The changing model of insulin use in type 2 diabetes. Techniques, tactics for getting to goal.

Type 2 diabetes is by far the predominant type of diabetes in the United States. Lifestyle changes can be effective in controlling blood glucose levels in many patients with early type 2 diabetes. However, as the disease evolves and slowly progresses, its successful treatment can move beyond diet and exercise to oral antidiabetic agents and later to the addition of insulin to oral therapy.

Epidemiology and control of schistosomiasis mansoni in communities living on the Cuando River floodplain of East Caprivi, Namibia.

The Cuando River area of eastern Caprivi, Namibia, is highly endemic for Schistosoma mansoni whereas S. haematobium transmission, due to the scarcity of its intermediate host snail, Bulinus africanus, does not occur. Chemotherapy (6-monthly blanket treatments with praziquantel) combined with focal mollusciciding (monthly application of niclosamide) was used in a project in the area to control the disease.

Transfer of DDT used in malaria control to infants via breast milk.

The transfer of p,p'-DDT (1,1,1-tricholoro-2,2-bis(4-chlorophenyl)ethane) and its metabolites to infants via breast-feeding was studied in an area of KwaZulu, South Africa, where DDT is used to interrupt malaria transmission. Samples of whole blood were collected from 23 infants, together with samples of breast milk from their respective mothers. The mean sigma DDT (total DDT) in the whole blood was 127.

The effects of parasite infections on cognitive processes in children.

Two studies were carried out in the Nyuswa area of Natal to investigate the effects of parasitic infection on cognitive function in children. In the first study, children infected with intestinal helminths were given tests of information processing and perceptual speed before and after treatment with a single 500 mg dose of Mebendazole. The pattern of results was consistent with the hypothesis that parasitic infections combine with nutritional deficits to impair the efficiency of cognitive processes.

Malaria control and levels of DDT in serum of two populations in Kwazulu.

Concentrations of p,p'-DDT, p,p'-DDE, and p,p'-DDD were determined in serum of members of households of two different areas of KwaZulu. Annual intradomiciliary application of DDT is used for the interruption of malaria transmission in one area (the exposed group) while the other served as the control. Demographic differences between the two groups resulted in significantly more females in the control group.

Serum levels of DDT and liver function of malaria control personnel.

The levels of DDT and metabolites in serum of 23 applicators involved in malaria control operations in Natal were determined using gas chromatography with electron capture detection. The mean levels (microgram/l, ppb) were 61.7 DDT, 129.

Factors affecting levels of DDT and metabolites in human breast milk from Kwazulu.

Concentrations of p,p'-DDT, p,p'-DDE, and p,p'-DDD have been determined in breast milk of mothers residing in two different areas of KwaZulu. Annual intradomiciliary application of DDT was used for the interruption of malaria transmission in one area, while the other served as the control. Milk from mothers living in DDT-treated dwellings had significantly higher mean levels of DDT and metabolites (mean sigma DDT 15.

Levels of DDT and metabolites in breast milk from Kwa-Zulu mothers after DDT application for malaria control.

Concentrations of DDT, DDE and DDD were determined in the breast milk of Kwa-Zulu mothers residing in two different areas--with and without annual intra-domiciliary applications of DDT for the interruption of malaria transmission (exposed and control groups, respectively). While no significant change in levels with time was found in the control group, both DDT and DDE in breast milk of the exposed group increased after DDT application and this continued for three more months, after which it did not decrease appreciably. Percentage DDT increased from 42.

Urinalysis reagent strips in the screening of children for urinary schistosomiasis in the RSA.

The use of urinalysis reagent strips (Labstix; Ames) in screening for Schistosoma haematobium infection in various schistosomiasis-endemic areas of the RSA was assessed in 941 children. Sensitivity, specificity, false-positive and false-negative rates and the positive predictive value for haematuria and proteinuria were calculated. Both haematuria and proteinuria were positively correlated with the presence of S.

Determining the most appropriate treatment for patients with non-insulin-dependent diabetes mellitus.

Today it is possible, with the available treatment armamentarium, for a physician to rationally choose a strategy to be customized to patients with type II diabetes. The keystone of treatment is a good nutritional plan that provides for proper nutrition as well as appropriate weight loss. Exercise is also a useful adjunct.

Morbidity from urinary schistosomiasis in relation to intensity of infection in the Natal Province of South Africa.

Morbidity from urinary schistosomiasis was assessed on clinical, radiological, parasitologic and biochemical evidence in 510 schoolchildren living in a Schistosoma haematobium endemic area. The results were viewed against the background of the prevalence and intensity of infection in the subjects. Clinical morbidity correlated well with the intensity of infection, the latter in turn being influenced by factors such as water contact pattern, sex and water source.

Sampling variability and its influence on the diagnostic yield of percutaneous needle biopsy of the liver.

In an investigation to determine the influence of sampling variability on the diagnostic yield of liver biopsy, 3 consecutive samples were obtained from each of 75 patients by redirecting the biopsy needle through a single entry site. In 14.7% of patients all 3 specimens were normal, and in 36% there were similar abnormalities in all 3 specimens.

Causes of hepatomegaly at King Edward VIII Hospital, Durban. A prospective study of 240 black patients.

In this prospective study of 240 black patients with liver enlargement admitted to the medical wards of King Edward VIII Hospital, Durban, a cause for the hepatomegaly was found in 92.5% of cases (63.8% without recourse to biopsy, 28.

Schistosomiasis and bladder carcinoma in Natal.

In a retrospective study 184 biopsy reports of primary malignant bladder tumours in males which had been received from the Department of Pathology, University of Natal, during 1971-1982 were analysed. The age and race of the patients, the histological type of the tumours and the presence or absence of concomitant schistosomal infection were noted. There were 103 squamous and 62 transitional cell carcinomas, and 19 adenocarcinomas or undifferentiated types of malignant tumour.

Hyperthyroidism and diabetes mellitus. An analysis of 70 patients.

Hyperthyroidism developed in 70 patients with diabetes mellitus. Nine patients had masked hyperthyroidism with weight loss as the main sign. Diabetic control deteriorated in 28 of 48 insulin-dependent patients and in four of 22 taking hypoglycemic agents orally.

Vertebral osteomyelitis in insulin-dependent diabetics.

Vertebral osteomyelitis continues to be a diagnostically and therapeutically challenging disease with a relatively high incidence in diabetics. The clinical features, investigations and treatment of 7 insulin-dependent diabetics with vertebral osteomyelitis are presented and possible aetiological factors in this group are discussed.