Effect of angiotensinogen gene T235 variant on the development of diabetic complications in type II diabetes mellitus.
Explore the source record for details and available documents.
Angiotensinogen↗
Biomedical subjects
M Small
Publications and source records attributed to M Small.
Do ACE inhibitors improve insulin sensitivity?
Explore the source record for details and available documents.
Angiotensin II↗
Insulin resistance and membrane abnormalities.
Explore the source record for details and available documents.
Diabetes Mellitus, Type 2↗
Perinatal and neonatal mortality in ethnic minorities.
Midwifery care could have a positive impact on the reduction of perinatal and neonatal mortality in ethnic minority groups. Midwives have several important roles to play in this area: health promotion and education identifying those women at risk improving access, uptake and quality of maternity care. To be effective, midwives must: have knowledge and understanding of clients' cultures that can be put to good use during their care. examine their attitudes towards women from black and ethnic minority populations and ensure that these do not contribute towards adverse pregnancy outcomes. embrace the social and psychological aspects of care and unify it with the medical approach.
Ethnicity↗
Glycated haemoglobin values: problems in assessing blood glucose control in diabetes mellitus.
OBJECTIVE: To see whether two measures of glycated haemoglobin concentration--the haemoglobin A1 (HbA1) value and the haemoglobin A1c (HbA1c) value--assess blood glucose control differently in diabetes. DESIGN: Diabetic patients had glycaemic control assessed on the basis of HbA1 and HbA1c values measured by the same high performance liquid chromatography instrument and on the basis of HbA1 measured by electrophoresis. SETTING: A diabetic outpatient clinic. SUBJECTS: 208 diabetic patients and 106 non-diabetic controls. MAIN OUTCOME MEASURES: Glycated haemoglobin concentrations classified according to European guidelines as representing good, borderline, or poor glycaemic control by using standard deviations from a reference mean. RESULTS: Fewer patients were in good control (25;12%) and more poorly controlled (157;75%) as assessed by the HbA1c value compared with both HbA1 assays (39 (19%) and 130 (63%) respectively when using high performance liquid chromatography; 63 (30%) and 74 (36%) when using electrophoresis). The median patient value was 8.0 SD from the reference mean when using HbA1c, 5.9 when using HbA1 measured by the same high performance liquid chromatography method, and 4.1 when using HbA1 measured by electrophoresis. CONCLUSIONS: Large differences exist between HbA1 and HbA1c in the classification of glycaemic control in diabetic patients. The HbA1c value may suggest a patient is at a high risk of long term diabetic complications when the HbA1 value may not. Better standardisation of glycated haemoglobin measurements is advisable.
Adolescent↗
Isolation of CD3-, CD4-, CD8-, IL-2R+ thymocyte precursors by panning.
We present a panning method for isolation of thymocytes that are CD3-, CD4-, CD8- and IL-2R+. These cells have been isolated by positive selection on dishes coated with 7D4 antibody followed by treatment with biotinylated 145-2C11, GK1.5, and 53-6.7 antibodies and negative selection on avidin coated dishes.
Animals↗
How lateralised is visuospatial neglect?
Seventeen patients with left visuospatial neglect caused by cerebral infarction undertook the six subtests of the Behavioural Inattention Test (BIT) as soon as possible following their neurological event. The group mean results on line, letter and star cancellation tasks revealed a linear decrement in performance from right to left on the displays. However, subsequent analysis of patients' cancellations revealed that this finding was not representative of individual performance. Many patients in fact made both marked left- and right-sided omissions on the three cancellation tasks. This was not merely a transitory phenomenon because it remained present at weekly follow-up intervals. Patients' performance on a laterally extended version of the star cancellation task was also investigated. These findings strongly suggest that patients with visuospatial neglect can initially present with a diverse range of performance deficit. Many patients, in particular those with the lowest BIT scores, showed a consistent pattern in the results on letter and star cancellation, providing evidence that their inattention consistently included a considerable section of right-sided (including the extreme right of displays) as well as left-sided space.
Aged↗
Left visuo-spatial neglect can be worse in far than in near space.
We tested five patients with marked left-sided visuo-spatial neglect and two control subjects on a test of line bisection. A series of horizontal lines was presented to each subject, who had to indicate the centre with a projection light-pen. All five patients misplaced the centre to the right, in accordance with their left-sided neglect. However, in all five the angular displacement was greater for lines well beyond reach, than for lines of identical angular size within reaching distance. This result, precisely because it is opposite to that of a previous report, supports the conclusion that there are separate dissociated neural systems concerned with the perception of, and response to, stimuli in near and far space.
Aged↗
Insulin-like growth factor binding protein 1 response to acute insulin induced hypoglycaemia in type 1 diabetes.
OBJECTIVES: Insulin is believed to be the prime regulator of insulin-like growth factor binding protein 1 (IGFBP-1) secretion, and in normal subjects acute insulin induced hypoglycaemia exerts a rapid effect on concentrations of IGFBP-1, and may also influence insulin-like growth factor I (IGF-I) concentrations. The rise in IGFBP-1 concentrations in normal subjects following hypoglycaemia has been suggested to be due to suppression of endogenous insulin secretion. We have examined this further by studying diabetics with no endogenous insulin secretion. DESIGN: We have compared the IGFBP-1 response to acute insulin induced hypoglycaemia in normal subjects and patients with Type 1 (insulin dependent) diabetes mellitus. METHODS: Insulin tolerance tests were performed using a bolus of insulin (0.15 U/kg), in six control subjects and six patients with Type 1 diabetes. MEASUREMENTS: Serum levels of IGFBP-1, insulin, glucose, and IGF-I were measured at regular intervals during the insulin tolerance test. RESULTS: Blood glucose fell to a nadir which coincided with the onset of the acute autonomic reaction 'R' in both groups. The basal concentration of IGF-I was significantly lower in the diabetic group at 0.4 +/- 0.1 kU/l, compared to 0.9 +/- 0.1 kU/l in the control group, but there was no significant change in IGF-I concentrations in response to hypoglycaemia in either group. Hypoglycaemia provoked a fall in IGFBP-1 in patients with Type 1 diabetes, from 38 +/- 9 micrograms/l basally to 17 +/- 3 micrograms/l at R + 120 minutes, with a return to basal values of 45 +/- 11 micrograms/l at R + 180 minutes. In the control subjects there was no fall in IGFBP-1, but a significant increase to 71 +/- 14 micrograms/l at R + 180 minutes. CONCLUSION: This difference in the IGFBP-1 response in the presence of a similar glucose response suggests that in Type 1 diabetes there may be different sensitivities to the actions of exogenous insulin on IGFBP-1 regulation.
Adult↗
A ward comparison between the One Touch II and Glucometer II blood glucose meters.
A 6-week clinical evaluation of the One Touch II blood glucose meter was performed in a medical ward specializing in diabetic patients and compared to the existing Glucometer II system. Nursing staff trained in both methods performed 267 capillary blood glucose measurements using the two meters. A reference capillary blood glucose was performed simultaneously on 129 of these occasions using a Yellow Springs Instrument analyser. The One Touch II correlated better with the reference (r = 0.97) than the Glucometer II (r = 0.86) and was equally close or closer to the Yellow Springs Instrument on 82% of occasions. A greater proportion of samples measured by the One Touch II were within 15% of the reference value (83% vs 66%). There were also 17 cases where the One Touch II was able to give a measurement which was outwith the analytical range of the Glucometer II. A questionnaire revealed the nursing staff unanimously preferred using the One Touch II to their present meter. It is concluded that in a ward setting the One Touch II meter showed improved accuracy, usefulness in its wider analytical range, and a greater user preference in comparison to the Glucometer II.
Blood Glucose↗
Brief remission periods in visuospatial neglect: evidence from long-term follow-up.
Ten patients with left-sided visuospatial neglect due to cerebrovascular accident were monitored using the Behavioural Inattention Test (BIT) at weekly intervals, on a long-term basis. The novel finding was that some patients showed occasional but transitory marked improvement in their visuospatial neglect at times producing a normal score. This spontaneous phenomenon was evidenced by the patient cancelling sections or the entire block of left-sided targets, without any additional cues or prompts. Such episodes indicate that, in this small group of patients, visuospatial neglect is not necessarily irrevocable, at least for simple stimuli.
Aged↗
Denial of eye closure in acute stroke.
BACKGROUND AND PURPOSE: Many patients suffering from stroke exhibit denial of illness. As part of this symptom complex we observed denial of eye closure. We therefore aimed to document the frequency and phenomenology of denial of eye closure in acute stroke. METHODS: Denial of eye closure was sought in 43 cases of denial of illness from a series of 400 acute strokes. Subjects underwent a neurological examination, and audiotaped interviews were performed during which they were asked to finger count through their closed eyes and their denial was challenged. RESULTS: Five of 43 patients with denial of hemiplegia after acute stroke were also found to have denial of eye closure (12%). Denial of eye closure was associated with drowsiness and in all but one patient with disorientation. In the three cases with imaging or autopsy data available, lesions were moderate to large, in the right hemisphere, and involved the frontal lobe. Three subjects confabulated as to what they saw through their closed eyes. One subject mislocalized the hospital closer to her home. CONCLUSIONS: Denial of eye closure occurs in a minority of patients with denial of illness after acute stroke. This phenomenon sheds light on denial as a whole and cannot easily be accounted for by unilateral explanations, such as inattention to one half of the body or loss of sensory input. There are aspects of denial, such as denial of eye closure, mislocalization, and the delusional intensity of beliefs, that can only be understood in cognitive terms.
Aged↗
Low-density lipoprotein particle size in type 2 diabetic patients and age matched controls.
Non-enzymatic glycation of low-density lipoprotein (LDL), and the predominance of small dense LDL particles may together contribute to the increased risk of atherosclerosis in diabetes. We aimed to establish whether the size of LDL particles is related to plasma triglyceride concentration, and to the extent of LDL glycation in type 2 diabetic patients. Sixteen men with type 2 diabetes and 16 age matched non-diabetic controls were studied. LDL size was measured by rapid density gradient ultracentrifugation, and LDL glycation by affinity chromatography. Modal LDL density correlated with plasma triglyceride concentrations in both diabetic and control groups (r = 0.86, P < 0.0001, and r = 0.76, P < 0.0008, respectively). There was no significant difference in these variables between the groups. LDL modal density showed no correlation with HbA1, serum fructosamine or plasma glucose in either group. In the diabetic group the degree of LDL glycation correlated with serum fructosamine (r = 0.74, P < 0.001), HbA1 (r = 0.65, P < 0.008), and with plasma glucose (r = 0.64, P < 0.008). Our results suggest that, in well controlled type 2 diabetic patients LDL size is independent of short-term glycaemic control but can be predicted by plasma triglyceride concentrations.
Adult↗
Pressor and subpressor doses of angiotensin II increase insulin sensitivity in NIDDM. Dissociation of metabolic and blood pressure effects.
There is evidence that the renin-angiotensin system may be involved in the metabolic as well as the cardiovascular features of diabetes and that pressor doses of angiotensin II (ANG II) increase insulin sensitivity in parallel with blood pressure (BP) in healthy subjects, but the effects of ANG II on insulin sensitivity have not been previously reported in patients with non-insulin-dependent diabetes mellitus (NIDDM). In a randomized, double-blind, placebo-controlled, crossover study, 11 patients with NIDDM attended 3 study days to evaluate the effects of a 3-h infusion of subpressor and pressor doses of ANG II on whole body insulin sensitivity using the euglycemic hyperinsulinemic clamp. BP and heart rate were recorded, and blood samples were collected for serum insulin, C-peptide, potassium, catecholamines, plasma renin activity, and plasma ANG II concentrations. Plasma levels of ANG II (means +/- SD) were 9 +/- 4, 29 +/- 9, and 168 +/- 47 pmol/ml after placebo, low dose infusion, and high dose infusion, respectively. The higher dose of ANG II was associated with significant increases in BP (e.g., 18 mmHg systolic BP at 150 min) and plasma aldosterone. Whole body insulin sensitivity was 23.8 +/- 12.7 mumol glucose.kg-1.min-1 after placebo and 30.6 +/- 12.7 and 27.2 +/- 13.3 following low and high dose ANG II infusions, respectively (P < 0.05, analysis of variance). In summary, acute infusion of ANG II, with or without an increase in BP, increases insulin sensitivity in normotensive patients with NIDDM.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Effect of bovine growth hormone administration on the pattern of thymic involution in mice.
Age-related decline of the thymus in mice was reversed by repeated injections of bovine growth hormone. After hormone administration that was begun at 5, 8, or 11.5 months of age, the cortical volume fraction (Vc), cortical/medullary ratio (C/M) and thymocyte numbers found were in the range obtained with younger mice. Growth hormone injection reduced the slope of the curves for Vc and C/M as a function of age, indicating a slowing down of the involution process.
Aging↗
Carbohydrate consumption prior to repeated bouts of high-intensity exercise.
Rapid depletion of muscle glycogen occurs during activities greater than 100% of maximal oxygen uptake. While carbohydrate ingestion prior to an endurance event has been shown to be beneficial, the effects of carbohydrate ingestion on repeated bouts of high-intensity exercise are not known. Therefore, the purpose of this study was to determine if carbohydrate ingestion prior to repeated bouts of high-intensity, short-duration exercise would improve performance. Ten well-trained male cyclists performed two experimental rides, one 15 min after consumption of 5.0 ml.kg-1 body weight of a 19.7% carbohydrate drink and one following a placebo. The experimental ride consisted of four 1.6 km timed performance rides separated by 4.8 km steady-state rides at 80% of maximal oxygen uptake (between the last two performance rides the steady-state rides were 1.6 km at 80% and 1.6 km at 90%). Blood glucose levels were significantly increased following both the ingestion of the carbohydrate beverage and the performance of the exercise bout. Total exercise time following ingestion of the experimental drink [mean (SD); 25.6 (3.3) min] was not different from that following ingestion of the placebo [25.2 (3.3) min]. Similarly, the sum of all four timed performance rides following ingestion of the experimental drink [6.8 (0.9) min] was not different from that following ingestion of the placebo [6.6 (0.9) min]. In the present study, carbohydrate ingestion 15 min prior to exercise increased blood glucose levels, although performance time was not affected.
Adult↗
Severe radionecrosis of the temporal bone.
Severe radionecrosis of the temporal bone is a potentially lethal condition which still occurs despite improvements in radiotherapy. A series of seven such cases is presented to outline the varied clinical features and management of this disease.
Adult↗
Face perception after brain injury. Selective impairments affecting identity and expression.
Current theoretical models of face perception postulate separate routes for processing information needed in the recognition of a familiar face, for matching photographs of unfamiliar faces and for the analysis of facial expressions. The present study investigated this claim in a group of ex-servicemen who had sustained unilateral brain injuries affecting posterior areas of the left or right cerebral hemisphere. Care was taken to confirm the nature of impairment by using two different tasks to assess each of the three theoretically defined abilities (leading to a total of six tasks). We adopted a stringent application of the double dissociation methodology to investigate the pattern of performance across tasks of individual ex-servicemen. A selective impairment was defined as a significantly impoverished performance on both tests of a specific ability, while all other tasks were performed within normal limits. In addition, we used both accuracy and response latency measures to substantiate evidence for spared or defective abilities. The results showed selective impairments of all three abilities on accuracy scores. Response latency data confirmed the finding of a selective deficit in the processing of facial expressions, but produced evidence suggesting that impairments affecting familiar face recognition and unfamiliar face matching were not completely independent from each other in this group of ex-servicemen.
Brain Injuries↗