Self testing for diabetes mellitus.

OBJECTIVE--To develop a simple, economically viable, and effective means of population screening for diabetes mellitus. DESIGN--A postal request system for self testing for glycosuria with foil wrapped dipsticks. Preprandial and postprandial tests were compared with a single postprandial test. The subjects were instructed how to test, and a result card was supplied on which to record and return the result. All those recording a positive test result and 50 people recording a negative result were invited for an oral glucose tolerance test. SETTING--General practice in east Suffolk, list size 11534. PATIENTS--All subjects aged 45-70 years registered with the practice were identified by Suffolk Family Health Services Authority (n = 3057). The 73 subjects known to have diabetes from the practice''s register were excluded, leaving 2984 subjects, 2363 (79.2%) of whom responded. 1167 subjects completed the single test and 1196 the two tests. MAIN OUTCOME MEASURES--Response rate and number of patients with glycosuria. Sensitivity, specificity, and positive predictive value of a single postprandial test and preprandial and postprandial tests. Number of new cases of diabetes identified and cost of screening. RESULTS--Of the patients completing the single postprandial test, 29 had a positive result, an oral glucose tolerance test showed that eight (28%) had diabetes, six (21%) impaired glucose tolerance, and 14 (48%) normal glucose tolerance. 44 of the group who tested before and after eating had a positive result; nine (20%) had diabetes, five (11%) impaired tolerance, and 26 (11%) normal tolerance. Screening cost 59p per subject and 81 pounds per case detected. Of the 17 people with previously undiagnosed diabetes, eight were asymptomatic and 11 had not visited their general practitioner in the past three months. CONCLUSIONS--A postal request system for self testing for postprandial glycosuria in people aged 45-70 is a simple and effective method of population screening for diabetes mellitus.     

Self similarity of protein surfaces.

Scaling properties of the surfaces of 53 proteins are studied on the basis of experimentally determined 3-D structures of these biological macromolecules. It is found that the surfaces show self similarity within a yardstick range of 1.5 A less than epsilon less than 15 A. The self similarity is measured by the fractal dimension D of the surface. Two different algorithms for the determination of the fractal dimension are applied, both based on cubic yardstick particles. One is related to the contact surface (CS), which was first introduced by Connolly (17), while the other corresponds to the solvent accessible surface (SAS) of Richards (9). The fractal dimensions of both are different. While the CS type approach leads to relatively high values of D in the range 2.5 to 2.6 the SAS approach gives fractal dimensions of D approximately 2.     

Self referral to accident and emergency department: patients' perceptions.

A study was conducted (a) to assess the number of patients registered with a south London general practice who over 11 weeks referred themselves to an accident and emergency department, (b) to identify the characteristics of those patients, and (c) to determine their perceptions of the services and resources available within their general practices and of the role of accident and emergency departments. Two hundred and thirty four patients referred themselves to a casualty department during the study period, of whom 217 (93%) were interviewed by means of a semistructured questionnaire. Of the 217 patients interviewed, only 15 had tried to contact their general practitioner before attending the casualty department. Eighty nine patients considered that their problem was urgent and required immediate attention and many that they would need an x ray examination. A substantial minority of patients thought that their doctor would not be available. It is concluded that patients'' perceptions of their problems and of access to their doctors are the main determinants of self referral to a casualty department. These findings have important implications for patient education.     

Religion against the Self: An Ethnography of Tamil Rituals.

Religion against the Self: An Ethnography of Tamil Rituals. Isabelle Nabokov. New York: Oxford University Press, 2000. 230 pp.     

Self diffusion of water in frog muscle.

Self diffusion of cell water has been measured at diffusion times ranging form 0.3 ms to 2.4 s for three muscle types of Rana pipiens, using various magnetic field gradient nuclear magnetic resonance methods. Intracellular diffusion coefficients and membrane permeabilities are calculated with the aid of previous theoretical results for regularly spaced permeable planar barriers. The intracellular diffusion coefficient is 1.6 x 10-5 cm2/s, in approximate agreement with other literature values for skeletal muscles. The outer membrane permeabilities are estimated at 0.01 cm/s for two of the muscle types, and much higher for the other one.