Suicide and role strain among physicians.
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Biomedical subjects
Publications and source records attributed to P Singer.
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In 20 diabetic inpatients with type IIb, III, IV and V hyperlipoproteinemia (HPL) the triglyceride fatty acid pattern (TFAP) of serum, adipose tissue and liver biopsy specimens before and after one year of clofibrate treatment has been determined by gas-liquid chromatography. Compared to previous results which revealed a correlation between fat droplet size and the TFAP in liver parenchyma cells, remarkable changes were observed after long-term therapy. In adipose tissue, only linoleic acid increased significantly from 8.6 to 11.3%. In serum, myristic and palmitic acid decreased, whereas linoleic, eicosatetraenoic (arachidonic) and eicosapentaenoic acid rose significantly. In liver fat, palmitic acid decreased, whereas linoleic, eicosatrienoic, arachidonic and eicosapentaenoic acid significantly increased. After clofibrate therapy, the TFAP in diabetic subjects with HLP became similar to that of diabetics without HLP. The most pronounced changes were found in the liver, serum having an intermediate position between liver and adipose tissue. The pathophysiological relevance in view of possible relations to prostaglandins has been discussed.
A brief review of some therapy results in 763 episodes of diabetic coma from 1960 to 1973 reveals a significant decrease in lethality after institution of an intensive care unit. Present aspects of management are: intensification of shock therapy, potassium substitution and treatment of cerebral edema. The possibly dangerous role of hypotonic solutions is discussed. The lowering of the as yet high lethality of diabetic coma is an urgent necessity.
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