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R Corcoy

Publications and source records attributed to R Corcoy.

51 records · Page 3Linked to original sources
PubMed1994

A hybrid knowledge based system for therapy adjustment in gestational diabetes.

This poster describes a system to analyze self-monitoring data of gestational diabetic patients, for obtaining an assessment of their metabolic control with the final goal of supporting decision-making in therapy adjustment. The system is able to manage incomplete data and to make temporal reasoning under uncertainty, the two most important constraints when analyzing ambulatory monitoring data. Two different formalism have been used to represent and manage the knowledge: a dynamic Bayesian network and a production system based on rules. The outcomes provided by the whole system are: information on possible patient transgressions of the prescribed treatment and recommendations of treatment adjustments.

Artificial Intelligence↗
PubMed1992

Outcome and long-term effects of pregnancy in women with hyperprolactinaemia.

Twenty-four women with high circulating prolactin became pregnant on 39 occasions, of which 32 ended in delivery. Sixteen patients showed radiological evidence of pituitary tumour, 6 exhibited a normal CT and 2 had an empty sella. The pregnancies were induced in 4 patients after successful pituitary surgery, in 3 after surgery and medical treatment, and in the rest by bromocriptine (16) long-acting repeatable bromocriptine (1) and methergoline (1). No major complications related to hyperprolactinaemia or its treatment were observed during pregnancy in the patients or offspring. Prolactin after pregnancy was lower than before (basal 95 micrograms/l, after 1st pregnancy 38 micrograms/l P < 0.002, after 2nd pregnancy 24 micrograms/l P < 0.005 compared to basal prolactin); this prolactin reduction tended to be greater in the 9 multiparous patients, but did not attain statistical significance, probably because the number of multiparous patients was too small. A new empty sella developed after delivery in 4 women and persisted in another 2, all of which were medically treated; prolactin fell in all 6 cases normalizing in 3; 4 of these patients had undergone two or more pregnancies. The mean period of follow-up from the last pregnancy was 41.6 months (8-101). These data suggest that pregnancy may hasten a tendency to spontaneous improvement of hyperprolactinaemia, and multiparity may be beneficial in this way.

Adenoma↗
PubMed1992

[Serum insulin and androgen concentrations in women with histories of gestational diabetes].

BACKGROUND: There is a certain degree of peripheral cell resistance to insulin in the physiopathology of gestational diabetes. These disturbances may persist following pregnancy giving place to secondary hyperinsulinism. Insulin exerts a trophic action on the ovary and favors the production of androgens. The aim of this study was to verify whether the patients diagnosed of gestational diabetes present androgenic alterations following pregnancy. The existence of a correlation between the values of insulin and androgens was analyzed. METHODS: Fifty-one patients were studied. The study group (n = 297) was composed of patients diagnosed of gestational diabetes during their last week of pregnancy. The control group (n = 24) included patients with normal carbohydrate tolerance. The basal values of insulin, glucose, androstenedione, testosterone and SHBG were determined in a postmenstrual phase. RESULTS: Insulin was found to be higher in the study group (78.1 +/- 32.9 pmol/1 vs 63.0 +/- 27.6 pmol/1) although the differences were not significant. The insulin/glucose ratio was significantly higher in the study group (18.1 +/- 8.0 vs 13.9 +/- 7.7; p less than 0.05). Basal insulin and the insulin/glucose ratio were comparable among the obese and non obese patients of both groups. The remaining parameters studied dit not present any significant differences. No significant associations were observed between the values of insulin and insulin/glucose with the androgenic hormonal parameters. CONCLUSIONS: No elevated androgenic profile was observed in the women with previous gestational diabetes. The use of insulin and insulin/glucose values as indicators of insulin resistance did not demonstrate any correlation with the androgenic parameters.

Adult↗
PubMed1992

Gestational diabetes. What are the implications?

Although gestational diabetes may have serious consequences for both mother and fetus, it is usually symptomless. The diagnosis can be missed unless all pregnant women are screened to determine those who need a full oral glucose tolerance test. When gestational diabetes is diagnosed, it is essential to (1) achieve euglycemia with diet and, if needed, insulin and (2) monitor for potential complications. Glucose tolerance must be reevaluated in the post-partum period and periodically thereafter to detect continuing intolerance or diabetes.

Diabetes, Gestational↗
PubMed1991

Serum fructosamine is not a useful screening test for gestational diabetes.

Serum fructosamine was measured in 569 samples of pregnant women without gestational diabetes. We defined abnormal fructosamine as mean + 2SD, and analysed its potential value to detect patients with gestational diabetes diagnosed with current screening criteria. We found serum fructosamine to be an insensitive parameter: Measured at the time of a positive 50 g glucose screening, SF would have detected 4/48 gestational diabetes.

Blood Glucose↗
PubMed1989

Fertility in a case of progeria.

A 32-year-old woman with Hutchinson-Gilford disease (progeria) is described. The absence of complete sexual maturation has been considered characteristic of the syndrome, but this woman delivered a normal child at the age of 23.

Adult↗
PubMedDate not supplied

Plasma immunoreactive somatostatin is elevated in diabetic ketoacidosis and correlates with plasma non-esterified fatty acid concentration.

In experimental diabetes and after the administration of beta-hydroxybutyrate and non-esterified fatty acids (NEFA), an increase in circulating immunoreactive somatostatin (IRS) has been described. Both ketones and NEFA are raised in diabetic ketoacidosis. Therefore, we decided to investigate 10 patients in diabetic ketoacidosis by measuring, on admission and throughout the initial 24 hours of therapy, circulating levels of IRS, beta-hydroxybutyrate, acetoacetate, triglycerides, blood glucose, pH and NEFA. Fluids and insulin were administered IV following a previously established protocol. Nine patients showed abnormally high levels of circulating IRS. When compared with a group of controlled insulin-dependent diabetic patients, basal IRS was high (111 +/- 15 vs 28 +/- 3 pmol/l), and remained elevated for at least 24 h despite clear improvement of metabolic status. On admission we also found elevated levels of NEFA (1.04 +/- 0.2 mmol/l), triglycerides (4.7 +/- 1.1 mmol/l), beta-hydroxybutyrate (22.1 +/- 4mmol/l), and acetoacetate (4.8 +/- 1.1 mmol/l). A significant correlation was found initially between IRS and NEFA (p less than 0.01). We conclude that circulating IRS is high in most cases of diabetic ketoacidosis. The mechanism behind this hypersomatostatinaemia could be related to the abnormalities of lipid metabolism which occur in diabetic ketoacidosis.

3-Hydroxybutyric Acid↗
PubMedDate not supplied

DIABCARD--an application of a portable medical record for persons with diabetes.

The medical record is central to the management of patients. For people with a chronic disease their many records, held at different locations, often pose a problem. Electronic patient records have been discussed for a long time. This article reports on the paradigm of a portable computer-based patient record on a smart card. It describes the development of the chip card based medical information system for chronic diseases in ambulatory and hospital care. The system has been implemented, tested and evaluated. DIABCARD could demonstrate that for a speciality patient record the capacity and functionality of the existing card is sufficient. Finally, the perspectives of chip cards in health care are discussed.

Computing Methodologies↗
PubMedDate not supplied

DIABNET: a qualitative model-based advisory system for therapy planning in gestational diabetes.

An intelligent decision support system for the analysis of home monitoring data and therapy planning in gestational diabetes is presented. The paper describes the integration of qualitative and quantitative reasoning modules within the DIABNET advisory system. The system kernel is a qualitative model of the physiological processes involved in the glucose metabolism of this type of diabetic patient. A causal probabilistic network (CPN) has been used to represent the qualitative model in order to manage uncertain and missing monitoring data. The DIABNET inputs are the patient's available ambulatory monitoring data, and the output is a dietary and insulin therapy adjustment that includes initiation of insulin therapy, quantitative insulin dose changes and qualitative diet and schedule modifications. Over periods of up to seven days, monitoring data are analysed by the CPN to detect any diet or insulin therapy items which may require modification. The qualitative insulin needs are translated into a quantitative proposal in line with the characteristics of the patient and the modification strategies usually used by doctors. The first evaluation of the system has been accomplished, the encouraging results of which are also presented.

Blood Glucose Self-Monitoring↗
PubMedDate not supplied

[Sensory polyneuropathy and neural conduction block as an initial manifestation of polyarteritis nodosa].

Polyarteritis nodosa (PAN) is a systemic necrotising vasculitis which affects middle calibre arteries and which has a tendency to form aneurysms. It may appear as one of a great variety of clinical forms depending on the vascular territory afflicted. Almost any organ may be involved although the lung is usually unaffected. Neurological manifestations are very frequent in this disease (global incidence being around 80%), especially at the peripheral nervous system level. Multiple mononeuritis is the most usual manifestation classically associated with this type of vasculitis, but it may also appear as distal sensorimotor polyneuropathy, this being its most infrequent form of presentation. The presence of nerve conduction blocks has also been recently described, usually associated with demyelinating processes. However peripheral nerve affectation in vasculitis has its origins in small ischaemic infarcts in the sensorimotor conduction fibres. It may well be that segmentary demyelination and axonal degeneration reflect different levels of ischaemic damage.

Cerebral Angiography↗