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1.
In both adults and children with diabetes, technologies such as continuous subcutaneous insulin infusion using insulin pumps and continuous glucose monitoring can help improve diabetes control, reduce hypoglycaemia and improve quality of life. Access to these technologies in the UK is very variable. Some technologies are recommended by the National Institute for Health and Care Excellence, while others have not been appraised, and new technologies are emerging all the time. Additionally, different guidelines for adults and children further complicate access to diabetes technology in the transition from paediatric to adult care. Against this background, Diabetes UK and NHS England have brought together a multidisciplinary group of experts, including clinicians and people with diabetes, to develop this consensus guideline, combining the different technologies into a common pathway to aid clinical and policy decision‐making. We created a pathway that supports the incremental addition of technology as monotherapy and then dual therapy in the same way that we incrementally add in therapeutic agents to support people with Type 2 diabetes to achieve their personalized glycaemic targets. The pathway emphasizes the importance of structured education, specialist support and appropriate access to psychological therapies, as essential pillars for optimized use of diabetes‐related technology, and recommends the re‐evaluation of its use when the individual is unable either to use the technology appropriately or to achieve the intended outcomes. This pathway is endorsed by UK‐wide clinical and patient associations and we recommend that providers and commissioners use it to ensure the right individual with diabetes has access to the right technology in a timely way to help achieve better outcomes. 相似文献
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Brandon JC; Teplick SK; Haskin PH; Sammon JK; Muhr WF; Hofmann AF; Gambescia RA; Zitomer N 《Radiology》1988,166(3):665-667
The authors describe their experience with methyl tertiary butyl ether (MTBE) in a larger series of patients than previously reported in order to acquaint physicians with both its effectiveness for dissolution of common bile duct calculi and the limitations of its use. Ten patients with 13 biliary calculi underwent percutaneous stone dissolution treatment with the experimental cholesterol solvent, MTBE. Three stones completely dissolved within 30 minutes, seven were reduced in size, and three were visibly unaffected. All stones not completely dissolved were easily extracted by means of a stone basket except for one in a patient taken to surgery. Although MTBE perfusion is an effective technique for management of biliary calculi, practitioners should be aware that its use is quite time consuming and its odor difficult to control. 相似文献
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Darai E; Leblanc M; Walker-Combrouze F; Bringuier AF; Madelenat P; Scoazec JY 《Human reproduction (Oxford, England)》1998,13(5):1346-1352
We evaluated the immunohistochemical expression of cadherins and CD44
variants in 20 endometriomas, 20 cystadenomas, 20 borderline ovarian
tumours as well as 20 ovarian carcinomas, and the serological and cystic
fluid concentrations of soluble E-cadherin and soluble CD44 standard
(sCD44sdt) in 20 endometriomas, 20 cystadenomas, six borderline and 11
carcinomas of the ovary. In endometriomas, immunostaining of E- and
N-cadherin was negative (20 and 30% respectively). CD44 H, v3 and v6
immunostaining were detected in 63, 10 and 40% respectively. A difference
in immunostaining for E-cadherin was found between endometriomas and
cystadenomas (P < 0.001) and for N- cadherin between endometriomas and
carcinomas (P < 0.001). A difference in CD44H immunostaining was
observed between endometriomas and cystadenomas (P < 0.035) but not with
borderline ovarian tumours and carcinomas. No difference in serum
concentrations of soluble E- cadherins and CD44 standard was found between
the four groups of tumours. Cystic fluid concentrations of E-cadherin were
lower in endometriomas than in borderline tumours and ovarian carcinomas (P
< 0.001). High concentrations of soluble CD44 standard cystic fluid were
found in endometriomas than in other ovarian cysts. Endometriomas and
borderline tumours share alterations of cadherins and CD44 isoforms which
may help in the understanding of the aggressive and invasive potentials of
endometriotic cells.
相似文献
9.
Genital asymmetry in men 总被引:1,自引:0,他引:1
This study examined genital asymmetry in a large sample of men. The
probands were 6544 non-delinquent men who were interviewed by the Kinsey
Institute for Research in Sex, Gender and Reproduction from 1938 to 1963.
The measures were four indicators of penile and scrotal asymmetry, along
with self-reported handedness, from Kinsey's interview protocol. Most men
reported some degree of lateral asymmetry in their flaccid penis and in
their testicles; less asymmetry was reported for their erect penis. The
asymmetry typically occurred in the left direction, and this pattern
occurred in both right- and nonright- handers. However, this 'leftward'
pattern was significantly less pronounced in nonright-handers. The results
are discussed in relation to previous findings of genital asymmetry in men,
the possible relationship of genital asymmetry to functional cerebral
asymmetry, and recent data suggesting genital asymmetry may predict
patterns of cognitive performance and genital/sexual organ cancers.
相似文献
10.
Sircar AR Tripathi AK Choudhary SK Misra R 《The Journal of the Association of Physicians of India》1998,46(9):775-778
The present study describes the clinical and epidemiological features of 74 patients with human immunodeficiency virus (HIV) infection who presented to a referral hospital. Sixty two patients (83.7%) were diagnosed to have acquired immune deficiency syndrome (AIDS). Mean age of the patients was 34.9 +/- 12 years and male to female ratio was 3:1. Majority of patients (80%) were from lower socio-economic class. Multiple unprotected heterosexual contact with commercial sex workers in metropolitan cities of India, mainly Mumbai, was major risk factor in 82.1% male patients while most of the females (66.6%) had acquired infection from HIV positive husbands. Blood transfusion was the risk factor in 9(12.1%) patients. Sixty eight patients were infected with HIV 1, one with HIV 2, and five patients with both HIV 1 and HIV 2. Fever and weight loss were the commonest presenting symptoms. Tuberculosis, oropharyngeal candidiasis, and interstitial pneumonitis were present in 54.8%, 40.3% and 20.9% patients, respectively. Fourteen patients (22.5%) had generalised lymphadenopathy. Herpes zoster, cryptococcal meningitis, and peripheral neuropathy were infrequent. Response to standard antifungal and antitubercular treatment was satisfactory. Kaposi's sarcoma, lymphoma, and CNS toxoplasmosis were not found. The clinical manifestations of AIDS patients are strikingly different from that in the Western countries. It, thus, necessitates setting up of different guidelines for the clinical diagnosis and management of AIDS in India. 相似文献