bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypernatremia in diabetic ketoacidosis
Authors: Monroe K. W. , King W. D. , Nichols M. H. , Atchison J. A. 
Published: March 2007

AbstractThe elevated blood glucose in DKA creates an osmotic gradient which typically results in hyponatremia. Many patients present with elevated serum sodium concentrations in DKA and very little is known about these patients. We questioned if these patients represent a ‘sicker’ population than those with normal or low serum sodium concentrations.The objective of this study was to characterise those patients who develop elevated corrected serum sodium levels in diabetic ketoacidosis (DKA). A retrospective medical record review was done of all episodes of DKA at The Children's Hospital of Alabama between January 1992 and June 1994. All cases of DKA were in patients less than 17 years of age.Among the 79 study entries which consisted of 52 separate individuals 46% female (n=36) 54% male (n=43), 11 patients were admitted for more than one episode of DKA, 27% (n=21) were patients with new onset diabetes and 73% (n=58) were patients with a prior history of diabetes mellitus. Of the corrected serum concentrations of sodium, 85% (n=67) were less than 149 mmol/L. In the patients with corrected serum sodium concentrations greater than 149 mmol/L (n=12), 35% (n=4) were African‐American and 65% (n=8) Caucasian, which was representative of the overall study population race distribution. Sixty seven per cent (n=8) of the hypernatremic patients were male, 33% (n=4) female.Patients with new onset diabetes were more likely to present with elevated concentrations of sodium in serum than known diabetic patients (t=5.52, p=0.02); 33% (n=7) of the patients with new‐onset diabetes were hypernatremic. No association was found between corrected sodium and age (t=0.31, p=0.76), duration of symptoms (t=0.42, p=0.68) or serum urea nitrogen concentration which was used as a marker for level of hydration (t=1.48, p=0.14). Duration of symptoms was found to be longer among patients with new onset diabetes (ZT=4.31, p < 0.001) and patients presenting with elevated serum concentration of sodium (ZT=2.20, p=0.028).We conclude that patients with new onset diabetes are more likely to present with elevated sodium values unrelated to age or level of hydration.
Blood glucose meters: an independent head‐to‐head comparison
Authors: Engel L , Delaney C , Cohen M 
Published: March 2007

AbstractA new generation of blood glucose meters is now available for use by people with diabetes and health professionals, but little independent evaluation data is available. Previous models are prone to a variety of errors. We compared the accuracy, precision and features of the six latest meters available in Australia as of 1996. Meters studied were the Mini‐Accutrend and Advantage (Boehringer Mannheim), Precision QID and Companion 2 (MediSense), Glucometer Elite (Bayer) and Lynx (National Diagnostic Products). We measured the blood glucose levels of 50 people with diabetes with these meters, and compared them to a reference method (YSI glucose analyser). Error grid analysis confirmed that accuracy of all meters was sufficient for their intended use as patient monitors. Precision was assessed using 25 samples from control solutions provided for each meter, and the coefficient of variation calculated. Improvements in strip and meter technology in some models have increased ease of use and reduced the likelihood of user error. This study, when considered with individual preferences for various features and price should assist patients in choosing a new blood glucose meter.
How do patients dispose of syringes?
Authors: Bain A , Graham A 
Published: March 2007

AbstractLocally, patients on insulin therapy are advised about the current BDA recommendations for syringe disposal. A systematic survey was conducted to investigate the disposal practices of patients in our area. Fifty insulin‐treated patients were chosen randomly over a four week period. Each patient was interviewed by a diabetes specialist nurse using a specially devised questionnaire. Various health professionals involved in diabetes care were also surveyed regarding syringe disposal.Results showed that 23 (46%) patients disposed of their syringes in a safe manner, but only 13 (26%) followed the recommended procedure; 21 (42%) made some attempt to immobilise the syringe, but not in an acceptable manner; 6 (12%) disposed of their syringes unaltered and unprotected in the household rubbish. Data on a comparison of patient practice in relation to age, length of time using insulin and recall of syringe disposal advice are given.Overall, there appears to be a wide variation in the practice of syringe disposal among patients. The regular educational evaluation of these patients needs to include an assessment of their syringe disposal practice, and their knowledge updated when required.
The benefits of dietitian‐led community clinics for people with diabetes: Using audit to raise GP awareness
Authors: Pediani L , Bowie P 
Published: March 2007

AbstractResearch has highlighted the importance of individual dietary advice for people with type 1 and type 2 diabetes1. The purpose of this small study was to audit the impact of a recently established community‐based diabetes dietetic service by establishing both levels of awareness and rates of referral to the clinics by local general practitioners (GPs). Findings from an initial survey of 63 local GPs (71.4% response rate) revealed that 57.8% were aware of the service but only 55.6% had actually referred their diabetic patients to the clinics. Twenty (44.4%) GPs cited specific reasons for not referring to the clinic. These included a preference to use a practice nurse to dispense dietary advice (n=3) and opting for referral to the hospital diabetes clinic (n=11). However, no respondents indicated that they disapproved of this type of community‐based service. After implementing an action plan designed to raise both GP awareness of the service and the importance of dietary support and advice provided, the audit loop was closed by repeating the study six months after the initial survey. The repeat audit findings highlighted a significant increase in GP awareness of the service, rising from 57.8% to 94.0% (p<0.001) of respondents. Similarly, the number of GPs referring their diabetic patients increased from 55.6% to 76.0% (p<0.05). By identifying a specific problem with our service, we have used the audit process to evaluate and review our practices and so improve the level of shared care available to diabetic patients requiring diet therapy.
Self‐monitoring of blood glucose from abdominal skin: An extraordinary method
Authors: Holstein A , Hinze S , Perret U , Nahrwold D , Egberts EH 
Published: March 2007

AbstractA 70 year old man with type 1 diabetes self‐monitored his blood glucose for 15 years by withdrawing capillary blood from the abdominal skin. The precision of this method was determined by simultaneously comparing the specific enzymatic glucose concentrations from the abdominal skin and the finger pad. Intra‐ and inter‐method differences and the means of self‐monitoring values from abdominal skin and finger pad, measured by reflectometers, did not differ statistically from their corresponding laboratory monitorings. Thus, self‐monitoring from abdominal skin is equal to and interchangeable with self‐monitoring from finger pads, provided a high monitoring standard is given. Bootstrap simulation with another 1,000 samples, accidentally fixed by a computer, confirmed the accuracy and reproducabilityof the new method.Blood glucose self‐monitoring from abdominal skin cannot generally be recommended, but after a quality check, this method might be an alternative to the well‐established method of the finger pad for some people with diabetes.
Intensive dietary therapy in the treatment of type 2 diabetic patients in primary versus specialist care
Authors: Iványi J , Gyimesi A 
Published: March 2007

AbstractThe six‐year prospective data on 100 people newly diagnosed with type 2 diabetes, aged 40–69 years, were analysed. After careful and controlled dietetic training, carbohydrate metabolism parameters, physical status, fundus pictures and laboratory data were examined yearly, and alterations in treatment were noted. Twenty‐four subjects dropped out during the six year study period. At the end of the six years, 41% of the patients had continued to maintain good control by dietary means. The data were compared with those on 100 similarly detected new type 2 diabetic cases, whose education and control were provided by family physicians. The level of carbohydrate metabolism control was significantly better in the diabetic clinic‐controlled patients; the proportion of sulphonylurea‐treated patients was only 40.5% after six years compared with 68.9% among family physician‐controlled patients. The importance of a correct and controlled diet, good education and continuous control is emphasised.
Monitoring of elderly housebound and mobile diabetic patients in 31 Leicestershire practices: A comparative study
Authors: Farooqi A , Sorrie R 
Published: March 2007

AbstractThe objective of this study was to compare the monitoring of housebound and mobile diabetic patients aged 75 years and over. In addition, a survey was undertaken to assess the views of health professionals on the results obtained from the study and the service provided to patients.Thirty‐one volunteer general practices conducted a clinical audit of their diabetic patients using an audit protocol. They were then asked to identify which patients over the age of 75 years were housebound, using a standard definition provided to them. Results were analysed by the Primary Care Audit Group (PCAG) and the audit leads in each participating practice were asked to complete a questionnaire seeking their views on aggregated results and aspects of service provision.Data were collected on 682 mobile and 152 housebound diabetic patients aged 75 or over.The results indicate that housebound diabetic patients had significantly lower recorded standards of monitoring for each of seven key audit criteria, addressing annual assessment of symptoms, glycated haemoglobin, feet, urinalysis, fundi, blood pressure and smoking (p<0.001).Twenty‐eight (90.3%) of the audit leads returned the questionnaire and none of the respondents felt that housebound patients should attend hospital for monitoring. Respondents identified time and training as important resource issues for better monitoring in the community. Respondents also favoured the increased use of diabetic health visitors and domiciliary opticians and for nursing homes to take more responsibility for ensuring that their own patients were monitored.
Prayer foot: A potential cause of serious complication in diabetes
Authors: Kaufman BM , Hurst N 
Published: March 2007

AbstractA case is presented of severe foot infection in a diabetic Asian man secondary to callus formation from local pressure sustained while at prayer (‘prayer foot’). The presence of poorly‐controlled diabetes and peripheral neuropathy were probably contributory factors, and particular attention to ‘prayer foot’ and patient education is indicated when such risk factors are present.
Long‐term outcome of infra‐inguinal bypass for limb salvage: Are we giving diabetic patients a fair deal?
Authors: Sigurdsson HH , MacAulay EM , Cooper GG , McHardy KC 
Published: March 2007

AbstractWe have reviewed the long‐term outcome of one surgeon's practice of surgery for lower limb ischaemia in diabetic and non‐diabetic patients, with a minimum follow‐up period of three years. Of 56 critically ischaemic lower limbs in 52 diabetic patients, 43 were managed by infra‐inguinal bypass and 13 by amputation. A similar pattern of management was observed in a control group of 126 non‐diabetic patients who underwent infra‐inguinal bypass (96 limbs) or primary amputation (40 limbs). In the infra‐inguinal bypass group, actuarial survival at three years was 49% for those with diabetes and 55% for those without. Actuarial amputation‐free survival atthree years was42% for diabetic patients and 50% for others. Although there appears to be a trend for diabetic patients to perform less well, there was no statistically significant difference in these outcome measures (survival—Chi) Square 3.1693, p=0.075; amputation‐free survival—Chi Square 2.627, p=0.105. We conclude that groups of diabetic patients, like non‐diabetic patients, can expect substantial benefit from infra‐inguinal bypass.
Digital retinal imaging increases detection of diabetic retinopathy in a hospital‐based eye screening programme
Authors: Lindsay RS , Ferguson SC , Bal SK , Young MJ , Walker JD , Frier BM 
Published: March 2007

AbstractComputerised digital retinal imaging systems may offer an advance for screening programmes set up to detect diabetic retinopathy. The present study examined whether the addition of digital retinal imaging to ophthalmoscopic screening increased the detection of diabetic eye disease, in the context of a routine screening programme in a teaching hospital clinic. A total of 611 consecutive patients with Type 1 or Type 2 diabetes mellitus eligible for annual eye screening were randomised either to our current screening process (direct ophthalmoscopy following mydriasis and assessment of visual acuity) or to routine screening with the addition of digital retinal imaging. The addition of a digital retinal image to routine ophthalmoscopic screening increased the detection of background retinopathy (prevalence of background retinopathy 36.1% with digital imaging versus 22.2% without: p<0.01). In the hospital specialist clinic, digital retinal imaging was a useful adjunct to direct ophthalmoscopy in the detection of non‐sight‐threatening diabetic retinal disease.
Blood pressure measurement in diabetes: Lack of effect from stress factors in the clinic
Authors: Zambanini Andrew , Cox Alison , Chan Nor N , Feher Michael D 
Published: March 2007

AbstractPrecise blood pressure (BP) measurements are an important part of the clinical assessment of patients with diabetes, and may be influenced by patient and observer‐related factors. Several ‘stress’ events specific to the diabetes clinic may influence the BP including the finger prick for capillary blood glucose measurement and the consultation with a doctor. Semi‐automated oscillometric devices may be helpful in the diabetes clinic as these not only allow for multiple measurements to be obtained easily but may also reduce observer errors.The aims of this study were to assess BP changes during specific ‘stress’ events and to evaluate the role of a semi‐automated BP device (Omron HEM‐705CP) in the diabetes clinic.Fifty‐one routine follow‐up patients (35 men and 16 women) participated in this diabetes clinic‐based observational study. Mean BP mmHg (±SD) were: on arrival to the clinic 143/84 (26/12); pre‐finger prick 141/83 (24/11); post‐finger prick 141/81 (24/11); pre‐doctor consultation 142/81 (23/14); post‐doctor consultation 142/82 (23/13); end of the clinic 146/84 (24/17); 15 minutes after clinic 140/79 (22/10). There were no significant differences, as assessed by single ANOVA, in either systolic or diastolic BP recordings.There appears to be no significant alerting response related to potential stress events in a diabetes clinic and BP can be measured at any stage using the Omron HEM‐705CP.
Polymer crystals—a review
Authors: Fava R. A. 
Published: March 2007

AbstractThe unique properties that are a direct consequence of chain folding in polymer crystals are described. It is shown that there is a close link between morphology and molecular studies in these entities. It is also shown that the unusual phenomenon of folding persists not only in crystals from very dilute solutions but also in the complex crystalline aggregates of the bulk polymer. Although the experimental crystallisation data can be described exactly in terms of standard nucleation theory, the melting process has proved to be too complex for a simple explanation in terms of thermodynamic principles.
Gel permeation chromatography measurements on PVC resins and plasticisers
Authors: Pedersen H. L. , Lyngaae‐Jørgensen J. 
Published: March 2007

AbstractThe value of gel permeation chromatography (g.p.c.) measurements of PVC resins is discussed in relation to quality control of commercial suspension types. Some examples of simple solvent fractionation and precipitation with methanol are given. In addition, chromatograms of selected plasticisers are shown for analytical identification together with an indication of an approximate determination of the mol. wt. of plasticisers ranging from 400–10,000. Finally a short discussion of the influence of the parameters of operation, i.e. flow rate, volume of injection and concentration of the solution in tetrahydrofuran, is given.It is concluded that g.p.c. determinations of weight‐average mol. wt. are in fair agreement with light‐scattering measurements.
INTRINSIC VISCOSITY OF COPOLYMERS
Authors: Imai S. 
Published: March 2007

AbstractThe intrinsic viscosity of a copolymer has been calculated using the method developed by Fixman. The result shows that the relation [η] = KM1/2 may be observed under certain conditions (where [η] is intrinsic viscosity, M is molecular weight, and K is a constant). However, even in such a case, the ‘unperturbed dimensions’ of the copolymer cannot be obtained in the manner usually adopted for homopolymers. In general, there is no θ state for a copolymer, i.e. no stage at which all interactions between pairs of segments vanish simultaneously.
Heat resistance of epoxy resins
Authors: Pogany G. A. 
Published: March 2007

AbstractA torsion pendulum has been found to be a sensitive tool to detect the first steps of pyrolysis. It has been shown that some primary bonds break at elevated temperatures, but in the presence of oxygen, new crosslinks can form simultaneously. In resin heated in air, embrittlement due to these crosslinks starts on the surface of the resin and progresses inwards with time.
Sequence studies of vinyl acetate copolymers with acrylic, fumaric and maleic esters using nuclear magnetic resonance spectroscopy
Authors: Moyles A. F. , Reynolds G. E. J. 
Published: March 2007

AbstractThe infra‐red spectra of copolymers of vinyl acetate with acrylic esters and fumaric and maleic di‐esters show no features which enable differentiation one from another. High‐resolution nuclear magnetic resonance, however, shows differences in backbone structure between vinyl acetate‐acrylic esters and vinyl acetatefumaric or maleic esters. Furthermore, there are finer differences between the fumaric and maleic ester copolymers and, with the aid of specially prepared model compounds, it has been established that these differences are accounted for by a greater tendency for the occurrence of fumaric ester sequences than maleic ester sequences in the copolymers. The differing sequence distribution of vinyl acetate‐fumaric ester and vinyl acetate‐maleic ester has been shown to be in qualitative agreement with that expected from reactivity ratios.
Preparation of sections of plastics and polymers for the electron microscope
Authors: Farmer Joan , Little Kitty 
Published: March 2007

AbstractExperimental details of a method for sectioning rubbers and plastics at room temperature are presented. Usually specimens are embedded in a butyl‐isobutyl methacrylate mixture (provided that they do not dissolve in the monomer) which can be polymerised by ultra‐violet light to varying hardness. This enables sections through fibres and surfaces to be obtained. Because of distortion of the surface layers the angle between the knife and specimen is critical. The thickness of these distorted surface layers rather than the total thickness of the specimen provides a limit to the resolution obtained. Choice of the sectioning angle was made primarily by means of sense of touch, so that a microtome design incorporating a direct transmission of pressure from specimen to hand is needed.
Initiator complexes derived from dichlorobiscyclopentadienyl titanium and alkyl aluminium compounds: II. The 1:1 adduct
Authors: Amass A. J. , Hay J. N. , Robb J. C. 
Published: March 2007

AbstractThe adduct prepared from dichloro‐biscyclopentadienyl titanium and triethyl aluminium at a molar ratio 1:1 was studied as an active catalyst for the polymerisation of styrene. The overall rate of polymerisation was found to be first‐order in monomer, and half‐order in adduct concentration; it was also time dependent, and decreased markedly with time. The molecular weights of the polymer samples also increased with conversion. The values of the transfer constants to monomer, toluene and adduct, and the activation energies of the various steps in the overall polymerisation scheme were consistent with a radical mechanism involving the reduction of Ti (IV) to Ti (III). This mechanism is substantiated by a kinetic study of the deceleration of the polymerisation and of the reduction reaction.
Emulsion polymerisation of vinyl chloride in relation to the chemical structure of the emulsifier
Authors: Hopff H. , Fakla I. 
Published: March 2007

AbstractThe influence of the chemical structure of the emulsifier on the rate of polymerisation, the yield and the properties of the polymer in the emulsion polymerisation of vinyl chloride was studied. The highest molecular weights were obtained with the sodium salts of the sulphuric acid esters of fatty alcohols with a chain length of 10 and 18 C atoms. In the group of aliphatic sulphonates, sulphates and salts of fatty acids there was no great difference. In general the effect of emulsifiers increases with the chain length. Unsaturated emulsifiers decrease the rate of polymerisation. Non‐ionic emulsifiers are less active than ionic ones.
A descriptive study of school discipline referrals in first grade
Authors: Rusby Julie C. , Taylor Ted K. , Foster E. Michael 
Published: March 2007

AbstractSchool discipline referrals (SDRs) may be useful in the early detection and monitoring of disruptive behavior problems to inform prevention efforts in the school setting, yet little is known about the nature and validity of SDRs in the early grades. For this descriptive study, SDR data were collected on a sample of first grade students who were at risk for developing disruptive behavior problems (n = 186) and a universal sample (n = 531) from 20 schools. Most SDRs were given for physical aggression and the predominant consequence was time out. As expected, boys and at‐risk students were more likely to receive an SDR and to have more SDRs than were girls and the universal sample. A large difference between schools regarding the delivery of SDRs was found. A zero‐inflated Poisson model clustered by school tested the prediction of school‐level variables. Students in schools that had a systematic way of tracking SDRs were more likely to receive one. Also, schools with more low‐income students and larger class sizes gave fewer SDRs. SDRs predicted teacher ratings, and to a lesser extent, parent ratings of disruptive behavior at the end of first grade. Practitioners and researchers must examine school‐level influences whenever first grade discipline referrals are used to measure problem behavior for the purpose of planning and evaluating interventions. © 2007 Wiley Periodicals, Inc. Psychol Schs 44: 333–350, 2007.