[Quantitative and qualitative analysis of disorders of insulin-secretion in diabetic syndromes].
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Biomedical subjects
Publications and source records attributed to M Ellorhaoui.
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Antibiotics are of high importance in iatrogenic pathology. The emergence of resistent strains is a sanitary problem of remarkable consequences particularly under hospital conditions. Modern pulmology is not imaginable without antibiotic and chemotherapeutic drugs. A rational and economic therapy is possible only if the mechanisms and sites of antibacterial action and of drug resistance in bacteria are known.
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Maturity onset diabetes (MOD) is characterized by the fact that the response of insulin secretion to glucose loading is either completely missing or is reduced if compared with that of persons whose metabolism is intact. But insulin secretion can be provoked by other specific stimuli. However, the quantitative IRI response can provide no information as to which of the MO diabetics must be treated by dietetic measures only and which of them are liable to treatment with sulfonylurea. It was, therefore, investigated whether in 109 patients suffering from recently developed overt MOD a differentiation from a therapeutical point of view can be attained by joint evaluation of stimulated IRI secretion, of glucose tolerance, of the dynamics of free fatty acids, of the fasting values of triglycerides and cholesterol and of the body weight. The findings suggest that no better differentiation for the two methods of treatment of MOD stated above is possible by simultaneous evaluation of the parameters of fat metabolism, glucose level and IRI secretion than by IRI secretion and carbohydrate tolerance alone.
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On the basis of a survey is attempted to describe mode of development, symptomatology, individual forms and the different possibilities of therapy of the spontaneous hypoglycaemias. A particularly broad range was devoted to the cerebral sequelae, since in these cases--according to our experience--on account of simulation of neurologico-psychiatric symptoms at the soonest wrong diagnoses are to be expected. Furthermore, it is attempted to classify the hypoglycemias according to their development, in which cases their incompleteness was evident from the very beginning. The individual forms of appearance are treated according their to significance. Out of the inducible hypoglycaemias a particular attention is devoted to the forms caused by insulin and oral antidiabetics, since these most frequently participate in the development. Finally the author inquires into diagnostic measures for recognition of special forms of hypoglycaemia. In this place the diagnostics of hyperinsulinism conditioned by adenomatosis or tumours of other kinds is of particular importance. Finally conservative and operative possibilities of the therapy of these tumours are discussed,whereby the only recently tested treatment with streptotocin is mentioned.
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Various types of insulin secretion may be differentiated in diabetes mellitus. In juvenile diabetes, there can not be induced in general any stimulation of insulin secretion, whereas in maturity-onset type diabetes a significant increase of the serum level was found after stimulation with glucagon or tolbutamide. However, neither moderate glucose doses given orally nor very high glucose doses given intravenously were able to stimulate insulin secretion in some of these patients. These findings suggest a complete insufficiency of beta cell glucose receptors in this specific type of maturity-onset diabetes.
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Incombatibility reactions can be observed in almost all antibiotics and chemotherapeutics. Kind and severity oftthe side effects depend on the terrain component and on the particular antibiotics. Clinical distinctions were made between allergic, toxic and dysmicrobial reactions. Special attention was given to nephrotoxicity and to the side effects of the combination of trimethoprim and sulfomethoxazol.
The number of the Doege-Potter-syndrome cases described above is less than one hundred. Even rarer are thoracic tumours with associated hypoglycaemia. The pathophysiologic mechanisms of the syndrome have not been fully elucidated as yet. There are also divergencies about the etiology of hypoglycaemia. Several hypotheses are under discussion. Even our observation shows the difficulty of discovering the genesis of tumour-conditioned hypoglycaemia.
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