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Biomedical subjects

M Buysschaert

Publications and source records attributed to M Buysschaert.

At least 91 records · Page 5Linked to original sources
PubMed1982

[Intravenous administration of ritodrine to pregnant insulin-dependent diabetics. Metabolic impact].

Seven diabetic patients who had been dependent on insulin before pregnancy (classes B, C, D of White) threatened to go into premature labour between the 31st and 36th week of the pregnancy. They were treated by intravenous administration of Ritodrine, the dosage varying between 100 and 400 micrograms per minute. The changes in the mother consisted in a rise in the blood glucose level which rose from 140 +/- 34 mg % to 212 +/- 56 mg % (p less than 0.01). This occurred in spite of a mean rise of 49% of insulin (p less than 0.0025) and a moderate ketonuria in two patients and a severe acido-ketosis in two further patients. In five patients there were no effects on the fetus as far as repeated observations of the fetal heart rate could detect. On the other hand, in the two mothers who developed acido-ketosis during the transfusion the fetal heart rythm showed signs of acute fetal distress, which however was temporary. Oscillations were reduced and there were late decelerations. These disappeared when the maternal metabolic state was brought back to equilibrium. 13.1 +/- 7.3 days were gained for the fetus by using tocolytic treatment, and this is considered a success. Discussion of these cases is accompanied by a complete review of the literature of the administration of beta-mimetic drugs in diabetic women. The authors point out that special precautions have to be taken and special conditions have to be fulfilled when this type of treatment is used. These consist of changes in the amounts of insulin that are given and particularly careful observation of the fetal heart rhythm before and during treatment.

Adult↗
PubMed1981

Continuous subcutaneous insulin infusion in the treatment of juvenile-onset diabetes.

Control of glycemia by means of continuous subcutaneous insulin infusion (CSII) was examined in two groups of diabetic patients. In the first group of five totally insulin-dependent diabetics, the glycemic profile was compared in hospital during optimized conventional insulin therapy and CSII. A second group of five recently diagnosed diabetic patients was treated for periods up to 70 days with CSII. Two insulin infusion systems were used: (1) a commercially available infusion pump and (2) a specially developed device, permitting a more flexible infusion rate and including an audible warning of malfunction. In the first group the mean plasma glucose levels decreased significantly under CSII (202 +/- 18 mg/dl vs 151 +/- 18 mg/dl; p less than 0.05; mean +/- SEM) although the M value and the MAGE index were similar during CSII and the optimized conventional therapy. In the second group of subjects, improved diabetic control, as assessed by the mean blood glucose level (135 +/- 18 mg/dl), and M value and the MAGE index, was rapidly achieved by CSII in all patients. Insulin requirements fell to zero in two of the three patients who maintained CSII at home for 60 and 70 days. It is concluded that CSII permits blood glucose control at least as good as optimized conventional treatment in totally insulin-dependent diabetics in hospital as well as in newly diagnosed diabetics.

Adult↗
PubMed1980

Use of an extracorporeal glucose monitor for the diagnosis and surgical treatment of an insulinoma.

An extracorporeal glucose monitor (EGM) has been used in a patient with an insulinoma. This system, which continuously measures blood glucose, can be used in combination with a feedback-controlled glucose infusion to maintain glycaemia at any preselected level. It prevents the risk of severe hypoglycaemia during diagnostic tests (total fast, tolbutamide and insulin tolerance tests) as well as during surgery. It also helps in determining whether all the insulin-secreting tumour tissue has been removed. The EGM is thus helpful in the diagnosis and surgical treatment of insulinomas.

Adenoma, Islet Cell↗
PubMed1979

[Treatment of ambulatory unstable diabetic patients by continuous subcutaneous infusion of insulin: preliminary results (author's transl)].

The aim of the present work was to examine the possibility of improving the metabolic control of ambulatory unstable diabetic patients by continuous subcutaneous infusion of insulin. For this purpose, a simple portable pump infusing insulin at a constant rate of 0.8 or 1.1 U/h was utilized. Pulses of a more concentrated insulin solution were superimposed 30-60 min. before meals. Blood glucose control during conventional insulin therapy and during continuous infusion was compared by measuring the mean blood glucose and the M-value of Schlichtkrull. Blood glucose fluctuations were estimated by the MAGE index of Service and Molnar. Three patients were submitted to continuous subcutaneous infusion of insulin during periods of 1, 5 and 6 weeks. In two cases, the application of this technic considerably improved the metabolic control as evidenced by a remarkable decrease of the three measured parameters. In one patient, continuous infusion of insulin was stopped after one week since it did not lead to an improvement of diabetic equilibrium. This failure was apparently due to emotional intolerance of the new technic. On two occasions, infection at the site of infusion was noted. These results should encourage longer-term studies involving a larger number of patients.

Ambulatory Care↗
PubMed1976

[Hepatic puncture biopsy by the transjugular route].

The authors report their experience of transjugular liver biopsy, a method which consists in taking a liver specimen with a needle placed in a hepatic vein. This method was used in 13 patients in whom conventional liver needle biopsy was contraindicated because of massive ascites or bleeding tendency. In 10 of these patients, a liver specimen was obtained; in patients with cirrhosis or chronic active hepatitis, the liver specimens were more or less divided into small fragments, which prevented correct assessment of liver architecture in three of them. The examination was well tolerated. The authors conclude that transjugular liver biopsy is not technically difficult in centers where hepatic vein catheterization is available and that this method is indicated in patients in whom conventional liver needle biopsy is contraindicated.

Biopsy, Needle↗
PubMedDate not supplied

Pancreas transplantation for treatment of generalized allergy to human insulin in type 1 diabetes.

We report the case of a 29-year-old man with a 14-year history of type 1 diabetes, normal renal function, and mild diabetic retinopathy. The patient progressively developed a generalized allergic reaction to two insulin excipients--protamine and metacresol--with systemic manifestations of tremor, tachycardia, vertigo, shortness of breath, and short episodes of unconsciousness causing him to be out of work. In June 2003, he received a vascularized cadaveric pancreas transplant using induction with polyclonal antibodies along with tacrolimus and sirolimus but without steroids. A hyperglycemic episode following corticosteroid therapy for rejection treatment required reintroduction of insulin therapy with prompt reappearance of allergic manifestations. Now, the patient is euglycemic without insulin or allergic manifestations and a glycated hemoglobin of 6.4%.

Adult↗