In a group of 51 women who had given birth to giant children, the glucose tolerance test (GTT) was performed at entry in the study and after intervals of 6 to 12 years. The results of the first determination, estimated according to the WHO's criteria (1980), have revealed an impaired glucose tolerance (IGT) in 7 cases (14%); the second determination showed IGT in 10 cases (20%) and diabetes mellitus in 2 (4%). Insulinemia assays, concomitant with the second performance of GTT, showed the highest values in the diabetic subjects, moderate values in those with IGT, and low values in those with normal glucose tolerance. The presence of obesity in some cases could not be considered as fully responsible for the glucose tolerance impairment in the women with fetal gigantism. The dynamics of glucose tolerance disorders showed variations in time, i.e. the initial pathologic changes were no more recorded on the second testing in the same subjects, while women with normal initial GTT showed high insulinemia or IGT on the second determination.

Adult↗

PubMedDate not supplied

Characteristics of severe diabetic ketoacidoses occurring before and after 60 years of age.

Between 1978 and 1982, 459 cases of severe diabetic ketoacidosis (pH less than or equal to 7.20, total -CO2 less than or equal to 10 mMol/l) were admitted to our Intensive Care Unit. 416 (241 males, 175 females) were under 60 years (41 +/- 7) and 43 (22 males, 21 females) exceeded 60 years of age (67 +/- 7). The precipitating causes were fairly similar, in both groups, with infections foremost (68%). Presenting biochemical parameters, before and after 60 years showed differences in: blood glucose: 32.7 +/- 12 versus 34.8 +/- 8.1 mMol/l; plasma sodium 137 +/- 14 versus 143 +/- 16 mMol/l; plasma potassium 4.2 +/- 0.9 versus 4.9 +/- 0.7 mMol/l; hydrogen ion concentration 95 +/- 17 versus 73 +/- 12 mMol/l, (p less than 0.01); plasma osmolarity 327 +/- 98 versus 379 +/- 96 mOsm/l. The difference was significant (p less than 0.01) in frequency of hypernatremic hyperosmolarity (initial sodium greater than 147 mMol/l): 7.4% of 202 cases before age 60 years versus 24.1% of 29 case after age 60 years. The fluid amounts administered i.v. within the first 24 h was greater before (7516 +/- 2121 ml; p less than 0.01) than after 60 years (5276 +/- 1132 ml); insulin requirements were greater after 60 years (236 +/- 78 U/24 h; p less than 0.01) than before the age of 60 years (182 + 59 U/24 h). The mortality rate in the course of severe diabetic ketoacidoses was significantly lower before 60 years (1.3%, p less than 0.01) as against 6.9% after age 60 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

PubMedDate not supplied

Effect of the antidiabetic treatment of hyperlipoproteinemia in newly detected diabetes mellitus.

A parallel study concerning the influence of antidiabetic treatment of the carbohydrate and lipid disturbances were carried out in 209 patients with newly discovered diabetes mellitus: 120 females and 89 males, ranging in age from 28 to 73 years. The treatment applied in terms of the clinical from of the disease was: insulin in 12 cases, tolbutamide in 25 cases, glurenorm (a sulphenyl urea derivative in 114 cases, biguanide in 45 cases, tolbutamide associated with biguanide in 13 cases. After 60 days of treatment, the incidence of HLP fell from 55.02% to 43.06% (in 90 of 209 cases), with a change in the distribution of the five HLP types. Parallel analysis of blood glucose, triglycerides (Tg) and cholesterol (Ch) revealed appraisable differences in the post-therapeutic evolution of the three biochemical parameters in terms of the treatment applied. A statistically significant, parallel and comparable decrease in glycemia, Tg and Ch was recorded after insulin and glurenorm; biguanides lowered only glycemia and Tg, and tolbutamide only glycemia. The fact that correction of carbohydrate disturbances is accompanied by a significant decrease only of Tg and not of Ch suggests that the pathophysiologic mechanisms by which these lipid fractions are modified in diabetes mellitus, differ and are probably independent on one another. The close relationship between the weight excess and plasma Tg (but not also plasma Ch) levels, likewise lends support to this assumption.

Adult↗

PubMedDate not supplied

[The repair of voluminous postoperative abdominal wall defects with synthetic mesh].

Important postoperative abdominal wall defects, especially recurrent or multirecidivated ones, are raising multiple problems to the surgeon. We are presenting a homogeneous trial of 209 patients with such lesions, in which the abdominal wall repair was made with different kind of synthetic materials, with good results. In a single case the mesh was rejected, because a silent quiescent infection. In three patients undergoing iterative abdominal operations for other diseases we performed optical and electronic microscopical studies showing out that the material integration was done by normal biological reaction. This provides the materials' tolerability and a normal reaction of the organism.

Abdominal Muscles↗

PubMedDate not supplied

[Immediate and early reinterventions in the surgery of colorectal cancer].

Out of 584 cases submitted to colorectal surgery 461 (78.92%) were performed for cancer. Thirty-three patients (7.16%) necessitated immediate (1) or precocious reinterventions for bleeding, fistulae, peritoneal infections, bowel occlusion, necrosis or stenosis of the iliac anus. We are out the technical procedures chosen for each class of complications asking for reintervention. We registered 4 deaths, in aged patients with hard associated morbidity, with emergency reinterventions. We appreciate that a correct preoperative preparation reduces the rate of reintervention and an early reintervention reduces the post-operative mortality.

Adult↗