ISSN:1357-8170    

DOI:10.1002/pdi.1960050402

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960050403

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960050404

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractUsing self‐administered blood sampling on filter paper mailed for analysis of glucose, we evaluated the feasibility of home screening for diabetes mellitus (DM) and impaired glucose tolerance (IGT) in a specific target group, ie all people in a community aged 50–59. Of the 967 subjects we excluded 23 with known DM (2.4%), four with IGT, four having moved and four having died. Of the remaining 932, 688 participated. Fifty‐two people had a postprandial homeblood glucose value exceeding 7.1 mmol/l. Subjecting these to repeated oral glucose tolerance (OGTT) according to WHO 1985 we diagnosed DM in 12 and IGT in five more cases. Thus, for each known diabetic patient there may be another one undiagnosed in the age group st

ISSN:1357-8170    

DOI:10.1002/pdi.1960050405

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractDiabetes mellitus is a common problem with profound health consequences. Much attention has been directed towards the patient's role in the prevention of the complications of diabetes. The authors reviewed the clinical records of 46 diabetic patients in a Family Practice Residency Program with emphasis on the prevention of diabetic complications from the standpoint of the physician's responsibility. Eye, lower extremity, and renal care were evaluated, along with hypertension since it is an important exacerbating factor in diabetes. Clinic attrition rates were also assessed. Retinal history was recorded for 24% of patients while only 22% were referred to ophthamologists. A urinalysis was obtained in 57% of patients with approximately 25% of those examined having proteinuria. Blood pressure measurements were uniformly recorded although adequate blood pressure control was achieved in only 41% of the study group. Twenty‐eight per cent of patients had recorded evidence of significant lower extremity pathology, yet just 37% had any documentation of a lower extremity examination. The median clinic attendance time was 2.94 months with 43% of patients lost to follow‐up after the first visit. While these data suggest inadequate documentation of the performance of routine measures in the case of diabetes mellitus, they provide a strong incentive for improvem

ISSN:1357-8170    

DOI:10.1002/pdi.1960050406

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractA structured two session education programme (2 × 2 hours) was introduced for newly diagnosed Type II diabetic patients who were invited to attend within one month of diagnosis. To assess its value, 59 consecutive new patients were divided into attenders (n = 49) and non‐attenders (n=10). At diagnosis, HbA1cwas similar in the two groups (median, range); (attenders 12.3% (6.1–15.8) non‐attenders 13.1% (8.9–16.4)) and was significantly reduced in both groups six months after diagnosis; (attenders 7.9% (5.6–12.9), non‐attenders 8.5% (5.7–13.2)). Attenders lost weight during this period, while non‐attenders gained weight (attenders −3 kg (−12‐+3.5), non‐attenders +0.75 kg (−7.9‐+7) p=0.03). Although the initial therapy was diet alone in all 59 patients, at six months significantly fewer attenders required the addition of oral therapy than non‐attenders (20% v 60% p=0.01). All patients were tested after six months with a 17 point questionnaire of knowledge and compliance. Attenders scored higher than non‐attenders (median 85% v 65%, p=0.0003).There was an inverse correlation between age and test score (rs= −0.28, p=0.03) in the whole patient group.It is concluded that attendance at the education sessions improved patients' knowledge about diabetes and led to a reduced depend

ISSN:1357-8170    

DOI:10.1002/pdi.1960050407

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractThe self‐assessed compliance of 100 randomly‐selected diabetics (42 males, 58 females: age range 14–83 years) attending the Hammersmith Hospital outpatient department was examined using a short, anonymous, multiple‐choice questionnaire. Over three‐quarters of the sample admitted to a significant degree of dietary non‐compliance, especially those under the age of 60 years (p<0.05). Although 96% of those on insulin or oral hypoglycaemics stated that they took medication exactly as prescribed, over half the sample admitted to being non‐compliant when performing home blood glucose monitoring. Almost a quarter of the sample said they had, at some time, fabricated results of blood or urine glucose testing, and eight subjects indicated that they had deliberately omitted to bring record books to clinic in the past.The vast majority (94%) of the diabetics said they would report diabetes‐related problems (such as hypoglycaemia) even if they had to be asked directly, but a small percentage would not report such problems at all. Almost all (96%) patients considered at least some of their fellow diabetics to be dishonest during an outpatient consultation, while only 25% thought that the clinic doctors believed everything their diabetic patients reported. These results suggest that, although compliance is poor, diabetic patients will usually admit to it in confidence. Thus, direct questioning remains a key tool in the management of diabet

ISSN:1357-8170    

DOI:10.1002/pdi.1960050408

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960050409

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractThis paper reviews five cases of malignant otitis externa treated in Portsmouth between 1979 and 1986. These five patients constitute all the cases seen in the Portsmouth, South East Hampshire, Chichester and South West Sussex area during the period, indicating the condition to be rare. All cases showed a number of features in common: all were elderly (over 55 years); diabetic; the majority (4:1) being male. In all casesPseudomonus aeruginosawas cultured from pus exuding from the external auditory canal. Each of the five cases was resident in the Chichester and South West Sussex part of the catchment area. Every case presented with otorrhoea and otalgia and all were treated with a combination of topical and intravenous antibiotics plus intensified diabetic control. Two cases followed ear syringing.Neurological complications seen in this series of patients included facial palsy (three cases), fifth nerve palsy, dysphagia, vocal cord palsy, ataxia and Argyll‐Robertson pupi

ISSN:1357-8170    

DOI:10.1002/pdi.1960050410

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960050411

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY