bluuebunny/crossref_metadata_2025_split huggingface dataset:
A geriatric diabetic clinic reviewed
Authors: Turnbull C J 
Published: March 2007

AbstractOne hundred and seventy‐three patients attending geriatric diabetic clinics were reviewed. The mean age was 79.2 years and 25% of patients were on insulin treatment, though most had Type 2 diabetes.A high prevalence of large vessel complications such as stroke and ischaemic heart disease was found. Control of diabetes was poor and the reasons for this are discussed. There was minimal evidence of an association of poor control, history of smoking or hypertension with complications.
An audit of diabetic inpatient care
Authors: Lewis Fiona , Jones Julie , Jones Heather , Child D F 
Published: March 2007

AbstractAn audit of diabetic inpatients in a district general hospital over a period of one month revealed that 6% of all admissions were diabetic; half of these were due to diabetes or diabetic‐related complications. Average length of stay was 11.1 days as compared to 6.95 days for all patients.Increased length of stay was mainly attributable to diabetic foot disease, with an average length of stay of 17.8 days.Management of non‐medical diabetic admissions was an important part of the diabetic team's workload.
The “piqure” effect
Authors: Quin J D , Maccuish A C , O'Donnell J 
Published: March 2007

AbstractTreatment for hypoglycaemia with glucagon and IV glucose improved consciousness in a 28‐year‐old male diabetic. He remained confused, however, which was thought to be the result of prolonged hypoglycaemia and he was treated with mannitol and IV insulin. Twenty‐four hours after admission he was lucid and a CT scan performed 24 hours later was normal.
An audit of patient satisfaction
Authors: Harrison C J , Roaf E J , Boulton A J M , Tomlinson S 
Published: March 2007

AbstractThe Manchester Diabetes Centre was opened in March 1988 to replace the traditional diabetic clinic at the Manchester Royal Infirmary. In order to audit the effect of this move on the satisfaction of patients, surveys were undertaken both before and after the move. Patients questioned in the Diabetes Centre were significantly more satisfied with the organisation, waiting times, environment, clinical care, education and relationships with staff than those questioned in the traditional clinic.
Comparison of human isophane insulin (Human InsulatardTM) with crystalline insulin zinc suspension (Human UltratardTM) as night‐time longer‐acting insulins in a multiple injection regimen
Authors: Mansell P I , Havard F , O'Hare J P 
Published: March 2007

AbstractIn a randomised cross‐over study we compared human isophane insulin (Human InsulatardTM) with human crystalline insulin zinc suspension (Human UltratardTM) as longer‐acting, night‐time insulins given thrice daily soluble insulin in the management of diabetes. We studied 20 insulin‐dependent patients aged 20–47 years. At the end of each 12‐week study period, total daily insulin dose was 56.9 ± 3.9U with Human InsulatardTM and 59.4 ± 4.4U with Human UltratardTM (no significant difference). The amount of longer‐acting insulin used was lower with Human InsulatardTM than with Human UltratardTM (23.3 ± 2.5 vs 29.0 ± 3.2U per day, p<0.001), despite which the early morning (fasting) blood glucose concentration was lower using Human InsulatardTM (7.4 ± 0.6 vs 10.0 ± 1.0mmol per litre, p<0.02). Serum fructosamine, glycosylated haemoglobin and mean daily blood glucose concentrations were similar with either insulin. Patients reported a total of 85 (range 0.25, median 2) hypoglycaemic episodes using Human InsulatardTM compared with 161 (0.33, 3) when using Human UltratardTM (0.05 <p<0.10). Following the study, 15 patients elected to use Human InsulatardTM compared with five choosing Human UltratardTM (p<0.05). In many patients, human isophane insulin appears to be more satisfactory than human crystalline insulin zine suspension as a longer acting insulin in a multiple injection regimen.
Quality control of blood pressure readings performed by practice nurses
Authors: Burden M L , Burden A C 
Published: March 2007

AbstractPractice nurse measurement of blood pressure is an accepted technique for blood pressure screening and monitoring of anti‐blood pressure therapy in the diabetic clinic. Consequently it is important to design a quality control programme to ensure accuracy of measurement. We describe such a technique employing the Society of Hypertension video on Blood Pressure. Responses were obtained from 36 practice nurses attending a study day on diabetes. Major potential errors of equipment and maintenance were discovered (64% not calibrated or overhauled; 22.5% unable to be adjusted for height). Errors of measurement were also found: 50% of diastolic values were incorrect, and 30% of systolic values. Since anti‐hypertensive treatment is so important in people with diabetes, the responses described demonstrate the need for more care about the teaching on blood pressure measurement and a continuing quality control programme.
Diabetes mellitus, papilloedema, benign intracranial hypertension
Authors: Singh B M , Kilvert J A , Fitzgerald M G 
Published: March 2007

AbstractTwo cases are outlined of patients with visual deterioration due to papilloedema that may have easily been attributed to an anterior ischaemic optic neuropathy if a lumbar puncture diagnostic of benign intracranial hypertension (cerebrospinal fluid pressure > 200mm) had been omitted, with the consequent missed opportunity for beneficial vision‐saving therapeutic intervention. In one case hypothalamic pituitary dysfunction, a known association of benign intracranial hypertension, was documented during an insulin hypoglycaemia stress test, and this may have contributed to sudden onset of unheralded severe hypoglycaemia. The chance co‐occurrence of benign intracranial hypertension and diabetes mellitus may present clinical problems that require careful consideration of the differential diagnosis.
Structuring diabetes care within general practice
Authors: Goulder J , Balme M , Hooper P 
Published: March 2007

AbstractIn an eighteen month project within the Portsmouth and SE Hants Health District, facilitators helped structure diabetes care in 27 practices. In total 39 practices were visited. The prevalence of diabetes in the practices providing structured care was 1.56% (2,684 diabetics in a population of 177,100). Delivery of structured care within the District increased four‐fold by the end of the project.
Random blood glucose estimations on admission as a screening test for diabetes in an elderly population
Authors: Shotliff K , Prasad A 
Published: March 2007

AbstractThe prevalence of diabetes mellitus increases with advancing age but often remains undiagnosed. We examined the use of a blood glucose assay, performed on admission in 515 consecutive acute admissions, aged 65 years and over as an initial screening test for diabetes mellitus. Of these, 7.6% were previously known to have diabetes and 4.7% were newly diagnosed on the basis of subsequent fasting blood glucose estimations. Using a random blood glucose level ≥8.0mmol/1, 18.5% of those screened needed further investigation. Although this method has been used for many years to screen for diabetes a formal comparison with a glucose tolerance test is needed before it can be used as the sole screening test.
Moving to adult care
Authors: Dunning T 
Published: March 2007

AbstractThe transfer from paediatric to adult diabetes care is often stressful for young people with insulin‐dependent diabetes mellitus (IDDM) and their parents. Since 1984 we have been conducting an after‐hours clinic for IDDM patients aged 18–30 years. Eleven criteria for an appropriate IDDM clinic were identified and evaluated, using a 10cm Likert scale, by clinic attendees and the clinic staff. The results indicate that our clinic is meeting the expectations of our young IDDM patients, but privacy during consultations could be improved.
A multicentre study of the B‐DTM (Becton Dickinson) Pen as a delivery system for human insulin
Authors: Anderson Dm , Barnett Ah , Pizzey M , Rowe Br , Songer N 
Published: March 2007

AbstractOne thousand and sixteen insulin‐treated patients from 84 UK diabetes centres were entered into a 12‐week open study to assess the acceptability and safety of the B‐DTM (Becton Dickinson) Pen with HumulinTM (human insulin [prb], Eli Lilly & Co) cartridges. Patients completed an acceptability questionnair after six and 12 weeks' use of the Pen. Patients were asked to score various Pen characteristics on a five‐point scale of very easy to very difficult which included: changing the needle and storing and carrying the Pen; setting the insulin dose; fitting a new cartridge; injecting insulin; reading the dosage markings and noting when the cartridge was empty. Nine hundred and ten patients (90%) completed the study.The commonest insulin used was Humulin M3, a fixed mixture of 30% soluble and 70% isophane insulin (33% of patients), and the most popular dosing regimen was twice daily, (65% of patients). The average daily dose of insulin was 39 units.Three per cent of patients reported some Pen malfunction during the study, and 9% of patients at week 6 and 16% at week 12 reported Pen breakage. All aspects of Pen usage were assessed as 'very easy/fairly easy' by over 84% of patients at both week 6 and week 12; the Pen compared favourably to previous injection methods. Ninety percent of patients who previously used a needle and syringe and 62% who previously used another pen device opted to continue using the B‐D Pen at the end of the study.
The supply of insulin to patients in the community: Problems and solutions
Authors: Cantrill JA , Baker L 
Published: March 2007

AbstractWith the large number of insulin preparations available, there is potential for confusion not only for patients but for health care professionals. The aim of this study was to identify any problems relating to the supply of insulin from community pharmacles to diabetic patients. Sixty‐five patients and 30 pharmacists were interviewed. Twenty‐four pharmacists reported a total of 34 problems relating to prescriptions for insulin, the most common being ambiguity over the species of the insulin. Six patients were aware that they had received prescriptions for the wrong insulin (five dispensed) and two had been given a prescription for viais when cartridges were required (two dispensed).This study reinforces the importance of educating patients about their insulin therapy and the need for health care professionals to keep up‐to‐date with developments in insulin therapy.
Management through pregnancy of a patient with an implantable programmable insulin infusion pump
Authors: Gallacher SJ , Maccuish AC , Lunan C B , Paterson KR 
Published: March 2007

AbstractA 31 year old woman with a 26 year history of Type 1 diabetes mellitus and reslstance to subcutaneous insulin who used a programmable implantable insulin infusion pump for intravenous insulin delivery became pregnant. This report describes our experience of management of this patient through her pregnancy. The pregnancy was complicated by, first, failure of the power supply of the insulin Infusion pump in the second trimester and, second, the later development of pregnancy‐induced hypertension and proteinurla. Throughout this pregnancy, glycaemic control was good with glycated haemoglobin ranging from 7.0−9.0% (non‐diabetic reference range 4.9−7.6%). A normal female infant was subsequently delivered by Caesarean section at 34 weeks' gestation.This report illustrates the fact that, with a well‐motivated patient, glycaemic control through pregnancy may be optimised using an implantable programmable insulin infusion pump.
Diabetes audit from 1987 to 1993 carried out in a general practice clinic
Authors: Smithson J 
Published: March 2007

AbstractA seven year audit of a GP practice nurse‐run diabetic review service was done with the aim of identifying any improvement in control by analysing the HbA1c results. The study also monitored the diagnostic rate of diabetes within the practice over this period. The audit showed some improvement in levels of control by 1993, with 75% of diabetic patients achieving ‘acceptable’ control. Over the seven year period the proportion of those diagnosed with diabetes within the practice increased from 1.1% to 1.6%.
Capillary blood sampling: How much pain is necessary?. Part 1: Comparison of existing finger stick devices
Authors: Fruhstorfer H , Müller T 
Published: March 2007

AbstractSix commercially available automatic lancing devices were examined with regard to puncture pain and capillary blood volume. They differed significantly in puncture pain: devices with greater penetration depth, thicker lancets and inexact lancet guidance got higher pain scores. Blood volumes obtained were generally too large.
Improvement in psychological well‐being in new NIDDMs. DSN versus medical initial assessment
Authors: Harrower ADB , Tallon L , McCue P , Sullivan P , Coates S , Jack H 
Published: March 2007

AbstractBecause of an increasing waiting list of new NIDDMs, we designed a new system to make better use of our existing facilities which include a small diabetes centre staffed by diabetes specialist nurses and a dietitian, and a conventional hospital clinic. Patients were usually seen at the clinic for medical assessment, where their treatment and education programme was also initiated. This programme was continued at the diabetes centre and an early clinic review was made to assess progress. After review of treatment protocols and establishment of clear guidelines for medical advice, a new system was introduced where initial assessment was made in the diabetes centre by a diabetes specialist nurse and dietitian, and medical examination was deferred until later. In order to assess this system, psychological well‐being was measured using Hospital Anxiety and Depression (HAD) scales in 150 consecutive new NIDDMs under the old system, and in 100 consecutive NIDDMs under the new system. A check on the presence of medical and diabetic complications was also made. There was a significant reduction (p<0.005) in anxiety alone and both anxiety and depression together, and no significant undiagnosed medical or diabetic complications were missed. With appropriate safeguards, initial assessment of new NIDDMs can be made by diabetes specialist nurses and, by providing an earlier appointment in a less stressful environment, patient well‐being is improved.
A questionnaire study into the use of blood glucose reflectance meters by general practice staff
Authors: Parker C 
Published: March 2007

AbstractAn audit of the use of blood glucose reflectance meters by staff working in 39 general practices. Questions focused on training in the use of meters; health, safety and legal implications of producing results by meters; and whether practices were employing internal or external quality assessments to monitor the results obtained.Results highlighted varied sources of training. Only a minority of practices had actively addressed health, safety and legal implications in the use of meters. The survey revealed that three practices employed internal quality control. No practices were using external quality assessments.
Implications of modern diabetes practice on glycaemic control and frequency of hypoglycaemia
Authors: Chalmers J , McBain AM , Campbell IW 
Published: March 2007

AbstractTo evaluate changes made in 1988 in clinical diabetes care, aimed at achieving best possible glycaemic control, an audit of HbA1 values was conducted in our insulin‐treated patients in 1992 and compared with the values of an earlier audit performed in 1987. In 1988 major innovations were made in our diabetes clinic with the appointment of a diabetes specialist nurse, the setting up of educational sessions for multiple injection regimens and blood glucose monitoring, along with open access daytime telephone advice. The mean HbA1 fell from 11.4% to 10.7% (normal range 5.6–9.0%) between 1987 and 1992. This reduction in HbA1 was not attributable to multiple injection or home monitoring but appears to be related to the time spent by the diabetes specialist nurse in education. This fall in HbA1 was achieved with no serious hypoglycaemia‐related morbidity or mortality, although the frequency of a severe hypoglycaemic episode doubled from 7–8% per year in 1987 to 15.4% in 1992. The DCCT implications for diabetes care show that the goal of improved glycaemic control, as assessed by HbA1, is not without its risk in increasing the frequency of severe hypoglycaemia with the associated difficulties relating to driving and occupation.
Capillary blood sampling: How much pain is necessary?. Part 3: Pricking the finger can be less painful
Authors: Fruhstorfer H , Lange H 
Published: March 2007

AbstractA new lancing device (Softclix®) with an adjustable penetration depth was compared to the Glucolet® which had proven to be the least painful device in an earlier study1. At the lowest depth setting for obtaining just enough blood for a glucose test (⩽20μl), the new device was significantly less painful. This is mainly due to the fact that the Glucolet® lacks low and intermediate depth settings.
A simple rule to identify people with diabetes at risk of foot ulceration
Authors: Jones RB , Gregory R , Murray KJ , Titterington DM , Allison SP 
Published: March 2007

AbstractThere is a need for a simple rule based on the sort of clinical data generated by annual review examinations, which predicts those at risk of foot ulcers with reasonable specificity and sensitivity. We have used data on 5, 153 patients free of ulcer or amputation at registration who were followed up at University Hospital Nottingham for between one and 12.4 years. A ‘sensitive’ rule using neuropathy and pulse ‘scores’ and HbA1 predicted 95% of those who developed an ulcer and missed only one person out of 39 who worsened to amputation. The rule seemed fairly effective when tested on data from Nottingham City Hospital, and although developed and tested on outpatient attenders, the rule should be relevant in primary care.
Standardisation of rapid in‐gel digestion by mass spectrometry
Authors: Granvogl Bernhard , Gruber Patrick , Eichacker Lutz Andreas 
Published: March 2007

AbstractIn‐gel digestion has been standardised using a poly(propylene) disposable. We designed a four‐step rapid and simple in‐gel digestion protocol which is carried out in one self‐contained reaction tube avoiding keratin contamination. In order to quantify the efficiency of in‐gel digestion, we developed a rapid on‐column peptide acetylation protocol. Results show that trypsin in‐gel uptake is increased and in‐gel digestion is 90% complete within 15 min. We further show that spectrum quality, peptide yield and sequence coverage for mass spectrometric analysis are enhanced. We utilise 2‐D PAGE separation of photosystem II from barley to demonstrate that the protocol facilitates identification of highly hydrophobic membrane proteins.
Use of fungal antagonists for biocontrol of damping‐off and sclerotinia diseases
Authors: Whipps John M. , McQuilken Mark P. , Budge Simon P. 
Published: March 2007

AbstractTwo mycoparasites, Pythium oligandrum and Coniothyrium minitans, have been tested for their ability to act as disease biocontrol agents. P. oligandrum oospores, grown in a cane molasses liquid medium and coated onto cress and sugar‐beet seeds using commercial thin‐film or pelleting techniques, gave significant control of damping‐off in cress and sugar‐beet caused by Pythium ultimum and Aphanomyces cochlioides respectively, in glasshouse pot trials. In some cases, the control was equivalent to fungicide drenches or standard fungicide seed treatments, but little control was achieved with any treatment when the pathogen inoculum potential in the soil was high. Pre‐planting application of a solid substrate preparation of C. minitans gave reproducible control of sclerotinia disease in the glasshouse. The degree of control was equivalent to that achieved with regular foliar sprays of vinclozolin, when there was less than 40% disease in the control plots naturally infested with Sclerotinia sclerotiorum. At higher disease levels biocontrol was lost. Nevertheless, C. minitans survived in the soil for over one year and continued to degrade sclerotia and reduce apothecial production. The commercial potential of these biocontrol agents is discussed.
The entomopathogenic fungus Metarhizium anisopliae and its potential as a biocontrol agent
Authors: Zimmermann Gisbert 
Published: March 2007

AbstractMetarhizium anisopliae is a well‐known entomopathogenic fungus active against many insect pests. This paper discusses the characteristics of M. anisopliae and related species of the same genus, its natural occurrence and host range, identifies the current target pest species and reports some new aspects in production and formulation; present safety data are summarized. Investigations on this fungus demonstrate that M. anisopliae can be an efficient biocontrol agent.
Evolving strategies for biological control of weeds with plant pathogens
Authors: Sandst David C. , Miller R. Vincent 
Published: March 2007

AbstractCurrent biological control strategies involve the use of exotic or native biocontrol agents, proven to be host‐specific and lethal. This is a successful field of endeavor, attractive lo a large cadre of entomologists and a few plant pathologists. The main limitation is that each weed species must be attacked by a separate host‐specific agent and these organisms are not always lethal. Only by using a radical paradigm shift can we reach a new strategy of biocontrol. In this strategy, lethal, broad host‐range pathogens are genetically modified to permit their safe release. Either they are rendered host‐specific or they are given a chemical dependency that prevents their spread or long‐term survival. This genetic‐manipulative approach offers numerous and diverse scenarios for biocontrol. Host‐specific promoters or toxins, host‐dependency by multiple auxotrophy, or mutants dependent on specific environmental conditions are all approaches that lend themselves to genetic modification. Such self‐delimiting pathogens may have the advantage of repeated marketability, environmental safely and multiple target weeds.
Market‐driven research and development in biological control
Authors: van Schelt Jeroen 
Published: March 2007

AbstractA short overview is given of native and introduced pests in Dutch glasshouses. Several examples are presented to illustrate how external and internal factors influenced the choice and introduction of natural enemies on the market. The development time and acceptance of new beneficials has shortened considerably. The factors that influenced the biological control program of aphids and thrips are discussed in more detail.