Physical therapists should consider that people with ALL may have hip or knee osteonecrosis without clinical symptoms. This notion supports the need for MRI in addition to a comprehensive examination of functional mobility.
BACKGROUND
Continuous insulin infusion (CII) to manage hyperglycemia is the accepted standard of care in the intensive care unit (ICU); however, the safety and efficacy of CII in the non-ICU setting has not been determined.
RESEARCH DESIGN AND METHODS
This is a retrospective analysis of 200 consecutive patients receiving CII while admitted to general medical-surgical units at Emory University Hospital. We evaluated clinical outcomes and rates of hyperglycemia (blood glucose [BG] >200 mg/dL) and hypoglycemia (BG <60 mg/dL) events during CII.
RESULTS
A total of 200 patients (age 52 ± 16 years; male/female [M/F] 108/92) were admitted to general medicine (45%) or surgery (55%) services, 88.5% with history of diabetes and 41% treated with corticosteroids. The mean BG prior to and during the CII was 323 mg/dL and 170 mg/dL, respectively. Blood glucose of ≤150 mg/dL was the targeted goal in 85% of patients and 67% achieved a BG ≤150 mg/dL by hospital day 2. Hypoglycemia (BG <60 mg/dL) occurred at least once in 22% of patients, and severe hypoglycemia (BG <40 mg/dL) occurred in 5% of patients. Multivariate regression analyses showed that nutrition status during CII was associated with increased frequency of hyperglycemia and hypoglycemia. Compared to patients kept nil per os (NPO), oral intake during CII increased rates of hyperglycemic (P = 0.012) and hypoglycemic events (P = 0.035).
CONCLUSIONS
CII resulted in rapid and sustained glycemic control and a rate of hypoglycemic events similar to that reported in recent ICU trials. The rates of hypoglycemic and hyperglycemic events are significantly higher in patients allowed to eat during CII.
Low levels of high-density lipoprotein cholesterol (HDL-C) constitute a strong risk factor for developing coronary heart disease. This risk can be decreased by even slight improvements in HDL-C levels. This review discusses both pharmacologic and nonpharmacologic treatments of patients with low levels of HDL-C, including lifestyle modifications and the benefits of oral estrogens, niacin, fibrates, statins, and combination drug therapy.
Patients and their caregivers seen at the Phase I clinic were invited to participate.• The table below summarises the instruments administered by a trained personnel at time of initiation of Phase I clinical trial and at 3 time intervals (1 month, 3 months and 6 months) • Paired-sample t-tests were used to test for QoL differences at different time intervals.
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