Search PubMed⌕ Search

Biomedical subjects

D Simmons

Publications and source records attributed to D Simmons.

At least 145 records · Page 8Linked to original sources
PubMed1993

Diabetes detection on the surgical wards in an area with a high prevalence of diabetes.

AIM: To describe the prevalence of diabetes and audit the processes used for diabetes detection on the surgical wards at Middlemore Hospital. METHODS: By the retrospective viewing of the notes of all admissions over a 12 month period. Comparison was made with routinely collected hospital discharge data. RESULTS: Notes from 10,893 of 11,004 (99.0%) admissions were viewed. 550 (5.0%) admissions involved a diabetic patient but diabetic patients were more likely to be readmitted (27.6% vs 13.5% diabetes vs no diabetes, chi 2 = 61.2, df = 1, p < 0.001). Only 18.2% of diabetic admissions and 24.5% of diabetic patients were identified as such on hospital discharge data. No screening for diabetes was undertaken in 34.2% of younger and 8.7% of older admissions and 7.5% of patients had either glycosuria or a glucose > or = 8.0 mmol/L but received no follow up. Only 17 new cases of diabetes were detected. Although no ethnic group difference in screening or identification of diabetes was found, in those aged > or = 60 years, 31% of Maori and 26% of Pacific Islands inpatients had diagnosed diabetes (vs 7.9% European). A similar excess of diabetes in Maori (18%) and Pacific Islands (16%) patients was found in those aged 40-59 years (Europeans 6%). CONCLUSION: In areas with a high proportion of Maori and Pacific Islands people, diabetes is an important medical condition to be considered in all surgical inpatients. Screening tests for diabetes need to be more closely followed up, perhaps by informing the general practitioner of the inpatient glucose.

Adult↗
PubMed1993

Diabetes.

Explore the source record for details and available documents.

Adult↗
PubMed1993

Relationship between myoinositol influx and lipids in diabetic neuropathy.

Diabetic neuropathy is associated with abnormalities in lipid metabolism and has been postulated to be associated with abnormal myoinositol metabolism. Leucocyte myoinositol influx was measured using a triple isotope method in long-standing type 1 (insulin-dependent) diabetic patients with and without diabetic neuropathy and in a group of matched controls. No differences in fasting lipid, glucose concentrations or glycated haemoglobin were found in the diabetic groups. Myoinositol influx was significantly but negatively correlated with the serum very low density lipoprotein (VLDL) cholesterol concentration in patients with and without neuropathy but not in the controls. The VLDL cholesterol concentration also correlated negatively with the transporter Km (Rs = -0.87, P < 0.005, neuropathic group only) and Vmax (Rs = -0.93, P < 0.001, neuropathic group; Rs = -0.59, P < 0.05, non-neuropathic group). Myoinositol influx correlated with the glycated haemoglobin only in the diabetic patients without neuropathy. The lipid relationships in diabetic subjects were independent of glucose control, which suggests that myoinositol influx mechanisms represent another transporter affected by intracellular lipid metabolism. The control of VLDL metabolism by fibrates could offer a method for reducing the progression of diabetic neuropathy.

Blood Glucose↗
PubMed1993

Metabolic and anthropometric changes in female weight cyclers and controls over a 1-year period.

OBJECTIVE: Women who diet to lose weight often regain the weight over time, and the cycle repeats itself. The objective of this study was to identify a group of female weight cyclers and to match them with a control group who had never consciously tried to lose weight. For 1 year, weight patterns, eating habits, metabolic parameters, and body composition were assessed to determine whether there was a relationship between weight cycling and these variables. DESIGN: Measurements were done at baseline and at 6 and 12 months. Changes in weight, diet, and exercise were monitored throughout the year. SETTING: All testing was done at a university physiology laboratory. SUBJECTS/SAMPLES: Nine weight cyclers with a notable history of dieting and food restriction were recruited. Subsequently, nine control subjects were selected and matched for age, height, weight, lean body mass, and exercise habits. MAIN OUTCOME MEASURE: The observational study included measures of 3-day diet records, skinfold and girth, serum glucose, insulin and triiodothyronine, and resting energy expenditure. STATISTICAL ANALYSES PERFORMED: The main variables were analyzed using a 2 x 3 (diet group x time) analysis of variance with repeated measures on the time factor. Comparison of the means was done by Tukey post hoc test. RESULTS: A 7-point satisfaction scale indicated that the weight cyclers were dissatisfied with their weight compared with the noncyclers (P = .03). Otherwise, there were no differences between groups in dietary intakes or the physiologic variables. APPLICATIONS/CONCLUSIONS: In the parameters measured, a history of weight cycling did not affect the metabolic profiles of the weight cyclers compared with the noncyclers.

Adipose Tissue↗
PubMed1993

Long-term oral etoposide in metastatic breast cancer: clinical and pharmacokinetic results.

To evaluate the activity of long-term, single-agent oral etoposide against advanced breast cancer, this study employed etoposide 50 mg/day and 100 mg/day (given over 14 days) in previously treated and chemotherapy-naive patients with histologically confirmed, recurrent or metastatic breast cancer. Of 38 patients, 24 had had chemotherapy, 34 had prior radiotherapy, and 31 had received hormone therapy. Etoposide courses in both treatment groups were repeated every 4 weeks for at least two courses; delays were instituted when patients' total leukocyte nadir fell to or below 3.0 x 10(9)/l. Dose reductions were made in the 100-mg group (to 50 mg/day) if World Health Organization leukopenia grade 3 or higher was present. Plasma pharmacokinetic profiles were measured in selected patients to assess inter- and intrapatient variability in etoposide's oral bioavailability. No complete responses were achieved among the 36 patients evaluable for response, but eight patients had a partial response. Responses were more frequent at the 100-mg dose and in previously untreated patients (seven of eight partial responders had not had previous chemotherapy). Median duration of response was 16 weeks (range, 7 to 46). Myelosuppression (variable and unpredictable) and alopecia (universal) were the notable toxicities. Pharmacokinetic analyses of oral bioavailability revealed significant interpatient variability, but much less intrapatient variability when successive etoposide courses in individual patients were evaluated. Despite the relatively small number of patients in this study, the responses achieved by previously untreated patients suggest etoposide's value against breast cancer. Further trials should use pharmacokinetic studies to assess bioavailability as well as to help define 'target' etoposide doses, based on plasma etoposide levels, during treatment.

Administration, Oral↗
PubMed1993

Diabetes in the elderly: an under-diagnosed condition.

The proportion of the population aged 65 years and over is increasing. The Coventry Diabetes Study was able to investigate the prevalence of diagnosed and undiagnosed diabetes among elderly (aged > or = 65 years) Europeans (n = 1600) and South Asians (n = 288) in Foleshill, Coventry. The total prevalence of diabetes was higher in South Asians than Europeans among males (30.7 (95% CI 24.0-37.9)% vs 7.7 (95% CI 5.8-10.0)%, respectively) and females (24.0 (95% CI 17.5-32.4)% vs 12.5 (95% CI 10.6-14.8)%, respectively). The proportion with diagnosed diabetes was higher among South Asians than Europeans (55% vs 33%, p < 0.001), possibly because of their earlier onset. These findings suggest that detection of diabetes in elderly Europeans in urban areas may be inadequate.

Age Factors↗
PubMed1993

Metabolic and clinical characteristics of south Asians and Europeans in Coventry.

A house to house survey in Foleshill, Coventry, compared risk factors for Type 2 diabetes and ischaemic heart disease (IHD) among adult United Kingdom Europeans (n = 5508, 64% screened) and South Asians (n = 4395, 84% screened). Those with a high glucose and a randomized 10% of others had a glucose tolerance test while those with previously diagnosed diabetes (104 Europeans, 223 South Asians) were re-interviewed in more detail. By the age of 29 years, South Asians had higher 2 h glucose 5.4 +/- 1.0 vs 4.84 +/- 1.2 mmol l-1, p < 0.005) and insulin (45.6 vs 23.8 mU l-1, p < 0.001) concentrations and in males, a higher cholesterol concentration (5.1 +/- 0.9 vs 4.6 +/- 1.2 mmol l-1, p < 0.05). South Asians with known Type 2 diabetes had an earlier age at diagnosis (48 +/- 11 vs 57 +/- 14 years, p < 0.001), a lower body mass index in the past (29.0 +/- 4.8 vs 32.1 +/- 6.9 kg m-2, p < 0.001) and currently (27.1 +/- 3.7 vs 29.1 +/- 6.4 kg m-2, p < 0.001), were more likely to present with acute symptoms, were less likely to attend the hospital clinic (14% vs 31%, p < 0.001), and were less likely to be treated with diet alone (14% vs 21%) or with insulin (9% vs 16%) than Europeans. Glycaemic control was similar in the two ethnic groups. These findings suggest an earlier onset of the disease processes involved in diabetes in South Asians. Important ethnic differences in patterns of care exist that make clinical comparisons difficult.

Adult↗
PubMed1993

Physiological effects of weight cycling in female lightweight rowers.

Repeated cycles of weight loss and regain are referred to as weight cycling. It is a practice of many athletes who must achieve a low body weight. The purpose of this study was to determine whether a history of weight cycling results in sustained metabolic changes. Healthy female rowers with a history of dieting and weight fluctuation (n = 7) were compared to a control group of rowers who had never dieted (n = 7). Anthropometric and metabolic measurements were done at pre-, peak, and off-season during a 1-year period. At peak season the weight cyclers restricted their food intake and lost 4.2 +/- 1.8 kg, and subsequently regained 4.0 +/- 2.1 kg in the off-season. This was different from the controls (p = .003), who maintained a stable body weight at all times. No other group differences were observed. Resting metabolic rate (RMR) and triiodothyronine (T3) changed with time (p = .001, p = .000, respectively) in both groups, which appeared to reflect changes in fat free mass (FFM), not body weight. Long-term metabolic changes were not observed in these athletes.

Adipose Tissue↗
PubMed1993

ICAM-3 expression on endothelium in lymphoid malignancy.

Intercellular adhesion molecule-3 (ICAM-3), the third receptor for lymphocyte function-associated antigen molecule-1 and a new member of the immunoglobulin superfamily has been recently characterized using specific monoclonal antibodies. In the present study, we show immunocytochemically that ICAM-3 is present on T and B cells in the mantle zones and on a subpopulation of follicular center cells in reactive lymph nodes and only occasionally in endothelium. In 52 cases of Hodgkin's disease, ICAM-3, although present on the majority of the reactive lymphoid cells, was absent from the Reed-Sternberg cells and their variants. However, in 28 cases (54%), there was prominent endothelial staining in small vessels. Similar findings were noted in 16 out of 49 cases (33%) of non-Hodgkin's lymphomas. This finding suggests that analogous to ICAM-1 and ICAM-2, ICAM-3 expression can be induced on endothelial cells in lymphoid neoplasms, probably by an as yet unidentified cytokine-mediated mechanism.

Antigens, CD↗
PubMed1992

Selective expression of mitogen-inducible cyclooxygenase in macrophages stimulated with lipopolysaccharide.

Two forms of cyclooxygenase are known to be present in eukaryotic organisms: a cyclooxygenase (COX-1) first purified from ram seminal vesicles encoded by a 2.8-kilobase mRNA, and a newly discovered mitogen-inducible cyclooxygenase (COX-2) encoded by a 4-kilobase mRNA. Expression of these two forms of the enzyme in rat alveolar macrophages stimulated with lipopolysaccharide was investigated by 1) determining the activity of newly synthesized enzyme after inactivating the endogenous enzyme with aspirin; 2) comparing levels of newly synthesized enzyme proteins in cells treated with or without lipopolysaccharide; and 3) assessing the expression of the mRNAs encoding COX-1 and COX-2. Levels of enzyme proteins were assessed by Western blot analysis and immunoprecipitation of 35S-labeled enzyme using two different antibodies, one specific for COX-2 and the other recognizing both forms of the enzyme but preferentially recognizing COX-1. We report here that the enhanced cyclooxygenase activity induced by the bacterial lipopolysaccharide in rat alveolar macrophages is caused by selective expression of the COX-2. Expression of COX-2 in macrophages stimulated by lipopolysaccharide was completely inhibited by dexamethasone, whereas COX-1 was unaffected. In resting unstimulated macrophages, only COX-1 but not COX-2 was detected. Levels of mRNA for the COX-2 in macrophages were increased, but those of the COX-1 were not affected by lipopolysaccharide as assessed by reverse transcription coupled with polymerase chain reaction. These results indicate that increased synthesis of prostaglandins and thromboxanes in lipopolysaccharide-stimulated macrophages results from selective expression of COX-2.

Animals↗
PubMed1992

Has the process causing noninsulin dependent diabetes start at birth? Evidence in neonates from a population with a high prevalence of diabetes.

AIMS: to investigate whether differences in the glucose-insulin axis are present at birth in neonates from ethnic groups at high risk of diabetes. METHODS: fructosamine samples were taken from Maori, European and Pacific Island expectant mothers at their 28 week appointment at the public outpatients clinic at National Women's Hospital, Auckland. Umbilical cord samples for insulin, C-peptide and fructosamine assay were taken at delivery and babies had their subscapular skinfold fat thickness measured by callipers. RESULTS: the mean maternal 28 week fructosamine was similar in the three populations in spite of a higher prevalence of gestational diabetes among Pacific Islanders. Of the 1066 deliveries, cord samples were available for 207 Europeans, 81 Maoris and 113 Pacific Islanders. Both Pacific Island and Maori babies had higher cord fructosamine concentrations than European babies. However, Pacific Island babies were also heavier, and had higher cord insulin concentrations and subscapular skinfold thickness than European babies. CONCLUSIONS: the elevated cord fructosamine concentrations suggest that Maori and Pacific Island babies, who share a high risk of noninsulin dependent diabetes mellitus later in life, are hyperglycaemic at birth. The paradoxical insulin results and the cause for the relative neonatal hyperglycemia warrant further investigation.

Adult↗
PubMed1992

Mimicry of elastin repetitive motifs by Theileria annulata sporozoite surface antigen.

Theileria annulata is an important pathogen of cattle in the tropics. The gene sequence of a sporozoite surface antigen (SPAG-1) is reported. Data is also presented demonstrating that SPAG-1 is synthesised as a large precursor. This antigen, which is a candidate for inclusion in a subunit vaccine, shows a remarkable degree of molecular mimicry to the extracellular matrix protein elastin. It contains both repetitive motifs PGVGV and VGVAPG. Immunofluorescence using a monoclonal antibody against VGVAPG confirmed that this peptide is expressed on sporozoites as predicted. The presence of VGVAPG is particularly interesting since this is the ligand for elastin receptors on a range of cell types, including macrophages/monocytes which are a major class of host target cells. It is proposed that this antigen represents the ligand whereby T. annulata recognises its host cells.

Amino Acid Sequence↗
PubMed1992

Gender issues and borderline personality disorder: why do females dominate the diagnosis?

There are significantly more females with the diagnosis of borderline personality disorder than males. This article explores the developmental factors that place females at a greater risk to develop the disorder. Societal expectations that increase the emerging of borderline symptoms are also discussed. Gender differences of "normal" behavior that effect the assigning of the diagnosis are explained. The theory that borderline personality disorder has become the "virus" of psychiatry is presented.

Adult↗
PubMed1992

A phase II trial of goserelin (Zoladex) in relapsed epithelial ovarian cancer.

Thirty patients with advanced epithelial ovarian cancer were treated with the luteinising hormone releasing agonist, goserelin. There were two partial responses lasting 40 and 105 weeks respectively. In addition five patients had disease stabilisation lasting 25, 35, 40, 66 and 70 weeks respectively and 23 patients had progressive disease. No significant or unexpected toxicities occurred. This minimally toxic therapy halted disease progression for 6 months or more in 23% of patients, the majority of whom were heavily pretreated. There were five early deaths due to disease progression. The use of goserelin in patients with epithelial ovarian cancers resistant to or relapsing soon after first line platinum based chemotherapy needs to be further evaluated.

Adult↗