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Biomedical subjects

I MacFarlane

Publications and source records attributed to I MacFarlane.

12 recordsLinked to original sources
PubMed2001

Trends in the smoking habits of young adults with diabetes.

OBJECTIVES: To examine changes in the prevalence of smoking in young adult diabetic patients between 1990 and 1999. SETTING: Walton Diabetes Centre, University Hospital Aintree, Liverpool, UK. DESIGN: Direct questioning as well as the urinary cotinine:creatinine ratio were used to assess the smoking habits of 99 young type 1 diabetic patients in 1991 (mean age 21.5 years, duration of diabetes 7.3 years), and in 112 similar patients in 1999 (mean age 23.4 years, duration of diabetes 9.6 years). RESULTS: The admitted smoking rate was 31/99 (31%) in 1990 compared with 31/112 (28%) in 1999 (not significant). However, in 1990 there were an additional 17 "covert" smokers (patients who denied smoking, but had an unequivocally raised urinary cotinine:creatinine ratio), but only three in 1999 (p<0.05). This gave a corrected validated smoking rate of 48/99 (48%) in 1990 and 34/112 (30%) in 1999, representing a significant fall (p<0.02). CONCLUSION: Smoking rates in young type 1 diabetic patients appear to have fallen during the last decade, and reporting of smoking behaviour is now more honest.

Adolescent↗
PubMed1999

Clinical presentation of thyroid dysfunction and Addison's disease in young adults with type 1 diabetes.

In a clinic population of 509 type 1 diabetic patients aged 16-45 years, 5.5% had received treatment for thyroid disorders (20 hypothyroid, three males; eight thyrotoxicosis, four males), and Addison's disease was present in four patients (0.8%, one male). In all patients, type 1 diabetes preceded the diagnosis of the other autoimmune disorder. The clinical presentation of hypothyroidism was usually insidious with few symptoms, although an increased frequency of hypoglycaemic symptoms and/or raised serum cholesterol levels often prompted thyroid function testing. In contrast, the patients with thyrotoxicosis had florid symptoms, weight loss (mean 8.12 kg), palpable goitres, increasing insulin requirements, and low cholesterol levels. Six patients did not achieve remission or had recurrent thyrotoxicosis after oral antithyroid treatment and required 131I or thyroid surgery. A family history of autoimmune disease was present in 25% of patients with thyroid disorders (seven thyrotoxic and one hypothyroid) and in three of the four patients with Addison's disease. In this population of young adult type 1 diabetic patients, appropriate tests for thyroid dysfunction and Addison's disease should be carried out if there is clinical suspicion and/or unexplained changes in diabetic metabolic control or serum cholesterol. Careful follow-up of patients with a family history of these conditions is recommended.

Addison Disease↗
PubMed1995

Cigarette smoking and free radical activity in young adults with insulin-dependent diabetes.

Cigarette smoke is potentially capable of generating a high free radical load in the body and many patients with diabetes are smokers. This study was designed to investigate the relationship between long-term smoking and free radical activity in young adult insulin-dependent diabetic patients with no evidence of macrovascular disease. Eight-five patients (48 male) aged 17-40 years were studied. Mean duration of diabetes was 10.5 years (0.08-33) and 39 were cigarette smokers. All had normal serum creatinine levels. The free radical markers measured were: thiobarbituric acid reactive substances, glutathione peroxidase, and superoxide dismutase. No significant differences in thiobarbituric acid reactive substances, glutathione peroxidase, or superoxide dismutase, were found between the diabetic smokers and non-smokers. Also no difference was found comparing the diabetic patients with 40 non-diabetic control subjects (20 smokers). Persistent albuminuria was present in 16 patients (10 microalbuminuria) and free radical marker concentrations in these subjects were similar to the normoalbuminuric patients. This data suggests that any increase in free radical activity due to cigarette smoke is adequately scavenged in young adults with diabetes who are free of significant macrovascular disease.

Adolescent↗
PubMed1995

Free radical activity in young adult cigarette smokers.

Cigarette smoke is capable of generating free radicals. In this study markers of free radical activity (thiobarbituric acid reactivity, superoxide dismutase and glutathione peroxidase) were measured in young adult smoking and non-smoking volunteers. No significant differences were found in any of the free radical markers between the two groups. The number of leucocytes was elevated and a positive correlation was found between the number of leucocytes and thiobarbituric acid reactivity in the smokers. The results from this study suggest that any free radical activity generated from long term cigarette smoking in young adults is adequately scavenged.

Adolescent↗
PubMed1995

Whose back is it?

This is a question that every nurse should consider as it could be a major factor in their nursing career. Indeed if training needs and education at all levels of the National Health Service are not reviewed and brought up to date, nursing could be heading for serious difficulties in the near future. Fortunately for nursing, the European Community has decided to bring manual lifting and handling to the forefront by issuing directives which they hope will 'harmonise health and safety standards throughout the European Community such that competitive advantage cannot be gained by lowering costs as a direct result of lowering standards'. The most important of these as far as nursing is concerned is Directive 90/269, especially articles three to four which state employers have 'an existing duty to prepare and revise as necessary and bring to the attention of their employees, a written Health and Safety Policy'. It also expects employers to provide equipment which will allow workers to avoid manual handling and to ensure that a full assessment of all manual lifting tasks is carried out prior to their commencement, whether there is a risk of injury or not to the employee.

Back Pain↗
PubMedDate not supplied

Educational achievements, employment and social class of insulin-dependent diabetics: a survey of a young adult clinic in Liverpool.

The educational achievements, current employment, and social class of 137 diabetic patients aged 20.9 +/- 3.0 years (mean +/- SD), attending a Young Adult Diabetic clinic in North Liverpool were surveyed. The duration of diabetes was 7.8 +/- 5.0 years. Patients who developed diabetes in childhood (age at diagnosis less than 13 years) were more likely to have achieved educational qualifications, be employed, and be of social class I or II than those developing diabetes aged 13-25 years. Compared with non-diabetic young adults from North Liverpool, diabetics achieved similar educational qualifications and were as likely to be employed after leaving full-time education. This is an encouraging finding in the present harsh economic climate. The clustering of social classes I and II in childhood diabetics found in this study requires a larger epidemiological study of social class and insulin-dependent diabetes for confirmation.

Adult↗