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Biomedical subjects

T Greiner

Publications and source records attributed to T Greiner.

At least 19 recordsLinked to original sources
PubMed2006

Portal hyperperfusion causes disturbance of microcirculation and increased rate of hepatocellular apoptosis: investigations in heterotopic rat liver transplantation with portal vein arterialization.

Clinical results of portal vein arterialization (PVA) in liver transplantation are controversial. One reason for this is the lack of a standardized flow regulation. Our experiments in rats compared PVA with blood-flow regulation to PVA with hyperperfusion in heterotopic auxiliary liver transplantation (HALT). In group I (n = 19), the graft's portal vein was completely arterialized via the right renal artery in-stent technique, using a 0.3-mm stent, leading to a physiological average portal blood flow. In group II (n = 19), a 0.5-mm stent was used. In group II, the average portal blood flow after reperfusion was significantly elevated (group II: 6.4 +/- 1.5; group I: 1.7 +/- 0.4 mL/min/g of liver weight; P < .001). The sinusoidal diameter after reperfusion was significantly greater in group II (9.8 +/- 0.5 microm) than in group I (5.5 +/- 0.2 microm; P < .001). Red blood cell velocity in the dilated sinusoids was significantly lower in group II (171 +/- 18 microm/s) than in group I (252 +/- 13 microm/s). Stasis of erythrocytes occurred; consequently, the functional sinusoidal density was significantly reduced in group II (38 +/- 7%) compared with group I (50 +/- 3%; P < .01). Two hours after reperfusion of the portal vein, the number of apoptotic hepatocytes was significantly higher in group II than in group I (I: 0 +/- 0 vs II: 7 +/- 9 M30-positive hepatocytes/10 high-power fields). The 6-week survival rate was 9 of 11 in both groups. In group II, 6 of 9 grafts showed massive hepatocellular necroses after 6 weeks, whereas in group I, only 1 of 9 presented a slight hepatocellular necrosis. Finally, our results demonstrate negative effects of portal hyperperfusion in transplanted livers, which are correctable by adequate flow regulation.

Animals↗
PubMed2006

Iodine deficiency persists in the Zanzibar Islands of Tanzania.

BACKGROUND: Iodine is an essential micronutrient for normal human growth and development. It is estimated that more than 1.6 billion people live in iodine-deficient environments, yet there are still some countries and areas where the prevalence of iodine-deficiency disorders is unknown. OBJECTIVE: To establish the prevalence of iodine-deficiency disorders in the Zanzibar Islands, a community assumed to have ready access to iodine-rich seafoods. METHODS: In a cross-sectional study, 11,967 schoolchildren were palpated for goiter prevalence, a subsample was evaluated for urinary iodine concentration, and the availability of iodated salt was assessed at the household and retail levels. RESULTS: The mean total goiter prevalence was 21.3% for Unguja and 32.0% for Pemba. The overall median urinary iodine concentration was 127.5 microg/L. For Unguja the median was 185.7 microg/L, a higher value than the median of 53.4 microg/L for Pemba (p < .01). The household availability of iodated salt was 63.5% in Unguja and 1.0% in Pemba. The community was not aware of the iodine-deficiency problem and had never heard of iodated salt. CONCLUSIONS: The inadequate intake of iodine documented in the Zanzibar Islands belies the common assumption that an island population with access to seafood is not at risk for iodine-deficiency disorders. We urge health planners to implement mandatory salt iodation and education efforts to alleviate the situation.

Adolescent↗
PubMed2005

A two year family based behaviour treatment for obese children.

BACKGROUND: Childhood obesity has become a nutritional problem in China since the 1990s. AIMS: A family based behavioural treatment was developed and tested, to see if its use was feasible in China and to evaluate its impact on obese schoolchildren. METHODS: In a single school in Beijing, 33 obese children were randomly assigned to a treatment group and 35 to a control group. The treatment group participated in a family based behavioural treatment programme for two years. Height and weight were measured every six months for all participants. Blood pressure, cholesterol, and triglyceride levels were measured at baseline and after two years of programme implementation. RESULTS: Body mass index (BMI, kg/m2) was significantly reduced in the treatment group (from 26.6 (1.7) to 24.0 (0.9), 95% CI 2.06 to 3.18) but not in the control group (from 26.1 (1.5) to 26.0 (1.6)). Total cholesterol decreased 5.5% and triglycerides 9.7% in the treatment group. There was a significant correlation between change in BMI and change in triglycerides. There were no significant changes in plasma lipids in the controls. Blood pressure values also decreased significantly in the treatment, but not the control group. CONCLUSIONS: A family based behavioural intervention was feasible to use in treating obesity in schoolchildren in Beijing, China. After two years of implementation, it successfully decreased the degree of obesity, reduced levels of blood pressure, and decreased serum lipids in treatment; there were no significant changes among control children.

Adolescent↗
PubMed2005

Iodine nutrition among indigenous Tarahumara schoolchildren in Mexico.

This paper adds iodine data to the nutritional survey recently published in the Eur J Clin Nutr (2004;58:532-540) to identify growth retardation and micronutrient deficiencies among Tarahumara children from five selected indigenous boarding schools in Mexico. Total goiter rate (TGR) (n=384), urinary iodine concentrations (UI) (n = 100), and iodine content of salt were measured. Overall, TGR was 7.0% (grade 1 = 6.8%, grade 2 = 0.2%). The median UI of the group was 125 microg/l, while the median UI across the schools ranged from 92.0-156.5 microg/l, with 32 and 6% of the children having UI between 50-99 microg/l and 20-49 microg/l, respectively. The iodine content in all the salt packages checked at the schools was above 25 parts per million. Based on TGR and UI, there is a marginal iodine deficiency in this sample of children, probably due to an insufficient iodine intake. These results add to existing evidence that iodine deficiency still constitutes a public health problem in certain populations living in the mountainous regions in Mexico.

Adolescent↗
PubMed2004

Nutritional status of indigenous children at boarding schools in northern Mexico.

OBJECTIVE: To assess the nutritional status of Tarahumara children at indigenous boarding schools. DESIGN: Cross-sectional comprehensive nutritional survey. SETTING: The schools sampled were located in indigenous municipalities of the northern Mexican state of Chihuahua. SUBJECTS: The study was carried out in 2001 among 331 children aged 6-14 y from a sample of five schools. Anthropometric measurements, a thyroid exam and capillary haemoglobin levels were obtained from the children. Serum concentrations of ferritin, iron, total iron-binding capacity, vitamin B(12), folic acid and zinc were collected from a subsample of 100 children. RESULTS: The prevalence of wasting and overweight (children 6-9 y) was 1.1 and 4.6%, respectively, and of underweight, risk of overweight and overweight (10-14 y) was 3.2, 5.1 and 0.6%, respectively. Stunting (6-12 y) was present in 22.3% of the children. The total goitre rate was 5.4%. The prevalence of anaemia was 13% (boys 11.4, girls 14.5%). Overall, 24.2% of the children were iron deficient (depletion 11.1%, deficient erythropoiesis 3%, iron deficiency anaemia 10.1%). No child had folic acid values <3 ng/ml, but 20.2% had low (<200 microg/dl) and 27.3% marginal (200-300 microg/dl) vitamin B(12) levels, and 80.2% had low zinc concentrations (<60 microg/dl). CONCLUSIONS: Nutritional underweight and stunting were similar to those reported in rural localities at the national level, but overweight was less prevalent in children aged 10-14 y. Various micronutrient deficiencies was identified including zinc and vitamin B(12), but the prevalence of iron and folic acid deficiency was lower than expected. These results suggest that Tarahumara children attending boarding schools may be the better-off children from these extremely poor and marginalized areas. SPONSORSHIP: Swedish Agency for Research Cooperation with Developing Countries and the Mexican Social Security Institute.

Adolescent↗
PubMed2001

Clinical and pathological features of posttransplant lymphoproliferative disorders: influence on survival and response to treatment.

PURPOSE: To review the clinical and pathological characteristics of patients with posttransplant lymphoproliferative disorders (PTLD) occurring after solid organ transplantation and determine the influence of these characteristics on response to treatment and survival. PATIENTS AND METHODS: Retrospective review of 32 patients. RESULTS: Overall five-year survival was 59%. Forty-five percent of patients diagnosed within the first year after transplant had advanced disease. Characteristics that were associated with poorer survival were diagnosis within the first year posttransplant, monoclonal tumors and presentation with an infectious mononucleosis-like syndrome. Six of eight patients treated with surgery are alive and disease-free. CONCLUSION: Patients with PTLD can achieve long-term survival. Surgery can play an important role in selected patients. Characteristics that may be associated with poorer survival are diagnosis within the first year after transplant, presence of a monoclonal tumor or an infectious mononucleosis-like presentation.

Adolescent↗
PubMed2001

Increase in serum beta-carotene following dark green leafy vegetable supplementation in Mebendazole-treated school children in Bangladesh.

OBJECTIVE: To study the effect of consumption of dark green leafy vegetables (DGLV) and sweet pumpkin on serum beta-carotene and retinol concentrations in children treated for Ascaris lumbricoides. DESIGN: Experimental study with a randomised design. SUBJECTS: A total of 110 primary school children aged 8-12 y in northwestern Bangladesh. INTERVENTIONS: All children were de-wormed and 2 weeks later randomly assigned to one of three groups to receive for 6 days per week, for 6 weeks, one complete meal containing either: (1) 4.4 mg beta-carotene from DGLV (n=37, after 18 dropouts); (2) 1.5 mg beta-carotene from sweet pumpkin (n=36, 18 dropouts); or (3) vegetables containing virtually no beta-carotene (control) (n = 37, 18 dropouts). RESULTS: Significant increases (P < 0.001) in mean serum beta-carotene concentrations were seen in all three study groups, with a statistically higher increase (micromol/l) in the DGLV group (0.44; 95% confidence interval (CI) 0.32, 0.55) compared to the control group (0.20; 95% CI 0.14, 0.26; P = 0.002). The increase in serum retinol (micromol/l) was statistically significant (P=0.04) only in the DGLV group (mean 0.066; 95% CI 0.002, 0.13), but this increase was not different from the increase in the control group. CONCLUSION: In children successfully treated for Ascaris lumbricoides, a substantial increase in serum beta-carotene was seen after feeding with a moderately high cumulative dose of DGLV for 6 weeks.

Animals↗
PubMed2001

Evidence of grave vitamin A deficiency among lactating women in the semi-arid rural area of Makhaza in Zimbabwe. A population-based study.

OBJECTIVE: To assess the vitamin A and iron status of lactating women. DESIGN: A population-based cross-sectional descriptive study. SETTING: A semi-arid rural area of Makhaza in Zimbabwe. SUBJECTS: Two hundred and seven lactating women with babies aged 2-12 months. METHODS: Serum retinol (SR) was measured by HPLC, serum ferritin (SF) by ELIZA, haemoglobin (Hb) by HemoCue and C-reactive protein (CRP) by a turbo metric method. A seven-day recall of consumption of vitamin A containing foods was recorded. MAIN OUTCOME MEASURES: Relative dose response (RDR), SR, SF, Hb and CRP. RESULTS: Dark green leafy vegetables were the main sources of vitamin A; retinol-containing foods and yellow to red fruits and vegetables were rarely consumed. Five women had elevated CRP and these women had lower SR (P < 0.001) than the rest. Forty percent of the women had vitamin A deficiency (SR < 20 microg/dl), 76% had low liver stores of vitamin A (RDR > 20%) while 15 women had both abnormal SR and abnormal RDR. Forty percent had anaemia (Hb < 12 g/l) while 12% had iron deficiency (SF < 12 microg/dl) and 4% (n = 7) had iron deficiency anaemia. CONCLUSION: Vitamin A and iron deficiencies are problems of public health significance among the lactating women in the Makhaza area.

Adolescent↗
PubMed2001

Exclusive breast-feeding is rarely practised in rural and urban Morogoro, Tanzania.

OBJECTIVE: To investigate and compare feeding practices among infants of less than 7 months of age in a rural and an urban area in Tanzania. DESIGN: Cross-sectional, questionnaire-based interview of mothers and focus group discussions with extension workers and community leaders. SETTING: Eleven villages in a rural district and 10 wards in an urban district in the Morogoro region, Tanzania, west of Dar es Salaam. SUBJECTS: Probability samples of mothers with infants of less than 7 months of age from each area). RESULTS: Exclusive breast-feeding was rarely practised in either the rural or urban areas investigated. However, the urban mothers initiated breast-feeding earlier, discarded colostrum less frequently, breast-fed exclusively for a longer period, gave breast milk as the first feed more often and delayed the introduction of solid foods for longer than their rural counterparts. The rural mothers, on the other hand, breast-fed their previous infants slightly longer than the urban mothers. CONCLUSIONS: The better performance of urban mothers could be partly due to sustained breast-feeding support in hospital settings and other campaigns which may not have reached the rural areas. In both the rural and urban areas more efforts are needed to encourage exclusive breast-feeding, to avoid premature complementation and, in the case of the urban areas, to protect extended breast-feeding.

Adult↗
PubMed2001

Variability in nutrient intakes among pregnant women in Indonesia: implications for the design of epidemiological studies using the 24-h recall method.

Few studies have assessed the reliability of dietary intake methods during pregnancy. Between 1996 and 1998, a longitudinal study of dietary intake during pregnancy was carried out among 451 women in Central Java, Indonesia. Six 24-h recalls were performed each trimester. We report here on intraindividual and interindividual variability in energy and nutrient intakes, as well as the reliability of the 24-h diet recall method. Implications of the use of different numbers of replicate days for estimating dietary intake and the relationships between dietary intake and health outcomes are also discussed. Intravariance-to-intervariance ratios were <1 for energy and carbohydrates and >1 for all other nutrients throughout pregnancy. Reliability analyses found good agreement (reliability coefficient >0.7) with three replicates for the macronutrients, but at least six replicates were needed for an agreement of > or =0.6 for the micronutrients. To estimate true individual average intake with a precision of +/-20%, six replicate recalls were sufficient for energy, carbohydrates, vitamin A, iron and vitamin C. In conclusion, mean intake of several nutrients can be reliably measured with the 24-h recall method, using a limited number of days. The nutrient of interest, the primary objectives and method of analyses should all be taken into account when planning sample size and number of replicates.

Adult↗
PubMed2001

Supplementing lactating women with puréed papaya and grated carrots improved vitamin A status in a placebo-controlled trial.

Doubts have been raised about the effectiveness of carotene-containing foods in improving the vitamin A status of populations at risk. We investigated the effect of papaya and carrots on the vitamin A status of lactating women with 2- to 12-mo-old infants in ZIMBABWE: The women were randomly assigned to three supplementation groups and a placebo group, and received 6 mg of beta-carotene capsules, 650 g puréed papaya, 100 g grated carrots or a placebo, daily for 60 d. All groups were given a meal containing 10 g of vegetable oil daily. Serum retinol, relative dose response, serum ferritin, hemoglobin and C-reactive protein were measured before and after the supplementation period. Mean serum retinol increased significantly after supplementation in the beta-carotene group (P < 0.001), the papaya group (P < 0.001) and the carrot group (P < 0.001), but not in the placebo group (P > 0.05). The relative dose response decreased significantly (P < 0.05) in the beta-carotene and papaya groups, but not in the carrot or placebo groups (P > 0.05). There was an increase in mean serum ferritin in all groups but the increase did not differ among groups. The hemoglobin increases in the beta-carotene and papaya groups were greater than that in the placebo group. We conclude that puréed papaya and grated carrots can improve the vitamin A and iron nutriture of lactating women. These findings reinforce the importance of plant food-based approaches in the control of vitamin A deficiency in low income countries.

Adult↗
PubMed2001

Infant feeding practices during the first six months of life in a rural area in Tanzania.

OBJECTIVE: To assess breastfeeding practices in infants aged 0-6 months, focussing particularly on beliefs, knowledge and practices affecting exclusive breastfeeding. DESIGN: A house-to-house survey with individual interviews using a structured questionnaire, key informants interviews and focus group discussions. PARTICIPANTS: One hundred and seven mothers were interviewed, nearly all of those living in Nkinga community with infants less than seven months old. The focus group discussions and key informant interviews were also held. SETTING: Nkinga community, Igunga District, Tabora region, Tanzania. RESULTS: Sixty four per cent of the sample was put to the breast within two to eleven hours. Prelacteal feeds were given to about 25% of the infants. The type of prelacteal fluid given was mainly glucose water in hospital and plain water with home deliveries. Forty six per cent of the mothers discarded colostrum. The median duration of exclusive breastfeeding was about two months and of full breastfeeding was about four months. CONCLUSION: The average duration of exclusive breastfeeding, though far below recommended levels, is higher than is found in most studies in Africa and Tanzania. This may be due to the efforts of hospital staff who had received special training on breastfeeding in recent years.

Adolescent↗
PubMed2001

Information and socioeconomic factors associated with early breastfeeding practices in rural and urban Morogoro, Tanzania.

UNLABELLED: A cross-sectional study was undertaken in a rural and an urban area in Tanzania with the aim of identifying factors related to early infant feeding practices. The study included 320 mothers from each area with infants below 7 mo of age. A significant proportion of both rural and urban mothers had erroneous beliefs about infant feeding practices. None of the socioeconomic, demographic or biological variables studied were associated with feeding practices. Urban residence was positively associated with the duration of exclusive but not predominant breastfeeding. Better knowledge about specific breastfeeding issues was positively associated with the duration of both exclusive and predominant breastfeeding. Ownership of a radio was positively associated with both exclusive and predominant breastfeeding in the rural area. Although both rural and urban mothers had a high antenatal clinic attendance rate, 65% of the rural and 14% of the urban mothers delivered at home. Urban mothers informed about breastfeeding at the antenatal clinic had better feeding practices. CONCLUSION: We hypothesize that exclusive breastfeeding is not a traditionally recognized practice and thus its duration is mainly associated with information and knowledge about breastfeeding. This suggests that information programmes to provide knowledge, beginning at antenatal visits, may reduce premature complementation, though additional support may also be required.

Adult↗
PubMed2000

Relationships between vitamin A, iron status and helminthiasis in Bangladeshi school children.

OBJECTIVE: To explore the relationships between biochemical indicators of vitamin A and iron status and the intestinal helminths Ascaris lumbricoides and hookworm in primary school children. SETTING: Two rural governmental schools in northwestern Bangladesh. DESIGN: Cross-sectional study. SUBJECTS: The sample consisted of 164 children in grades 3-5. METHODS: Serum retinol and beta-carotene (by high-performance liquid chromatography, HPLC), haemoglobin (HemoCue), ferritin (enzyme-linked immunoadsorbent assay, ELIZA) and height and weight were measured. Dietary intake of vitamin A was assessed using a food frequency questionnaire and faecal analyses were done using Stoll's egg-count technique. RESULTS: The mean serum retinol was 26.8 microg dl(-1) and 20% had a level of < 20 microg dl(-1), the cut-off value for low vitamin A status. There was a strong positive association between serum beta-carotene and serum retinol (r = 0.44, P < 0.001), suggesting those with higher retinol levels had a higher carotene intake. Thirty-one per cent were anaemic (Hb < 11.5 g dl(-1)), 30% had iron deficiency (serum ferritin < 12.0 microg l(-1)) and 14% were suffering from iron deficiency anaemia. Children with a serum retinol level of 20 microg dl(-1) had significantly lower ferritin (14.0 compared to 26.0 microg l(-1), P = 0.005) and Hb levels (11.7 compared to 12.4 g dl(-1), P = 0.005) than those with higher levels. The proportion of iron deficiency anaemia was significantly greater among children with hookworm. Our data suggest that hookworm exerts its impact on iron status independently of the vitamin A status of the host. CONCLUSIONS: Programmes to improve iron status should consider including both vitamin A prevention programmes and deworming.

Anemia, Iron-Deficiency↗