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Biomedical subjects

V J McCann

Publications and source records attributed to V J McCann.

32 records · Page 2Linked to original sources
PubMed1980

Association of retinopathy and glycosylated haemoglobin levels in diabetes mellitus.

One hundred and forty patients with diabetes mellitus were examined in the small mining town of Kalgoorlie, Western Australia. The primary object was to determine the incidence of retinopathy in the diabetic community. One hundred and thirty-eight sets of data were obtained. There were 69 males and 69 females. The diabetes was controlled with orally administered hypoglycaemic agents in 62 patients, in 58 patients with insulin, and in 18 by diet alone. Forty-six of the 138 volunteers (33%), were found to have retinopathy and this included eight of the 14 Aboriginals taking part in the survey. Glycosylated haemoglobin levels ranged from 8.1% to 18.8% (mean 11.7%; SD; 2.28%) of total haemoglobin concentration, and plasma glucose levels from 1.2 mmol/L to 27.3 mmol/L (mean, 9.5 mmol/L, SD, 5.06 mmol/L); there was a positive correlation between levels of glycosylated haemoglobin and plasma glucose (r = 0.63; P less than 0.001). Diabetics with retinopathy had a mean glycosylated haemoglobin level of 12.5% compared with 11.3% in those without this complication. Examination by treatment groups showed that patients with retinopathy whose disease was controlled with insulin had significantly higher levels of glycosylated haemoglobin compared with those without this complication (0.01 greater than P greater than 0.001). Patients whose disease was controlled with orally administered hypoglycaemic agents did not show this difference.

Adolescent↗
PubMed1980

Medical correlates and diabetic retinopathy screening.

A systematic ophthalmological, medical, and biochemical screening of a rural population of diabetics in Western Australia is being carried out. A team of ophthalmologists, physicians, and paramedical personnel establish regional screening centres on a voluntary basis at weekends. Every attempt is made to locate and examine all known diabetics. All patients are given a thorough ophthalmic examination including standard multiple field colour fundus photography. Thorough physical examination includes assessment of cardiovascular and neurological status. Biochemical parameters include random blood sugar, urine analysis, serum creatinine, glycosylated haemoglobin, cholesterol, and high density lipoprotein. A detailed questionnaire and interview is carried out to assess the historical degree of control and the patient's knowledge of the control and management of diabetes. The sample now comprises an unselected population of 400 diabetics living in rural areas and allows comparison of areas which have scarce medical services with centres that are well supplied with medical practitioners. Incidence of retinopathy varies from 25 to 36 per cent of the diabetic population. Positive correlations of retinopathy have been found with duration, age, hypertension, level of control assessed biochemically at the time of examination, presence of ischaemic heart disease, peripheral neuropathy, and renal disease. Smoking also correlates positively. The data provide a baseline by which attempts to alter diabetic knowledge, management, and control may be measured in follow-up studies.

Adolescent↗
PubMed1979

Intracranial abscess.

Thirty-one patients with intracranial abscess who were treated at Royal Perth Hospital during the past 10 years are reviewed. There were 17 males and 14 females with a mean age of 39.2 years. Fifteen deaths indicate an over-all mortality of 45%. However, the mortality was 62% in the first five years, and 39% during the latter five years. The clinical features of the patients are reviewed. Factors contributing to the high mortality were severe local and multisystem disease, delay in diagnosis and surgical drainage, and inappropriate or inadequate antibiotic therapy. The use of high doses of antibiotics is suggested and recommendations are made concerning appropriate regimens.

Adolescent↗
PubMed1978

Glycosylated haemoglobin levels in patients with diabetes mellitus.

Glycosylated haemoglobin A1 levels were measured in 186 patients with diabetes mellitus and 108 non-diabetic controls. Forty-nine diabetics were considered well controlled with at least three blood glucose levels below 10 mmol/L, while 50 diabetic patients were poorly controlled with at least three blood glucose levels above 15 mmol/L. Mean glycosylated haemoglobin A1 levels for the 108 normal controls was 7.45% +/- 0.73%, for the well controlled diabetics, 10.7% +/- 2%, and for poorly controlled diabetics, 15.0% +/- 2.5% of total haemoglobin. In patients with the onset of diabetes after the age of 40 years, there was a significant difference between the haemoglobin A1 levels in those with diabetic retinopathy and those without complications. There was a significant association between haemoglobin A1 levels and the duration of the disease in diabetics controlled with insulin.

Adult↗
PubMed1978

Serum pyridoxal concentrations in patients with diabetic neuropathy.

Serum pyridoxal (vitamin B6) concentrations were measured in 50 patients with significant diabetic neuropathy. There were 24 males and 26 females with a mean age of 58.2 years and a mean duration of diabetes of 9.8 years. The level of pyridoxal was significantly lower in these patients when compared with randomly selected diabetic patients matched for age and sex without clinical evidence of neuropathy. There was no significant difference in the duration of the diabetes between the two groups. The results indicate an association between pyridoxal deficiency and neuropathy in diabetic patients.

Adolescent↗
PubMed1978

Carpal tunnel syndrome, diabetes and pyridoxal.

Serum pyridoxal concentrations were estimated in 13 patients who had both diabetes and carpal tunnel syndrome. The clinical features and response to treatment in these patients did not differ from that seen in non-diabetic patients with this syndrome. No significant difference in mean serum pyridoxal concentrations was noted between diabetics with carpal tunnel syndrome, diabetics without neuropathy, and normal subjects. These results indicate that carpal tunnel syndrome in diabetics is distinct from polyneuropathy in that it is not associated with a reduction in serum pyridoxal levels which is a feature of diabetic polyneuropathy.

Adult↗
PubMed1975

Cortisol metabolism in chronic liver disease.

Impairment of cortisol metabolism, evidence of endogenous hypercortism and sensitivity to oral corticosteroids are known to occur in patients with chronic liver disease. Measurements were made of plasma 11-OHCS and urinary cortisol levels and other parameters of adrenal function in a group of such patients. The mean plasma total 11-OHCS was lower in patients than in control subjects, although this difference was not statistically significant and the normal circadian rhythm was maintained. However, in patients with chronic liver disease a greater proportion of the 11-OHCS was in the non-protein bound state resulting in an elevation of this fraction. This elevation of non-protein bound 11-OHCS must represent a resetting of the pituitary-adrenal feedback mechanism in these patients. Corticosteroid binding globulin was lower in patients than in control subjects, although the difference was not statistically significant. Urinary cortisol excretion was significantly reduced as was excretion of 17-ketosteroids. Cortisol secretion rate was found to be normal. It is suggested that elevation of plasma non-protein bound 11-OHCS, resulting from impaired metabolism and reduced protein binding of cortisol in patients with hepatic disease, may explain the features of endogenous hypercorticism seen in such patients. Moreover, in the presence of impaired steroid metabolism and reduced protein binding, these patients may exhibit an increased sensitivity to corticosteroid therapy, and therefore administration of a reduced dosage may be advisable.

11-Hydroxycorticosteroids↗
PubMedDate not supplied

Glycosylated hemoglobin concentrations in patients with diabetic neuropathy.

Glycosylated hemoglobin (Hb) concentrations were measured in 50 patients with clinically significant diabetic neuropathy. There were 24 males and 26 females with a mean age of 58.1 years and a mean duration of diabetes of 8.9 years. The glycosylated Hb concentration was not significantly different in these patients (13.9% +/- 2.4 SD) compared with randomly selected diabetic patients matched for age (+/- 5 years), sex and therapy without clinical evidence of neuropathy (13.6% +/- 2.2). There was no significant difference in the duration of diabetes between the two groups. The results would suggest that factors other than the degree of control of diabetes are important in the pathogenesis of diabetic neuropathy.

Adolescent↗