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Biomedical subjects

Eric S Kilpatrick

Publications and source records attributed to Eric S Kilpatrick.

10 recordsLinked to original sources
PubMed2004

Hypopituitarism presenting as a mixed hyperlipidaemia.

A case report is presented of a 37-year-old man who, largely by chance, was found to have a marked mixed hyperlipidaemia. As a teenager he had been treated for apparent idiopathic growth hormone deficiency, but had also never developed secondary sexual characteristics. Pituitary hormone measurement was now consistent with hypopituitarism and magnetic resonance imaging showed hypoplasia of his pituitary stalk as the likely cause. His hyperlipidaemia improved after appropriate hormone replacement. He thus appears to have had a mixed hyperlipidaemia secondary to hypopituitarism, which was secondary to a pituitary stalk abnormality, which in turn may have been associated to the trauma surrounding his normal breech delivery.

Adult↗
PubMed2003

Tumour markers: their use and misuse by clinicians.

BACKGROUND: Several guidelines exist on the appropriate use of serum tumour markers in the management of patients with cancer. This study audited tumour marker requesting against these guidelines in a busy teaching hospital over a 12-month period. METHODS: All marker requests from 1 April 2001 to 31 March 2002 were collected using the laboratory computer. From one 24-h period, the case notes from all hospital requests [excluding prostate-specific antigen (PSA)] were examined. RESULTS: Tumour marker workload increased by 125% from 1997-98 to 2001-02. Of 27 323 tumour marker requests, 7166 were from general practice, 2312 were requested on hospital admission before further investigation, 612/3636 of CA125 and 98/374 of CA15.3 requests were on men and 12/11585 PSA requests on women. Of 34 case notes examined, 18 had tumour markers measured before biopsy and only nine after. Of 19 patients with 'normal' markers, one had malignancy on biopsy and, of 15 with one or more raised markers, four had normal biopsies. CONCLUSIONS: Tumour marker workload is rapidly increasing. Tumour markers are frequently and inappropriately requested, either because they are on patients of the wrong sex, or because they are taken before a cancer diagnosis is reached. Results from these tests can be falsely reassuring or unduly alarming.

Aged↗
PubMed2002

Beneficial effects of soy phytoestrogen intake in postmenopausal women with type 2 diabetes.

OBJECTIVE: Phytoestrogen consumption has been shown to reduce risk factors for cardiovascular disease. Type 2 diabetes confers an adverse cardiovascular risk profile particularly in women after menopause. The aim of this study was to determine whether a dietary supplement with soy protein and isoflavones affected insulin resistance, glycemic control, and cardiovascular risk markers in postmenopausal women with type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 32 postmenopausal women with diet-controlled type 2 diabetes completed a randomized, double blind, cross-over trial of dietary supplementation with phytoestrogens (soy protein 30 g/day, isoflavones 132 mg/day) versus placebo (cellulose 30 g/day) for 12 weeks, separated by a 2-week washout period. RESULTS: Compliance with the dietary supplementation was >90% for both treatment phases. When compared with the mean percentage change from baseline seen after 12 weeks of placebo, phytoestrogen supplementation demonstrated significantly lower mean values for fasting insulin (mean +/- SD 8.09 +/- 21.9%, P = 0.006), insulin resistance (6.47 +/- 27.7%, P = 0.003), HbA(1c) (0.64 +/- 3.19%, P = 0.048), total cholesterol (4.07 +/- 8.13%, P = 0.004), LDL cholesterol (7.09 +/- 12.7%, P = 0.001), cholesterol/HDL cholesterol ratio (3.89 +/- 11.7%, P = 0.015), and free thyroxine (2.50 +/- 8.47%, P = 0.004). No significant change occurred in HDL cholesterol, triglycerides, weight, blood pressure, creatinine, dehydroepiandrosterone sulfate, androstenedione, and the hypothalamic-pituitary-ovarian axis hormones. CONCLUSIONS: These results show that dietary supplementation with soy phytoestrogens favorably alters insulin resistance, glycemic control, and serum lipoproteins in postmenopausal women with type 2 diabetes, thereby improving their cardiovascular risk profile.

Blood Glucose↗
PubMed2002

Biological variation of homeostasis model assessment-derived insulin resistance in type 2 diabetes.

OBJECTIVE: Individuals with type 2 diabetes are particularly vulnerable to cardiovascular disease. Insulin resistance is a major determinant of this increased risk and is a potential therapeutic target. This study was undertaken to establish the natural biological variation of insulin resistance in individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS: The biological variation of insulin resistance was assessed by measuring insulin resistance at 4-day intervals on 10 consecutive occasions in 12 postmenopausal women with diet-controlled type 2 diabetes and in 11 weight- and age-matched postmenopausal women without type 2 diabetes. Insulin resistance was derived using the homeostasis model assessment for insulin resistance (HOMA-IR) method. RESULTS: The distribution of HOMA-IR was log Gaussian in the type 2 diabetic study group and Gaussian in the control group. The HOMA-IR in the type 2 diabetic group was significantly greater than that of the control group (mean +/- SD: 4.33 +/- 2.3 vs. 2.11 +/- 0.79 units, P = 0.001). After accounting for analytical variation, the mean intraindividual variation was also substantially greater in the type 2 diabetic group than in the control group (mean 1.05 vs. 0.15, P = 0.001). Consequently, at any level of HOMA-IR, a subsequent sample must increase by >90% or decrease by >47% to be considered significantly different from the first. CONCLUSIONS: HOMA-IR is significantly greater and more variable for individuals with type 2 diabetes. Therefore, this inherent variability needs to be accounted for in studies evaluating therapeutic reduction of HOMA-IR in this group.

Diabetes Mellitus, Type 2↗