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Biomedical subjects

R Bendezu

Publications and source records attributed to R Bendezu.

5 recordsLinked to original sources

Temperature dependence of the chromatographic assay of hemoglobin A1 and application of a temperature controlled assay to clinical evaluation of diabetic control.

We investigated the temperature dependence of the cation-exchange chromatographic properties of hemoglobin A1 using the "Fast Hemoglobins Test System" obtained from Isolab, Inc., Akron, OH, U.S.A. and a temperature control chamber constructed in our laboratory. Six patient samples, two each from the "normal" range (5--8.5%, "transitional" range (8.5--12.0%) and "uncontrolled diabetic" range (12--20%) described by Isolab (as measured at 24 degrees C) were collected, hemolyzed and assayed according to product insert instructions. Each sample was assayed in triplicate in three separate runs at 20 degrees C, 22 degrees C, 24 degrees C, 26 degrees C and 28 degrees C in the temperature controlled (+/- 0.25 degrees C) chamber. Resultant mean increases in assay results of 0.8, 1.1 and 1.6% hemoglobin A1 per 2 degrees C increase in temperature for the three ranges respectively, indicate that the temperature dependence of the microcolumn assay for hemoglobin A1 is at least partially a function of the relative percentage of glycosylated hemoglobin in the sample. By controlling assay temperature we have reduced interassay variation throughout all concentration ranges by more than one-half to less than 5%. We applied this temperature controlled assay to measurement of hemoglobin A1 levels in 33 non-diabetic subjects and to the screening of hemoglobin A1 levels in 77 diabetic patients regularly attending the diabetic-endocrine outpatient clinic of this hospital. No non-diabetic subject had a HbA1 level above 8.5% and of the diabetic patients, 26% fell within the "normal" range, 43% within the "transitional" range and 31% within the "uncontrolled diabetic" range.

Adolescent↗

Experience with low-dose insulin infusion in diabetic ketoacidosis and diabetic hyperosmolarity.

Forty patients with diabetic ketoacidosis and eight patients with the diabetic hyperosmolar state were treated with low-dose insulin infusion in four teaching hospitals in the Cleveland area. The clinical and biochemical responses observed support previous favorable reports on this treatment modality. Two elderly patients with the hyperosmolar syndrome died. The advantages of this form of treatment over intermittent insulin schedules are emphasized. Early potassium administration, unless otherwise contraindicated, is recommended. Rarely, increasing doses of insulin may be required if insulin resistance is encountered.

Adolescent↗

Unusual events preceding hyperthyroidism with diffuse goiter.

Two unique patients with hyperthyroidism are presented here. A 48-year-old woman with a family history of Graves' disease was first evaluated and treated for a toxic adenoma with radioactive iodine. Three months later, she was again hyperthyroid, was found to have a diffuse thyromegaly, and was treated with radioactive iodine for the second time. This patient represents, to our knowledge, the first reported case of two sequential forms of endogenous hyperthyroidism. The second patient, a 64-year-old woman, had well-documented hypothyroidism that was presumably primary. She was admitted in thyroid storm and subsequently died. The autopsy disclosed characteristic changes in the thyroid of hyperthyroidism and a normal pituitary gland. The timing of the onset of Graves' disease with hyperthyroidism cannot be accurately determined.

Adenoma↗

Certain metabolic consequences of jejunoileal bypass.

Jejunoileal bypass for obesity has been shown to be associated with increased hepatic triglycerides during the period of brisk weight loss. The current report describes certain metabolic changes observed in 29 patients 21 months after bypass. Significant decreases in serum cholesterol, serum triglycerides, blood sugar after a glucose load, and fasting plasma insulin levels were noted. Increased oxalate excretion and occasional episodes of hypomagnesemia occurred. Repeated clinical and laboratory observations by a medical-surgical team offer the best opportunity to evaluate this procedure.

Adolescent↗