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Biomedical subjects

G Libby

Publications and source records attributed to G Libby.

11 recordsLinked to original sources
PubMed2006

Pre-eclampsia and the later development of type 2 diabetes in mothers and their children: an intergenerational study from the Walker cohort.

AIMS/HYPOTHESIS: Studies have shown a relationship between pre-eclampsia and later coronary artery disease. This study investigated whether there is a relationship between pre-eclampsia and the development of type 2 diabetes in mothers and their babies and how this is affected by infant birthweight. SUBJECTS AND METHODS: This was an intergenerational cohort study. The study population comprised 7,187 mothers who gave birth and 8,648 babies who were born in Dundee, Scotland between 1952 and 1958. Their later diabetic status was defined from 1980 to 2003 by linkage to population-based datasets. RESULTS: There were 810 (11.3%) mothers with pre-eclampsia and 745 (10.4%) who subsequently developed type 2 diabetes. Logistic regression showed an increased risk of developing type 2 diabetes for mothers with pre-eclampsia, unadjusted odds ratio (OR) 1.37 (95% CI 1.10-1.71), p=0.005. This relationship persisted after adjustment for infant birthweight, OR 1.40 (95% CI 1.12-1.75), p=0.003. Of the babies born between 1952 and 1958, 221 (2.6%) had developed type 2 diabetes, 137 of them male (2.9% of male subjects in study population) and 84 female (2.2% of female subjects). The relationship between pre-eclampsia in the mother and the risk of type 2 diabetes in the offspring did not reach statistical significance, OR 1.38 (95% CI 0.90-2.10). Babies with birthweight in the lowest quintile (adjusted for sex, gestation and birth order) had an increased risk of developing type 2 diabetes, OR for lowest quintile vs highest quintile 1.84 (95% CI 1.24-2.72), p=0.002. CONCLUSIONS/INTERPRETATION: Pre-eclampsia is associated with increased risk of developing type 2 diabetes in the mother, but birthweight is a more important determinant of future risk for the offspring.

Birth Weight↗
PubMed2001

Impaired bioavailability of vitamin A in adults and children with persistent diarrhoea in Zambia.

BACKGROUND: We have previously demonstrated a strong relationship between low serum retinol concentration and mortality in Zambian AIDS patients with diarrhoea, but were unable to detect any benefit from oral micronutrient supplementation. AIM: To test the hypothesis that this is related to impaired availability of vitamin A, we analysed serum retinol concentration changes over 6 h following oral mega-dose therapy (60, 120 or 180 mg retinol). METHODS: Twenty-four men without diarrhoea, 15 adults with persistent diarrhoea and 11 children (six girls, five boys) with persistent diarrhoea were studied. RESULTS: Men with persistent diarrhoea had lower baseline serum retinol concentrations (median 0.39 micromol/L, interquartile range 0.21-0.56) than controls (median 1.16 micromol/L, interquartile range 0.84-1.47; P=0.0003). After 60 mg retinol, the rise in serum retinol in HIV seropositive controls (median 0.63 micromol/L, interquartile range 0.35-0.77) did not differ significantly from that observed in HIV seronegative controls (median 0.35 micromol/L, interquartile range - 0.04-0.56; P=0.20). Increasing the dose to 120 mg or 180 mg retinol did not enhance the increase in serum retinol concentration. The increase in serum retinol was less in adults with persistent diarrhoea (median 0.25 micromol/L, interquartile range 0.04-0.35) and in children (median 0.11 micromol/L, interquartile range 0.04-0.46) than in men without diarrhoea (median 0.44 micromol/L, interquartile range 0.26-0.74; P=0.03). Adults and children with diarrhoea had greater losses of retinol in urine over a 24-h period than controls, but less than 1% of the ingested dose was excreted. CONCLUSIONS: These results suggest that persistent diarrhoea in this population is associated with reduced bioavailability of retinol. Further work is required to determine the metabolic fate of therapeutic doses of retinol and to determine appropriate replacement strategies for HIV infected individuals.

Administration, Oral↗
PubMed2001

Record-linkage methodology for prescribing research.

Record-linkage refers to the linking together of data relating to the same individual from separate source files. In this paper, we discuss ways in which the technique can enhance observational prescribing research in large populations. We draw upon the work of the Medicines Monitoring Unit (MEMO), University of Dundee, to illustrate its contribution to prescribing research.

Data Collection↗
PubMed1997

Longevity of fixed partial dentures.

STATEMENT OF PROBLEM: The anticipated length of service and reasons for replacement of fixed partial dentures (FPDs) are a frequent inquiry by patients. Previous reports have provided limited information on material and techniques used in restoration or standards in evaluations of restorations at delivery. PURPOSE: This study determined the reasons for failure and length of service for FPDs delivered with specific clinical, radiographic, and laboratory procedures. METHODS: A clinical and retrospective chart review was conducted on all patients with FPDs who were treated in the prosthodontic clinic at the University of Iowa Hospital for routine dental hygiene recalls during a 6-month period. Fifty patients were examined with a total of 89 FPDs. Of the 89 FPDs, 13, or 15%, were identified as failures or had been replaced because of failure. Dental caries was the most frequent cause of failure (38%), followed by periapical involvements (15%), perforated occlusal surfaces (15%), fractured post and cores (8%), defective margins (8%), fractured teeth (7%), and porcelain failures (8%). The mean length of service for failed FPDs ranged from 16.0 years, because of failure from dental caries, to 4.1 years, because of a fractured post and core. RESULTS: A linear regression model of years in service against number of failed FPDs indicated that the number of years in service provided no information on predictability of failure for FPDs. CONCLUSIONS: This study supported previous reports of dental caries as the primary cause for failure of FPDs, but specific radiographic, clinical, and laboratory procedures can increase the length of service of these restorations.

Adult↗
PubMed1995

Abnormal illness attitudes in patients with irritable bowel syndrome.

The Illness Attitudes Scales (IAS) and the Beck Depression Inventory (BDI) were administered to 40 patients with irritable bowel syndrome (IBS) and these were compared with 35 patients with organic gastrointestinal (GI) disease, 37 depressed patients, and 40 healthy volunteers. The BDI score was found to be greater in the IBS patients than in either the patients with organic disease or healthy subjects. All the patient groups had abnormal IAS scores compared with the healthy group, but these were most marked among the IBS patients with elevated scores on six out of the eight subscales. Three of these were specific to the IBS patients: bodily preoccupation, hypochondriacal beliefs and disease phobia. The results of this study indicate that clinical IBS is associated with abnormal illness attitudes which are not simply a reflection of either an associated depression or of experiencing physical symptoms.

Adolescent↗
PubMed1992

Abnormal REM sleep in the irritable bowel syndrome.

Motor abnormalities of the small bowel that occur only during the waking state have been reported in the irritable bowel syndrome (IBS), suggesting that central nervous system arousal is a necessary condition for expression of the disorder and that it may reflect inappropriate brain-gut interaction. This possible relationship was explored further by synchronous polysomnography and recording of upper small bowel motility in six healthy subjects and six patients with IBS. During sleep, there was no difference in the patterns of intestinal motility between the two groups. There was no difference between the rapid eye movement (REM) latency or number of REM episodes, but the proportion of REM sleep was markedly increased (36.5% +/- 5.7% vs. 18.2% +/- 5.7%; P less than 0.01) in the IBS group, although the duration of sleep was similar (468 +/- 13 minutes in IBS vs. 444 +/- 10 minutes in controls; P greater than 0.1). Sleep apnea was detected in three of six patients with IBS but was not seen in controls. The data are consistent with the model of IBS as a disorder of brain-gut interaction.

Adult↗
PubMed1989

Prospective, controlled, randomized trial of naloxone infusion in early hyperdynamic septic shock.

To determine whether naloxone infusion is efficacious in severe hyperdynamic septic shock, we conducted a prospective study of 22 patients randomly assigned to a naloxone or placebo group. Patients were treated 12 +/- 2 h (SEM) after the onset of shock, with a mean arterial pressure (MAP) of 63 +/- 3 mm Hg. All patients had clinical evidence of an infectious process and required dopamine 20 +/- 2 micrograms/kg.min. Five (46%) of 11 patients in the naloxone group and one (9%) of the other 11 patients in the placebo group responded clinically. The MAP among the five responders increased from 62 +/- 5 to 89 +/- 4 mm Hg within 20 min of naloxone treatment (p less than .01). This favorable hemodynamic response was sustained throughout the patients' clinical course. In contrast, the MAP did not change significantly in the nonresponders who received naloxone, nor did it change in the placebo group. More patients in the naloxone group than in the placebo group received steroids concurrently. Survival rate was 100% in those who responded to naloxone clinically. However, overall survival rate in each group was essentially the same. No adverse effects were observed, except for mild agitation in some of the patients receiving naloxone. We conclude that naloxone infusion is clinically efficacious in improving the hemodynamic profile of a subgroup of patients with severe early hyperdynamic septic shock, but does not appear to improve the overall survival rate.

Aged↗
PubMedDate not supplied

The prevalence of symptoms of irritable bowel syndrome among acute psychiatric inpatients with an affective diagnosis.

An interview study of 87 inpatients with affective diagnoses, according to the International Classification of Diseases (9th Edition), yielded a prevalence of irritable bowel syndrome (IBS) of 39.7%, approximately twice that found in the general population. The IBS symptoms almost invariably preceded the onset of the affective disorder, but were exacerbated by it. The consultation rate for bowel symptoms (41.9%) was greater than that in the general population. In this study, 69.2% of consulters and 55.5% of nonconsulters had experienced an exacerbation of their IBS symptoms since the onset of their emotional disorder. These findings suggest that such disorders may influence the subjective severity of IBS and also consultation behavior, but do not play a major part in the etiology of the gastrointestinal symptoms.

Acute Disease↗