[Changes of authorship characteristics in Hungarian medical publications in the period of 1967-97]. / A hazai orvosi közlemények néhány szerzói jellegzetességének változása 1967 és 1997 között.

Authorship characteristics of publications appeared in the 1967-1977-1987-1997 volumes of the Orvosi Hetilap (Medical Weekly) were analysed and compared with corresponding data in the international medical literature. Following results were achieved: 1. The total number of medical publications gradually decreased although the number of pages of the volumes steadily increased during the period studied; this could be explained rather by a changed structure or editorial policy than by lowering of the readiness for publishing. 2. The number of authors per paper gradually increased over a period of forty years, the same trend was observed in the world literature as well. 3. Heads of department are more and more included among the authors; previously they gave preference to the first place, presently they figure mostly as last authors. 4. As to the origin of the communications the pattern did nor change essentially: about half of the papers came from university departments, while about 20 to 30 per cent of the authors worked in hospitals; the remaining papers were the result of cooperations. 5. Both the absolute number of ratio of the dual publication of "original" articles decreased in the last twenty years; the language used for dual publication in international journals markedly changed: while in 1967 both English and German were used with the same frequency, in 1997 English was chosen in 95 per cent of dual publications.--Results were discussed rather shortly, similar studies in the international literature were cited, but authors did not intend neither to outline their's point of view nor to to take part in the current international discussion on authorship.

Diabetes in urban African-Americans. I. Cessation of insulin therapy is the major precipitating cause of diabetic ketoacidosis.

OBJECTIVE: To identify the causes of diabetic ketoacidosis (DKA) in a large urban hospital. RESEARCH DESIGN AND METHODS: Consecutive patients admitted during a 3-month period with a primary diagnosis of DKA and who had moderate-to-severe illness as shown by serum glucose > 13.9 mmol/l ( > 250 mg/dl), bicarbonate < 15 mmol/l, and pH < 7.35 were studied. Diabetes nurse educators interviewed patients and reviewed their medical records for the following: precipitating causes of DKA; content of previous diabetes education; frequency of blood glucose monitoring; recognition of symptoms of metabolic decompensation; and types of medical assistance obtained once patients were ill. RESULTS: There were 56 episodes of DKA, and 75% of the episodes were in patients with known diabetes. In the known diabetic patients, the most common cause of DKA was stopping insulin therapy, which occurred in 67% of episodes. Half of the patients (50%) stopped insulin because of reported lack of money to buy insulin from an outside pharmacy or get transportation to the hospital; 21% stopped insulin because of lack of appetite; 14% stopped insulin because of behavioral or psychological reasons; and 14% did so because they did not know how to manage diabetes on sick days. Of the known diabetic patients, > 80% recalled having been instructed as to blood glucose testing and acute and chronic complications, but fewer patients recalled having been instructed as to insulin dose adjustment (28%) or sick day management (35%). Symptoms of decompensated diabetes were recognized in 55% of the 42 episodes of DKA in patients with known diabetes. However, only 5% of patients contacted the Diabetes Unit when they became ill; the majority (95%) went directly to the emergency room. CONCLUSIONS: DKA occurred most often in patients with known diabetes who stopped insulin therapy because of reported lack of money for purchasing insulin or for transportation to the hospital and limited self-care skills in diabetes management. In urban African-American populations, up to two-thirds of the episodes of DKA may be preventable by improving patient education and access to care.