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Biomedical subjects

D Mattingly

Publications and source records attributed to D Mattingly.

At least 19 recordsLinked to original sources

Predictors of fear of falling in dizzy and nondizzy elderly.

Fear of falling may constitute an independent risk factor for disability, leading older people to unnecessarily restrict their activity. Sixty older adults with chronic dizziness and 66 healthy controls were studied to help clarify the interrelationships among demographic factors, psychological status, physical health, and fear of falling. Chronic dizziness was strongly associated with fear of falling; among dizzy patients, nearly half (47%) expressed fear of falling, in comparison with 3% of controls. In participants with dizziness, 3 factors predicted fear of falling: an activity of daily living score, the revised Symptom Checklist 90 Depression (Derogatis, 1983) score, and stability when standing with feet together. These results support the concept that fear of falling is multiply determined and that psychological factors play a major role in influencing the symptoms and responses in many older patients with dizziness.

Accidental Falls

Estimation of urinary aldosterone using thin-layer chromatography and fluorimetry.

AIMS: To develop a fluorimetric method for the estimation of urinary aldosterone; to establish a normal range in 24 hour and overnight urine samples; and to investigate the use of overnight urines for detecting hyperaldosteronism. METHODS: Essential steps include hydrolysis of the 18 conjugate to release aldosterone and its oxidation with Benedict's solution, followed by thin-layer chromatography on silica gel and development of fluorescence on the plate with sulphuric acid. RESULTS: There was a linear correlation between the amount of aldosterone and the area under the peak on the chromatogram. The mean intra-assay and interassay coefficients of variation were 4.4% and 6.8%, respectively. The mean aldosterone excretion in 67 adults was 15.7 (SD 8.1) nmol/24 hours. The mean overnight excretion in 65 adults was 2.6 (1.4) nmol/8 hours. The method detected raised concentrations in patients with primary and secondary aldosteronism. CONCLUSIONS: This technique provides an accurate means of assaying urinary aldosterone. Overnight estimations seem to be as effective as 24 hour assays for identifying patients with hyperaldosteronism.

Adolescent

Plasma melatonin levels in anorexia nervosa.

Plasma melatonin levels were measured at three-hourly intervals over 24 hours in 11 women with untreated anorexia nervosa, and in nine healthy women of normal weight. The circadian rhythm was unaltered but the nocturnal secretion of melatonin was significantly greater in anorectics. It is possible that this was related to nocturnal hypoglycaemia.

Adolescent

Acrocyanosis in anorexia nervosa.

Acrocyanosis, an uncommon disorder of the peripheral circulation, may occur in patients with anorexia nervosa. It is not known why this should be, nor whether acrocyanosis correlates with any other features of the disorder. The findings in an unselected series of 155 anorectics are reported. Acrocyanosis occurred in 32 and was more prevalent among the more severely ill. It was associated also with pallor of the face and trunk, slower pulse rates and higher fasting plasma glucose levels. Acrocyanosis could represent a more extreme form of a heat conserving mechanism not uncommon in anorectics. The possible relationship between peripheral vascular changes and plasma glucose levels requires further study.

Adolescent

Fluorimetric method for simultaneous estimation of cortisol, corticosterone, and testosterone in plasma.

The simultaneous estimation of steroids in plasma was carried out by the assay of cortisol, corticosterone, and testosterone. The method entails separation by means of thin layer chromatography, followed by conversion to a fluorophore and fluorimetric measurement. Its major advantages are its high specificity, its ability to detect unknown substances, and the ease with which it can be performed. The method has acceptable levels of accuracy and precision and the normal values obtained by it compare well with those given by methods in general use.

Chromatography, Thin Layer

Anorexia nervosa: some observations on "dieters" and "vomiters", cholesterol and carotene.

Twenty consecutive cases of anorexia nervosa admitted to a general medical ward were found to consist of ten who reduced weight by means of dieting and ten who in addition employed self-induced vomiting. Clinical and biochemical differences between "dieters' and "vomiters' were less pronounced than those reported elsewhere. However, the "vomiters' had higher scores on the anxiety, somatic and depression subscales of the Crown-Crisp Experiential Index and lower serum carotene concentrations. The implications of these findings are discussed.

Adolescent

Overnight urinary 11-hydroxycorticosteroid estimations in diagnosis of Cushing's syndrome.

Overnight specimens of urine were collected from control, obese, and hirsute women and from 11 women with Cushing's syndrome. Urinary 11-hydroxycorticosteroid levels in the group with Cushing's syndrome were significantly higher than in the other three groups. This simple test has proved invaluable when screening for Cushing's syndrome in a busy outpatient clinic.

11-Hydroxycorticosteroids

Simultaneous investigation and treatment of suspected acute adrenal insufficiency.

The increase in plasma-fluorogenic-corticosteroids in response to a single injection of tetracosactrin depot was measured in eleven patients with suspected acute renal insufficiency who were treated simultaneously with prednisolone and deoxycorticosterone acetate (D.O.C.A.). Acute adrenal insufficiency was excluded in seven patients within 24 hours. There was no response in the remaining four patients, and prolonged corticotrophin stimulation tests confirmed the diagnosis of Addison's disease.

11-Hydroxycorticosteroids

Plasma and urinary 11-hydroxycorticosteroids in differential diagnosis of Cushing's syndrome.

Morning plasma 11-hydroxycorticoids, urinary 11-hydroxycorticoids, and urinary 17-oxogenic steroids were measured before and during a dexamethasone suppression test. This consisted in the administration by mouth of 2 mg of dexamethasone daily for 48 hours, followed by 8 mg daily for 48 hours. In addition midnight plasma 11-hydroxycorticoids were measured before the start of the test. The subjects investigated were 21 patients with Cushing's syndrome, 27 obese female patients, 10 female patients with the Stein-Leventhal syndrome, and 8 female patients with idiopathic hirsutism.The results showed that the clearest distinction between the groups was made by measurement of the basal urinary 11-hydroxycorticoid excretion, where, in the group of patients with Cushing's syndrome, all the levels were well above the upper limit of normal. In addition raised midnight plasma 11-hydroxycorticoid levels were of great diagnostic value. By using these results together with those of the dexamethasone suppression tests it was possible to make a firm preoperative diagnosis of pituitary-dependent Cushing's syndrome in 90% of patients in this series.

17-Hydroxycorticosteroids

Plasma 11-hydroxycorticoid levels after carbenoxolone sodium.

A definite rise in plasma 11-hydroxycorticoid levels has been shown in eight patients with duodenal ulcer following the oral administration of carbenoxolone sodium. A similar rise was seen in one patient with sarcoidosis whose pituitary A.C.T.H. secretion had been acutely suppressed with dexamethasone. No such rise, however, was seen in three patients suffering from adrenal insufficiency. It is suggested that carbenoxolone acts directly on the adrenal cortex, causing an increased production of corticosteroids.

Addison Disease