alcohol consumption and access to details on sickness absence, labour turnover, and promotion. It has provided evidence that even moderate alcohol consumption in the working population is associated with social costs for the employer and the employee, including substantial sickness absence, and lack of promotion in men, although the increase in labour turnover was not statistically significant. The longitudinal examination of consumption in this study suggests that early intervention in a drinking career may reduce alcohol consumption and consequently avoid years of morbidity and sickness absence, as well as having a favourable influence on performance and labour turnover.

Absenteeism↗
PubMed1992

Effects of a protein-rich diet during convalescence from shigellosis on catch-up growth, serum proteins, and insulin-like growth factor-I.

Shigellosis in children can cause growth retardation, worsening of malnutrition, and hypoproteinemia. To assess the effects of ingestion of a protein-rich diet during convalescence, 22 children aged 2 to 4 y with culture-proven shigellosis were randomly assigned after 5 d of antibiotic treatment to 21-d feeding regimens of either a 150 kcal/kg/d high-protein diet with 15% of calories as protein or an isocaloric control diet with 6% of calories as protein. At the start and end of dietary treatment, weight, height, mid-arm circumference, skinfold thickness, serum protein concentrations, and serum IGF-I were measured. Means of weight gain and increases in mid-arm circumference were greater in children fed high-protein diets than those fed control diets (1.23 versus 0.76 kg; 1.40 versus 0.96 cm; p < 0.05). Mean increase in height in children fed high-protein diets (0.83 cm) was not significantly greater than with control diets (0.74 cm). Mean increases in serum concentrations of total protein, prealbumin, and retinol-binding protein were greater in the high-protein group than in controls (p < 0.05). Mean serum concentrations of IGF-I were low in both groups before treatment [4.2 +/- 2.6 nmol/L (31.9 +/- 19.6 ng/mL) in controls; 3.1 +/- 3.4 nmol/L (24.0 +/- 26.3 ng/mL) in the high-protein group] but increased more in the high-protein group [39.0 +/- 16.2 nmol/L (298 +/- 124 ng/mL)] than in the control group [16.7 +/- 9.2 nmol/L (128 +/- 70 ng/mL), p < 0.01].(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Proteins↗
PubMed1992

Prevalence of human immunodeficiency virus infection in hospitalized adults at a teaching hospital in west Texas.

The prevalence of infection with human immunodeficiency virus (HIV) among hospitalized adults at a teaching hospital in West Texas was estimated by conducting a serological survey. Of the 2,458 patients tested, 12 (0.5%) were seropositive. All 12 were men of ages 28 through 50 years; 11 were white and 1 was Hispanic. Eleven were previously known to be HIV positive and were hospitalized for illnesses related to acquired immunodeficiency syndrome (AIDS). All seropositive patients were hospitalized on nonsurgical services of internal medicine, medical-surgical neurology, and family practice. These results indicated that the sampled population in West Texas showed a relatively low prevalence of HIV infection and that seropositive patients were predominantly white men hospitalized for AIDS-related illnesses.

Adolescent↗
PubMed1992

Plasma components protect erythrocytes against experimental haemolysis caused by mechanical trauma and by hypotonicity.

To examine the ability of plasma to prevent haemolysis caused by mechanical trauma and by hypotonicity, in-vitro experiments were carried out. Human red blood cells (RBC) were agitated with glass beads at 37 degrees C for 18 h in isotonic tris-buffered saline (TBS) or with additions of test substances to TBS. RBC were incubated for 18 h at 37 degrees C in a stationary water-bath to test effects of hypotonic solutions. Release of haemoglobin was quantitated by measuring optical density of supernates at 412 nm in a spectrophotometer. Agitation of RBC with glass beads in TBS resulted in release of about 30% of haemoglobin, and this haemolysis was inhibited by autologous plasma. Components of plasma that contributed to protection against mechanical haemolysis were albumin, a supernatant of plasma after heating to 100 degrees C that was albumin-free, and a heat-stable extract of fresh frozen plasma (FFP), whereas little or no protection was provided by gamma-globulin, haptoglobin, ceruloplasmin or alpha-2-macroglobulin. Relative viscosity of solutions containing plasma or dextran correlated poorly with protection against mechanical haemolysis. Hypotonic solutions of plasma and addition of the extract of FFP to TBS caused reductions in rates of haemolysis when compared to corresponding osmolalities of solutions of TBS. These results, which showed protective effects of plasma and plasma components against mechanical and hypotonic haemolysis, suggest that a deficiency of protective factors in plasma of patients could contribute to the development of haemolytic anaemia.

Anemia, Hemolytic↗
PubMed1991

Efficacy of a single dose of furazolidone for treatment of cholera in children.

To test the efficacy and safety of furazolidone given as a single dose for childhood cholera, a randomized double-blind placebo-controlled trial was carried out among 118 culture-positive dehydrated children with diarrhea. Patients were randomly assigned to one of four groups to receive medication orally in liquid suspension: furazolidone at 7 mg/kg/day once, furazolidone at 7 mg/kg/day divided into four doses for 3 days, placebo once, or placebo for 3 days. After 12 patients with furazolidone-resistant infections were excluded from the analysis of efficacy, it was determined that both groups treated with furazolidone showed significantly higher rates of bacteriologic success (stool cultures negative for Vibrio cholerae on days 2 to 4 after start of therapy) and clinical success (cessation of diarrhea within 72 h after start of therapy) than corresponding placebo groups (P less than 0.001). There were no significant differences between responses to the 3-day and single-dose regimens of furazolidone, but there was a trend toward better clinical responses in patients who received furazolidone for 3 days. No patient treated with furazolidone dropped out because of side effects. These results indicate that furazolidone, given as either a single dose or divided doses for 3 days, is effective treatment for childhood cholera.

Adolescent↗
PubMed1991

The diagnosis of dementia in the elderly. A comparison of CAMCOG (the cognitive section of CAMDEX), the AGECAT program, DSM-III, the Mini-Mental State Examination and some short rating scales.

The performance of CAMCOG, the cognitive section of the CAMDEX, is compared in a non-random sample of 222 elderly people with diagnoses based on AGECAT and on DSM-III criteria, and with the MMSE and some short rating scales. With a cut-off point of 69/70 and AGECAT organic syndrome as the criterion, the sensitivity of CAMCOG was 97% and the specificity 91%. However, 21% of DSM-III diagnoses of dementia scored above this cut-off; these were mostly mild cases. The correlation between CAMCOG and MMSE scores was 0.87, and the advantage of CAMCOG may be more apparent in longitudinal studies. Multivariate analyses showed that CAMCOG scores are affected by age, sociocultural factors and hearing and visual deficits in addition to dementia, but not by depression. There was a suggestion that individual subsections are differentially affected.

Aged↗
PubMed1990

Treatment of experimental Salmonella typhimurium infection in mice with lomefloxacin.

To evaluate the difluorinated quinolone lomefloxacin in murine typhoid, mice were inoculated intraperitoneally with the LT-2 strain of Salmonella typhimurium and treated with graded doses of the drug given once daily by an orogastric needle. Treatment with lomefloxacin for seven days reduced mortality with a 50% effective dose of 2.5-7.8 mg/kg/day. When given once daily for three days, doses greater than or equal to 5 mg lomefloxacin/kg/day caused significant reductions in splenic counts of S. typhimurium and prevented the inflammatory response to infection in the spleen.

4-Quinolones↗
PubMed1989

Clinical trial of clonidine hydrochloride as an antisecretory agent in cholera.

Clonidine hydrochloride (an alpha 2-adrenoceptor agonist) was tested for antisecretory effects in patients with cholera in a randomized controlled trial. Nineteen adults with diarrhea due to Vibrio cholerae were treated with clonidine (0.9 mg/24 h orally for 72 h) and 18 served as controls. During the first 24 h of treatment and for 24 h afterwards, the mean +/- SD concentrations of sodium (in millimoles per liter) in the stools of clonidine-treated patients were 120.6 +/- 10.9 and 112.3 +/- 11.9, which were significantly lower than 135.5 +/- 17.1 and 125.0 +/- 16.4 in the controls (p less than 0.01). Stool chloride concentrations (in millimoles per liter) were also significantly less in the clonidine group during the same periods: 82.1 +/- 16.8 and 62.4 +/- 19.4 vs. 92.1 +/- 18.3 and 78.0 +/- 23.0, respectively (p less than 0.05). Concentrations of potassium but not bicarbonate were also significantly reduced in the stools of clonidine-treated patients (p less than 0.05). However, there were no significant differences in the mean +/- SD stool volumes (in liters) between the clonidine and the control group in any of the six 12-h periods after treatment or in the cumulative volumes in 72 h (24.2 +/- 10.6 and 22.9 +/- 8.3, respectively). We conclude that clonidine causes modest reduction of stool electrolyte loss but does not significantly reduce fecal fluid loss in patients with cholera.

Adult↗
PubMed1989

Connective tissue breakdown in ovulation.

A meshwork of collagen over the apical region of the follicle must be breached to permit the ovum to escape. We propose that specific collagenase activity is responsible for collagen breakdown in this region. Immature rats are primed with pregnant mare serum gonadotropin (PMSG), followed at 48 h by hCG. At 8 h after hCG, collagenase activity, measured in extracts of ovarian tissue, is elevated about five-fold. Ovulation follows at 10-12 h. Ovaries from PMSG-primed rats are dissected at 48 h, placed in a perfusion apparatus, and perfused with luteinizing hormone and 3-isobutyl-1-methyl xanthine. The ovulations induced by this treatment can be blocked to the extent of 70% with a synthetic collagenase inhibitor. The activation of procollagenase is believed to involve plasminogen activator and plasmin. In support of this, we find that tranexamic acid at 1 mM inhibits ovulation about 70%. The inhibitor must be added within 3-4 h of LH to be effective. A specific plasmin inhibitor, D-Val-Phe-Lys-chloromethyl ketone, is similarly effective.

Animals↗
PubMed1989

Causes of death and the histopathologic findings in fatal shigellosis.

Thirty-seven children (median age, 2 years) with shigellosis in Bangladesh were subjected to postmortem examination to determine causes of death and the spectrum of intestinal histopathology. Infecting species were: Shigella dysenteriae 1, 7 cases; S. dysenteriae 2, 2 cases; Shigella flexneri, 23 cases; Shigella boydii, 4 cases; and mixed infection with Shigella boydii and Shigella sonnei, 1 case. Complicating conditions detected before death included malnutrition in 25 cases, pneumonia in 11 cases and septicemia in 8 cases. In all 37 cases the colon showed gross colitis, consisting of mucosal erythema and edema; superficial ulcerations were visible in 15 cases. Microscopically in the colon the lamina propria showed inflammatory cellular infiltration in 27 cases and crypt abscesses were present in 22 cases. In 9 cases each there were colonic glands in the submucosa and branching of colonic crypts, indicating increased regenerative activity of crypt cells. Severe lesions were mucosal denudation and deep ulceration in 15 cases with a pseudomembrane in 7 and pseudopolyposis in 2 of these patients. The most common underlying cause of death was colitis, whereas the most common immediate and associated causes were, respectively, septicemia and pneumonia. These results indicated that fatal childhood shigellosis results from severe colitis, often complicated by septicemia and concomitant malnutrition and pneumonia.

Bangladesh↗
PubMed1989

Cellulitis caused by Rhizomucor pusillus in a diabetic patient receiving continuous insulin infusion pump therapy.

We have reported a case of primary cutaneous zygomycosis in a diabetic patient receiving continuous insulin infusion pump therapy. We believe this to be the first reported case of a fungal infection associated with the use of an insulin pump. The infection itself was an unusually mild and chronic zygomycosis, possibly due to a low production rate of proteolytic enzymes by a rare opportunistic human pathogen, Rhizomucor pusillus.

Adult↗
PubMed1989

Single-dose treatment of cholera with furazolidone or tetracycline in a double-blind randomized trial.

To evaluate single doses of 400 mg of furazolidone and 1 g of tetracycline given orally to patients with diarrhea due to Vibrio cholerae, we studied 87 adults in a randomized, double-blind, placebo-controlled trial. All patients received intravenous fluids for rehydration and no other drugs. The total volumes of stool (mean +/- standard deviation) during a 6-day period after treatment were significantly smaller in the tetracycline group (10.5 +/- 8.6 liters) than in the furazolidone group (20.9 +/- 15.9 liters) and the placebo group (19.1 +/- 10.5 liters) (P less than 0.01). The duration of diarrhea and volumes of intravenous fluids were also significantly reduced in the tetracycline group (P less than 0.05). However, there were no differences between the furazolidone and the placebo groups with regard to stool volume, intravenous fluid, and duration of diarrhea. Within 48 h of treatment, tetracycline significantly reduced the number of patients with positive stool cultures for V. cholerae (37%) compared with furazolidone treatment (96%) and the placebo (97%) (P less than 0.001). Although the tetracycline group had a significantly higher incidence (61%) of bacteriologic relapse (negative stool cultures on days 2 and 3, followed by positive cultures afterward) compared with that in the furazolidone group (40%) and the placebo group (33%), this was not associated with clinical relapse. There were no differences between the furazolidone and placebo groups with regard to any of the bacteriologic responses examined. These data indicate that a single dose of 1 g of tetracycline is effective in the treatment of cholera, but it is asymptomatic bacteriologic relapse. A single dose of 400 mg of furazolidone is not therapeutically effective in cholera.

Adult↗
PubMed1989

Histopathology and etiology of childhood pneumonia: an autopsy study of 93 patients in Bangladesh.

The causes and pathogenesis of severe childhood pneumonia in a developing country were studied in lungs removed at autopsy from 119 Bangladeshi children who presented with pneumonia and/or diarrhea. Pneumonia was observed in 93 patients. Morphologic features included acute alveolar exudate in 51% (of the 93 patients), necrotizing pneumonia in 31%, interstitial pneumonia in 22%, and caseating granulomas in 4%, while a mixed pattern occurred in 16% of patients. Causes of pneumonia were Gram-negative bacteria in 27%, pneumococcus in 8%, cytomegalovirus (CMV) in 8%, Pneumocystis carinii (PC) in 4%, mycobacteria in 3%, aspergillus in 3%, mixed anaerobes in 3%, viral (not CMV) in 2%, Staphylococcus aureus in 1% and ascaris in 1%. Two causative agents were identified in 7% of patients. In 46% of the cases, no etiologic agent was identified. Our data suggest that most pneumonias had a bacterial etiology; however, viruses, including CMV, and other opportunistic organisms such as PC, were also important pathogens. Gram-negative pneumonia was partially attributed to concomitant intestinal infections. Opportunistic infections resulted from malnutrition and debilitated host defenses during prolonged fatal illnesses.

Adolescent↗
PubMed1988

Orally administered bovine colostral anti-cholera toxin antibodies: results of two clinical trials.

PURPOSE: Previous reports have suggested that binding of luminal toxin by orally administered antitoxin antibodies might be a feasible treatment for cholera. We therefore conducted two randomized, controlled clinical trials to test the therapeutic efficacy of orally administered anti-cholera toxin bovine colostral immunoglobulins in patients with cholera diarrhea. PATIENTS AND METHODS: In Trial I, 45 patients with cholera were randomly assigned to receive two doses (2 g in 100 ml of water each) of anti-cholera toxin bovine colostral immunoglobulins, non-immune bovine colostral immunoglobulins, or 100 ml of water alone. In Trial II, 20 patients were randomly assigned to receive either 2 g of anti-cholera toxin bovine colostral immunoglobulins or non-immune bovine colostral immunoglobulins or water every two hours for a total of eight doses. The mean stool volumes in each of two sequential eight-hour periods following initiation of therapy were not significantly different among study groups in either trial. RESULTS: Measurement of immunoglobulin in stools showed that bovine IgG was detected in 19 of 25 patients given bovine colostral immunoglobulins in both trials. Cholera toxin neutralizing activity, as assessed with the rabbit ileal loop assay, was found in the stools of three of seven patients given anti-cholera toxin bovine colostral immunoglobulins in Trail I, and in all six patients given anti-cholera toxin bovine colostral immunoglobulins in Trail II. CONCLUSION: We conclude that oral anti-cholera toxin bovine colostral immunoglobulins are not effective in the treatment of patients with active cholera diarrhea. The prophylactic benefit of oral antitoxin antibody remains to be determined.

Administration, Oral↗