[C-peptide measurement in patients with type II diabetes mellitus: its possible use in the insulin therapy decision]. / La medición del péptido C en los pacientes con diabetes mellitus (DM) Tipo II: su posible utilidad en la decisión de terapia insulínica.

Considering pancreatic reserve recognition a more rational basis for starting insulin therapy in NIDDM, during 1988 we studied fasting and post-breakfast plasma C-peptide levels in 31 patients (21 w, 10 m, mean age 48.2 +/- 17.7 yr), referred to our department for insulin therapy evaluation because of primary or secondary failure to other measures. Major features were obesity and chronically uncontrolled illness. Our patients were categorized as follows: group A, considered non responders which included four patients; group B, taken as responders consisting in seven; and a remaining of 20 hyperresponsive patients which formed group C; these with patients of group B, embodied an 87.1% of patients. Among nonresponders there was no any case of total B cell loss of function, and plasma C-peptide activity surpassed through those limits considered for ketoacidosis. We believe that these patients should be eligible candidates for insulin therapy. We failed to found out correlation of plasma C-peptide activity with either age or duration of illness. Our observation supports that fasting plasma C-peptide evaluation would suffice for pancreatic reserve evaluation. We conclude that our patients mainly presented an insulin resistant state associated with obesity thus enhancing the commonplace call for reinforcing nonpharmacologic treatment modalities such as caloric restriction, weight loss and exertion to achieve a better control in NIDDM patients.

[Current status of cardiopulmonary resuscitation in Monterrey, Nuevo León, Mexico]. / Estado actual de la reanimación cardiopulmonar en Monterrey. Nuevo León, México.

Upon a questionnaire based on the international standards of the American Heart Association on Basic Cardiac Life Support (CPR) a survey was conducted to determine the knowledge and capabilities of doctors and nurses of different hospitals of the Mexican Institute of Social Security in Monterrey, NL. The findings reported upon three groups were: the first (A) with informal training, the second group (B) without it, and the 3rd one (C) with formal training in cardiopulmonary resuscitation. Within these first levels and depending on the academic one, seven subgroups were formed. The four basic areas in the questionnaire were evaluated with percentage of correct answers from both, general and individual answers and the results were analyzed through statistical references. Outstanding was the very low number of people with formal training and of those with informal training, only 30% had executed practices with manikins. Both groups A and B had a 64% of correct answers, when compared to the 88% obtained by group C, give us a statistical value of P less than 0.001. Underlining the very low results and outcomes in the four areas analyzed. The conclusion reached is the need of formal training of both medical and nurse staff in the various techniques of cardiopulmonary resuscitation in our community.