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  • 1
    ISSN: 1432-0428
    Keywords: Keywords Type II (non-insulin-dependent) diabetes mellitus ; HLA-DR4 ; microalbuminuria ; mortality ; cardiovascular risk factors ; immunological markers ; neuropathy ; NEFA.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To test the hypothesis that interaction between genetic, immunological, clinical and metabolic risk factors influences the outcome of Type II (non-insulin-dependent) diabetes mellitus, we examined which of the above factors present at baseline were associated with mortality in 134 Type II diabetic patients followed for 9 years. Thirty-eight patients (29 %) died during the follow-up period; the majority of whom (68 %) died from cardiovascular disease. At baseline, the deceased patients had higher HbA1 c values (p = 0.002), higher LDL-triglycerides (p = 0.007), lower HDL-cholesterol (p = 0.007), higher non-esterified fatty acid (NEFA) concentrations (p = 0.014), and higher albumin excretion rate (p 〈 0.0001) than the patients who survived. In addition, the frequency of HLA-DR4 (21 vs 39 %, p = 0.048) and of parietal cell antibodies (5 vs 14 %, p = 0.016) were decreased in the deceased as compared to the living patients. Patients who died during follow-up also had more retinopathy (42 vs 16 %, p = 0.002), neuropathy (57 vs 23 %, p 〈 0.001), microalbuminuria (45 vs 6 %, p 〈 0.0001), coronary heart disease (50 vs 13 %, p 〈 0.0001), and peripheral vascular disease (27 vs 9 %, p = 0.005) at baseline than patients who survived. In a multiple logistic regression analysis macroangiopathy (p = 0.004), neuropathy (p = 0.007), HbA1 c (p = 0.018) and albumin excretion rate (p = 0.016) were independent risk factors for death. In patients free of cardiovascular disease at baseline, conventional risk factors such as LDL-cholesterol (p = 0.005) and age (p = 0.003) were associated with subsequent development of cardiovascular disease. In conclusion, in addition to coexisting macroangiopathy, increased albumin excretion rate, poor glycaemic control and neuropathy are risk factors for cardiovascular mortality in patients with Type II diabetes. The presence of HLA-DR4 and signs of autoimmunity may be associated with decreased risk of cardiovascular disease. [Diabetologia (1998) 41: 1253–1262]
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 0942-0940
    Keywords: Keywords: Haemangioblastoma; von Hippel-Lindau disease; surgery; survival.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ The aim was to assess the frequency of von Hippel-Lindau disease (VHL) and the long-term prognosis of VHL and non-VHL patients among 110 consecutive patients with haemangioblastoma (HB) of the CNS treated between 1953 and 1993 at one neurosurgical unit.  To reveal VHL manifestations we performed a detailed clinical and radiological examination (neuraxis and abdomen) (61/110), VHL-gene mutation analysis (40/110), and collection of all available clinical, imaging, operative and autopsy data from the hospitals involved. All patients were followed-up with a median of 14 years (excluding 14 operative deaths), and no patient was lost to follow-up. Altogether 49 patients died during the follow-up.  In the 14 VHL patients (13%), HB(s) of the CNS were detected at a median age of 33 years, retinal HB(s) at 39 years, and renal cell carcinoma (RCC) at 43 years. The frequency of VHL in patients operated on for HB(s) was 29% before the age of 25 years, 19% between 25 and 45 years, and only 2% after 45 years. HB patients not meeting the VHL criteria had internal organ cysts in 14%. One non-VHL patient (4%) had two adjacent HBs in the same cyst wall. The growth rates of non-VHL and VHL-related HBs were similar as indicated by the median time to recurrence and the proliferation indices (MIB-1). Recurrence of the HB in patients whose primary operation was considered radical developed in four of the 10 VHL patients at a median of 19 years, and in nine of the 74 non-VHL patients at a median of 11 years. The median length of life of all VHL and non-VHL patients was 46 and 63 years, respectively. In VHL, RCC and HBs were equal causes of death.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-2630
    Keywords: diabetes mellitus ; diabetic eye disease ; iris neovascularisation ; vitreous haemorrhage ; retinal detachment ; vitrectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The presence or absence of retinal detachment, especially detachment of the macula, was the most critical parameter predicting visual outcome, and long duration of detachment worsened the prognosis (P=0.0084). In contrast, the time interval from vitreous haemorrhage to surgery did not associate with the long-term visual outcome. Pre-operative visual acuity of counting fingers 1 m or better was associated with favourable visual outcome (P=0.0032). Other pre- or per-operative parameters (e.g. aphakia, iris rubeosis, extent of photocoagulation, retinal breaks) did not associate with visual prognosis significantly. Significant association between general parameters and visual outcome was found only in the group of traction retinal detachment where loss of vision was related to shorter duration of diabetes (P=0.0213), and shorter duration of background retinopathy (P=0.0300), and proliferative retinopathy (P=0.0072).
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study evaluated RapID ANA and API 20 A systems for identification of anaerobic gram-positive and gram-negative bacteria isolated from oral and non-oral infections using standard reference methods. A total of 480 isolates were tested in both systems. The RapID ANA system correctly identified 74 % of the strains to species level and 17.5% to genus level; 5 % were misidentified. The API 20 A system correctly identified 50 % of the strains to species level and 24.5 % to genus level; 8 % were misidentified and 17.5 % could not be identified by the API 20 A system.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Bilophila wadsworthia is an anaerobic, gram-negative, asaccharolytic, urease-positive, bile-resistant, catalase-positive bacillus, originally recovered from infections in patients with gangrenous and perforated appendicitis. Additional isolations from clinical specimens, including pleural fluid, joint fluid, blood and pus from a scrotal abscess, mandibular osteomyelitis and axillary hidradenitis suppurativa are described here.Bilophila is found as normal flora in feces and, occasionally, in saliva and in the vagina. Isolates from humans are usually β-lactamase positive and therefore resistant to certain β-lactam antibiotics. Two percent of strains are also resistant to clindamycin.
    Type of Medium: Electronic Resource
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