ISSN:1357-8170    

DOI:10.1002/pdi.1960140618

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960140602

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960140603

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

摘要:

AbstractThe effect of a palliative radiotherapy (local X‐ray irradiation with a total of 2.45 Gy) over standard treatment was assessed in a placebo‐controlled double blind study in 12 diabetic patients with acute neurogenic osteoarthropathy (Charcot foot). All patients received standard treament as performed in this institution, including absolute pressure relief (bed rest and/or wheel chair) and preventive application of antibiotics (oral cephalexin or clindamycin), and either radiotherapy or sham‐radiotherapy. The time until healing (defined as absence of swelling, redness and hyperthermia during mild to moderate weight‐bearing re‐calcification of previous fractures or osteolyses on the first of two consecutive roentgenogrammes) was recorded as outcome measure.There was no difference in healing time according to radiotherapy (7 [95% Cl 4–10] months versus 9.7 [4–15]months, p>0.05). However, compliance versus non‐compliance with non‐weight‐bearing was associated with a significant reduction in healing time (5.5[3–7] months versus 10.5[8–20]months, p<0.05).In conclusion, non‐weight‐bearing supports healing of acute Charcot feet in diabetes, wh

ISSN:1357-8170    

DOI:10.1002/pdi.1960140604

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

摘要:

AbstractPeople with diabetes who administer a premixed insulin with a pen may require a largedose. Pens contain 150 or 300 units of insulin which is unlikely to be an exact multiple of the dose. Patients were asked what they did when the reservoir approached exhaustion. Twenty seven out of 110 patients were regularly giving two injections of insulin to avoid waste, although none had been instructed to do so. Seven other patients were taking action to avoid waste including five who were giving the wrong dose. The wastage of insulin is much less when using a 3 ml disposable pen than when using a 1.5 ml cartridge. If patients are instructed to use pens containing 300 units and advised to use the insulin left at the end of a pen for the smaller injection, the amount of insulin wasted is 3.6% compared with 13.6% wasted when using 1.5 ml cartridges. The total cost of insulin when using a dis‐posable pen is approximately one and a half times more than when using a cartridge, twice as much as when using a vial of the same human insulin, and two and half times more than when using pork insuli

ISSN:1357-8170    

DOI:10.1002/pdi.1960140605

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

摘要:

AbstractThe elevated blood glucose in DKA creates an osmotic gradient which typically results in hyponatremia. Many patients present with elevated serum sodium concentrations in DKA and very little is known about these patients. We questioned if these patients represent a ‘sicker’ population than those with normal or low serum sodium concentrations.The objective of this study was to characterise those patients who develop elevated corrected serum sodium levels in diabetic ketoacidosis (DKA). A retrospective medical record review was done of all episodes of DKA at The Children's Hospital of Alabama between January 1992 and June 1994. All cases of DKA were in patients less than 17 years of age.Among the 79 study entries which consisted of 52 separate individuals 46% female (n=36) 54% male (n=43), 11 patients were admitted for more than one episode of DKA, 27% (n=21) were patients with new onset diabetes and 73% (n=58) were patients with a prior history of diabetes mellitus. Of the corrected serum concentrations of sodium, 85% (n=67) were less than 149 mmol/L. In the patients with corrected serum sodium concentrations greater than 149 mmol/L (n=12), 35% (n=4) were African‐American and 65% (n=8) Caucasian, which was representative of the overall study population race distribution. Sixty seven per cent (n=8) of the hypernatremic patients were male, 33% (n=4) female.Patients with new onset diabetes were more likely to present with elevated concentrations of sodium in serum than known diabetic patients (t=5.52, p=0.02); 33% (n=7) of the patients with new‐onset diabetes were hypernatremic. No association was found between corrected sodium and age (t=0.31, p=0.76), duration of symptoms (t=0.42, p=0.68) or serum urea nitrogen concentration which was used as a marker for level of hydration (t=1.48, p=0.14). Duration of symptoms was found to be longer among patients with new onset diabetes (ZT=4.31, p<0.001) and patients presenting with elevated serum concentration of sodium (ZT=2.20, p=0.028).We conclude that patients with new onset diabetes are more likely to present with elevated sodium values unrelated to age or level of hy

ISSN:1357-8170    

DOI:10.1002/pdi.1960140606

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960140607

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960140608

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960140609

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960140610

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY