A method is proposed for classification to ordinal categories by applying the search partition analysis (SPAN) approach. It is suggested that SPAN be repeatedly applied to binary outcomes formed by collapsing adjacent categories of the ordinal scale. By a simple device, whereby successive binary partitions are constrained to be nested, ...

Pemphigoid is a group of bullous diseases that have a diversified morphologic presentation and affect the skin, oral mucosa, and other mucosal membranes, alone or in combination. In the literature, the condition has been subclassified into bullous pemphigoid and cicatricial pemphigoid (mucous membrane pemphigoid) on the basis of the primary ...

The occurrence of immunoglobulin A nephropathy (IgAN) in patients with noninsulin dependent diabetes mellitus (NIDDM) is a rare event and of pathogenetic interest. It is not clear whether this is merely coincidence. We report here five patients with IgAN in NIDDM associated with or without diabetic glomerulosclerosis. All of the ...

The World Health Organisation (WHO) [1] consultation group and the American Diabetes Association (ADA) [2] have recently published revised criteria for the classification and diagnosis of diabetes. If widely implemented, these recommendations, together with earlier and improved treatment, could have a profound impact on the morbidity and mortality associated with ...

A 44-year-old woman with a 5-year history of poorly controlled Type 1 diabetes mellitus presented with a painful, firm and warm swelling in her right thigh. Pain was severe but the patient was not febrile, and had no history of trauma or abnormal exercise. Laboratory tests showed ketoacidosis, major inflammation ...

Epithelioid haemangioendothelioma has not been previously described in a patient with congenital hemihypertrophy and diabetes mellitus. Hepatic nodules were incidentally discovered on a routine US examination searching for known associated abnormalities. Pulmonary nodules were present on chest X-ray and CT of the lungs. The diagnosis was confirmed by open biopsy ...

The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus announced the new diagnostic criteria for diabetes mellitus on 23 July 1997. The most notable change in the new criteria is a reduction in the cut-off point for fasting plasma glucose to that of 7.0 mmol/L (126 mg/dL). The ...

BACKGROUND: In 1967, Badham used the term angina bullosa hemorrhagica (ABH) to describe an entity we already knew as traumatic oral hemophlyctenosis (TOH) (1933) and later renamed recurrent oral hemophlyctenosis (ROH) (1971). OBJECTIVES: The objective of this study was to review and discuss the literature, and to report 54 new ...

The differential diagnosis of hyperglycemia in childhood and adolescence has to take into consideration early-onset non-insulin-dependent diabetes, defined as maturity onset diabetes of the young (MODY). To date, mutations in genes of five proteins have been shown to cause MODY: glucokinase (MODY2), hepatic nuclear factor-1 alpha (HNF-1 alpha) (MODY3), hepatic ...

Studies performed for drug registration provide little insight into the long-term use and effectiveness of drugs in "real world" populations and settings. To obtain such insight, we used 10 years of electronic medical-record data from Kaiser Permanente Northwest Division, a large, group-model health maintenance organization in the United States, to ...

BACKGROUND: Serum tryptase level measured by RIA is the main in vitro tool to confirm the diagnosis of anaphylaxis. METHODS: Serum tryptase levels were determined by UniCAP-Tryptase fluoroimmunoassay (Pharmacia & Upjohn, Uppsala, Sweden), in 30 consecutive patients who presented at the emergency room with a clinical allergic reaction of less ...

Diagnosis of diabetes is not in doubt when there are classical symptoms of thirst and polyuria and a random venous plasma glucose level > or =11.1 mmol/L. The Australasian Working Party on Diagnostic Criteria for Diabetes Mellitus recommends: Immediate adoption of the new criterion for diagnosis of diabetes as proposed ...

AIMS: We have investigated denial of disease in patients with Type 2 diabetes mellitus (DM) and its possible association with metabolic control, and with psychosocial variables: satisfaction with medical care, perceived stress, social support, knowledge of diabetes and belief in conventional medicine. METHODS: We studied 160 patients in a cross-sectional ...

OBJECTIVE: To determine whether the length of hospital stay for patients with either a primary or a secondary diagnosis of diabetes mellitus can be reduced by use of a diabetes cluster unit. METHODS: For a period of 12 months, we compared the length of hospital stay for 462 patients with ...

OBJECTIVES: To describe the course of clinical remission in adult patients (16-50 years of age) with type 1 diabetes and to identify factors predictive of the occurrence and length of remission. DESIGN: A retrospective cohort study. SUBJECTS: Sixty-two consecutive patients (43 men and 19 women) with new onset IDDM, 27 ...

In clinical practice, biochemical markers, particularly serum glucose levels are used to diagnose diabetes mellitus. However, at autopsy this marker is of no value due to the substantial and capricious fluctuations in glucose levels after death. The aim of this study was to evaluate the usefulness of the postmortem determination ...

OBJECTIVES: To investigate the ability of classifying diabetes mellitus with clinical and biochemical characteristics at diagnosis in 25-45 years old patients. DESIGN: We determined age, body mass index (BMI), ICA, fasting C-peptide and HbA1c at diagnosis, and after 4-27 months follow up, these variables were related to the type of ...

The breast is not classically included among the organs damaged by diabetic complications. The first cases of breast lesions associated with Type 1 diabetes mellitus were only described in 1984. The disease, designated as diabetic or fibrous mastopathy, is benign but may clinically simulate breast carcinoma. Its frequency is difficult ...

New recommendations for the classification and diagnosis of diabetes mellitus include the preferred use of the terms "type 1" and "type 2" instead of "IDDM" and "NIDDM" to designate the two major types of diabetes mellitus; simplification of the diagnostic criteria for diabetes mellitus to two abnormal fasting plasma determinations; ...

Children (n = 38) aged 3-15 y were randomly chosen, at the time of diabetes diagnosis, for conventional management at a hospital ward, or for treatment partly in a training apartment where the family was offered problem-based education and special therapeutic support. HbA1c, blood glucose stability, urinary C-peptide excretions and ...

A 73-year-old woman with multiple myeloma experienced four episodes of loss of consciousness, convulsions and profuse sweating whilst she was in the hospital. A thorough investigation in the department of medicine disclosed that with each attack, she had a serum glucose < 1.6 mM L-1, insulin level > 1400 pMol ...

We are in the midst of an epidemic of diabetes, and the prevalence appears to be especially marked within Delaware. To prevent tragic long-term complications of diabetes, and to minimize the enormous costs associated with treating them, an emphasis must be placed on the early diagnosis and aggressive management of ...

We used broad-range bacterial PCR combined with DNA sequencing to examine prospectively cerebrospinal fluid (CSF) samples from patients with suspected meningitis. Fifty-six CSF samples from 46 patients were studied during the year 1995. Genes coding for bacterial 16S and/or 23S rRNA genes could be amplified from the CSF samples from ...

The American Diabetes Association (ADA) has recently revised the system of classification and criteria for diagnosis of diabetes to help remedy the problem of undiagnosed diabetes, as well as to move away from a system of diagnosis based on treatment used toward a system based on disease etiology. The ADA ...

The classification of diabetes mellitus and the tests used for its diagnosis were brought into order by the National Diabetes Data Group of the USA and the second World Health Organization Expert Committee on Diabetes Mellitus in 1979 and 1980. Apart from minor modifications by WHO in 1985, little has ...

The American Diabetes Association have recommended that the fasting plasma glucose level for the diagnosis of diabetes is lowered and that this becomes the main diagnostic test. We have used population-based data from three ethnic groups in Newcastle upon Tyne to examine the implications of this change. Data were available ...

BACKGROUND: Limited joint mobility (LJM) in childhood insulin-dependent (type 1) diabetes is associated with a substantially increased risk of microvascular complications. Cross-sectional studies have not demonstrated a relationship between LJM and metabolic control. This study was designed to determine whether glycemic control, as measured by glycohemoglobin (hgbA1C) levels from the ...

The diagnosis and classification of diabetes mellitus have been reviewed and revised for the first time since 1979. A precedent-setting recommendation by the American Diabetes Association for routine screening of adults is an effort to identify the estimated 8 million people in the United States with undiagnosed diabetes. Stricter diagnostic ...

OBJECTIVE: To determine the extent to which Medicare provided reimbursement for therapeutic footwear to diabetic Medicare beneficiaries in Washington, Alaska, and Idaho in 1995. RESEARCH DESIGN AND METHODS: Using inpatient, outpatient, and durable medical equipment claims data, we selected a cohort of diabetic Medicare beneficiaries. Therapeutic footwear claims were identified ...

For the first time in almost 20 years, new recommendations on diagnosis, classification, and testing strategies for diabetes have been issued. For clinical labs, combatting this old enemy under the new guidelines will include expanded patient screening and closer monitoring. Learn about the high-risk groups in the U.S. population, the ...

OBJECTIVE: To report on cases of diabetic cataracts in a paediatric and adolescent population. METHODOLOGY: Medical histories of children and adolescents attending the Royal Children's Hospital Diabetes Service who had developed cataracts between 1981 and 1996 were examined. RESULTS: Nine cases of diabetic cataracts have been managed over the 16-year ...

OBJECTIVE: We hypothesized that patients with cystic fibrosis (CF) have higher rates of protein breakdown than normal volunteers and that the infusion of insulin would result in less suppression of proteolysis. Methods. Using [1-C]leucine and a three-step hyperinsulinemic euglycemic clamp, we measured rates of leucine appearance in 29 adult CF ...

The diagnosis of necrotizing enterocolitis (NEC) in neonates has traditionally depended on a combination of clinical signs, biochemical parameters and radiological changes. The measurement of intramucosal pH by gastrointestinal tonometry provides a simple means of long-term monitoring which may detect the development of NEC before conventional techniques. We present our ...

We investigated the association of serum antibodies to glutamic acid decarboxylase (GADab) with early start of insulin treatment (< or = 1 year from diagnosis, or < or = 2 years from diagnosis) using data from a representative sample of 374 adult-onset insulin-treated individuals from the Tasmanian Diabetes Register. Furthermore, ...

OBJECTIVE: To evaluate the hospital care rendered to hyperglycemic individuals who did not have a diagnosis of diabetes before admission. RESEARCH DESIGN AND METHODS: A total of 1,034 consecutively hospitalized adult patients at a 750-bed inner-city teaching hospital were evaluated. Patients with one or more plasma glucose values > 200 ...

A 60-year-old diabetic male presented with transient ischemic attacks. Initial neurological examination and head CT were normal. Dysarthria, ataxia, delirium, and lethargy developed. A diagnosis of cryptococcal meningitis was made after lumbar puncture and treatment with intravenous amphotericin B and 5-fluorcytosine was begun. A repeat head CT showed an anterior ...

Using a sensitive sandwich enzyme-linked immunosorbent assay (ELISA) method, we measured the concentration of total tau protein in the cerebrospinal fluid (CSF) from nine patients with corticobasal degeneration (CBD) in comparison with 12 normal control subjects in order to assess its diagnostic value. The CSF concentration of tau in patients ...

The development of genetic and serological markers of autoimmune Type I diabetes has allowed us to begin to identify subjects at risk for the development of Type I diabetes. Assessment of these variables can assign risk to subjects and permit the implementation of immune intervention trials in an attempt to ...

There has been an explosive growth in knowledge about diabetes mellitus since the National Diabetes Data Group promulgated diagnostic criteria and a classification system in 1979 that was largely adopted by the World Health Organization. However, recent findings regarding the levels of glucose associated with development of retinopathy, and growing ...

The urodynamic profiles of 97 patients with benign prostatic hyperplasia undergoing low-energy transurethral microwave thermotherapy (TUMT) for lower urinary tract symptoms were analysed using the Abrams/Griffiths nomogram, the urethral resistance algorithm, the linPURR, Schäfer nomogram, and the CHESS classification. A significant clinical response was seen for the whole group, as ...

To define the clinical and metabolic characteristics of children with non-insulin-dependent diabetes mellitus (NIDDM), we reviewed the medical records of 18 children and adolescents who met either or both of the following criteria for the diagnosis of the disease: evidence of continued endogenous secretion of insulin beyond that expected in ...

The aim of this study was to evaluate CA 125 II, C-reactive protein (CRP) and serum amyloid A (SAA) and anticardiolipin antibody (aCL) concentrations for the diagnosis of pelvic endometriosis. The study population consisted of 15 women without endometriosis, as confirmed by laparoscopy (group A), and 35 patients with pelvic ...

An 11-year-old male castrated Persian cat with spontaneous hyperadrenocorticism was presented. Both adrenals were grossly enlarged and calcified. A diagnosis of pituitary-dependent hyperadrenocorticism was made. Signs of hyperadrenocorticism resolved with long-term mitotane treatment. Concurrent diabetes mellitus resolved after 220 days of therapy. No severe adverse drug reactions were noted.

A case of renal glycosuria is reported. A 55 year old female was diagnosed and treated in an upcountry hospital for diabetes mellitus. She developed symptoms of hypoglycaemia while on an oral hypoglycaemic agent, leading to her admission in Mulago Hospital. Persistent glycosuria was noted despite treatment and normal serum ...

Pyogenic osteomyelitis is often accompanied by diabetes, but the disease in the clavicula has rarely been reported. We describe an unusual case of a 53-year-old man with poorly controlled non-insulin-dependent diabetes mellitus who presented with pyogenic clavicular osteomyelitis and developed DIC and acute renal failure. A 67Ga scintigram revealed an ...

We describe two type 2 diabetic patients with unilateral emphysematous pyelonephritis who responded to medical treatment alone. Escherichia coli was isolated in both patients. The presence of gas was confirmed early by ultrasound and CT scan of abdomen. Following treatment, good functional recovery was demonstrable in the affected kidneys by ...

To determine whether improved metabolic control during the first two years of insulin-dependent diabetes (IDDM) modified beta cell function, we studied 108 subjects with recent-onset IDDM diagnosed between March 1986 and April 1992 and followed up prospectively for 2 years. Two insulin regimens were used: 1) conventional insulin treatment (CIT) ...

Better awareness of the clinical presentation of idiopathic haemochromatosis is a key element for early diagnosis and treatment. We retrospectively analysed the medical records of 105 patients (80 males, 25 females) diagnosed with idiopathic haemochromatosis over the past two decades in the two academic hospitals of Louvain University. Age at ...

The annual meeting of the American Diabetes Association was held in Boston, MA. There were over 6500 participants, one-third from overseas, and 1103 papers were presented. Abstracts from the meeting have been published, from which abstract numbers are given below, e.g., (A141). Considerable progress has been made in understanding the ...

Focal infarction of skeletal muscle is a complication of diabetes mellitus. In the appropriate clinical setting and with characteristic magnetic resonance imaging (MRI) findings, prompt diagnosis can prevent unnecessary morbidity by avoiding excisional biopsy. We report a case of diabetic muscular infarction presenting as a painful thigh mass and review ...