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Biomedical subjects

M Thorogood

Publications and source records attributed to M Thorogood.

At least 109 records · Page 6Linked to original sources
PubMed1985

Immunogenicity and the vascular risk of oral contraceptives.

Data concerning circulating immune complexes were obtained for women who had had a pulmonary embolism, myocardial infarction, or cerebral thrombosis, and for 224 healthy controls. In women with pulmonary embolism who had used oral contraceptives concentrations of circulating immune complexes were significantly higher than in healthy controls (regardless of oral contraceptive use), or in those with pulmonary embolism who had never used these preparations. Concentrations of circulating immune complexes were not raised in myocardial infarction, but these women had major risk factors for ischaemic heart disease. The group of patients with cerebral thrombosis without risk factors tended to have high concentrations of circulating immune complexes. The data provide some confirmation that immunological mechanisms may play a role in thrombotic episodes associated with oral contraceptives, especially when they occur in the absence of risk factors for vascular disease.

Adolescent↗
PubMed1984

Subtrochanteric fracture after Garden screw fixation: a review of predisposing factors and management in nine cases.

Nine cases of subtrochanteric fracture are reviewed following 300 fixations of subcapital fractures with Garden screws. In six cases technical operative errors were considered to contribute to the fracture. It is stressed that adequate reduction and suitably placed crossed Garden screws are demanding requirements and that every attempt should be made to avoid making extra holes with guidewires. In two technically satisfactory cases the low position of the lower Garden screw-hole in the femur probably predisposed to the subtrochanteric fracture. A computerized two-dimensional finite analysis confirmed smaller magnitudes of stress at a more proximally positioned lower Garden screw, and in patients at risk, particularly those with a valgus femoral neck or valgus reduction, it is suggested that if this method of internal fixation is to be used, the screws should be crossed less obliquely, with the lower screw more proximally positioned in the femur.

Adult↗
PubMed1984

A family study of the association between insulin dependent diabetes mellitus, autoantibodies and the HLA system.

A family study of the patients attending a paediatric diabetic clinic was undertaken. Seventy-three percent of the index patients and their families provided samples for HLA typing and autoantibody analysis. The HLA types were analysed and correlated with the auto-antibody data. Ways of predicting which siblings are at risk of developing insulin dependent diabetes mellitus (IDDM) were sought. The antigen DR4 carries a higher relative risk and delta value (viz. 27 and 0.93) than any other antigen. The data did not support the notion of heterogeneity of IDDM on the basis of HLA types or autoantibody status. However, the majority of patients with a younger age of onset were DR4/DR4 homozygotes. The presence of ICA was a good marker for siblings at risk of developing IDDM. Some siblings who developed IDDM had ICA and CF-ICA for long periods of time before developing diabetes. The data supported an intermediate model of inheritance for IDDM.

Adolescent↗
PubMed1983

Epidemiology of type 1 (insulin-dependent) diabetes in Scotland 1968-1976: evidence of an increasing incidence.

A computer file of all Scottish hospital admissions in the period 1968-1976 was searched to identify the 2,505 children (aged less than 19 years) with a diagnosis of diabetes. The average annual incidence of the disease (based on first hospital admission) was estimated to be 13.8 per 100,000 children aged less than 19 years (boys 14.4 per 100,000; girls 13.2 per 100,000). The highest incidence, 20.0 per 100,000 was in the age group 10-14 years and the lowest 7.1 per 100,000 in those aged less than 5 years. It is estimated that during the study period there was an 80% increase in the annual incidence of juvenile diabetes, from about 10 per 100,000 in 1968 to about 18 per 100,000 in 1976. First admission rates showed seasonal variations for those aged 5 years or more, with peaks in October/November and January/February. Marked variation was found in the incidence rates in the different counties of Scotland. The central lowlands which includes the cities of Edinburgh and Glasgow was an area of low incidence. There appeared to be an inverse correlation between the incidence rate in each county and population density. In Glasgow, there was an inverse association between the incidence rate in each city ward and the average number of persons per room. There was no evidence of space-clustering of the disease in different years within the parishes (rural districts) of each county and there was no convincing evidence that the variation in the incidence of diabetes between parishes in the same county was more than might have been expected to arise by chance. The observations are compatible with the disease having a viral aetiology but it is difficult to explain the striking rise in incidence over the study period on this basis.

Adolescent↗
PubMed1983

A community study of diabetes in Oxfordshire.

A mailed questionnaire was used to identify people with diagnosed diabetes in a population of approximately 14,000. A response rate of 90 per cent was obtained and the prevalence of diabetes was found to be 0.8 per cent. The questionnaire method compared favourably with other methods of identifying diabetics in the area.Eighty-two diabetics were interviewed and examined for diabetic complications and 55 of these completed a questionnaire on their attitudes to diabetes and its care.The medical records of all 108 diabetics identified were examined. A greater proportion of patients who attended either a general practice mini-clinic or a hospital diabetic clinic had examination for complications recorded than patients attending their general practitioner in ordinary surgery time. Patients attending on demand were seen less often and had fewer observations recorded when they came.Comparison of measures of control between hospital and general practice patients showed that hospital patients tended to be more tightly controlled even though most were on insulin and likely to have more severe diabetes.Half of non-insulin diabetics and a quarter of those on insulin considered that their diabetes should be managed solely by their general practitioner.This was a pilot study and caution should be exercised in interpreting results from comparatively small numbers. The study has since been extended to a larger population. f10sl60

Adult↗
PubMed1981

Oral contraception and myocardial infarction revisited: the effects of new preparations and prescribing patterns.

All deaths from myocardial infarction occurring during 1978 in women aged 15-44 years in England and Wales have been investigated. Using a case-control approach, oral contraceptives were found to be associated with an approximately two-fold increase in risk of this condition, but the effect was apparent only in women with no known risk factors for ischaemic heart disease. Preparations containing 30 micrograms or less oestrogen were associated with the same risk as those containing 50 micrograms oestrogen, but this could be due to the fact that preparations containing less oestrogen tend to contain higher doses of progestogens. Oral contraceptives appear no longer to be prescribed for women with recognised coronary risk factors and this improved prescribing practice has probably resulted in a substantial decrease in mortality attributable to oral contraceptive use.

Adolescent↗
PubMed1979

Infant feeding and overweight in two Oxfordshire towns.

In a study of feeding and growth in the first year of life in two Oxfordshire market towns, the frequency of overweight babies was the same for the 'intervention' town (where a research health visitor gave intensive advice to mothers on feeding) as for the control town. Eighteen per cent of bottle-fed infants and three per cent of those breast fed were overweight at one year. It seems that an increase in the number of health visitors does not affect the frequency of overweight infants, but it may be that a greater emphasis on breast feeding might reduce the frequency.

Bottle Feeding↗
PubMed1978

Autoimmunity in juvenile diabetics and their families.

Pancreatic islet cell, thyroid, and gastric antibodies were studied in 116 young insulin-dependent diabetics and 257 relatives. Seventy-four per cent of the diabetics studied within three months of diagnosis had islet-cell antibodies but only 20% of those studied three years or more after diagnosis. Persistence of these antibodies was associated with a high prevalence of thyrogastric autoimmunity, which suggests that some cases have an aetiology similar to that of "polyendocrine" autoimmune disease. Retinopathy or nephropathy, or both, was present in 10 diabetics, who were all members of "autoimmune" families, in which one or more members had organ-specific antibodies. Nine of the 10 healthy relatives with islet-cell antibodies and all families with more than one diabetic were also in this autoimmune group. These data suggest that an autoimmune factor may contribute to juvenile diabetes and that such autoimmune diabetes has a tendency to run in families and may be more likely to cause complications.

Adolescent↗
PubMed1978

Serum lipids in treated diabetic children and their families.

Fasting lipid concentrations have been measured in fifty treated juvenile diabetics, their siblings and parents to determine which types of hyperlipoproteinaemia co-exist with juvenile diabetes and whether the abnormalities relate to diabetic control, or represent familial disorders. Lipid concentrations amongst the parents did not differ from adult control. Triglyceride concentrations were significantly higher in those diabetic children with fasting blood glucose concentrations greater than 10 mmol/l than those with concentrations less than 10 mmol/l. The latter group had similar triglyceride levels to non-diabetic siblings. Cholesterol concentrations were not related to fasting blood glucose and were similar in diabetic and sibling controls. Hyperlipoproteinaemia (types IIa, IIb and IV) was present in ten of the diabetic patients. Six of the nine diabetic patients with raised cholesterol had at least one parent with cholesterol in the highest quintile for the control population, whereas only six of the forty-one with lower levels had parents in this category. A similar trend for cholesterol was apparent amongst the non-diabetic siblings. However, no association was apparent between the triglyceride levels of diabetics (or their siblings) and parents. Thus although hyperlipidaemia associated with juvenile diabetes appears to be largely due to inadequate control, raised cholesterol concentrations frequently occur.

Adolescent↗
PubMed1977

The care of oral contraceptive users by general practitioners in Oxfordshire.

A questionnaire was circulated to a sample of general practitioners in Oxfordshire enquiring about the supervision of women taking oral contraceptives. A high standard of care was being offered and the doctors believed that there was a wide range of conditions that should influence the prescription of oral contraceptives. We conclude that while suitably trained paramedical staff could provide the same standard of care as the general practitioners, this could not be achieved through the use of a package insert listing possible contraindications.

Contraceptives, Oral↗
PubMed1976

Oral contraceptive use in older women and fatal myocardial infarction.

A previous study of women who had died from myocardial infarction and of a control group of women matched with them for age suggested a fivefold increase in the risk of death from myocardial infarction among users of oral contraceptive aged 40-44 years compared with women not using such preparations. Only a small proportion of women in the infarction and control groups had used oral contraceptives, however, so the margin of error was wide. We therefore investigated a further 54 women in this age group who died from myocardial infarction and compared their oral contraceptive histories with those of age-matched, living controls. Combination of the findings from the present investigation with the previous results have enabled a revised estimate of a threefold increase in risk to be made. Although this risk estimate is similar to that previously shown for a younger age group, the total mortality attributable to complications associated with the use of oral contraceptives remained considerably greater among women over the age of 40.

Adult↗