Endometriosis

Diabetes increases the risk for disorders that predispose individuals to hospitalization, including coronary artery, cerebrovascular and peripheral vascular disease, nephropathy, infection, and lower-extremity amputations. The management of diabetes in the hospital is generally considered secondary in importance compared with the condition that prompted admission. Recent studies (1,2) have focused attention to the possibility that hyperglycemia in the hospital is not necessarily a benign condition and that aggressive treatment of diabetes and hyperglycemia results in reduced mortality and morbidity. The purpose of this technical review is to evaluate the evidence relating to the management of hyperglycemia in hospitals, with particular focus on the issue of glycemic control and its possible impact on hospital outcomes. The scope of this review encompasses adult nonpregnant patients who do not have diabetic ketoacidosis or hyperglycemic crises.

For the purposes of this review, the following terms are defined (adapted from the American Diabetes Association [ADA] Expert Committee on the Diagnosis and Classification of Diabetes Mellitus) (3): 

The prevalence of diabetes in hospitalized adult patients is not known. In the year 2000, 12.4% of hospital discharges in the U.S. listed diabetes as a diagnosis. The average length of stay was 5.4 days (4). Diabetes was the principal diagnosis in only 8% of these hospitalizations. The accuracy of using hospital discharge diagnosis codes for identifying patients with …

https://care.diabetesjournals.org/content/diacare/27/2/553.full.pdf

Management of diabetes and hyperglycemia in hospitals.

Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are two of the most serious acute complications of diabetes. These hyperglycemic emergencies continue to be important causes of morbidity and mortality among patients with diabetes in spite of major advances in the understanding of their pathogenesis and more uniform agreement about their diagnosis and treatment. The annual incidence rate for DKA estimated from population-based studies ranges from 4.6 to 8 episodes per 1,000 patients with diabetes (1,2), and in more recent epidemiological studies in the U.S., it was estimated that hospitalizations for DKA during the past two decades are increasing (3). Currently, DKA appears in 4-9% of all hospital discharge summaries among patients with diabetes (4,5). The incidence of HHS is difficult to determine because of the lack of population-based studies and the multiple combined illnesses often found in these patients. In general, it is estimated that the rate of hospital admissions due to HHS is lower than the rate due to DKA and accounts for <1% of all primary diabetic admissions (4,5,6).

Treatment of patients with DKA and HHS uses significant health care resources, which increases health care costs. In 1983, the cost of hospitalization for DKA in Rhode Island for 1 year was estimated to be $225 million (2). It was recently reported that treatment of DKA episodes represents more than one of every four health care dollars spent on direct medical care for adult patients with type 1 diabetes and for one of every two dollars in those patients experiencing multiple episodes of ketoacidosis (7). Based on an annual average of ∼100,000 hospitalizations for DKA in the U.S. (4) and estimated annual mean medical care charges of ∼$13,000 per patient experiencing a DKA episode (7), the annual hospital cost for patients …

https://care.diabetesjournals.org/content/diacare/24/1/131.full.pdf

Management of Hyperglycemic Crises in Patients With Diabetes

Molecular, clinical, and environmental toxicolog , Molecular, clinical, and environmental toxicolog , کتابخانه دیجیتال جندی شاپور اهواز

Molecular, Clinical and Environmental Toxicology

Animal studies show clear evidence for a causal link between testosterone and aggression. This review assesses studies involving androgens, principally testosterone, and human aggression. Evidence for a possible effect of prenatal androgens is inconclusive. In adults, higher testosterone levels are found in groups selected for high levels of aggressiveness. Correlations between testosterone and aggression were low when hostility inventories were used, but higher (r = .38) when aggressiveness was rated by others. Regression analysis data and studies of boys at puberty were inconclusive. Other studies show that the outcome of aggressive and competitive encounters can alter testosterone levels, thus confounding interpretation of the correlational evidence. The design of future studies to reveal evidence of a causal link is considered. Suggestions concerning two important methodological problems, the experimental manipulation of hormone levels and the nature of the dependent variable, are made.

The influence of testosterone on human aggression

The serum androgen response to physical exercise was studied in highly trained athletes and in normal male medical students. Serum androgens rose in response to maximal exercise and the rise was independent of serum luteinizing hormone. No response was obtained with submaximal exercise.

https://www.bmj.com/content/bmj/1/5852/520.full.pdf

Androgen Responses during Physical Exercise

Objective: To document adverse effects of anabolic-androgenic steroid (AAS) use in community-based users attending a medical clinic. Design and setting: Prospective recruitment, questionnaire-based interview, physical examination and investigations, with follow-up, of people who attended, anonymously, an inner-city hospital clinic established specifically to examine AAS use. Participants: 58 men, comprising 27 past AAS users, 14 present users and 17 potential users (who formed the control group). Main outcome measure: Clinical adverse effects and abnormal laboratory findings. Results: Cyclical use of oral and intramuscular, human and veterinary AASs were reported. The most commonly reported source of AASs was friends (59%), gymnasiums (25%) and doctors (14%). The most common reported adverse effects were alterations in libido (61%), changes in mood (48%), reduced testis volume (46%) and acne (43%). Although mean systolic and diastolic blood pressure was not significantly different between groups, five present (29%), 10 past (37%) and one potential user (8%) were hypertensive. Gynaecomastia was found in 10 past users (37%; P<0.01 v. potential users), two present users (12%) and no potential users. Mean testis volume was significantly smaller in present users (18 mL; P< 0.02) than in the other groups. Twenty past users (83%), eight present users (62%) and five potential users (71%) had abnormal liver function test results (P=0.5). After discussion of test results, only 11 participants (19%) reported they would not use AASs in the future. Conclusions: Adverse effects were reported by or detected in most of the AAS users who attended the clinic. Despite awareness of adverse consequences, most participants planned future use of AASs.

Anabolic-androgenic steroids: medical assessment of present, past and potential users.

Analysis of progesterone in unextracted serum: A method using danazol [17α-pregn-4-en-20-yno(2,3-d) isoxazol-17-ol] a blocker of steroid binding to proteins

Studies of serum cortisol were performed on 11 male veteran athletes aged 36 to 67 yr. Venous blood was collected in a basal state, again immediately before competitive exercise, and after a 1500 m and a 5000 m race. The precompetition cortisol (28.9 ± 3.5 μg/100 ml) was twice that of the basal state (14.9 ± 4.0 μg/100 ml), p < 0.001, and there was an increase (p < 0.025) to 40.8 ± 3.3 μg/100 ml after the 1500 m race, and a further increase (p < 0.025) to 59.1 ± 4.9 μg/100 ml following the 5000 m race. In 2 subjects where the serum cortisol was markedly elevated prior to the exercise there was no change afterwards. The younger athletes were faster in both 1500 m (r–0.97) and the 5000 m races (r–0.94), but there was little correlation between age or speed and the pre- or postrace serum cortisol. The oldest subject aged 67 yr, studied before and after a marathon of 42.19 km, showed serum cortisols of 11.3 and 70.9 μg/100 ml, respectively. This study indicates that competitive athletics is a greater stimulus...

The adrenocortical response to competitive athletics in veteran athletes.

This study examines the basal testosterone production of a group of 25 women aged 18 to 35 years with hirsutism managed by 3 simple forms of treatment: 1) a small evening dose of betamethasone for adrenal suppression; 2) anovulatory steroid; and 3) combination of the 2 drugs. The women were studied before and after treatment with basal plasma testosterone assays and a metabolic clearance rate determination. Competitive protein binding measured testosterone after preliminary chromatography. Mean basal plasma testosterone level was 70 +or- 30 ng/dl significantly higher than the mean (50 +or- ng/dl) for 23 normal women (p<0.01). Basal metabolic clearance rate (MCR) of testosterone (760 +or- 260 1/24 hour) was also significantly higher than that given for normal women using identical methodology (584 +or- 125 1/24 hour). Mean production rate of testosterone (PRT) in 19 women was 567 +or- 241 mcg/24 hours significantly higher than that for normal women (316 +or- 101 mcg/24 hour) (p<0.001) the latter value being derived using a double isotope dilution derivative technique. Mean PRT in 13 patients declined to 356 mcg/24 hour (p=0.05) after 4 months in betamethasone therapy (0.5 mg at bedtime); in 9 anovulatory steroids reduced mean PRT to 345 mcg/24 hour (p<0.05 0.025). Combination of both therapies in 10 reduced PRT to 148 mcg/24 hour (p<0.001) suggesting moderate success in reducing hair growth in 6 of 10 patients. Although 14 patients with hirsutism and 13 with acne claimed benefits from the regimen clinical benefits in individual cases did not correlate well with reduction in PRT. The combination of anovulatory steroids and small dose of betamethasone appears to be effective in treating hirsutism with no apparent side effects.

Chronic treatment regimens for hirsutism in women: effect on blood production rates of testosterone and on hair growth.

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

John H. Casey

Author Tools

Chat about Author