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Biomedical subjects

A C Burden

Publications and source records attributed to A C Burden.

At least 91 records · Page 5Linked to original sources
PubMed1986

The effect of short term intensive insulin therapy in non-insulin-dependent diabetics who had failed on sulphonylurea therapy.

To determine the effect of short term intensive insulin therapy in non-insulin-dependent diabetes mellitus (NIDDM) we studied 10 patients who had been on maximal doses of sulphonylurea therapy, with a glycosylated haemoglobin value persistently above the normal range. All patients were non-ketonuric, had negative islet cell antibodies, and had been on sulphonylureas for a mean duration of 5.6 yr. Patients were maintained at euglycaemia (plasma glucose 4-7 mmol/l) for 24 hr using an open-loop intravenous insulin regimen, and then underwent a standard 75 g oral glucose tolerance test (OGTT). This was repeated after 3 months of treatment with insulin. Mean fasting plasma glucose and glycosylated haemoglobin were 10.1 mmol/l and 12.2% respectively before, and 7.1 mmol/l (p less than 0.001) and 8.4% (p less than 0.001) after treatment. There was no significant change in body weight. Plasma insulin and C-peptide responses to 75 g OGTT did not change significantly, but the total amount of intravenously infused insulin required for 24-hr euglycaemia fell from a mean value of 138 u before treatment to 87 u (p less than 0.001) at the end of insulin therapy. Remission, with glycosylated haemoglobin in the normal range for more than 3 months after stopping insulin, was observed in 5 out of the 10 patients. All 5 who failed to achieve remission had markedly blunted maximal insulin responses of less than 10 mu/l on both OGTT's. Our study shows that insulin treatment in NIDDM appears to exercise a beneficial effect by lowering insulin resistance. We suggest that this may be of advantage early on in patients with NIDDM in preserving B-cell reserve.

Adult↗
PubMed1985

Plasma glucose responses to glucose, sucrose, and honey in patients with diabetes mellitus: an analysis of glycaemic and peak incremental indices.

We have studied the hyperglycaemic effect of the carbohydrate of glucose, sucrose, and honey equivalent to 20 g in twelve normal volunteers, eight patients with insulin-dependent diabetes mellitus (IDDM), and six patients with non-insulin-dependent diabetes mellitus (NIDDM). Honey produced an attenuated postprandial glycaemic response in normal volunteers (vs glucose p less than 0.005; vs sucrose p less than 0.05) and IDDMs (vs glucose p less than 0.005; vs sucrose p less than 0.05). The glycaemic index (GI) showed considerable variability within each subject group. Combined with a peak incremental index (PI), the two indices appear to be more valuable in predicting the glycaemic effects of carbohydrates rather than either one alone. We suggest that honey may prove to be a valuable sugar substitute in diabetics, and that both the GI and PI should be used in the analysis of food.

Adult↗
PubMed1985

Thoracic inlet compression due to amiodarone induced goitre.

We report a case of amiodarone induced toxic goitre, presenting with thoracic inlet obstruction which required surgical intervention. Though thyrotoxicosis caused by amiodarone is recognised, to our knowledge thoracic inlet compression has not been previously described.

Airway Obstruction↗
PubMed1983

Predictors of renal function in diabetic and non-diabetic renal disease.

Forty-two patients with renal disease due to diabetic nephropathy (14 patients), tubulointerstitial disease (14 patients) and glomerular disease (14 patients) underwent measurement of glomerular filtration rate (GFR) by the 51Cr-EDTA 'one-shot' method and simultaneous serum beta 2-microglobulin, serum creatinine and creatinine clearance estimation. Serum creatinine was a significantly better predictor of GFR than serum beta 2-microglobulin in patients with diabetic nephropathy, whereas both methods were equally useful predictors of GFR in non-diabetic renal disease. Serum creatinine measurement remains the best method for detecting early reduction of GFR on a serum sample.

Adult↗
PubMed1980

Fibrinolysis and the prediction of postoperative deep vein thrombosis.

Fibrinolytic activity was measured in 28 patients undergoing elective abdominal surgery in order to assess the value of fibrinolytic activity as a predictive indicator of deep vein thrombosis. Eighty-nine non-smoking adults acted as controls. Fibrinolytic activity was estimated before and during operation, immediately postoperatively and 24 h and 48 h after operation. The onset of deep vein thrombosis was assessed daily for 5 days using 125I-fibrinogen uptake scans. Fibrinolytic activity in 9 patients changed significantly and 7 of these developed deep vein thrombosis. Preoperative assessment of fibrinolytic activity cannot alone predict deep vein thrombosis but changes in the pattern of activity may be of help in defining those at risk.

Abdomen↗
PubMed1980

Reversible hypertension and hypothyroidism.

Six patients with hypothyroidism and hypertension whose blood pressure fell to normal when treated with thyroxine (172 +/- 7.2/112 +/- 2.1 to 140 +/- 3.2/84+/- 1.6 mmHg, P < 0.001) are described. Plasma renin activity (1.76 +/- 0.63 ng angiotensin I.ml-1.h-1) was low before treatment. Hypertension with low plasma renin is consistent with sodium retention. Hypertension in the hypothyroid patient only requires further evaluation if it persists after adequate treatment with thyroxine.

Adult↗