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Biomedical subjects

R Elkeles

Publications and source records attributed to R Elkeles.

6 recordsLinked to original sources
PubMed2000

Workforce planning. Remote control.

The current system of medical manpower planning fails to balance doctors' training requirements with the demands of the NHS. Urgent action is needed to avoid a manpower crisis. Specialist registrars regularly have to leave their hospitals for training sessions, forcing the cancellation of sessional work. Hospital medicine is relying heavily on locums and doctors from abroad. Consultants should be given the junior support they need in order to provide a proper service, possibly through increasing the time spent at senior house officer level.

Consultants↗
PubMed1997

The ultrasonic evaluation of the carotid intima-media thickness and its relation to risk factors of atherosclerosis in normal and diabetic population.

High-resolution ultrasound provides an excellent tool for the non-invasive assessment of the severity of atherosclerosis. It allows the measurement of the common carotid artery (CCA) intima media thickness (IMT) which has been found to be a feasible and reliable method for the evaluation of the progression and regression of the disease. The aim of this study was to evaluate the influence of risk factors of atherosclerosis on the mean CCA IMT in both normal and non-insulin dependent diabetic (NIDDM) individuals and to determine the effect of diabetes as a major atherosclerotic risk factor on the CCA IMT. Four hundred and eighty-four subjects were studied, 244 normal individuals and 240 non insulin dependent diabetic patients. The right and left CCA IMT were measured using high resolution ultrasonography. Both in the normal and diabetic individuals, the mean CCA IMT was found to increase linearly with age (p < 0.01), was directly related to total serum cholesterol and triglyceride and inversely related to HDL-cholesterol (p < 0.01). Multiple linear regression analysis showed the most important risk factor influencing the CCA IMT and hence early athrosclerosis to be the presence of diabetes, followed by serum HDL-cholesterol (inverse relation), total cholesterol, age and serum triglyceride. This study has shown that high resolution ultrasonography can be used to evaluate the effect to risk factors on early atherosclerosis and could be used to monitor future clinical trails aiming to modify the progression of atherosclerosis in the population.

Adult↗
PubMed1994

Carotid intima-media thickness: correlation with the British Regional Heart Study risk score.

OBJECTIVES: The thickness of the intima-media (IMT) layer of the common carotid artery is a marker of severe and extensive coronary artery disease and it has been reported that it is related to the presence of risk factors for atherosclerosis. The purpose of this study was to establish whether the IMT correlates with the British Regional Heart Study (BRHS) risk score which identifies a large proportion of men who may experience a major ischaemic heart disease event within 5 years of initial screening. SUBJECTS: High resolution ultrasonography was used to measure the thickness of the intima-media layer in 89 individuals. The BRHS risk score of these individuals was also recorded. MAIN OUTCOME MEASURES: Correlation between the carotid IMT and the BRHS score. RESULTS: The IMT was linearly related to the BRHS score (r = 0.56; P < 0.001). There was a highly significant difference between the mean IMT in individuals with a risk score greater and those with a risk score lesser than the 80th percentile (P < 0.001). CONCLUSION: It is concluded that the IMT may be a useful surrogate end-point or biological marker of coronary artery disease and might be considered for use in prospective studies and clinical trials.

Adult↗
PubMedDate not supplied

The effects of gender and type of diabetes on HDL-cholesterol.

OBJECTIVE: To investigate the influence of gender and type of Diabetes on plasma lipoproteins and post-heparin plasma lipoprotein lipase and hepatic lipase activities. DESIGN AND PATIENTS: Cross sectional study of 22 lean Type 2 diabetic subjects (11 men, 11 women) individually matched for gender, BMI and HbA1 with 22 Type 1 (C-peptide negative) diabetic subjects. MEASUREMENTS: Samples were taken for fasting lipids and post heparin samples were obtained for estimation of post heparin lipolytic activity. RESULTS: In men, HDL-Cholesterol was higher in Type 1 diabetes [1.56 (range 0.97-2.27) vs 1.07 (0.54-1.78) mmol/l, p = 0.009] and this was reflected in both HDL2-cholesterol [0.42 (0.02-1.36) vs 0.22 (0.01-0.90) mmol/l, p = 0.05] and HDL3-cholesterol [1.00 (0.75-1.51) vs 0.72 (0.53-0.87) mmol/l, p = 0.02] subfractions while serum triglyceride concentrations were similar. Lipoprotein lipase activity was higher in men with Type 1 diabetes [16.2 (6.2-42.4) vs 9.77 (5.6-22.6) mmol/h/l, p = 0.02] while hepatic lipase activities were similar [15.7 (9.3-23.0) vs 14.0 (6.8-24.0) mmol/h/l, NS). In women, there were no significant differences between Type 1 and Type 2 diabetes in triglycerides, HDL-C, HDL2 or HDL3. Lipoprotein lipase activity was higher in Type 1 women [19.3 (14.1-35.7) vs 11.0 (7.2-15.2) mmol/h-1 1-1, p = 0.0006] but lipatic lipase activity was also higher [12.1 (4.8-20.5) vs 7.3 (2.3-21.4) mmol/h-1 1-1, p = 0.023]. CONCLUSION: In non-obese diabetic subjects, men with Type 1 diabetes have higher HDL-cholesterol than those with Type 2 diabetes, possibly due to the action of peripheral insulin on lipoprotein lipase activity, while in women, HDL-cholesterol concentrations were similar in Type 1 and Type 2 subjects possibly because of lowered lipatic lipase activity in Type 2 women which offsets the increased lipoprotein lipase activity of the Type 1 women.

Blood Glucose↗