OBJECTIVE: The prevalence of chronic diarrhea in patients with type I and type II diabetes is uncertain, most data being available from tertiary referral centers. We report the prevalence and etiology of chronic diarr...
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OBJECTIVE: The prevalence of chronic diarrhea in patients with type I and type II diabetes is uncertain, most data being available from tertiary referral centers. We report the prevalence and etiology of chronic diarrhea in 861 heterogeneous diabetic patients attending a primary care diabetic outpatient clinic. METHODS: All patients attending the clinic were asked to fill in a questionnaire relating to their bowel habits. Patients who fulfilled the criteria for chronic diarrhea underwent a comprehensive workup to define the cause of the diarrhea. Additional parameters were the mean duration of diabetes, hemoglobin-A1c levels, and the presence of autonomic neuropathy. RESULTS: Chronic diarrhea was diagnosed in 32 patients (overall prevalence of 3.7%). The prevalence of nondiabetic diarrhea was higher among type I diabetic patients than among type II patients (3.29% vs 2.3%), although it did not reach statistical significance. Diabetic diarrhea was more common among type I than type Il diabetic patients (5.2% vs 0.4%, respectively, p < 0.01). The most common cause of nondiabetic diarrhea was medication induced (metformin). CONCLUSIONS: Chronic diarrhea is more frequent in type I diabetic patients. The higher prevalence of diarrhea in this population can be attributed to diabetic diarrhea (which is quite rare in type II patients). The most common cause of nondiabetic diarrhea is drug therapy with metformin. (Am J Gastroenterol 1999;94:2165-2170. (C) 1999 by Am. Coll. of Gastroenterology).
Background: Hemodialysis patients have frequent infections, especially of the vascular access site, and often harbor antimicrobial-resistant pathogens. Therefore a voluntary national system was created to monitor and ...
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Background: Hemodialysis patients have frequent infections, especially of the vascular access site, and often harbor antimicrobial-resistant pathogens. Therefore a voluntary national system was created to monitor and prevent infections in these patients. Methods: From October 1999 to May 2001, participating centers recorded the number of chronic hemodialysis outpatients that were treated (denominator), Several outcome events, including infections of the vascular access site, were monitored, Data were reported on paper forms or via an Internet-based data entry and analysis system. Results: Among 109 participating centers, the vascular access infection rate per 100 patient-months was 3.2 overall and varied markedly by type of vascular access: 0.56 for native arteriovenous fistulas, 1.36 for synthetic arteriovenous grafts, 8.42 for cuffed catheters, and 11.98 for noncuffed catheters. Among 76 dialysis centers reporting at least 200 patient-months of data, 11 had a significantly low and 14 a significantly high rate of vascular access infection. Conclusion: Initial results from the first national project to monitor infections in patients undergoing hemodialysis indicate that vascular access infections were common and that risk varied substantially among different vascular access types and different dialysis centers. These results can be used for quality improvement at individual centers and to help evaluate the efficacy of specific infection control measures.
Although knowledge of safer sex practices is increasing in high-risk populations, such as STD clinic patients, this knowledge does not often translate into behavior change. As a result, STD reinfection rates among cli...
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This project set out to determine whether there is a relationship between the minor emergency facility an individual uses and their choice of a hospital for in-patient care. In studying [his relationship, the factors ...
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