Kaohsiung J Med Sci
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Kaohsiung J Med Sci · Apr 2009
Case ReportsOrtner's syndrome--a rare cause of unilateral vocal cord paralysis: a case report.
Hoarseness attributed to vocal cord palsy is associated with injury to the recurrent laryngeal nerve. Hoarseness resulting from left recurrent laryngeal nerve palsy, cardiovocal syndrome (Ortner's syndrome), has rarely been reported. ⋯ The severity of the vocal cord paralysis was improved by surgical intervention. This case illustrates that life-threatening cardiovascular comorbidities can cause hoarseness and that an impaired recurrent laryngeal nerve might be correctable.
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Kaohsiung J Med Sci · Apr 2009
Adherence to a diabetic care plan provides better glycemic control in ambulatory patients with type 2 diabetes.
Tight control of blood sugar improves the outcomes for diabetic patients, but it can only be achieved by adhering to a well-organized care plan. To evaluate the effect of a diabetes care plan with reinforcement of glycemic control in diabetic patients, 98 ambulatory patients with type 2 diabetes who visited our diabetes clinic every 3-4 months and who completed four education courses given by certified diabetes educators within 3 months after the first visit, were defined as the Intervention group. A total of 82 patients fulfilling the inclusion criteria for the Intervention group but who missed at least half of the diabetes education sessions were selected as controls. ⋯ The maximal HbA1c decrement occurred during the first 3 months, and accounted for 95.6% and 94.6% of the total HbA1c decrements in the Intervention and Control groups, respectively. In the multiple regression model, after adjustment for age, body mass index, and duration of diabetes, the Intervention group may still have a 12.6% improvement in HbA1c from their original value to the end of 1 year treatment compared with the Control group (p < 0.05). Diabetes care, with reinforcement from certified diabetes educators, significantly improved and maintained the effects on glycemic control in ambulatory patients with type 2 diabetes.