Population, general practitioner and practice characteristics are associated with screening procedures for microvascular complications in Type 2 diabetes care in Norway.

AIMS: To assess population, general practitioner (GP) and practice characteristics associated with the performance of microvascular screening procedures and to propose strategies to improve Type 2 diabetes care. METHODS: A cross-sectional survey in Norway (281 GPs from 77 practices) identified 8246 people with a Type 2 diabetes duration of 1 year or more. We used multilevel regression models with either the recording of at least two of three recommended screening procedures (albuminuria, monofilament, eye examination) or each procedure separately as dependent variable (yes/no), and characteristics related to the person with diabetes, GP or practice as independent variables. RESULTS: The performance of recommended screening procedures was recorded in the following percentages: albuminuria 31.5%, monofilament 27.5% and eye examination 60.0%. There was substantial heterogeneity between practices, and between GPs within practices for all procedures. Compared with people aged 60-69 years, those aged < 50 years were less likely to have an albuminuria test performed [odds ratio (OR) 0.75, 95% CI 0.61 to 0.93] and eye examination (OR 0.79, 95% CI 0.66 to 0.95). People with macrovascular disease had fewer screening procedures recorded (OR 0.68, 95% CI 0.59 to 0.78). Use of an electronic diabetes form was associated with improved screening  (OR 2.65, 95% CI 1.86 to 3.78). GPs with high workload recorded fewer procedures (OR 0.59, 95% CI 0.39 to 0.90). CONCLUSIONS: Performance of screening procedures was suboptimal overall, and in people who should be prioritized. Performance varied substantially between GPs and practices. The use of a structured diabetes form should be mandatory.

Persistent erythrovirus B19 urinary tract infection in an HIV-positive patient.

We report a urinary tract infection (UTI) with erythrovirus B19 in an HIV-1-positive homosexual man persisting for more than 7 months after the decline of viremia after a primary infection. During the course of the UTI, the patient complained of soreness in the kidney region and suffered from transient episodes of edema and hematuria. Proteinuria and elevated serum concentrations of creatinine further substantiated the hypothesis of a renal focus of a persistent erythrovirus B19 infection.

Design and performance of the Phyto-Nutri-Tron: a system for controlling the root and shoot environment for whole-plant ecophysiological studies.

A controlled environment system, termed the Phyto-Nutri-Tron (PNT), has been established to study whole plant ecophysiological responses to multiple environmental factors. The PNT is a computer-controlled highly flexible growth facility with independent control of the shoot and the root environment. The facility consists of two growth cabinets each containing four separate hydroponic growth systems. The growth cabinets can be used as assimilation chambers with individual control of temperature, humidity, light, CO2 and monitoring of O2. The hydroponic growth systems are connected to nutrient supply units with disinfection systems and individual control of temperature, pH and oxygen. The ionic composition of the solutions has automated feedback control through a PO4 autoanalyzer and a flow injection analyzer which also analyzes NH4+, NO2- and NO3-. Other ions are automatically monitored by ICP-AES. The system has automated calibration procedures of the analytical equipment and prolonged studies of plant growth can be performed under constant environmental conditions. This paper describes the design and construction of the PNT, the results of a number of tests showing the degree of control of environmental factors and the results of a comparative study on NH4+ and NO3- uptake kinetics by Juncus effusus conducted in the PNT demonstrate the use of the PNT in ecophysiological studies.

Effects of Air Contact on Growth, Inorganic Carbon Sources, and Nitrogen Uptake by an Amphibious Freshwater Macrophyte.

Callitriche cophocarpa Sendtner is a heterophyllous amphibious macrophyte that produces apical rosettes of floating leaves. The importance of air contact for inorganic carbon and N uptake and for growth was investigated. Plants were grown with the floating rosette in contact with air of various humidities (10, 50, and >90% relative humidity) and with the submerged parts in N-free water at 350 [mu]M free CO2 and the roots in sediment with low or high NH3-N content. Humidity greatly affected the transpiration rate, whereas growth rate and N content were unaffected and were comparable to values measured for fully submerged shoots. Air contact had, however, a significant impact on growth when the free CO2 concentration in the water was low. Thus, the growth rate of shoots with air contact was about 3 times faster than the rate of fully submerged shoots when grown at air-equilibrium concentration of dissolved free CO2 in the water (16 [mu]M). This difference decreased with increased dissolved free CO2 concentration in the water, and the two shoot types grew at the same rate when the submerged shoots received >350 [mu]M free CO2. The quantitative importance of the floating rosette for total carbon uptake declined also with decreased ratio of floating rosette to total shoot weight. It is concluded that floating rosettes can enhance the inorganic carbon uptake of Callitriche. In contrast, air contact is of minor importance for nutrient transport.