It has proved possible to measure well-being and treatment satisfaction in a large community-based samples of older people with diabetes. At the level of glycemic control in this population, neither parameter correlated with HbA1c. The lower well-being in insulin-treated patients remained significant in multivariate analysis.
Road, Manchester M6 8HD, UK. Recent studies, in combination with advances in modern electronics, suggest a role for electrotherapy in reversing muscle wasting. However, its effects on human subjects are not always clear-cut. The authors propose that conventional uniform frequency stimulation may deprive the muscle of adaptive information normally encoded in the nonuniform discharge of its motoneuron. This hypothesis was tested in a double blind control trial by stimulating the quadriceps femoris (QF) of elderly subjects with osteoarthritis of the knee. A stimulation pattern replicating that occurring in a normal, fatigued QF motor unit (patterned neuromuscular stimulation) was compared with uniform stimulation of the same mean frequency and random pattern stimulation (created by shuffling the order of the interpulse intervals in the replicated stimulus train). A'sham' stimulation protocol provided an effective placebo. Subjects were assessed at the level of impairment (muscle strength, endurance and cross-sectional area), disability (timed 10-metre walk, timed sit-to-stand) and handicap (part II of the Nottingham Health Profile).Following stimulation, some descriptive improvements in outcome measures were observed in favour of PNMS, particularly in functional tests such as walking speed and sit-to-stand time. No stimulation pattern emerged as being significantly better than another, although statistically significant ( p ≤ 0.05) differences between individual stimulation patterns were observed at a number of assessment weeks.
A man with a prolactin secreting pituitary carcinoma was treated by surgery and radiotherapy. Persistent hyperprolactinaemia partially responded to oral bromocriptine for four years. Serum prolactin then rose considerably with rapid, invasive tumour recurrence. Cytotoxic chemotherapy halted tumour progression for twelve months before fatal spread throughout the brain. Failure to normalise serum prolactin with bromocriptine may precede an aggressive course in patients with prolactinoma. (surgery,3 " radiotherapy5 and chemotherapy) is then unclear.
In several diseases the concentration of lysozyme is often high in body fluids. Raised serum lysozyme levels have been reported in such granulomatous diseases as sarcoidosis, pulmonary tuberculosis, and Crohn's disease.1 2 We have extended studies on the diagnostic significance of lysozyme content in body fluids to the pleural fluid in pleurisy of various aetiologies.
This study examined 15 different leaflets routinely given to elderly patients in the diabetes unit of a teaching hospital. It used (1) a Fog Index to give a rough guide of readability, and (2) examined the size and style of print. Results were compared with those of information leaflets taken from the hospitals' acute elderly care unit, rehabilitation unit, physiotherapy department, day hospital and outpatients department. Seven out of a total 70 leaflets (10%) were as hard to read as the British Medical Journal. None of these came from the diabetes unit, which may be because the diabetes leaflets were prepared by educators with considerable experience in communicating with patients. However, the authors' awareness of the need to use simple language was greater than their awareness of the need to use legible type. Eleven of the 15 leaflets from the diabetes unit (73%) failed to meet guidelines suggested by the Royal National Institute for the Blind, a rate which differed little from the overall rate (77%). These findings suggest that those responsible for producing patient information should be more aware of the principles of effective written communication.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.