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Biomedical subjects

H K Delcher

Publications and source records attributed to H K Delcher.

At least 19 recordsLinked to original sources
PubMed1996

A hospital-based home health diabetes education model.

For continuity in delivering healthcare across the continuum, an institutionally based home healthcare department was established at Georgia Baptist Medical Center, Atlanta, Georgia. The overall mission of home healthcare services is to maintain high levels of care while maintaining the lowest reasonable costs. Much of the department's patient care focuses on patients challenged with diabetes. This article describes the creation of a progressive, self-directed diabetes education model within this hospital-based home care program.

Critical Pathways↗
PubMed1985

Personality variables and metabolic control in children with diabetes.

Insulin-dependent diabetic children and a group of their nondiabetic peers were compared on measures of self-concept, locus of control and health locus of control. A metabolic measure of long term diabetes control was also obtained on the children with diabetes. Data analyses revealed that metabolic control was not related to any of the personality measures in the diabetic sample. Diabetic and non-diabetic children did not differ on measures of locus of control and self-concept, but diabetics exhibited a health locus of control which was significantly more internal than that of control subjects. A possible explanation for these results was discussed and practical implications for health care providers working with young diabetics were presented.

Adolescent↗
PubMed1982

A mechanism of susceptibility to mucormycosis in diabetic ketoacidosis: transferrin and iron availability.

The defect in host defense that makes the diabetic ketoacidotic (DKA) patient susceptible to mucormycosis has not been identified. Sera from 10 DKA patients and three normal volunteers were tested for their capacity to support the in vitro growth of a common etiologic agent of mucormycosis, Rhizopus oryzae. After equilibration with room air none of the normal or DKA sera, each of which was now extremely alkaline, supported growth of R. oryzae. When the sera were placed in a CO2 atmosphere that permitted simulation of the in vivo clinical pH (normal 7.40 and DKA 7.3-6.6), four of seven DKA sera supported profuse fungal growth. No growth occurred in normal serum. The three DKA sera that did not support fungal growth at pH less than or equal to 7.3 contained less iron (x = 13 micrograms/dl) than the four sera that supported profuse fungal growth (x = 69 micrograms/dl). Increasing the iron content of iron-poor DKA serum that did not support R. oryzae growth allowed profuse growth at acidotic conditions but not at pH greater than or equal to 7.4. Simulated acidotic conditions (pH 7.3-6.6) also decreased the iron-binding capacity of normal serum stepwise from 266 micrograms/dl to 0. Our data indicate that acidosis temporarily disrupts the capacity of transferrin to bind iron and suggest that this alteration abolishes an important host defense mechanism that permits growth of R. oryzae.

Diabetic Ketoacidosis↗
PubMed1979

Spin-off cost/benefits of expanded nutritional care.

Eight years ago, in caring for persons with diabetes at Grady Memorial Hospital, Atlanta, priority was given to the use of oral hypoglycemic agents and insulin, with only minimal attention to nutrition. In 1971, an "expanded nutritional care program" was instituted, with emphasis on nutritional education and follow-up. Use of oral agents was discontinued, and, since 1972, less insulin has been used. The new dietary program, with dietitians playing a key role, includes a one-week total fast, stringent low-calorie diets, individualized dietary planning and instruction, and careful follow-up monitoring. Comparative pre-1971 and current data show: a 50 per cent reduction in lower extremity amputations, less diabetic ketoacidosis, fewer hospitalizations, weight reduction of 40 per cent with no increase in plasma glucose (in a 127-patient cohort with complete follow-up), and a savings to the hospital of more than $96,000 in the cost of medications and $3,700,000 in hospitalizations in eight years.

Blood Glucose↗
PubMed1975

A comparison of the structure of hamster pancreatic insulin and insulin extracted from a transplantable hamster islet-cell carcinoma.

Insulin has been isolated from pancreases of the Syrian hamster and from a transplantable islet-cell tumor of the hamster. Acid/ethanol extraction, ether precipitation, ion exchange and gel filtration chromatography gave preparations of suitable purity for structural studies. Using trypsin cleavage, automatic Edman degradation and manual Edman degradation, a complete sequence of the pancreatic insulin B chain was determined. By automatic Edman degradation, the amino-terminal 10 residues of the pancreatic A chain were assigned and the sequence of carboxy-terminal eleven residues could be deduced by homology to other mammalian and avian insulins. The sequence assigned to hamster insulin A chain is identical to that of the rat, mouse and spiny mouse. The sequence of hamster insulin B chain is identical to rabbit and spiny mouse B chain. In terms of protein evolution, hamster insulin thus appears to occupy an intermediate position between rabbit and rat insulins. Amino acid composition, tryptic peptide composition and partial sequence analysis of the hamster tumor insulin showed no differences from hamster pancreatic insulin.

Adenoma, Islet Cell↗
PubMedDate not supplied

Parental versus professional perceptions of obstacles to pediatric diabetes care.

Parents of children with insulin-dependent diabetes mellitus (IDDM) (n = 38) were surveyed to identify common and difficult obstacles to diabetes care. A list of these obstacles was cross-validated by a second parent sample (n = 47) who rated each item according to how common and difficult each item was for them. The list then was rated by a sample of diabetes professionals (n = 15) to evaluate the extent of agreement between parents and health care professionals regarding the frequency with which these obstacles occur and the difficulty they pose to everyday diabetes care. Professionals disagreed with parents regarding which obstacles were most common and difficult, generally rating problems as significantly more common and difficult (t = 5.20, P = < .001) than did the parents who experienced them. The results of the survey underscore the importance of health care providers evaluating the concerns of the local patient community when developing educational and treatment services for these patients.

Adolescent↗