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Biomedical subjects

J L Moses

Publications and source records attributed to J L Moses.

10 recordsLinked to original sources
PubMed1995

Neuropsychological function in older subjects with non-insulin-dependent diabetes mellitus.

Neuropsychological function was compared in three well-matched groups of subjects: Group 1, 20 diabetic patients with hypertension, mean age 69.1 +/- 4.8 years, 14 males and 6 females; Group 2, 20 normotensive diabetic patients, mean age 69.0 +/- 6.2 years, 14 males and 6 females; Group 3, 20 healthy community controls, mean age 68.1 +/- 4.5 years, 13 males and 7 females. There were no significant differences between the groups in education or estimated IQ using the NART (National Adult Reading Test). Groups 1 and 2 did not differ significantly in duration of diabetes (mean 10.6 and 9.5 years, respectively), or mean glycosylated haemoglobin, HbA1 (mean 9.8 and 10.6%, respectively), or mean blood glucose before and after testing. On a battery neuropsychological tests, sensitive to cognitive impairment in older subjects, analysis of covariance using estimated IQ as the covariate showed no significant differences between the groups on tests of recall, with (Brown-Peterson Test) and without (Kendrick Object Learning Test) interference, forward and backward digit span, concentration (serial subtraction), verbal fluency, immediate and delayed prose recall, digit symbol substitution or psychomotor speed (Kendrick Digit Copying Test). These results provide no support for an association between cognitive deficits and Type 2 diabetes mellitus in older subjects or for the view that such deficits may also be mediated by hypertension.

Aged↗
PubMed1986

Evaluation of blood glucose measurement techniques: locating sources of error.

Researchers evaluating the accuracy of rapid blood glucose monitoring (RBGM) techniques have often concluded that RBGM was sufficiently accurate for clinical use. However, investigators of patients' use of RBGM have more often reported unacceptable levels of accuracy and have shown individual differences between patients in the level of accuracy attained. Responsibility for excessive errors has commonly been attributed to patients' inadequacy in using RBGM. The logic of such attributions is questioned. Data are presented which indicates that errors attributed to patient inaccuracy may actually be due to (a) inaccuracy of reference blood glucose determinations used to evaluate patients' accuracy and (b) variable accuracy of RBGM techniques dependent on the range of blood glucose levels: some patients may appear to be less accurate than others simply because their blood glucose levels fall into a range less accurately measured by the RBGM technique. Furthermore, data presented reveal batch to batch variation in accuracy of the particular reagent strips used. Such variation between batches may help to account for inconsistencies between RBGM evaluation studies in which apparently identical reagent strips were used.

Autoanalysis↗
PubMed1985

Accuracy of subjective blood glucose estimation by patients with insulin-dependent diabetes.

A between-groups design using a baseline, treatment, follow-up procedure was used to investigate the accuracy of 20 patients with insulin-dependent diabetes when subjectively estimating their blood glucose levels. Patients were encouraged to attend to their mood for cues when making estimates of their blood glucose. Their capacity for reducing estimation errors when given immediate or delayed feedback of actual blood glucose was examined. The results showed that neither delayed nor immediate feedback produced a significant improvement in the mean estimation accuracy of these groups of patients or in their ability to predict whether their blood glucose was in the acceptable or unacceptable range. Patients were particularly inaccurate in detecting Low [less than 4.0 mmol/L (less than 72.0 mg/dl)] and Very High [greater than 16.0 mmol/L (greater than 288.0 mg/dl)] blood glucose levels. Examination of mood-blood glucose relationships revealed consistent patterns for individual subjects and considerable differences between subjects.

Adult↗
PubMed1984

Development of scales to measure perceived control of diabetes mellitus and diabetes-related health beliefs.

A series of scales was designed to measure perceived control of diabetes and diabetes-related health beliefs with a view to predicting treatment preferences and individual differences in response to the treatments. Scale development is described and the psychometric properties examined with responses from 286 insulin requiring adult diabetic patients. Patients were significantly more likely (p less than 0.001) to attribute responsibility for their diabetes control to themselves rather than to their medical advisors or to other factors. For most of the patients the benefits of treatment were perceived substantially to outweight any barriers (p less than 0.001). Compared with their perceptions of vulnerability to disorders unrelated to diabetes, patients thought that they were more vulnerable to such diabetes related complications as eye, kidney and foot problems (p less than 0.001) but not to heart disease.

Diabetes Mellitus, Type 1↗
PubMed1984

A feasibility study of the use of continuous subcutaneous insulin infusion in a diabetic clinic: patients' choice of treatment.

Insulin-treated diabetic patients attending a busy diabetic clinic were approached to determine their interest in using continuous subcutaneous insulin infusion (CSII) via a portable pump. Three hundred and eighty-two patients were offered the choice of CSII, intensified conventional therapy (ICT) or continuation of less intensified treatment. One hundred and sixteen patients (30.4%) chose CSII, 169 (44.2%) chose ICT, 97 (25.4%) chose the less intensive regimen. Those choosing CSII represented a broad cross section of the clinic population, though older patients with a longer duration of diabetes tended to continue with less intensified therapy. There were no differences between groups in the level of blood glucose control or the prevalence of complications at the outset of the study. Of 104 patients not previously using CSII, 86 have so far commenced the therapy. Twenty-seven (32.6%) of these discontinued within one year, 23 doing so in the first three months of treatment. Metabolic control, assessed by glycosylated haemoglobin, was significantly improved in the CSII group after three months and in the other treatment groups by six months. Glycosylated haemoglobin levels achieved with CSII were significantly lower at three and six months when compared with the other treatments.

Adolescent↗
PubMed1979

Orbital decompression.

A new technique for exposure of the orbit for decompression of the orbit is described. It may be used for other purposes such as orbital fracture repair, orbital exploration for tumors in the inferior orbit, or reconstruction of the orbit by a variety of methods. The technique provides ready, broad exposure. The approach also avoids not uncommon complications of the eyelid, approaches to the orbit such as skin shrinkage and ectropion of the lower lid. It also results in minimal cosmetic deformity.

Fractures, Bone↗
PubMed1979

Exposure of the inferior orbit with fornix incision and lateral canthotomy.

Exposure of the inferior orbit is necessary for exploration of the orbit for repair of orbital fractures, reconstruction of the orbit to correct enophthalmos with a volume implant, and decompression of the orbit to relieve the symptoms and improve appearance in cases of dysthyroid exophthalmos. The usual approach to the inferior orbit has been through a subciliary skin incision and dissection of a skin flap to the orbital rim. A technique is presented which utilizes an inferior fornix conjunctival incision combined with a lateral canthotomy and outward rotation of the lower lid. The advantages of this technique are that it avoids a lengthy skin incision with dissection which may present skin shrinkage if repeated surgery is necessary, employs a very simple closure, and provides better exposure of the nasal, inferior and lateral orbits while leaving the lower lid structures intact, preserving its integrity.

Adult↗