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Patrick Manning

Publications and source records attributed to Patrick Manning.

6 recordsLinked to original sources
PubMed2005

Evaluation of diabetes care in the Otago region using a diabetes register, 1998-2003.

AIM: To assess changes in diabetes care between 1998 and 2003 using data from the Otago Diabetes Register. METHODS: A regional diabetes register was established in 1998 to monitor diabetes care in the Otago region, New Zealand. Cross-sectional data relating to process and outcome measures were collected annually from participating general practices, 93% of general practitioners in the region. Generalised estimating equations with robust standard errors were used to test for trends in clinical measures across the study period. RESULTS: Process measures improved dramatically over the 6-year period. The proportion of patients prescribed ACE inhibitors and other antihypertensives increased markedly (32.3-52.4% and 13.2-27.1%, respectively) and both mean systolic and diastolic blood pressure decreased significantly (140.6-137.0 mmHg, p < 0.001 and 78.6-77.0 mmHg, p < 0.001, respectively). The proportion prescribed lipid lowering medication more than trebled (12.4-40.0%), while mean lipid levels improved significantly (total cholesterol: 5.94-5.21 mmol/l, p < 0.001, HDL-cholesterol: 1.23-1.28 mmol/l, p < 0.001 and triglycerides: 2.17-1.94 mmol/l, p < 0.001). Mean weight increased significantly, as did HbA1c in all treatment groups except type 2 diabetic patients treated with combined insulin and oral hypoglycaemic agents. CONCLUSIONS: At a population level appreciable improvements in blood pressure and lipid control were observed, but not glycaemic control, probably due to insufficient attention to necessary lifestyle changes.

Aged↗
PubMed2005

A cluster of thyrotoxicosis associated with consumption of a soy milk product.

OBJECTIVE: To determine whether a New Zealand cluster of thyrotoxicosis with low uptake on scintiscan was associated with soy milk consumption. METHOD: A case-control study was conducted, with controls matched by age, sex, and region. RESULTS: All cases (5/5) and one control (1/30) consumed soy milk before the index date. The cases all drank a brand of soy milk that had unexpectedly high levels of iodine. In a simple unmatched unadjusted analysis, the lower bound of the 95% confidence interval for the odds ratio was 19. CONCLUSION: This cluster was associated with consumption of a soy milk product. The thyrotoxicosis was probably due to iodine-induced thyrotoxicosis. IMPLICATIONS: This investigation raises issues about quality control in manufacturing processes and the monitoring of food products for their safety. It also raises issues about public and health professional awareness of the potential health effects from food additives in some processed foods.

Case-Control Studies↗
PubMed2005

[18F]fluoro-2-deoxy-D-glucose ([18F]FDG) positron emission tomography imaging of thymic carcinoid tumor presenting with recurrent Cushing's syndrome.

We report a case of a young woman with Cushing's syndrome (CS), in whom although endocrine investigations and negative pituitary imaging were suggestive of ectopic ACTH secretion, the results of inferior petrosal sinus (IPS) sampling after coricotropin-releasing hormone (CRH) stimulation were suggestive of pituitary ACTH hypersecretion. (111)In-labelled octreotide and high-resolution computer tomography (CT) revealed a lesion possibly responsible for the ACTH source in the thymus. Thymectomy confirmed concomitant ectopic CRH and probable ACTH production by a thymic neuroendocrine carcinoma. After an 8-year remission period the patient developed a clinical and biochemical relapse. A high-resolution computed tomography (CT) scan of the thorax showed a 2-cm nodule in the thymic bed, which was positive on a [(18)F]fluoro-2-deoxy-D-glucose ([(18)F]FDG) positron emission tomography (PET) scan. However, a repeated thymectomy did not result in remission. A repeat [(18)F]FDG PET study showed persistent disease in the thymic bed and also uptake in the adrenals. The patient underwent bilateral adrenalectomy, which resulted in clinical remission. A further [(18)F]FDG PET scan 8 months later showed no progression of the thymic tumor and confirmed complete excision of the adrenals. This is a rare case of concomitant CRH and ACTH secretion from a thymic carcinoid tumor; the case illustrates the usefulness of functional imaging with [(18)F]FDG PET in the diagnosis, management and follow-up of neuroendocrine tumors.

Adrenalectomy↗
PubMed2003

The deleted in colorectal carcinoma (DCC) gene 201 R --> G polymorphism: no evidence for genetic association with autoimmune disease.

The product of the deleted in colorectal carcinoma (DCC) gene has a role in apoptosis and is a positional candidate for IDDM6, the putative chromosome 18q12-q23 autoimmune disease locus. We hypothesised that a nonconservative substitution (DCC 201 R --> G; nucleotide (nt) 601 C --> G), located in an extracellular immunoglobulin-like domain of DCC, is an aetiological determinant of autoimmunity. We tested this hypothesis by genetically testing the nt 601 C --> G polymorphism for association with three autoimmune phenotypes in a large population-based case-control study. There was no evidence for association of DCC nt 601 C --> G with autoimmune disease in cohorts comprising 2253 subjects with rheumatoid arthritis, type I diabetes and Graves' disease, and 2225 control subjects, from New Zealand and the United Kingdom. Furthermore, using the transmission disequilibrium test, there was no significant evidence for biased transmission of the nt 601 C --> G polymorphism to probands within a 382 family type I diabetes affected sibpair cohort from the United Kingdom. Thus, the DCC 201 R --> G polymorphism does not appreciably influence risk of developing the autoimmune diseases tested.

Adult↗
PubMed2002

Establishing a regional diabetes register and a description of the registered population after one year.

AIM: To establish a regional diabetes register in order to determine baseline data with which to monitor diabetes care in Otago, New Zealand. METHODS: All general practitioners (GPs) in Otago were invited to participate in the project. Diabetic patients were identified from GP diabetes registers and invited to participate in the project. Written consent was obtained before any data were transferred from general practices to the Otago Diabetes Register. An Access-based computer programme was developed to record and analyse patient data. RESULTS: In 1998, 1693 consenting diabetic patients were enrolled on the Otago Diabetes Register. The ratio of male to female patients was almost 1:1; the median age was 67 years; 11.9% had Type 1 diabetes and 86.5% had Type 2 diabetes; 44.5% were treated with hypoglycaemic tablets only and 25.6% were treated with insulin only. For those aged over 16 years, the mean systolic BP was 140.6 mmHg and the mean diastolic BP was 78.7 mmHg. 65.4% had undergone a retinal examination within the previous two years and 36.2% a feet examination within the previous year. CONCLUSIONS: The 1998 data will be used to monitor changes in diabetic care over time. Ongoing patient recruitment and data collections will also assist with informing funding decisions for diabetes services and improving diabetes information in New Zealand.

Adolescent↗