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  • 1
    Electronic Resource
    Electronic Resource
    Slow metabolic deterioration towards diabetes in islet cell antibody positive patients with autoimmune polyendocrine disease (1994)
    Springer
    Diabetologia 37 (1994), S. 365-371 
    Details
    ISSN: 1432-0428
    Keywords: Intravenous glucose tolerance test ; 37k-antibodies ; islet cell antibody staining pattern ; polyendocrinopathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We studied metabolic progression to IDDM in a cohort of adults who are ICA-positive and have associated autoimmune endocrine disease or circulating organ-specific autoantibodies (the Polyendocrine Study). Of the 186 individuals recruited 27 developed overt diabetes after a median follow-up of 4.5 years (range 0.4–12). Of these, eight patients did not require insulin treatment until at least 6 months after clinical diagnosis, with an interval of 1.8 years (1.2–5.7). An IVGTT was performed in 38 subjects and 23 had sequential studies. Of the initial 38 subjects six developed diabetes and only three showed a loss of FPIR to glucose (below the first percentile of a normal control group) before clinical onset of the disease. An additional three subjects showed a loss of the FPIR, and all still have normal glucose tolerance after median follow-up of 28 months (22–95). A “whole” or “mixed” pattern of islet cell staining was found in five of the six patients who developed diabetes and antibodies against an islet 37 k-antigen were detectable in four patients, all of whom required insulin soon after diagnosis. A beta-cell “selective” ICA staining pattern was seen in 14 of 17 subjects who did not develop diabetes and the “mixed” pattern in only three. None of this group had detectable 37k-antibodies. We conclude that metabolic deterioration is slow in polyendocrine patients, and that the IVGTT has less prognostic significance in this group than in first degree relatives of patients with IDDM. In contrast, the presence of the “whole” or “mixed” ICA staining pattern or of 37k-antibodies can identify a high risk of progression to IDDM within this polyendocrine population and may indicate the rate of metabolic deterioration.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00408472
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Distinct cytoplasmic islet cell antibodies with different risks for Type 1 (insulin-dependent) diabetes mellitus (1992)
    Springer
    Diabetologia 35 (1992), S. 385-388 
    Details
    ISSN: 1432-0428
    Keywords: Islet cell antibodies ; Type 1 (insulin-dependent) diabetes mellitus ; polyendocrinopathy ; indirect immunofluorescence ; glutamate decarboxylase
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The cytoplasmic islet cell antibody patterns of sera from islet cell antibody positive non-diabetic and diabetic endocrine autoimmune patients, and newly-diagnosed Type 1 (insulin-dependent) diabetic patients were characterised using four layer immunofluorescence with monoclonal antiproinsulin or anti-glucagon antibodies. Two distinct islet cell antibody types were identified. One gave a diffuse cytoplasmic staining in both Beta and Alpha cells (‘whole’ islet pattern), and was not affected by pre-incubation with rat brain homogenate. The other had a granular appearance with staining restricted predominantly to Beta cells (‘selective’ islet pattern) and was completely inhibited by pre-incubation with rat brain homogenate. Some sera appeared to have a ‘mixed’ islet pattern, in which glucagon-positive cells gave a weaker cytoplasmic staining than proinsulin-positive cells. The granular ‘selective’ pattern was found in sera from 19 (79%) of 24 non-diabetic endocrine autoimmune patients, in two (22%) endocrine autoimmune patients who developed Type 1 diabetes (p〈0.0001 vs non-diabetic endocrine autoimmune patients), and in none of 19 newly-diagnosed diabetic patients. The ‘whole’ islet pattern was found only in sera from patients who had, or who subsequently progressed to, Type 1 diabetes. This study has identified a novel islet cell antibody specificity and demonstrates that in islet cell antibody positive endocrine autoimmune patients, only islet cell antibodies which stain both Beta and Alpha cells are associated with progression to Type 1 diabetes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00401207
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Studies on drug monitoring in thrice and once daily treatment with aminoglycosides (1993)
    Springer
    Intensive care medicine 19 (1993), S. 215-220 
    Details
    ISSN: 1432-1238
    Keywords: Aminoglycosides ; Drug monitoring ; Netilmicin ; Peak concentration ; Once daily treatment ; Thrice daily treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives To investigate at what time the peak level should be determined under conventional thrice daily (t.i.d.) administration of the aminoglycoside netilmicin and to study its serum concentrations under once daily (od) treatment to define the required daily dose and to gain information about convenient drug monitoring. Design The design of the study was a consecutive sample trial. Setting The study took place in a university hospital. Patients 41 intubated patients of a surgical ICU who received netilmicin as a short-term infusion over 30 min for life-threatening infections were included in the study. Interventions In 21 patients netilmicin was administered t.i.d. The virtual peak levels which had been determined by pharmacokinetic dosage calculation were compared with the serum concentrations obtained directly after the administration as well as after 15, 30, 60 and 180 min. In 20 patients the netilmicin serum concentrations during od treatment were determined directly before and immediately after the application as well as 0.5, 1, 3, 7 and 12 h later. To achieve a virtual peak level of 25 mg/l and a trough level of 0.5 mg/l individual adjustment of the dosage based on pharmacokinetic calculations was performed. Measurements and results In t.i.d. treatment the serum concentration measured after 30 min was closest to the virtual peak level; therefore, this is the best time to determine the peak level. In od treatment the required daily dose was 7.86 mg/kg body weight (median) in patients with normal renal function. During od dosing the trough level was extremely important in drug monitoring, whereas determination of the high peak level was of doubtful value. Conclusions The peak level should be determined during t.i.d. administration at 30 min. In od treatment the initial daily dose should be 7 mg/kg body weight; in drug monitoring the trough level is very important.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01694773
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    Paper (German National Licenses)
    Fulltext
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