[Communication and interactive education in health and its application to the management of the diabetic patient]. / Comunicaión y educación interactiva en salud y su aplicación al control del paciente diabético.

This article analyzes the need for participation of the groups that are the recipients of health messages in order to make health education more effective. Taking the traditional educational approach as the point of departure, the different options for communication and education processes in this field are explored in depth. The participatory communication model, in which the subject plays the role of both transmitter and recipient, leads to the coproduction of health education messages. In light of the experience of the Diabetes Education Program of the National Endocrinology Institute of Cuba, a health education model based on a strategy of interactive communication is presented. Its objective is to develop in the patient the capability to think and decide about his or her health through discussion groups facilitated by a health care provider. In this model, the beneficiaries of the health message help shape its aim and content. The discussion centers on the patient, taking into account his or her real health needs and feelings. The results obtained with this methodology are reviewed, and it is concluded that this model opens new educational possibilities that will facilitate decision-making with regard to health and healthy lifestyles.

Protein electrophoretic patterns of bovine and porcine ovarian follicular fluid.

Sodium Dodecyl Sulphate polyacrylamide electrophoresis (SDS-PAGE) was used to reveal changes in the protein pattern of porcine and bovine ovarian follicular fluid at different maturational stages. Separate pools were made of follicles with a diameter of 1-2, 3-4, 5-6, 7-8, 9-10 and greater than 11 mm excluding hemorrhagic and cystic follicles. Prior to electrophoresis, estradiol-17 beta and androstenedione were analyzed to define the atresic or healthy state of the follicular. Glucose and total protein content of follicles fluid were determined to assess follicular metabolism. Densitometric analysis of both pig and cow follicular fluids from 3-4 mm follicles revealed a distinct band which was absent in other follicle sizes. On the other hand the protein pattern of follicular fluid of cow and pig showed differences in zones of molecular weight higher than 150,000 and lower than 30,000 dalton. This study suggests the possible existence of a common protein to both species which determines the follicle destiny towards ovulation or atresia.

Posibilidades de un programa de prevención de diabetes mellitus. Revisión bibliográfica. (I. Prevención primaria) / Possibilities of diabetes mellitus prevention programme. Bibliographical review. (I. Primary prevention)

Se analizan posibilidades de prevención en los diferentes tipos de diabetes al enfocar la importancia de los factores ambientales y genéticos. Los factores ambientales se estudian separadamente dividiéndolos en secundarios (aquellos que actúan indirectamente) y primarios (aquellos que actúan directamente). Se analizan los factores virales, la obesidad, la desnutrición, ciertas drogas y el estrés como causas probables de diabetes. Se recomiendan las medidas con potencial éxito para la prevención de las causas más importantes del síndrome diabético. Se precisa la importancia de que estas medidas sean tomadas básicamente sobre los grupos de riesgo, los cuales se enumeran(AU)

Interrelationships of microangiopathy, plasma glucose and other risk factors in 3583 diabetic patients: a multinational study.

In a multinational study, fasting plasma glucose values in 3583 diabetic patients, aged 34-56 years, were related to the characteristics of these subjects and to the presence and severity of microangiopathy as ascertained by standardised methods. The patients were from nine different populations and ranged in number from 193 to 686 per population (London, Warsaw, Berlin (FRG), New Delhi, Tokyo, Havana, Oklahoma Indians, Arizona Pima Indians, and a national sample in Switzerland). In the total group, mean fasting plasma glucose was 8.1 mmol/l for those on diet alone, 9.7 mmol/l for those on oral agents, and 12.7 mmol/l for insulin-treated patients, of whom 25% had values exceeding 16.5 mmol/l. Since many variables were measured in each patient, it was possible to take into account many confounding factors in evaluating the relationship of plasma glucose levels to retinopathy and nephropathy.

[Rehabilitation of the diabetic child in Cuba]. / Rehabilitación del niño diabético en Cuba.

The author describes a series of important steps followed in Cuba for the rehabilitation of the diabetic child, like education of the patient and his relatives, active participation of the child in his treatment (self control), hospital attention advisable for a minimal period exclusively in severe cases, attention in office visits as ambulatory patient, participation in vocational, social and psychological orientation activities of the antidiabetic center, areas for sport and recreation, vocational camping for diabetic children, homes, education through press, television and radio of special programs on diabetes.

Diabetes mellitus and vasopressin sensitive diabetes insipidus.

The rare association of diabetes mellitus and vasopressin sensitive diabetes insipidus found in 5 patients attending the Institute of Endocrinology and Metabolic Diseases in a ten-year period is reported. Suspicious signs and criteria for diagnosis were discussed and a brief review made on the pathogenesis and treatment of this association.

[Our experiences with prehypoglycemic insulin treatment in the care of pregnant diabetics]. / Unsere Erfahrungen mit der prähypoglykämisierenden Insulinbehandlung bei der Betreuung der schwangeren Diabetikerin.

Results are shown obtained from 88 patients who were pregnant and diabetic, treated from November 1972 until November 1976 at the "Gonzalez Coro" Hospital and the Endocrinology Institute of Havana. These patients received a therapeutical regime which took into consideration an increase in the dosis of simple, regular insulin, until the "maximum tolerated dosis" was reached in each case, which was capable of situating this patient in a real prehipoglicemic status. Among the modifications which were introduced was the diet with calories requirements estimated attending to the weight, height and age of the pregnant women. We employed two classifications for the patients: that from Pricilla White modified by Pedersen, and our own institution's, which was aimed to know the "mother-fetus-prognosis". The group includes 17 patients of type A, 14 of type B, 20 of type C, 29 of type D and 8 of type F. These last ones were diagnosed through kidney-biopsia during the puerperium. A fix date for birth was not predeterminated; each patient was allowed to go ahead with her pregnancy until spontaneous delivery began. The rate of cesarean operation was 52%, and the weight of the newborns was within the average limits, except in 4 cases. The perinated death-rate of the group was 3,4% and the Apgar-score at the first minute of life was satisfactory in 79,5% of the group. It is concluded that the individual normoglicemia is essential for the control of the diabetic woman, and that mother's glicemia will have an effect on the fetus, producing a reduction of the gradient of mother-fetus glicemia and, on account of this, also a reduction of the hiperinsulinism reaction of the fetus with all its ill results.

Disgenesia gonadal

Se presenta un estudio hecho en 28 casos de disgenesia gonadal; señalando los signos y síntomas más frecuentes así como la variedad clínica del síndrome. Se hacen conclusiones en cuanto al diagnóstico(AU)