XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

Let's read! We will often find out this sentence everywhere. When still being a kid, mom used to order us to always read, so did the teacher. Some books are fully read in a week and we need the obligation to support reading. What about now? Do you still love reading? Is reading only for you who have obligation? Absolutely not! We here offer you a new book enPDFd the perception of the visual world to read.

The Perception of the Visual World. By James J. Gibson. U.S.A.: Houghton Mifflin Company, 1950 (George Allen & Unwin, Ltd., London). Price 35s.

Revitalization of plant growth promoting rhizobacteria for sustainable development in agriculture.

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Nerves and Nerve Injuries.

can be recommended strongly to anyone interested in the modern treatment of neoplastic diseases. This monograph presents a discussion of the current concepts of clinical and pathological classification of Hodgkin's disease, approaches to therapy and clinical management. Among the advantages of the presentation are the excellent compilations of the classifications of the disease and tabulations of results achieved to date with regard to therapy and survival. While the author has carefully reviewed the pertinent material, his comments and conclusions are inexplicable in many instances. Examples include the recommendation for radical surgery in early or focal disease. None of the surgical series is a randomized prospective study nor do the majority include an adequate number of cases for statistical validity to warrant the author's recommendation. In presenting Kaplan's results with radical radio-therapy, there is an excellent reproduction of data showing the superiority of radical versus conventional radiotherapy. The author comments nevertheless that conventional therapy is \"fairly satisfactory !\" The scheme for radiotherapy of Stage I is reasonable, but the method employed is not that of most centers utilizing the radical approach in this country. For Stage III disease the plan seems less comprehensible since it involves treatment of involved but not adjacent areas. If it is intended to be \"curative,\" there is inadequate therapy for adjacent areas. If it is intended to be palliative, it would be unnecessary to treat asymptomatic although involved areas. The discussion of chemotherapy consists of general comments regarding efficacy and toxicity without a well defined analysis of comparative responses derived from objective assessment. A few opinions are cited without data to support the claims. In presenting clinical problems in the management of the disease, there are references to the immunological studies of patients with Hodgkin's disease, but no description of the specific immunologic status. Extra-nodal Hodgkin's disease as a specific entity also appears to have been neglected. In summary, this monograph provides an interesting review of some advances in Hodgkin's disease. The quality of the presentation in terms of organization and conclusions could be improved. The diagnosis and proper understanding of neurologic disorders depend heavily on thorough knowledge of the structure of the nervous system, and of the relationships between structure and function. Dr. Brodal's work represents an authoritative exposition of these relationships. The present edition is a thorough revision of the original book, published in English in 1946. Comparison of the two volumes provides a …

Neurological Anatomy in Relation to Clinical Medicine

Feasibility of using a video-based motion analysis system for measuring thumb kinematics

Functional workspace for precision manipulation between thumb and fingers in normal hands.

https://www.oarsijournal.com/article/S1063-4584(12)00944-2/pdf

Pain in patients with equal radiographic grades of osteoarthritis in both knees: the value of gray scale ultrasound

The insufficient exploration of intervertebral translation during flexion and extension prevents the further understanding of the cervical biomechanics and treating the cervical related dysfunction. The objective of this study was to quantitatively measure the continuous intervertebral translation of healthy cervical spine during flexion and extension by videofluoroscopic technique. A total of 1,120 image sequences were analyzed for 56 healthy adult subjects by a precise image protocol during cervical flexion and extension. our results showed there were no statistical angular differences among five spinal levels in either flexion or extension, except for the comparison between C2/3 (13.5°) and C4/5 (22.6°) angles. During cervical flexion, the smallest anterior translations were 0.7 mm at C2/3 level, followed by 0.9 mm at C6/7, 1.0 mm at C3/4, 1.1 mm at C5/6, and the largest 1.2 mm at C4/5 levels. The significantly greater translations were measured in the posterior direction at C3/4 (1.1 mm, P = 0.037), C4/5 (1.3 mm, P = 0.039), and C5/6 (1.2 mm, P = 0.005) levels than in the anterior one. The relatively fluctuant and small average posterior translation fashion at C6/7 level (0.4 mm) possibly originated from the variations in the direction of translation during cervical extension among subjects. Normalization with respect to the widths of individual vertebrae showed the total translation percentages relative to the adjacent vertebrae were 9.5, 13.7, 16.6, 15.0, and 8.6% for C2/3 to C6/7 levels, respectively, and appeared to be within the clinical-accepted ranges of translation in cervical spine. The intervertebral translations of cervical spine during flexion and extension movements were first described in quality and quantity based on the validated radiographic protocol. This analysis of the continuous intervertebral translations may be further employed to diagnose translation abnormalities like hypomobility or hypermobility and to monitor the treatment effect on cervical spines.

/pdf/the-quantitative-measurements-of-the-intervertebral-422s4fs09l.pdf

The quantitative measurements of the intervertebral angulation and translation during cervical flexion and extension

BACKGROUND: The flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) are critical for finger flexion. Although research has recently focused on these tendons' coactivity, their contributions in different tasks remain unclear. This study created a novel simultaneous approach to investigate the coactivity between the tendons and to clarify their contributions in different tasks. METHODS: Ten human cadaveric hands were mounted on our custom frame with the FDS and FDP of the third finger looped through a mechanical pulley connected to a force transducer. Joint range of motion, tendon excursion and loading force were recorded during individual joint motion and free joint movement from rest to maximal flexion. Each flexor tendon's moment arm was then calculated. RESULTS: In individual motions, we found that the FDP contributed more than the FDS in proximal interphalangeal (PIP) joint motion, with an overall slope of 1.34 and all FDP-to-FDS excursion (P/S) ratios greater than 1.0 with force increase. However, the FDP contributed less than the FDS in metacarpophalangeal (MCP) joint motion, with an overall slope of 0.95 and P/S ratios smaller than 1.0 throughout the whole motion except between 1.9% and 13.1% force. In free joint movement, the FDP played a greater role than the FDS, with an overall ratio of 1.37 and all P/S ratios greater than 1.0. CONCLUSIONS: The new findings include differences in finger performance and excursion amounts between the FDS and FDP throughout flexion. Such findings may provide the basis for new hand models and treatments.

/pdf/assessing-finger-joint-biomechanics-by-applying-equal-force-1yzf8jwj95.pdf

Li-Chieh Kuo

Papers

Feasibility of using a video-based motion analysis system for measuring thumb kinematics

Functional workspace for precision manipulation between thumb and fingers in normal hands.

Pain in patients with equal radiographic grades of osteoarthritis in both knees: the value of gray scale ultrasound

The quantitative measurements of the intervertebral angulation and translation during cervical flexion and extension

Assessing finger joint biomechanics by applying equal force to flexor tendons In vitro using a novel simultaneous approach