The Experts below are selected from a list of 309 Experts worldwide ranked by ideXlab platform
Sung Kil Lim - One of the best experts on this subject based on the ideXlab platform.
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internet Diabetic Patient management using a short messaging service automatically produced by a knowledge matrix system
Diabetes Care, 2007Co-Authors: Chulsik Kim, Haijin Kim, Ji Sun Nam, Min Ho Cho, Jong Suk Park, Eun Seok Kang, Chul Woo Ahn, Bong Soo Cha, Eun Jig Lee, Sung Kil LimAbstract:Lifelong strict self-care is essential in the management of diabetes, along with easy access to the health care system (1–3). However, there is an evident limitation in fulfilling these conditions in the current health care system, which is oriented toward outPatient care (4–7). Thus, various strategies have been designed to improve the quality and efficiency of treating Diabetic Patients. Wireless technology is a worldwide communication system that allows a person to contact others anywhere at any time. Therefore, doctor-Patient communication becomes possible anywhere with the use of this system (8). Currently, in civilized countries, nearly all adults and adolescences have their own cellular phones and use short message services (SMSs) in their daily lives. Moreover, numerous people are using ultra-fast Internet services at work or in the home. We designed an Internet-based Diabetic Patient management system using SMS that was automatically produced by a knowledge matrix. Subsequently, we compared biochemical profiles and clinical status between Diabetic Patients who used our system for 12 weeks and those who received the conventional outPatient management over the same time period. We developed a knowledge matrix containing information on proper diet and exercise for Diabetic Patients based on the Korea Staged Diabetes Management Guideline (Table 1). Moreover, with the technical assistance from ISU UBCare, we created a Web site program (http://yds.healthkorea.net) that was used to formulate appropriate messages through an automated algorithm. We also designed a device that had the dual function of a glucometer and a pedometer. By connecting this device to the …
Crystal M Holmes - One of the best experts on this subject based on the ideXlab platform.
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physician knowledge of a rare foot condition influence of Diabetic Patient population on self described knowledge and treatment
Clinical Diabetes and Endocrinology, 2017Co-Authors: Brian M Schmidt, James S Wrobel, Crystal M HolmesAbstract:Background Charcot neuroarthopathy (CN), a rare foot and ankle condition usually complicating diabetes mellitus, leads to deformity, poor quality of life, and increased mortality and morbidity. The prevalence of this condition in the Diabetic Patient population is not currently known but has been reportedly misdiagnosed in up to 95% of cases.
Eugene J Barrett - One of the best experts on this subject based on the ideXlab platform.
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severe hypernatremia from a urea induced diuresis due to body protein wasting in an insulin resistant type 2 Diabetic Patient
The Journal of Clinical Endocrinology and Metabolism, 2013Co-Authors: Amy D Anderson, Eugene J BarrettAbstract:Context: Hypernatremia is encountered after pituitary or hypothalamic surgery and typically is secondary to vasopressin deficiency resulting in increased free water clearance with inadequate water replacement. Objective: We report a type 2 Diabetic Patient with severe hypernatremia (Na+ = 161 mEq/L) after hypothalamic surgery. Unexpectedly, this was accompanied by persistent urinary hypertonicity and negative total but positive electrolyte free water clearance. Main Outcome Measure: Measurement of urinary electrolytes and urea revealed that an osmotic diuresis induced by urea derived principally by breakdown of endogenous protein was causative. Body protein losses over 48 hours were estimated to exceed 2 kg of lean mass. High-dose glucocorticoid, insulin resistance, and a postsurgical catabolic stress likely contributed. Conclusion: In surgically severely stressed individuals, proteolysis of endogenous protein can strongly impact body water metabolism and contribute to severe hypernatremia.
Mario Stefanelli - One of the best experts on this subject based on the ideXlab platform.
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AIMDM - Multi-modal Reasoning in Diabetic Patient Management
Artificial Intelligence in Medicine, 1999Co-Authors: Stefania Montani, Riccardo Bellazzi, Luigi Portinale, Alberto Riva, Mario StefanelliAbstract:We present a decision support tool for Insulin Dependent Diabetes Mellitus management, that relies on the integration of two different methodologies: Rule-Based Reasoning (RBR) and Case-Based Reasoning (CBR). This multi-modal reasoning system aims at providing physicians with a suitable solution to the problem of therapy planning by exploiting the strengths of the two selected methods. RBR provides suggestions on the basis of a situation detection mechanism that relies on structured prior knowledge; CBR is used to specialize and dynamically adapt the rules on the basis of the Patient's characteristics and of the accumulated experience. Such work will be integrated in the EU funded project T-IDDM architecture, and has been preliminary tested on a set of cases generated by a Diabetic Patient simulator.
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protocol based reasoning in Diabetic Patient management
International Journal of Medical Informatics, 1999Co-Authors: Stefania Montani, Riccardo Bellazzi, Alberto Riva, Cristiana Larizza, Giuseppe Dannunzio, Stefano Fiocchi, R Lorini, Mario StefanelliAbstract:We propose a system for teleconsultation in Insulin Dependent Diabetes Mellitus (IDDM) management, accessible through the use of the net. The system is able to collect monitoring data, to analyze them through a set of tools, and to suggest a therapy adjustment in order to tackle the identified metabolic problems and to fit the Patient's needs. The therapy revision has been implemented through the Episodic Skeletal Planning Methodi, it generates an advice and employs it to modify the current therapeutic protocol, presenting to the physician a set of feasible solutions, among which she can choose the new one.
Tomoatsu Mune - One of the best experts on this subject based on the ideXlab platform.
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Pseudoaldosteronism induced by Yokukansan in an elderly Japanese type 2 Diabetic Patient with Alzheimer's disease.
Journal of diabetes investigation, 2015Co-Authors: Shinji Kamei, Hideaki Kaneto, Shintaro Irie, Tomoe Kinoshita, Akihito Tanabe, Hidenori Hirukawa, Fuminori Tatsumi, Masashi Shimoda, Kenji Kohara, Tomoatsu MuneAbstract:The number of Patients with Alzheimer's disease (AD), and/or behavioral and psychological symptoms of dementia (BPSD) has been markedly increasing all over the world, and has become a social and health problem. Furthermore, it has been recently established that the Diabetic condition is a major risk factor for the development of dementia1. Second-generation antipsychotics have been used, but some cases are refractory2. Yokukansan is a licorice-containing Chinese medicine, and has been very often used for the treatment of such disease3. A previous report showed that Yokukansan exerts beneficial effects and can be used very safely3. It is known that a large amount of licorice could induce pseudoaldosteronism, but Yokukansan contains only a small amount of licorice. Therefore, it has been thought that the use of Yokukansan does not lead to the onset of pseudoaldosteronism. However, here we report a case of pseudaldosteronism that developed after starting Yokukansan in an elderly Japanese Diabetic Patient with AD and BPSD. In February 2013, a 77-year-old Japanese man with type 2 diabetes was admitted to the Kawasaki Medical School, Kurashiki, Japan, because of hypokalemia and weight gain. He had been taking Yokukansan for 5 months (7.5 g/day containing 1.5 g of licorice). He frequently felt general fatigue, and his bodyweight was increased by 7 kg. On admission, his bodyweight was 64.3 kg and height 160.5 cm. He did not have vomiting or diarrhea and did not use any diuretics. Physical examination revealed mild systolic hypertension. Marked pretibial pitting edema was observed in the bilateral lower extremities. TableTable11 shows the laboratory findings on admission. Serum potassium was 3.0 mEq/L with mild renal dysfunction. The low-renin and low-aldosterone state was observed with concomitant metabolic alkalosis. In addition, the transtubular potassium gradient (TTKG) was very high (11.0). Given these findings, we made the diagnosis of Yokukansan-induced pseudoaldsteronism, and stopped this drug. After commencement of oral potassium replacement, potassium level was increased (3.8 mEq/L at day 10) and TTKG was decreased to 3.5. Pitting edema disappeared with 6-kg weight reduction. On day 20, he was discharged from the hospital. Table 1 Laboratory findings on admission Recently, Yokukansan has been very often used for dementia, and its sales amount has been drastically increasing. It has been thought that Yokukansan can be used very safely3. To the best of our knowledge, this is the first report showing that Yokukansan induced pseudoaldosteronism in Diabetic Patients. The mechanism of how licorice causes pseudoaldosteronism is likely through the inhibition of renal enzyme 11-hydroxysteroid dehydrogenase type 2. Cortisol, as well as aldosterone, can bind to the mineralocorticoid receptor (MR), but, 11-hydroxysteroid dehydrogenase type 2 converts cortisol to cortisone that does not work on MR. As a result, aldosterone dominantly binds to MR4. However, licorice inactivates 11-hydroxysteroid dehydrogenase type 2 and increases the cortisol binding to MR, which explains the mechanism for licorice-induced pseudoaldosteronism. It is known that the onset of pseudoaldosteronism depends on the dose of licorice, but the present case developed pseudoaldosteronism with a very low dose of licorice (1.5 g/day). In fact, a similar frail and elderly female case of Yokukansan-induced pseudoaldosteronism with severe hypokalemia was reported by Nishiya et al.5 Thereby, we should pay careful attention when using Yokukansan, even with a low-dose component of licorice. Taken together, we should consider the possibility of pseudoaldosteronism when we use Yokukansan for dementia, and careful monitoring of electrolytes, especially potassium, is necessary.