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Biomedical subjects

R S Scott

Publications and source records attributed to R S Scott.

At least 19 recordsLinked to original sources
PubMed1992

Prevalence of diabetes mellitus in an ambulant elderly New Zealand population.

The prevalence of diabetes mellitus (both known and previously undiagnosed) was studied in a population sample, predominantly Caucasoid and resident in the community with an age/sex distribution representative of the New Zealand population aged 65 + years, using WHO criteria. The population sample was randomly selected from the age/sex register of a large urban medical centre in Christchurch, New Zealand. Three hundred and sixty-nine subjects (participation rate 69.4%) were screened by casual glucose and glycated haemoglobin measurement, followed by oral glucose tolerance testing (OGTT) if one or both were elevated. The minimum prevalence rate of diabetes in the study sample was 17.2 +/- 3.3% in men and 12.5 +/- 2.2% in women (since not all patients underwent OGTT). The rate was only significantly higher in men than women in the 70-74 year age group (P less than 0.01). The combined age-adjusted prevalence rates for the New Zealand elderly are estimated to be 9.9% known diabetes, 5.0% previously undiagnosed, with the total prevalence rate 14.9%. Newly diagnosed subjects had a significantly higher body mass index than known diabetic or non-diabetic subjects (P less than 0.01). Eighty-two percent of newly diagnosed subjects had visited their general practitioner at least once during the previous 6 months. Measurement of glycated haemoglobin had a greater positive predictive value than casual blood glucose in the detection of new cases. There was no difference in frequency of attendance with general practitioners or in hospital admission rates between non-diabetic patients, or those with known or newly diagnosed diabetes. This study suggests that diabetes mellitus may be a prevalent disorder amongst the New Zealand elderly.

Age Factors↗
PubMed1992

Plasma non-cholesterol sterols in patients with non-insulin dependent diabetes mellitus.

Plasma plant sterol concentrations (an index of cholesterol absorption efficiency) and plasma lathosterol concentration (an index of cholesterol synthesis rate) were measured in 52 patients with non-insulin dependent diabetes mellitus (NIDDM) and 36 non-diabetic controls. Plasma plant sterol concentrations were significantly (P less than 0.01) lower in diabetic patients (campesterol: men -36%, women -48%; betasitosterol: men -35%, women -42%). Fasting serum insulin levels were inversely correlated with plasma plant sterol concentrations in diabetic patients (campesterol: r = -0.347, P = 0.012; betasitosterol: r = -0.345, P = 0.012) and in non-diabetic men (campesterol: r = -0.578, P = 0.039; betasitosterol: r = -0.702, P = 0.008). Serum insulin levels were also correlated significantly with plasma lathosterol concentration in diabetic patients (r = 0.295, P = 0.034). The results of this study suggest that absorption of plant sterols and possibly cholesterol from the diet may be reduced in hyperinsulinemic diabetics.

Adult↗
PubMed1992

Temporal variation in incidence of IDDM in Canterbury, New Zealand.

OBJECTIVES: To establish the statistical significance of observed variations over the last decade in the incidence of insulin-dependent diabetes mellitus (IDDM) in the 0- to 19-yr-old age-group and to determine whether incidence has increased in Canterbury, New Zealand. RESEARCH DESIGN AND METHODS: The Canterbury, New Zealand, Diabetes Registry has recorded all incidence cases of diabetes mellitus prospectively since 1982. All IDDM subjects aged 0-19 yr at diagnosis and using insulin are included in the study. Ascertainment is believed to be 100%. Prevalence was recorded at 1 January 1982 and 1 January 1990. Annual incidence for 1982-1990 was determined using age and sex cross-sectional census population denominators. The statistical significance of temporal, age, sex, and seasonal variations in incidence rates was ascertained by Poisson regression models (GLIM statistical software). RESULTS: Prevalence on 1 January 1990 was 115/100,000. Incidence rates during the 9 yr were periodic, with two major peaks--one in the early 1980s, the other in 1989 continuing into 1990. The temporal variation (P less than 0.02) was not age or sex specific. Incidence rates for boys were three- to fourfold higher during peak versus trough years, with a peak level of 20.7/100,000 in 1990. For girls, there was less variation, with a peak rate of 21.6/100,000 in 1990. There has been no significant increase in IDDM incidence over time. The mean rate of incidence across all age-groups for 1982-1990 was 12.7/100,000 person-yr. A significant seasonal association to the onset of IDDM was found only in boys, with incidence rates being significantly higher in winter than in summer (P less than 0.01). CONCLUSIONS: IDDM in Canterbury, New Zealand, presents in cycles of incidence peaks and troughs, each spanning 2-3 yr.

Adolescent↗
PubMed1991

Simvastatin and side effects.

OBJECT: to investigate the symptomatic and biochemical side effect profile of simvastatin (a new cholesterol lowering drug) following routine use in a specialist hospital outpatient clinic. METHODS: all patients (n = 110) newly commenced on simvastatin at the lipid disorders clinic at the Princess Margaret Hospital in the first ten months of prescription availability were asked to complete a side effects questionnaire and biochemical evaluation at six months of therapy. RESULTS: 76.4% of patients reported experiencing no side effects with 8% of patients spontaneously reporting feeling better since commencing therapy. Nineteen point one percent of patients reported experiencing symptoms they attributed to simvastatin but had continued therapy, while a further 4.5% of patients had withdrawn from therapy because of side effects. The most frequently reported side effects were muscle ache (13.6%), and gastrointestinal symptoms (4.5%). No abnormalities in biochemical safety tests occurred. CONCLUSIONS: the rate of side effects reported with prescription use exceeds that previously encountered in clinical trials. Since simvastatin is considered effective and well tolerated it is likely to receive wide acceptance in the management of high risk hypercholesterolaemic patients. However, this study indicates the need for continued physician awareness of the main symptoms and their frequency amongst those treated with simvastatin.

Adult↗
PubMed1991

Treatment of primary hypercholesterolaemia with simvastatin. New Zealand multicentre evaluation.

OBJECTIVE: To assess the efficacy of simvastatin in a large patient cohort. DESIGN: In an open multicentre study, after a four week placebo phase, patients were treated with simvastatin for 24 weeks; a subgroup continued therapy for a further 24 weeks. Efficacy of simvastatin (a) with prolonged use over three years, and (b) in combination with bezafibrate was assessed in an open single site study. SETTING: Lipid or cardiology specialist hospital outpatient clinics. PATIENTS: For the open multicentre study, 228 patients with primary hypercholesterolaemia (total cholesterol level greater than 6.5 mmol/L) were recruited, of whom 224 met entry criteria and completed the study. Forty-seven of these patients continued therapy for one year. In the open single site study, 22 patients (with low density lipoprotein [LDL] cholesterol levels greater than 4.3 mmol/L) participated in studies of long term use (n = 9) or of combined therapy (n = 13). INTERVENTION: Therapy in the open multicentre study began with 10 mg of simvastatin per day, doubling to 20 mg after six weeks and then 40 mg after 12 weeks of therapy if total cholesterol levels persisted above 5.2 mmol/L. In the study of long term use, simvastatin (40 mg daily) was taken continuously over three years. In the study of combination therapy, bezafibrate (600 mg daily) was taken in addition to simvastatin (40 mg daily) for 10 months. MAIN OUTCOME MEASURES: Plasma lipid and lipoprotein concentrations. RESULTS: In the multicentre study, total plasma cholesterol levels were reduced by 32.8% from 9.11 +/- 1.84 (in mmol/L, mean +/- SD) to 6.12 +/- 1.25 (P less than 0.001), and LDL cholesterol levels by 41.4% from 6.90 +/- 1.92 to 4.04 +/- 0.31 (P less than 0.001). The effect of therapy was sustained in those patients continuing therapy to 48 weeks. The study of long term use found no significant attenuation of effect over three years of monotherapy. Combined simvastatin/bezafibrate therapy reduced the LDL cholesterol concentration by a further 19.9% (P less than 0.001) from levels achieved on simvastatin alone. CONCLUSIONS: Simvastatin is an effective, well tolerated lipid lowering drug, without significant attenuation of effect with prolonged use. Simvastatin plus bezafibrate appears to be a potentially useful drug combination.

Adult↗
PubMed1991

Oat bran and cholesterol reduction: evidence against specific effect.

Most placebo-controlled studies testing the hypo-cholesterolaemic action of oat bran have compared high fibre against low fibre diets. To determine whether oat bran had greater cholesterol-lowering action than another source of fibre (wheat bran) we compared the effect of breads of similar total fibre content containing either oat bran or additional wheat bran. Twelve hyperlipidaemic subjects (38-66 years) were stabilised on lipid-lowering diets for at least three months prior to the study. Subjects were given each type of bread for four-week periods in a single-blind, cross-over design. Cholesterol, triglyceride and LDL-cholesterol levels did not change significantly during the oat and wheat bread periods. HDL-cholesterol rose equivalently but only to a just significant level during the oat bran diet. Body weights, lipids and lipoprotein parameters were not significantly different between the two diet periods. Both diet treatments lowered serum cholesterol approximately 4%. We conclude that this oat bran bread consumed as part of a lipid-correcting diet did not influence lipoproteins to any greater extent than wheat bread of similar total fibre content.

Adult↗
PubMed1991

Prevalence and incidence of insulin-treated diabetes mellitus in adults in Canterbury, New Zealand.

A population-based diabetes register showed a prevalence of insulin-treated diabetes mellitus (n = 1148) in Canterbury, New Zealand, of 3.3 per 1000 population at 1 January 1984. Median age was 52 years, with equal sex distribution. Eleven percent were aged 0-19 years. Prevalence was highest in those aged 50 years or more, reaching 7.6 per 1000 in the 70-79 years age group. Only 28% of cases presented with diabetes under 20 years of age. Of those diagnosed in adulthood, only 17% did not commence insulin therapy as their permanent treatment modality within 12 months post-diagnosis. Incidence of new insulin-requiring diabetic cases between 1981 and 1986 (excluding persons commencing insulin more than 12 months after diagnosis) was 12.8 per 100,000 per year. There were two incidence peaks, one in adolescence (16.9 per 100,000), the other in the older age group. Rates in the elderly peaked at 25.9 per 100,000 for males aged 60-69 years, and at 19.5 per 100,000 for females aged 70 or more years. Only 83 of the 268 new cases starting insulin within this period were 0-19 years of age. Based on prevalence surveys of diabetes mellitus in Canterbury, New Zealand, it was determined that 14.3% of all known adult diabetic people were insulin-treated.

Adult↗
PubMed1989

Simvastatin (MK 733): an effective treatment for hypercholesterolemia.

This study describes the efficacy of the drug simvastatin. It is likely to be the first HMG CoA reductase inhibitor in Australia and New Zealand available for the treatment of hyperlipidemia. Twenty-four patients, 12 men and 12 women with primary hypercholesterolemia were randomly allocated to treatment by cholestyramine (eight patients) or to simvastatin (16 patients) for a 12-week period. With simvastatin, total cholesterol levels decreased by 37.5% from a baseline mean of 10.33 mmol/L to 6.4 mmol/L after 12 weeks. Low density lipoprotein (LDL) cholesterol concentration decreased by 48.2% from 8.40 mmol/L to 4.39 mmol/L. These effects were better than observed for cholestyramine alone where cholesterol and LDL-cholesterol reductions were 24.9% and 33.1% respectively. Thirteen patients, however, did not achieve target LDL levels of 3.62 mmol/L, or below, and therefore were treated with a combination of cholestyramine and simvastatin, resulting in a decrease of total cholesterol and LDL-cholesterol by 45.5% and 53.5% of baseline values studied over an eight-week period. No major clinical side-effects were encountered. One patient appeared to have had a change in colour vision at the end of the study at 20 weeks, without loss of visual acuity.

Adult↗
PubMed1989

Treatment of hyperlipidaemia with acipimox.

In an open, uncontrolled study, the hypolipidaemic effect of acipimox was evaluated in 34 patients with Types IIa, IIb, IV or V hyperlipidaemia. Doses of 250 mg twice daily or 250 mg 3-times daily were maintained over a 12-week treatment period. The reduction in total plasma cholesterol levels was small and not statistically significant; however, significant increases in high density lipoproteins were achieved. Triglyceride levels were significantly lowered in patients with Type IV hyperlipidaemia. Acipimox was well tolerated by patients and no biochemical or haematological changes were noted. Considerable resolution in tubo-eruptive xanthomata was observed in 1 patient with Type V hyperlipidaemia.

Adult↗
PubMed1987

Diabetic focal myelopathy.

The existence of myelopathy as a complication of diabetes is debatable and, in the few reported cases, spinal involvement has been diffuse. We describe 2 cases of focal myelopathy. Two insulin-dependent, middle-aged men with adult-onset diabetes presented with gradually ascending lower limb pain and numbness without sphincteric symptoms. Examination showed mixed upper and lower motor signs in the lower limbs, with a severe impairment of cutaneous sensation below a sharply demarcated band at the T9-10 level with relative preservation of posterior column function. Myelography was normal. CSF showed mild elevation of protein and in one case showed 23 x 10(6) white cells/L. Nerve conduction studies showed a co-existing, mild sensorimotor neuropathy. There was no evidence of truncal radiculopathy on paraspinal EMG. Extensive investigation for other causes of myelopathy was negative.

Adult↗
PubMed1986

Diabetes awareness.

Explore the source record for details and available documents.

Diabetes Mellitus↗
PubMed1986

Complications resulting from spurious fields produced by a microwave applicator used for hyperthermia.

Microwave hyperthermia applicators are generally characterized at two or three frequencies. These frequencies usually are at the extremes of the applicator's operating range. However, such applicators are often used at arbitrary frequencies within their range. The most common reason for choice of frequency is to achieve acceptable coupling in the clinical configuration with a given patient. Occasionally a spurious transmission pattern will result from the frequency chosen that can lead to undetected high power densities well away from the target volume. In the present report, such a situation is discussed. The transmission pattern resembled "horns" reported at the field edge of certain accelerators. This pattern resulted in the inability to heat the target volume and the production of thermal blisters outside that volume. Such an occurrence underscores the need to characterize the transmission characteristics of a microwave hyperthermia applicator at all the frequencies used.

Diathermy↗