Search PubMed⌕ Search

Biomedical subjects

R A Fisken

Publications and source records attributed to R A Fisken.

At least 37 records · Page 2Linked to original sources
PubMed1990

Longitudinal changes in serum fructosamine do not parallel those in glycated haemoglobin in young adults with insulin-dependent diabetes.

In 93 adolescent and young adult patients with type 1 diabetes (163 paired comparisons) changes in fructosamine concentration correlated poorly with changes in HbA1 (r = 0.53); this correlation was no better if fructosamine values were adjusted for serum albumin by calculating a fructosamine/albumin index, F.A.I. (155 pairs, r = 0.50). These correlation coefficients were lower than those for cross-sectional comparisons (HbA1 vs. fructosamine, r = 0.74; HbA1 vs. F.A.I., r = 0.80). One-way analysis of variance showed that values of HbA1, fructosamine and F.A.I. all tended to increase as glycaemic control, judged by the clinician, worsened (P less than 0.001). HbA1 correlated better with clinical assessment than did either uncorrected fructosamine or F.A.I. We conclude that changes in fructosamine from one clinic visit to the next do not provide a basis for changing therapy. Clinical assessments tend to agree with values for HbA1, which may be more reliable than fructosamine because of its longer biological half life.

Adolescent↗
PubMed1989

Orocaecal transit time in health and in thyroid disease.

Altered bowel habit commonly occurs in thyroid disease. We measured orocaecal transit in healthy volunteers and in hyperthyroid and hypothyroid patients before and after treatment, using the lactulose hydrogen breath test incorporating a standard liquid meal to obtain a more physiological assessment. Mean transit time in 12 control subjects was 85 (8) minutes (mean (SE)) (mean coefficient of variation between replicate studies, 8.6% (3%)). In eighteen hyperthyroid patients transit was more rapid at 49 (4) minutes (p less than 0.01). Ten hypothyroid patients had a transit time similar to controls at 91 (9) minutes. Transit time returned to normal in thyrotoxic patients after treatment but in eight hypothyroid patients retested, it remained unchanged. Our findings suggest that (a) the inclusion of a liquid meal provides a reproducible method of measuring orocaecal transit using the lactulose hydrogen breath test, (b) rapid small bowel transit in thyrotoxicosis may be one factor in the diarrhoea which is a feature of the disease and (c) if altered gut transit is the cause of sluggish bowel habit in hypothyroidism, delay in the colon, and not small bowel, is likely to be responsible.

Adult↗
PubMed1989

Treatment of insulin-dependent diabetes using an injection pen: control, problems and patient preferences.

Twice-daily insulin injections do not always provide good glycaemic control in insulin-dependent diabetes (IDDM) and impose restrictions on patients' lifestyles. Basal/prandial insulin schedules require four injections per day but are feasible using a self-contained injection pen. In 26 patients with IDDM a basal/prandial schedule (using ultralente and soluble insulins) was compared with twice-daily injections. Measurements of mean blood glucose, M-value, mean amplitude of glycaemic excursions and glycated haemoglobin showed no improvement in glycaemic control on the basal/prandial regimen. Patients liked the regimen, however, 21/23 opting to stay on it after the trial, and believed themselves to be better controlled on this schedule (p less than 0.001). They especially appreciated the flexibility of meal timing, ease of injection and portability. As the basal insulin, ultralente was associated with problems of unheralded, severe hypoglycaemia and of difficulty with injections; isophane or lente formulations would be more suitable.

Adult↗
PubMed1982

The effects of cimetidine on serum calcium and parathyroid hormone levels in primary hyperparathyroidism.

1 Cimetidine has been reported to reduce serum calcium and parathyroid hormone (PTH) levels in primary hyperparathyroidism, but some studies have reported negative findings. 2 A double-blind, controlled trial of cimetidine in this condition was, therefore, conducted. Eight patients were given cimetidine and placebo for 2 months each, in random order. Only one patient showed a significant fall in serum calcium on cimetidine and no patient showed a fall in PTH levels. 3 In addition, eight patients were studied during a 48 h continuous intravenous infusion of cimetidine. The first five patients exhibited no effect of the drug on either calcium of PTH levels, but in the sixth there appeared to be a dose-dependent suppression of PTH. The seventh and eighth patients were, therefore, given a higher dose of the drug but it failed to suppress calcium or PTH values. 4 It is concluded that cimetidine is not of value in primary hyperparathyroidism.

Administration, Oral↗
PubMed1981

Hypercalcaemia in hospital patients. Clinical and diagnostic aspects.

The relative importance of different causes of hypercalcaemia was studied, and diagnostic tests were evaluated as predictors of the cause of hypercalcaemia. In one year, hypercalcaemia was identified in 166 hospital inpatients. Serum-calcium was below 3.00 mmol/l in 63%. Among 153 patients investigated the commonest cause of hypercalcaemia was malignancy (89 cases), especially breast and bronchial tumours. 75% of the 89 patients had obvious metastases at presentation. 51 patients had primary hyperparathyroidism: their symptoms were non-specific and only 20% had renal stones. Other causes of hypercalcaemia were rare (9% of patients seen). Of patients with no diagnosis initially, 64% had hyperparathyroidism and 32% malignancy, but this was demonstrated early in the illness. Serum phosphate and chloride and acid/base status were unsatisfactory as diagnostic tests; multivariate analysis was more discriminating overall, but incorrect classification was still a significant problem.

Calcium↗
PubMed1980

Hypercalcaemia--a hospital survey.

In order to provide information about the prevalence of hypercalcaemia and its different causes, a retrospective survey was carried out in all hospital in-patients in whom serum calcium was elevated. Six hundred and forty-four cases were seen in two years and eight months, but a number of these were excluded as being spurious measurements leaving 496 cases of genuine hypercalcaemia. Four hundred and sixty-nine records (95 per cent) were successfully traced and analysed. Two hundred and nineteen cases of hypercalcaemia with malignancy were found together with 68 cases with chronic renal failure and 59 cases of primary hyperparathyroidism. In 102 cases no cause was identified.

Adolescent↗
PubMed1976

Cellular changes in the lateral geniculate nucleus of the cat and monkey after section of the optic tract.

Cellular changes in the lateral geniculate nucleus following section of the optic tract have been studied in adult cats and monkeys. The cats were allowed to survive for periods varying from 20 to 363 days after operation, and the monkeys from 14 to 90 days. No cellular changes were seen in the lateral geniculate nucleus of the cat at survivals up to 120 days. After 200 days, however, there was shrinkage of the cells in all laminae and measurements showed this to be between 20 and 30%. In the monkey shrinkage of cells was found, and was up to 30% after 28 days and 40% after 90 days. The delayed onset of the cellular shrinkage in adult cats resulting from section of the optic tract, as compared with that occurring after eye enucleation (63 days), suggests that even in adult cats there is some degree of 'competition' present between cells of the laminae related respectively to the ipsilateral and contralateral eye.

Animals↗