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Biomedical subjects

P Taft

Publications and source records attributed to P Taft.

At least 19 recordsLinked to original sources
PubMed1990

A study to assess the efficacy of chemoprophylaxis in the prevention of endoscopy-related bacteraemia in patients aged 60 and over.

Five hundred and fifteen patients aged 60 and over (mean age 74.7; 278 men and 237 women) underwent routine endoscopic procedures (gastroscopy, bronchoscopy and cystoscopy). Alternate patients were given antibiotics before the procedure, as currently recommended, and blood was taken for culture from all patients within five minutes of completion of the procedure. Of 74 patients who underwent bronchoscopy, only one culture, from one of 37 controls was positive. Of 262 who underwent gastroscopy, cultures were negative in the 130 who received antibiotics but positive in 13 of the 132 controls (9.8 per cent p less than 0.001). Cystoscopy was performed in 179; one culture was positive in the 88 given antibiotics (1.1 per cent) compared to 25 in the 91 controls (27.5 per cent; p less than 0.001). Bacteraemia rates appear to be low following bronchoscopy (less than 5 per cent) but higher with gastroscopy (10 per cent) and cystoscopy (28 per cent). Chemoprophylaxis was effective in reducing these rates in this patient group.

Aged↗
PubMed1981

Familial euthyroid thyroxine excess: an appropriate response to abnormal thyroxine binding associated with albumin.

Responses of the pituitary-thyroid axis and T4 binding to plasma proteins were studied in three kindreds with familial euthyroid T4 excess, an autosomal dominant condition in which affected subjects have high concentrations of plasma T4 with a high free T4 index, but normal free T4 by equilibrium dialysis. Treatment of affected subjects with exogenous T4 or T3 led to gradual suppression of TSH secretion when the free level of T4 or T3 increased above normal. When total T4 was reduced toward normal by potassium iodide treatment or previous subtotal thyroidectomy, the findings suggested mild hormone deficiency. In affected subjects from all three families, equilibrium dialysis showed increased [125I]T4 binding, with evidence of abnormal high capacity binding when an excess of unlabeled T4 was added. In contrast, T3 binding showed no major abnormality. Serum concentrations of T4-binding globulin, prealbumin, and albumin were normal, but gel electrophoresis and immunoprecipitation of binding proteins indicated that 25-30% of tracer [125I]T4 was albumin bound (normal, 10-12%). Abnormal binding, studied by an adsorption separation system in the presence of T4 excess, was inhibited by increments of barbitone. These findings suggest that T4 excess is an appropriate response to abnormal T4 binding so as to maintain normal free T4. The excess bound T4 is associated with a normal quantity of albumin. The basis for increased T4-albumin binding remains to be determined.

Adolescent↗
PubMed1979

The course of untreated mild T3 toxicosis.

A selected group of 12 patients with mild T3 toxicosis, has been assessed without treatment during a period of from seven to 38 months. Progression to typical hyperthyroidism with combined T4 and T3 excess occurred in one case of solitary toxic adenoma, while a spontaneous remission with return of the thyrotropin response to thyrotropin-releasing hormone occurred in one patient with a diffuse goitre. The other 10 patients showed persistence of isolated high levels of T3 without clinical or biochemical progression. These findings suggest that progression to typical hyperthyroidism is infrequent in mild T3 toxicosis. Because of the possible adverse effects of therapy it may be appropriate to observe, rather than treat, some patients with mild clinical and biochemical features of hyperthyroidism.

Humans↗
PubMed1978

Hyperthyroidism without triiodothyronine excess: an effect of severe non-thyroidal illness.

Serial changes in thyroid hormone levels are described in two patients in whom hyperthyroidism was associated with transient non-thyroidal illness. In a 74-year-old woman with mild hyperthyroidism, two episodes of cholecystitis were associated with subnormal concentrations of serum T3 and increased concentrations of serum rT3; T3 became elevated during recovery, associated with a simultaneous fall in rT3. The TSH response to TRH was undetectable on three occasions. A cholecystectomy was performed after preparation with Lugol's iodine and subsequent tests showed evolution through T3 toxicosis to classical hyperthyroidism. In the second case, symptoms and signs of classical hyperthyroidism were noted during an undiagnosed illness characterized by severe abdominal pain and fever. Six days after the onset of this illness, an elevated level of serum T4 was associated with a normal total T3 concentration and increased concentration of rT3. After resolution of abdominal symptoms, serum T3 was markedly increased, associated with persistent T4 and rT3 excess. These findings indicate that the changes in T3 and reverse T3 described in non-thyroidal illness also occur in hyperthyroid patients, and suggest that the fall in T3 may be of sufficient magnitude to make T3 measurement diagnostically unreliable in the presence of non-thyroidal illness.

Adult↗
PubMed1977

The high prevalence of diabetes mellitus on a Central Pacific Island.

A diabetes prevalence study on an isolated urbanized Central Pacific Island has established a prevalence rate of 34.4% in individuals aged 15 years and over. Of these, 10.4% had previously known diabetes; in the others the diagnosis was made on the basis of a plasma glucose level of at least 160 mg/100 ml 2h after a 75 gm oral glucose load. A further 11.3% of the subjects had borderline diabetes as judged by a 2-h plasma glucose of between 140 and 159 mg/100 ml. Of the diabetics, 72% had a positive family history of diabetes. The high prevalence rate appears to be related to a number of factors including a diabetic genotype, urbanization, and obesity.

Adolescent↗
PubMed1976

The action and uses of insulin.

Diabetes is a metabolic state consequent upon insulin deficiency, in which catabolism exceeds anabolism. Where anabolism cannot be restored by dietary or oral agents, insulin treatment is necessary.

Diabetes Mellitus↗
PubMed1976

Principles of management of maturity onset diabetes.

By far the largest group of diabetics coming under treatment are those falling into the category maturity onset. While symptoms of thirst and polyuria, or symptoms or signs of complications may bring cases to attention, many are asymptomatic. The final proof, glycosuria being the presentation, should be sought by glucose tolerance test since it is essential to have confirmation of diagnosis prior to commitment by doctor and patient to life long treatment.

Diabetes Mellitus↗