Diabetic complications and hypoacusia

The relationship between diabetes mellitus and hypacusia has been discussed since the work of Jordao, in 1857. Numerous authors are openly pro this viewpoint, whereas other deny it. The hypoacusis is typically bilateral, progressive and of neurosensory nature, affecting the higher frequencies. In the etiologic aspect some authors bet for an angiopathic origin, but others suppose a neuropathic cause. We have achieved a comparative study with the aim to get some conclusions that could enlighten this field. Forty patients with diabetes mellitus type II were audiometrically examinees (at threshold and with supraliminar tests) and the results compared with those of a control group. We also assessed several complications of the disease and their possible report with the auditive impairment (retinopathy and neuropathy). We found out a sensorineural, bilateral and symmetrical hearing impairment. Employing the Man Whitney's U test we compare distinct groups and explain the gained outcomes. Bibliographic review of authors defending the vascular or the nervous starting point.     

Diabetic ketoacidosis and rhabdomyolysis following excessive intake of a weight reducing diet

We describe two unusual cases in sheep of subclinical mastitis caused by Streptococcus parasanguinis. This bacterium has been associated with the development of experimental endocarditis; its presence at relatively high concentrations in apparently healthy sheep milk may pose a health risk in persons with predisposing heart lesions.     

Locus of control and extreme behavior.

Explored the relationship between locus of control and extreme behavior in regard to risk taking, persistence, shifts in level of aspiration, and estimation of success. 173 high school freshmen girls completed Rotter's Internal-External Control Scale and a questionnaire assessing extreme behavior. Analysis of the data indicate that external Ss, as opposed to internal Ss, were characterized by a preference for extreme risks, low persistence, and atypical shifts in level of aspiration; they were more extreme in their estimation of success when responding to items related to academic, occupational, and cognitive activities. The findings, along with an integration of the literature are related to several methodological and theoretical issues. (22 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Infectious complications: prevention and strategies for their control

Despite major advances in burn wound management and other supportive care regimens, infection remains the leading cause of morbidity in the thermally injured patient. Changes in nursing practices and patient isolation have played a significant role in reducing the incidence of burn wounds and other infections, particularly those that result from cross-contamination in the hospitalized burn patient. This article focuses on the sources of the most common infections seen in burn centers today and on the infection control strategies developed for their prevention and treatment.     

Diabetes mellitus in Egypt: glycaemic control and microvascular and neuropathic complications

We performed a cross-sectional, population-based survey of persons 20 years of age and older living in Cairo and surrounding rural villages. The purpose was to describe glycaemic control and the prevalence of microvascular and neuropathic complications among Egyptians with diagnosed diabetes, previously undiagnosed diabetes, impaired glucose tolerance, and normal glucose tolerance. A total of 6052 households were surveyed. The response rate was 76% for the household survey and 72% for the medical examination. Among people with previously diagnosed diabetes, mean haemoglobin A1c, was 9.0%. Forty-two per cent had retinopathy, 21% albuminuria, and 22% neuropathy. Legal blindness was prevalent (5%) but clinical nephropathy (7%) and foot ulcers (1%) were uncommon in persons with diagnosed diabetes. Among people with diagnosed diabetes, microvascular and neuropathic complications were associated with hyperglycaemia. Retinopathy was also associated with duration of diabetes; albuminuria with hypertension and hypercholesterolaemia; and neuropathy with age, female sex, and hypercholesterolaemia. Albuminuria was as common in people with previously undiagnosed diabetes (22%) as those with diagnosed disease (21%). Mean haemoglobin A1c was lower (7.8%) and retinopathy (16%) and neuropathy (14%) were less prevalent in people with previously undiagnosed disease. Ocular conditions, blindness, and neuropathy were prevalent in the non-diabetic population. The microvascular and neuropathic complications of diabetes are a major clinical and public health problem in Egypt.     

Minimizing respiratory complications of nasoenteric tube feedings: state of the science

This article summarizes research findings regarding ways to minimize the two most dreaded complications of tube feedings: (1) introduction of feedings through tubes positioned in the respiratory tract, and (2) pulmonary aspiration. Bedside methods that lack reliability in ruling out inadvertent respiratory placement of feeding tubes include the auscultatory method, the bubbling under water method, and observing for respiratory symptoms. Testing the pH of aspirates from feeding tubes can be of use in ruling out respiratory placement of newly inserted tubes when acidic values are properly obtained; further, this method can also be helpful in determining when a tube has migrated from the stomach to the intestine. Based on experience, the most frequently cited values for excessive gastric residuals are 100 to 150 ml. In a recent small study, researchers concluded that the residual volume that should raise concern in patients with nasogastric tubes is 200 ml and in patients with gastrostomy tubes the amount is 100 ml. Several recent studies indicate that although elevating the head of the bed 30 to 45 degrees does not prevent aspiration, it does reduce its frequency and severity. Because many studies described in this review have not been replicated, readiness of their findings for clinical application is variable. Many questions regarding methods to prevent respiratory complications in tube-fed patients remain unanswered, largely because it is difficult to design clinical studies with sufficient control of significant variables.     

Controlling ourselves, controlling our world: Psychology's role in understanding positive and negative consequences of seeking and gaining control.

This article begins by examining psychology's contributions to understanding the positive consequences of control for individual mental and physical health. Person-environment control mismatches and the negative personal, interpersonal, and societal consequences of seeking and having control are then discussed. As corrections to mismatches and negative consequences, three methods of analyses are provided. First, definitional and conceptual precision is offered, including a more careful matching of control-related interventions to multidimensional, individual-specific control profiles. Second, therapeutic assessment and interventions are placed within a biopsychosocial model of control. Finally, philosophy of science and paradigmatic issues underlying control theories are highlighted, particularly as they affect psychology's role in examining values toward which control efforts should be directed. These topics are important for people's personal and collective well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Typical complications and their control after restorative proctocolectomy

The overall rate of complications after ileal pouch-anal anastomosis is 60%. This rate, however, includes complications such as bowel-obstruction and hernias. Pouch-related complications occur after ileal pouch-anal anastomosis with a frequency of 15-25%. In an analysis of the recent literature the main risk factors are: tension of the ileal pouch-anal anastomosis, anastomotic leakage, lack of protective ileostomy, preoperatively undiagnosed Crohn's disease and the experience of the surgeon. We classified pouch related-complications into (1) surgical complications (leakage, bleeding, pelvic sepsis, fistulas); (2) technical problems (long S-pouch spout, rectal cuff stenosis, etc.); (3) functional problems (anal sphincter insufficiency, night incontinence, hypermotility, evacuation disorders); (4) pouchitis; (5) pouch neoplasias. Pathogenesis, diagnostic features, and medical and surgical therapy are discussed in detail. In our own series of 11 pouch-redo operations we had 6 pouch fistulas (3 related to Crohn's disease, 3 postoperative fistulas), 3 wrongly constructed pouches, 1 chronic pouchitis and 1 long S-pouch spout. In 3 cases the pouch had to be excised completely. Two patients remained with a permanent ileostomy. In 6 patients the pouch could be preserved on long term. Due to the technical complexity, the need to understand pathophysiology and the need for a differentiated diagnostic procedure, this operation should be performed only in specialised centers.     

Inhibitory control over no-longer-relevant information: adult age differences

Hartmann and Hasher (1991) used a garden-path task in which younger and older adults generated the final word for each of a series of high-cloze sentences. Under instructions to remember the final word, the experiment included critical sentences for which the generated word was replaced by a new, to-be-remembered target. Using an implicit priming task, the first experiment replicated a basic finding: Younger adults showed priming only for the target words, whereas older adults showed priming for both the generated and target words. Two experiments explored the boundary conditions. One showed that an additional sentence that interpreted the new target word enabled older adults to narrow access to only the target word. The provision of additional time following the introduction of the new target word did not. Specific information, not more time, is required for inefficient inhibitory mechanisms to clear the recent past from memory.     

Control and loss of control over eating: An experimental investigation.

The present study provides experimental evidence for the restraint theory's proposition of a causal link between restraint and disturbances in food-intake control. Twenty-seven obese women were randomly assigned to a diet group (high restraint), an exercise group (low restraint), or a control group for a 7-week group treatment program. On Weeks 4 and 6, all subjects participated individually in two laboratory sessions designed to investigate the regulation of food intake. In Session 1, food intake and appetite for food were assessed before and after a preload. In Session 2, food intake was assessed under stressful conditions. The results showed that the dieters ate more than either of the other two groups in all conditions. The possible mechanisms linking conscious regulation of eating with disturbances in control are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral control over aversive events: Does control that requires effort reduce anxiety and physiological arousal?

Investigated whether the amount of effort required to control an aversive event influenced the amount of anxiety and physiological arousal associated with the aversive event. 89 male undergraduates participated in a 3 (unavoidable threat, avoidable threat, no threat)?×?2 (high-effort task performance, low-effort task performance)?×?2 (anticipation period, performance period) factorial experiment. Results indicate that (a) the aversive event (threat of electrical shock) increased Ss' anxiety and physiological arousal; (b) exercising control was effective for decreasing Ss' anxiety to the nonthreat level, but only when low effort was required; (c) the prospect of control decreased Ss' physiological arousal to the no-threat level while the Ss were waiting to exercise control over the aversive event; and (d) while actually exercising the control, Ss showed high physiological arousal similar to Ss who could not control the event. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hierarchical control and skilled typing: Evidence for word-level control over the execution of individual keystrokes.

Routine actions are commonly assumed to be controlled by hierarchically organized processes and representations. In the domain of typing theories, word-level information is assumed to activate the constituent keystrokes required to type each letter in a word. We tested this assumption directly using a novel single-letter probe technique. Subjects were primed with a visual or auditory word or a visually presented random consonant string and then probed to type a single letter from the prime or another randomly selected letter. Relative to randomly selected letters, probe responses were speeded for first, middle, and last letters contained in visual and auditory word primes but not for middle and last letters contained in random consonant primes. This suggests that word-level information causes parallel activation of constituent keystrokes, consistent with hierarchical processing. The role of hierarchical processing in typing and routine action is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stimulus-driven and goal-driven control over visual selection.

This article explored the extent to which stimulus-driven control over visual selection is modulated by goal-driven factors. Observers searched for a no-onset color target among 3 distractors and signaled its location either manually or with a saccade. Additional distractors appeared either with or without an abrupt onset and were either similar or dissimilar to the target. Abrupt onsets disrupted saccades to the target, especially when they shared the target color. Irrelevant onsets also interfered with the manual responses, but this interference was dependent on the particular type of manual response. Stimulus-driven and contingent capture can occur within a single paradigm, but the extent and nature of these effects depend on the specific response required. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived control over development and subjective well-being: Differential benefits across adulthood.

The relationship between perceived control over development (PCD) and subjective well-being (SWB) across adulthood was examined in 3 studies. In Study 1, with 480 adults aged between 20 and 90 years, PCD was closely related to SWB. Chronological age moderated the associations between PCD and SWB beyond individual differences in health, intelligence, social support, and socioeconomic status. In the longitudinal Study 2, with 42 older adults, strong PCD was associated with increased positive affect only when desirable events had occurred previously. In Study 3, older adults experienced greater satisfaction when attributing attainment of developmental goals to their ability, whereas younger adults were more satisfied when attributing such successes to their own efforts. Findings point to adaptive adjustments of control perceptions to age-related actual control potentials across adulthood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)