Search

Introduction: The sly start of type 2 diabetes (DM2) very often complicates the patient before diagnosis. An early diagnosis of diabetes is strongly stressed nowadays so as to avoid or retard the progression of chronic complications. But the same emphasis is not put on the urgency of the diagnosis of these complications, at the same time as diabetes is diagnosed. If we consider that around 50% of type 2 diabetics are not aware of their condition, the problem of chronic complications of varied severity in them needs special consideration., Objective: The present study was designed in order to evaluate the presence of chronic complications and their evolutive stage in our population., Patients and Method: Three hundred and two newly diagnosed diabetic patients (NDD) underwent full clinical examination and laboratory evaluation within 30 days of diagnosis. Diagnostic procedures and tests were standardized for each complication., Results: The mean age of the sample was 53±10 years (range, 24-77), with no difference between sexes. Complications were present in 156 patients (51.7%); 70 (44.9%) had one complication and 86 (55.1%) had 2 or more. Hypertension (HTA) was present in 192 (63.6%) NDD, 38.6% had coronary heart disease (by Minnesota Code). Among lipid alterations, low high-density lipoprotein cholesterol was the most frequent (34.6%). Microvascular complications were prevalent both in women and men, in decreasing order: neuropathy (27.5%), nephropathy (20.2%), retinopathy (17.9%). Taking into account the severity of complications, retinopathy showed preponderance in evolutive stage. The silent myocardial infraction seems to be a more frequent pathology than expected (17.7%)., Conclusions: It must be stressed the need for identification of chronic complications immediately after the diagnosis of DM2., (Copyright © 2008 Sociedad Española de Endocrinología y Nutrición. Published by Elsevier Espana. All rights reserved.)

Bacterial agents causing diarrea in patients attended in a hospital of Rosario, Argentina. The frequency of bacterial agents causing diarrhea can vary in patients of different areas, and through the time. In an epidemiological surveillance we studied 304 patients with diarrheal diseases looking for Salmonella enterica, Shigella spp, Campylobacter spp, Aeromonas spp, Yersinia enterocolitica, and diarrheogenic Escherichia coli. C. jejuni was isolated in 30 patients (9,9 %), Salmonella in 18 (5,9 %), and enteropathogenic E. coli (EPEC) in 7 (2,3 %). Most cases due ton C. jejuni had mucus and/or blood in their feces. Unexpectedly we didn't fine any cases due to Shigella spp. There was much less cases due to EPEC than in our previous studies, and occurred only in children of less than 5 years old. It is necesary to take in consideration that C. jejuni cause nearly all the cases of diarrhea in patients with mucus and blood in their feces actually in our region.

An interview system was used to survey 56,199 students in Avellaneda between the ages of 3 and 20 years, representing 60.6% of the population of that age group in the census. The study covered 178 of the 201 pre-schools, grade schools, high schools and special schools in the area. Thirty three diabetic children were identified (18 girls, 15 boys), with a mean of 12.5 years of age. This represents a prevalence of diabetes in the school age population of 0.45/1000 in the 3-12 year old group, 1.25/1000 in the 13-20 year old group, with 0.59/1000 for the total of children surveyed. (93.82 of ascertainement, 95% CI 0.34 to 0.42/1000). Similar figures have resulted from studies in developed countries. The most frequent initial symptoms were the typical ones, with only 15% showing acidosis or diabetic coma as the initiation of the illness. Viral infections and stress appeared to be related to the onset of the disease. Diabetes was in the family history of 48.5% of the diabetic children, and 24.5% of the non-diabetics. The most common diabetic relative was the paternal grandfather. The maternal side showed a higher number of diabetic relatives with preponderance of males. No socio-economic differences were found between diabetics and non-diabetics.

To study the cost-effectiveness of fecal culture in the detection of enteropathogenic or enteroinvasive bacteria, a review and analysis was done of fecal cultures from ambulatory or hospitalized patients treated for acute diarrhea at a Buenos Aires sanatorium during 1985. Of 1,295 fecal cultures performed, pathogens were isolated in 369 cases (28.5%), of which 79 corresponded to Shigella sp. (S. flexnerii, 49; S. sonnei, 29; S. dysenteriae, 2), 25 to Salmonella sp., and 270 to enteropathogenic Escherichia coli (EPEC) of the infant. There was no statistically significant difference between the ambulatory patients and the hospitalized patients in the proportion of positive fecal cultures. The cost of each positive fecal culture was US$ 60.36, while the cost of diagnosing invasion of the mucous membrane (isolation of Shigella sp. or detection of leukocytes in feces) was US$ 109.74. These costs are excessive and could be greatly reduced if the test were applied in only selected cases. Many of the strains of Shigella sp., Salmonella sp., and EPEC that were found were resistant to ampicillin, chloramphenicol, and cotrimoxazole. These cases of resistance suggest that fosfomycin may be one of the antibiotics of choice for the treatment of diarrhea caused by invasive organisms.