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Biomedical subjects

P Marsden

Publications and source records attributed to P Marsden.

14 recordsLinked to original sources
PubMed1992

Improved diabetes care in a UK health district.

The present study reports an analysis of diabetes care in general practice in a London Health District. A specialist nurse facilitator used various techniques to obtain practice information building up individual practice profiles. Four groups of constraints were identified as affecting the provision of GP diabetes care. Individual practice plans were formulated, working with key staff, to apply various interventions to ameliorate identified constraints. Using a non-prescriptive approach, GPs were encouraged to become involved in diabetes care in the way they felt most appropriate for their practice. Using this method, GP involvement in diabetes care has increased from 17 to 53% during the three years of the study.

Diabetes Mellitus↗
PubMed1977

In-vitro studies of normal human thyroid cells: responses to thyrotrophin and dibutyryl cyclic AMP.

Follicular cells isolated from normal human thyroid tissue have been cultured for up to 140 h with bovine thyrotrophin (TSH) or dibutyryl cyclic AMP (DBcAMP). Both compounds induced marked reorganization of the cells into three-dimensional follicular structures, whilst non-supplemented cells assumed a monolayer form. Cultures treated initially with TSH or DBcAMP showed a greater iodide uptake capacity, in comparison with unsupplemented cultures, in which iodide uptake was markedly diminished after 24 h. The release of tri-iodothyronine (T3) and thyroxine (T4) into the medium was determined by radioimmunoassay. Both TSH- and DBcAMP-treated cells showed a significant increase in iodothyronine output compared with unsupplemented control cells. In contrast to the "classical" TSH-induced depression of the T4:T3 ratio in vivo, an increase in the ratio was observed for both TSH- and DBcAMP-supplemented cells in vitro. The ratio was also significantly greater after TSH than after DBcAMP, and possible implications of this findings are discussed.

Bucladesine↗
PubMed1976

Thyrotoxicosis and hypercalcaemia: response to antithyroid drugs and salmon calcitonin.

Four patients with thyrotoxicosis, hypercalcaemia and metabolic bone disease are described. One of them had a 'hot nodule', T3 toxicosis and a parathyroid tumour and another had thin bones, subperiosteal cortical bone erosions and complete dysphagia. Hypercalcaemia persisted during treatment with antithyroid drugs in two patients, both of whom had hyperparathyroidism. The administration of salmon calcitonin to these two patients before starting antithyroid treatment produced an immediate and sustained fall in serum calcium and urinary hydroxyproline levels. Calcitonin administration should be of value in the early management of hypercalcaemic patients.

Alkaline Phosphatase↗
PubMed1976

Rapid radioimmunoassay of triiodothyronine on Sephadex G-25 by the Ames kit.

A rapid kit method for the determination of serum triiodothyronine levels is described. The method was satisfactory in cases of thyrotoxicosis, but its lower sensitivity in euthyroid patients gave higher levels (range 2.3-3.3 nM/liter) than normally found. The kit would be of value as a rapid method (little over 3 hr) to screen patients suspected of early or T3 thyrotoxicosis.

Contraceptives, Oral↗
PubMed1975

Hormonal pattern of relapse in hyperthyroidism.

22 patients with Grave's disease were followed up for up to a year after antithyroid drug therapy was discontinued. Clinical assessment and serum T3, T4, and thyroid-stimulating-hormone (T.S.H.) estimations were done serially and simultaneously. Serum T3 or T4 concentrations may be elevated briefly in the first few weeks after antithyroid drugs are stopped, as a rebound effect not necessarily indicative of subsequent relapsf. Clinical relapse of hyperthyroidism with subsequent improvement on antithyroid drugs occurred in 13 patients. Of these 13, serum T3 concentrations became elevated before serum T4 concentrations in 5, thus predicting the subsequent development of clinical hyperthyroidism. In the remaining 8 patients who relapsed, serum T4 was elevated a month before the serum T3. Hyperthyroidism was diagnosed clinically after elevated serum T3 concentrations in 11 patients and at the same time in 2 patients. The mean period of "biochemical hyperthyroidism" in these 11 patients was 12 weeks, with a range of 1 to 56 weeks. During this period 9 of the 11 had minor clinical changes attributable to hyperthyroidism. It is concluded that serial estimations of serum T3 provide the most reliable method of monitoring relapse in hyperthyroidism.

Carbimazole↗
PubMed1975

Serum triiodothyronine concentration in the diagnosis of hyperthyroidism.

The serum triiodothyronine concentration is superior to the serum thyroxine concentration, the resin uptake test and the free thyroxine index in the diagnosis of hyperthyroidism. Over a 14 month period fifty-five patients attending an endocrine clinic with suspected thyrotoxicosis of all degrees of severity had blood taken on initial attendance and the serum was stored for routine thyroid function tests and triiodothyronine estimation. The patients were followed up and forty-six proved to be toxic and seven to be euthyroid; two could not be classified. Analysis of the initial serum showed that the serum triiodothyronine concentration was superior to the serum thyroxine concentration, the resin uptake test and the free thyroxine index in predicting the clinical outcome.

Adenoma↗
PubMed1975

Serum triiodothyronine in solitary autonomous nodules of the thyroid.

Seventeen patients with solitary autonomous nodules of the thyroid were studied. Eight had clinical features of hyperthyroidism though in some the clinical manifestations were mild. The serum T3 concentration was elevated in all patients with hyperthyroidism but the serum T4 and free thyroxine index were within the normal range in five. All patients with hyperthyroidism subsequently responded to treatment. These findings suggest a high incidence of preferential T3 hypersecretion in hyperthyoidism associated with solitary autonomous thyroid nodule. A further nine patients with single autonomous nodules were clinically euthyroid with normal serum T3 and T4 concentrations and remained euthyroid from 6 to 24 months on serial review.

Chromatography, Gel↗
PubMed1975

A comparative study of serum total thyroxine estimation on unextracted serum by radioimmunoassay and by competitive protein binding.

A rapid and precise radioimmunoassay (RIA) for serum total thyroxine (T4) on as little as 1-10 mul of unextracted serum is described. Results in hypothyroidism (overt and borderline), in euthyroid subjects in pregnant and oestrogen-medicated subjects, and in hyperthyroidism (overt and borderline) are compared with the results on the same sera by an established competitive protein binding technique (Ames' Tetralute) on unextracted serum from a different laboratory. The correlation between the two methods was excellent (r= 0.94) and no significant difference between overall appeared to measure total T4 Reliaby in sera containing only 1-3 or 2-6 nmol/1. Both methods predicted the clinical outcome in borderline hypothyroidism and borderline hyperthyroidism equally well and both gave normal results in T3-toxicosis. It is concluded that both techniques reliably measure total T4- RIA appears to have advantages of sensitivity and precision (especially in the hypothroid range), of simplicity, and of low cost.

Binding, Competitive↗