The American journal of medicine
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Case Reports
Angioneurotic edema, agranulocytosis, and fatal septicemia following captopril therapy.
Captopril, an angiotensin converting enzyme inhibitor used in the treatment of hypertension, has been associated with hematologic as well as dermatologic side effects. Two patients with captopril-induced angioneurotic edema, one of whom had fatal granulocytopenia and overwhelming polymicrobial sepsis, are presented.
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomized trial of computer-assisted insulin delivery in patients with type I diabetes beginning pump therapy.
Sixteen patients with type I diabetes were randomly assigned to two groups to evaluate the utility of computer-assisted insulin dosage decision-making. All patients used the same solid-phase reagent strip system for glucose measurement and the same pump. The standard group (n = 9) used standard algorithms for insulin adjustment, whereas the computer group (n = 7) relied on interactive instruction from a small, inexpensive (less than $100) computer. ⋯ Hemoglobin A1c values at six weeks correlated with the mean number of blood glucose values charted per week of the study. There was no difference between groups in symptomatic hypoglycemic episodes. Computer-assisted insulin dose decision-making is feasible, safe, and effective in enabling persons with type I diabetes mellitus to achieve lower mean blood glucose values over a six-week period while initiating pump therapy.
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Several major financial trends affecting medical education are delineated and their implications described. To channel these new economic forces in a productive manner, the curriculum of undergraduate and, especially, graduate medical education need to be reevaluated to ensure that medical training is accomplished in an efficient manner and reflects career opportunities of graduates in an era of excess physician supply.