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  • 1
    ISSN: 1432-0428
    Keywords: Persistent proteinuria ; relative mortality ; prognosis ; Type 1 diabetes ; diabetic complications ; angiopathy ; nephropathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We followed 1, 134 patients with Type 1 (insulin-dependent) diabetes, diagnosed between 1933 and 1952, until 1982 or death or until their emigration. Their age at onset of diabetes was under 31 years. Information concerning the development of persistent proteinuria was sought in every case. In 104 cases, the data were either questionable or the patient could not be traced. Twenty-nine patients developed non-diabetic proteinuria. Among the remaining 1,001 patients, 406 developed persistent proteinuria (350 died) and 595 did not (166 died). The incidence of persistent proteinuria was highest among men; it decreased with increasing year of diabetes onset from 1933 to 1952, and decreased with increasing age at onset. The relative mortality was extremely high among patients with persistent proteinuria, increasing to a maximum of about 100 at age 35 years. Patients not developing proteinuria had a relatively constant low relative mortality of about 2. The decreasing incidence of persistent proteinuria and the decreasing mortality with increasing calender year of diabetes onset resulted in a 50% increase in life-expectancy among patients diagnosed in 1950 compared with patients diagnosed in 1935. In patients who developed persistent proteinuria, relative mortality was higher in women than men at all ages. In patients who did not develop proteinuria, relative mortality was similar in men and women after the age of 35. Uraemia was the main cause of death in patients with persistent proteinuria, although cardiovascular deaths were more frequent than in patients without proteinuria. Thus, proteinuria is associated not only with death from uraemia but also from cardiovascular disease. It is concluded that the development of persistent proteinuria is a major life-threatening complication in patients with early-onset Type 1 diabetes. Patients who do not develop proteinuria have almost a normal life expectancy.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Experimental brain research 38 (1980), S. 205-219 
    ISSN: 1432-1106
    Keywords: Hippocampus ; Analysis of theta cells
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The participation of physiologically identified hippocampal neurons in spontaneous and hypothalamically induced theta activity was studied in rabbits lightly anaesthetized with urethane. Dentate granule cells were identified by their orthodromic response to perforant path stimulation, CA1 and CA3 pyramids by antidromic activation from the alveus and Schaffer collaterals, respectively, and basket cells by their response to increasing orthodromic activation. The discharges of many hippocampal cells were grossly correlated to the pattern of slow wave activity. Few cells were spontaneously active during irregular slow wave activity. With the appearance of rhythmical slow wave activity of 4–6 Hz, the unit discharges also increased in frequency. Dentate granule cells had the lowest threshold for activation and also a longer duration of the increased discharge frequency, compared to other cell types. There was a characteristic pattern of transition for dentate granule cells and CA1 pyramidal cells from a silent to an active state. The cell discharges paralleled the changes in amplitude, regularity, and frequency of theta slow waves. Large-amplitude, high-frequency theta was correlated with rhythmic burst discharges of up to 2–3 spikes per burst. As theta amplitude and frequency decreased, the number of spikes per burst reduced until only regular single spikes occurred. When theta activity was replaced by irregular slow wave activity, the cell discharges became irregular and sometimes ceased entirely. At high levels of activation, CA1 pyramids often showed clusters of high-frequency discharges with declining amplitude (complex spikes). For each cell a cycle histogram was constructed, placing the discharges in one of 20 bins according to their time relation to the simultaneously recorded slow theta waves. In addition, by Fourier transformation of the cycle histograms, the technique allowed a quantitative description of the degree and type of rhythmicity. The analysis indicated that virtually all dentate granule cells and CA1 pyramidal cells were phaselocked to the negative portion of the theta waves recorded from the corresponding region. The cells differed in their degree of coupling, as expressed by the modulation index of their cyclic histograms. Dentate granule cells had higher modulation indices than the CA1 pyramids. There was a suggestion that basket cells and CA3 cells had smaller modulation indices, but the low number of cells recorded mitigate against any strong conclusions. The results are interpreted as corroborating earlier findings that the dentate granule region and the CA1 pyramidal region are the main generators of hippocampal theta activity. A “size principle” was proposed to explain the role of synaptic depolarizing pressure in the rhythmic activation of hippocampal neurons and the fact that small neurons (dentate granules and CA1 pyramids) were better driven than larger neurons.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0428
    Keywords: Type 1 diabetes ; mortality ; regression analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The relative mortality of Type 1 (insulin-dependent) diabetes in Denmark during the period 1933–1981 was studied using a modification of Cox's regression model on the basis of two patient populations, ascertained in different ways and independently of each other. Initial analysis showed that the two groups could be combined completely into one common analysis. Relative mortality was the same for both sexes. The additional variables studied were age at diagnosis, current age, calendar year at diagnosis and calendar time during follow-up. All these interrelated variables were accounted for in the analysis. The analysis showed that relative mortality (a) decreased with increasing age at diagnosis; (b) increased from 1933 to a maximum in about 1965, after which it decreased; (c) increased with increased duration of diabetes to a maximum at 15–25 years, after which it declined.
    Type of Medium: Electronic Resource
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