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We present our experience with twenty children with insulin dependent diabetes mellitus admitted during the past 2 1/2 years.
Sixteen patients were admited with acute onset of ketoacidosis while four were having gradual onset. Active and symptomatic
treatment was started in all diabetic ketoacidotic patients. One patient died during the acute stage. Eleven patients were
followed for 3–6 months or more. Glycosylated hemoglobin was considered as a criteria for control. Three had good control,
two fair and six poor control; six developed diabetic ketoacidosis and three developed hypoglycemia 相似文献
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Kallol Ray Chaudhuri Pablo Martinez-Martin Anthony H V Schapira Fabrizio Stocchi Kapil Sethi Per Odin Richard G Brown William Koller Paolo Barone Graeme MacPhee Linda Kelly Martin Rabey Doug MacMahon Sue Thomas William Ondo David Rye Alison Forbes Susanne Tluk Vandana Dhawan Annette Bowron Adrian J Williams Charles W Olanow 《Movement disorders》2006,21(7):916-923
Nonmotor symptoms (NMS) of Parkinson's disease (PD) are not well recognized in clinical practice, either in primary or in secondary care, and are frequently missed during routine consultations. There is no single instrument (questionnaire or scale) that enables a comprehensive assessment of the range of NMS in PD both for the identification of problems and for the measurement of outcome. Against this background, a multidisciplinary group of experts, including patient group representatives, has developed an NMS screening questionnaire comprising 30 items. This instrument does not provide an overall score of disability and is not a graded or rating instrument. Instead, it is a screening tool designed to draw attention to the presence of NMS and initiate further investigation. In this article, we present the results from an international pilot study assessing feasibility, validity, and acceptability of a nonmotor questionnaire (NMSQuest). Data from 123 PD patients and 96 controls were analyzed. NMS were highly significantly more prevalent in PD compared to controls (PD NMS, median = 9.0, mean = 9.5 vs. control NMS, median = 5.5, mean = 4.0; Mann-Whitney, Kruskal-Wallis, and t test, P < 0.0001), with PD patients reporting at least 10 different NMS on average per patient. In PD, NMS were highly significantly more prevalent across all disease stages and the number of symptoms correlated significantly with advancing disease and duration of disease. Furthermore, frequently, problems such as diplopia, dribbling, apathy, blues, taste and smell problems were never previously disclosed to the health professionals. 相似文献
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The lipid-lowering agents, statins, are the most commonly prescribed class of drugs in the western world. Because of their
widespread use, many patients undergo surgical procedures while on statins. Statins, in addition to cholesterol-lowering effects,
also have anticoagulant, immunosuppressive, and antiproliferative properties that may affect the risk of local wound complications.
This study investigated the relationship between statins and postoperative wound complications in a large cohort of patients
undergoing inguinal or ventral hernia repair. Data mining was performed in the Veterans Integrated Service Network (VISN)16
Data Warehouse. This database contains clinical and demographic information about all veterans cared for at the ten VA Medical
Centers that comprise the South Central VA Healthcare Network in the mid-south region of the US. Aggregate data (age, body
mass index, smoking history, gender, race, history of diabetes, statin use, and postoperative wound complications) were obtained
for all patients who underwent inguinal or ventral hernia repair during the period October 1, 1996–November 30, 2004. During
the period of the query, 10,782 patients (10,676 male, 106 female), 1,242 (11.5%) of whom received statins, underwent herniorrhaphy.
Statin use did not affect the risk of wound infection or delayed wound healing. Statin use was, however, associated with an
increased rate of local postoperative bleeding complications (P=0.01). When the type of hernia, age, smoking, diabetes, and body mass index were included in a multivariate analysis, statins
remained borderline significant as an independent predictor of wound hematoma/postoperative bleeding (P=0.04), odds ratio 1.6 (95% CI 1.03–2.44). Patients who undergo inguinal herniorrhaphy while on statins have an increased
risk of postoperative wound hematoma/hemorrhage. Focus on additional factors that may affect the propensity to postoperative
bleeding and on meticulous intraoperative hemostasis are particularly important in such patients. 相似文献