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Adolescent Diabetes Clinic: A Specialized Treatment Approach 青少年糖尿病诊所:一种专门的治疗方法
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 1982-08-01 DOI: 10.1177/263501068200800310
Gunter-Hunt Gail, Lisa Root Parker, M. Spencer
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引用次数: 5
Past President's Message 前任总统致辞
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 1982-08-01 DOI: 10.1177/263501068200800301
B. Wedman
It is hard to believe that 1999 is now history. 1999 was a year of transition for the Association as well as the industry. Papers from the Vancouver meeting will be the last that members will receive published through Elsevier under the Journal of Geochemical Exploration. The new Journal, Geochemistry: Exploration, Environment, Analysis (GEEA)5 will be published through a cooperative effort with the Geological Society of London. Brick WeUand The anticipated lower cost to libraries and electronic publication should result in increased visibility and accessibility, thus helping to sustain the publication well into the future. Please note that although the new Journal will be accepting submissions of papers in January of 2000, the Journal will not be ready for distribution until 2001 due to our now terminated contract with Elsevier. However, Council authorized that all members will receive the book "Drift Exploration in Glaciated Terrain" as a substitute for not receiving a journal during 2000. The book is edited by M.B. McClenaghan, S. Cook, and P.T. Bobrowsky and focuses on till geochemical and indicator mineral methods of exploration in the glaciated terrain of Canada with direct application to glaciated terrains of North America, northern Europe and Asia and mountainous regions of South America.
很难相信1999年已经成为历史。1999年是协会和行业转型的一年。温哥华会议的论文将是成员们通过爱思唯尔在《地球化学勘探杂志》下收到的最后一篇论文。新的期刊《地球化学:勘探、环境、分析》(GEEA)将通过与伦敦地质学会的合作出版。预计图书馆和电子出版物的成本会降低,这应该会增加可见性和可访问性,从而有助于在未来很好地维持出版物。请注意,虽然新期刊将于2000年1月开始接受论文投稿,但由于我们与爱思唯尔的合同已经终止,期刊要到2001年才能开始发行。然而,理事会授权所有成员在2000年期间将收到一本名为“冰川地形漂流探索”的书,以替代未收到的期刊。该书由M.B. McClenaghan, S. Cook和P.T. Bobrowsky编辑,重点介绍了加拿大冰川地形的地球化学和指示矿物勘探方法,并直接应用于北美,北欧和亚洲的冰川地形以及南美洲的山区。
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引用次数: 0
The Establishment of a Reimbursable Diabetes Education Program 建立可报销的糖尿病教育计划
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 1982-08-01 DOI: 10.1177/263501068200800309
M. Davidson, Mary A. Pearce, Roz Morgan, M. Crane, Becki Bales, Barbara Graham
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引用次数: 1
President's Message 总统的消息
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 1982-08-01 DOI: 10.1177/263501068200800302
Rita Schluneger
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引用次数: 0
Arterial Reconstruction: Femoral, Popliteal Tibial, Peroneal 动脉重建:股动脉、腘动脉、胫动脉、腓动脉
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 1982-08-01 DOI: 10.1177/263501068200800305
F. Wheelock
One of the major causes of prob lems of the diabetic foot is vascular insufficiency. New modes of diagnosis and treatment have led to improved circulation and have bypassed amputation. It is well established that diabetes often accelerates the development of arteriosclerosis , particularly in the arteries of the lower extremity . This results in poor arterial blood supply and may produce symptoms of claudication , ischemic rest pain , and eventually gangrenous ulcers of the toe(s) or foot. Many years ago the progression of arterial disease and limb loss was accepted as inevitable because there was no capability for replacing the occluded arteries and no interest in pursuing the problem because the disease was thought to be generalized so where would the replacement start or end? With the development of arteriographic techniques , it was discovered that the generalized pattern of arterial narrowing was not the case and that often a segment of artery might be narrow or occluded, but open artery of adequate dimensions might be present proximally and distally. The French surgeons were the leaders in devising and carrying out surgical operations to help patients with these problems. The technique of anastomosing vessels had been developed by Carrel in 1906 but had applied only to salvage injured arteries. In the early 1950's, Carrel's teachings were utilized in placing artery grafts to re-establish arterial flow. At first, short blocks were sought for the diseased artery resected, and a graft salvaged from the corpse of a young person who had died of injuries or perhaps a brain tumor. The grafts were kept frozen and sterilized in plastic bags by means of cathode radiation . Soon we gave up resecting the diseased arterial segment, (usually located in the adductor canal), divided the artery above and below the block, and sutured the graft in place . The next advance was to use the end-toside anastomosis which tremendously increased the scope of arterial surgery . Now a graft could originate as a side branch from aorta , iliac, or common femoral artery without interfering with the function of that artery . Of further help is the fact that arterial disease involves primarily the posterior walls of arteries leaving soft anterior surfaces for suturing. The next step in the advance of surgical capability was the discovery that the saphenous vein was strong enough and , in most people, large enough (4 mm at the smallest end when gently distended) to serve as an artery . Meanwhile, the search for a plastic or other type of graft was pursued to obviate the need for tediously removing the saphenous vein or for use in those patients without an adequate vein. The search still continues with only modest success. Neither plastic nor preserved umbilical vein grafts serve as well as does the patient's own saphenous or cephalic vein, though the gap between the two modalities is narrowing. It should be mentioned that the cephalic vein was found to make an excellent graf
糖尿病足问题的主要原因之一是血管不全。新的诊断和治疗模式改善了血液循环,并绕过了截肢。众所周知,糖尿病常常加速动脉硬化的发展,尤其是下肢动脉硬化。这导致动脉供血不足,并可能产生跛行、缺血性休息痛等症状,最终导致脚趾或足部坏疽性溃疡。许多年前,动脉疾病的发展和肢体丧失被认为是不可避免的因为没有能力替代闭塞的动脉也没有兴趣去解决这个问题因为这种疾病被认为是普遍的那么替代从哪里开始或结束?随着动脉造影技术的发展,人们发现动脉狭窄的普遍模式并不是这样,经常有一段动脉狭窄或闭塞,但近端和远端可能存在足够尺寸的开放动脉。法国外科医生在设计和实施外科手术来帮助这些问题的病人方面处于领先地位。血管吻合技术是卡雷尔在1906年发明的,但只用于抢救受伤的动脉。在20世纪50年代早期,卡雷尔的学说被用于放置动脉移植物以重建动脉流动。起初,切除病变动脉的短块被寻找,并从一个死于受伤或可能是脑瘤的年轻人的尸体上抢救出移植物。移植物冷冻保存,并在塑料袋中进行阴极辐射灭菌。很快,我们放弃了切除病变动脉段(通常位于内收管),将阻塞上方和下方的动脉分开,并将移植物缝合到位。下一个进步是使用端侧吻合极大地增加了动脉手术的范围。现在,移植物可以作为主动脉、髂动脉或股总动脉的侧分支而不干扰该动脉的功能。进一步的帮助是动脉疾病主要涉及动脉后壁,留下柔软的前表面进行缝合。手术能力进步的下一步是发现隐静脉足够强大,而且对大多数人来说,它足够大(轻微扩张时最小端为4毫米),可以充当动脉。同时,寻找一种塑料或其他类型的移植物,以避免繁琐的移除隐静脉的需要,或用于那些没有足够静脉的患者。搜寻工作仍在继续,只取得了有限的成功。塑料和保留的脐静脉移植物都不如患者自身的隐静脉或头静脉,尽管两种方式之间的差距正在缩小。应该提到的是,头静脉被发现是一个很好的移植物,但由于它的壁很薄,它的工作相当困难。
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引用次数: 0
Aorto-iliac Disease in Diabetes 糖尿病中的主动脉-髂疾病
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 1982-08-01 DOI: 10.1177/263501068200800307
C. S. Hoar
In determining which mode of treatment or operation to undertake , clinical judgment is stillmore valuable than noninvasive tests . However in cases where clinical judgment leaves question , the non -invasive laboratory results may be extremely important , especially when they support the clinical impression. The noninvasive laboratory may be of value in differentiating an ischemic from a neuropathic origin of pa in or ulcerat ion in a pulseless foot . A neuropathic pat ient may develop arterial occlusions and so no longer have palpable pulses, but may have excellent collateral circulation . The vascular laboratory is of undisputed value in detecting major areas of thrombophlebitis (above the knee) as well as evaluation of the carotid circulation . Description Systolic blood pressures are taken with cuffs placed at appropriate areas (thigh, calf, ankle) with aDoppler used to listen to arterial flow at the ankle.
在决定采取何种治疗或手术方式时,临床判断仍比非侵入性检查更有价值。然而,在临床判断存在问题的情况下,非侵入性实验室结果可能非常重要,特别是当它们支持临床印象时。无创实验室检查可用于鉴别足部无脉性溃疡是缺血性还是神经性起源。神经病变患者可能出现动脉闭塞,因此不再有可触及的脉搏,但可能有良好的侧支循环。血管实验室在检测血栓性静脉炎(膝盖以上)的主要区域以及评估颈动脉循环方面具有无可争议的价值。在适当部位(大腿、小腿、踝关节)放置袖口测量收缩压,并使用aDoppler聆听踝关节动脉血流。
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引用次数: 0
Schumann Article 舒曼的文章
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 1982-08-01 DOI: 10.1177/263501068200800322
A. Lasswell, L. Hochheiser, M. E. Jackson, G. Seltzer
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引用次数: 0
Learning about Diabetes can be FUN 了解糖尿病可以很有趣
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 1981-02-01 DOI: 10.1177/263501068100700108
A. Winch
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引用次数: 0
Book Review: The American Diabetes association/the American Dietetic association Family Cookbook 书评:美国糖尿病协会/美国饮食协会家庭食谱
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 1981-02-01 DOI: 10.1177/263501068100700124
B. Wedman
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引用次数: 0
Book Review: Management of Juvenile Diabetes Mellitus 书评:青少年糖尿病的管理
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 1981-02-01 DOI: 10.1177/263501068100700125
B. Giordano
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引用次数: 0
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Science of Diabetes Self-Management and Care
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