Use this URL to cite or link to this record in EThOS: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.641850
Title: Studies on nutrition and the acute phase plasma protein response
Author: Boyd, Alan Thomas
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1993
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Abstract:
Malnutrition is associated with an increased incidence of morbidity and mortality after surgical operations. The acute phase plasma protein response is believed to be an important mechanism in the repair and resolution of inflammation following operation. This study attempted to determine if the acute phase response is attenuated by malnutrition and thus a possible contributor to the observed increase in the incidence of complications after surgery. Four groups of patients were studied. Normally nourished patients with benign disease of the upper gastrointestinal tract, normally nourished patients with malignant disease of the oesophagus or stomach, malnourished patients with malignant disease of the oesophagus or stomach and malnourished patients with malignant disease of the oesophagus or stomach who had received intravenous nutrition for 7 days prior to operation. Firstly, nutritional indices of the patients were assessed. Then, in the in vivo study, the acute phase proteins C-reactive protein, alpha₁-antitrypsin, and alpha₁-acid glycoprotein were measured sequentially following radical surgery for upper gastrointestinal carcinoma in groups 2, 3 and 4. Finally liver biopsies from all 4 groups were incubated in vitro in the presence of interleukin-1 an acute phase stimulant and the production of C-reactive protein measured using an ELISA assay. The magnitude of the acute phase plasma protein response in vivo and in vitro was compared amongst the groups and correlations were sought between the magnitude of the acute phase plasma protein response in vivo and in vitro and the various nutritional indices. No influence of nutritional factors could be demonstrated in either arm of the study. This could be a genuine finding or the result of inadeguacy in the design of the study or the power of the study in relation to the number of patients studied. Further studies using methods to improve the preservation of the liver slices by shorter incubation and improved oxygenation are suggested.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.641850  DOI: Not available
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