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Biomedical subjects

F Vinicor

Publications and source records attributed to F Vinicor.

62 records · Page 4Linked to original sources
PubMed1975

Recurrent acute renal failure with idiopathic paroxysmal myoglobinuria.

A second episode of myoglobinuric renal failure requiring dialysis developed in a muscular 30-year-old man. His first episode, which was not exercise-related, had occurred in childhood and was accompanied by chills, fever, and leukocytosis, whereas the second followed unaccustomed exertion 15 years later. Despite two occurrences of severe renal failure and intermittent episodes of myoglobinuria, renal function is presently normal. Idiopathic paroxysmal myoglobinuria may produce recurrent life-threatening acute renal failure; however, the prognosis for recovery, as evidenced by this case, appears favorable.

Acute Kidney Injury↗
PubMedDate not supplied

The Diabetes Education Study: a controlled trial of the effects of intensive instruction of internal medicine residents on the management of diabetes mellitus.

The Diabetes Education Study was a controlled trial of the effects of physician and patient education. This article describes an educational program for internal medicine residents and its effects on ambulatory diabetes management practices. Forty-five of 86 residents practicing in the general medicine clinic of a university-affiliated city/county hospital were assigned randomly to receive a multifaceted program intended to 1) provide specific care recommendations, 2) teach necessary skills, and 3) make the professional and institutional environment more supportive. During the subsequent 11 months, 323 diabetic patients were interviewed and their records audited for evidence of changes in care. Experimental residents utilized fasting blood glucose determinations more often than controls (i.e., during 40% of visits vs. 31%, p = 0.004). Experimental residents also engaged more frequently in a variety of recommended dietary management recommendations. Isolated differences in monitoring/management of chronic complications also were found (e.g., lipid screening: 70% of experimental residents' patients vs. 58%, p = 0.016). Intensive, multifaceted programs of this nature are concluded to result in improvements in diabetes care, over and above that which is attainable through routine methods of clinical training for residents.

Diabetes Mellitus↗
PubMedDate not supplied

Pregnancy following renal transplantation in a patient with insulin-dependent diabetes mellitus.

Renal transplantation and peritoneal or hemodialysis are therapeutic options increasingly available to diabetic patients with uremia. We report a patient with insulin-dependent diabetes mellitus (IDDM) and advanced retinopathy and nephropathy who had three pregnancies. Her first pregnancy resulted in a living female with Pierre-Robin syndrome and arthrogryposis. The second pregnancy, 8 mo post-kidney transplantation, necessitated a therapeutic abortion for an anencephalic fetus. Her third pregnancy, 22 mo after kidney transplantation, was associated with intensive diabetes management and resulted in delivery by cesarean section of a healthy boy. Renal and retinal function remained stable during both her second and third pregnancies. As more patients with IDDM achieve fertility post-renal transplantation, aggressive principles of diabetes regulation need to be expanded to include consideration of the interaction of the post-kidney-transplant state and diabetes mellitus during pregnancy.

Adult↗
PubMedDate not supplied

The diabetes education study: a controlled trial of the effects of diabetes patient education.

The Diabetes Education Study (DIABEDS) was a randomized, controlled trial of the effects of patient and physician education. This article describes a systematic education program for diabetes patients and its effects on patient knowledge, skills, self-care behaviors, and relevant physiologic outcomes. The original sample consisted of 532 diabetes patients from the general medicine clinic at an urban medical center. Patients were predominantly elderly, black women with non-insulin-dependent diabetes mellitus of long duration. Patients randomly assigned to experimental groups (N = 263) were offered up to seven modules of patient education. Each content area module contained didactic instruction (lecture, discussion, audio-visual presentation), skill exercises (demonstration, practice, feedback), and behavioral modification techniques (goal setting, contracting, regular follow-up). Two hundred seventy-five patients remained in the study throughout baseline, intervention, and postintervention periods (August 1978 to July 1982). Despite the requirement that patients demonstrate mastery of educational objectives for each module, postintervention assessment 11-14 mo after instruction showed only rare differences between experimental and control patients in diabetes knowledge. However, statistically significant group differences in self-care skills and compliance behaviors were relatively more numerous. Experimental group patients experienced significantly greater reductions in fasting blood glucose (-27.5 mg/dl versus -2.8 mg/dl, P less than 0.05) and glycosylated hemoglobin (-0.43% versus + 0.35%, P less than 0.05) as compared with control subjects. Patient education also had similar effects on body weight, blood pressure, and serum creatinine. Continued follow-up is planned for DIABEDS patients to determine the longevity of effects and subsequent impact on emergency room visits and hospitalization.

Blood Glucose↗