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D Becker

Publications and source records attributed to D Becker.

389 records · Page 22Linked to original sources
PubMedDate not supplied

The role of self-monitoring of blood glucose in the routine management of children with insulin-dependent diabetes mellitus.

We report a double-crossover study to assess the impact of self-monitoring of blood glucose (SMBG) on the glycemic control of children with insulin-dependent diabetes mellitus (IDDM) on a conventional therapeutic regimen. Sixteen children were assigned to one of two groups--group A, period 1 (wk 1-13): urine testing plus SMBG; period 2 (wk 14-26): urine testing only; group B, period 1: urine only; period 2: urine testing plus SMBG. Frequent telephone contact was maintained throughout to help optimize insulin dose adjustment. At the outset, the two groups were similar in age, diabetes duration, and glycosylated hemoglobin levels (10.5 +/- 0.6% and 9.5 +/- 0.3% in groups A and B, respectively). No significant differences could be detected between the two groups at any stage of the study. There was, however, a trend toward lower mean blood glucose (MBG) concentration in both groups toward the end of the SMBG period. No complications of SMBG were noted, but compliance was a major problem in three children. SMBG confirmed symptoms of hypoglycemia in all children, and detected asymptomatic hypoglycemia (BG less than or equal to 40 mg/dl) in 11. Sixty-nine percent preferred SMBG to urine testing. We conclude that SMBG is an acceptable part of routine diabetes care in children. It is associated with very few complications and helps to confirm symptomatic hypoglycemia and detect asymptomatic hypoglycemia. However, the addition of SMBG to routine diabetes care does not necessarily lead to improved metabolic control.

Adolescent↗
PubMedDate not supplied

Frequency and accuracy of self-monitoring of blood glucose in children: relationship to glycemic control.

We evaluated the long-term effects of self-monitoring of blood glucose (SMBG) on glycemic control in a large unselected group of insulin-dependent diabetic (IDD) children and adolescents (N = 282) treated at a diabetes clinic. Among those who had been taught SMBG techniques (N = 229) and reported frequency of use (N = 209), only 26% reported monitoring three or more times per day. HbA1 levels of patients who monitored their blood most frequently did not differ from those who monitored blood less frequently or those who monitored only urine. Likewise, HbA1 levels of patients who monitored with machines did not differ from Chemstrip bG users. Accuracy was assessed in a subsample of 100 randomly selected Chemstrip bG users by comparing their Chemstrip reading with a laboratory value. Fifty-eight percent of the readings were within 20% of the laboratory value. Accuracy did not relate to frequency of monitoring or to HbA1 levels. These data suggest that frequency and accuracy of SMBG are independent and that neither ensures good glycemic control.

Adolescent↗
PubMedDate not supplied

Behavioral skills in self-monitoring of blood glucose: relationship to accuracy.

Sixty-two children and adolescents with IDDM were observed while performing self-monitoring of blood glucose (SMBG) to determine which of the behaviors involved in SMBG were most likely to be performed incorrectly and which errors had the greatest effect on the accuracy of SMBG readings. Behaviors related to cleanliness and timing were performed most poorly; only 60% of the subjects correctly timed the first minute, and 30-33% correctly timed the second interval. The duration of SMBG and frequency of monitoring were not related to proper performance of the behaviors involved in SMBG. Accuracy of SMBG was assessed by comparing subjects' readings to laboratory values obtained immediately afterward. The behavior that had the greatest effect on the accuracy of SMBG readings was that concerning whether the blood was adequately wiped from the Chemstrip bG. This behavior should receive more emphasis in SMBG training programs. The systematic observation procedure used in this study may help to identify errors made by patients while performing SMBG and may serve as the basis for training programs to improve SMBG accuracy.

Adolescent↗
PubMedDate not supplied

[Maxillofacial adenoid cystic carcinoma. Retrospective clinical study of 51 cases].

The clinical behavior of 51 adenoid cystic carcinomas of the salivary glands demonstrated a protracted and partly insidious course of disease with obstinately recurring tumors and a high tendency for distant metastases. The tumors are mainly localized in the minor salivary glands, invasion and growth along adjoining nerves are characteristic of these tumors. With increasing size of the tumor the prognosis significantly deteriorates. The treatment of choice is radical surgery, possibly combined with irradiation. A treatment of both the primary tumor and the recurrent tumor is of benefit in the presence of distant metastases, because the latter remains clinically symptomless for years. Because of the protraction of the disease the importance of early detection of these tumors is pointed out.

Adult↗
PubMedDate not supplied

Reevaluation of serum-plasma differences in total cholesterol concentration.

We measured total cholesterol levels in serum and disodium ethylenediaminetetraacetate (EDTA) plasma samples obtained from 84 healthy medical students during their entrance physical examinations and 48 adults from a cholesterol screening program who were resampled because they had initial values of 5.17 mmol/L (200 mg/dL) or higher. Plasma cholesterol concentrations were 4.7% lower than those in serum samples. The plasma and serum values were highly correlated (r = .994), however, suggesting that measurements in EDTA plasma can be converted readily to equivalent serum concentrations. Thus, the negative bias in EDTA plasma was greater than the 3% value cited in the National Cholesterol Education Program Guidelines, probably because the amount of EDTA now provided in evacuated blood collection tubes is 50% greater than in those used when the 3% value was established. These findings are relevant to the interpretation of both cholesterol screening measurements and follow-up lipoprotein analyses.

Adult↗
PubMedDate not supplied

Electrophysiological and psychological changes induced by steroid hormones in men and women.

The effects of hormonal changes during the menstrual cycle and of oral contraceptives on the EEG, heart-rate and a number of performance tasks were investigated in 16 female subjects (Ss). Powerspectral analysis in the EEG revealed significantly increased alpha-frequencies and heart-rates during the luteal phase of the menstrual cycle whereas the mean theta-frequency and power decreased. A number of psychological test variables, such as reaction time to a tone, to a flickering light and to a colour-tone sequence and the time to solve simple arithmetic problems was shorter at the periovulatory time. Another minimum was reached during the perimenstrual phase. The flicker-fusion-frequency was higher during these two periods. No such effects could be observed when the same Ss were treated with oral contraceptives. It is concluded that the phenomena observed during the luteal phase of the cycle may be the expression of a slight general arousal effect, possibly medicated by progesterone via the noradrenergic system. In a subsequent double blind study 30 male Ss were treated with an gestagenic compound (D-Norgestrel, 2.5 mg/die), an estrogenic compound (estradiolvalerate, 5 mg/die), an androgenic substance (Mesterolone, 100 mg/die) or with placebo. Only treatment with the progestational compound revealed significant changes in the EEG and the performance tests. These changes were qualitatively similar to those observed during the luteal phase of the female Ss. Under both conditions, i.e. the luteal phase and D-Norgestrel treatment, the body-temperature was significantly increased. Hence, the question whether gestagens exert their effects directly on CNS structures which modulate EEG appearance and behavior or indirectly via increased body-temperature cannot be answered convincingly.

Adolescent↗