The artificial endocrine pancreas in clinical practice and research. The present position and future perspectives.

The artificial endocrine pancreas (AEP) is a controlled glucose and/or insulin infusion system in which continuously monitored blood sugar values are fed to a computerised analyser that uses predetermined algorithms to establish the doses to be administered. Since its first appearance in clinical practice and diabetological research during the Sixties, the AEP has been modified in various ways to overcome technical problems associated with the gluco-sensor and algorithms so as to make better use of the glucose-insulin feedback mechanism, and hence obtain a closer correspondence to physiological islet cell activity. As a result of these changes, the AEP can be employed in accordance with the physiopathological principles of insulin secretion in a variety of clinical conditions to secure the short-term control of metabolic alterations in the diabetic. Surgery is one field in which the AEP is used to great advantage, since this and its accompanying anaesthetics are the source of stress, which in turn may result in a rapid and sometimes serious postoperative metabolic derangement, including an increased secretion of anti-insulin hormones. The AEP has also been proposed for diabetic pregnancy and for the treatment of subjects in diabetic coma. It has proved useful in the diagnosis and management of hypoglycaemia due to organic hyperinsulinism, in diabetics with renal failure, in the honeymoon period, and in cases of unstable diabetes. The versatility of its application and its underlying physiopathological principles have enabled the AEP to be predominantly employed in research.(ABSTRACT TRUNCATED AT 250 WORDS)

Circadian periodicity and other clinical features of biliary pain.

We studied the time of onset and other clinical features of biliary pain in 54 patients living in Northern Italy. All patients had cholelithiasis documented by ultrasonography. The time of onset of pain followed a circadian periodicity with its peak occurring at 9:30 p.m. The typical biliary pain was steady, mostly localized in the right upper quadrant of the abdomen or the epigastrium, lasted over 1 h, and required analgesics for relief. The pain was not related to meals or body position. What precipitates biliary pain is still an enigma.

Migrant careers and well-being of women.

PIP: This article deals with the psychosocial adjustment of Latin American female migrants in the US. The analysis focuses on how changes in employment, marital status, family structure, and life-style affect subjective assessments of well-being. Using qualitative and quantitative research methods, the role of these social factors was explored. The psycho-social well-being of migrant women was found to be worse than that of men. Never-married women were equally as demoralized as married women. The disruption of social networks entailed in migration from one country to another may have a greater impact on unmarried than married women. The results of this study are offered as a contribution to the formulation of policy for relocated populations and to the design and implementation of support programs for women in the US regardless of national origin.^ieng