Background:The information-motivation-behavioral skills (IMB) model of health behavior is an effective tool to evaluate the behavior of diabetes self-management. The purpose of this study was to explore behavioral factors affecting the practice of self-monitoring of blood glucose (SMBG) within the frame of IMB model of health behavioral among adult patients with type 1 diabetes in a single diabetes clinic in China.Methods:A questionnaire with three subscales on SMBG information, motivation, and behavioral skills based on IMB model was developed. Validity and reliability of the measures were examined and guaranteed. Adult patients with type 1 diabetes visiting our diabetes clinic from January to March 2012 (n = 55) were consecutively interviewed. The self-completion questionnaires were administered and finished at face-to-face interviews among these patients. Both descriptive and correlational analyses were made.Results:Fifty-five patients finished the questionnaires, with the median duration of diabetes 4.5 years and the median of SMBG frequency 2.00. Specific SMBG information deficits, motivation obstacles, and behavioral skill limitations were identified in a substantial proportion of participants. Scores of SMBG motivation (r = 0.299, P = 0.026) and behavioral skills (r = 0.425, P = 0.001) were significantly correlated with SMBG frequency. The multiple correlation of SMBG information, SMBG motivation, and SMBG behavioral skills with SMBG frequency was R = 0.411 (R2 = 0.169, P = 0.023).Conclusions:Adult patients with type 1 diabetes in our clinic had substantial SMBG information deficits, motivation obstacles, and skill limitations. This information provided potential-focused education targets for diabetes health-care providers.
Purpose of reviewRheumatoid arthritis is a systemic inflammatory disorder, which can involve many organs; among which, CNS involvement, as in rheumatoid meningitis (RM), is rare and difficult to recognize. Our goal is to present collective data of RM cases to better characterize this disease process and to start new discussions about pathophysiology, diagnosis, and treatment.Recent findingsSince Kato et al., 39 cases of RM have been reported. Approximately 59% were women, presenting with neurologic deficits (56%) and diagnosed by MRI findings, leptomeningeal enhancement (69%), after CSF analysis. Seventy-four percent were treated with corticosteroids, 64% as maintenance therapy, with 46% experiencing improvement or resolution in symptoms without relapse.SummaryDiagnosis and prognosis of RM has drastically changed since the year 2000. Early detection with CSF and MRI or biopsy findings, coupled with early treatment using corticosteroids and immunologic therapy, has reduced mortality in this population.
Objective: Primary aldosteronism is one of the most common causes of secondary hepertension. We present here a case of primary aldosteronism in a 38-year-old Chinese male with a 6-year history of uncontrolled hypertension that evaded diagnosis until an attack of rhabdomyolysis due to profound hypokalemia. We also present the results of a comprehensive review of the current literature.Methods: We describe the presentation and symptoms of the patient and review the relevant literature. A thorough literature search disclosed 15 further cases of rhabdomyolysis due to undiagnosed primary aldosteronism reported between 1978 and 2013. We summarized the clinical features, treatments, and outcomes of those cases.Results: Many of the cases presented with previous hint of primary aldosteronism, yet they evaded diagnosis. Three of these patients developed acute renal failure. All patients survived, and many of them were restored to normal blood pressure and normal serum potassium levels after adrenal surgical interventions. Conclusion:Primary aldosteronism can lead to severe acute consequences of rhabdomyolysis via hypokalemia. It is important to alert physicians to the need for hyperaldosteronism workup when a rhabdomyolysis patient is found to be hypokalemic. (AACE Clinical Case Rep. 2015;1:e21-e27) Abbreviations: ARR = aldosterone to renin ratio; AVS = adrenal venous sampling; CPK = creatinine phosphokinase; CT = computed tomography; PA = primary aldosteronism; PAC = plasma aldosterone concentration; PRA = plasma renin activity
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