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Biomedical subjects

F I Martin

Publications and source records attributed to F I Martin.

At least 73 records · Page 4Linked to original sources
PubMed1978

The clinical characteristics of diabetes mellitus in Papua New Guinea.

The typical patient with diabetes mellitus seen at major hospitals in Papua New Guinea between 1974 and 1977 had florid symptoms, a very high blood glucose, was non-obese and non-ketotic and, frequently had neuropathy and proteinuria. In 25% hypertension was present which was significantly more common in the presence of proteinuria. Diagnosis was often delayed by failure to test urine for glucose and treatment was usually ineffective so that coma, usually non-ketotic, severe infections and gangrene occurred frequently. Although not as common as in other South Pacific countries, diabetes is increasing in Papua New Guinea. The provision of simple adequate facilities to test urine for glucose in all hospitals and the establishment of diabetic out-patient clinics in major centres to instruct both patients and other health workers are essential to improve treatment and reduce mortality and morbidity.

Adolescent↗
PubMed1978

Experience in the treatment of diabetes at Port Moresby General Hospital.

Dietary restriction of refined carbohydrate with regular meals and exercise, preventative foot care, and often daily inulin injections will reduce the mortality and morbidity from diabetes in Papua New Guinea. It is necessary to explain to both the diabetic and their family practical means of treatment including urine tests for glucose. Regular follow up is essential and the establishment of diabetic clinics in major centres would provide the best means of achieving this.

Diabetes Mellitus↗
PubMed1977

Pregnancy in diabetic women.

Pregnancy in 207 diabetic women managed at a diabetic antenatal unit over a six-year period (1970 to 1976) resulted in a perinatal mortality of 16 (7-8%). One hundred and fifty-nine women (70%) were receiving insulin before pregnancy and 20% had evidence of diabetic microangiopathy. Still birth was twice as frequent as neonatal death, and severe respiratory distress syndrome was uncommon, resulting in only one death. Bad control of diabetes was associated with a poor prognosis. This was contributed to be lack of cooperation, anxiety and poor knowledge of diabetes. The accurate assessment of gestation and maturity, the monitoring of fetal-placental function, careful blood glucose level control, and an understanding of neonatal physiology have contributed to a reduction in fetal mortality. Close cooperation between an obstetrician, physician and neonatal pediatrician experienced in the problems encountered in the management of pregnant diabetic women is essential if the best results are to be obtained.

Blood Glucose↗
PubMed1977

Attempted suicide by insulin overdose in insulin-requiring diabetics.

Four cases of suicidal insulin overdose in insulin-requiring diabetics presented to one hospital in three years. In three cases there was a history of depression; but despite huge doses of insulin (3,000 and 1,500 units) in two, no patient died and only one had residual signs of clinical brain damage. The estimated plasma insulin level was not well correlated with the severity of the hypoglycaemia. It is probable that suicidal insulin overdose is more common than reports in the literature suggest, and may often be unrecognized. The dissociation between huge doses of insulin and the severity of the subsequent hypoglycaemia in diabetics is unexplained.

Adult↗
PubMed1977

Glucagon and diabetes. I. The failure of hyperglucagonaemia to influence the response of established diabetic ketoacidosis to therapy.

Clinical and biochemical variables were examined during two standardized, low-dose insulin regimens in seven subjects with diabetic ketoacidosis and one with hyperosmolar coma, in order to determine whether glucagon levels can be suppressed in ketoacidosis and whether hyperglucagonaemia influences the clinical and biochemical responses to treatment. Glucagon concentrations were significantly elevated (36.6-697.0 pmol/l) at presentation in all subjects. After institution of insulin treatment (4-8 u/h), glucose and glucagon levels decreased rapidly, and in five of the eight subjects glucagon levels reached undetectable concentrations (less than 3.0 pmol/l) during the initial treatment period. Further, neither plasma glucagon concentrations at presentation, nor the rate of glucagon decline during insulin treatment, appeared to influence the rapidity of the glucose decline or the persistence of the ketoacidosis. Thus, low-dose exogenous insulin suppresses glucagon secretion in diabetic ketoacidosis, and the changes in glucagon concentrations during treatment are unrelated to the clinical response.

Adult↗
PubMed1977

Use of a computer-based postal questionnaire for the detection of hypothyroidism following radioiodine therapy for thyrotoxicosis.

A computer-processed postal questionnaire was devised to detect hypothyroidism in patients treated previously for thyrotoxicosis with radioiodine. In a study of 232 patients treated with 131I at the Royal Melbourne Hospital between four and ten years previously, the sum of symptomatic answers in the questionnaire was a sensitive discriminator of hypothyroidism, and allowed 80% of euthyroid patients to be excluded from further assessment. Questions concerned with general well-being and energy, voice and skin changes, showed the highest sensitivity and specificity. The combination of these questions alone was an effective means of identifying hypothyroidism, with a sensitivity and specificity comparable to the more sophisticated technique of discriminant function analysis. Hypothyroidism had an incidence of between 20% and 35% six to eight years after 131I therapy and was related to a smaller initial goitre size for a given dose of 131I. This postal questionnaire, in conjunction with a computer-based automatic recall system, promises to be an efficient and reliable screening tool for the detection of hypothyroidism in the increasing number of patients "at risk" following 131I therapy.

Australia↗
PubMed1977

Amniotic fluid lecithin/sphingomyelin ratio in pregnancy complicated by diabetes.

The lecithin/sphingomyelin (L/S) ratio in the amniotic fluid of 57 patients attending an antenatal diabetic clinic was determined. The L/S ratio in Class A, B and C patients (White, 1965) showed a similar rise with gestation to nondiabetic patients; 89 per cent in this group had an L/S ratio above 2 : 1, but of these 27 per cent developed mild or moderate respiratory distress syndrome (RDS). In Class D, F and R diabetic patients there was a little correlation of the L/S ratio with gestational age and in this group 55 per cent of the infants developed some form of RDS. The value of measuring amniotic fluid L/S ratios in the diabetic pregnancy is questioned.

Amniotic Fluid↗
PubMed1976

Absolute neonatal insulin levels in children of insulin-requiring diabetic patients.

This report describes the relationship between cord plasma insulin and neonatal blood glucose in nine children of diabetic patients treated during pregnancy with monocomponent insulins. Plasma insulin in cord blood was similar to that found in patients with gestational diabetes and was not related to either neonatal blood glucose or maternal diabetic control.

Adolescent↗
PubMed1976

Hypothalamic hypopituitarism following external radiotherapy for tumours distant from the adenohypophysis.

Three cases of panhypopituitarism and five of isolated growth hormone deficiency which occurred following previous external irradiation of tumours distant from the adenohypophysis are described. The hypothalamic pituitary region received between 2800 and 12 000 rads in each case, 1-9 years before endocrine deficiency was recognized. Evidence is presented that the site of damage is in the region of the hypothalamus rather than the pituitary gland itself. Individuals treated with X-ray therapy in whom the hypothalamic-pituitary region is exposed to irradiation would appear to be at risk of developing some degree of delayed hypothalamic-pituitary dysfunction.

Adolescent↗
PubMed1976

Correlation between insulin receptor binding in isolated fat cells and insulin sensitivity in obese human subjects.

This study examined the relationship between receptor binding of insulin in a metabolically significant target tissue in vitro and sensitivity to insulin in vivo in obese human subjects. Specific insulin binding was measured at 24 degrees C in isolated enlarged fat cells obtained from 16 patients, by observing the effect of increasing concentrations of unlabeled insulin on the binding of [125I]insulin. Scratchard plots of the binding data were curvilinear with an upward concavity, similarity shaped, and essentially parallel. Kinetic studies on the dissociation of [125I]insulin from fat cells indicated that these curvilinear Scratchard plots could be explained by the presence of site:site interactions of the negative cooperative type. Differences in binding between individual patients were predominantly due to differences in the numbers of receptor sites whether expressed in relation to cell number, cell volume, or cell surface area. These findings were not accounted for by differences in [125I]insulin degradation. Acute exposure of adipose tissue to insulin in vitro had no significant effect on [125I]insulin binding to isolated cells. The number of receptor sites was directly correlated with insulin sensitivity in vivo, measured as the rate constant (Kitt) for the fall in blood glucose after intravenous insulin, and was inversely correlated with the level of fasting plasma insulin. These findings corroborate those from other studies using human mononuclear leukocytes and various tissues from the obese mouse, which indicate that decreased insulin binding is a characteristic feature of insulin resistance in obesity.

Adipose Tissue↗
PubMed1976

The nature and use of purified insulins.

The limited availability of highly purified insulin preparations for the treatment of diabetes mellitus in australia since 1975, has prompted a review of their history, clinical use and potential in the treatment of diabetics receiving insulin.

Diabetes Mellitus↗
PubMed1975

Down syndrome and thyroid function in adults.

Thyroid function has been studied in 11 middle-aged and elderly subjects with proven Down syndrome. Unequivaocal biochemical evidence of hypothyroidism was found in 6, and of thyrotoxicosis in 1. It is concluded that, in contrast to the situation in children with Down syndrome, thyroid dysfunction is exceedingly common in adults with the syndrome.

Adult↗
PubMed1975

Factors influencing the prognosis of vascular disease in insulin-deficient diabetes of long duration: a seven-year follow-up.

Fifty-one insulin-dependent nonobese diabetics with duration of disease from 15 to 40 yr were reassessed after 7 yr. Those presenting with clinical vascular disease, hypertension, or elevated fasting triglycerides initially were found to have a bad prognosis. Serum cholesterol fasting blood sugar, age, or duration of diabetes were not related to outcome, Acute insensitivity to intravenous insulin was correlated with presence of initial vascular disease and was significantly related to both death and clinical deterioration in either large or small vessels over the period of follow-up. Insulin sensitivity was reproducible and may be of value in predicting the progression of long-term vascular changes in the insulin-requiring diabetic.

Adult↗
PubMed1975

HL-A8: a genetic link with thyrotoxicosis.

The incidence of HL-A8 was significantly increased in 64 Caucasian patients with thyrotoxicosis compared with 700 Australian blood donors (42% versus 24%). No significant correlation was observed between HL-A8 and autoantibodies to thyroid components in thyrotoxic patients; thus the association of HL-A8 must be either with the disease itself, or possibly with immune responses not tested for this study.

Autoantibodies↗
PubMed1975

Prolonged control of hypoglycaemia by L-asparaginase in islet cell carcinoma producing insulin and gastrin.

L-asparaginase (140,000 units) infused into the hepatic artery resulted in a remission from disabling hypoglycaemia for nine months in a man with islet cell carcinoma of the pancreas and hepatic metastases. The tumour produced insulin and gastrin with resulting hypoglycaemia and recurrent peptic ulceration which were unresponsive to other drugs. Following L-asparaginase there was a fall in both plasma and insulin and gastrin.

Adenoma, Islet Cell↗