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Biomedical subjects

C C Macintyre

Publications and source records attributed to C C Macintyre.

28 records · Page 2Linked to original sources
PubMed1989

Abnormal eating attitudes in young insulin-dependent diabetics.

All insulin-dependent diabetics between the ages of 16 and 25 years attending the diabetic clinic at the Royal Infirmary, Edinburgh, (152 women and 139 men) were asked to complete the EAT, the EDI, and the GHQ, and to provide a control subject (sibling or close friend) of similar age who would do likewise. Marked differences were found between diabetic women (but not men) and their controls in eating attitudes, in many of the psychological characteristics associated with eating disorders, and in GHQ scores. Although some of the women had classic anorexia nervosa or bulimia, others with abnormal eating attitudes did not fulfil the formal criteria. Overall, diabetics were significantly heavier than controls but the differences in eating attitudes were not eliminated by correcting for overweight. Abnormal scores were associated with high HbA1 levels and independently with retinopathy. The weight gain and psychological effects of diabetes are identified as probably of aetiological importance in the abnormal eating attitudes of young diabetic women.

Adolescent↗
PubMed1988

Reproducibility of reactive hyperaemia test in the measurement of peripheral arterial disease.

The reproducibility and sources of variation in ankle and brachial systolic pressures were determined for a reactive hyperaemia test used to assess peripheral arterial disease in the lower limbs. Thirty-six subjects had repeat measurements taken by four observers on two separate days using a Doppler probe and random zero sphygmomanometer. Ankle pressures were measured before and after 4 min of arterial occlusion above the knee. The 95 per cent confidence limits for a postocclusion reduction in pressure was approximately +/- 25 mmHg and for the postocclusion ankle-brachial ratio was +/- 20 per cent. The corresponding figures for the mean of four measurements taken by two observers on 2 days was approximately +/- 17 mmHg and +/- 13 per cent. In patients with vascular disease analysis of variance showed that the greatest sources of variation in the postocclusion ankle-brachial ratio were the 'biological' variations between subjects and between legs. But for postocclusion reductions in pressure, variability due to observers and repeat readings was as important as the 'biological' differences between subjects and legs. Thus, in respect of variability, the ratio may be a better parameter to detect differences between subjects.

Adult↗
PubMed1988

The importance of the time interval between insulin injection and breakfast in determining postprandial glycaemic control--a comparison between human and porcine insulin.

This study assessed the effect of the time interval between insulin injection and breakfast in determining subsequent postprandial glycaemic control and also whether this differed between highly purified porcine insulin and human insulin (crb) in six diabetic patients (age range 24-36 years, duration of diabetes greater than 10 years) usually treated with twice daily Actrapid MC and Monotard MC and with stable insulin requirements and diabetic control. On separate mornings each patient was given, after an overnight fast, their usual dose of either Actrapid MC and Monotard MC or Humulin S and Humulin Zn injected 5, 20, or 40 min before a standard breakfast. The postprandial glycaemic profile was not significantly different at any of the three time intervals with Actrapid MC and Monotard MC. However, with the human insulin the profile was significantly better at the 40 min interval than at the 5 min interval (p less than 0.05) and this was also better than any of the profiles with the porcine insulin, there being a significant difference between the two types of insulin (p less than 0.05). These findings suggest that the time interval between insulin injection and breakfast may be more important with human insulin than with porcine insulin.

Adult↗
PubMed1988

Variability of ankle and brachial systolic pressures in the measurement of atherosclerotic peripheral arterial disease.

The aim of this study was to determine the variability of measurements of ankle and brachial systolic pressures and ankle brachial ratios in order to assess their suitability for use in epidemiological studies of arterial disease in the lower limbs. Thirty-six subjects had repeat measurements taken by four observers on two separate days using a Doppler probe and random zero sphygmomanometer. The variability in the measurement of ankle systolic pressure was comparable to that for brachial systolic pressure. The 95% confidence limits of one measurement of the ankle brachial ratio was estimated to be +/- 16%, reducing to +/- 10% for the mean of four measurements taken by two observers on two days. Analysis of variance indicated that the variability in the measurement of ankle brachial ratios attributable to observers, days, timing of measurements on the same day, and repeat measurements was considerably less than the "biological" variability between subjects and between legs. These results suggest that repeatability of the ankle brachial ratio is such that a single measurement is suitable for most epidemiological studies of atherosclerotic peripheral arterial disease.

Adult↗
PubMed1987

Constant i.v. infusions of nalbuphine or buprenorphine for pain after abdominal surgery.

A double-blind, sex-stratified, study compared the analgesic efficacy and side effects of nalbuphine 10 mg ml-1 (group N) and buprenorphine 0.15 mg ml-1 (group B) administered as a continuous infusion (0.2 ml kg-1/24 h), after abdominal surgery. Patients could request additional i.m. analgesic for pain. The study groups were well matched. The trial was stopped after 55 patients had been studied (nalbuphine 29, buprenorphine 26), because nine patients in the nalbuphine group had inadequate pain relief (P less than 0.01) shortly after surgery (mean 2.5 h). Analysis of the results on an "intention to treat" basis showed that the patients who received buprenorphine had significantly greater pain relief at 1, 3, 6 and 20 h after surgery. Patients who received buprenorphine were assessed by the physiotherapist to have less pain and better chest expansion. More additional analgesic was given to the patients receiving nalbuphine. In the patients receiving buprenorphine, the mean ventilatory rate was less (N = 19 b.p.m., B = 14 b.p.m.) (P less than 0.001) and the increase in PaCO2 was greater (N = 0.5 kPa, B = 1.1 kPa) (P less than 0.001), compared with the value before operation. Side effects were equal, and no serious adverse effects were observed in either group.

Abdomen↗
PubMed1986

Progression of subclinical polyneuropathy in young patients with type 1 (insulin-dependent) diabetes: associations with glycaemic control and microangiopathy (microvascular complications).

The progression of subclinical polyneuropathy over 2.5 years has been studied in a representative group of 75 young patients with Type 1 (insulin-dependent) diabetes (initial age 16-19 years). The relationships between changes in nerve function, glycaemic control and concurrently developing microvascular complications (retinopathy, microproteinuria) were investigated. Deterioration of motor, sensory and autonomic nerve function, retinopathy and microproteinuria was related to poor glycaemic control. In addition, there was an association between developing neural and microvascular complications which was not diminished when their common relationship to hyperglycaemia was taken into account. These findings suggest that, although poor glycaemic control is an essential permissive factor in the early development of diabetic polyneuropathy, other influences, shared with microvascular complications, must also be important.

Adolescent↗
PubMed1986

A randomized double blind cross-over trial of nifedipine in the treatment of primary Raynaud's phenomenon.

During three winter months, 23 women participated in a double blind placebo controlled cross-over clinical trial of nifedipine in the treatment of Raynaud's phenomenon. Nifedipine and placebo were given in random order for two consecutive four-week periods. The dose of nifedipine was increased from 5 mg three times daily (tds) to 15 mg tds. During the final two weeks, the median number of attacks of Raynaud's phenomenon on nifedipine was 2.3 per week compared to 5.0 on placebo (P less than 0.01). Fifteen patients gave nifedipine a higher drug evaluation score than placebo (P less than 0.01). Side-effects were experienced by 14 patients (61%) on nifedipine and by two on placebo (P = 0.005). Finger systolic pressure after digit cooling did not differ significantly at the end of each treatment period. Nifedipine is effective in primary Raynaud's phenomenon in most patients but side effects are common.

Adolescent↗
PubMed1984

A randomized trial of 48 hours of prophylactic cefotaxime versus single dose in transurethral prostatic surgery.

A previous randomized trial from this department demonstrated that there was significant reduction in morbidity and post-operative bacteriuria when men undergoing transurethral prostatectomy were given a prophylactic perioperative regimen of 48 h of cefotaxime compared with a no treatment control group. In this paper we report the results of a new randomized trial to determine whether a single dose of cefotaxime given with the induction of anaesthesia would be of equal efficacy to the previous 48 h regimen. We also investigated the ward bacterial flora for cefotaxime resistance before and during the trial. The 48 h regimen was significantly superior to the single dose in terms of the number of men who developed post operative complications and there was also a small but significant reduction in post-operative hospital stay. Forty-eight hours of prophylaxis covers the normal time of post-operative urethral catheterization and this may explain our findings. There was no evidence of emergence of cefotaxime resistant strains.

Bacteriuria↗
PubMedDate not supplied

Urinary excretion of beta-thromboglobulin and N-acetyl-beta-D-glucosaminidase in type 1 diabetes: potential indicators of early nephropathy?

While microalbuminuria indicates the glomerular damage of early diabetic nephropathy, tubular abnormalities also occur at an early stage of diabetic renal disease. Urinary excretion of beta-thromboglobulin (BTG) and N-acetyl-beta-D-glucosaminidase (NAG) was measured in 132 normotensive Type 1 (insulin-dependent) diabetic patients with no evidence of overt renal disease, of whom 35 had microalbuminuria and the remainder had normal urinary albumin excretion. Of 21 patients in whom there was a detectable urinary BTG concentration, only 8 (38%) had a concurrently abnormal urinary albumin excretion. NAG excretion was elevated in 22 (63%) of the 35 patients with microalbuminuria; significant associations were also identified between urinary NAG excretion and smoking habit (x2 = 12.7, p less than 0.001) and glycated haemoglobin (r = 0.49, p less than 0.01). It is concluded that measurement of urinary BTG is not of sufficient sensitivity to be of value in the detection of early diabetic renal disease, but measurement of urinary NAG may be of value in the detection of diabetic nephropathy at a potentially reversible stage.

Acetylglucosaminidase↗