ISSN:1357-8170    

DOI:10.1002/pdi.1960160402

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960160403

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

摘要:

AbstractPedal osteomyelitis in diabetic patients is a serious clinical problem. There is no single, reliable diagnostic tool; plain films are inaccurate, bone scans nonspecific and the role of human pooled immunoglobulin (Hig) scans remains unclear. Magnetic Resonance Imaging (MRI) may prove useful. We therefore aimed to compare these four diagnostic modalities. Thirteen diabetic patients with possible pedal osteomyelitis were recruited. Nine were found to have osteomyelitis based on clinical, microbiological, and surgical findings. All were scanned with all four modalities and the results compared. MRI scans correctly identified all positive cases, with two false positive cases, and excelled in localising infection, allowing for surgical planning. Plain film and Hig scans were less sensitive (6/9 and 7/9 cases, respectively), were difficult to interpret and were poor in localising infection. Bone scans identified eight of the nine cases, with no false positives. In conclusion, this small study suggests that plain films and Hig scans did not confer any additional benefit in the diagnosis of pedal osteomyelitis. Bone scans are a useful screening tool, but when positive an MRI scan should be sought to confirm the diagnosis.

ISSN:1357-8170    

DOI:10.1002/pdi.1960160404

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960160405

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

摘要:

AbstractAimsThis study considers how a local diabetes team can develop a system for patient data registration and follow‐up to enhance quality control and health economic analysis, and how a high response rate for patient data can be achieved.Patients and methodsA geographic population of yearly 120–130 intensively treated type 1 diabetes children.<19 years of age was studied. A prospective patient questionnaire monitored: blood glucose and urine testing, insulin doses, acute complications, medications for hypertension and epilepsy, tobacco and snuff use, and any open questions and needs of the patient. This was completed before every visit to the out‐patient department and used as a database for consultation. Data were thereafter registered in regular computer software, and analysed on a yearly basis.ResultsResponse rate increased with time to near 100%. There was a time gain for diabetes nurse and physician. Many patients found the questionnaire good for overviewing treatment and easy to complete, whereas some found it was irksome and boring. The total cost of the method was<160 SEK/patient year.ConclusionsA very high patient data response rate can be achieved over years by a patientsupportive questionnaire integrated in the treatment program. Treatment and outcome analysis can then be performed locally at low costs. The combination of a patient questionnaire with regular hard‐ and software is easy to create, manage and develop. Benefits for diabetes team and patients exceed the tot

ISSN:1357-8170    

DOI:10.1002/pdi.1960160406

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

摘要:

AbstractThe six‐year prospective data on 100 people newly diagnosed with type 2 diabetes, aged 40–69 years, were analysed. After careful and controlled dietetic training, carbohydrate metabolism parameters, physical status, fundus pictures and laboratory data were examined yearly, and alterations in treatment were noted. Twenty‐four subjects dropped out during the six year study period. At the end of the six years, 41% of the patients had continued to maintain good control by dietary means. The data were compared with those on 100 similarly detected new type 2 diabetic cases, whose education and control were provided by family physicians. The level of carbohydrate metabolism control was significantly better in the diabetic clinic‐controlled patients; the proportion of sulphonylurea‐treated patients was only 40.5% after six years compared with 68.9% among family physician‐controlled patients. The importance of a correct and controlled diet, good education and continuous control is

ISSN:1357-8170    

DOI:10.1002/pdi.1960160407

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960160408

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960160409

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

摘要:

AbstractThe objective of this study was to compare the monitoring of housebound and mobile diabetic patients aged 75 years and over. In addition, a survey was undertaken to assess the views of health professionals on the results obtained from the study and the service provided to patients.Thirty‐one volunteer general practices conducted a clinical audit of their diabetic patients using an audit protocol. They were then asked to identify which patients over the age of 75 years were housebound, using a standard definition provided to them. Results were analysed by the Primary Care Audit Group (PCAG) and the audit leads in each participating practice were asked to complete a questionnaire seeking their views on aggregated results and aspects of service provision.Data were collected on 682 mobile and 152 housebound diabetic patients aged 75 or over.The results indicate that housebound diabetic patients had significantly lower recorded standards of monitoring for each of seven key audit criteria, addressing annual assessment of symptoms, glycated haemoglobin, feet, urinalysis, fundi, blood pressure and smoking (p<0.001).Twenty‐eight (90.3%) of the audit leads returned the questionnaire and none of the respondents felt that housebound patients should attend hospital for monitoring. Respondents identified time and training as important resource issues for better monitoring in the community. Respondents also favoured the increased use of diabetic health visitors and domiciliary opticians and for nursing homes to take more responsibility for ensuring that their own patients were monito

ISSN:1357-8170    

DOI:10.1002/pdi.1960160410

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960160411

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY