User:Alteripse/workshop4

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A room off our garage

Sources of controversy Are doctors providing accurate information to each other and to patients?

• What are the best sources of information?
• How much weight does one put on recommendations from various sources?

Can surgery be performed differently to improve the outcome?

• Timing
• Technique

Does this condition require surgical correction? Who is the best person/people to make this decision, and at what age? What is the best way to handle sex assignment in various conditions of ambiguity?

• What are best criteria for best choice?

refs

Mig, wis jcem 45 sdt

Glycosylation is the attachment by molecular bonding of glucose to a larger molecule, usually a [[protein]. This process occurs in animal tissues in variety of both normal and abnormal contexts, involving a wide variety of proteins.

One of the most common contexts in which glycosylation is discussed is diabetes mellitus, a disease charaterized by high levels of glucose in blood and tissues much of the time. This type of glycosylation is spontaneous and non-enzymatic, and described as an Amadori reaction. The amount of glycosylation depends on the amount of glucose present and duration of exposure (i.e., the "lifetime" of the protein). Glycosylation alters the physical properties of some proteins, and this may contribute to tissue damage from chronic hyperglycemia and the subsequent long-term microvascular complications of diabetes.

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In diabetes care, and in medical practice in general, the most well-known glycosylated protein is hemoglobin. Glycosylated hemoglobin is also called glycohemoglobin and hemoglobin A1c in clinical contexts (though there are minor technical distinctions between the terms). The percentage of hemoglobin that is glycosylated reflects the average level of glucose in the blood over the preceding 2-3 months, and is the most important measure of glycemic control in diabetes management.

Possible changes

Nice work from several people. A few changes occurred to me but I'd like to list them here first in case anyone objects:

1. this is a horrible disease, but this should be apparent immediately from the description, so I would leave out "serious"
2. I would be a little more specific than genetic disorder and refer to it as a genetic inborn error of metabolism, which is the usual medical classification
3. mostly males? do you know of a female case? lose "mostly"
4. list the gouty arthritis last rather than first, as all the other manifestations tend to occur earlier.
5. Add growth failure as a major manifestation.

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thus resembling reactive hypoglycemia except that low glucose levels cannot be demonstrated at the time of symptoms and the episodes are not always rapidly relieved by sugar.

reduce the popular confusion produced by the various partly overlapping, partly incompatible usages of the

Hypoglycemia is also a term of contemporary American folk medicine which refers to a recurrent state of symptoms of altered mood and cognitive efficiency, sometimes accompanied by adrenergic symptoms, but not necessarily by measured low blood glucose. The symptoms are primarily those of altered mood, behavior, and mental efficiency. This condition is usually treated by dietary changes which range from simple to elaborate.

This condition therefore overlaps with the condition of hypoglycemia described in the remainder of this article but is not entirely congruent. When low glucose levels can be measured, this condition is what is usually described by physicians as idiopathic reactive hypoglycemia. When glucose levels are not low enough to distinguish the patient's glucose from normal levels, this type of hypoglycemia does not carry the same risks of coma or brain damage as measurable hypoglycemia that meets the Whipple criteria. A variety of terms have been used in the medical literature: functional hypoglycemia, idiopathic postprandial syndrome, pseudohypoglycemia, nonhypoglycemia, and "hypoglycemia". The terms range from favorable to pejorative and reflect the range of attitudes of physicians as much as the nature of the condition. Most hypoglycemia websites describe a conflated mixture of reactive hypoglycemia and idiopathic postprandial syndrome but do not recognize a distinction.