Biomedical subjects

J Stephenson

Publications and source records attributed to J Stephenson.

At least 217 records · Page 12Linked to original sources

PubMed1996

Uptake of medical interventions in women with HIV infection in Britain and Ireland. Study Group for the MRC Collaborative Study of HIV Infection in Women.

OBJECTIVE: To determine the uptake of medical interventions amongst women known to be HIV positive and in contact with service providers. SUBJECTS: 400 HIV positive women from 15 STD/HIV clinics in Britain and Ireland recruited to the MRC collaborative study of HIV infection in women between June 1992 and August 1994. METHODS: Data obtained prospectively through direct questioning of all women by a physician or research nurse and review of medical and laboratory records. Data recorded on standardised forms and analysed centrally. RESULTS: Nearly one quarter (24%) of women with an AIDS diagnosis had never received Pneumocystis carinii pneumonia prophylaxis, and 24% had never received any antiretroviral therapy. Fewer than two-thirds of black African women had had a chest radiograph. Only one woman had received Pneumovax and only 4% of women had ever taken part in a clinical trial. CONCLUSIONS: A substantial proportion of women with HIV infection did not receive interventions of proven benefit, and participation in clinical trials was very uncommon. The reasons for such poor uptake should be explored among both health care workers and women with HIV infection.

AIDS-Related Opportunistic Infections↗

PubMed1996

A comparison of renal disease across two continents; the epidemiology of diabetes complications study and the EURODIAB IDDM Complications Study.

OBJECTIVE: To compare prevalence rates of increased albumin excretion in the Epidemiology of Diabetes Complications Study (EDC) (in the U.S.) to similar rates in the EURODIAB study (in Europe) and determine if any differences relate to hypertension, glycemic control, or smoking status. RESEARCH DESIGN AND METHODS: The study population is made up of two epidemiological clinic-based IDDM populations with comparable ages (chi = 28 years, both studies), sex distribution (50% male, EURODIAB; 49% male, EDC), and duration characteristics. Comparison of two cross-sectional (prevalence) studies was made. Despite different laboratory assays, comparability was established for urinary albumin (r = 0.98) and GHb measures (r = 0.95). Hypertension was measured with an identical protocol. Renal status was determined by 24-h urine albumin excretion (< 20 micrograms/min normal, 20-200 micrograms/min microalbuminuria, > 200 micrograms/min macroalbuminuria) in EURODIAB. Identical cutoffs were used for EDC, though two of three samples (24-h, 4-h clinic, and/or overnight sample) had to be positive in one range. (Main findings are confirmed using only 24-h results from EDC.) RESULTS: The prevalence of macroalbuminuria was higher in EDC (27%) than in EURODIAB (12%). Rates of microalbuminuria were similar (22 vs. 25%, respectively). These patterns were seen at all durations and ages and in both sexes. Controlling for glycemic control, hypertension, or smoking did not account for the higher rate in EDC, nor did exclusion of subjects with raised serum creatinine. CONCLUSIONS: Advanced renal disease is more prevalent in IDDM in EDC (Pittsburgh, PA) than in Europe. This is not explained by hypertension, glycemic control, or smoking.

Adolescent↗

PubMed1996

Cardiovascular disease and its risk factors in IDDM in Europe. EURODIAB IDDM Complications Study Group.

OBJECTIVE: To study the prevalence of cardiovascular disease (CVD), its risk factors, and their associations in IDDM patients in different European countries. RESEARCH DESIGN AND METHODS: The prevalence of CVD (a past history or electrocardiogram abnormalities) and its risk factors were examined in a cross-sectional study in 3,250 IDDM patients from 16 European countries (EURODIAB IDDM Complications Study). The patients were examined in 31 centers and were stratified between centers for age, sex, and duration of diabetes. The mean +/- SD duration of diabetes was 14.7 +/- 9.3 years. RESULTS: The prevalence of CVD was 9% in men and 10% in women. The prevalence increased with age (from 6% in patients 15-29 years old to 25% in patients 45-59 years old) and with duration of diabetes. The between-center variation for the whole population was from 3 to 19%. In both sexes, fasting triglyceride concentration was higher and HDL cholesterol lower in those patients with CVD than in those without. In men, duration of diabetes was longer, waist-to-hip ratio greater, and hypertension more common in patients with CVD. In women, a greater BMI was associated with increased prevalence of CVD. There was no association between insulin dose, HbA1c level, age-adjusted rate of albumin excretion, or smoking status and CVD. Waist-to-hip ratio, particularly in men, was positively associated with age, age-adjusted HbA1c, prevalence of smoking, daily insulin dose, albumin excretion rate, and fasting triglyceride concentrations. CONCLUSIONS: The overall prevalence of CVD in these IDDM patients was approximately 10%, increasing with age and duration of diabetes and with a sixfold variation between different European centers. CVD prevalence was most strongly associated with elevated triglyceride and decreased HDL cholesterol concentrations. CVD was also associated with albuminuria, but when adjusted by age, this association vanished. Increasing waist-to-hip ratio was associated with a number of adverse characteristics, particularly in IDDM men, reflecting the metabolic syndrome previously described in other populations.

Adolescent↗

PubMed1995