Improving inpatient diabetes care: nursing issues.

As the epidemic of diabetes continues to escalate, the number of patients with diabetes who are hospitalized also will grow. Current evidence shows the value of good glycemic control in reducing morbidity and mortality in patients with diabetes. Nurses will increasingly be called on to provide the majority of the hospitalized care for these patients, and to implement care strategies that are safe, efficient, and effective.

[Case report: Ectopia cordis in a German Holstein calf].

A case of ectopia cordis pectoralis was diagnosed in a black and white coloured German Holstein calf. The heart and pericard were displaced through a fissure in the breastbone. The heart was connected with the thoracic cavity by its large vessels.

Improving the effectiveness of the medical visit: a brief visit-structuring workshop changes patients' perceptions of primary care visits.

Objective: To teach visit-structuring strategies to primary care clinicians with a 1.5-h experiential workshop and assess its effect on patient perceptions of their medical visits.

Methods: We developed and conducted a 90 min workshop for 75 clinicians from seven primary care clinics, and evaluated the effectiveness of the workshop by assessing changes in patients' ratings of visit qualities from 1 week prior (n=301) to 1 week after (n=322) the workshop.

[Case report: equine arteritis virus (EAV) as the cause of abortion in alpacas?].

Here we report a case of a late abortion of a primiparous alpaca where genome fragments of the equine viral arteritis virus (EAV) could be detected in fetal tissues using reverse transcription polymerase chain reaction (RT-PCR). All five alpacas of the herd had virus neutralizing antibodies against EAV. EAV thus must be regarded as a potential agent for abortions in alpacas.

[Genetic typing of classical swine fever viruses--a review].

Classical swine fever (CSF) is a notifiable disease of domestic pigs and wild boar. It is caused by the highly contagious CSF virus and in its acute form the disease generally results in high morbidity and mortality. Due to the great economical impact an outbreak can cause to the pig industry it is one of the most important swine diseases worldwide.

[Severe pneumonia from psittacosis in a bird-keeper].

A 67-year-old man was admitted due to severe pneumonia. Initially he was treated with beta-lactam antibiotics and oxygen. However, he developed respiratory failure and was transferred to the intensive-care unit for mechanical ventilation.

Management of the difficult patient.

All physicians must care for some patients who are perceived as difficult because of behavioral or emotional aspects that affect their care. Difficulties may be traced to patient, physician, or health care system factors. Patient factors include psychiatric disorders, personality disorders, and subclinical behavior traits.

Implementation of two-step vaccination in the control of bovine viral diarrhoea (BVD).

Bovine viral diarrhoea (BVD) control/eradication programmes based on the test and removal of persistently infected cattle without use of vaccination were first introduced by the Scandinavian countries in the early 1990s. Within the last 10 years the programmes have proven to be very successful and have served as a blueprint for several other European regions. However, in areas with high cattle densities, intense animal trade and high BVD prevalence this control approach is risky, because there is a high probability that herds, which have been cleared of persistently infected (PI) animals and have become partly or fully susceptible to reintroduction of the virus, will come in contact with a BVD virus (BVDV) infected animal.

[Analysis of bulk milk samples using polymerase chain reaction: an additional tool for bovine viral diarrhea monitoring].

Programmes for the eradication and control of infections with bovine viral diarrhea virus (BVDV) concentrate on the identification and elimination of persistently infected (PI) animals. The identification of these animals is mainly based on the detection of viral antigen using ELISA techniques. Protocols detecting viral nucleic acid using RT-PCR have been described recently.

Management of diabetes mellitus medications in the nursing home.

Nursing home staff are well aware of the increasing number of residents who experience diabetes mellitus. These residents consume an inordinate amount of resources and often have major disabilities and co-morbidities. Although nonpharmacological therapies, such as consistent carbohydrate intake and increased activity levels, are always indicated in diabetes management, pharmacological therapies are often necessary to prevent the acute complications of diabetes and delay some of the long-term complications.

Rabies in red foxes (Vulpes vulpes) experimentally infected with European bat lyssavirus type 1.

The susceptibility of red foxes (Vulpes vulpes) to European bat lyssavirus type 1 (EBLV-1) infection was examined. Eight foxes were inoculated intramuscularly (i.m.

Urinary acetoacetate or capillary beta-hydroxybutyrate for the diagnosis of ketoacidosis in the Emergency Department setting.

Objectives: We compared the semiquantitative measurement of acetoacetate using urinary dipsticks with the bedside quantitative fingerprick measurement of the principal ketone bodies 3-beta-hydroxybutyrate, for the diagnosis of ketoacidosis.

Methods: This is a one year retrospective study of patients who presented with hyperglycemia levels of 250 mg/l or greater in the Emergency Department setting. We compared the sensitivity, specificity, and predictive value of ketonuria and ketonemia for the diagnosis of ketoacidosis (urine or blood ketone bodies, blood bicarbonates <20 mmol/l, anion gap >16 meq/l) in a sample of patients for whom the levels of ketone bodies in the blood and urine as well as serum electrolytes were available.

Phocine distemper in German seals, 2002.

Approximately 21,700 seals died during a morbillivirus epidemic in northwestern Europe in 2002. Phocine distemper virus 1 was isolated from seals in German waters. The sequence of the P gene showed 97% identity with the Dutch virus isolated in 1988.

Diabetes in nonveterans, veterans, and veterans receiving Department of Veterans Affairs health care.

Objective: To compare behavioral risk factors and health and disease characteristics among three groups of adults with diabetes: nonveterans, veterans not receiving Department of Veterans Affairs (VA) health care, and veterans using VA services.

Research Design And Methods: Two data sources were used to describe the veteran population. First, the 2000 Behavioral Risk Factor Surveillance System (BRFSS) characterized the U.

The surface glycoprotein E2 of bovine viral diarrhoea virus contains an intracellular localization signal.

The intracellular transport of the surface glycoprotein E2 of bovine viral diarrhoea virus was analysed by expressing the cloned gene in the absence of other viral proteins. Immunofluorescence analysis and surface biotinylation indicated that E2 is located in an early compartment of the secretory pathway and not transported to the cell surface. In agreement with this result, E2 was found to contain only high-mannose oligosaccharide side-chains but no N-glycans of the complex type.

Impact of policies and performance measurement on development of organizational coordinating strategies for chronic care delivery.

Objective: To examine the impact of policy directives and performance feedback on the organization (specifically the coordination) of foot care programs for veterans, as mandated by public law within the Department of Veterans Affairs Health Care System (VA).

Study Design: Case study of 10 VA medical centers performing diabetes-related amputations.

Patients And Methods: Based on expert consensus, we identified 16 recommended foot care delivery coordination strategies.

Teaching behavior change skills to first-year medical students: a small group experiential approach.

Purpose: Develop and evaluate a course to help first-year medical students learn about health-related behavior change by focusing on their personal health goals. COURSE METHODS: Students each identified two health-related behavior change goals for themselves. Lectures presented relevant content concerning behavior change.

Changing family physicians' visit structuring behavior: a pilot study.

Objective: This study assessed the degree to which family physicians elicit patients' agendas and negotiate the agenda of the medical visit, related this behavior to late-arising patient concerns and satisfaction with the visit, and assessed the degree to which visit-structuring behavior can be modified by a brief workshop.

Methods: We reviewed 65 audiotaped clinic visits conducted by three experienced family physicians before (36 visits) and after (29 visits) a workshop on structuring outpatient visits. We also collected patient and physician satisfaction ratings through post-visit questionnaires.

Neurological complications of Werner's syndrome.

Patients with Werner's syndrome have the appearance of premature ageing. Neurological complications are usually regarded as uncommon. The neurological manifestations in three patients with cardinal features of Werner's syndrome, including short stature, premature greying and baldness, thin arms and legs, cataracts and scleroderma-like skin changes, are presented.

The relationship between provider coordination and diabetes-related foot outcomes.

Objective: To investigate the relationship between provider coordination and amputations in patients with diabetes.

Research Design And Methods: The study design was a cross-sectional, descriptive study of process and outcomes for diabetes-related foot care at 10 Department of Veterans Affairs (VA) medical centers representing different geographic regions, population densities, patient populations, and amputation rates. The subjects included all providers of diabetes foot care and a random sample of primary care providers at each medical center.