| |  | Hearst, Marti | Tagclouds: Data Analysis tool or Social Signaller? read moreAbstract: Sorry no abstract available for this article | 2008 |
| | | Chen, Z. L. | Trends in speciation analysis of vanadium in environmental samples and biological fluids--a review read moreAbstract: A comprehensive review is presented addressing recent trends in the speciation and determination of vanadium in environmental and biological sample matrices, including important analytical aspects such as sample clean up, pre-concentration and method development. Methodology based on both separation and spectroscopic techniques for the determination of vanadium speciation is discussed. A brief outline of analytical principles, together with an overview of the recent developments and applications of vanadium speciation determination is included. The newer methods for detecting metal ions including hyphenated spectroscopic techniques and sample preparation schemes are also discussed. | 2008 |
| | | Jong, Paul D. | Screening, monitoring, and treatment of albuminuria: Public health perspectives. read moreAbstract: Microalbuminuria is an early sign of progressive cardiovascular and renal disease in individuals with and without diabetes. Despite compelling data, at present only a minority of patients with diabetes and rarely individuals without diabetes are screened for albuminuria in a systematic way. All of the criteria to implement systematic albuminuria screening are fulfilled in diabetes, and most are nearly fulfilled for microalbuminuria screening in individuals without diabetes. Because of the growing evidence that treatment of microalbuminuria in individuals without diabetes may offer a cost-effective benefit to prevent cardiovascular disease, nephrologists and other health care providers should pay more attention to the early detection and subsequent treatment of individuals with microalbuminuria. | 2006 |
| | | Karter, A. J. | Role of self-monitoring of blood glucose in glycemic control read moreAbstract: OBJECTIVE: To examine the role of self-monitoring of blood glucose (SMBG) in the management of diabetes mellitus. METHODS: Current trends and published evidence are reviewed. RESULTS: Despite the widespread evidence that lowering glycemic levels reduces the risks of complications in patients with diabetes, little improvement in glycemic control has been noted among patients in the United States and Europe in recent years. Although SMBG has been widely used, considerable controversy surrounds its role in achieving glycemic control. The high cost of test strips has made considerations regarding appropriate recommendations for SMBG a priority, especially in light of the current climate of health-care cost-containment. Existing clinical recommendations lack specific guidance to patients and clinicians regarding SMBG practice intensity and frequency, particularly for those patients not treated with insulin. Previous studies of the association between SMBG and glycemic control often found weak and conflicting results. CONCLUSION: A reexamination of the role of SMBG is needed, with special attention to the unique needs of patients using different diabetes treatments, within special clinical subpopulations, and during initiation of SMBG versus its ongoing use. Further understanding of the intensity and frequency of SMBG needed to reflect the variability in glycemic patterns would facilitate more specific guideline development. Educational programs that focus on teaching patients the recommended SMBG practice, specific glycemic targets, and appropriate responses to various blood glucose readings would be beneficial. Continuing medical education programs for health-care providers should suggest ways to analyze patient SMBG records to tailor medication regimens. For transfer or communication of SMBG reports to the clinical staff, a standardized format that extracts key data elements and allows quick review by health-care providers would be useful. Because the practice of SMBG is expensive, the cost-effectiveness of SMBG needs to be carefully assessed. | 2006 |
| | | Higgs, Gary | A Literature Review of the Use of GIS-Based Measures of Access to Health Care Services read moreAbstract: Sorry no abstract available for this article | 2005 |
| | | Radermecker, R. P. | Continuous subcutaneous insulin infusion with short-acting insulin analogues or human regular insulin: efficacy, safety, quality of life, and cost-effectiveness read moreAbstract: Portable insulin infusion devices are effective and safe insulin delivery systems for managing diabetes mellitus, especially type 1 diabetes. Rapidly absorbed insulin analogues, such as insulin lispro or insulin aspart, may offer an advantage over regular human insulin for insulin pumps. Several open-label randomised crossover trials demonstrated that continuous subcutaneous insulin infusion (CSII) with insulin lispro provided a better control of postprandial hyperglycaemia and a slightly but significantly lower glycated haemoglobin level, with lower daily insulin requirement and similar or even less hypoglycaemic episodes. A CSII study comparing insulin lispro and insulin aspart demonstrated similar results with the two analogues, and better results than those with regular insulin. Because these analogues have a quicker onset and a shorter duration of action than regular insulin, one might expect an earlier and greater metabolic deterioration in case of CSII interruption, but a more rapid correction of metabolic abnormalities after insulin boluses when reactivating the pump. These expectations were confirmed in randomised protocols comparing the metabolic changes occurring during and after CSII interruption of various durations when the pump infused either insulin lispro or regular insulin. The extra cost resulting from the use of CSII and insulin analogues in diabetes management should be compensated for by better metabolic control and quality of life. In conclusion, CSII delivering fast-acting insulin analogues may be considered as one of the best methods to replace insulin in a physiological manner by mimicking meal and basal insulin requirements, without higher risk of hypoglycaemia or ketoacidosis in well-educated diabetic patients. | 2004 |
| | | Liebl, A. | Challenges in optimal metabolic control of diabetes read moreAbstract: The results of the Diabetes Control and Complications Trial (DCCT) and the United Kingdom Prospective Diabetes Study (UKPDS) showed that tight glycemic control with any of several therapeutic regiments has the potential to significantly reduce the risks for long-term microvascular complications of type 1 or type 2 diabetes. The results of these large-scale long-term studies also demonstrated that there is no threshold for the relationship between blood glucose [i.e. glycosylated hemoglobin (HbA(1c))] and reduced risk. This means that optimal glycemic control in a patient with type 1 or type 2 diabetes is a blood glucose level as close as possible to the level in an individual without diabetes. Limitations of most available therapies for type 1 and 2 diabetes have hampered achievement of this goal. Most available insulin preparations used to treat patients with type 1 disease can achieve approximately normal basal insulin levels only when used with a pump or a complex treatment regimen requiring a large number of daily injections. Pumps are limited by high expense, and complex injection protocols increase the potential for patient errors and non-compliance. The development of new insulins such as aspart insulin and lispro insulin, both short-acting, and insulin glargine, a long-acting insulin analogue suitable for once-daily administration, may help overcome these challenges.In patients with type 2 diabetes, achieving optimal glycemic control is complicated by the progressive nature of the disease and the loss of efficacy of oral agents (e.g. sulfonylureas, metformin, and thiazolidinediones) over time. Moreover, neither oral therapy nor insulin alone is likely to achieve optimal glycemic control in most of these patients in the long term. The availability of new insulin preparations that mimic the normal mealtime bursts of insulin, and another that provides a sustained insulin supply similar to basal insulin secretion in an individual without diabetes has the potential to significantly improve long-term control over blood glucose in patients with type 2 diabetes. | 2002 |
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