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Biomedical subjects

R E Gilbert

Publications and source records attributed to R E Gilbert.

5 recordsLinked to original sources
PubMed1992

Semi-quantitative determination of microalbuminuria by urinary dipstick.

Microalbuminuria predicts subsequent clinical nephropathy and mortality in diabetic patients. This study was undertaken to determine the usefulness of a new immunochemical urinary dipstick test (Micral-Test, Boehringer Mannheim, GmbH Mannheim, Germany) in identifying urinary albumin concentrations within the microalbuminuric range (urinary albumin concentration 20-200 mg/L). Twenty-four hour urine specimens were collected from 298 consecutive diabetic outpatients. Micral-Test was performed by two laboratory scientists blinded to each other's results and those of radioimmunoassay (RIA) and immunoturbidimetry on the same specimen. When compared with RIA, Micral-Test had an overall sensitivity of 92.2%, specificity of 92.3% and positive predictive value of 86.4%. However, at the threshold value of 20 mg/1 Micral-Test showed false positive results in 37.8% of samples when compared with RIA. Similar results were obtained when Micral-Test was compared with immunoturbidimetry. We conclude that Micral-Test is a useful screening method for the detection of microalbuminuria. We suggest that positive tests be confirmed by a timed urine collection using established methodology and that patients whose Micral-Test is negative be subjected to annual retesting.

Albuminuria↗
PubMed1991

Relationship between ambulatory blood pressure and albuminuria in normal subjects.

Elevation of the urinary albumin excretion rate (AER) may be an important marker of vascular disease in nondiabetic as well as diabetic patients. Although hypertension is associated with an elevated AER, little is known regarding the relationship between AER and blood pressure in normal subjects. We studied 13 healthy, normotensive, nondiabetic subjects over 48 h. Urine was collected every 2 h and blood pressure was measured half hourly during the day using an ambulatory sphygmomanometric device. Overnight, blood pressure was measured hourly and a single overnight urine collection was obtained. Daytime blood pressures were higher than those overnight for systolic (122 +/- 9 v 105 +/- 8, P less than .01), diastolic (122 +/- 9 v 105 +/- 8, P less than .01) and mean arterial pressures (92 +/- 7 v 78 +/- 6 mm Hg, P less than .01). Similarly, AER fell overnight [day 5.9 (3.8 to 9.5) v night 3.6 (2.3 to 5.2) micrograms/min, median (interquartile range), P less than .01]. In the majority of subjects there was a significant positive correlation between AER and systolic (N = 9), diastolic (N = 10), and mean (N = 10) arterial pressure. We conclude that systemic blood pressure may influence AER in normal subjects.

Adult↗
PubMed1991

Inherited metabolic diseases in the sudden infant death syndrome.

All sudden, unexpected infant deaths presenting during a two year period within a defined geographical area in Avon and north Somerset were investigated for inherited metabolic disease. Of 95 deaths, 88 were classified as cases of sudden infant death syndrome (SIDS). In addition to the normal postmortem investigations, samples of cerebrospinal fluid, urine, vitreous humour, and skin were collected for metabolic studies. No abnormal organic acid metabolites were found in the fluids from the 88 cases of SIDS. Fatty acid oxidation was assessed in skin fibroblasts from 70 cases of SIDS, but no examples of medium chain acyl CoA dehydrogenase (MCAD) deficiency were found. One case with abundant glycogen in the liver was subsequently diagnosed as having glycogen storage disease type 1c. These findings suggest that the incidence of MCAD deficiency and other metabolic diseases in SIDS is much lower than previously claimed.

Acyl-CoA Dehydrogenase↗
PubMed1991

Baby Check and the Avon infant mortality study.

Thirty seven sudden, unexpected infant deaths from the Avon study were scored retrospectively for serious illness using a modified version of Baby Check. Three cases (8%) scored very highly. In a small proportion of sudden deaths, Baby Check could have identified serious illness before death and led to hospital admission.

Humans↗