ABSTRACT
UNLABELLED: In paediatrics, a diagnosis of Klinefelter syndrome can occur after prenatal testing or because of symptoms such as learning difficulties or incomplete puberty. After the diagnosis, parents have to decide when and how to speak about this condition to their child. Parents and healthcare professionals (HCPs) may have different perceptions related to disclosure of this diagnosis. Due to the absence of clear guidelines, parents and HCPs may feel uncomfortable discussing the condition and may hide the truth in a prolonged fashion. CONCLUSION: For patients with a prenatal diagnosis, we recommend a gradual and personalised disclosure process starting between the ages of 5 and 13 years. For older patients, a personalised approach should also be the goal. Various communication strategies and recommendations regarding disclosure of Klinefelter syndrome are proposed.
Subject(s)
Attitude of Health Personnel , Klinefelter Syndrome/psychology , Parent-Child Relations , Parents/psychology , Professional-Family Relations , Professional-Patient Relations , Truth Disclosure , Adolescent , Age Factors , Child , Child, Preschool , Female , Humans , Klinefelter Syndrome/diagnosis , Male , Pregnancy , Prenatal Diagnosis , Professional-Family Relations/ethics , Professional-Patient Relations/ethics , Truth Disclosure/ethicsABSTRACT
Self-monitoring of blood glucose is a fundamental part of diabetes management. It is mandatory for tight glucose control. For the past 30 years, intermittent measurement of capillary blood glucose has been the method of choice for self-monitoring. The main disadvantage of such measurements is that they provide isolated glucose values which do not reflect variations occurring throughout the day and night. Hence systems monitoring blood glucose concentrations on a "continuous basis" have been developed. In clinical studies, different devices were shown to provide useful information on glycemic excursions in people with diabetes with sufficient accuracy. Thus, in clinical practice, this approach has also been shown to help in the medical management leading to a reduction in glycated hemoglobin and glycemic variability. However, because of lack of experience, this technology has yet to replace standard capillary blood glucose monitoring. In this paper, we review the biochemical perspectives of continuous glucose monitoring and its clinical use in type 1 diabetes.
Subject(s)
Blood Glucose/analysis , Diabetes Mellitus, Type 1/diagnosis , Monitoring, Ambulatory/instrumentation , Humans , Monitoring, Ambulatory/methodsABSTRACT
OBJECTIVES: Because biological data are instrument-dependent and because technology has evolved over the last two decades, the published capillary blood reference values for blood gases, lactate, ionized calcium (iCa) and glucose may not reflect the present day situation. Hence, we report such values for healthy term neonates at 48 +/- 12 h of life. DESIGN AND METHODS: The Institution Ethics Review Board for Research on Human Subjects has accepted the protocol. Extra blood sample was obtained at the time heel-pricks were performed in the frame of the Quebec genetic screening program. One hundred twenty-six term neonates (39.6 +/- 1.2 weeks of gestation) were included in the study. pH, pO2, pCO2, lactate, ionized calcium and glucose were simultaneously measured with selective electrodes on the ABL 735 blood gas analyzer (Radiometer). RESULTS: All variables exhibited a Gaussian distribution. Since there was no gender effect, all data were pooled.
