11 results on '"Atkinson AB"'
Search Results
2. Effects of low dose versus conventional dose thiazide diuretic on insulin action in essential hypertension.
- Author
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Harper R, Ennis CN, Sheridan B, Atkinson AB, Johnston GD, and Bell PM
- Subjects
- Bendroflumethiazide therapeutic use, Blood Pressure drug effects, Dose-Response Relationship, Drug, Double-Blind Method, Female, Humans, Hypertension drug therapy, Hypertension physiopathology, Liver metabolism, Male, Middle Aged, Potassium metabolism, Bendroflumethiazide administration & dosage, Hypertension metabolism, Insulin metabolism
- Abstract
Objective: To see whether low dose thiazide diuretics given to patients with essential hypertension might avoid the adverse metabolic consequences seen with conventional doses., Design: Double blind randomised crossover study of two 12 week treatment periods with either low dose (1.25 mg) or conventional dose (5.0 mg) bendrofluazide given after a six week placebo run in period., Setting: Outpatient clinics serving the greater Belfast area., Subjects: 16 white non-diabetic patients (9 male) under 65 with essential hypertension recruited from general practices within the greater Belfast area., Main Outcome Measures: Systolic and diastolic blood pressure and peripheral and hepatic insulin action., Results: One man failed to complete the study. There were no differences between doses in their effects on systolic and diastolic blood pressure. Bendrofluazide 1.25 mg had substantially less effect on serum potassium concentration than the 5.0 mg dose. There were no intertreatment differences in fasting glucose, insulin, cholesterol, and triglyceride concentrations. Bendrofluazide 5.0 mg significantly increased postabsorptive endogenous glucose production compared with baseline (mean 10.9 (SD 1.2) v 10.0 (0.8) mumol/kg/min), whereas bendrofluazide 1.25 mg did not. Postabsorptive endogenous glucose production was significantly higher with bendrofluazide 5.0 mg compared with 1.25 mg (10.9 (1.2) v 9.9 (0.8) mumol/kg/min) but was suppressed to a similar extent after insulin (bendrofluazide 5.0 mg 2.8 (1.5) mumol/kg/min v bendrofluazide 1.25 mg 2.2 (1.5) mumol/kg/min). Exogenous glucose infusion rates required to maintain euglycaemia were not significantly different between doses and were similar to baseline., Conclusions: Bendrofluazide 1.25 mg is as effective as conventional doses but has less adverse metabolic effect. In contrast with conventional doses, low dose bendrofluazide has no effect on hepatic insulin action. There is no difference between low and conventional doses of bendrofluazide in their effect on peripheral insulin sensitivity.
- Published
- 1994
- Full Text
- View/download PDF
3. Insulin resistance in offspring of hypertensive parents.
- Author
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Beatty OL, Harper R, Sheridan B, Atkinson AB, and Bell PM
- Subjects
- Adolescent, Adult, Blood Glucose analysis, Female, Glucose Tolerance Test, Humans, Hypertension blood, Insulin blood, Male, Risk, Hypertension genetics, Insulin Resistance genetics
- Abstract
Objective: To determine if insulin resistance is present in normotensive adults at increased risk of developing hypertension., Design: Normotensive subjects with at least one hypertensive parent were paired with offspring of normotensive parents (controls), being matched for age, sex, social class, and physical activity., Setting: Outpatient clinic., Subjects: 30 paired subjects (16 men and 14 women) with and without a family history of hypertension, aged 18-32, with a body mass index < 25 kg/m2, with blood pressure < 130/85 mm Hg, and not taking drugs., Interventions: Euglycaemic glucose clamp (two hour infusion of insulin 1 mU/kg/min) and intravenous glucose tolerance test (injection of 100 ml 20% glucose)., Main Outcome Measures: Insulin mediated glucose disposal and insulin secretion., Results: The offspring of hypertensive parents had slightly higher blood pressure than did the controls (mean 117 (SD 6) v 108 (5) mm Hg systolic, p = 0.013; 76 (7) v 67 (6) mm Hg diastolic, p = 0.017). Their insulin mediated glucose disposal was lower than that of controls (29.5 (6.5) v 40.1 (8.6) mumol/kg/min, p = 0.002), but, after adjustment for blood pressure, the difference was not significant (difference 6.9 (95% confidence interval -1.5 to 15.3), p = 0.10). Insulin secretion in the first hour after injection of glucose was slightly but not significantly higher in the offspring of hypertensive patients (9320 (5484) v 6723 (3751) pmol.min/l). The two groups had similar concentrations of plasma glucose (5.2 (0.3) v 5.1 (0.4) mmol/l), serum cholesterol (4.4 (0.8) v 4.6 (0.8) mmol/l), serum triglyceride (0.89 (0.52) v 0.68 (0.27) mmol/l), and serum low density lipoprotein cholesterol (2.81 (0.65) v 2.79 (0.61) mmol/l). The offspring of hypertensive parents, however, had lower serum concentrations of high density lipoprotein cholesterol (1.24 (0.31) v 1.56 (0.35) mmol/l, p = 0.002) and higher serum concentrations of non-esterified fatty acids (0.7 (0.4) v 0.4 (0.4) mmol/l, p = 0.039)., Conclusions: Young normotensive subjects who are at increased risk of developing hypertension are insulin resistant.
- Published
- 1993
- Full Text
- View/download PDF
4. Captopril in renovascular hypertension: long-term use in predicting surgical outcome.
- Author
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Atkinson AB, Cumming AM, Lever AF, Morton JJ, Brown JJ, Fraser R, Leckie B, and Robertson JI
- Subjects
- Humans, Hypertension, Renovascular surgery, Captopril therapeutic use, Hypertension, Renal drug therapy, Hypertension, Renovascular drug therapy, Proline analogs & derivatives
- Published
- 1982
- Full Text
- View/download PDF
5. Unusual presentations of acanthosis nigricans and insulin resistance in a brother and sister.
- Author
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Ritchie CM, Walshe K, Kennedy AL, Andrews WJ, Atkinson AB, Sheridan B, and Traub AI
- Subjects
- Acanthosis Nigricans blood, Acanthosis Nigricans immunology, Adult, Antibody Specificity, Female, Humans, Hypogonadism blood, Hypogonadism genetics, Male, Prolactin blood, Syndrome, Acanthosis Nigricans genetics, Insulin Resistance
- Published
- 1985
- Full Text
- View/download PDF
6. Captopril in renovascular hypertension: long-term use in predicting surgical outcome.
- Author
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Atkinson AB, Brown JJ, Cumming AM, Fraser R, Lever AF, Leckie BJ, Morton JJ, and Robertson JI
- Subjects
- Adolescent, Adult, Aldosterone blood, Angiotensin I blood, Angiotensin II blood, Captopril adverse effects, Female, Humans, Hypertension, Renovascular drug therapy, Kidney surgery, Male, Middle Aged, Preoperative Care, Prognosis, Renin blood, Captopril therapeutic use, Hypertension, Renal surgery, Hypertension, Renovascular surgery, Proline analogs & derivatives
- Abstract
The angiotensin converting-enzyme inhibitor captopril was used as long-term preoperative treatment in a series of hypertensive patients with unilateral renal arterial disease. There were immediate and sustained falls in plasma angiotensin II and aldosterone concentrations, with converse increases in circulating renin and angiotensin I. In patients with sodium and potassium deficiency and secondary aldosterone excess before treatment captopril corrected the sodium and potassium deficits; in these cases the initial hypotensive response was profound but the later effect was less pronounced. When sodium and potassium state was initially normal it remained unchanged during captopril treatment, while the full hypotensive effect took up to three weeks to be attained. The immediate, but not long-term, falls in arterial pressure with captopril were proportional to the immediate decrements of plasma angiotensin II. Nevertheless, while the immediate blood-pressure reduction with captopril variously overestimated and underestimated the eventual surgical response, the absolute blood-pressure values during long-term captopril related well with those after operation. Pretreatment plasma renin and angiotensin II concentrations, while closely predicting the immediate captopril response, are fallible guides to surgical prognosis. In contrast, long-term treatment with converting-enzyme inhibitors may provide an accurate indication of surgical outcome.
- Published
- 1982
- Full Text
- View/download PDF
7. Motor vehicle driving among diabetics taking insulin and non-diabetics.
- Author
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Stevens AB, Roberts M, McKane R, Atkinson AB, Bell PM, and Hayes JR
- Subjects
- Adolescent, Adult, Aged, Attitude to Health, Diabetes Mellitus, Type 1 drug therapy, Diabetes Mellitus, Type 1 psychology, Humans, Hypoglycemia complications, Insurance, Accident, Jurisprudence, Middle Aged, Northern Ireland, Retrospective Studies, Visual Perception, Accidents, Traffic statistics & numerical data, Diabetes Mellitus, Type 1 complications, Insulin therapeutic use
- Abstract
Objective: To determine whether rates of road traffic accidents were higher in diabetics treated with insulin than in non-diabetic subjects., Design: Controlled, five year retrospective survey., Setting: Diabetic, dermatology, and gastroenterology outpatient clinics., Patients: 596 Diabetics treated with insulin (354 drivers) aged 18-65 attending two clinics and 476 non-diabetic outpatients (302 drivers)., Main Outcome Measures: Rates of accidents in diabetic and non-diabetic subjects., Results: A self completed questionnaire was used to record age, sex, driving state, and rates of accidents and convictions for motoring offences among diabetic and non-diabetic volunteers. For the diabetic volunteers further information was obtained on treatment, experience of hypoglycaemia, and declaration of disability to the Driving and Vehicle Licensing Centre and their insurance company. Accident rates were similar (81 (23%) diabetic and 76 (25%) non-diabetic drivers had had accidents in the previous five years). A total of 103 diabetic drivers had recognised hypoglycaemic symptoms while driving during the previous year. Only 12 reported that hypoglycaemia had ever caused an accident. Overall, 249 had declared their diabetes to an insurance company. Of these, 107 had been required to pay an increased premium, but there was no excess of accidents in this group., Conclusions: Diabetic drivers treated with insulin and attending clinics have no more accidents than non-diabetic subjects and may be penalised unfairly by insurance companies.
- Published
- 1989
- Full Text
- View/download PDF
8. Serum cortisol concentrations during low dose dexamethasone suppression test to screen for Cushing's syndrome.
- Author
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Kennedy L, Atkinson AB, Johnston H, Sheridan B, and Hadden DR
- Subjects
- Adolescent, Adult, Aged, Cushing Syndrome blood, Cushing Syndrome urine, Female, Humans, Hydrocortisone urine, Male, Middle Aged, Cushing Syndrome diagnosis, Dexamethasone administration & dosage, Hydrocortisone blood, Pituitary-Adrenal Function Tests
- Abstract
Forty four subjects (23 obese controls, 11 patients with possible Cushing's syndrome, and 10 patients with definite Cushing's syndrome) underwent low dose (0 X 5 mg every six hours for two days) dexamethasone suppression tests during which serum cortisol concentration at 0800 and excretion of urinary free cortisol over 24 hours were measured. Serum cortisol concentration fell to below 60 nmol/1 (2 X 2 micrograms/100 ml) in 31 subjects and remained above 250 nmol/1 (9 X 1 micrograms/100 ml) in the 13 others. Excretion of urinary free cortisol showed a similar response, falling to below 110 nmol (40 micrograms)/24 h in 31 and remaining above 180 nmol (65 micrograms)/24 h in the 13 others. There was complete concordance between the two variables in terms of the pattern of response. Serum cortisol concentration fell to below 60 nmol/1 (2 X 2 micrograms/100 ml) in at least 97% (31 of a possible 32) of subjects without Cushing's syndrome. On the other hand, a serum cortisol concentration of above 250 nmol/1 (9 X 1 micrograms/100 ml) after low dose dexamethasone gave a false positive diagnosis of Cushing's syndrome in at most only one of 13 patients (7 X 7%). Measurement of serum cortisol concentration during the low dose dexamethasone test is simpler than, and as accurate and reliable as, measurements of urinary steroids.
- Published
- 1984
- Full Text
- View/download PDF
9. Five cases of cyclical Cushing's syndrome.
- Author
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Atkinson AB, Kennedy AL, Carson DJ, Hadden DR, Weaver JA, and Sheridan B
- Subjects
- Adrenocorticotropic Hormone blood, Adult, Aged, Bromocriptine therapeutic use, Child, Preschool, Creatinine urine, Cushing Syndrome blood, Cushing Syndrome drug therapy, Cyproheptadine therapeutic use, Dexamethasone pharmacology, Female, Humans, Hydrocortisone blood, Hydrocortisone urine, Male, Cushing Syndrome urine, Periodicity
- Abstract
Reported cases of cyclical Cushing's syndrome are rare. Of 14 successive patients with Cushing's syndrome nine collected sequential urine samples for the estimation of cortisol:creatinine ratio. Five had cyclical Cushing's syndrome while two had considerable variation in urinary cortisol excretion without a cyclical pattern being established. Two of the five patients with a cyclical syndrome had paradoxical responses to dexamethasone. In only one patient with a cyclical pattern did the cortisol:creatinine ratio fall after treatment with bromocriptine or cyproheptadine, or both. The high incidence of the cyclical form of Cushing's syndrome has important clinical implications. A high index of suspicion of the syndrome is required in patients with symptoms or signs of Cushing's syndrome but with normal cortisol values, in patients with fluctuating cortisol values, and in patients with anomalous responses to dexamethasone. Because of possible variations in steroidogenesis the results of drug studies in Cushing's syndrome must be interpreted cautiously.
- Published
- 1985
- Full Text
- View/download PDF
10. Changes in glucose tolerance and development of gall stones during high dose treatment with octreotide for acromegaly.
- Author
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McKnight JA, McCance DR, Crothers JG, and Atkinson AB
- Subjects
- Adult, Cholelithiasis diagnosis, Humans, Octreotide administration & dosage, Prospective Studies, Ultrasonography, Acromegaly drug therapy, Blood Glucose analysis, Cholelithiasis chemically induced, Octreotide adverse effects
- Published
- 1989
- Full Text
- View/download PDF
11. Insulinoma (apud cell carcinoma) in a diabetic.
- Author
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Atkinson AB, Buchanan KD, Carson DJ, Kennedy T, O'Hare MM, Sloan JM, and Hadden DR
- Subjects
- Adult, Humans, Insulin blood, Male, Pancreatic Polypeptide analysis, Adenoma, Islet Cell complications, Apudoma complications, Diabetes Complications, Pancreatic Neoplasms complications
- Published
- 1978
- Full Text
- View/download PDF
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