bluuebunny/crossref_metadata_2025_split huggingface dataset:
Embedded strong discontinuity finite elements for fractured geomaterials with variable friction
Authors: Foster C. D. , Borja R. I. , Regueiro R. A. 
Published: March 2007

AbstractThe strong discontinuity approach to modelling strain localization, combined with an enhanced strain element, has been used for more than a decade to model strain localization in materials including geomaterials. Most implementations of enhanced strain elements in the post‐localization regime use very simple constitutive formulations along the discontinuity, such as linear softening or a constant friction coefficient. However, the softening relations can be much more complex for geomaterials. For rocks this softening is induced by micro‐fractures coalescing into macroscopic cracks during a narrow time interval called ‘slip weakening.’ During this interval the cohesive resistance on the nucleating crack decays to zero while the frictional resistance increases. Furthermore, research has shown that the coefficient of friction for these materials is not constant, but in fact is a function both of the slip speed and the state of the material, including wear, temperature, and other factors. In this paper we augment the modelling capabilities of an enhanced strain element by incorporating a cohesive softening law and a popular rate‐ and state‐dependent friction model commonly used for describing the constitutive properties of rocks and rock‐like materials sliding along the fractured surface. Copyright © 2007 John Wiley & Sons, Ltd.
Correlation between prenatal ultrasound and fetal autopsy findings in fetal anomalies terminated in the second trimester
Authors: Akgun Hulya , Basbug Mustafa , Ozgun Mahmut Tuncay , Canoz Ozlem , Tokat Fatma , Murat Nurcan , Ozturk Figen 
Published: March 2007

AbstractObjectiveThe aim of the study was to compare the consistency of major/minor fetal anomalies detected by second trimester prenatal ultrasound examination with the findings in fetal autopsies following the termination of pregnancy (TOP) in the second trimester.DesignIn a 4‐year long prospective study, 107 second‐trimester TOP was performed due to fetal malformation diagnosed by second trimester‐ultrasound examination at a tertiary referral center. Ultrasound findings were compared with fetal autopsy findings.ResultOf the 107 cases with major fetal anomalies diagnosed by prenatal ultrasound, 49% had central nervous system anomalies, 23% had kidney and urinary tract anomalies, 11% had congenital heart disease. All of these major anomalies leading to TOP were confirmed by fetal autopsy (100% success rate in major anomalies). Overall success rate in prenatal ultrasound for major and minor anomalies was 77%. The percentage of additional minor anomalies detected in fetal autopsies was 20%. Three percent of the minor anomalies detected by prenatal ultrasonography could not be confirmed during autopsy. Chromosomal anomalies were detected in 9 (16%) out of 57 cases.ConclusionEvaluation of fetal autopsies following TOP enables diagnosis of pathologies undetected by prenatal ultrasound alone, leading to better preconceptional counseling for subsequent pregnancies. Copyright © 2007 John Wiley & Sons, Ltd.
Misleading capillary glucose measurements
Authors: Sandler M , Low‐Beer T 
Published: March 2007

AbstractGlucose reagent strips are routinely used to monitor capillary glucose concentrations in patients in whom there is a risk of significant fluctuation of blood glucose. This method is regarded as being safe, rapid and accurate especially at the lower limits of glucose measurement. We report on three cases which highlight a particular clinical situation in which this form of glucose monitoring may be inaccurate, and may lead to inappropriate administration of glucose.
Comprehensive care programme for young adults with IDDM
Authors: Dunning Patricia , Best J D , Alford F P 
Published: March 2007

AbstractIn 1985 St Vincent's Hospital, Melbourne developed a diabetes service tailored to the special needs of young adults in the 18‐35 year age range with insulin‐dependent diabetes. The service comprises a weekly outpatient clinic, social‐educative evening meetings and a telephone/drop‐in service. The three aspects of the scheme are inter‐related, have common goals and are serviced by the same team members (diabetes specialists, diabetes educators, dietitian and social worker). The total clinic population is 150, of these 45 are referrals from the paediatric hospital. The clinics are small (8–12) and patients see the same doctor at each visit. Analysis of clinic attendance records indicates that people keep their appointments and are more likely to telephone if unable to attend, since the inception of the scheme. Four people have not continued attendance after transfer from the paediatric hospital. Each evening meeting is attended by 30–40 people, depending on individual interest in the topic, and other personal commitments. A core group of 16 regular attenders has emerged. Individual telephone consultations average 12 patient contacts per month. Drop‐in consultations average eight patient contacts each month of > 30 minutes duration, and six contacts of < 30 minutes duration per month. There were two hospital admissions from the group who regularly attend the clinic and evening meetings compared with 12 from the non attenders.
Does the quality of the diet sheet matter?
Authors: Frost G , Heavens Patricia , Masters Karon 
Published: March 2007

AbstractThe aim of the study was to investigate whether the type of dietary advice sheets make a significant difference to metabolic control and/or knowledge of newly diagnosed non‐insulin‐dependent diabetics (NIDDM). Thirty four subjects were randomly assigned to one of two groups. Group A (n = 17) were given “attractive” diabetic dietary advice sheets (incorporating colourful cover and illustrations), and Group B (n = 17) were given “unattractive” dietary advice sheets (the same text but without illustrations). There was no significant difference in age, body mass index, fasting blood glucose, fructosamine or type of drug treatment between the two groups.There was a significant improvement (p<0.01) in the knowledge score of Group A and an improvement in fructosamine and fasting blood glucose levels (p<0.05).“Attractive” dietary advice literature, therefore, may improve theoretical knowledge of the diet and also, possibly, glycaemic control.
Compliance with glibenclamide treatment in non‐insulin‐dependent diabetic patients
Authors: Babiker I E , Jerrom D W A , McInerney D , Hartog M 
Published: March 2007

AbstractCompliance with glibenclamide therapy was tested in a group of 18 non‐insulin‐dependent diabetic patients. A considerable degree of non‐compliance was found – only nine (50%) achieved a compliance score of 95‐105% at an unscheduled home visit. Five (28%) were found to be taking more than the prescribed amount.A significant relationship was found between taking less than the prescribed amount and somatic symptoms and indices of social dysfunction.
Introducing reflectance meters to hospital wards
Authors: Weedon L M , Wills P D 
Published: March 2007

AbstractThe introduction of Reflolux S blood glucose meters (BM UK Ltd) onto all wards of a District General Hospital is described. We established a continuing, structured education programme and a laboratory‐based quality assurance scheme (QA) and issued guidelines regarding safety and correct usage of the meter. A formal hospital policy on blood glucose monitoring together with certification of user competence recorded on a database has enabled evaluation of nurse training and audit. The introduction of a QA scheme has allowed assessment of meter results, identified areas where more education was needed and provided data to feed back to ward staff. Poor performers have benefited from positive liaison with diabetic nurse specialists at an early stage.
Detailed investigation of the cause of impotence in 20 diabetic men
Authors: Ryder R E J , Facey P , Hayward M W J , Evans W D , Bowsher W G , Peters J R , Owens D R , Hayes T M , Robinson L Q , Watkins S E , Williams P A 
Published: March 2007

AbstractTo clarify the cause of their impotence, 20 diabetic patients underwent detailed assessments of: diabetic autonomic neuropathy (acetylcholine sweatspot test, pupil test‐PD%, five cardiovascular tests); vascular disease (radioisotope phallogram, response to intracorporeal papaverine); nocturnal penile rigidity; psychiatric disturbance (General Health Questionnaire). Results suggested cause as: vascular 7/20 (35%), vascular and autonomic neuropathy 7/20 (35%), autonomic neuropathy 3/20 (15%), psychiatric disturbance 2/20 (10%), beta‐blockers 1/20 (5%). The sweatspot test appeared to be the most sensitive assessment of autonomic neuropathy. Investigations suggested an alternative aetiology in all cases with a normal sweatspot test. In one patient with autonomic neuropathy, high deep‐artery velocity on Doppler but loss of papaverine‐induced erection, dynamic cavernosography revealed venous leakage; impotence was improved by surgical venous ligation. The results suggest that most impotence in diabetics has an organic basis. The sweatspot test (ideally in conjunction with cardiovascular tests and pupil test) and response to intracorporeal papaverine may identify and categorise most of these patients. Those with normal tests are unlikely to have organic disease and could be referred for psychosexual/psychiatric counselling. Doppler studies may identify those who need investigating for venous leakage. The others could then, in the first instance, be offered one of the recently described non‐invasive devices for overcoming diabetic impotence. Self‐administered intracorporeal papaverine may also be considered, but only a minority of diabetic patients seem to respond.
Awareness of foot problems
Authors: Barker R A , Macleod A F , Till A S , Lowy C , Sönksen P H 
Published: March 2007

AbstractTwo hundred and nine diabetic patients, randomly selected from the diabetic clinic, were questioned about foot problems and care of the feet. The feet were then examined for ulcers, amputations, pulses, presence or absence of ankle jerks and vibration perception threshold measured.The prevalence of neuropathy was 22% (45/207). To direct questioning, 30% of the patients admitted to having problems with their feet and had significantly higher vibration perception threshold (p<0.005 for the great toes) than those with no problems. Although 81% of patients realised that diabetic subjects may have problems with their feet, only 54% took any precautions; those who did not had significantly higher vibration perception thresholds than those who did.In patients with evidence of peripheral neuropathy, about half (51%) were asymptomatic and over half (56%) took no precautions in terms of looking after their feet. This latter group, who are most in need of education about care of the feet, would have to be identified by a comprehensive screening programme if prophylactic foot care is to be effective in preventing disability.
Quality of life assessment in diabetes: A preliminary study of young adults in Liverpool
Authors: Wallymahmed M E , Baker G A , MacFarlane I A 
Published: March 2007

AbstractA quality of life questionnaire was completed by 38 young adults with insulin‐dependent diabetes (IDDM) from Liverpool. Ages ranged from 15‐26 years and 18 were male. The questionnaire explored three domains: The impact of diabetes, concerns about the effects of diabetes, and personal satisfaction. Thirty‐eight non‐diabetic subjects aged 15‐27 years, 12 male, also completed non‐diabetic related questions on personal satisfaction, health and social/vocational worries.The perceived quality of life in these young adults with IDDM was not related to glycaemic control (HbA1), or gender. The Liverpool patients with diabetes reported significantly more personal satisfaction than the non‐diabetic males. Comparing the questionnaire scores with published data on IDDM patients from the USA, young adults have a similar perceived quality of life to adolescents in the USA with a trend towards a better perceived quality of life than older adults in the USA. These preliminary findings merit further investigation.
Photography of the peripheral retina: Assessment of its value in screening for diabetic retinopathy
Authors: Smith S A , Shilling J S , Sonksen P H 
Published: March 2007

AbstractThe diagnostic value of peripheral retinal photography in screening for retinopathy was assessed in 100 eyes from 95 diabetic patients following pharmacological mydriasis. Polaroid prints of the central 45° field and of 4 peripheral fields were assessed by a consultant ophthalmologist. There were 45 eyes judged to have no retinopathy centrally. Of the 55 eyes with retinopathy, 21 were referred: 3 for pre‐proliferative retinopathy and 18 for maculopathy. The 4 Polaroids of the peripheral retina were assessed at a second reviewing session. There was significant agreement in diagnosing the presence or absence of retinopathy from the central versus the peripheral review. No proliferative retinopathy was identified from any of the photographs. There were 7 eyes judged to have clear central fields in which the peripheral photographs revealed retinopathy, though none of these required referral. It is concluded that additional peripheral photographs are not essential for routine screening.
The economics of setting up a diabetic foot clinic
Authors: Moriarty K T , Slater N , Welsh C , Hardisty C 
Published: March 2007

AbstractThough the combined diabetic foot clinies have been shown to be beneficial, very little is known of either their workload or the costs of running them. The foot clinic at this hospital has been established for five years and referral patterns and workload are now relatively constant.Information was collected about all the patients who attended clinic in a one‐year period. Data about each outpatient and inpatient attendance was recorded to enable estimation of the costs involved in running such a clinic as a guide to those who may wish to set up a similar service.
Abnormal gastric scintigraphy is not a reliable sign of diabetic autonomic neuropathy
Authors: Nilsson H , Lilja B , Rosén I , Ekberg O , Sundkvist G 
Published: March 2007

AbstractTo evaluate whether gastric scintigraphy could be considered a reliable test of autonomic neuropathy in diabetic patients, two patients, with vomiting and abnormal gastric scintigraphy are reported. Although the clinical presentations were similar, extensive investigation revealed that one patient suffered from autonomic neuropathy as part of a generalized neuropathy while the second patient showed a reversible gastroparesis without objective signs of neuropathy. Accordingly, before gastric scintigraphy can be considered to reflect autonomic neuropathy, other tests have to be carried out.
An evaluation in the diabetes clinic of the Cholestech L‐D‐X analyser
Authors: Cummings MH , Watts GF , Mazurkiewicz JC , Slavin BM 
Published: March 2007

AbstractThe Cholestech L‐D‐X lipid analyser (LDX) is one of the first fully automated desktop analysers to determine serum high‐density‐lipoprotein cholesterol (HDL‐C) concentration, an important measurement for assessing dyslipidaemia, particularly in patients with non‐insulin‐dependent diabetes mellitus. We compared results of total cholesterol (TC), triglyceride (TG) and HDL‐C concentrations measured by the LDX and by a standard (DAX) laboratory analyser from serum obtained from 40 patients in our diabetic clinic. The mean differences between the concentrations measured were not statistically significant, there being a very close correlation between methods (TC: LDX = 0.98. DAX + 0.06, r = 0.98, p<0.01; TG: LDX = 1.01. DAX + 0.05, r = 0.99, p<0.01 and HDL ‐C: LDX = DAX + 0.03, r = 0.97, p<0.01). Random error assessed by analysis of variance was minimal. We conclude that the Cholestech L‐D‐X analyser may be useful for providing rapid and accurate measurements of serum lipid profiles, particularly in patients in whom measuring HDL‐C concentration is important. The small size, speed of analysis and simplicity of use of the LDX make it an ideal instrument for utilisation in the diabetes clinic and lipid out‐patient clinic.
General practitioner Clinical Assistant rotation in the diabetes clinic increases confidence in the care of patients with diabetes
Authors: O'Mullane NM 
Published: March 2007

AbstractA Clinical Assistant rotation in the diabetes clinic lasting four months was offered to general practitioners, with a view to giving “hands‐on” experience in diabetes care.Six general practitioners have completed the scheme so far. The general practitioners spent time with the diabetes physician, dietitian, chiropodlst, specialist nurse and also saw the patients themselves. A visual analogue scale was used to assess their confidence before and after the course.Confidence scores before: after, and range of mean () were: neuropathic assessment 3.5 (2−4): 7.5 (5−9), assessment of retinopathy 2.5 (1−3): 6.1 (5−8), relevance of blochemical tests 4.3 (2−7): 7.8 (7−8), advice on diet 4.6 (4−5): 7.3 (4−8), use of oralhypoglycaemics 3.8 (3−5): 7.3 (6−8), knowledge of insulins 2.8 (1−4): 6.3 (5−8). Patient educational topics included action of insulins 4.5 (2−6): 7.5 (5−10), action of tablets 4.6 (3−6): 7.8 (6−10), blood glucose monitoring 5.1 (4−6): 8.1 (5−10) and foot care 4.6 (1−8): 7.8 (4−10).A structured rotation for general practitioners for four months through the diabetes clinic improved their confidence in education, treating and screening patinets with diabetes.
An unusual case of relapsing brittle diabetes
Authors: Gill G , Kent L , Williams G , Walford S , Alberti G 
Published: March 2007

AbstractA case is presented of a young female insulin‐dependent diabetic (IDDM) patient who required continuous hospitalisation over a two year period for factitiously produced ketoacidosis (DKA). Her instability resolved after implantation of an insulin infusion pump as well as psychiatric therapy. Eighteen months later, however, she presented with recurrent severe hypoglycaemia, also shown to be factitious. She again resolved, and over nine years of subsequent follow‐up she remains well with non‐problematic glycaemic control.
What happens in the long‐term to the intensively treated IDDM patient? A four year follow‐up
Authors: Haakens K , Dahl‐Jørgensen K , Vaaler S , Aagenaes Ø , Mosand R , Hanssen KF 
Published: March 2007

AbstractA four year follow‐up of treatment with continuous subcutaneous insulin infusion (CSII) or multiple injections (MI) in not‐highly selected insulin‐dependent diabetic patients is presented. Forty patients (CSII 25; MI 15) were followed for 51.0 months from the start of intensified insulin therapy. Eleven patients (44%) changed from CSII to MI; none changed in the reverse direction or to any other regimen. The initial improvement in HbA1c was lost both in the CSII, MI and change‐over groups. On CSII three patients experienced five subcutaneous abscesses at infusion sites, and two were hospitalised with diabetic ketoacidosis. Hypoglycaemia requiring assistance was equally common on the two treatment modalities. The initial weight gain tended to continue.We conclude that insulin‐dependent diabetic patients clearly prefer Intensified Insulin therapy, especially MI, for long‐term treatment. How ever, the initial improvement in glycaemic control was not maintained in the long‐term in these patients who were not highly selected. Subcutaneous abscesses at infusion sites and diabetic ketoacidosis requiring hospitalisation occurred exclusively on CSII. These results have important implications for the long‐term treatment of those with insulin‐dependent diabetes.
Over‐estimating glycated haemoglobin
Authors: Connolly VM , Kesson C 
Published: March 2007

AbstractGlycated haemoglobin measurement has become increasingly important in the management of diabetes and is often used for diagnostic purposes. Several assays are available for measuring glycated haemoglobin, some of which do not differentiate glycated haemoglobin from fetal haemoglobin. We report a case where this led to an erroneous diagnosis of diabetes.
The effects of an integrated education programme on the management of diabetic ketoacidosis
Authors: Thompson C J , Cummings F , Jung R T , Newton R W 
Published: March 2007

AbstractA twelve month retrospective case note audit of the management of 35 episodes of diabetic ketoacidosis revealed deficiencies in the delivery of intravenous fluid and potassium chloride administration and in the rate of nasogastric intubation. These defects were addressed in a structured education programme for junior medical staff. A subsequent twelve month case note audit of 30 cases of diabetic ketoacidosis was conducted to evaluate changes in practice. Following introduction of the treatment protocol and education programme, patients were treated with larger volumes of intravenous fluid (median 5.8 v 3.6 litres, p=0.0001) and potassium chloride (150 v 60 mmol, p=0.0001), were more likely to have nasogastric intubation where clinically indicated (68% v 0%, p<0.001) and were less likely to become hypokalaemic (13% v 63%, p=0.001). Patients were returned more rapidly to subcutaneous insulin (20 v 29 hours, p=0.0005), though duration of hospital stay and complication rates were unchanged. Management of diabetic ketoacidosis can be successfully changed after introduction of an integrated postgraduate education programme.
Case history notes designed as an aid to professional education. Metabolic cataract causing loss of vision in newly diagnosed insulin‐dependent diabetes mellitus
Authors: Chalmers J , Herlihy OH , Macdonald M , Campbell W 
Published: March 2007

AbstractLoss of vision is a worrying symptom for any diabetic patient, particularly in young diabetic subjects with poor control. Once osmotic lens change has been excluded, patients presenting with recent changes in their vision should have careful ophthalmological assessment. In this case, a recently diagnosed insulin‐dependent diabetic patient was found to have bilateral metabolic cataracts. Following their surgical removal satisfactory vision was restored. Metabolic cataracts are unusual but should be kept in mind as a cause of visual loss in young people with diabetes.
Diabetic gastroparesis
Authors: Goddard WP , Youde JY , Davies MJ , Rathbone BJ , McNally PG 
Published: March 2007

AbstractWe describe the case of a man with chronic poor glycaemic control who developed multiple complications. Gastroparesis was proven on radio‐nucleotide scanning and failed to respond to therapeutic interventions. Despite his glycaemic control being optimised he was admitted frequently with intractable vomiting and abdominal pain and did not respond to conventional treatment. A percutaneous endoscopic feeding gastro‐jejunos‐tomy was inserted under local anaesthesia. The double lumen system allowed easy drainage of retained gastric content while facilitating jejunal feeding via a soft biliary tube. The technique we have described may be of benefit in the management of severe diabetic gastroparesis.