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Aims: To explore the experiences and perceptions of gestational diabetes mellitus reported by women within online parental‐support forums and, specifically, to analyse what women say about a diagnosis of gestational diabetes, their future risk of type 2 diabetes, and lifestyle behaviour for management of gestational diabetes and prevention of type 2 diabetes. Methods: The discussion boards of two parenting websites (Mumsnet and Netmums) were searched using the search term 'gestational diabetes or GD' in February 2019. Relevant posts made by users with gestational diabetes on or after 1 January 2017 were retained for analysis. Framework analysis using pre‐existing framework from a previous study was used to organize and analyse the data. Results: A total of 646 posts generated by 282 unique users were included in the analysis. Analysis of the online content identified three important implicit messages that may be being conveyed to readers. The first is that gestational diabetes is not a serious diagnosis that warrants undue concern. Secondly, few users recognized the importance of their own behaviours or lifestyle, with others minimizing personal responsibility or attributing gestational diabetes to non‐modifiable factors. Finally, there was a lack of acknowledgment of heightened risk of type 2 diabetes. These three messages will all directly mitigate against the efforts of clinicians (and others) to encourage women with gestational diabetes to improve their lifestyle behaviours in the longer term. Conclusions: These findings highlight messages that are being widely disseminated and that are unlikely to support prevention of type 2 diabetes. What's new?: Perceptions of gestational diabetes mellitus (GDM) and future risk of type 2 diabetes have previously been explored in traditional research interviews. This study used data from online discussion boards, which may overcome some of the biases present in interviews with volunteer participants.The study highlighted messages potentially being widely disseminated which may be unhelpful in promoting type 2 diabetes prevention; for example, that women need not take personal responsibility for GDM and lack of acknowledgement of the heightened risk of type 2 diabetes.Clinicians need to be aware of these perceptions and address them where necessary. [ABSTRACT FROM AUTHOR]

Abstract: Aim: Women with gestational diabetes mellitus (GDM) are at increased risk of Type 2 diabetes. This study aimed to explore experiences, knowledge and perceptions of women with GDM to inform the design of interventions to prevent or delay Type 2 diabetes. Methods: Semi‐structured interviews were carried out with 16 women with GDM who were recruited from a clinic in one Scottish health board. A framework approach was used to manage and analyse data according to themes informed by psychological theory (self‐regulation model and theory of planned behaviour). Results: GDM is not seen as an important, or even real diagnosis among some women, and this perception may result from the perceived minimal impact of GDM on their lives. Some women did experience a bigger emotional and practical impact. Knowledge and understanding of Type 2 diabetes was poor in general and many women were unconcerned about their future risk. Lower concern appeared to be linked to a lower perceived impact of GDM. Lifestyle changes discussed by women mostly related to diet and were motivated primarily by concern for their baby's health. Many women did not maintain these changes postnatally, reporting significant barriers. Conclusions: This study has suggested potential avenues to be explored in terms of content, timing and potential recipients of interventions. Educational interventions postnatally could address illness perceptions in women with GDM and redress the situation where lack of aftercare downplays its seriousness. For lifestyle interventions, the child's health could be used as a motivator within the context of later joint or family interventions. [ABSTRACT FROM AUTHOR]

Exocrine pancreatic insufficiency ( EPI) is a digestive disorder resulting from the insufficient secretion of enzymes from the pancreas. In dogs, this condition is often attributed to pancreatic acinar atrophy, wherein the enzyme-producing acinar cells are believed to be destroyed through an autoimmune process. Although EPI affects many diverse breeds, to date, molecular studies have been limited to the German Shepherd dog. A recent study of major histocompatibility genes in diseased and healthy German Shepherd dogs identified both risk and protective haplotypes. Herein, we genotyped DLA- DQB1 in Pembroke Welsh Corgis to determine whether dog leukocyte antigen alleles contribute to the pathogenesis of EPI across dog breeds. We evaluated 14 affected and 43 control Pembroke Welsh Corgis, which were selected based on an age of onset similar to German Shepherd dogs. We identified one protective allele (odds ratio = 0.13, P-value = 0.044) and one risk allele (odds ratio = 3.8, P-value = 0.047). As in German Shepherd dogs, the risk allele is a duplication of DLA- DQB1 (alleles DQB1*013:03 and 017:01); however, Pembroke Welsh Corgis have acquired a single polymorphism on DQB1*017:01. Thus, the DLA- DQB1 duplication is a risk allele for EPI in at least two breeds. [ABSTRACT FROM AUTHOR]

Diabet. Med. 29, 792-795 (2012) Abstract Aim To characterize the numbers of reagent strips dispensed for self-monitoring of blood glucose to patients with Type 2 diabetes in Tayside, Scotland, in 1993, 1999 and 2009. Methods A diabetes clinical information system in Tayside, record-linked to electronic dispensed prescribing records, was used to collate all dispensed prescribing records for three cross-sectional samples of patients with Type 2 diabetes in 1993 ( n = 5728), 1999 ( n = 8109) and at 1 January 2009 ( n = 16 450). The numbers of reagent strips dispensed during the relevant calendar year were calculated and patients stratified by treatment. We also explored whether age, sex or material and social deprivation were associated with whether a patient received strips. Results Proportions of people who received self-monitoring reagent strips increased from 15.5% in 1993, to 24.2% in 1999 to 29.8% in 2009, as did numbers of strips dispensed. While the proportion of diet-treated patients who received reagent strips was still very low in 2009 (5.6%), the proportion among those treated with oral agents tripled from 9.4 to 27.4% between 1993 and 2009. Over 90% of patients treated with insulin received reagent strips and, among non-insulin-treated patients, this was more common among women, younger people and less deprived groups. Conclusions The numbers of reagent strips dispensed for self-monitoring of blood glucose has increased and almost all insulin-treated patients receive strips. While few diet-treated patients receive strips, they are more extensively dispensed to those treated with oral agents. Given that self-monitoring of blood glucose is no longer routinely recommended in non-insulin treated patients, strategies to reduce unnecessary dispensing of reagent strips are needed. [ABSTRACT FROM AUTHOR]

Objectives To compare the prevalence of use of potentially inappropriate medicines (PIMs) between older patients living in their own homes versus those living in nursing or residential homes, and to test the association between exposure to PIMs and mortality. Design Cohort study stratified by place of residence. Setting Tayside, Scotland. Participants All people aged between 66 and 99 years who were resident or died in Tayside from 2005 to 2006. Main outcome measures The exposure variable was PIM use as defined by Beers' Criteria. All cause mortality was the main outcome measure. Results 70 299 people were enrolled in the cohort of whom 96% were exposed to any medicine and 31% received a PIM. Place of residence was not associated with overall risk of receiving PIMs, adjusted OR 0.94, 95% CI 0.87 to 1.01. Exposure to five of the PIMs (including long-acting benzodiazepines) was significantly higher in nursing homes whereas exposure to five other PIMs (including amitriptyline and NSAIDs) was significantly lower. Exposure to PIMs was similar (20–46%) across all 71 general practices in Tayside and was not associated with increased risk of mortality after adjustment for age, gender and polypharmacy (adjusted OR 0.98, 95% CI 0.92 to 1.05). Conclusions The authors question the validity of the full list of PIMs as an indicator of safety of medicines in older people because one-third of the population is exposed with little practice variation and no significant impact on mortality. Future studies should focus on management of a shorter list of genuinely high-risk medicines. [ABSTRACT FROM PUBLISHER]

Diabet. Med. 27, 1124–1129 (2010) Aims To determine absolute and relative risks of all-cause and cardiovascular mortality among patients newly diagnosed with Type 2 diabetes. Methods In an observational cohort study using record-linkage databases, based in Tayside, Scotland, UK, we identified newly diagnosed patients with Type 2 diabetes in 1993–2004. We also identified a set of non-diabetic comparators from lists of patients registered with a general practice, individually matched to the diabetic patients by sex, age and deprivation. We followed up patients for mortality and cardiovascular mortality over a 12-year period and calculated hazard ratios using Cox regression. Results There were 10 532 patients with Type 2 diabetes and 21 056 non-diabetic comparators. Diabetic patients in every age/sex group had higher absolute mortality rates. Even taking deprivation into account, the hazard ratio for mortality was 1.32 (95% CI 1.25–1.40), decreasing to 1.15 (1.09–1.22) after adjusting for pre-existing cardiovascular disease. The hazard ratios for cardiovascular mortality were higher, decreasing from 1.51 (1.37–1.67) to 1.23 (1.11–1.36) after adjusting for pre-existing cardiovascular disease. The hazard ratios decreased with increasing age at diagnosis, although the difference in absolute rate of mortality increased slightly with age. Increased mortality risks were only evident 2 years after diagnosis and increased thereafter. Conclusions Patients with Type 2 diabetes have an increased risk of all-cause and cardiovascular mortality compared with non-diabetic comparators, although this is not observable immediately after diagnosis. Age at diagnosis and duration of the disease independently affect absolute and relative mortality risk. [ABSTRACT FROM AUTHOR]

Analysis of a diabetes clinical information system in Tayside, Scotland, shows that a significant proportion of insulin-treated patients with diabetes are not self-monitoring blood glucose according to current clinical guidance and recommendations, with some not self-monitoring their blood glucose at all. Although there has been an increase in the number of reagent strips dispensed over the past decade, this increase is mainly accounted for by increased testing frequency among people with diabetes already testing. [ABSTRACT FROM AUTHOR]

Our recent paper advocating adaptive management of invasive nonnative species (INS) in Kings Bay, Florida received detailed responses from both Daniel Simberloff, a prominent invasion biologist, and Mark Sagoff, a prominent critic of invasion biology. Simberloff offers several significant lines of criticism that compel detailed rebuttals, and, as such, most of this reply is dedicated to this purpose. Ultimately, we find it quite significant that Simberloff, despite his other stated objections to our paper, apparently agrees with our argument that proposals for alternative management of established INS (i.e., alternatives to minimization/eradication) should not be rejected on an a␣priori basis. We argue that more specific development and application of adaptive approaches toward INS management, whether in Kings Bay or other appropriate case studies, would be facilitated if ecosystem managers and invasion biologists follow Simberloff’s lead on this key point. While Sagoff largely shares (and, indeed, served as a primary source for developing) our general arguments that challenge common moral and scientific assumptions associated with invasion biology, he does question our suggestion that participatory adaptive management provides an appropriate framework for approaching environmental problems in which science and politics are inherently entangled. We attempt to answer this criticism through a brief sketch of what participatory adaptive management might look like for Kings Bay and how such an approach would differ from past management approaches. [ABSTRACT FROM AUTHOR]

The superconducting properties of (Mx/YBa2Cu3O7-δy)N multilayer films were studied for varying layer thickness x. Different M phases were examined including green-phase Y2BaCuO5 (211), Y2O3, BaZrO3, CeO2, SmBa2Cu3O7-δ (Sm123), brown-phase La2BaCuO5 (La211), and MgO. Multilayer (Mx/YBa2Cu3O7-δy)N structures were grown by pulsed laser deposition onto SrTiO3 or LaAlO3 single-crystal substrates by alternate ablation of separate YBa2-Cu3O7-δ (123) and M targets, at temperatures of 750°C to 790°C. The x layer thickness was varied from 0.1 nm to 4.5 nm, and the y 123 layer thickness was kept constant within a given range of 10 to 25 nm. Different M phase and x layer thicknesses caused large variations of the microstructural and superconducting properties, including superconducting transition (Tc), critical current density as a function of applied magnetic field Jc(H), self-field Jc(77 K), and nanoparticle layer coverage. Strong flux-pinning enhancement up to 1 to 3x was observed to occur for M additions of 211 and BaZrO3 at 65 to 77 K, Y2O3 at 65 K, and CeO2 for H < 0.5 T. BaZrO3 had a noticeably different epitaxy forming smaller size nanoparticles ~8 nm with 3 to 4x higher areal surface particle densities than other M phases, reaching 5 x 1011 nanoparticles cm-2. To optimize flux pinning and Jc (65 to 77 K, H = 2 to 3 T), the M layer thickness had to be reduced below a critical value that correlated with a nanoparticle surface coverage <15% by area. Unusual effects were observed for poor pinning materials including Sm123 and La211, where properties such as self-field Jc unexpectedly increased with increasing x layer thickness. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: The aim of this study was to evaluate the risk of adverse cardiovascular outcomes in patients with type 2 diabetes newly treated with sulfonylureas and metformin. Subjects and methods: The Diabetes Audit and Research in Tayside Scotland (DARTS) diabetes information system and the Medicines Monitoring Unit (MEMO) dispensed prescribing database for the population of Tayside, Scotland (400,000 people) were employed. Patients newly prescribed with oral hypoglycaemic agents between 1994 and 2001 were classified into five study cohorts according to the treatment received: metformin only, sulfonylureas only, sulfonylureas added to metformin, metformin added to sulfonylureas, and both drugs simultaneously. In Cox regression analyses, we estimated relative risks for all-cause mortality, cardiovascular mortality and cardiovascular hospital admission for patients in the five study cohorts, with metformin monotherapy as the reference group. Results: Of the 5,730 study patients, 1,000 died during a maximum of 8 years follow-up. Patients in the sulfonylureas only cohort had increased risks of mortality and cardiovascular mortality, with unadjusted relative risks of 3.12 (95% CI 2.54–3.84) and 3.71 (95% CI 2.64–5.22), respectively. After adjusting for differences between groups (age, sex, duration of diabetes, blood pressure, cholesterol, HbA1c, smoking, previous hospital admission, treatment with cardiovascular medication), these relative risks were 1.43 (95% CI 1.15–1.77) and 1.70 (95% CI 1.18–2.45), respectively. Patients in the combination cohorts had significantly increased risks of cardiovascular hospital admission, as well as increased risks of mortality and cardiovascular mortality. Conclusions/interpretation: In this cohort study of patients newly treated with oral hypoglycaemic agents, those treated with sulfonylureas only, or combinations of sulfonylureas and metformin, were at higher risk of adverse cardiovascular outcomes than those treated with metformin alone. [ABSTRACT FROM AUTHOR]

The DARTS diabetes register was used to determine incidence rates of diabetes and related complications in 1997.The diabetes register records detailed clinical information for all patients diagnosed with diabetes in Tayside, Scotland. The study population included patients who were alive and registered with a Tayside GP for the duration of 1997 or who died in Tayside during this time. Patients who had diabetes prior to 1997, those who developed diabetes in 1997, and those who developed diabetic complications in 1997, were identified.In the Tayside population of 385 774 at the start of 1997, there were 942 and 6632 patients with Type 1 and Type 2 diabetes, with a further 29 and 744 patients diagnosed in 1997. The incidence rates (with 95% confidence intervals) of diabetic complications per 1000 patients with Type 1 and Type 2 diabetes, respectively, were: angina 8.8 (4.5–17.3) and 38.4 (33.4–44.2); myocardial infarction 8.6 (4.4–16.9) and 21.9 (18.4–25.9); cerebrovascular accident 1.1 (0.3–6.0) and 14.2 (11.6–17.5); lower extremity amputation 3.2 (1.2–9.4) and 3.1 (2.1–4.8); peripheral vascular disease 5.5 (2.4–12.8) and 13.6 (11.0–16.8); registered blindness 1.1 (0.3–5.9) and 1.6 (0.9–2.9); end-stage renal failure 6.4 (3.0–13.8) and 5.0 (3.6–7.0). Mortality was 14.6 per 1000 (9.6–25.7) in Type 1 diabetes and 50.0 per 1000 (45.1–55.3) in Type 2 diabetes.This study provides baseline figures for rates of diabetic complications for Type 1 and Type 2 diabetes, and confirms the increased burden of macrovascular disease in Type 2 diabetes.Diabet. Med. (2004) [ABSTRACT FROM AUTHOR]

Abstract Aim To investigate whether patients require insulin as a result of poor adherence to oral hypoglycaemic agents (OHAs) in Type 2 diabetes. Methods A diabetes information system and a database of drugs dispensed for the study period 1993–1996 were used in Tayside, Scotland (population 400 000). Patients aged over 34 years with Type 2 diabetes who had at least 6 months exclusive therapy with OHAs (sulphonylureas or metformin) prior to insulin treatment were identified. Intended duration of every OHA prescription was calculated from prescription details. Adherence was estimated by dividing total intended duration of OHA therapy by study time for each patient, and compared between those who did and did not convert to insulin. Results There were 2537 patients on sulphonylureas (51% male, mean age 67 years). There was improved adherence in the 262 patients who commenced insulin, who had mean adherence of 88.3% (95% confidence interval (CI) 85.9–90.6%) compared with the remaining 2275 patients whose mean adherence was 87.4% (95% CI 86.7–88.2%). In a logistic regression analysis, the adjusted odds ratio (OR) for commencing insulin was 1.20 (95% CI 1.07–1.35) for a quartile increase in adherence. There were 1519 patients on metformin (49% male, mean age 64 years). Mean adherence was 79.7% (95% CI 76.4–83.1%) and 83.1% (95% CI 82.0–84.1%) in 169 patients who did and 1350 who did not commence insulin, respectively, with an adjusted OR for a quartile increase in adherence of 0.91 (95% CI 0.78–1.07). Conclusion Despite suboptimal adherence to OHAs in Type 2 diabetes, this is not associated with subsequent requirement for insulin. Diabet. Med. 19, 685–688 (2002). [ABSTRACT FROM AUTHOR]

Record-linkage refers to the linking together of data relating to the same individual from separate source files. In this paper, we discuss ways in which the technique can enhance observational prescribing research in large populations. We draw upon the work of the Medicines Monitoring Unit (MEMO), University of Dundee, to illustrate its contribution to prescribing research. [ABSTRACT FROM AUTHOR]

Abstract Aims To define the number of people in Tayside, Scotland (population 349 303) with Type 2 diabetes who use metformin, the incidence of contraindications to its continued use in these people and the proportion that discontinued metformin treatment following the development of a contraindication. Methods Retrospective cohort study of the incidence of contraindications to metformin in all patients with Type 2 diabetes using metformin from January 1993 to June 1995. The contraindications of acute myocardial infarction, cardiac failure, renal impairment and chronic liver disease were identified by: the regional diabetes information system, biochemistry database and hospital admissions database and a database of all encashed community prescriptions. Results One thousand eight hundred and forty seven subjects (26.3% of those with Type 2 diabetes) redeemed prescriptions for metformin. Of these, 3.5% were admitted with an acute myocardial infarction (71 episodes); 4.2% were admitted with cardiac failure (114 episodes); 21.0% received metformin and loop diuretics for cardiac failure concurrently; 4.8% developed renal impairment; and 2.8% developed chronic liver disease. The development of contraindications rarely resulted in discontinuation of metformin, for example only 17.5% and 25% stopped metformin after admission with acute myocardial infarction and development of renal impairment, respectively. In total, 24.5% of subjects receiving metformin, 6.4% of all people with Type 2 diabetes, had contraindications to its use. There was one episode of lactic acidosis in 4600 patient years. Conclusions This population-based study shows that 24.5% of patients prescribed metformin have contraindications to its use. Development of contraindications rarely results in discontinuation of metformin therapy. Despite this, lactic acidosis remains rare. Diabet. Med. 18, 483–488 (2001). [ABSTRACT FROM AUTHOR]

The growing importance of understanding and controlling particulate emissions from gasoline engines is outlined, and an experimental simulation approach is described which has the potential for exploring particle deposition/capture and oxidation phenomena under well-controlled conditions, thus avoiding some of the uncertainties involved in interpreting engine experiments. Artificially generated sub-100 nm carbon particles are introduced into a synthetic exhaust gas stream, simulating engine-out soot emissions. Initial experiments in insulated pipe flows have shown very little particle deposition or change in mean size for residence times up to 1–2 s at uniform temperatures up to 400 °C and hydrocarbon concentrations up to 4000 ppm C[sub 1] , in line with the results of supporting analytical and computational studies. Further numerical predictions suggested that it might be possible to capture some 20–30 per cent of the particles by turbulent diffusion alone at higher gas flowrates more representative of those in engine exhaust pipes. The effect of two different catalysts and an uncoated monolith on particle size and concentration has been investigated at space velocities of 50 000 and 100 000 h[sup -1], with an inlet gas temperature of 400 °C. Particle penetration through the catalysts increased with particle size but in all cases exceeded 70 per cent, with no evidence of significant changes in particle mean size. In the next phase of experimental and modelling work, the contribution of thermophoresis to particle deposition in uninsulated pipes will be examined. [ABSTRACT FROM AUTHOR]

Objective: Utilization and costs of prescription drugs were investigated in diabetic and nondiabetic patients.Research Design and Methods: The study was carried out in Tayside, Scotland, U.K. A validated population-based diabetes register was used to identify patients with type 1 and type 2 diabetes, and a database of all prescriptions dispensed in the community was used to investigate drug utilization in 1995.Results: In a population of 406,526, there were 974 (0.2%) with type 1 diabetes and 6,869 (1.7%) with type 2 diabetes. The mean dispensed prescribing rates for all drugs (excluding antidiabetic medication) were higher across all age-groups for diabetic patients. After adjusting for age, patients with type 1 diabetes were 2.07 times (95% CI 2.03-2.11) more likely and patients with type 2 diabetes were 1.70 times (1.69-1.71) more likely to be dispensed a drug item than people without diabetes. This likelihood was increased in every drug category, even those not directly related to diabetes, and the proportion and cost of drug items dispensed to diabetic patients was therefore higher than expected given the prevalence of diabetes. Upon projecting these results to the U.K. population, it was discovered that nearly 8% of the U.K. drug budget (Pound Sterling 350 million) is accounted for by patients with diabetes (90% of that by patients with type 2 diabetes).Conclusions: This study highlights the increased usage and cost of prescription drugs in diabetes, with type 2 diabetes constituting a particular burden. It was discovered that 1.4% of drug usage in the entire population can be accounted for by the increased prescribing rate of diabetic patients compared with that of nondiabetic patients. [ABSTRACT FROM AUTHOR]

The coupled phase approach is extended to model sound propagation in an emulsion of two compressible, thermoviscous liquids. This provides an alternative to scattering theory for modeling sound propagation in emulsions in the low-acoustic radius regime. Predictions of the new theory are compared with predictions of multiple-scattering theory and experimental results for ultrasonic velocity and attenuation in an emulsion. For the particular set of experimental data used here, the coupled phase theory gives predictions close to the scattering theory predictions, and a better prediction of the dependence of the attenuation on volume fraction. A similar difference between the two theoretical approaches has been found in earlier work on coupled phase models for sound propagation in suspensions. © 1997 Acoustical Society of America. [ABSTRACT FROM AUTHOR]

A simple, rapid, and accurate method for measuring oxygen consumption in infants is described. Expired gas is entrained in a stream of air drawn through a gently applied face mask. Oxygen consumption is derived from (1) gas flow rate, measured with a flowmeter, and (2) the fall in oxygen concentration of the gas mixture, measured with a paramagnetic analyser. A measurement can be made at the bedside within 2 minutes without disturbing the infant. In 17 mature 2-day-old neonates mean oxygen consumption was 6.52 ml/kg per min, SD 0.90, similar to that previously reported using less simple methods, [ABSTRACT FROM AUTHOR]

BACKGROUND: To evaluate the relation between non-steroidal anti-inflammatory drugs (NSAIDs) and colitis due to inflammatory bowel disease. METHODS: A case-control study was conducted using a prospectively constructed, record linkage database containing hospital event and dispensed drug data (1989-93). The study population consisted of 319,465 people resident in Tayside in January 1989, and still resident (or dead) in October 1994. RESULTS: Of the 785 patients admitted to hospital as emergencies with colitis between July 1989 and June 1993, 200 fulfilled the case criterion of colitis due to inflammatory bowel disease. A further 1198 persons were used as community controls. Odds ratios were calculated for three exposure periods (current, recent, and past exposure). The overall odds ratios (with 95% confidence intervals) for current and recent exposure to NSAIDs were 1.77 (1.01 to 3.10) and 1.93 (1.20 to 3.09) respectively. Current and recent exposure to NSAIDs was also associated for incident cases, with odds ratios of 2.96 (1.32 to 6.64) and 2.51 (1.13 to 5.55). There was a trend for recent exposure among non-incident cases. CONCLUSION: The use of NSAIDs may be associated with an increased risk of emergency admission to hospital for colitis due to inflammatory bowel disease, particularly among patients with no previous history. [ABSTRACT FROM PUBLISHER]

The volume flow rate of blood in the portal vein was measured using a duplex ultrasound system. The many errors inherent in the duplex method were assessed with particular reference to the portal vein and appropriate correction factors were obtained by in vitro calibration. The effect of posture on flow was investigated by examining 45 healthy volunteers in three different positions; standing, supine and tilted head down at 20 degrees from the horizontal. The mean volume blood flow in the supine position was 864 (188)ml/min (mean 1SD). When standing, the mean volume blood flow was significantly reduced by 26% to 662 (169)ml/min. There was, however, no significant difference between flow when supine and when tilted head down at 20 degrees from the horizontal. [ABSTRACT FROM PUBLISHER]

A duplex scanner which consists of a real time two dimensional scanner and a pulsed Doppler flowmeter was used to measure superior mesenteric blood flow in 70 healthy subjects. By processing the Doppler shift signals, the instantaneous average Doppler shift frequency and then the instantaneous average velocity of the flow rate were calculated. Both diameter of the vessel and angle between vessel and beam were measured from real time imaging. The mean (+/- standard error of the mean) of the superior mesenteric blood flow was 517 +/- 19 ml/min. There was neither significant difference in flow between sexes, nor correlation between flow and age (r = 0.042). The mean of coefficients of variability were 6.8% over the short term, and 8.2% in long term studies. [ABSTRACT FROM PUBLISHER]

To determine whether the effects of platelet activating factor on the airways may be due to the production of leukotrienes we studied the effects of pretreatment with the selective cysteinyl leukotriene antagonist SK&F 104353-Z2 on the airway and cellular responses to inhaled platelet activating factor. Eight healthy men were studied in a randomised, double blind placebo controlled cross-over study. A single dose of platelet activating factor that caused a fall of at least 35% in specific airways conductance (sGaw) was determined initially for each subject. Challenge with this dose of platelet activating factor was then carried out on two further occasions after pretreatment with a single nebulised dose of SK&F 104353-Z2 or placebo. The % reductions in specific airways conductance and of partial flow at 30% of vital capacity (PVmax30) were less after SK&F 104353-Z2 than after placebo (22 versus 34 for sGaw, 19 versus 31 for PVmax30). The mean (95% confidence limits (CL] differences in the maximum % fall from control values for SK&F 104353-Z2 and placebo were -12.6 (-23.8, -1.4) for sGaw and -12.5, (-20.8 -4.2) for PVmax30. The mean % fall in neutrophil count was similar after SK&F 104353-Z2 (46%) and after placebo (50%) (95% CL of difference 13.6, 6.6). Bronchial responsiveness to methacholine did not increase above baseline values in any subject when measured two weeks after challenge by platelet activating factor. This study suggests that leukotrienes play a part in the response to platelet activating factor in man. [ABSTRACT FROM PUBLISHER]