What the radiologist needs to know about the diabetic patient

Diabetes mellitus (DM) is recognised as a major health problem. Ninety-nine percent of diabetics suffer from type 2 DM and 10% from type 1 and other types of DM. The number of diabetic patients worldwide is expected to reach 380 millions over the next 15 years. The duration of diabetes is an important factor in the pathogenesis of complications, but other factors frequently coexisting with type 2 DM, such as hypertension, obesity and dyslipidaemia, also contribute to the development of diabetic angiopathy. Microvascular complications include retinopathy, nephropathy and neuropathy. Macroangiopathy mainly affects coronary arteries, carotid arteries and arteries of the lower extremities. Eighty percent of deaths in the diabetic population result from cardiovascular incidents. DM is considered an equivalent of coronary heart disease (CHD). Stroke and peripheral artery disease (PAD) are other main manifestations of diabetic macroangiopathy. Diabetic cardiomyopathy (DC) represents another chronic complication that occurs independently of CHD and hypertension. The greater susceptibility of diabetic patients to infections completes the spectrum of the main consequences of DM. The serious complications of DM make it essential for physicians to be aware of the screening guidelines, allowing for earlier patient diagnosis and treatment

Psychometric validation of measures of alcohol expectancies, retrospective subjective response, and positive drinking consequences for use with adolescents

The Anticipated Effects of Alcohol Scale (AEAS), the Subjective Effects of Alcohol Scale, and the Positive Drinking Consequences Questionnaire (PDCQ) are psychometrically sound measures of alcohol expectancies (expectancies), subjective response to alcohol, and positive drinking consequences, respectively, for use with adults. Prior research using these measures suggests that expectancies, subjective response, and positive drinking consequences are related yet distinct determinants of drinking. The current study presents psychometric evaluations of these measures for use with adolescents including confirmatory factor analyses (CFA) of the previously identified latent structures, internal consistency, and test-criterion relationships. Legally, alcohol cannot be administered to adolescents, so we assessed retrospective subjective response (during the first drinking episode ever [SEAS First] and the most recent drinking episode [SEAS Recent]). The sample comprised 248 Connecticut high school students (53.6% male; mean age 16.50 [1.19] years; 71.4% White) who completed an anonymous survey. CFA confirmed the latent factor structures for each measure. The AEAS, SEAS First, SEAS Recent and the PDCQ were internally consistent (mean α AEAS = 0.83; SEAS First = 0.88; SEAS Recent = 0.89, PDCQ = 0.87). AEAS subscales evidenced moderate overlap with corresponding SEAS First subscales (mean = 0.36) and SEAS Recent subscales (mean = 0.46) and modest overlap with the PDCQ (mean = 0.17). Expectancies, subjective response, and positive drinking consequences also accounted for significant variance in monthly drinking, lifetime maximum number of drinks consumed, and alcohol-related problems. In sum, the AEAS, the retrospective SEAS, and the PDCQ are psychometrically sound measures for use with adolescents

The orientation dependence of dislocation slip in NaCl single crystals

Results are presented of investigations into the role of dislocation motion in deforming NaCl single crystals, using the technique of pulsed N.M.R. In particular, the spin-locking pulse sequence is used to measure T 1p, which is the spin-lattice relaxation time in the presence of a resonant r.f. magnetic field. T 1p, depends strongly on the mean free path L which is covered by the dislocations during successive jumps between obstacles in their glide plane. The mean free path is determined in crystals compressed in different directions, in which cases either the {110} or the {100} planes are primarily activated. It is shown that both the mean free path, measured as a function of strain rate and of the applied stress, and the work hardening differ remarkably for the two different primary slip planes. The magnitude of the mean free path is compared with the mean distance between dislocations in the crystal and the activation length of dislocations at obstacles, as obtained from mechanical stress relaxation experiments

The mean free path of mobile dislocations in doped NaCl single crystals measured by N.M.R. between room temperature and 300°C

The mean free path of mobile dislocations has been measured by determining the spin–lattice relaxation rate of deforming NaCl single crystals as a function of temperature and of the concentration of Ca2+ impurities. The latter may influence the magnitude of the mean free path, but this depends to a large extent on the point-defect configuration. The degree of association and the mobility of the point defects has been studied by measuring the spin–lattice relaxation rate without deforming the samples. On the other hand, the distribution of dislocations also varies with temperature, and this affects the mobility of dislocations too. The work-hardening rate of the crystals is compared with the mean free path as a function of temperature, and it is shown that both quantities have extremes under the influence of competitive mechanisms such as an enhanced thermal activation of dislocations at obstacles, an increasing mobility of point defects and an increasing number of intersections of mobile dislocations with dislocation dipoles

Dislocation dynamics in alkali halide single crystals investigated by nuclear spin relaxation measurements

La résonance magnétique nucléaire est appliquée à l'étude de la variation de la vitesse des dislocations avec la contrainte de compression appliquée dans des cristaux d'halogénures alcalins. T1ρ a été mesurée en fonction du taux [MATH] de la déformation plastique. La route moyenne des dislocations mobiles a été déterminée. Nous indiquons les résultats des expériences sur de différents noyaux, sur de différentes orientations des cristaux et sur des températures différentes.Dislocations moving at various velocities in deforming alkali halide single crystals were studied using the technique of pulsed nuclear magnetic resonance. The spin lattice relaxation rate in the rotating frame is measured as a function of the plastic deformation rate [MATH]. From this the mean free path of mobile dislocations can be determined. The results for different resonant nuclei, different crystal orientations with respect to the crystal axis and different temperatures are presented

Diabetes, glucose control, glucose lowering medications, and cancer risk: A 10-year population-based historical cohort

Background: Both diabetes and glucose-lowering medications have been associated with an increased risk of cancer incidence. This study will compare cancer incidence rates in individuals with and without diabetes; and will investigate, in individuals with diabetes, an association between glucose control and cancer incidence; and between the use of specific glucose-lowering medications, as well as no drug exposure, and cancer incidence.Methods/design: This is a population based historical cohort study of all individuals aged 21 years or older (about 2,300,000) who were insured by Clalit Health Services, the largest health maintenance organization in Israel during a ten-year study period. Four study groups will be established according to the status of diabetes and cancer at study entry, Jan 1, 2002: cancer free, diabetes free; cancer free, diabetes prevalent; cancer prevalent, diabetes free; and cancer prevalent, diabetes prevalent. Individuals without diabetes at study entry will be followed for diabetes incidence, and all four groups will be followed for specific cancer incidence, including second primary neoplasms. Glucose control will be assessed by HbA1c and by fasting plasma glucose levels. Time dependent regression models for cancer incidence will account for glucose-lowering medications as they are added and changed over the follow-up period. A large number of demographic and clinical variables will be considered, including: age, gender, BMI, smoking status, concomitant medications, glucose control (assessed by HbA1c and by fasting plasma glucose) and cancer screening tests.Discussion: Strengths of this study include the large population; high quality comprehensive data; comparison to individuals without diabetes, and to those with diabetes but not treated with glucose-lowering medications; and the extensive range of variables available for analysis. The great increases in diabetes prevalence and in treatment options render this study particularly relevant and timely. The Israeli national healthcare system, characterized by high standard and uniform healthcare, offers an advantageous environment for its conduct. \ua9 2012 Dankner et al.; licensee BioMed Central Ltd