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Biomedical subjects

W Gatling

Publications and source records attributed to W Gatling.

25 records · Page 2Linked to original sources
PubMed1985

Screening for early diabetic nephropathy: which sample to detect microalbuminuria?

In a study to monitor the acceptability of using a timed overnight urine collection to measure microalbuminuria in a large diabetic population, it was found that only 184 (69.4%) of 265 diabetics returned the urine collection to the hospital laboratory. Three proposals for an initial screening test to predict high risk microalbuminuria were analysed. Proposal I: a random urinary albumin concentration (RAC) greater than 25 micrograms/ml predicts an overnight albumin excretion rate (AER) greater than 30 micrograms/min. In 159 diabetics, the sensitivity of this screening test was 56%, specificity 81%, and predictive value 15%. Proposal II: an albumin concentration greater than 20 micrograms/ml in an early morning urine sample predicts an overnight AER greater than 30 micrograms/min. In 175 diabetics, the sensitivity of this screening test was 86%, specificity 97%, and predictive value 71%. Proposal III: an albumin/creatinine ratio (albumin mg/l creatinine mmol/l) greater than 3.5 in an early morning urine sample predicts an overnight AER greater than 30 micrograms/minute. In 171 diabetics, the sensitivity of this screening test was 100%, specificity 95%, and predictive value 64%. It is concluded that an albumin/creatinine ratio performed on an early morning urine sample brought to the diabetic clinic would be a useful initial screening test to detect an overnight AER greater than 30 micrograms/min.

Albuminuria↗
PubMed1983

Toxic shock syndrome complicated by laryngeal oedema.

A 50-year-old woman was admitted as an acute medical emergency and was diagnosed as having toxic shock syndrome. Thirty-six hours after admission she went into hepato-renal failure and had disseminated intravascular coagulation. She developed severe laryngeal oedema, a complication which has not been reported previously, and was intubated with great difficulty. She recovered from this, but died 5 weeks after the presentation of a pulmonary embolus.

Female↗
PubMedDate not supplied

The Oxford Community Diabetes Study: evidence for an increase in the prevalence of known diabetes in Great Britain.

A prevalence survey for known diabetes was conducted in a geographically defined population of nearly 40,100 in Oxford in April 1982. The age-adjusted prevalence rate was 10.4/1000 which did not differ significantly from age-adjusted rates of 9.5/1000 in Poole and 10.5/1000 in Southall. The prevalence increased with age and was higher in men than women over the age of 30 years. Our results confirm that there has been a change in the male to female sex ratio and suggest that there are about 500,000 diagnosed diabetics in England and Wales including about 190,000 insulin-treated patients. These findings are consistent with a secular increase in the prevalence of diagnosed diabetes over the last two decades which has important implications for the planning and provision of resources for care.

Age Factors↗
PubMedDate not supplied

Microalbuminuria in diabetes: a population study of the prevalence and an assessment of three screening tests.

A single observer reviewed 842 of the 917 known diabetic patients registered with 40 GPs in the Poole area. A midstream urine specimen was tested for proteinuria using Albustix (Ames) and cultured to detect bacterial infection. After the first 3 months of the survey, the aliquot of this specimen was frozen for later determination of the random albumin/creatinine ratio (R-Alb/Creat). Patients were requested to submit a timed overnight urine collection for estimation of urinary albumin excretion rate (AER). Of the 842 patients reviewed, 493 (59%) submitted timed overnight urine collections; 43 were excluded because of urinary infection and/or proteinuria. One hundred and thirty-three (30%) of 450 diabetic patients were found to have microalbuminuria, although only 31 (7%) had an AER greater than 30 micrograms/min. Six hundred and seven urine samples were collected for R-Alb/Creat but 68 were excluded because of infection and/or proteinuria; in 10 further samples urinary creatinine was not measured. Two hundred and four (38%) of 532 diabetic patients were found to have an elevated R-Alb/Creat. There was a significant correlation between AER and R-Alb/Creat (r = 0.32, p less than 0.001) but a considerable number of patients showed either a normal AER and high R-Alb/Creat or the reverse. The value of R-Alb/Creat or an overnight urinary albumin concentration, or an overnight urinary albumin/creatinine ratio (ON-Alb/Creat) as screening tests to predict AER greater than 30 micrograms/min was assessed. An ON-Alb/Creat greater than 2.0 mg/mmol was the optimal screening test (sensitivity 96% and specificity 99.7%).(ABSTRACT TRUNCATED AT 250 WORDS)

Albuminuria↗
PubMedDate not supplied

Microalbuminuria in diabetes: relationships between urinary albumin excretion and diabetes-related variables.

A single observer reviewed 842 of the 917 known diabetic patients registered with 40 GPs in the Poole area. Fifty-nine per cent (493) of those reviewed submitted a timed overnight urine collection to measure albumin excretion rate (AER) and overnight albumin/creatinine ratio (ON-Alb/Creat); 43 samples were excluded because of urinary tract infection and/or proteinuria. A random urine sample was obtained in 607 diabetic patients to measure the random albumin/creatinine ratio (R-Alb/Creat); 68 specimens were excluded because of infection and/or proteinuria, and in a further 10 samples urinary creatinine was not measured. Stepwise multiple regression analyses found significant associations with the following variables: for AER, blood glucose (p = 0.001), smoking category (p = 0.002), sex (p = 0.034), and systolic blood pressure (p = 0.035); for R-Alb/Creat, blood glucose (p = 0.001), retinopathy (p = 0.004), systolic blood pressure (p = 0.004), diastolic blood pressure (p = 0.015), coronary artery disease (p = 0.02), sex (p = 0.034), and vibration sense (p = 0.038). Interestingly, glycosylated haemoglobin was not a significant determinant of albuminuria in either analysis.

Albuminuria↗