Medical treatment of hyperthyroidism.
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Biomedical subjects
Publications and source records attributed to M A Totten.
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Clinical observations for 49 diabetic patients who required chronic hemodialysis or renal transplantation during a four year period are presented. Twenty-seven dialysis patients had a two year cumulative survival of 74% compared to 54% for 22 transplantation patients. The cumulative survival of live-related donor recipients (77%) was similar to that of the dialysis group and significantly better than that of cadaveric allograft recipients (36%). While the incidences of cardiomegaly and of motor neuropathy were high among live-related donor recipients, dialysis patients more often demonstrated peripheral vascular disease. Causes of death in hemodialysis patients included cardipulmonary arrest and patient decision to discontinue therapy; in the transplantation group included cardiopulmonary arrest, sepsis, and stroke. Living-related transplantation remains the preferred mode of therapy because of the potential for rehabilitation. In terms of patient survival, the risks of cadaver transplantation must be weighted against the discomforts of chronic dialysis.
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Throughout the process of diagnosis, evaluation and institution of a treatment regime, the physician-nurse practitioner team is essential for patients with diabetes mellitus. Initial consultation with the physician regarding the issues of diagnosis, insulin dose and type, and patient symptomatology relative to hyper/hypoglycemic reactions is necessary. Nursing assessments and implementation of teaching plans are also invaluable in assisting with control of hyperglycemia, adaptation and response to individual variations of this chronic disease, and continuous on-going bio-psycho-social care.