David Bowen-jones - Academia.edu (original) (raw)

Papers by David Bowen-jones

Research paper thumbnail of Communicating Hydrocephalus in the Intellectual Deterioration of Diabetes Mellitus

Journal of the Royal Society of Medicine, 1983

Atherosclerosis of cerebral vessels (Grunnet 1963) and hypoglycaemia (Bale 1973) are thought to b... more Atherosclerosis of cerebral vessels (Grunnet 1963) and hypoglycaemia (Bale 1973) are thought to be involved in the premature intellectual deterioration which occurs in some diabetics. Two diabetics are now reported who, in the course of their investigation for intellectual deterioration, were found to have communicating hydrocephalus.

Research paper thumbnail of Occult ectopic adrenocorticotropic hormone syndrome

Research paper thumbnail of Screening for diabetic retinopathy

Practical Diabetes International, Mar 1, 1999

Research paper thumbnail of An association between sub-arachnoid haemorrhage and influenza A infection

Postgraduate Medical Journal, 1979

The sera of 25 patients with confirmed sub-arachnoid haemorrhage were assayed by complement fixat... more The sera of 25 patients with confirmed sub-arachnoid haemorrhage were assayed by complement fixation for 14 viruses. Twenty (80%) showed elevated titres to influenza A virus compared with 3 out of 25 (12%) of control subjects matched for age, sex and district and 3 out of 17 (17%) of a group of patients with other neurological disorders. A seasonal variation in the notification of subarachnoid haemorrhage appeared to be related to changes in the incidence of influenza A infection.

Research paper thumbnail of A retrospective study of seven-day consultant working: Reductions in mortality and length of stay

Journal of the Royal College of Physicians of Edinburgh, 2015

Weekend admission is associated with higher in-hospital mortality than weekday admission. Whether... more Weekend admission is associated with higher in-hospital mortality than weekday admission. Whether providing enhanced weekend staffing for acute medical inpatient services reduces mortality or length of stay is unknown Methods This paper describes a retrospective analysis of in-hospital mortality and length of stay before and after introduction of an enhanced, consultant-led weekend service in acute medicine in November 2012. In-hospital mortality was compared for matching admission calendar months before and after introduction of the new service, adjusted for case volume. Length of stay and 30-day post-discharge mortality were also compared; illness severity of patients admitted was assessed by cross-sectional acuity audits. Results Admission numbers increased from 6,304 (November 2011–July 2012) to 7,382 (November 2012–July 2013), with no change in acuity score in elderly medical patients but a small fall in younger patients. At the same time, however, a 57% increase in early-warni...

Research paper thumbnail of Does opportunistic screening for diabetic retinopathy result in timely and appropriate referral?

Practical Diabetes International, 2001

Aims. We studied the quality of opportunistic screening for diabetic retinopathy, which existed i... more Aims. We studied the quality of opportunistic screening for diabetic retinopathy, which existed in the absence of a formal screening programme. Methods. Patients referred during the period from June 1992 to May 1997 were identified. The findings and outcome at first ophthalmic consultation were used as surrogate measures to determine the appropriateness of referral. We considered patients to have had sight-threatening retinopathy (STDR) if laser treatment or fluorescein angiography was recommended, or follow-up at 6 months or less was arranged. Patients whose fundi could not be visualised were also included in the STDR group. Results. Two hundred and eighty-nine case records were available for analysis; 190 of these (65.7%) were considered to have STDR and 41 (14.2%) had other pathology, without concurrent diabetic retinopathy. The agreement between the referrer's diagnosis and the diagnosis made by the ophthalmologist was only fair, when comparing major diagnostic categories (kappa 0.35, 95% CI 0.30-0.41) and also for grading of retinopathy (kappa 0.30, 95% CI 0.23-0.37). Conclusions. Our findings suggest that opportunistic screening can identify retinopathy only at a late stage. Our data should be valuable in measuring the benefits of formal screening for diabetic retinopathy as compared to previously existing services.

Research paper thumbnail of Preliminary study of heat shock protein 70 gene expression and serum levels in newly diagnosed type 1 and type 2 diabetes

Research paper thumbnail of Frequent Occurrence of an Intron 4 Mutation in Multiple Endocrine Neoplasia Type 1

The Journal of Clinical Endocrinology & Metabolism, 2002

MEN1 is an autosomal dominant disorder characterized by parathyroid, pituitary, and pancreatic tu... more MEN1 is an autosomal dominant disorder characterized by parathyroid, pituitary, and pancreatic tumors. The MEN1 gene is located on chromosome 11q13 and encodes a 610-amino acid protein. MEN1 mutations are of diverse types and are scattered throughout the coding region, such that almost every MEN1 family will have its individual mutation. To further characterize such mutations we ascertained 34 unrelated MEN1 probands and undertook DNA sequence analysis. This identified 17 different mutations in 24 probands (2 nonsense, 2 missense, 2 in-frame deletions, 5 frameshift deletions, 1 frameshift deletional-insertion, 3 frameshift insertions, 1 donor splice site mutation, and a g→a transition that resulted in a novel acceptor splice site in intron 4). The intron 4 mutation was found in 7 unrelated families, and the tumors in these families varied considerably, indicating a lack of genotype-phenotype correlation. However, this intron 4 mutation is the most frequently occurring germline MEN1 ...

Research paper thumbnail of Anne/Learning & Development Strategy

Research paper thumbnail of Prediction of life expectancy in individuals in the United Kingdom using current cohort tables

Journal of insurance medicine, 2014

This paper provides updated cohort tables of life expectancy for individuals in the United Kingdo... more This paper provides updated cohort tables of life expectancy for individuals in the United Kingdom. Using 2008-based projections from the UK Office for National Statistics (ONS) cohort and period expectation of life tables (the Ogden tables); predicted future life expectancies were calculated for quintiles of age from 0-90 years in men and women with mortality ratios between 100% and 1000%. Period tables have been included to illustrate the differences between period and cohort life expectancy in men and women at various ages. These tables are not intended to predict specific life expectancy in individuals but may indicate the mean life expectancy of a cohort of similarly affected people in the UK.

Research paper thumbnail of Audit on the management of adrenal incidentaloma

Research paper thumbnail of A meta-analysis of type 1 diabetes mellitus, all-cause and cause-specific mortality

Research paper thumbnail of Projection of Impaired Life Expectancy in Individuals in the United Kingdom Using Mortality Ratios

Journal of Insurance Medicine

Projections of life expectancy are widely used in medicine, actuarial practice, and in the medico... more Projections of life expectancy are widely used in medicine, actuarial practice, and in the medicolegal and insurance fields. For individuals considered to have average future survival, nationally-derived life expectancy tables are available, referred to as the Ogden Tables. In the United Kingdom, updated tables (the 8th edition) were published in July 2020. We have calculated impaired projected life expectancies for the United Kingdom based on age and gender, derived from the 8th edition of the Ogden Tables together with various assumed lifelong mortality ratios.

Research paper thumbnail of Projection of Impaired Life Expectancy for Individuals in the United Kingdom Using Estimated Excess Death Rates

Journal of Insurance Medicine

We have recently constructed tables of the estimated life expectancies of impaired lives on the b... more We have recently constructed tables of the estimated life expectancies of impaired lives on the basis of mortality ratios and the cohort life expectancy tables given in the 8th edition of the Ogden Tables, which are derived from the ONS 2018-based population projections for the United Kingdom.1,2 The life expectancy of impaired lives may also be estimated using excess death rates. In this paper, we give tables of life expectancies for impaired lives using a range of excess death rates for males and females from age 0 to age 100. As both mortality ratios and excess death rates are widely used in medical and legal settings, it is hoped that these additional tables of life expectancies will be of practical value.

Research paper thumbnail of Measure of the Rate at which Mortality in Type 2 Diabetes Mellitus Occurs: Protocol for a Systematic Review

Acta Medica International, 2015

Research paper thumbnail of Treatment of carbimazole-induced agranulocytosis and sepsis with granulocyte colony stimulating factor

International journal of clinical practice, 2003

We present the management of agranulocytosis and neutropenic sepsis secondary to carbimazole with... more We present the management of agranulocytosis and neutropenic sepsis secondary to carbimazole with recombinant human granulocyte colony stimulating factor (G-CSF). A 72-year-old woman with a history of thyrotoxicosis presented with sore throat and fever two weeks after starting carbimazole. Investigations confirmed a leucopenia and neutropenia. G-CSF was used as an adjunctive therapy with discontinuation of carbimazole, barrier nursing and a broad-spectrum antibiotic regimen to treat her neutropenic sepsis. Total white cell count and neutrophil count returned to normal and she made an uneventful recovery. She was subsequently rendered euthyroid with radioiodine treatment.

Research paper thumbnail of Incorrect diagnosis of diabetes mellitus in a patient with persistence of fetal haemoglobin

International journal of clinical practice, 1998

A 65-year-old woman, referred to the endocrine clinic for investigation of tiredness and arthriti... more A 65-year-old woman, referred to the endocrine clinic for investigation of tiredness and arthritis, was diagnosed as having diabetes on the basis of a positive family history and a raised glycated haemoglobin (HbA1) measurement. Subsequently, she was shown not to have diabetes but to have a persistently raised haemoglobin F (HbF) level. Initial assessment of HbF level by electroendosmosis demonstrated a normal HbF level but high values were confirmed using HPLC. Thalassaemia was excluded following DNA analysis. This case illustrates the importance of a glucose tolerance test following WHO criteria for the diagnosis of diabetes and emphasises that HbA1 is not a diagnostic test for diabetes.

Research paper thumbnail of An unusual case of chronic liquorice ingestion presenting as hypokalemic paralysis

Endocrine Abstracts, 2013

Research paper thumbnail of Prediction of life expectancy in individuals in the United Kingdom using current cohort tables

Journal of insurance medicine (New York, N.Y.), 2014

This paper provides updated cohort tables of life expectancy for individuals in the United Kingdo... more This paper provides updated cohort tables of life expectancy for individuals in the United Kingdom. Using 2008-based projections from the UK Office for National Statistics (ONS) cohort and period expectation of life tables (the Ogden tables); predicted future life expectancies were calculated for quintiles of age from 0-90 years in men and women with mortality ratios between 100% and 1000%. Period tables have been included to illustrate the differences between period and cohort life expectancy in men and women at various ages. These tables are not intended to predict specific life expectancy in individuals but may indicate the mean life expectancy of a cohort of similarly affected people in the UK.

Research paper thumbnail of Mortality in type 2 diabetes mellitus: magnitude of the evidence from a systematic review and meta-analysis

The British Journal of Diabetes & Vascular Disease, 2013

Background: Type 2 diabetes is associated with an increase in age-related mortality. A systematic... more Background: Type 2 diabetes is associated with an increase in age-related mortality. A systematic review and meta-analysis were performed to define the relative risks (RR) of all-cause or cause-specific mortality in type 2 diabetes and to determine gaps in current research. Methods: A comprehensive literature search was undertaken for studies (published 1990–2010) on mortality in type 2 diabetes. The study reports on the measure of mortality as defined by RR for all-cause and cause-specific mortality, heterogeneity, sensitivity analyses and biases. Results: In total 35 studies (220,689 patients; mean follow-up of 10.7 years) were eligible for inclusion: 33 studies reported increased mortality risks; 24 had full data on 95% confidence intervals (CIs), one study reported no excess mortality in men diagnosed after 65 years whereas three reported increased mortality in similar age groups in both sexes. Meta-analysis showed RR = 1.85 (95% CI 1.79–1.92) for all-cause mortality [men RR=1.5...

Research paper thumbnail of Communicating Hydrocephalus in the Intellectual Deterioration of Diabetes Mellitus

Journal of the Royal Society of Medicine, 1983

Atherosclerosis of cerebral vessels (Grunnet 1963) and hypoglycaemia (Bale 1973) are thought to b... more Atherosclerosis of cerebral vessels (Grunnet 1963) and hypoglycaemia (Bale 1973) are thought to be involved in the premature intellectual deterioration which occurs in some diabetics. Two diabetics are now reported who, in the course of their investigation for intellectual deterioration, were found to have communicating hydrocephalus.

Research paper thumbnail of Occult ectopic adrenocorticotropic hormone syndrome

Research paper thumbnail of Screening for diabetic retinopathy

Practical Diabetes International, Mar 1, 1999

Research paper thumbnail of An association between sub-arachnoid haemorrhage and influenza A infection

Postgraduate Medical Journal, 1979

The sera of 25 patients with confirmed sub-arachnoid haemorrhage were assayed by complement fixat... more The sera of 25 patients with confirmed sub-arachnoid haemorrhage were assayed by complement fixation for 14 viruses. Twenty (80%) showed elevated titres to influenza A virus compared with 3 out of 25 (12%) of control subjects matched for age, sex and district and 3 out of 17 (17%) of a group of patients with other neurological disorders. A seasonal variation in the notification of subarachnoid haemorrhage appeared to be related to changes in the incidence of influenza A infection.

Research paper thumbnail of A retrospective study of seven-day consultant working: Reductions in mortality and length of stay

Journal of the Royal College of Physicians of Edinburgh, 2015

Weekend admission is associated with higher in-hospital mortality than weekday admission. Whether... more Weekend admission is associated with higher in-hospital mortality than weekday admission. Whether providing enhanced weekend staffing for acute medical inpatient services reduces mortality or length of stay is unknown Methods This paper describes a retrospective analysis of in-hospital mortality and length of stay before and after introduction of an enhanced, consultant-led weekend service in acute medicine in November 2012. In-hospital mortality was compared for matching admission calendar months before and after introduction of the new service, adjusted for case volume. Length of stay and 30-day post-discharge mortality were also compared; illness severity of patients admitted was assessed by cross-sectional acuity audits. Results Admission numbers increased from 6,304 (November 2011–July 2012) to 7,382 (November 2012–July 2013), with no change in acuity score in elderly medical patients but a small fall in younger patients. At the same time, however, a 57% increase in early-warni...

Research paper thumbnail of Does opportunistic screening for diabetic retinopathy result in timely and appropriate referral?

Practical Diabetes International, 2001

Aims. We studied the quality of opportunistic screening for diabetic retinopathy, which existed i... more Aims. We studied the quality of opportunistic screening for diabetic retinopathy, which existed in the absence of a formal screening programme. Methods. Patients referred during the period from June 1992 to May 1997 were identified. The findings and outcome at first ophthalmic consultation were used as surrogate measures to determine the appropriateness of referral. We considered patients to have had sight-threatening retinopathy (STDR) if laser treatment or fluorescein angiography was recommended, or follow-up at 6 months or less was arranged. Patients whose fundi could not be visualised were also included in the STDR group. Results. Two hundred and eighty-nine case records were available for analysis; 190 of these (65.7%) were considered to have STDR and 41 (14.2%) had other pathology, without concurrent diabetic retinopathy. The agreement between the referrer's diagnosis and the diagnosis made by the ophthalmologist was only fair, when comparing major diagnostic categories (kappa 0.35, 95% CI 0.30-0.41) and also for grading of retinopathy (kappa 0.30, 95% CI 0.23-0.37). Conclusions. Our findings suggest that opportunistic screening can identify retinopathy only at a late stage. Our data should be valuable in measuring the benefits of formal screening for diabetic retinopathy as compared to previously existing services.

Research paper thumbnail of Preliminary study of heat shock protein 70 gene expression and serum levels in newly diagnosed type 1 and type 2 diabetes

Research paper thumbnail of Frequent Occurrence of an Intron 4 Mutation in Multiple Endocrine Neoplasia Type 1

The Journal of Clinical Endocrinology & Metabolism, 2002

MEN1 is an autosomal dominant disorder characterized by parathyroid, pituitary, and pancreatic tu... more MEN1 is an autosomal dominant disorder characterized by parathyroid, pituitary, and pancreatic tumors. The MEN1 gene is located on chromosome 11q13 and encodes a 610-amino acid protein. MEN1 mutations are of diverse types and are scattered throughout the coding region, such that almost every MEN1 family will have its individual mutation. To further characterize such mutations we ascertained 34 unrelated MEN1 probands and undertook DNA sequence analysis. This identified 17 different mutations in 24 probands (2 nonsense, 2 missense, 2 in-frame deletions, 5 frameshift deletions, 1 frameshift deletional-insertion, 3 frameshift insertions, 1 donor splice site mutation, and a g→a transition that resulted in a novel acceptor splice site in intron 4). The intron 4 mutation was found in 7 unrelated families, and the tumors in these families varied considerably, indicating a lack of genotype-phenotype correlation. However, this intron 4 mutation is the most frequently occurring germline MEN1 ...

Research paper thumbnail of Anne/Learning & Development Strategy

Research paper thumbnail of Prediction of life expectancy in individuals in the United Kingdom using current cohort tables

Journal of insurance medicine, 2014

This paper provides updated cohort tables of life expectancy for individuals in the United Kingdo... more This paper provides updated cohort tables of life expectancy for individuals in the United Kingdom. Using 2008-based projections from the UK Office for National Statistics (ONS) cohort and period expectation of life tables (the Ogden tables); predicted future life expectancies were calculated for quintiles of age from 0-90 years in men and women with mortality ratios between 100% and 1000%. Period tables have been included to illustrate the differences between period and cohort life expectancy in men and women at various ages. These tables are not intended to predict specific life expectancy in individuals but may indicate the mean life expectancy of a cohort of similarly affected people in the UK.

Research paper thumbnail of Audit on the management of adrenal incidentaloma

Research paper thumbnail of A meta-analysis of type 1 diabetes mellitus, all-cause and cause-specific mortality

Research paper thumbnail of Projection of Impaired Life Expectancy in Individuals in the United Kingdom Using Mortality Ratios

Journal of Insurance Medicine

Projections of life expectancy are widely used in medicine, actuarial practice, and in the medico... more Projections of life expectancy are widely used in medicine, actuarial practice, and in the medicolegal and insurance fields. For individuals considered to have average future survival, nationally-derived life expectancy tables are available, referred to as the Ogden Tables. In the United Kingdom, updated tables (the 8th edition) were published in July 2020. We have calculated impaired projected life expectancies for the United Kingdom based on age and gender, derived from the 8th edition of the Ogden Tables together with various assumed lifelong mortality ratios.

Research paper thumbnail of Projection of Impaired Life Expectancy for Individuals in the United Kingdom Using Estimated Excess Death Rates

Journal of Insurance Medicine

We have recently constructed tables of the estimated life expectancies of impaired lives on the b... more We have recently constructed tables of the estimated life expectancies of impaired lives on the basis of mortality ratios and the cohort life expectancy tables given in the 8th edition of the Ogden Tables, which are derived from the ONS 2018-based population projections for the United Kingdom.1,2 The life expectancy of impaired lives may also be estimated using excess death rates. In this paper, we give tables of life expectancies for impaired lives using a range of excess death rates for males and females from age 0 to age 100. As both mortality ratios and excess death rates are widely used in medical and legal settings, it is hoped that these additional tables of life expectancies will be of practical value.

Research paper thumbnail of Measure of the Rate at which Mortality in Type 2 Diabetes Mellitus Occurs: Protocol for a Systematic Review

Acta Medica International, 2015

Research paper thumbnail of Treatment of carbimazole-induced agranulocytosis and sepsis with granulocyte colony stimulating factor

International journal of clinical practice, 2003

We present the management of agranulocytosis and neutropenic sepsis secondary to carbimazole with... more We present the management of agranulocytosis and neutropenic sepsis secondary to carbimazole with recombinant human granulocyte colony stimulating factor (G-CSF). A 72-year-old woman with a history of thyrotoxicosis presented with sore throat and fever two weeks after starting carbimazole. Investigations confirmed a leucopenia and neutropenia. G-CSF was used as an adjunctive therapy with discontinuation of carbimazole, barrier nursing and a broad-spectrum antibiotic regimen to treat her neutropenic sepsis. Total white cell count and neutrophil count returned to normal and she made an uneventful recovery. She was subsequently rendered euthyroid with radioiodine treatment.

Research paper thumbnail of Incorrect diagnosis of diabetes mellitus in a patient with persistence of fetal haemoglobin

International journal of clinical practice, 1998

A 65-year-old woman, referred to the endocrine clinic for investigation of tiredness and arthriti... more A 65-year-old woman, referred to the endocrine clinic for investigation of tiredness and arthritis, was diagnosed as having diabetes on the basis of a positive family history and a raised glycated haemoglobin (HbA1) measurement. Subsequently, she was shown not to have diabetes but to have a persistently raised haemoglobin F (HbF) level. Initial assessment of HbF level by electroendosmosis demonstrated a normal HbF level but high values were confirmed using HPLC. Thalassaemia was excluded following DNA analysis. This case illustrates the importance of a glucose tolerance test following WHO criteria for the diagnosis of diabetes and emphasises that HbA1 is not a diagnostic test for diabetes.

Research paper thumbnail of An unusual case of chronic liquorice ingestion presenting as hypokalemic paralysis

Endocrine Abstracts, 2013

Research paper thumbnail of Prediction of life expectancy in individuals in the United Kingdom using current cohort tables

Journal of insurance medicine (New York, N.Y.), 2014

This paper provides updated cohort tables of life expectancy for individuals in the United Kingdo... more This paper provides updated cohort tables of life expectancy for individuals in the United Kingdom. Using 2008-based projections from the UK Office for National Statistics (ONS) cohort and period expectation of life tables (the Ogden tables); predicted future life expectancies were calculated for quintiles of age from 0-90 years in men and women with mortality ratios between 100% and 1000%. Period tables have been included to illustrate the differences between period and cohort life expectancy in men and women at various ages. These tables are not intended to predict specific life expectancy in individuals but may indicate the mean life expectancy of a cohort of similarly affected people in the UK.

Research paper thumbnail of Mortality in type 2 diabetes mellitus: magnitude of the evidence from a systematic review and meta-analysis

The British Journal of Diabetes & Vascular Disease, 2013

Background: Type 2 diabetes is associated with an increase in age-related mortality. A systematic... more Background: Type 2 diabetes is associated with an increase in age-related mortality. A systematic review and meta-analysis were performed to define the relative risks (RR) of all-cause or cause-specific mortality in type 2 diabetes and to determine gaps in current research. Methods: A comprehensive literature search was undertaken for studies (published 1990–2010) on mortality in type 2 diabetes. The study reports on the measure of mortality as defined by RR for all-cause and cause-specific mortality, heterogeneity, sensitivity analyses and biases. Results: In total 35 studies (220,689 patients; mean follow-up of 10.7 years) were eligible for inclusion: 33 studies reported increased mortality risks; 24 had full data on 95% confidence intervals (CIs), one study reported no excess mortality in men diagnosed after 65 years whereas three reported increased mortality in similar age groups in both sexes. Meta-analysis showed RR = 1.85 (95% CI 1.79–1.92) for all-cause mortality [men RR=1.5...