Archive for April, 2011

DIABETES: PROBLEMS WITH BLOOD GLUCOSE TESTING

Thursday, April 28th, 2011 | Diabetes | Comments Off

Getting blood If you have problems obtaining blood, a quick test can become a prolonged misery. Some people have thicker skin than others – most finger-pricking systems have several different platforms allowing different depths of penetration of the lancet. Some trial and error will help you to find the right depth. If your fingers are cold you will have trouble obtaining blood. Squeezing the finger tip hard makes it sore and dilutes the blood with serum, giving an unduly low reading. So warm your hands before testing. Milk the blood up from the base of your finger. Another trick to increase blood flow is to shake your hand vigorously with the fingers downwards by your side. See your fingertips go pink. (This is rather like shaking the sauce bottle to get the last drops out!) People with thin skin or who bruise easily need less needle penetration so use a thicker platform. Your fingers should not become sore. If they are ask your diabetic specialist nurse for help.
Inaccurate results If you do not put the right amount of blood on the test strip you will not obtain an accurate answer. Smearing or dabbing invalidates the result as does drowning the pad in a giant drop. If you mistime the reaction the result will be meaningless – this includes failing to look at your watch or not pressing the button on the meter or biosensor immediately. Failure to press the biosensor button as soon as the blood touches the pad will lead to unduly low readings. Do not tilt the strip or biosensor while the blood drop is on the strip. Cold, heat, wind or rain can all make nonsense of the result by affecting the glucose oxidase (heat, cold) or by drying out (heat, wind) or diluting the blood drop (rain).John is 15. He has had diabetes since infancy. He always produces a neat diabetic diary. But his clinic glucose concentrations are always higher than his home tests. One day, away from the hospital, I saw him test his glucose. He pricked his finger, smeared some blood onto the test strip, counted up to sixty out loud, wiped the blood off on his trousers, counted up to sixty (faster this time) and glanced at the strip – “9,” he said, casually.
*6/102/5*

LYME DISEASE

Monday, April 11th, 2011 | Anti-Infectives | Comments Off

Lyme disease is the most common vector-borne illness in the United States and is an important outpatient “hot topic” because its incidence is on the rise. In fact, Healthy People 2010 lists reduction in the incidence of Lyme disease among its public health goals for the next decade. Lyme disease is caused by the spirochete Borrelia burgdorferi. The organism is transmitted by tick vectors, which require host mammals and seasonal variation to complete the life cycle. Lyme disease remains most prevalent in areas that provide a hospitable environment for ticks and their hosts. Prompt diagnosis and treatment are vital to symptom resolution and prevention of long-term sequelae.The incidence of Lyme disease increased more than 30-fold from 1982 to 1996. In 2000, 17,730 cases were reported, representing an 8% increase from 1999. The incidence is highest in the Northeast (especially Connecticut, Rhode Island, New Jersey, New York, Delaware, Pennsylvania, Massachusetts, New Hampshire, and Vermont), the mid-Atlantic (particularly Maryland), and the Midwest (Wisconsin, Minnesota). Lyme disease has also been identified on the West Coast. There are endemic and hyperendemic counties within these states.The distribution of Lyme disease is bimodal, typically occurring in children 5 to 9 years of age and adults 50 to 59 years of age, with a slightly higher number of males affected. The majority of cases occur in June, followed by July and August. People who live and work in residential or wooded areas are at greatest risk. *160/348/5*

 

April 2011
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