Showing papers by "Denis Burkitt published in 1974"

Dietary fiber and disease.

Abstract: Many diseases common in and characteristic of modern western civilization have been shown to be related to the amount of time necessary for the passage of intestinal content through the alimentary tract, and to the bulk and consistency of stools. These factors have in turn been shown to be greatly influenced by the fiber content of the diet and by the amount of cereal fiber in particular. Mechanisms are postulated whereby these changes in gastrointestinal behavior could in part explain the occurrence of such common disorders as ischemic heart disease, appendicitis, diverticular disease, gallbladder disease, varicose veins, deep vein thrombosis, hiatus hernia, and tumors of the large bowel. Calorie intake, speed of passage through the intestine, levels of intracolonic pressures, number and type fecal bacteria, as well as levels of serum cholesterol and changes in bile-salt metabolism have all been shown to be related to the amount of dietary fiber consumed. ( JAMA 229:1068-1074, 1974)

Aspects of the epidemiology of diverticular disease and ischemic heart disease.

Abstract: Diverticular disease (DD) of the colon is common in populations where the intake of cereal fiber in the diet has been reduced dramatically for several decades. Also it has been shown that the addition of fiber in the form of wheat bran relieves the symptoms of the uncomplicated forms of the disease. Both diverticular and ischemic heart disease (IHD) have become major problems of the industrial nations of the Western world in this dentury. Consequently, it has been suggested that a deficiency of dietary fiber may play a part in the causation of IHD. The historical emergence and the geopraphical distribution of both DD and IHD are discussed and are shown to support this contention. New data regarding their prevalence in rural Africa and Asia have been obtained from over 170 hosptals, together with details of the radiological incidence of diverticulosis in India and South Africa. Admittedly the incidence of both diseases is known in very few countries with any degree of accuracy, but it is still crystal clear that DD and IHD appeared on the clinical scene together and that they are very closely associated geographically. Frequently they are found together in the same patient. This paper proposes that fiber deficiency may help to cause not only diverticulosis but also IHD.

An epidemiologic approach to cancer of the large intestine: The significance of disease relationships

Abstract: Available evidence suggests that the return of an adequate amount of cereal fiber to the diet would virtually abolish constipation, and almost do away with the need for laxatives. It seems likely that it would also greatly reduce the prevalence of certain common, painful, and often fatal diseases that are characteristic of modern western civilization, and it seems possible that it might significantly reduce the incidence of large intestinal cancer. There is, on the other hand, no evidence that an increase in cereal fiber in the quantities envisaged, 2 to 6 g of crude fiber a day, could result in any conceivable harm. This is only a working hypothesis which still requires proof, but no alternative hypothesis which could satisfactorily explain these associations has been suggested. The betting odds in adopting this procedure would therefore appear to be “heads I win and tails I don't lose”—not bad odds!

Cancer Registry in Uganda

Abstract: This is the first volume of a collection of essays on problems of contemporary toxicology by the professor of toxicological pathology at the University of Zurich, who is also a consultant to a number of governmental agencies regulating the control of drugs. This book is concerned with adverse reactions to drugs, which in the last 25 years have become a new dimension in the aetiology of disease. The first chapter is concerned with formal toxicology, on which the clinical trial and marketing of new drugs depends, often predetermined by official regulations. In this sphere the practising toxicologist is concerned mostly with demonstrating the safety rather than the toxicity of new products. As there is probably no such thing as an effective and completely safe drug the second chapter on speculative toxicology describes the methods employed in attempting to anticipate the probable adverse reactions to a new drug from its chemical and physical properties. The third and fourth chapters discuss respectively comparative and pharmacodynamic toxicology, and include cocment on experiments on the extent to which the toxicity developed by a drug in animals can be extrapolated to its therapeutic use in man. This is followed by symptomatic toxicology-a consideration of how to identify the offending drug and its mechanism of action in producing the adverse clinical effect. Such an investigation is often more akin to a criminal investigation than to scientific research: it detects suspected problems to be more thoroughly investigated, leading possibly to the eventual apprehension of the criminal. The next sectionsystematic toxicologyclassifies chemical substances according to their structure, physical properties, or pharmacological action and aids the understanding of the relationship of toxicology to chem;ical structure. Lastly, a thought-provoking essay on geographical toxicology discusses the puzzling variations which occur in the incidence of adverse reactions to drugs in different parts of the world. This is sometimes due to the variety of fashions in prescribing which exist, to environmental factors such as climate, or to the dissimilarity in their reaction to drugs shown by different human races just as they are by a variety of animal species. These essays are not only full of accurate scientific and technical information but also of wisdom. It is odd that on such an unlikely subject the culture and humour of the author becomes evident. Just as English is often attractive when spoken with a foreign inflection, so one would not for the world alter the small grammnatical liberties with the language of Shakespeare which occasionally pervade the text. This and subsequent volumes will repay reading by toxicologists, clinical pharmacologists, research workers in the pharmaceutical industry, and by those engaged in governmental regulatory agencies.