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  • 1
    ISSN: 1432-0428
    Keywords: Type 1 (insulin-dependent) diabetes mellitus ; glycaemic control ; HbA1c ; fetal haemoglobin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Glycated haemoglobin levels (HbA1 and HbA1c) are established parameters of long-term glycaemic control in diabetic patients. Depending on the method used, fetal haemoglobin interferes with the assays for glycated haemoglobin. If present in high amounts, fetal haemoglobin may lead to overestimation of glycated haemoglobin levels, and therefore, of average blood glucose concentration in diabetic patients. Glycated (HbA1c) and fetal haemoglobin levels were measured by high pressure liquid chromatography in 60 (30 female) adult Type 1 (insulin-dependent) diabetic patients of Swiss descent, and were compared with levels obtained from 60 normal, non-diabetic control subjects matched for age and sex. Fetal haemoglobin levels were significantly higher in the diabetic patients (0.6±0.1%, mean±SEM; range: 0–3.6%) than in the control subjects (0.4±0.1%, p〈0.001). Elevated fetal haemoglobin levels (≥0.6%) were found in 23 of 60 diabetic patients (38%) compared to 9 of 60 control subjects (15%; χ 2=8.35, p〈0.01). In addition, fetal haemoglobin levels in diabetic patients are weakly correlated with glycated haemoglobin (HbA1c) (r=0.38, p〈0.01). Fetal haemoglobin results were confirmed with the alkali denaturation procedure, and by immunocytochemistry using a polyclonal rabbit anti-fetal haemoglobin antibody. A significant proportion of adult patients with Type 1 diabetes has elevated fetal haemoglobin levels. In certain patients this may lead to a substantial over-estimation of glycated haemoglobin levels, and consequently of estimated, average blood glucose levels. The reason for this increased prevalence of elevated fetal haemoglobin remains unclear, but it may be associated with poor glycaemic control.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 32 (1989), S. 227-230 
    ISSN: 1432-0428
    Keywords: diabetes control ; diabetes mellitus ; fetal haemoglobin ; glycated haemoglobin ; insulin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Fetal haemoglobin levels were measured in 106 patients with Type 1 (insulin-dependent) diabetes mellitus during a period of two to three years. In 15 patients (14.1%) increased fetal haemoglobin levels (〉0.5%), determined by high pressure liquid chromatography, were found in contrast to 3% in a healthy control group (n: 100) of equal age distribution. In children aged over 6 years, elevated fetal haemoglobin levels were measured in 13 diabetic patients (13.3%) in contrast to none of the control group. There was no correlation between fetal haemoglobin levels and duration of diabetes, diabetic control (glycated haemoglobin) and dosage of insulin (U·kg−1, day−1). The 15 patients had a younger mean age at onset of diabetes (5.6 years) than a sex and age matched control group of diabetic patients without increased fetal haemoglobin levels (7.4 years, p〈0.05). Longitudinal assessment revealed a significant decline of fetal haemoglobin levels with age (p〈0.005) but a further increase in fetal haemoglobin levels were found in adolescent patients (n: 2). These data indicate a possible effect of insulin-treatment on delaying transition from fetal to adult haemoglobin synthesis or on reactivation of fetal haemoglobin production.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Anatomy and embryology 23 (1904), S. 609-618 
    ISSN: 1432-0568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Anatomy and embryology 25 (1904), S. 701-764 
    ISSN: 1432-0568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1440
    Keywords: Juvenile obesity ; body composition ; total body potassium ; insulin release ; small doses of glucose ; Juvenile Adipositas ; Körperzusammensetzung ; Ganzkörperkalium ; Insulinausschüttung ; kleine Glucose-Dosen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei 12 adipösen Kindern (relatives Gewicht 161–222%) wurden Schwellenuntersuchungen der Insulinsekretion durchgeführt. Glucose wurde in steigenden Dosen (0,02, 0,04, 0,08 und 0,33 g/kg) und stündlichen Abständen innert einer Minute intravenös verabreicht. Glucose und immunoreaktives Insulin (IRI) wurden in kurzen Intervallen nach jeder Dosis bestimmt. Als Kontrollgruppe dienten 12 Normalgewichtige, die so gewählt wurden, daß das totale Gewicht der beiden Vergleichsgruppen ähnlich war. Die Glucosetoleranz war in beiden Gruppen identisch. Das IRI, der IRI/Glucosequotient und der IRI-Anstieg (Δ IRI) waren bei den Adipösen bei allen Dosen signifikant höher. Die kleinste Glucosedosis erlaubte die Unterteilung der Adipösen in zwei Gruppen: Gruppe A mit normalem Δ IRI und Gruppe B mit stark erhöhtem Δ IRI. Die mittels Ganzkörperkaliumbestimmung geschätzte Körperzusammensetzung zeigte, daß die Adipösen der Gruppe B mehr Fettgewebe aufweisen als diejenigen der Gruppe A. Die Resultate zeigen, daß die pathologisch vermehrte Insulinsekretion mit der Körperzusammensetzung zusammenhängt.
    Notes: Summary In twelve obese children (relative weight 161–222%) threshold studies of insulin secretion were performed after administration of increasing doses of glucose I.V. (0.02, 0.04, 0.08 and 0.33 g/kg body weight) given at 0, 60, 120, and 180 minutes. Glucose and immunoreactive insulin (IRI) levels were determined at short intervals after each dose. The contrast group consisted of twelve subjects of normal body weight selected in such a way that the total weight of the two groups was comparable. The IRI, IRI/Glucose quotient and the increment of IRI over the baseline values (Δ IRI) were significantly increased in the obese group. The response to the smallest glucose dose allowed to divide the obese into two subgroups: group A with a normal Δ IRI and group B with a considerably increased Δ IRI. Determination of the body composition by means of a whole body counter showed that patients of group B have more fat tissue than patients of group A. These results clearly indicate that the pathological insulin secretion is related to body composition.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Journal of cancer research and clinical oncology 47 (1938), S. 413-420 
    ISSN: 1432-1335
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zusammenfassung Beim Meso- und Hypopharynxtumor beobachtet man häufig nach Erzielung lokaler Symptomfreiheit durch Strahlentherapie das Auftreten eines sekundären Oesophagustumors. Es läßt sich zeigen, daß jeder 7. bis 8. Patient, der lokal durch die Bestrahlung geheilt werden kann, an einemsekundären Oesophagustumor stirbt. Die Untersuchung des Materials ergibt, daß es sich um eineMetastase des primären Meso- oder Hypopharynxtumor handeln muß, und es kann ferner durch die zahlenmäßige Auswertung eines großen Materials bewiesen werden, daß der sekundäre Oesophagustumor fast immer auf dem Wege einerImpfmetastase angeht. Nur selten handelt es sich um lymphogene Metastasen. Die weitere Betrachtung des Materiales macht es wahrscheinlich, daß die Vornahme der Probeexcision das Auftreten der Oesophagusmetastase begünstigt. Man sollte, wenn irgend möglich, die Probeexcision bei Meso- und Hypopharynxtumoren mit der elektrischen Schlinge durchführen.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1076
    Keywords: Coeliac disease ; Diabetes mellitus type I ; Antigliadin antibodies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Screening for coeliac disease (CD) with serum antigliadin antibodies (AGA) was performed in 1032 diabetic children and adolescents. In 8 children CD had been diagnosed before study entry. Of the remaining 1024 children, 33 had an elevated AGA titre in the first serum sample. On follow-up an elevated AGA titre was confirmed in only 17 of 31 patients. Nine of the repeatedly positive patients underwent jejunal biopsy, and CD was diagnosed in two asymptomatic patients; both were positive for IgG- and IgA-AGA. Among 10 AGA-positive patients in whom biopsies could not be performed, only 1 showed IgA-AGA and thus carried a high risk for CD. From our results we estimate a prevalence of CD in Swiss and German diabetic children between 1.1% and 1.3%. Falsepositive AGA titres occurred significantly more often in patients with diabetes duration of less than 1 year. AGA testing teached a specificity of 99% if performed at least 1 year after the onset of diabetes. Children suffering from both diabetes and CD showed a diabetes manifestation at a significantly younger age than non-coeliac patients, whereas CD tended to be diagnosed at a remarkably late age.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-1076
    Keywords: Microalbuminura ; Type 1 diabetes mellitus ; Children ; Proteinuria ; Diabetic nephropathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Microalbuminura (MA) was determined in 127 children and adolescents (age 3–21 years) with type 1 (insulin-dependent) diabetes mellitus. Patients with clinical evidence of long-term complications or macroproteinuria were excluded. Urinary albumin excretion was measured in a nocturnal 12-h collection and correlated with the albumin/creatinine ratio of a urine sample freshly voided on the morning immediately following the collection. The patients were divided into group A (n=83, age 〈16 years, duration of diabetes 1–13 years, mean 4.4) and group B (n=44, age 〉16 years, duration of diabetes 1–19 years, mean 8.7) and compared with appropriate controls. MA above 15 μg/min was present in 11 of 83 (13.3%) patients in group A and in 7 of 44 (15.9%) in group B. In a repeat urine collection at least 3 months later elevated MA persisted in 1 of 11 (group A) and in 4 of 7 (group B) patients. There was no correlation between increased MA in a 12-h urine collection and the albumin/creatinine ratio in a subsequently voided urine sample. MA was not strictly dependent on age, sex, duration of diabetes, haemoglobin A1, mean arterial blood pressure, plasma creatinine, creatinine clearance or serum beta-2-microglobulin. Further systematic studies and careful follow up are necessary to appraise whether intermittent MA is indeed an early manifestation of incipient kidney disease in children with type 1 diabetes.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1076
    Keywords: Insulin-dependent diabetes mellitus ; Childhood Microalbuminuria ; Puberty Diabetic nephropathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Microalbuminuria is generally accepted to be highly predictive of overt diabetic nephropathy which is the leading cause of end-stage renal failure and, consequently, of death in patients with type 1 (insulin-dependent) diabetes mellitus (IDDM). Its early identification and therapy are exceedingly important. We studied prospectively the occurrence of microalbuminuria (MA) in relation to puberty and its pubertal stages in 164 children and adolescent patients (83 girls and 81 boys) with IDDM. Analysing 100 healthy subjects, normal values for albumin excretion (range: 0–10.1 μg/min/1.73 m2) according to sex and the different pubertal stages were defined. No significant difference between the groups were noted and, therefore, 20 μg/min per 1.73 m2 (3 SD above the mean) was generally defined as cut-off for MA. Of the patients with IDDM studied, 20% (20 females and 12 males) developed persistent MA (22.1–448.2 μg/min/1.73 m2) during the study period of 8 years. The first manifestation of persistent MA was in 69% (13 females and 9 males) during stages of early and midpuberty; and in 28% (6 females and 3 males) at a late pubertal stage or at the end of puberty. The only child who developed MA before the onset of puberty (range: 23.5–157.4 μg/min/1.73 m2) was found to have dystopic kidney. Therefore, all patients with IDDM should be screened for MA regardless of diabetes duration, sex and level of diabetes control beginning at the very first stage of puberty and neither earlier nor after puberty as suggested by the American Diabetes Association.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 151 (1992), S. 786-788 
    ISSN: 1432-1076
    Keywords: Alternative nutrition ; Goitre ; Iodine deficiency ; Carnitine deficiency ; Dietary deficiency disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 7.5-month-old infant with failure to thrive, developmental delay, muscular hypotonia, a visible goitre and severe osteopenia is described. Laboratory examination revealed a markedly increased serum TSH with low free T4, severe iodine and carnitine deficiency. The infant was breastfed until the age of 2.5 months and was then given a mixture of almond extract in water. The mother is a strict vegan and the father a lactovegetarian. The nutritional intake of the child was severely depleted in calories (−46%), calcium (−73%) and iodine (−88%). The restrictive alternative nutrition was responsible for the various deficiency disorders.
    Type of Medium: Electronic Resource
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