bluuebunny/crossref_metadata_2025 huggingface dataset:
Colour vision and blood glucose self‐monitoring in diabetics
Authors: Allwood M C , Tyler Rachel
Published: March 2007

The aim of this study was to assess the ability of diabetic patients to interpret visually‐read blood glucose strips and to assess the value of a simple test to identify patients with colour vision defects who may be unable to correctly interpret these strips. The simplified Colour Vision Test identified patients suffering from red‐green, blue yellow or mixed colour vision defects. Some patients who exhibited red‐green colour vision deficiency were unable to interpret Glucostix correctly, whereas many patients exhibiting a mixed deficiency had difficulty in interpreting both Glucostix and BM‐Test‐Glycemie 1–44 strips. Patients with either no detectable colour vision defect or blue‐yellow colour vision deficiency had no clinically significant difficulty in interpreting either set of strips. Therefore, the use of the Simplified Colour Vision Test has been shown to identify groups of patients with colour vision defects who may be unable to use blood glucose strips. Glucostix should not be given to patients who are found to be red‐green colour blind, and the use of visually‐read blood glucose strips should be avoided altogether in patients with a mixed colour vision deficiency.
Liver function tests after hypoglycaemia in insulin‐dependent‐diabetic patients
Authors: Patrick A W , Fisher B M , Collier A , Howie A F , Frier B M
Published: March 2007

Liver function tests were measure in 16 patients with insulin‐dependent diabetes mellitus following controlled insulin‐induced hypoglycaemia (Group A) and in 12 patients admitted to an Accident And Emergency Department in hypoglycaemic coma (Group B). Bilirubin, alanine aminotransferase and aspartate aminotransferase were normal in all patients. Gamma‐glutamyl transferase was elevated in three patients in Group B, of whom two were receiving phenytoin therapy and the third had a history of excessive alcohol consumption. It appears that significant abnormalities of liver function tests are not a common sequel of hypoglycaemia in diabetic patients in the absence of predisposing liver disease.
Lipoatrophy with highly purified insulins and treatment with recombinant human insulin
Authors: Jowett N I , McNally P G
Published: March 2007

Lipoatrophy at insulin injection sites is a distressing local complication of therapy with conventional insulin preparations. The introduction of highly purified insulins has markedly reduced its occurrence, and intra‐lesional injection of monocomponent porcine insulin is a widely utilised stratagem for reversing these cutaneous changes. We describe a patient who developed insulin‐induced lipoatrophy following treatment with purified bovine insulin (“Neulente”), which actually became worse when treated conventionally with monocomponent porcine insulin (“Mixtard”). This is the first description of successful reversal of insulin‐induced lipoatrophy with biphasic recombinant human insulin (“Humulin M2“).
Documentation of complications of diabetes in a primary care centre
Authors: Hempel R J , Deeb L C
Published: March 2007

Diabetes mellitus is a common problem with profound health consequences. Much attention has been directed towards the patient's role in the prevention of the complications of diabetes. The authors reviewed the clinical records of 46 diabetic patients in a Family Practice Residency Program with emphasis on the prevention of diabetic complications from the standpoint of the physician's responsibility. Eye, lower extremity, and renal care were evaluated, along with hypertension since it is an important exacerbating factor in diabetes. Clinic attrition rates were also assessed. Retinal history was recorded for 24% of patients while only 22% were referred to ophthamologists. A urinalysis was obtained in 57% of patients with approximately 25% of those examined having proteinuria. Blood pressure measurements were uniformly recorded although adequate blood pressure control was achieved in only 41% of the study group. Twenty‐eight per cent of patients had recorded evidence of significant lower extremity pathology, yet just 37% had any documentation of a lower extremity examination. The median clinic attendance time was 2.94 months with 43% of patients lost to follow‐up after the first visit. While these data suggest inadequate documentation of the performance of routine measures in the case of diabetes mellitus, they provide a strong incentive for improvement.
Patient evaluation of a pen‐sized glucose meter
Authors: Spivey Rosemary S , Davies Glenys , Matthews D R
Published: March 2007

A pensized glucose meter has been developed which uses electrochemistry to give a digital glucose read out 30 seconds after the application of whole blood. We describe here an evaluation of its use among 51 diabetic patients who used the meter at home for two weeks and made duplicate recordings from a finger prick test. The coefficient of variation was 9.2% between duplicate values. The response to a questionnaire suggested that most patients were enthusiastic about this fast and portable method of home blood glucose monitoring.
Some eating habits of Scottish children: Implicaths for the diabetic child
Authors: Johnston Alison , Massie Wendy , Ross Kathleen , Young Eileen , Craig J O
Published: March 2007

The diet of Scottish children is surveyed in terms of the particular foods eaten. There is evidence of improvement in eating habits and some old beliefs seem out‐dated. In the teenage years, however, a deterioration in eating habits occurs. The full implementation of a national dietary policy, as in Norway, is mentioned and reference is made to the education of the individual in dietetics. Recent signs of improvement in the national diet suggest that the diet of the diabetic child is not as far from “normal” as it once was.
Experience with Penject: Comparison of two and four daily insulin injection regimens
Authors: Lakhdar A A , McLellan I , McLaren E H , Neilson J McE
Published: March 2007

Eighteen insulin‐dependent diabetics, aged 20–45 years, participated in a study comparing twice and four‐times‐daily insulin injection regimens while using Penject, an insulin injection device. After a two month run‐in period on twice‐daily insulin given with conventional syringes they were randomised into either four injections of short‐acting insulin or two injections of mixed short and intermediate‐acting insulins for a six months period using Penject in a crossover fashion.

HbAIc, fell over the run‐in period from 7.3 ± 1.9% to 6.7 ± 1.5% HbAIc was lower during the four‐injection regimen at 6.2 ± 1.3%, compared with 7 ± 1.6% during the two‐injection regimen. There was a trend towards lower mean blood glucose values during the four‐injections regimen, reaching statistical significance pre‐dinner (P <0.05) and pre‐lunch (P <0.05). There was no significant change in HbAIc, between the twice‐daily injections regimen and the run‐in period.

All patients except one found Penject easy and convenient to use. Four daily injections offered flexibility and better diabetic control, with only four patients needing a longer‐acting insulin at night.
Simple screening tests for detection of microalbuminuria
Authors: Stamp R J , Simpson R D
Published: March 2007

Two screening tests, Albuscreen (Cambridge Life Sciences plc, Cambridge, UK) and Microalbutest (Ames Division, Miles Ltd, Slough, UK), designed for the detection of raised urine albumin concentration in the microalbuminuria range, were evaluated and compared. Both tests detected albumin concentrations greater than 24 mg/I as determined by a quantitative immunonephelometric assay, the Albuscreen test yielding slightly fewer false positive and false negative results and being easier to use. In a preliminary study of 55 diabetic patients, two patients (3.7%) had Albustix (Ames Division, Miles Ltd) positive proteinuria. In patients whose urine samples were Albustix negative and who successfully fulfilled the protocol requirements, four of 51 patients (7.8%) had microalbuminuria with albumin exretion rates greater than 30 μg/min, and a further seven patients (13.7%) had albumin excretion rates within the range 12–30 μglmin, indicating possible early diabetic nephropathy. Those patients with overnight albumin excretion rates greater than 30 μg/min had albumin: creatinine ratios (albumin mg/I creatinine mmo/I) greater than 3.5 and random urine albumin concentrations greater than 24 mg/I, suggesting that these findings might predict microalbuminuria. A further study on a larger diabetic population is needed to determine the reliability of simple screening tests applied to random and first morning urine samples for predicting raised overnight albumin exretion.
Improvement of recurrent diabetic ketoacidosis due to danazol
Authors: Davis S N , Stephenson P
Published: March 2007

Recurrent diabetic ketoacidosis (DKA) is a serious problem for the patient and the attending health care team. We report the first ease of Danazol (Winthrop Laboratories, Guildford, UK), a synthetic derivative of ethisterone to improve this condition.
The Stoke Mandeville diabetes record system ‐effective management and teamwork without a computer
Authors: Brown L A , Brown R S , Chiverton N A , Green J E , Hull R P , Knight A H , List M E , Mayon‐White V A , McGough N I , Stratford J , Thackray J , Turner E V
Published: March 2007

A complete purpose‐designed diabetes record system was introduced for the hospital‐based diabetes service at Stoke Mandeville in 1982. It seeks to overcome many of the deficiencies inherent in hospital records and has proved effective, easy to use, and inexpensive. Even in its original form it has been flexible enough to accommodate new ideas and alterations in working practice, but further refinements were made for its second edition (January 1988). The record system itself has provided a valuable infrastructure for coordinating the activities of the multidisciplinary team working in the continually changing situation of our developing District Diabetes Centre (Ref 1). This system, with minimal local modification, has now been successfully introduced into three other NHS districts.
Assessment of glycaemic control in the diabetic clinic
Authors: Gill G V , Huddle K R
Published: March 2007

We assessed the value of home urine glucose monitoring, home blood glucose monitoring, and clinic random blood glucose (RBG) level in measuring overall glycaemic control in a group of 66 Type 1 diabetic patients. Each parameter was compared with the glycosylated haemoglobin (HbA1) level for each patient.

Both home urine and blood testing measurements showed no relationship with HbA1. RBG levels reflected HbA1 only at the lowest (0‐5.0 mmoyl/l) and highest (>30.0 mmoyl/l) levels of RBG (mean HbA1 for these groups 7.9±1.8% and l2.0±2.2% respectively, p<0.00l). Home monitoring results, and clinic RBG levels, may be useful in individual cases; but they must be used with caution to assess average glycaemic control.
Self monitoring of capillary blood glucose in diabetic pregnancy
Authors: McCance D R , Hadden D R , Traub Ai , Harley J M G
Published: March 2007

Home monitoring of capillary blood glucose is now a well‐established feature of pregnancy in the diabetic woman. We have analysed the data from 48 pregnancies to determine if reasons could be found why some mothers achieved better blood glucose control than others.

A mean weekly pre‐prandial blood glucose was calculated for each week from the date of first booking (from the estimated date of conception in some).

No difference in age, weight, age at onset of diabetes or duration of diabetes was found between those diabetic mothers who achieved excellent (all weekly means <6 mmol/l), intermediate, or only fair blood glucose control (weekly mean blood glucose >6 mmol/l on more than six of the weeks monitored). The blood HbA1 values related best to mean capillary blood glucose in the third trimester but were always lowest in those with excellent mean blood glucose values. Insulin resistance is increased during both normal and diabetic pregnancy: a calculated “insulin‐resistance” factor (ratio of mean total insulin dose to mean capillary blood glucose) showed this to be higher in the less well controlled patients. This may represent the effect of further insulin resistance due to food intake in excess of requirement, or to the efkfect of the persistent hyperglycaemia itself. Optimum control of blood glucose will not always guarantee a normal fetal outcome, but frequent self‐monitoring has provided the means to assess factors influencing hyperglycaemia in pregnancy.
The use of a multiple injection insulin regimen for diabetic adolescents
Authors: Challener Jill , Barnes N D
Published: March 2007

The treatment of 20 adolescent diabetics (M:F 9:11, age range 10‐18 years) was changed from twice daily injection of short and intermediate acting insulin to a multiple injection regimen of a long acting insulin to a multiple injection regimen of a long acting insulin zinc suspension (Ultratard, Novo Laboratories, Basingstoke, Hants) once daily, with soluble insulin (Actrapid, Novo) preprandially two or three times daily using a multiple injection device (NovoPen, Novo). The effiects on insulin dose, diabetic control as assessed by glycosylated haemoglobin values and growth were studied after one year. Total insulin dosage was unchanged but the flexibility of the regimen was welcomed and no patients requested to return to a regimen with fewer injections. Symptomatic improvement occurred especially in those who had frequent or severe hypoglycaemic reactions on a twice daily regimen. Mean glycosylated haemoglobin values increased sharply at three months and slightly at six months, but then fell and at one year the mean value was significantly lower than the control value (p<0.0l). Growth rates showed no significant change.

The best results were achieved and the injection regimen remained acceptable when the Ultratard was given as a separate injection at bedtime.
Barriers to comprehensive diabetic care in the Northern Region
Authors: Whitford D L , Avery Alison J
Published: March 2007

In mid 1986 a questionnaire on diabetic care was sent to a 50% random sample of general practitioners in the Northern Region of England; 78% responded.

A similar questionnaire was sent to consultant diabetologists in the region; 95% responded. There was a high level of support for the concept of shared diabetic care among both general practitioners and consultants, but less evidence of its actual presence.

Further development of the diabetes team, district and practice facilities, postgraduate education in diabetes and the concept of shared care is necessary to work towards a system of comprehensive diabetic care in the Northern Region.
Comparison of well‐controlled and poorly‐controlled IDDs in central Liverpool: Are knowledge and attitude to diabetes important?
Authors: Casson I F , Kent Linda , Spibey Peta
Published: March 2007

Knowledge of diabetes and attitude to diabetes in well‐controlled (HbA1c<9.0%) and poorly‐controlled (HbA1c >12.1%) insulin dependent diabetics attending the main diabetic clinic at the Royal Liverpool Hospital, were assessed by means of questionnaires. Eighty‐two questionnaires were completed (50 poorly‐controlled). No differences were found between well‐controlled and poorly‐controlled diabetics. Basic clinical data were also collected and it was found that although the two groups had similar age, weight and duration of diabetes, the daily dose of insulin was significantly greater in the poorly‐controlled group (p<0.005).
Influence of shaking vials on insulin mixture concentrations
Authors: Mather H M , Lockwood Diana , Jakobsen Grethe , Kurtz A B
Published: March 2007

Patients using insulin mixtures (eg Mixtard 30/70 Nordisk/Wellcome, Epsom, Surrey, England), are taught to shake the vial before withdrawing insulin. It is not known whether inadequate mixing of the soluble and isophane components is a problem in clinical practice. We collected partially‐used Mixtard vials from 79 outpatients, asked them whether, and how, they shook their vials, and measured insulin concentrations in the residual insulin. Values were between 90 and 110 IU/ml in all vials with over 1 ml residual insulin, with a median value of 99.2 IU/ml. Concentrations were not influenced by shaking the vials. Values in vials from four patients who never shook them were >92 lU/ml. However, values in five out of six vials with less than 1 ml residual insulin were markedly lower (42.7 to 77.1 lU/ml). Inadequate mixing is probably not a problem in clinical practice, except when there is less than 1 ml residual insulin.
Accuracy of home blood glucose monitoring in children with insulin‐dependent diabetes mellitus
Authors: Clarke Caroline F , Warren Sheila
Published: March 2007

The accuracy of home blood glucose monitoring was assessed in a group of children with insulin‐dependent diabetes mellitus. Seventy six children each provided a blood sugar profile on filter paper treated with 5% boric acid. Only 42 (55%) of the patients estimated more than half of their readings accurately. Patients using reflectance meters were no more accurate than those using visually read strips. Of the 34 patients in whom the initial results were inaccurate, 15 (44%) showed some degree of improvement after further teaching, but only seven of these patients (21 %) improved to greater than 50% accuracy. This study confirms that diabetic children as a group are not particularly accurate in blood sugar monitoring at home and suggests that a significant number do not improve even with intensive education.
Serum fructosamine and glycosylated haemoglobin in the monitoring of glycaemic control in insulin‐dependent diabetic outpatients
Authors: Watts G F , Morris R W , Goodland F C , Kubal C , Shaw K M
Published: March 2007

This longitudinal study compares serum fructosamine (SF) and glycosylated haemoglobin (HbA1) in assessing glycaemic control in 172 insulin‐dependent diabetic outpatients over a 21 month period. Seven simultaneous measurements of SF and HbA1 were performed in sequential order at intervals of 10 to 12 weeks, during which patients received standard diabetic care. In common with other studies, the between‐subject correlation of SF and HbA1 was confirmed to be satisfactory (r = 0.68, p<0.001). However, the within‐subject correlation between these indices of glycaemic control was found to be of lower order (r = 0.21, p<0.05). This finding reflected the larger percentage variance due within‐subject variance of SF (47%) compared with HbA1 (17%), and was consistent with the shorter biological half‐life of serum albumin compared with haemoglobin. At the end of the study, there was a significant reduction in the SF concentration (mean difference 0.55 mmol/l, SEM 0.04, p<0.001), but not in the HbA1. There was no significant between‐or within‐subject correlation of SF and immunologically determined serum albumin concentration (range 30‐ 54 g/l). We conclude that when monitoring metabolic control in individual insulin‐dependent diabetic patients, SF and HbA1 provide different information on glycaemic status. Since this information may influence patient management, clinical trials should be undertaken to assess the merits conferred by use of either test. For the present we recommend that the measurement of SF and HbA1 be employed additively and not interchangeably in the routine care of the diabetic patient; correction of SF for serum albumin concentration is rarely required.
Diabetes care team treatment improves glycaemic control in dysregulated insulin‐treated diabetic subjects admitted to a diabetes day care unit
Authors: Sundkvist G , Jerntorp P , Ekberg G , Jeppsson J‐O
Published: March 2007

The education and treatment programme of the diabetes day care unit in Malmo, Sweden, was evaluated with regard to metabolic control in 34 poorly controlled insulin‐treated diabetic patients. Three to 12 months before admission and on admission, mean HbA1c was 9.09 ± 0.41% and 9.28 ± 0.35%, respectively, compared to 8.31 ± 0.38% and 8.41 ± 0.36%, respectively, p < 0.05, in 29 out‐patient diabetic controls (reference value:4.00‐5.20%). Despite unchanged mean insulin doses in the patients, glycaemic control improved significantly during the education period, and mean blood glucose decreased significantly (p < 0.001) from 12.8 ± 0.6 mmol/l on the day after admission to 9.2 ± 0.5 mmol/l on the last day before discharge. Six months after discharge from the unit, metabolic control was still improved and mean HbA1c values had been reduced to the level of the diabetic controls (8.11 ± 0.40 and 8.36 ± 0.39%, respectively).

An education and treatment programme promoted metabolic control in poorly regulated diabetic patients. An intense education programme, insulin dose adjustments and self‐monitoring of blood glucose contributed to this result.
Paediatric home care—a flexible approach to the family centred care of children with diabetes mellitus
Authors: Mair E J
Published: March 2007

There is no standard approach to caring for children with diabetes mellitus. For physical and psychological well‐being the care provided must meet the needs of the individual. This essay concentrates on the stresses associated with diabetes mellitus, and the psychological care and support needed, rather than clinical management. The factors which affect attitudes to illness, and specifically to diabetes mellitus, are outlined. It is suggested that a major part of the care of children should be based in the home. The need for hospital outpatient visits can be markedly reduced if the standard of home based care is of a high level, and liaison with hospital specialists continuous. Children and their families often find hospital clinics time consuming, difficult, stressful and of limited use. The care giver must meet the needs of the child and family, so the approach must be flexible. As well as having sound clinical knowledge, the carers need experience in counselling and methods of support. The team should be multidisciplinary, with a key worker for each family.
The memory blood glucose reflectance meter: A useful educational tool for the diabetic adolescent?
Authors: Challener Jill , Ozen Seza , Barnes N D
Published: March 2007

The value of computer‐linked “memory” blood glucose reflectance meters in the education and management of diabetic adolescents was assessed in a group cross‐over study.

Sixteen diabetic teenagers took part. After explanation of the new meters and instruction in their use, eight (Group A) were given memory meters while the remainder (Group B) continued to record blood glucose results in their logbooks as usual. After six weeks the memory meters were transferred from Group A to Group B. Glycosylated haemoglobin and blood test performance were recorded at the start, at 12 weeks and at 24 weeks. The results were discussed individually with the patients at routine clinic visits. The conclusions were; (1) blood glucose tests were accurately recorded; (2) use of the memory meter was associated with increased test frequency which continued for some weeks after the study; (3) there was a slight but definite improvement in glycaemic control; (4) most important, the computer printouts were of real help in demonstrating to diabetic adolescents the purpose and value of blood glucose monitoring.
Insurance company attitudes to diabetes
Authors: Jones Kay E , Gill G V
Published: March 2007

Diabetic patients frequently encounter difficulties when applying for insurance policies, as was demonstrated by a recent patient questionnaire survey from Glasgow (Ref1). The experiences of individual patients are, however, affected by various other factors such as duration of diabetes, treatment, complications and presence of other chronic diseases. We therefore decided to approach the problem differently, and ask insurance companies how they viewed particular diabetic patients when approached for insurance quotations.
An assessment of patients' knowledge of diabetes, its management and complications
Authors: Moran A , Hessett C , Pooley J , Boulton A J M
Published: March 2007

As part of the evaluation of diabetes services in Central Manchester, 243 patients attending the traditional diabetic clinic at the Manchester Royal Infirmary were randomly selected to complete a knowledge questionnaire. One hundred and sixty patients completed questionnaires giving a response rate of 66%. The mean knowledge score in insulin‐treated patients (n=84) was significantly higher than in non insulin‐treated patients (64% vs 44%: p<0.005). Knowledge of dietary management was generally poor, and half of the patients were unaware of the link between glycaemic control and long‐term complications. It was particularly worrying that 32% of insulin‐treated subjects were unaware that they should continue to take their insulin when ill. It is concluded that overall patient education is poor and there is therefore an urgent need to plan and implement educational programmes for both insulin‐requiring and non‐insulin‐requiring patients.
Do our shoe shops measure up?
Authors: Knowles E A , Lomax G , Jones G , Boulton A J M
Published: March 2007

Shoe shops in a large urban area were visited in order to assess their suitability to provide footwear for diabetic patients. Questionnaires were completed by the staff of 28 shops who were interviewed by study participants. Although most of those questioned were aware that foot problems may occur in diabetic patients, none had received any information or training on this subject. Most shops sold shoes without measuring feet, and 18% were unable to measure feet even when requested so to do. It is concluded that, as appropriate footwear is essential in the prevention of ulceration, a list of suitable shops should be available in diabetes clinics. It is hoped that the provision of educational sessions for shoe shop personnel will enable a more satisfactory service to be provided in the future.
Comparison of two methods of energy prescription for obese non‐insulin‐dependent diabetics
Authors: Frost G
Published: March 2007

Two groups of 15 known obese non‐insulin‐dependent diabetics were enrolled in a prospective study of weight loss over a 12 week period where energy was prescribed by two different methods. Group A: energy prescribed by a formula to estimate metabolic rate. Group B: energy prescribed by dietitian using a 24 hour dietary recall method.

Energy prescribed by the formula was significantly higher than that prescribed by the dietitian (P<0.001). However, energy intake over the period of the study, estimated by three day weighed food intake, was similar in each group. Group A initially over restricted their diet (P<0.05) with a rise to prescribed amount at 12 weeks, whereas, Group B's intake rose after the first four weeks to the level prescribed for Group A, and significantly greater than the original prescription for this group (P<0.05).

Both groups lost weight, Group A losing significantly greater amount (P<0.05) despite taking similar amounts of energy. This may be due to Group B underreporting their intake. Diet was prescribed as 55% carbohydrate, 15% protein, 30% fat. However, neither group managed to meet this recommendation, consuming significantly greater amounts of protein than was prescribed. Neither group showed any significant change in fasting blood glucose or fructosamine levels. Energy prescribed by a formula for estimating metabolic rate appears to prescribe energy at a higher level than estimated by a dietitian, which may lead to greater compliance and so improve weight loss.
Hypoglycaemia survey in insulin‐dependent diabetic population at time of change from beef to human insulin
Authors: Duncan C , Campbell I W , McBain A M , Jones I G
Published: March 2007

A retrospective survey of 367 insulin‐dependent diabetics (IDDMs) showed that the risk of a diabetic experiencing hypoglycaemic coma in any one year during the previous five years was 7%. Of 123 who experienced one or more hypoglycaemic comas in the previous five years, only 35 (28%) experienced warning symptoms and only 97 (79%) were carrying glucose‐containing tablets or sweets at the time. A total of 279 (76%) regularly carried glucose at the time of the interview but only 92 (25%) were aware of glucagon and only 31 (8%) had it readily available.

One‐hundred‐and‐twenty IDDMs were converted from beef to human insulins (Eli Lilly & Co Ltd, Basingstoke) with no resultant change in daily insulin requirements nor in glycaemic control as assessed by HbAl measurements. Further assessment of hypoglycaemia was done after a mean of 6.8 months on human insulin. Fifteen (12%) felt reactive symptoms occurred more frequently compared with 70 (58%) who felt they were less common, and 12 (10%) felt they experienced less ‘adrenergic’ warning symptoms. Ten (8%) were treated for hypoglycaemic coma between the time of change from beef to human insulin and follow‐up. Forty‐one (34%) diabetics who changed to human insulins were more satisfied with the new preparation, 72 (60%) felt no difference and seven (6%) were less satisfied.
An evaluation of nurse specialist diabetic clinics
Authors: Mallows Cathy , Nicholas M K , Beable Anne E , Waterfield M R , Baksi A K
Published: March 2007

The efficacy and safety of replacing doctors with nurse specialists in the routine care of diabetics was assessed in peripatetic diabetes clinics on the Isle of Wight. During the weekly clinic sessions biochemical control was monitored, and patients were educated about the disease. If a physical examination was required the patients were referred to a consultant clinic. The results of biochemical tests were noted in the patients records and copies were passed onto the doctors and consultants in charge.

After one year questionnaires were sent to all general practitioners and patients involved in the study to assess their opinions of the nurse specialist clinics. Random blood sugar levels were similar when the clinics were run by both doctors and nurse specialists. However, glycosylated haemoglobin improved in the Type 1 diabetics controlled by the nurse specialists, and in both Type 1 and Type 2 diabetics the numbers of admissions to hospital from hyper‐ or hypoglycaemia decreased.

The majority of GPs were in favour of the nurse run diabetes clinics; 68% felt that the nurse specialist clinics were beneficial for their patients. The patients were also in favour of the nurse specialist clincis, 97% said that they were confident in the nurse specialist system; and over half stated that they would prefer to have this kind of diabetes care in the future.
Fibrocalculous pancreatic diabetes detected in a British diabetic centre
Authors: Chong M S , Hately W , Hitman G A
Published: March 2007

A patient from St Lucia, resident in the UK for 24 years, was found to have fibrocalculous pancreatic diabetes who had been misdiagnosed as insulin‐dependent diabetes. This case emphasises that British diabetologists dealing with migrant communities should be aware of the possibility of types of diabetes in their patients, indigenous to their country of origin.
Proteomics‐based identification of HSP60 as a tumor‐associated antigen in colorectal cancer
Authors: He Yujun , Wu Yuzhang , Mou Zhirong , Li Wanlin , Zou Liyun , Fu Tao , Zhang Anping , Xiang Debing , Xiao Hualiang , Wang Xiangfeng
Published: March 2007

Patients with cancer frequently develop autoantibodies. The identification of tumor autoantigens may have utility in early cancer diagnosis and immunotherapy. In this study, we used serological proteomics analysis (SERPA) to identify tumor proteins that elicit humoral response in colorectal cancer (CRC). The CRC cell line HCT116 was used as a source of proteins for 2‐DE and subsequent Western blot analysis in which individual serum from patients with CRC was analyzed for autoantibodies. An autoantibody against HSP60 identified by MS was detected in 13 out of 25 patients with CRC and 1 out of 15 healthy subjects. In addition, the HSP60 expressions in tumor tissues collected from 40 patients with CRC were assessed by immunohistochemistry, and serum specimens from 100 patients with cancer and 30 healthy controls were screened for antibody titer to HSP60 by ELISA. The results showed that expressions of HSP60 in tumor tissue and serum antibody titer to HSP60 were significantly higher in patients with CRC than in healthy subjects. Thus, we conclude that the SERPA is an excellent assay for the identification of tumor‐associated antigens and tumor markers. The detection of HSP60 may have clinical utility in CRC screening, diagnosis, and immunotherapy.
Optical and electron paramagnetic resonance studies on radiation defects in Mn‐activated RbCdF3
Authors: Henke B. , Rogulis U. , Schweizer S.
Published: March 2007

The photoluminescence of Mn‐activated RbCdF3 shows a Mn2+ emission band at 560 nm; the corresponding excitation bands are between 240 and 520 nm. After X‐irradiation an increased Mn2+ emission can be observed and the excitation spectrum shows an additional broad intense band at 300 nm. Upon excitation at 300 nm the intensity of the Mn2+ emission decreases, whereas excitation at 240 nm leads to an increase in the PL intensity. Electron paramagnetic resonance shows that the number of Mn2+ ions is reduced upon X‐irradiation; the original Mn2+ level can be restored upon optical bleaching. (© 2007 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Mesoscopic ordering in the 0.9 Pb(Mg1/3Nb2/3)O3‐0.1 PbTiO3relaxor ferroelectric: a HRTEM study
Authors: Nistor L. C. , Ghica C. , Van Tendeloo G.
Published: March 2007

We report a microstructural and compositional study of a 90% Pb(Mg1/3Nb2/3)O3‐ 10% PbTiO3ceramic sample. High resolution transmission electron microscopy (HRTEM) revealed the presence of compositional ordered nano‐domains (1–4 nm), observable in two specific orientations, [0$ \bar 1 $1] and [11$ \bar 2 $]. However, the visibility and the ordering degree of the nano‐domains on the HRTEM images are not at all obvious. Fourier filtering of the images clearly revealed the ordered domains. Antiphase boundaries lying in the (111) planes separate them, while (100) and (111) facets separate the ordered domains from the disordered matrix. Their shape is plate‐like, not uniformly spread in the disordered matrix. Their average size varies in different regions of the sample, most probably due to a non‐uniform distribution of Ti, as observed by energy dispersive X‐ray spectroscopy. (© 2007 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Magnetic field dependence of triplet state in iridium complex phosphor
Authors: Akimoto Ikuko , Nagao Kazuhiro , Kan'no Ken‐ichi
Published: March 2007

The magnetic field dependence of photo‐luminescent spectrum in tris (2‐phenylpyridine) iridium complex is reported. Upon applying magnetic field from 0 to 6 T, remarkable change of spectral band shape was observed at 4.2 K. Comparing the spectral variation under magnetic field with the time resolved spectra, it is clarified that the luminescence involves distinctive contributions from, at least, two spectral sets of zero‐field‐split triplet sub‐levels, and an additional fast decay component which is presumably associated with the nearly singlet manifold. (© 2007 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Structural and optical properties of hafnium‐doped lithium‐niobate crystals
Authors: Galinetto P. , Rossella F. , Cristiani I. , Minzioni P. , Degiorgio V. , Kokanyan E. P.
Published: March 2007

The structural properties of HfO2‐doped Lithium Niobate crystals are investigated by micro‐Raman spectroscopy and discussed in connection with measurements of birefringence variation, observed under green‐light irradiation, in view of a possible utilization of these crystals as low‐photorefractivity crystals for wavelength converters operating at room temperature. Micro‐Raman measurements on crystals with different Hf content ranging from 2 mol% and 11 mol%, allow to prove the good crystalline quality with a structural disorder increasing linearly with increasing Hf content. (© 2007 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Energy transfer processes to Yb2+‐ and Ni2+‐ions in Yb:Y3Al5O12 crystals
Authors: Martynyuk N. , Fagundes‐Peters D. , Petermann K.
Published: March 2007

We report the quenching of Yb3+ luminescence observed in Yb:YAG and Ni(0,1%):YbAG crystals. Yb2+‐ions and impurity ions of nickel coming from the crucible during crystal growth were determined as efficient quenching centers in Yb:YAG crystals grown by the Czochralski‐method. As an indicator of the quenching process we measured the fluorescence lifetime of the investigated crystals and its dependence on the excitation power. The theoretical models for the energy transfer processes to Yb2+‐ and Ni2+‐ions are presented. (© 2007 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Syntheses and Crystal Structures of the Thallium(I) Iodobismuthates(III) Tl7Bi3I16 and Tl3BiI6
Authors: Aussieker Thomas , Keller Hans‐Lothar , Oldag Thorsten , Prots Yurii , Ruck Michael , Wosylus Aron
Published: March 2007

Dark grey (dark red with transmitting light) crystals of heptathallium(I) hexadecaiodo‐tribismuthate(III), Tl7Bi3I16, were obtained by slow cooling of a melt from 800 K to ambient temperature and, with higher crystal quality via solvothermal synthesis in aqueous HI by slowly cooling from 428 to 363 K. The compound is diamagnetic and melts congruently at 630(5) K. X‐ray diffraction on single‐crystals revealed that Tl7Bi3I16 crystallizes in the orthorhombic space group Cmcm with lattice parameters a = 2473.4(5), b = 1441.9(2), c = 3616.9(7) pm. The crystal structure can be interpreted as a layered intergrowth of fragments from the CsNiCl3 and K5Dy3I12 structure types with isolated [BiI6]3− octahedra and [Bi2I10]4− double octahedra. Rotation and distortion of the complex anions establish coordination numbers (c.n.) between 7 and 9 for the Tl+ cations. Dark red crystals of trithallium(I) hexaiodo‐bismuthate(III), Tl3BiI6, are only accessible via hydrothermal synthesis in aqueous HI and slowly cooling from 428 to 363 K. Thermal analysis reveals a peritectoid decomposition at 540(5) K into the neighboring phases Tl7Bi3I16 and TlI. Tl3BiI6 crystallizes in the monoclinic space group P21/c with lattice parameters a = 1352.6(3), b = 899.6(2), c = 1353.8(3) pm, and β = 104.18(3)°. In the crystal structure isolated [BiI6]3− octahedra are arranged according to the motif of a face‐centered pseudo‐cubic packing. Due to the tilted orientation of the [BiI6]3− groups the Tl+ cations have c.n. of 8 and 9. Although the crystal structure of Tl3BiI6 looks like a distorted variant of the elpasolith type, there is no symmetry relation according to a group subgroup formalism.
Outcomes of Hepatic Resection for a Single Large Hepatocellular Carcinoma
Authors: Cho Yong Beom , Lee Kuhn Uk , Lee Hae Won , Cho Eung‐Ho , Yang Sung‐Hoon , Cho Jai Young , Yi Nam‐Joon , Suh Kyung‐Suk
Published: March 2007

Background

The proper role of surgical resection, given the various treatment modalities available, needs to be further clarified in patients with a single large hepatocellular carcinoma (HCC). To evaluate the role of surgical resection in this group of patients, we studied the long‐term outcomes of patients that received hepatic resection for a single large (> 5–10 cm in diameter) HCC.

Methods

The clinicopathologic data and long‐term outcomes of 61 patients with a single large HCC (> 5–10 cm in diameter; L group) were compared with those of 169 patients with a single small HCC (≤ 5 cm; S group). Prognostic factors were evaluated by univariate and multivariate analysis.

Results

Operative mortality rates were low in both groups (0.6% in group S and 1.6% in group L), and the incidence of postoperative hepatic failure was rare even in group L (1.6%). The cumulative 5‐year overall survival rate in group S was 59.0%, whereas in group L it was 52.9% (p = 0.385), and the corresponding cumulative 5‐year disease‐free survival rates were 44.1% and 31.7%, respectively (p = 0.063). Child class B was found to predict poor overall and disease‐free survival by multivariate analysis versus Child class A in both groups. The presence of microvascular invasion was also identified as a significant prognostic factor, but it only affected disease‐free survival in the two groups.

Conclusions

Single large HCCs do not require a large extent of hepatic resection and the associated increased risk of postoperative liver failure. The long‐term survival of patients with a single large HCC is as good as that of patients with a single small HCC. We conclude that hepatic resection is a safe and effective therapy for single large HCCs.
Surgical Outcome of Elderly Patients 75 Years of Age and Older with Thoracic Esophageal Carcinoma
Authors: Shimada Hideaki , Shiratori Tooru , Okazumi Shinnichi , Matsubara Hisahiro , Shuto Kiyohiko , Akutsu Yasunori , Narushima Kazuo , Nabeya Yoshihiro , Hayashi Hideki , Ochiai Takenori
Published: March 2007

Background

This study aimed to evaluate the surgical outcome of esophagectomy in patients 75 years of age and older with thoracic esophageal carcinoma.

Patients and Methods

Between 1980 and 2002, 55 (46%) of 120 patients 75 years of age and older with thoracic esophageal carcinoma underwent an esophagectomy. The risk factors that resulted in decreased survival were analyzed by both univariate and multivariate analyses. Differences in surgical outcome and long‐term survival between the earlier time period (1980–1989) and later time period (1990–2002) were analyzed separately.

Results

Overall resection rate in elderly patients in both periods was similar (44%, earlier period; 46%, later period). Postoperative complications significantly reduced long‐term survival [adjusted hazard ratio for death, 4.05; 95% confidence interval (CI), 1.70–9.62; P < 0.01). Surgical blood loss greater than 1,000 ml was less frequently observed in the later period than in the earlier period (19% vs. 54%, P = 0.01). The postoperative morbidity rate was lower in the later than in the earlier period (29% vs. 63%, P = 0.02). Overall 5‐year survival rate was significantly higher in the later period than in the earlier period (57% vs. 18%, P < 0.01).

Conclusions

Elderly patients who underwent an esophagectomy in the later period appeared to manifest less neoadjuvant treatment, less surgical stress, fewer postoperative complications, and a better long‐term survival than those treated in the earlier period.
Demyelinating diseases and potential repair strategies
Authors: Radtke C. , Spies M. , Sasaki M. , Vogt P.M. , Kocsis J.D.
Published: March 2007

Demyelination is associated with a number of neurological disorders including multiple sclerosis (MS), spinal cord injury and nerve compression. MS lesions often show axon loss and therefore reparative therapeutic goals include remyelination and neuroprotection of vulnerable axons. Experimental cellular transplantation has proven successful in a number of demyelination and injury models to remyelinate and improve functional outcome. Here we discuss the remyelination and neuroprotective potential of several myelin‐forming cells types and their behavior in different demyelination and injury models. Better understanding of these models and current cell‐based strategies for remyelination and neuroprotection offer exciting opportunities to develop strategies for clinical studies.
IMMIGRATION, RETURN, AND THE POLITICS OF CITIZENSHIP: RUSSIAN MUSLIMS IN THE OTTOMAN EMPIRE, 1860–1914
Authors: Meyer James H.
Published: March 2007

The immigration of Muslims into the Ottoman Empire, especially from Russia and the Balkans, is a feature of late imperial Ottoman history whose legacy remains strong to this day. Millions of individuals in present-day Turkey trace their roots back to the Balkans or Russia, and interest in these regions remains high in Turkey. Estimates of Muslim immigrants to the Ottoman Empire vary, although most sources place the total number of Muslims leaving Russia for the Ottoman Empire in the latter half of the 19th century and early 20th century at well over one million. As Russian Muslims in 1897 were considered to number nearly 20 million while Ottoman Muslims counted in the same year numbered 14.1 million, this population shift involved a significant proportion of the Muslim populations of both empires.
Effects of heat release on turbulent shear flows. Part 3. Buoyancy effects due to heat release in jets and plumes
Authors: DIEZ FRANCISCO J. , DAHM WERNER J. A.
Published: March 2007

An integral method is presented for determining effects of buoyancy due to heat release on the properties of reacting jets and plumes. This method avoids the Morton entrainment hypothesis entirely, and thus removes the ad hoc ‘entrainment modelling’ required in most other integral approaches. We develop the integral equation for the local centreline velocity uc(x), which allows modelling in terms of the local flow width δ (x). In both the momentum-dominated jet limit and buoyancy-dominated plume limit, dimensional arguments show δ (x) ≈ x, and experimental data show the proportionality factor cδ to remain constant between these limits. The entrainment modelling required in traditional integral methods is thus replaced by the observed constant cδ value in the present method. In non-reacting buoyant jets, this new integral approach provides an exact solution for uc(x) that shows excellent agreement with experimental data, and gives simple expressions for the virtual origins of jets, plumes and buoyant jets. In the exothermically reacting case, the constant cδ value gives an expression for the buoyancy flux B(x) that allows the integral equation for uc(x) to be solved for arbitrary exit conditions. The resulting uc(x) determines the local mass, momentum and buoyancy fluxes throughout the flow, as well as the centreline mixture fraction ζc(x) and thus the flame length L. The latter provides the proper parameters Ω andΛ that determine buoyancy effects on the flame, and provides power-law scalings in the momentum-dominated and buoyancy-dominated limits. Comparisons with buoyant flame data show excellent agreement over a wide range of conditions.
Two-dimensional resonant piston-like sloshing in a moonpool
Authors: FALTINSEN ODD M. , ROGNEBAKKE OLAV F. , TIMOKHA ALEXANDER N.
Published: March 2007

This paper presents combined theoretical and experimental studies of the two-dimensional piston-like steady-state motions of a fluid in a moonpool formed by two rectangular hulls (e.g. a dual pontoon or catamaran). Vertical harmonic excitation of the partly submerged structure in calm water is assumed. A high-precision analytically oriented linear-potential-flow method, which captures the singular behaviour of the velocity potential at the corner points of the rectangular structure, is developed. The linear steady-state results are compared with new experimental data and show generally satisfactory agreement. The influence of vortex shedding has been evaluated by using the local discrete-vortex method of Graham (1980). It was shown to be small. Thus, the discrepancy between the theory and experiment may be related to the free-surface nonlinearity.