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Biomedical subjects

K M Shaw

Publications and source records attributed to K M Shaw.

At least 91 records · Page 5Linked to original sources
PubMed1974

Steroid aerosols in asthma: an assessment of betamethasone valerate and a 12-month study of patients on maintenance treatment.

Betamethasone valerate aerosol is a new compound for the treatment of asthma. Its clinical effectiveness was established in a double-blind cross-over trial in non-steroid-dependent asthmatic patients. At a dosage of 400 to 800 mug/day for three months there was no evidence of suppression of hypothalamic-pituitary-adrenal function, as assessed by tetracosactrin and insulin stress tests.A 12-month follow-up study of 120 patients using steroid aerosols (betamethasone valerate or beclomethasone dipropionate) indicated that tolerance does not develop and that a daily maintenance dose of 200 mug/day was adequate in most patients. Temporary lack of response was observed during episodes of sputum production or of heavy exposure to antigen.There were no observed side effects other than fungal infections of the respiratory tract. However, the incidence of candidiasis of the pharynx (13%) and particularly of the larynx (5%) in apparently immunologically normal patients was disturbing. These infections were not seen in patients taking 200 mug/day. Though there is yet no evidence that fungal infections associated with steroid aerosols may penetrate the trachea and bronchi the possibility of this indicates that caution should be exercised in their use, particularly in long-term high dosage.

Adolescent↗
PubMedDate not supplied

An examination of the covariability of subclinical albuminuria in insulin-dependent diabetes mellitus: implications for monitoring microalbuminuria.

We examined the covariability of subclinical albuminuria in a cohort of 160 insulin-dependent diabetics who underwent simultaneous measurements of overnight urinary albumin excretion rate (UAV) and several clinical variables on 7 occasions over a period of 18 months. After allowing for within-patient correlation between visits, significant within-patient associations were found between UAV and variations in tobacco consumption (regression coefficient = 0.006, S.E. = 0.002, P = 0.02), insulin dose (regression coefficient = 0.003, S.E. = 0.001, P = 0.01) and creatinine clearance (regression coefficient = 0.776, S.E. = 0.047, P < 0.0001); the association between UAV and creatinine clearance was not influenced by adjusting for urine flow rate. No significant associations were found between UAV and changes in blood pressure, glycaemic control or other variables. We then focused on 33 patients with intermittent microalbuminuria, defined as a UAV > 30 micrograms/min on at least one occasion, but not exceeding 3 consecutive occasions. These patients had a total of 52 episodes of microalbuminuria which were significantly associated at the 5% level with increases in creatinine clearance (P = 0.02), but not with changes in other variables. Our findings did not differ in patients with intermittent microalbuminuria defined with reference to a cut-off UAV of 20 micrograms/min. We conclude that changes in glomerular filtration rate (as reflected by creatinine clearance) may partly account for the within-patient variability in subclinical albuminuria in insulin-dependent diabetics, and that variables routinely measured in the clinic are not useful for deciding when to monitor patients for microalbuminuria.

Adolescent↗
PubMedDate not supplied

Tensile properties of human tendo Achillis: effect of donor age and strain rate.

Two sets of tensile tests were conducted on tendo Achillis taken from 16 embalmed cadavers (donor ages, 36 to 100 years). From the stress, sigma-versus-strain, epsilon results, values of the following properties were obtained: linear stiffness, ST (which is defined as the slope of the linear zone of the post-toe region of the load-versus-extension plot), ultimate tensile strength [UTS], the strain at the UTS point (herein called the ultimate tensile strain) [epsilon max], and the tangent modulus of elasticity, [ET] (which is the slope of the linear zone of the post-toe region of the sigma-epsilon curve). In the first set of tests, the loading rate was 10%/sec. The results are thus: linear stiffness: 685 +/- 262 N/mm.; UTS = 59 +/- 18 MPa; epsilon max = 22 +/- 7%; and ET = 375 +/- 102 MPa. It was found that donor age exerts an insignificant effect on linear stiffness, a marked effect on UTS, an insignificant effect on epsilon max, and a moderate effect on ET (Student's t-test; p < 0.05). In the second set of tests, the test tendons were taken from the cadavers of "middle-aged" donors (52 to 67 years), and the strain rate was 100%/sec. By combining the results of the first and second sets of tests for a subset of this group (i.e., those with matched counterparts), it was found that strain rate has a statistically significant effect on ST and ET but not on UTS and epsilon max (paired Student's t-test; p < 0.05). Based on all results and findings, donor age is suggested as one of the considerations when selecting tendo Achillis to be used as allografts for the repair of severely damaged or ruptured tendo Achillis or anterior cruciate ligament.

Achilles Tendon↗
PubMedDate not supplied

Serum lipids and lipoproteins in insulin-dependent diabetic patients with persistent microalbuminuria.

Serum lipid and lipoprotein concentrations were measured in 18 insulin-dependent diabetic patients with persistent microalbuminuria and an equal number with persistently normal albumin excretion. The groups were matched for sex, age, duration of diabetes, body mass index, insulin dose, and glycosylated haemoglobin. Diabetic patients with persistent microalbuminuria were found to have a significantly lower high density lipoprotein (HDL) cholesterol concentration (difference 0.29, 95% Cl 0.12 to 0.46, mmol l-1, p less than 0.01) and a higher low density lipoprotein (LDL) cholesterol:HDL cholesterol ratio (difference 0.97, 95% Cl 0.29 to 1.65, p less than 0.01) than patients with normal albumin excretion. No significant differences were found in total cholesterol, triglycerides, LDL cholesterol, apolipoprotein (apo) A-I and apo B concentrations. Compared to an age and sex-matched group of non-diabetic subjects with normal albumin excretion, diabetic patients with persistent microalbuminuria had significantly higher concentrations of total cholesterol (p less than 0.05), LDL cholesterol (p less than 0.05) and apo B (p less than 0.01), but a lower concentration of HDL cholesterol (p less than 0.05). No significant differences were found in serum lipids and lipoproteins between diabetic patients with normal albumin excretion and non-diabetic subjects.

Albuminuria↗