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Biomedical subjects

G V Gill

Publications and source records attributed to G V Gill.

At least 19 recordsLinked to original sources
PubMed1992

Diabetes in prison: can good diabetic care be achieved?

OBJECTIVE: To investigate the clinical characteristics and metabolic control of diabetic patients given structured diabetic care in prison. DESIGN: Survey of diabetic men serving prison sentences during a 22 month period in a large British prison. SETTING: HM Prison, Walton, Liverpool. SUBJECTS: 42 male diabetic prisoners, of whom 23 had insulin dependent and 19 non-insulin dependent diabetes. MAIN OUTCOME MEASURES: Episodes of diabetic instability, glycated haemoglobin concentrations, body mass index. RESULTS: No serious diabetic instability occurred. Between the initial assessment by the visiting consultant diabetologist and a second assessment 10 weeks later glycated haemoglobin concentrations had fallen from 10.8 (SD 2.9)% to 9.8 (2.4)% (p less than 0.05) in prisoners with insulin dependent diabetes and from 8.7 (1.9)% to 7.6 (1.2)% (p less than 0.05) in those with non-insulin dependent diabetes. Good glycaemic control continued, a mean glycated haemoglobin concentration of 7.6 (1.5)% being recorded in seven men remaining in prison for six to 18 months. Mean body mass index (weight (kg)/(height(m))2) did not change during the study (insulin dependent prisoners 23.3 (SD 2.1), non-insulin dependent prisoners 27.9 (3.8)). CONCLUSIONS: Good diabetic metabolic control is usual in prison, probably due to the rigid dietary regimen, no alcohol, and compliance with treatment. Many younger men had defaulted from their home diabetic clinics, and imprisonment allowed screening for diabetic complications and reassessment of treatment. Structured diabetic care should be offered in all prisons.

Adult↗
PubMed1992

The spectrum of brittle diabetes.

A group of 42 severely brittle insulin dependent diabetic patients were studied, and compared with a similar number of 'stable' diabetic patients. Brittle diabetics were predominantly female (86% v 45%, P < 0.01), were of younger age (mean +/- SD 27.9 +/- 12.8 years v 40.1 +/- 13.6 years, P < 0.001), and of shorter duration of diabetes (13.7 +/- 9.4 years v 19.6 +/- 11.2 years, P < 0.01). Control as measured by glycosylated haemoglobin (HbA1) was poorer (13.7 +/- 3.1% v 10.1 +/- 1.5%, P < 0.001), and daily insulin dose higher (98 +/- 81 u v 47 +/- 14 u, P << 0.001). There was no difference in diabetic complication rates, but psychosocial disturbances (74% v 17%) and factitious instability (40% v 2%) were highly significantly more common amongst brittle patients. Examination of patterns of admission revealed most brittle diabetics to have hyperglycaemic problems (70%), mainly due to recurrent ketoacidosis (52%). Recurrent hypoglycaemia accounted for 12% of the group, and only 5/42 patients (12%) had mixed forms of instability. Brittle diabetes is thus characterized by young age and female sex, and usually manifests itself as recurrent ketoacidosis or other forms of hyperglycaemic instability. Psychosocial problems and factitious metabolic decompensation are common.

Adult↗
PubMed1991

Horizontal transmission of hepatitis B virus amongst British 2nd World War soldiers in South-East Asia.

Infection with hepatitis B virus (HBV) is much more common in tropical than in temperate countries. Visitors to the tropics are thus at risk from HBV, though the degree of risk, and the routes of infection involved are uncertain. We report serological markers of HBV in two groups of 2nd World War soldiers, who served in the Thai/Burma jungles. The groups comprised 100 ex-prisoners of the Japanese (POW), and 100 Burma Campaign Veterans (BCV). Surface antigen to HBV (HbsAg) was positive in 0% of POW and 2% of BCV (P = not significant). Surface antibody (anti-HBs) and core antibody (anti-HBc) were both positive in 40% POW and 13% BCV (P less than 0.001). Quoted UK prevalence rates for these markers are 0.1% for HBsAg, 1.5% for anti-HBs and 0.7% for anti-HBc. Both groups thus show very high rates of past HBV infection. For the POW there were many possible reasons, including contaminated surgical instruments and needles, blood transfusions, and multiple beatings with common weapons. None of these factors operated significantly for BCV. Malarial transmission was, however, intense in both groups, though more so in POW. The data thus again raise the possibility of horizontal transmission of HBV by biting insects in tropical countries.

Hepatitis B↗
PubMed1979

Strongyloides stercoralis infection in former Far East prisoners of war.

Out of 602 consecutive people who had been prisoners of war in the Far East and were screened for tropical diseases, 88 (15%) were found to have Strongyloides stercoralis infection a mean period of 30 years after their return from the tropics. The classical strongyloid creeping eruption was the most common symptom (84%), while gastrointestinal disturbances were rare (5%). Thiabendazole was highly effective in eradicating the infection. Strongyloidiasis is an important condition, as when the host is immunosuppressed fatal hyperinfection may occur. Many undiagnosed cases of strongyloidiasis must exist among former prisoners of war, and it is thus important to identify and treat these patients.

Aged↗
PubMed1979

Endocarditis caused by Salmonella enteritidis.

A case of endocarditis caused by Salmonella enteritidis is reported in a 20-year-old African woman. This is only the fourth published case. The development of this rare infection in the patient reported here probably resulted from a reduction in immunity caused by pregnancy and a past splenectomy.

Adult↗
PubMed1979

Lack of immunoglobulin E response to longstanding strongyloidiasis.

Patients harbouring worm infections usually have very marked elevations of serum immunoglobulin E (IgE) concentration. However, in a group of twenty ex-Far East prisoners of war with strongyloidiasis only two (10%) had raised levels due to the worm, and these were only moderately elevated. This poor IgE response may be related to the very longstanding nature of the infection (at least 30 years). The patients may have a form of immunological incompetence, or may have become immunologically tolerant to the parasite.

Chronic Disease↗