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  • 1
    ISSN: 1432-0428
    Keywords: Diabetes education ; Type 1 diabetes ; severe hypoglycaemia ; diabetes care
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In two hospitals an identical diabetes teaching and treatment programme (in-patient, Monday to Friday, group teaching) was set up. Seventy-eight consecutive, conventionally treated Type 1 diabetic patients (duration of diabetes 10±6 years), referred during a certain period, were reinvestigated after 1 year, and again (for assessment of metabolic control only) 22 months after the teaching and treatment programme. Initially, mean glycosylated haemoglobin was 2.6%, after one year 1.0%, and after 22 months 1.5% above the upper limit of the normal range (p〈0.001). Hospital admissions were reduced from a mean of 10 to a median of 1 day per patient per year (p〈0.001). The long-term quality of diabetes care achieved by the diabetes teaching and treatment programme was unrelated to intelligence quotient, diabetes duration, or diabetes-related knowledge. Patients with normal levels of glycosylated haemoglobin on follow-up (33% of all patients) had particularly good compliance rates, and significantly lower initial values of glycosylated haemoglobin than patients with glycosylated haemoglobin levels ⩾10%. The data indicate that the diabetes teaching and treatment programme resulted in a substantial long-term improvement of metabolic control and a striking reduction of hospital admissions. The study substantiates the feasibility of applying this teaching and treatment programme on a large scale to other hospitals, so as to improve the quality of diabetes care and decrease health care costs.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1440
    Keywords: Glycosylated hemoglobin ; Hemolytic anemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Reduced levels of glycosylated hemoglobins (GHb) have been found to be closely related to red cell survival. We therefore studied the relation of this parameter to the clinical applicability in patients with hemolytic disease (n=20). During a 5-week period we repeatedly measured severity of anemia, i.e., hemoglobin (Hb), packed red cell volume (VPRC), and red blood cell count (RBC), as well as reticulocytosis and parameters of red cell destruction such as serum concentration of lactic dehydrogenase (LDH) and bilirubin together with GHb. There was a weak correlation between simultaneously measured GHb and RBC (r=0.5,P=0.02), but none was demonstrable between GHb and Hb, VPRC, reticulocyte counts, LDH, or bilirubin. A much closer correlation, however, was found between actual GHb levels and RBC determined 3–5 weeks previously (r=0.72,P=0.001), as well as Hb (r=0.56,P=0.015), VPRC (r=0.57,P=0.013), reticulocyte counts (r=−0.63,P=0.006), LDH (r=−0.53,P=0.02), and serum bilirubin concentrations (r=−0.55,P=0.016). GHb was also significantly decreased in patients with consistently low values of reticulocytes when red cell destruction was demonstrable. These result show that GHb is a measure of red cell destruction and restitution, and thus may be useful for long-term monitoring of patients with hemolytic disease.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1440
    Keywords: Chronic lymphatic leukemia ; B-cell proliferation ; Hypogammaglobulinaemia ; Immunomorphology ; Immunocytic lymphoma ; Chronisch lymphatische Leukämie ; B-Zellen Proliferation ; Hypogammaglobulinämie ; Immunmorphologie ; Immunocytisches Lymphom
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Aufgrund klinischer Befunde wurden 71 Patienten als chronisch lymphatische Leukämie (CLL) diagnostiziert, wobei die meisten den Stadien 0, I und II und nur 18% den Stadien III und IV nach Rai zuzuordnen waren. In allen Fällen stellte die Erkrankung eine Vermehrung der B-Lymphocyten Subpopulation dar (B-CLL). Beim Nachweis membrangebundener Immunglobuline (Ig) besaßen die leukämischen B-Zellen meist eine schwach ausgeprägte Immunfluoreszenz-Intensität. Damit in Übereinstimmung ergab die quantitative Bestimmung der Ig im Serum bei 72% der Patienten eine Verminderung einer oder mehrerer Ig-Klassen. Es war nicht möglich, die Zahl der B-Lymphocyten (und auch der T-Lymphocyten) oder die Konzentration der Ig im Serum mit dem Stadium der Erkrankung zu korrelieren. Um eine Abgrenzung der CLL von anderen lymphoproliferativen Erkrankungen, vor allem dem immunocytischen Lymphom, zu erreichen, wurde bei einem Großteil der Patienten ein Lymphknoten exstirpiert und histologisch sowie immunmorphologisch auf intracytoplasmatische Ig untersucht. Danach konnte die Diagnose einer CLL in 33 von 40 Fällen aufrechterhalten werden. Sechs Lymphknoten wurden als immunocytisches Lymphom erkannt, wobei sich klinisch in drei dieser Fälle eine Ig-Verminderung im Serum fand. Diese Beobachtung macht deutlich, daß die klinisch gestellte Verdachtsdiagnose einer CLL durch immunmorphologische Untersuchungen gesichert werden sollte.
    Notes: Summary Chronic lymphatic leukemia (CLL) was diagnosed in 71 patients based on clinical data. Most of the patients were in the stages 0, I and II, only 18% were in the stages III and IV according to Rai. In all cases, the disease was characterized by an increased number of B lymphocytes (B-CLL). The B cells mostly expressed a weak fluorescence intensity when tested for membrane bound immunoglobulins (Ig). In accordance to that, the quantitative measurement of Ig in the serum revealed a decrease of one or more Ig classes in 72% of the patients. No correlation existed between the number of B lymphocytes (and T lymphocytes) or the Ig concentration in the serum and the stage of the disease. To distinguish the CLL from related lymphoproliferative disorders, especially the immunocytic lymphoma, lymphnode biopsies were examined histologically and immunomorphologically for intracytoplasmic Ig. This examination confirmed the diagnosis of CLL in 33 out of 40 cases. Six lymphnodes were classified as immunocytic lymphoma of the lymphoplasmacytoid type. In three of the latter, the immunocytic lymphoma was clinically associated with decreased Ig concentrations in the serum. These findings emphasize that the clinically established diagnosis of CLL should be corroborated by immunomorphology.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 62 (1984), S. 531-532 
    ISSN: 1432-1440
    Keywords: Nephrotic syndrome ; Fibronectin ; Fibrinogen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In nine patients with nephrotic syndrome the behaviour of plasma fibronectin was studied. Of nine patients seven showed elevated plasma fibronectin levels while the plasma fibrinogen level was increased in eight of the nine investigated patients. A positive correlation was found between plasma fibronectin levels and fibrinogen (P〈0.01), cholesterol (P〈0.01) and proteinuria (P〈0.05). The results indicate that elevated plasma fibronectin levels could be an additional factor responsible for hypercoagulability in nephrotic syndrome.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 65 (1987), S. 97-100 
    ISSN: 1432-1440
    Keywords: Myocardial calcinosis ; Hemodialysis ; Hyperoxalemia ; Ascorbic acid ; Calcium oxalate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Secondary oxalosis in chronic hemodialyzed patients is caused by impaired renal excretion and inadequate removal of oxalic acid during hemodialysis. Ascorbic acid is a precursor of oxalic acid. We report a parathyroidectomized patient with chronic renal failure, on hemodialysis, who received over a period of several months a total dose of 91.0 g ascorbic acid i.v. The plasma oxalic acid level in this patient was 14-fold higher than in healthy persons. Increased oxalic acid synthesis from its precursor ascorbic acid may be responsible for hyperoxalemia, high content of oxalic acid in myocardium, aorta and lung, and calcium oxalate deposition in soft tissues. Application of high doses of ascorbic acid should be avoided in hemodialysed patients with chronic renal failure.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 66 (1988), S. 552-555 
    ISSN: 1432-1440
    Keywords: Hodgkin's disease ; Hypothermia ; Exploratory laparotomy ; Corticosteroids
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Hypothermia is a rare complication of unknown origin in Hodgkin's disease which has been reported after the administration of antineoplastic agents, chlorpromazine and paracetamol. We report a highly febrile patient with stage IV-B Hodgkin's disease of mixed cellularity type who underwent exploratory laparotomy. Because of suspected septic shock high-dose prednisolone was given during surgery. Postoperatively the patient's body temperature fell progressively to 32.9° C and remained at less then 35.5° C for the following 5 days. There seems to be some functional disorder of thermoregulation in Hodgkin's disease. Physical factors during surgery or certain drugs, especially cytotoxics, corticosteroids, anesthetics or antipyretics may lead to prolonged hypothermia.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1238
    Keywords: Pentoxifylline ; Septic shock ; Cytokines
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To evaluate the influence of pentoxifylline (PTX), a phosphodiesterase inhibitor, on cytokines and inflammatory proteins in patients suffering from septic shock. Design Prospective study comparing a therapy group to a matched control group. Setting Medical intensive care unit at a university hospital. Patients Twenty four patients fulfilling the criteria of septic shock were included in this study. Twelve patients received PTX (therapy group) and 12 patients matched for diagnosis, age and gender served as the control group. Interventions Pentoxifylline at 1 mg/kg per hour over 24 h in the therapy group. Measurements ad results Cytokine levels [tumor necrosis factor-α (TNF)], soluble TNF receptor [TNF-R], and interleukin-6 [IL-6] and inflammatory proteins [C-reactive protein, α-1-antitrypsin (AAT), fibronectin, and haptoglobin], as well as hemodynamic parameters and the APACHE III score were evaluated before initiation of therapy and 24 h later. After 24 h, TNF levels were significantly lower in the therapy group (p=0.013), while IL-6 levels were significantly higher in the therapy group (p=0.030). Within the 24 h TNF declined significantly in the therapy group (p=0.006), while IL-6 showed a significant increase (p=0.043). AAT and the APACHE III score tended to differ significantly after 24 h between the groups [AAT levels higher in the therapy group (p=0.05), APACHE III score lower (p=0.05)]. In the therapy group, the systemic vascular resistance index was significantly higher after 24 h (p=0.0026) whereas the cardiac index declined (p=0.035). Conclusions PTX does influence TNF levels in septic shock patients. Nevertheless, inhibiting a single mediator in severe septic shock cannot stop the inflammatory overreaction.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-1238
    Keywords: Key words Pentoxifylline ; Septic shock ; Cytokines
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To evaluate the influence of pentoxifylline (PTX), a phosphodiesterase inhibitor, on cytokines and inflammatory proteins in patients suffering from septic shock. Design: Prospective study comparing a therapy group to a matched control group. Setting: Medical intensive care unit at a university hospital. Patients: Twenty four patients fulfilling the criteria of septic shock were included in this study. Twelve patients received PTX (therapy group) and 12 patients matched for diagnosis, age and gender served as the control group. Interventions: Pentoxifylline at 1 mg/kg per hour over 24 h in the therapy group. Measurements ad results: Cytokine levels [tumor necrosis factor-α (TNF)], soluble TNF receptor [TNF-R], and interleukin-6 [IL-6] and inflammatory proteins [C-reactive protein, α-1-antitrypsin (AAT), fibronectin, and haptoglobin], as well as hemodynamic parameters and the APACHE III score were evaluated before initiation of therapy and 24 h later. After 24 h, TNF levels were significantly lower in the therapy group (p=0.013), while IL-6 levels were significantly higher in the therapy group (p=0.030). Within the 24 h TNF declined significantly in the therapy group (p=0.006), while IL-6 showed a significant increase (p=0.043). AAT and the APACHE III score tended to differ significantly after 24 h between the groups [AAT levels higher in the therapy group (p=0.05), APACHE III score lower (p=0.05)]. In the therapy group, the systemic vascular resistance index was significantly higher after 24 h (p=0.0026) whereas the cardiac index declined (p=0.035). Conclusions: PTX does influence TNF levels in septic shock patients. Nevertheless, inhibiting a single mediator in severe septic shock cannot stop the inflammatory overreaction.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 150 (1990), S. 19-21 
    ISSN: 1432-1076
    Keywords: Serum angiotensin converting enzyme activity ; Congenital heart disease ; Pulmonary blood flow ; Pulmonary arterial pressure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Serum angiotensin converting enzyme (ACE) activity was determined in 46 children with congenital heart disease with normal and abnormal lung perfusion: (1) congenital heart disease with normal pulmonary blood flow (12 patients); (2) congenital heart disease with increased pulmonary blood flow (18 patients); (3) congenital heart disease with decreased pulmonary blood flow (16 patients). There was no significant difference in serum ACE activity between the three groups. In group 2 serum ACE activity had a tendency to correlate inversely with both mean pulmonary arterial pressure (r=−0.43;P≤0.05) and pulmonary vascular resistance (r=−0.48;P=0.05). No further correlations between serum ACE activity and age, serum electrolytes, creatinine nor other haemodynamic data could be established.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Biochemical and Biophysical Research Communications 123 (1984), S. 1047-1053 
    ISSN: 0006-291X
    Keywords: [abr] MPO; myelperoxidase ; [abr] O^-"2; superoxide anion ; [abr] PMNL; polymorphonuclear leukocytes ; [abr] f-nLLP; N-formyl-norleucyl-leucyl-phenylalanine
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Chemistry and Pharmacology , Physics
    Type of Medium: Electronic Resource
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