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Sample records for adult type alport

  1. X-linked Alport syndrome

    DEFF Research Database (Denmark)

    Jais, Jean Philippe; Knebelmann, Bertrand; Giatras, Iannis

    2003-01-01

    Alport syndrome (AS) is a type IV collagen hereditary disease characterized by progressive hematuric nephritis, hearing loss, and ocular changes. Mutations in the COL4A5 collagen gene are responsible for the more common X-linked dominant form of the disease characterized by much less severe disease...... in girls and women. A "European Community Alport Syndrome Concerted Action" (ECASCA) group was established to delineate the Alport syndrome phenotype in each gender and to determine genotype-phenotype correlations in a large number of families. Data concerning 329 families, 250 of them with an X...... to increase after the age of 60 yr in women. Because of the absence of genotype-phenotype correlation and the large intrafamilial phenotypic heterogeneity, early prognosis of the disease in X-linked Alport syndrome carriers remains moot. Risk factors for developing renal failure have been identified...

  2. Genetics Home Reference: Alport syndrome

    Science.gov (United States)

    ... Testing Registry: Alport syndrome, X-linked recessive Other Diagnosis and Management Resources (3 links) GeneReview: Alport Syndrome and Thin Basement Membrane Nephropathy MedlinePlus Encyclopedia: Alport Syndrome MedlinePlus Encyclopedia: End-Stage ...

  3. Alport's Syndrome in Pregnancy

    OpenAIRE

    Suchita Mehta; Chadi Saifan; Marie Abdellah; Rita Choueiry; Rabih Nasr; Suzanne El-Sayegh

    2013-01-01

    Background. Alport's syndrome is an X-linked hereditary disorder affecting the glomerular basement membrane associated with ocular and hearing defects. In women, the disease is much less severe compared to that in men. However, women with Alport's syndrome can have an accelerated form of their disease during pregnancy with worsening of kidney function and can also develop preeclampsia. There are only four described cases of Alport's syndrome in pregnancy. Case Presentation. 20-year-old woman ...

  4. Alport Syndrome in Women and Girls.

    Science.gov (United States)

    Savige, Judy; Colville, Deb; Rheault, Michelle; Gear, Susie; Lennon, Rachel; Lagas, Sharon; Finlay, Moira; Flinter, Frances

    2016-09-07

    Alport syndrome is an inherited disease characterized by progressive renal failure, hearing loss, and ocular abnormalities. Inheritance is X-linked (85%) or autosomal recessive (15%). Many renal physicians think of Alport syndrome as primarily affecting men. However, twice as many women are affected by the X-linked diseases. Affected women are commonly undiagnosed, but 15%-30% develop renal failure by 60 years and often hearing loss by middle age. Half of their sons and daughters are also affected. Autosomal recessive Alport syndrome is less common, but is often mistaken for X-linked disease. Recessive inheritance is suspected where women develop early-onset renal failure or lenticonus. Their family may be consanguineous. The prognosis for other family members is very different from X-linked disease. Other generations, including parents and offspring, are not affected, and on average only one in four of their siblings inherit the disease. All women with Alport syndrome should have their diagnosis confirmed with genetic testing, even if their renal function is normal, because of their own risk of renal failure and the risk to their offspring. Their mutations indicate the mode of inheritance and the likelihood of disease transmission to their children, and the mutation type suggests the renal prognosis for both X-linked and recessive disease. Women with X-linked Alport syndrome should be tested at least annually for albuminuria and hypertension. The "Expert guidelines for the diagnosis and management of Alport syndrome" recommend treating those with albuminuria with renin-angiotensin-aldosterone system (RAAS) blockade (and adequate birth control because of the teratogenic risks of angiotensin converting enzyme inhibitors), believing that this will delay renal failure. Current recommendations are that women with autosomal recessive Alport syndrome should be treated with RAAS blockade from the time of diagnosis. In addition, women should be offered genetic counseling

  5. Alport's Syndrome in Pregnancy

    Directory of Open Access Journals (Sweden)

    Suchita Mehta

    2013-01-01

    Full Text Available Background. Alport's syndrome is an X-linked hereditary disorder affecting the glomerular basement membrane associated with ocular and hearing defects. In women, the disease is much less severe compared to that in men. However, women with Alport's syndrome can have an accelerated form of their disease during pregnancy with worsening of kidney function and can also develop preeclampsia. There are only four described cases of Alport's syndrome in pregnancy. Case Presentation. 20-year-old woman with a history of Alport's syndrome, which during pregnancy worsened resulting in hypertension, proteinuria, and acute kidney injury. Fortunately, there was complete resolution of the proteinuria and kidney injury with delivery, and the patient did not require any renal replacement therapy. Conclusion. One of the four reported cases had an accelerated form of the disease during pregnancy with rapid progression of kidney injury and end-stage renal disease. There are no definite guidelines to monitor these patients during pregnancy. Further studies are required to understand the exact pathophysiology of kidney damage that occurs in pregnant women with Alport's syndrome. This may give us some insight into the prognostic predictors, so that we can monitor these women more thoroughly and prevent adverse outcomes.

  6. Diffuse esophageal leiomyomatosis in a child with alport syndrome: case report

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    Ko, Hong Seok; Goo, Hyun Woo; Yoon, Chong Hyun [Asan Medical Center, Seoul (Korea, Republic of)

    2004-05-01

    Diffuse esophageal leiomyomatosis is an exceedingly rare, benign, neoplastic condition occurring predominantly in children and young adults. This condition may occur as an isolated finding, or it may be associated with Alport syndrome. We report a case of diffuse esophageal leiomyomatosis with Alport syndrome in a 5-year-old girl who had presented with recurrent pneumonia, and present a review of the literature. We suspected Alport syndrome in the patient because she had a clinical history of congenital cataracts and hematuria, as well as imaging findings of diffuse esophageal leiomyomatosis. Alport syndrome was subsequently confirmed by electron microscopy of the kidney.

  7. Alport syndrome in southern Sweden

    DEFF Research Database (Denmark)

    Persson, U; Hertz, Jens Michael; Wieslander, J

    2005-01-01

    The aim of the present investigation is to study the epidemiology of Alport syndrome in southern Sweden, to search for mutations in the COL4A5 gene and to estimate the mutation frequency.......The aim of the present investigation is to study the epidemiology of Alport syndrome in southern Sweden, to search for mutations in the COL4A5 gene and to estimate the mutation frequency....

  8. Comparative distribution of the alpha 1(IV), alpha 5(IV), and alpha 6(IV) collagen chains in normal human adult and fetal tissues and in kidneys from X-linked Alport syndrome patients.

    OpenAIRE

    Peissel, B; Geng, L.; Kalluri, R.; Kashtan, C; Rennke, H G; Gallo, G R; Yoshioka, K.; Sun, M J; Hudson, B.G.; Neilson, E. G.

    1995-01-01

    We have shown previously that the 5' ends of the genes for the alpha 5(IV) and alpha 6(IV) collagen chains lie head-to-head on Xq22 and are deleted in patients with Alport syndrome (AS)-associated diffuse leiomyomatosis. In this study, we raised a rabbit anti-human alpha 6(IV)chain antibody, demonstrated its specificity by the analysis of recombinant NC1 domains af all six type IV chains, and studied the distribution of the alpha 6(IV) chain in relation to the alpha 1(IV) and alpha 5(IV) chai...

  9. Ocular, Ear and Renal Manifestations of Alport Syndrome in Three Iranian Families

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    Mohammad Hossein Davari

    2014-12-01

    Full Text Available Alport syndrome is a genetic disorder of basement membranes caused by mutations in type IV collagen network. It was first identified by Dr. Alport in 1927. Its major clinical manifestations are included: glomerulopathy, sensory hearing loss, anterior lenticonus, and the prevalence of Alports’ gene in general population is about 1 in 5000 and the disease prevalence is 1 in 10000 [1-3]. Here we report ocular, ear and renal manifestations of Alport syndrome in 3 families that living in the east city of Iran, Birjand, and we have followed all of this family for 6 years so far.

  10. Association of Alport's syndrome with HLA-DR2 antigen in a group of unrelated patients

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    E.A. Donadi

    1998-04-01

    Full Text Available A few family studies have evaluated HLA antigens in Alport's syndrome; however, there are no large population studies. In the present report, we studied 40 unrelated white patients with Alport's syndrome seen at the Unit of Renal Transplantation, Faculty of Medicine of Ribeirão Preto, São Paulo, Brazil. HLA-A, -B, -DR and -DQ antigens were typed using a complement-dependent microlymphocytotoxicity assay. A control white population (N = 403 from the same geographical area was also typed for HLA antigens. Although the frequencies of HLA-A and -B antigens of patients were not statistically different from controls, the frequency of HLA-DR2 antigen observed in patients (65% was significantly increased in relation to controls (26%; P<0.001. The relative risk and etiologic fraction for HLA-DR2 antigen were 5.2 and 0.525, respectively. Although few immunological abnormalities have been shown in Alport's syndrome, in this report we emphasize the association of HLA molecules and Alport's syndrome. Besides the well-known inherited molecular defects encoded by type IV collagen genes in Alport's syndrome, the major histocompatibility alleles may be in linkage disequilibrium with these defective collagen genes

  11. X-linked Alport syndrome

    DEFF Research Database (Denmark)

    Jais, J P; Knebelmann, B; Giatras, I

    2000-01-01

    . Considerable allelic heterogeneity has been observed. A "European Community Alport Syndrome Concerted Action" has been established to delineate accurately the AS phenotype and to determine genotype-phenotype correlations in a large number of families. Data concerning 329 families, 250 of them with an X......-linked transmission, were collected. Characteristics of the 401 male patients belonging to the 195 families with COL4A5 mutation are presented. All male patients were hematuric, and the rate of progression to end-stage renal failure and deafness was mutation-dependent. Large deletions, non-sense mutations, or small...... mutations changing the reading frame conferred to affected male patients a 90% probability of developing end-stage renal failure before 30 yr of age, whereas the same risk was of 50 and 70%, respectively, in patients with missense or splice site mutation. The risk of developing hearing loss before 30 yr...

  12. Combined Alport syndrome and Klinefelter syndrome.

    Science.gov (United States)

    Nishida, Masashi; Hashimoto, Fusako; Kaito, Hiroshi; Nozu, Kandai; Iijima, Kazumoto; Asada, Dai; Hamaoka, Kenji

    2016-02-01

    To date, there have been a very limited number of case reports on combined Alport syndrome (AS) and Klinefelter syndrome (KS). We herein describe the case of a 9-month-old boy diagnosed with concomitant AS and KS. KS was detected on chromosomal analysis of the amniotic fluid, and hematuria/proteinuria was identified in urinary screening at 6 months of age. Renal biopsy indicated AS, with complete deficit of the α5 chain of type IV collagen in the glomerular basement membranes. On genetic analysis for AS, de novo homozygote mutation (c.3605-2a > c) was seen in the gene encoding α5 chain of type IV collagen (COL4A5) on the X chromosomes of maternal origin. This is the first case report of combined AS and KS diagnosed during infancy, and it indicates the need to consider the concurrent existence of these two disorders in infants with urine abnormalities, even in the absence of a family history.

  13. The 2014International Workshop on Alport Syndrome.

    Science.gov (United States)

    Miner, Jeffrey H; Baigent, Colin; Flinter, Frances; Gross, Oliver; Judge, Parminder; Kashtan, Clifford E; Lagas, Sharon; Savige, Judith; Blatt, Dave; Ding, Jie; Gale, Daniel P; Midgley, Julian P; Povey, Sue; Prunotto, Marco; Renault, Daniel; Skelding, Jules; Turner, A Neil; Gear, Susie

    2014-10-01

    Alport syndrome, historically referred to as hereditary glomerulonephritis with sensorineural deafness and anterior lenticonus, is a genetic disease of collagen α3α4α5(IV) resulting in renal failure. The collagen α3α4α5(IV) heterotrimer forms a network that is a major component of the kidney glomerular basement membrane (GBM) and basement membranes in the cochlea and eye. Alport syndrome, estimated to affect 1 in 5000-10,000 individuals, is caused by mutations in any one of the three genes that encode the α chain components of the collagen α3α4α5(IV) heterotrimer: COL4A3, COL4A4, and COL4A5. Although angiotensin-converting enzyme inhibition is effective in Alport syndrome patients for slowing progression to end-stage renal disease, it is neither a cure nor an adequate long-term protector. The 2014 International Workshop on Alport Syndrome, held in Oxford, UK, from January 3-5, was organized by individuals and families living with Alport syndrome, in concert with international experts in the clinical, genetic, and basic science aspects of the disease. Stakeholders from diverse communities-patient families, physicians, geneticists, researchers, Pharma, and funding organizations-were brought together so that they could meet and learn from each other and establish strategies and collaborations for the future, with the overall aim of discovering much needed new treatments to prolong kidney function.

  14. A Novel Mutation in a Kazakh Family with X-Linked Alport Syndrome.

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    Barshagul T Baikara

    Full Text Available Alport syndrome is a genetic condition that results in hematuria, progressive renal impairment, hearing loss, and occasionally lenticonus and retinopathy. Approximately 80% of Alport syndrome cases are caused by X-linked mutations in the COL4A5 gene encoding type IV collagen. The objective of this study was to define the SNP profiles for COL4A5 in patients with hereditary nephritis and hematuria. For this, we examined four subjects from one Kazakh family clinically affected with X-linked Alport syndrome due to COL4A5 gene mutations. All 51 exons of the COL4A5 gene were screened by linkage analysis and direct DNA sequencing, resulting in the identification of a novel mutation (G641E in exon 25. The mutation was found only in two affected family individuals but was not present in healthy family members or 200 unrelated healthy controls. This result demonstrates that this novel mutation is pathogenic and has meaningful implications for the diagnosis of patients with Alport syndrome.

  15. Podocyturia: A Clue for the Rational Use of Amiloride in Alport Renal Disease

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    H. Trimarchi

    2016-01-01

    Full Text Available No specific or efficient treatment exists for Alport syndrome, an X-linked hereditary disease caused by mutations in collagen type IV, a crucial component of the glomerular basement membrane. Kidney failure is usually a major complication of the disease, and patients require renal replacement therapy early in life. Microhematuria and subsequently proteinuria are hallmarks of kidney involvement, which are due to primary basement membrane alterations that mainly cause endothelial thrombosis and podocyte contraction and ulterior irreversible detachment. Commonly drug-based approaches include angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, which are employed to reduce proteinuria and thus retard kidney disease progression and cardiovascular morbidity and mortality. However, as any hereditary disease, it is expressed as early as in the intrauterine life, and usually an index case is helpful to detect family-related cases. As no specific treatment exists, pathophysiologically based approaches are useful. The present case illustrates the reduction rate of urinary podocyte loss and proteinuria after amiloride administration and suggests the molecular pathways involved in Alport renal disease. Finally, podocyturia rather than proteinuria should be considered as an earlier biomarker of kidney involvement and disease progression in Alport disease.

  16. Podocyturia: A Clue for the Rational Use of Amiloride in Alport Renal Disease

    Science.gov (United States)

    Trimarchi, H.; Canzonieri, R.; Muryan, A.; Schiel, A.; Araoz, A.; Paulero, M.; Andrews, J.; Rengel, T.; Forrester, M.; Lombi, F.; Pomeranz, V.; Iriarte, R.; Zotta, E.

    2016-01-01

    No specific or efficient treatment exists for Alport syndrome, an X-linked hereditary disease caused by mutations in collagen type IV, a crucial component of the glomerular basement membrane. Kidney failure is usually a major complication of the disease, and patients require renal replacement therapy early in life. Microhematuria and subsequently proteinuria are hallmarks of kidney involvement, which are due to primary basement membrane alterations that mainly cause endothelial thrombosis and podocyte contraction and ulterior irreversible detachment. Commonly drug-based approaches include angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, which are employed to reduce proteinuria and thus retard kidney disease progression and cardiovascular morbidity and mortality. However, as any hereditary disease, it is expressed as early as in the intrauterine life, and usually an index case is helpful to detect family-related cases. As no specific treatment exists, pathophysiologically based approaches are useful. The present case illustrates the reduction rate of urinary podocyte loss and proteinuria after amiloride administration and suggests the molecular pathways involved in Alport renal disease. Finally, podocyturia rather than proteinuria should be considered as an earlier biomarker of kidney involvement and disease progression in Alport disease. PMID:26942026

  17. Alport syndrome. Molecular genetic aspects

    DEFF Research Database (Denmark)

    Hertz, Jens Michael

    2009-01-01

    of AS is caused by mutation in the COL4A5 gene located at Xq22, and encoding the alpha 5-chain of type IV-collagen. The COL4A5 gene is a very large gene spanning 257 kb with a transcript of 6.5 kb distributed on 51 exons. In addition, two alternatively transcribed exons have been identified. In the second part...... 41A and 41B were directly sequenced. The PCR-SSCP method was compared to direct sequencing in 15 of the cases. No difference in mutation detection rates were found. Finally, a method based on RT-PCR analysis of mRNA extracted from cultured skin fibroblasts was established. A mutation in a patient...... a diagnosis of X-linked AS. A total of 64 different and putative disease causing mutations were found in 72 of the families. Half of the mutations identified were missense mutations. The most frequent mutations in AS were glycine substitutions in the Gly-Xaa-Yaa repeat sequence in the collagenous domain...

  18. Síndrome de Alport: estudo de uma família Alport's syndrome: a family study

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    Fernando Antônio de Macedo Leal

    2000-12-01

    Full Text Available Objetivo: A síndrome de Alport caracteriza-se por nefropatia hereditária, geralmente associada à surdez neurossensorial (Alport, 1927 e alterações oculares (Sohar, 1954. Estudaram-se as manifestações da síndrome em membros de uma mesma família, considerando aspectos clínicos e genéticos. Pacientes e Método: Foram submetidos a exame oftalmológico quinze indivíduos de uma família, dos quais quatro apresentavam síndrome de Alport. Os exames foram realizados na Clínica Oftalmológica do Hospital Getúlio Vargas - Universidade Federal do Piauí (HGV/UFPI. Resultados: Revelaram-se quatro indivíduos afetados pela síndrome de Alport, dos quais três apresentavam surdez moderada, lenticone anterior bilateral e nefropatia crônica, e um tinha manifestação renal isolada. Todos os pacientes eram brancos, do sexo masculino, com idade entre 12 e 25 anos. A acuidade visual dos olhos com lenticone variou de 20/50 a 20/100. Conclusões: A análise da família identificou três casos confirmados e um suspeito, sugerindo padrão de herança recessiva ligada ao X, não sendo possível afastar a herança autossômica dominante com penetrância incompleta.Purpose: Alport's Syndrome is characterized by hereditary nephritis, usually associated with neurosensitve deafness (Alport, 1927 and ocular disease (Sohar, 1954. Thus we intended to analize manifestations of the syndrome in a family, regarding clinical and genetical aspects. Patients and method: Fifteen patients of the same family of which four had Alport´s syndrome were submitted to ophthalmologic examination. The examinations were performed at the Ophthalmologic Clinic of HGV/UFPI. Results: Four patients with Alport´s syndrome were revealed, of which three had moderate deafness, anterior lenticonus and chronic nephropathy, and one of them had renal disease alone. All the patients were white, male aged 12 to 25 years. The visual acuity of eyes with lenticonus varied between 20/50 and 20

  19. X-Linked and Autosomal Recessive Alport Syndrome

    DEFF Research Database (Denmark)

    Savige, Judith; Storey, Helen; Il Cheong, Hae

    2016-01-01

    Alport syndrome results from mutations in the COL4A5 (X-linked) or COL4A3/COL4A4 (recessive) genes. This study examined 754 previously- unpublished variants in these genes from individuals referred for genetic testing in 12 accredited diagnostic laboratories worldwide, in addition to all publishe...

  20. Collagen alpha5 and alpha2(IV) chain coexpression: analysis of skin biopsies of Alport patients.

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    Patey-Mariaud de Serre, N; Garfa, M; Bessiéres, B; Noël, L H; Knebelmann, B

    2007-08-01

    Alport syndrome is a collagen type IV disease caused by mutations in the COL4A5 gene with the X-linked form being most prevalent. The resultant alpha5(IV) collagen chain is a component of the glomerular and skin basement membranes (SBMs). Immunofluorescent determination of the alpha5(IV) chain in skin biopsies is the procedure of choice to identify patients. In 30% of patients, however, the mutant protein is still found in the SBM resulting in a normal staining pattern. In order to minimize or eliminate false results, we compared the distribution of the alpha2(IV) chain (another SBM component) and the alpha5(IV) chain by standard double label immunofluorescence (IF) and by confocal laser scanning microscopy. The study was performed on 55 skin biopsies of patients suspected of Alports and five normal control specimens. In normal skin, IF showed the classical linear pattern for both collagens along the basement membrane. Additionally, decreased alpha5(IV) was found in the bottom of the dermal papillary basement membrane. Confocal analysis confirmed the results and show alpha5(IV) focal interruptions. In suspected patients, both techniques showed the same rate of abnormal alpha5(IV) expression: segmental in women and absent in men. Our results show a physiological variation of alpha5(IV) location with focal interruptions and decreased expression in the bottom of the dermal basement membrane. Comparison of alpha5(IV) with alpha2(IV) expression is simple and eliminates technical artifacts.

  1. Two Pregnancies with a Different Outcome in a Patient with Alport Syndrome

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    Biljana Gerasimovska Kitanovska

    2016-07-01

    CONCLUSIONS: Pre-pregnancy counselling and frequent controls during pregnancy are necessary for women with Alport syndrome, as well as regular monitoring after delivery. Recent reports are more in favour of good pregnancy and nephrological outcomes in women with Alport syndrome when renal disease is not advanced.

  2. Outcomes of male patients with Alport syndrome undergoing renal replacement therapy

    DEFF Research Database (Denmark)

    Temme, Johanna; Kramer, Anneke; Jager, Kitty J;

    2012-01-01

    Patients with the hereditary disease Alport syndrome commonly require renal replacement therapy (RRT) in the second or third decade of life. This study compared age at onset of RRT, renal allograft, and patient survival in men with Alport syndrome receiving various forms of RRT (peritoneal dialys...

  3. Immunohistochemical diagnosis of Alport's syndrome in paraffin-embedded renal sections: antigen retrieval with autoclave heating.

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    Naito, Ichiro; Ninomiya, Yoshifumi; Nomura, Shinsuke

    2003-03-01

    Alport's syndrome (AS) is a hereditary renal disease caused by mutations in the genes encoding collagen type IV. Immunohistochemical analysis of the alpha chains of collagen type IV has been found to be useful for the diagnosis of this disease. The monoclonal antibodies (mAbs) generated by us recognize alpha 1(IV) through alpha 6(IV) chains of collagen type IV on fresh-frozen sections but not on paraffin-embedded sections. Antigen retrieval by autoclave heating has been found to restore the epitopes recognized by the mAbs; however the heating conditions had not been well established. In this study, the heating conditions were carefully examined using renal sections obtained from AS and non-AS patients. The heating was performed in an autoclave, at 105 degrees -127 degrees C for 6-8 min. During the heating, the sections were immersed in 0.2 N HCl solution (pH 0.9). Then, the mAbs were applied for 30 min, and the bound mAbs were detected using the LSAB kit. The optimal temperature for the antigen retrieval varied among specimens, and was dependent on the type of basement membrane examined. Thus, it was considered that heating at two or three different temperatures could be helpful for the precise diagnosis of AS. Adopting the antigen retrieval method could extend the possibility of immunohistochemical diagnosis of AS to cases without using fresh-frozen sections.

  4. Cataract in a patient with the Alport syndrome and diffuse Leiomyomatosis Catarata em paciente com sindrome de alport e leiomiomatose difusa

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    Luis Santiago - Cabán

    2008-12-01

    Full Text Available We describe a case of painless progressive loss of vision in a 15 years old male patient with Alport syndrome and diffuse Leiomyomatosis. After a comprehensive history and ocular examination, a diagnosis of bilateral posterior subcapsular cataracts was given. Patient underwent cataract extraction. His best corrected post-operative visual acuity was 20/25 in both eyes. We conclude that posterior subcapsular cataracts may lead to painless and progressive loss of vision in patients with Alport syndrome and Diffuse Leiomyomatosis.Nós descrevemos o caso de perda visual progressiva indolor em um paciente de 15 anos, sexo masculino, com Síndrome de Alport e Leiomiomatose difusa. Após história completa e exame oftalmológico, foi feito o diagnóstico de catarata subcapsular posterior bilateral. O paciente foi submetido à cirurgia de catarata. Nós concluímos que cataratas subcapsulares posteriores podem levar a perda visual progressiva e indolor em pacientes com Síndrome de Alport e Leiomiomatose Difusa.

  5. Histopathological types in adult nephrotic syndrome

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    Md. Ghulam Yusuf

    2016-01-01

    Full Text Available In Bangladesh, there are very few studies about biopsy proven adult Nephrotic syndrome (NS with histological types and their clinical findings. To determine the histological types of glomerulonephritis (GN in adult NS and correlate them with the clinical presentations and biochemical parameters, we studied 100 biopsies in 87 patients who underwent ultrasonography- guided renal biopsy in Rangpur Medical College and Hospital from July 2010 to June 2012. The mean age of the patients was 32.8 ± 13.2 years; male was preponderance (72.4% and most of the patients (67.8% came from rural areas. Membranoproliferative GN (MPGN was the most common underlying cause that was found in 32 (36.8% patients followed by mesangial prolife- rative GN in 27 (31% patients, membranous GN in 16 (18.4% cases, minimal change disease in four (4.6% patients, diffuse proliferative GN in four (4.6% patients, focal segmental GN, and focal proliferative GN in two (2.4% patients each. High proteinuria level was found in minimal change disease, which was 7.59 ± 0.24 g/24 h (mean ± standard deviation. The most common symptoms were oliguria (92% and edema (86.2% followed by hematuria (dark urine (72.4% and hypertension (35.6%. MPGN was the most common histological type of adult NS in Rangpur.

  6. Mutation in the alpha 5(IV) collagen chain in juvenile-onset Alport syndrome without hearing loss or ocular lesions

    DEFF Research Database (Denmark)

    Zhou, J; Hertz, Jens Michael; Tryggvason, K

    1992-01-01

    -specific probes confirmed the inheritance of the mutation with the phenotype. The mutation changed the GGC codon for glycine-1143 to GAC for aspartate. Substitution of glycine-1143, located in the collagenous domain of the alpha 5(IV) chain, for any other amino acid can be expected to interfere......A single base mutation was identified in the type IV collagen alpha 5 chain gene (COL4A5) of a Danish kindred with Alport syndrome. The 27-year-old male proband developed hematuria in childhood and terminal renal failure at the age of 25 years. He has no hearing loss or ocular lesions. Electron...... gradient gel electrophoresis analysis suggested a sequence variant in the proband and his mother. This was confirmed by sequencing of the PCR-amplified exon 14 region of the hemizygous proband, which demonstrated the base change G----A abolishing an MspI restriction site. Hybridization analysis with allele...

  7. Alport syndrome: significance of gingival biopsy in the initial diagnosis and periodontal evaluation after renal transplantation.

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    Toygar, Hilal Uslu; Toygar, Okan; Guzeldemir, Esra; Cilasun, Ulkem; Nacar, Ahmet; Bal, Nebil

    2009-01-01

    Alport Syndrome (AS) is an important hereditary disorder affecting the glomerular basement membrane. Diagnosis of AS is based on the presence of hematuric nephropathy, renal failure, hearing loss, ocular abnormalities and changes in the glomerular basement membrane of the lamina densa. The aims of this case report were to show the changes in the gingival tissues in a patient with AS under therapy with cyclosporin-A after renal transplantation and to discuss the possible role of type IV collagen in gingival basal lamina as an alternative approach for the diagnosis of AS. A 20-year-old male patient with AS underwent periodontal therapy including a series of gingivectomy surgeries. Gingival samples obtained during the second surgery were examined histopathologically and by transmission electron microscopy for further pathological examination. Gingivectomy procedures have been performed every 6 months over the last 4 years. The excessive and fibrous gingival enlargements resulted in migration of the anterior teeth, but no alveolar bone loss occurred. This is the first report to demonstrate the possible changes in the gingival tissues caused by AS. It is suggested that gingival biopsy can be an initial diagnostic tool instead of renal or skin biopsies. Proper dental and periodontal care and regular visits to the dentist could provide limited gingival hyperplasia to patients with AS.

  8. Alport syndrome: significance of gingival biopsy in the initial diagnosis and periodontal evaluation after renal transplantation

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    Hilal Uslu Toygar

    2009-12-01

    Full Text Available Alport Syndrome (AS is an important hereditary disorder affecting the glomerular basement membrane. Diagnosis of AS is based on the presence of hematuric nephropathy, renal failure, hearing loss, ocular abnormalities and changes in the glomerular basement membrane of the lamina densa. The aims of this case report were to show the changes in the gingival tissues in a patient with AS under therapy with cyclosporin-A after renal transplantation and to discuss the possible role of type IV collagen in gingival basal lamina as an alternative approach for the diagnosis of AS. A 20-year-old male patient with AS underwent periodontal therapy including a series of gingivectomy surgeries. Gingival samples obtained during the second surgery were examined histopathologically and by transmission electron microscopy for further pathological examination. Gingivectomy procedures have been performed every 6 months over the last 4 years. The excessive and fibrous gingival enlargements resulted in migration of the anterior teeth, but no alveolar bone loss occurred. This is the first report to demonstrate the possible changes in the gingival tissues caused by AS. It is suggested that gingival biopsy can be an initial diagnostic tool instead of renal or skin biopsies. Proper dental and periodontal care and regular visits to the dentist could provide limited gingival hyperplasia to patients with AS.

  9. Laminin α2-mediated focal adhesion kinase activation triggers Alport glomerular pathogenesis.

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    Delimont, Duane; Dufek, Brianna M; Meehan, Daniel T; Zallocchi, Marisa; Gratton, Michael Anne; Phillips, Grady; Cosgrove, Dominic

    2014-01-01

    It has been known for some time that laminins containing α1 and α2 chains, which are normally restricted to the mesangial matrix, accumulate in the glomerular basement membranes (GBM) of Alport mice, dogs, and humans. We show that laminins containing the α2 chain, but not those containing the α1 chain activates focal adhesion kinase (FAK) on glomerular podocytes in vitro and in vivo. CD151-null mice, which have weakened podocyte adhesion to the GBM rendering these mice more susceptible to biomechanical strain in the glomerulus, also show progressive accumulation of α2 laminins in the GBM, and podocyte FAK activation. Analysis of glomerular mRNA from both models demonstrates significant induction of MMP-9, MMP-10, MMP-12, MMPs linked to GBM destruction in Alport disease models, as well as the pro-inflammatory cytokine IL-6. SiRNA knockdown of FAK in cultured podocytes significantly reduced expression of MMP-9, MMP-10 and IL-6, but not MMP-12. Treatment of Alport mice with TAE226, a small molecule inhibitor of FAK activation, ameliorated fibrosis and glomerulosclerosis, significantly reduced proteinuria and blood urea nitrogen levels, and partially restored GBM ultrastructure. Glomerular expression of MMP-9, MMP-10 and MMP-12 mRNAs was significantly reduced in TAE226 treated animals. Collectively, this work identifies laminin α2-mediated FAK activation in podocytes as an important early event in Alport glomerular pathogenesis and suggests that FAK inhibitors, if safe formulations can be developed, might be employed as a novel therapeutic approach for treating Alport renal disease in its early stages.

  10. Laminin α2-mediated focal adhesion kinase activation triggers Alport glomerular pathogenesis.

    Directory of Open Access Journals (Sweden)

    Duane Delimont

    Full Text Available It has been known for some time that laminins containing α1 and α2 chains, which are normally restricted to the mesangial matrix, accumulate in the glomerular basement membranes (GBM of Alport mice, dogs, and humans. We show that laminins containing the α2 chain, but not those containing the α1 chain activates focal adhesion kinase (FAK on glomerular podocytes in vitro and in vivo. CD151-null mice, which have weakened podocyte adhesion to the GBM rendering these mice more susceptible to biomechanical strain in the glomerulus, also show progressive accumulation of α2 laminins in the GBM, and podocyte FAK activation. Analysis of glomerular mRNA from both models demonstrates significant induction of MMP-9, MMP-10, MMP-12, MMPs linked to GBM destruction in Alport disease models, as well as the pro-inflammatory cytokine IL-6. SiRNA knockdown of FAK in cultured podocytes significantly reduced expression of MMP-9, MMP-10 and IL-6, but not MMP-12. Treatment of Alport mice with TAE226, a small molecule inhibitor of FAK activation, ameliorated fibrosis and glomerulosclerosis, significantly reduced proteinuria and blood urea nitrogen levels, and partially restored GBM ultrastructure. Glomerular expression of MMP-9, MMP-10 and MMP-12 mRNAs was significantly reduced in TAE226 treated animals. Collectively, this work identifies laminin α2-mediated FAK activation in podocytes as an important early event in Alport glomerular pathogenesis and suggests that FAK inhibitors, if safe formulations can be developed, might be employed as a novel therapeutic approach for treating Alport renal disease in its early stages.

  11. Quaternary epitopes of α345(IV) collagen initiate Alport post-transplant anti-GBM nephritis

    DEFF Research Database (Denmark)

    Olaru, Florina; Luo, Wentian; Wang, Xu-Ping

    2013-01-01

    Alport post-transplant nephritis (APTN) is an aggressive form of anti-glomerular basement membrane disease that targets the allograft in transplanted patients with X-linked Alport syndrome. Alloantibodies develop against the NC1 domain of α5(IV) collagen, which occurs in normal kidneys, including...... of alloantibodies against allogeneic collagen IV. Some alloantibodies targeted alloepitopes within α5NC1 monomers, shared by α345NC1 and α1256NC1 hexamers. Other alloantibodies specifically targeted alloepitopes that depended on the quaternary structure of α345NC1 hexamers. In Col4a5-null mice, immunization...... with native forms of allogeneic collagen IV exclusively elicited antibodies to quaternary α345NC1 alloepitopes, whereas alloimmunogens lacking native quaternary structure elicited antibodies to shared α5NC1 alloepitopes. These results imply that quaternary epitopes within α345NC1 hexamers may initiate...

  12. Next generation sequencing as a useful tool in the diagnostics of mosaicism in Alport syndrome.

    Science.gov (United States)

    Beicht, Sonja; Strobl-Wildemann, Gertrud; Rath, Sabine; Wachter, Oliver; Alberer, Martin; Kaminsky, Elke; Weber, Lutz T; Hinrichsen, Tanja; Klein, Hanns-Georg; Hoefele, Julia

    2013-09-10

    Alport syndrome (ATS) is a progressive hereditary nephropathy characterized by hematuria and/or proteinuria with structural defects of the glomerular basement membrane. It can be associated with extrarenal manifestations (high-tone sensorineural hearing loss and ocular abnormalities). Somatic mutations in COL4A5 (X-linked), COL4A3 and COL4A4 genes (both autosomal recessive and autosomal dominant) cause Alport syndrome. Somatic mosaicism in Alport patients is very rare. The reason for this may be due to the difficulty of detection. We report the case of a boy and his mother who presented with Alport syndrome. Mutational analysis showed the novel hemizygote pathogenic mutation c.2396-1G>A (IVS29-1G>A) at the splice acceptor site of the intron 29 exon 30 boundary of the COL4A5 gene in the boy. The mutation in the mother would not have been detected by Sanger sequencing without the knowledge of the mutational analysis result of her son. Further investigation of the mother using next generation sequencing showed somatic mosaicism and implied potential germ cell mosaicism. The mutation in the mother has most likely occurred during early embryogenesis. Analysis of tissue of different embryonic origin in the mother confirmed mosaicism in both mesoderm and ectoderm. Low grade mosaicism is very difficult to detect by Sanger sequencing. Next generation sequencing is increasingly used in the diagnostics and might improve the detection of mosaicism. In the case of definite clinical symptoms of ATS and missing detection of a mutation by Sanger sequencing, mutational analysis should be performed by next generation sequencing.

  13. Cholesterol and Alzheimer Type Dementia among Adults with Down Syndrome

    Science.gov (United States)

    Buckley, Frank

    2008-01-01

    This article reports a summary of research by Warren Zigman and colleagues investigating the link between cholesterol levels and Alzheimer type dementia among adults with Down syndrome. Warren Zigman and colleagues followed 123 adults with Down syndrome between May 1998 and April 2006. The participants were aged between 41 and 78 years at the…

  14. Type 2 Diabetes Widespread in Adults

    Science.gov (United States)

    ... be able to prevent or delay type 2 diabetes by cutting calories and increasing your physical activity to lose a modest amount of weight. A major study of people with pre-diabetes showed that lifestyle changes leading to a 5- ...

  15. Features of gene mutation and clinical phenotype in Alport syndrome%Alport 综合征家系的基因突变及临床表型分析

    Institute of Scientific and Technical Information of China (English)

    何威; 高春林; 夏正坤

    2016-01-01

    was used to identify gene mutations of related family mem-bers.Provean database was applied in protein function prediction.We collected and analyzed clinical data of AS patients on the basis of gene mutation. Results All 30 children were diagnosed with AS by gene sequencing, among whom 4 boys were autosomal reces-sive inheritance, 16 boys and 10 girls were X-linked Alport syndrome.Next-generation sequencing detected 35 different gene mutations of COL4A3, COL4A4, COL4A5, including 19 missense mutations, 2 synonymous mutations, 4 splice-site mutations, 3 truncating mu-tations, 2 insertion mutations, 4 deletion mutations and 1 compound mutations.It was observed by Sanger sequencing that 20 mutations were inherited from the mother, 8 from the father, homozygous mutation in 1 propositus from the parents respectively, 8 novel mutations and 1 with unidentified source.All the 30 children had an onset of hematuria or proteinuria, 17 cases had a positive family history, 1 case had hearing loss, and no pathogenesis or renal insufficiency was found in the children.Renal biopsy was performed on 23 children, 13 minimal change disease ( MCD) and 10 mesangial proliferative glo-merulonephritis ( MsPNG) by light microscope.Extensive lamination and split of glomerular basement membrane dense layers were found in 9 children by electron microscope. Conclusion XLAS ac-counts for most AS patients and missense mutation is the main type in pathogenic mutations.Altogether, 31 mutations without disease notification were found.Most of children showed MCD in renal biopsy, with atypical electron microscope manifestations and rare extra renal manifestations.

  16. Adult-type hypolactasia and regulation of lactase expression

    DEFF Research Database (Denmark)

    Troelsen, Jesper Thorvald

    2005-01-01

    A common genetically determined polymorphism in the human population leads to two distinct phenotypes in adults, lactase persistence and adult-type hypolactasia (lactase non-persistence). All healthy newborn children express high levels of lactase and are able to digest large quantities of lactose......, the main carbohydrate in milk. Individuals with adult-type hypolactasia lose their lactase expression before adulthood and consequently often become lactose intolerant with associated digestive problems (e.g. diarrhoea). In contrast, lactase persistent individuals have a lifelong lactase expression...... and are able to digest lactose as adults. Lactase persistence can be regarded as the mutant phenotype since other mammals down-regulate their lactase expression after weaning (the postweaning decline). This phenomenon does not occur in lactase persistent individuals. The regulation of lactase expression...

  17. Morphological method for the diagnosis of human adult type hypolactasia.

    OpenAIRE

    Maiuri, L; M. Rossi; V. Raia; Paparo, F; Coletta, S; Mazzeo, F; Breglia, A; Auricchio, S

    1994-01-01

    The primary adult type hypolactasia is the most common form of genetically determined disaccharidase deficiency. This study examined a large and homogeneous population of the south of Italy: surgical biopsy specimens of proximal jejunum from 178 adult subjects have been assayed for disaccharidase activities; the expression of lactase protein and lactase activity has also been investigated on tissue sections by immunomorphological and enzymohistochemical techniques. Histograms of lactase to su...

  18. Subjective sleep impairment in adults with type 1 or type 2 diabetes

    DEFF Research Database (Denmark)

    Nefs, Giesje; Donga, Esther; van Someren, Eus

    2015-01-01

    AIMS: Despite growing recognition of the impact of sleep on diabetes, a clear profile of people with diabetes regarding subjective sleep impairment has yet to be established. This study examines: (1) subjective sleep characteristics in adults with type 1 and type 2 diabetes; (2) the relationship...... of poor subjective sleep quality with glycaemic control, self-care and daytime functioning; (3) possible risk markers for poor sleep quality. METHODS: In a cross-sectional study, Dutch adults with type 1 (n=267) or type 2 diabetes (n=361) completed an online survey, including the Pittsburgh Sleep Quality...... Index (PSQI), socio-demographic, clinical, self-care and psychological measures. RESULTS: Poor sleep quality (PSQI-score >5) was reported by 31% of adults with type 1 and 42% of adults with type 2 diabetes. Participants with good and poor sleep quality did not differ in self-reported HbA1c...

  19. Mutations in the codon for a conserved arginine-1563 in the COL4A5 collagen gene in Alport syndrome

    DEFF Research Database (Denmark)

    Zhou, J; Gregory, M C; Hertz, Jens Michael

    1993-01-01

    We have screened 110 unrelated Alport syndrome kindreds for mutations in the exon 48 region of the COL4A5 collagen gene. Denaturing gradient gel electrophoresis (DGGE) of the PCR-amplified region of exon 48 revealed sequence variants in DNA from affected males and carriers of three unrelated kind...

  20. Suicidal ideation reported by adults with Type 1 or Type 2 diabetes

    DEFF Research Database (Denmark)

    Handley, T E; Ventura, A D; Browne, Jessica L

    2016-01-01

    or Type 2 diabetes not using insulin (14 and 12%, respectively). After controlling for depression, there was little difference in the prevalence of SI between diabetes types/treatments, but higher diabetes-specific distress significantly increased the odds of SI. CONCLUSIONS: As SI is a significant risk......AIMS: To examine the prevalence and correlates of suicidal ideation (SI) in a community-based sample of adults with Type 1 or Type 2 diabetes. METHODS: Participants were 3338 adults aged 18-70 years with Type 1 diabetes (n = 1376) or Type 2 diabetes (non-insulin: n = 1238; insulin: n = 724) from...... a national survey administered to a random sample registered with the National Diabetes Services Scheme. Depression and SI were assessed using the Patient Health Questionnaire, and diabetes-specific distress with the Problem Areas In Diabetes scale. Separate logistic regression analyses by diabetes type...

  1. Surgical Outcome of Adult Idiopathic Chiari Malformation Type 1

    Science.gov (United States)

    Yuh, Woon Tak; Kim, Chi Heon; Kim, Hyun-Jib; Jahng, Tae-Ahn; Park, Sung Bae

    2016-01-01

    Objective The pathophysiology of idiopathic Chiari malformation (CM) type 1 is disturbance of free cerebrospinal fluid (CSF) flow and restoration of normal CSF flow is the mainstay of treatment. Additional migration of the medulla oblongata in pediatric patients is referred to as CM type 1.5, but its significance in adult patients is unknown. This study is to compare surgical outcomes of adult idiopathic CM type 1.5 with that of type 1. Methods Thirty-eight consecutive adult patients (M : F=11 : 27; median, 33.5; range, 18–63) with syringomyelia due to idiopathic CM type 1 were reviewed. Migration of the medulla oblongata was noted in 13 patients. The modified McCormick scale (MMS) was used to evaluate functional status before and one year after surgery. All patients underwent foramen magnum decompression and duroplasty. Factors related to radiological success (≥50% decrease in the diameter of the syrinx) were investigated. The follow-up period was 72.7±55.6 months. Results Preoperative functional status were MMS I in 11 patients and MMS II in 14 of CM type 1 and MMS I in 8 and II in 5 of CM type 1.5. Of patients with MMS II, 5/14 patients in group A and 3/5 patients in group B showed improvement and there was no case of deterioration. Radiological success was achieved in 32 (84%) patients and restoration of the cisterna magna (p=0.01; OR, 46.5) was the only significant factor. Conclusion Migration of the medulla oblongata did not make a difference in the surgical outcome when the cisterna magna was restored. PMID:27651871

  2. Determinants of quality of life in adults with type 1 and type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Imayama Ikuyo

    2011-12-01

    Full Text Available Abstract Background Limited evidence exists on the determinants of quality of life (QoL specific to adults with type 1 diabetes (T1D. Further, it appears no study has compared the determinants of QoL between T1D and type 2 diabetes (T2D groups. The objectives of this study were to examine: (1 determinants of QoL in adults with T1D; and, (2 differences in QoL determinants between T1D and T2D groups. Methods The Alberta Longitudinal Exercise and Diabetes Research Advancement (ALEXANDRA study, a longitudinal study of adults with diabetes in Alberta, Canada. Adults (18 years and older with T1D (N = 490 and T2D (N = 1,147 provided information on demographics (gender, marital status, education, and annual income, personality (activity trait, medical factors (diabetes duration, insulin use, number of comorbidities, and body mass index, lifestyle behaviors (smoking habits, physical activity, and diet, health-related quality of life (HRQL and life satisfaction. Multiple regression models identified determinants of HRQL and life satisfaction in adults with T1D. These determinants were compared with determinants for T2D adults reported in a previous study from this population data set. Factors significantly associated with HRQL and life satisfaction in either T1D or T2D groups were further tested for interaction with diabetes type. Results In adults with T1D, higher activity trait (personality score (β = 0.28, p -0.27, p -0.12, p -0.14, p Conclusions Health services should target medical and lifestyle factors and provide support for T1D adults to increase their QoL. Additional social support for socioeconomically disadvantaged individuals living with this disease may be warranted. Health practitioners should also be aware that age has different effects on QoL between T1D and T2D adults.

  3. X-连锁Alport综合征的听力表现与皮肤α5(Ⅳ)胶原表达的关系%Relationship between Hearing Phenotype and Collagen Type IVα5 Chain Expression in Skin in X-linked Alport Syndrome

    Institute of Scientific and Technical Information of China (English)

    董程; 陈斯琦; 张焱琴; 薛俊芳; 陈丽; 王芳; 刘玉和; 丁洁

    2014-01-01

    目的:探讨中国人X连锁Alport综合征患者的听力表型与皮肤组织Ⅳ型胶原α5链表达的关系。方法收集2008年8月至2013年8月期间确诊为X连锁Alport综合征的31例患者临床资料,采用纯音听阈测试或ABR+40Hz相关电位检查+声导抗+耳声发射的方式进行听力评估,并采用免疫组化染色检测皮肤组织基膜Ⅳ型胶原α5链的表达,采用Pearson相关分析方法分析二者的关系。结果31例X连锁Alport综合征中听力下降患者均表现为轻、中度感音神经性聋。听觉损害共28例(90.3%),其中22例男性中中度12例,轻度5例,轻微损害5例;女性6例,轻度3例,轻微损害3例。按皮肤Ⅳ胶原α5链染色分级,阴性17例均为男性,其中听力正常4例(3例OAE异常),听力下降13例(轻度4例,中度9例);大部阴性与可疑阳性各1例,均为男性,分别为中度和轻度;连续±2例(男性),正常和中度各1例;间断阳性3例均为女性,均为正常或轻度;连续++7例(男3,女4),其中听力正常4例,听力下降3例(2例轻度,1例中度)。染色阴性的11例听力下降患者听阈与年龄呈正相关(P=0.043,r=0.616)。结论X连锁Alport综合征患者皮肤组织Ⅳ胶原α5链的表达男性低于女性,听力表现与皮肤组织Ⅳ胶原α5链的表达有一定的关系,其中Ⅳ胶原α5链表达阴性的患者听力下降程度与年龄存在相关性,但也存在听力正常的患者,说明还有其他因素影响患者的听力。皮肤组织中Ⅳ胶原α5链表达在一定程度上能反映耳蜗基底膜中Ⅳ胶原α5链的表达和功能。%Objective To study the relationship between the expression distribution of collagen typeⅣα5 chain (α5 (Ⅳchain) within the skin and hearing phenotype in Chinese individuals with X-linked Alport syndrome (XLAS). Methods The clinical data of 31 cases diagnosed with XLAS between 2008 August and 2013

  4. Contact lens fitting in a patient with Alport syndrome and posterior polymorphous corneal dystrophy: a case report

    Directory of Open Access Journals (Sweden)

    Juliana Maria da Silva Rosa

    2016-02-01

    Full Text Available ABSTRACT Alport Syndrome is a hereditary disease that is caused by a gene mutation and affects the production of collagen in basement membranes; this condition causes hemorrhagic nephritis associated with deafness and ocular changes. The X-linked form of this disease is the most common and mainly affects males. Typical ocular findings are dot-and-fleck retinopathy, anterior lenticonus, and posterior polymorphous corneal dystrophy. Some cases involving polymorphous corneal dystrophy and corneal ectasia have been previously described. Here we present a case report of a 33-year-old female with Alport syndrome, posterior polymorphous corneal dystrophy, and irregular astigmatism, whose visual acuity improved with a rigid gas permeable contact lens.

  5. Progression of Alport Kidney Disease in Col4a3 Knock Out Mice Is Independent of Sex or Macrophage Depletion by Clodronate Treatment.

    Directory of Open Access Journals (Sweden)

    Munkyung Kim

    Full Text Available Alport syndrome is a genetic disease of collagen IV (α3, 4, 5 resulting in renal failure. This study was designed to investigate sex-phenotype correlations and evaluate the contribution of macrophage infiltration to disease progression using Col4a3 knock out (Col4a3KO mice, an established genetic model of autosomal recessive Alport syndrome. No sex differences in the evolution of body mass loss, renal pathology, biomarkers of tubular damage KIM-1 and NGAL, or deterioration of kidney function were observed during the life span of Col4a3KO mice. These findings confirm that, similar to human autosomal recessive Alport syndrome, female and male Col4a3KO mice develop renal failure at the same age and with similar severity. The specific contribution of macrophage infiltration to Alport disease, one of the prominent features of the disease in human and Col4a3KO mice, remains unknown. This study shows that depletion of kidney macrophages in Col4a3KO male mice by administration of clodronate liposomes, prior to clinical onset of disease and throughout the study period, does not protect the mice from renal failure and interstitial fibrosis, nor delay disease progression. These results suggest that therapy targeting macrophage recruitment to kidney is unlikely to be effective as treatment of Alport syndrome.

  6. Gut microbiota in human adults with type 2 diabetes differs from non-diabetic adults

    DEFF Research Database (Denmark)

    Larsen, Nadja; Vogensen, Finn Kvist; van der Berg, Franciscus Winfried J

    2010-01-01

    Background Recent evidence suggests that there is a link between metabolic diseases and bacterial populations in the gut. The aim of this study was to assess the differences between the composition of the intestinal microbiota in humans with type 2 diabetes and non-diabetic persons as control....... Methods and Findings The study included 36 male adults with a broad range of age and body-mass indices (BMIs), among which 18 subjects were diagnosed with diabetes type 2. The fecal bacterial composition was investigated by real-time quantitative PCR (qPCR) and in a subgroup of subjects (N = 20) by tag...... = 0.04). Conclusions The results of this study indicate that type 2 diabetes in humans is associated with compositional changes in intestinal microbiota. The level of glucose tolerance should be considered when linking microbiota with metabolic diseases such as obesity and developing strategies...

  7. Alport syndrome

    Science.gov (United States)

    Hereditary nephritis; Hematuria - nephropathy - deafness; Hemorrhagic familial nephritis; Hereditary deafness and nephropathy ... women have high blood pressure, swelling, and nerve deafness as a complication of pregnancy. In men, deafness, ...

  8. A Galeazzi-variant type fracture-dislocation in adults

    Institute of Scientific and Technical Information of China (English)

    Raju Vaishya; Sundar Kumar Shrestha; Abhishek Vaish

    2013-01-01

    Objective:Fracture of either radius or ulna with a dislocation either at the proximal or distal radioulnar joint (DRUJ) is not a common injury and is inherently unstable.Here we report a case series,with both-bone forearm fractures associated with dislocation of DRUJ,as a Galeazzi-variant type fracture-dislocation,and try to analyze this injury pattern.Methods:The study was based on 6 patients having Galeazzi-variant type fracture-dislocation of different age (20 to 45 years).All fractures were closed type.Two fractures involved the same level and three fractures were at different levels of radius and ulna shaft.After thorough examination and investigations they were treated with limited contact dynamic compression plate without additional fixation for DRUJ.Results:All cases were followed up for 24 weeks.The maximum incidence occurred in age group between 31 and 40 years.All the fractures of both radius and ulna were united in average time of 12 weeks.Range of motion of wrist and elbow,supination and pronation at final follow-up were normal.There was no subsequent re-subluxation or dislocation of the DRUJ in any of the cases.Conclusion:Galeazzi variant in adult is a new undescribed pattern of forearm with wrist injury.Stable open reduction and internal fixation of both-bone forearm fractures is mandatory,followed by 3 to 4 weeks of immobilization in a cast for the healing of disrupted DRUJ.

  9. Percepção auditiva em síndrome de Alport Auditory perception in Alport’s Syndrome

    Directory of Open Access Journals (Sweden)

    Carla Mherlyn Viveiros

    2006-12-01

    Full Text Available A síndrome de Alport é caracterizada por comprometimentos auditivos, renal, e visual. Objetivo deste estudo é caracterizar as EOAT e a atividade do SOEM (efeito de supressão em indivíduos com Síndrome de Alport. MATERIAL E MÉTODO: Foram avaliados dez indivíduos com diagnóstico de síndrome de Alport. Foi realizado estudo prospectivo. Foi realizado registro das EOAT na ausência e na presença de estimulação acústica contralateral com a utilização do programa de computador ILO 92 - Otodynamics. RESULTADOS: As amplitudes de resposta das EOAT foram presentes para a resposta global (A e por faixa de freqüência em 1000, 1500, 2000 e 3000 Hz, em 4 (40% dos indivíduos e ausentes em 6 (60% dos indivíduos com perda auditiva. Foram ausentes as respostas na freqüência de 4000 Hz, nas orelhas direita e esquerda. Esses achados são compatíveis com o nível de audição (em dBNA avaliados. Os indivíduos com resposta global presente em EOAT apresentaram supressão dessa resposta na presença de ruído. CONCLUSÃO: Indivíduos com síndrome de Alport apresentam resultados de EOAT compatíveis com a perda auditiva. Ocorreu o efeito de supressão, sugerindo que a perda auditiva é predominantemente originada por uma disfunção coclear.Alport’s Syndrome is characterized by the presence of renal, hearing and visual disorders. Objective: To characterize the TOAE and the MOES activity (suppression effect in individuals with Alport’s Syndrome. MATERIAL AND METHOD: This is a prospective study of a sample included ten individuals with a diagnosis of Alport’s Syndrome. MOES recording was made in the presence and absence of contralateral stimulation (CLS stimulation using the computer software ILO 92 - Otodynamics. RESULTS: TOAE was present in the global response (A and in frequency ranges of 1000, 1500, 2000 and 3000 Hz in 4 individuals (40%, and absent in 6 individuals (60% with hearing loss. We observed no responses at 4000 Hz in the right

  10. Molecular differentiation of congenital lactase deficiency from adult-type hypolactasia

    Science.gov (United States)

    A limited fraction of the human adult population retains intestinal lactase-phlorizin hydrolase (LPH) activity during adulthood, and this is called the lactase persistence phenotype. However, 95% of all adults have adult-type hypolactasia (ATH) and have difficulty digesting milk sugar. Rarely, some ...

  11. High mutation detection rate in the COL4A5 collagen gene in suspected Alport syndrome using PCR and direct DNA sequencing

    DEFF Research Database (Denmark)

    Martin, P; Heiskari, N; Zhou, J

    1998-01-01

    Approximately 85% of patients with Alport syndrome (hereditary nephritis) have been estimated to have mutations in the X chromosomal COL4A5 collagen gene; the remaining cases are autosomal with mutations in the COL4A3 or COL4A4 genes located on chromosome 2. In the present work, the promoter...

  12. Gut microbiota in human adults with type 2 diabetes differs from non-diabetic adults.

    Directory of Open Access Journals (Sweden)

    Nadja Larsen

    Full Text Available BACKGROUND: Recent evidence suggests that there is a link between metabolic diseases and bacterial populations in the gut. The aim of this study was to assess the differences between the composition of the intestinal microbiota in humans with type 2 diabetes and non-diabetic persons as control. METHODS AND FINDINGS: The study included 36 male adults with a broad range of age and body-mass indices (BMIs, among which 18 subjects were diagnosed with diabetes type 2. The fecal bacterial composition was investigated by real-time quantitative PCR (qPCR and in a subgroup of subjects (N = 20 by tag-encoded amplicon pyrosequencing of the V4 region of the 16S rRNA gene. The proportions of phylum Firmicutes and class Clostridia were significantly reduced in the diabetic group compared to the control group (P = 0.03. Furthermore, the ratios of Bacteroidetes to Firmicutes as well as the ratios of Bacteroides-Prevotella group to C. coccoides-E. rectale group correlated positively and significantly with plasma glucose concentration (P = 0.04 but not with BMIs. Similarly, class Betaproteobacteria was highly enriched in diabetic compared to non-diabetic persons (P = 0.02 and positively correlated with plasma glucose (P = 0.04. CONCLUSIONS: The results of this study indicate that type 2 diabetes in humans is associated with compositional changes in intestinal microbiota. The level of glucose tolerance should be considered when linking microbiota with metabolic diseases such as obesity and developing strategies to control metabolic diseases by modifying the gut microbiota.

  13. Clinical features of adult patients with Eisenmenger syndrome associated with different types of congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    陈果

    2013-01-01

    Objective To explore the clinical features and hemodynamics of adult patients with Eisenmenger syndrome in different types of congenital heart diseases (CHD) .Methods Patients with Eisenmenger syndrome with different types of CHD diagnosed by right heart

  14. Body composition in adults with neurofibromatosis type 1

    Directory of Open Access Journals (Sweden)

    MARCIO SOUZA

    Full Text Available SUMMARY Objective To evaluate the body composition and nutritional status of neurofibromatosis type 1 (NF1 adult patients. Method A cross-sectional study of 60 NF1 patients (29 men, 31 women aged ≥ 18 years who were evaluated from September 2012 to September 2013 in a Neurofibromatosis Outpatient Reference Center. Patients underwent nutritional assessment including measurements of weight, stature, waist circumference (WC, upper-arm circumference (UAC, and skinfolds (biceps, triceps, subscapular, suprailiac. Body mass index (BMI, upper-arm total area (UATA, upper-arm muscle area (UAMA, upper-arm fat area (UAFA, body fat percentage (BFP, fat mass, fat-free mass, fat mass index, and fat-free mass index were also calculated. Results The mean age of the study population was 34.48±10.33 years. The prevalence of short stature was 28.3%. Low weight was present in 10% of the sample and 31.7% of patients had a BMI ≥ 25 kg/m2. Reduced UAMA (<5th percentile was present in 43.3% and no difference was found in UAFA between the sexes. The BFP was considered high in 30% and 17 (28.3% patients had a WC above the World Health Organization cutoffs. Conclusion In this study, NF1 patients had a high prevalence of underweight, short stature, and reduced UAMA, with no difference between the sexes. Reduced UAMA was more prevalent in underweight patients; however, this was also observed in the normal and overweight patients. Further studies should investigate the distribution of body tissues in NF1 patients, including differences between men and women, and the influence of diet and nutrition on clinical features in NF1.

  15. Cognitive function in adult offspring of women with Type 1 diabetes

    DEFF Research Database (Denmark)

    Clausen, Tine Dalsgaard; Mortensen, E L; Schmidt, L;

    2011-01-01

    Maternal diabetes may affect offspring cognitive function. The objective of the study was to evaluate cognitive function and potential predictors hereof in adult offspring of women with Type 1 diabetes.......Maternal diabetes may affect offspring cognitive function. The objective of the study was to evaluate cognitive function and potential predictors hereof in adult offspring of women with Type 1 diabetes....

  16. Adult atopic dermatitis and the risk of type 2 diabetes

    DEFF Research Database (Denmark)

    Andersen, Yuki M F; Egeberg, Alexander; Gislason, Gunnar H;

    2016-01-01

    While AD is not an independent risk factor for T2D in adjusted analysis, age, smoking, alcohol abuse and use of systemic and topical corticosteroids may increase the risk of T2D in adults with AD.......While AD is not an independent risk factor for T2D in adjusted analysis, age, smoking, alcohol abuse and use of systemic and topical corticosteroids may increase the risk of T2D in adults with AD....

  17. Subjective sleep impairment in adults with type 1 or type 2 diabetes : Results from Diabetes MILES-The Netherlands

    NARCIS (Netherlands)

    Nefs, Giesje; Donga, Esther; van Someren, Eus; Bot, Mariska; Speight, Jane; Pouwer, François

    2015-01-01

    AIMS: Despite growing recognition of the impact of sleep on diabetes, a clear profile of people with diabetes regarding subjective sleep impairment has yet to be established. This study examines: (1) subjective sleep characteristics in adults with type 1 and type 2 diabetes; (2) the relationship of

  18. Quality of life in adults with childhood-onset of Complex Regional Pain Syndrome type I

    NARCIS (Netherlands)

    Tan, Edward C T H; van de Sandt-Renkema, Nienke; Krabbe, Paul F M; Aronson, Daniel C; Severijnen, René S V M

    2009-01-01

    INTRODUCTION: The clinical presentation of Complex Regional Pain Syndrome type I (CRPS I) in children differs compared to the presentation in adults. Reported results of treatment of CRPS I in children are usually more favourable and seem better than the reported treatment of adults with CRPS I. We

  19. Young adult type 1 diabetes care in the West of Ireland: an audit of hospital practice.

    LENUS (Irish Health Repository)

    Casey, R

    2014-11-01

    It is well recognised that management of young adults with type 1 diabetes (T1DM) poses difficult challenges for physicians and health care organisations as a whole. In Ireland and in particular the west of Ireland there has been little audit or research on young adults with T1DM and the services available to them.

  20. Union Type and Depressive Symptoms among Mexican Adults

    Science.gov (United States)

    Schmeer, Kammi K.; Kroeger, Rhiannon A.

    2011-01-01

    Diversity in union type is increasing around the world as cohabitation and higher order unions become more prevalent in developing and developed countries. This necessitates a more nuanced understanding of how different union types relate to individual well-being across social settings. In this study, the authors analyze nationally-representative…

  1. Prognostic Value of Glomerular Collagen IV Immunofluorescence Studies in Male Patients with X-Linked Alport Syndrome

    Science.gov (United States)

    Gangemi, Concetta; Giannakakis, Kostas; Crisafi, Antonella; Faraggiana, Tullio; Fallerini, Chiara; Renieri, Alessandra; Muda, Andrea Onetti; Emma, Francesco

    2013-01-01

    Summary Background and objectives X-linked Alport syndrome (X-AS) is caused by mutations of the COL4A5 gene, which encodes for the collagen IV α5 chain (α5[COLIV]), resulting in structural and functional abnormalities of the glomerular basement membrane (GBM) and leading to CKD. The aim of the present study was to evaluate the prognostic value of residual collagen IV chain expression in the GBM of patients with X-AS. Design, setting, participants, & measurements The medical records of 22 patients with X-AS from 21 unrelated families collected between 1987 and 2009 were reviewed (median age at last follow-up, 19.9 years; range, 5.4–35.1 years); GBM expression of α1, α3, and α5(COLIV) chains was assessed by immunofluorescence microscopy. Results GBM distribution of the α5(COLIV) chain was diffuse in 1 and segmental or absent in 21 of the 22 patients; the expression of the α3(COLIV) chain was diffuse in 5 of 22 patients and segmental or absent in 17 of 22 patients. Patients with diffuse staining for the α3(COLIV) chain presented with proteinuria significantly later (median age, 16.9 versus 6.1 years; P=0.02) and reached an estimated GFR < 90 ml/min per 1.73 m2 at an older age (median age, 27.0 versus 14.9 years; P=0.01) compared with patients with segmental or absent staining. Two thirds of patients with abnormal α3(COLIV) expression by immunofluorescence studies had null or truncating COL4A5 mutations, as opposed to none of the 4 tested patients with diffuse α3(COLIV) chain glomerular distribution. Conclusions These results indicate that maintained expression of the α3(COLIV) chain is an early positive prognostic marker in patients with X-linked Alport symdrome. PMID:23371956

  2. Measuring insulin adherence among adults with type 2 diabetes.

    Science.gov (United States)

    Osborn, Chandra Y; Gonzalez, Jeffery S

    2016-08-01

    Non-adherence to insulin is common and associated with suboptimal health. We adapted the Morisky Medication Adherence Scale to specify insulin adherence (MIAS) and compared it to the Adherence to Refills and Medication Scale for Diabetes (ARMS-D) and the Summary of Diabetes Self-Care Activities medications subscale (SDSCA-MS) and an insulin-specific (SDSCA-IS) version. A sample of 144 insulin-treated adults (58 % African American/Black, 34 % Caucasian/White, 8 % Other/Mixed race; 6.9 % Hispanic) completed these measures along with a HbA1C test. The internal consistency and factor structure of the MIAS were adequate; 59 % of participants forgot to take insulin and 46 % reported non-adherence. The MIAS was associated with the ARMS-D, SDSCA-MS, and SDSCA-IS (p insulin adherence assessment tool for practice and research applications.

  3. Considering Personality Type in Adult Learning: Using the Myers-Briggs Type Indicator in Instructor Preparation at PricewaterhouseCoopers

    Science.gov (United States)

    Daisley, Richard J.

    2011-01-01

    This article explores the feasibility of using the Myers-Briggs Type Indicator (MBTI) as a framework for instructor development in a professional services training environment. It explores the consistency of MBTI with common adult learning theory, addresses questions on MBTI's reliability and validity, and explores the applicability of MBTI to the…

  4. Type of snack influences satiety responses in adult women.

    Science.gov (United States)

    Furchner-Evanson, Allison; Petrisko, Yumi; Howarth, Leslie; Nemoseck, Tricia; Kern, Mark

    2010-06-01

    The effect of different snack foods on satiety and plasma glucose and hormone responses was assessed. Nineteen fasted adult women (mean age: 39.2 + or - 0.7 years, mean BMI: 26.1 + or - 0.8 kg/m(2)) consumed test foods including dried plums, low-fat cookies, white bread and water only on separate days. The test foods (with the exception of water) provided 238 kcal and were similar in total carbohydrate, fat and protein content but differed in fiber and sugar content. Subjects rated their feelings of hunger using satiety index scales prior to snack consumption and again every 15 min for 2h following initiation of intake. Blood samples were collected at baseline and 15, 30, 45, 60, 90, and 120 min following intake. At the end of the 120-min test period, subjects were presented with a meal to be consumed until satisfied. The satiety index AUC was greater for the dried plum trial versus the low-fat cookie trial (p hunger relative to a low-fat cookie as evidenced by lower glucose and/or satiety-regulating hormone concentrations.

  5. Depression, anxiety and self-care behaviours of young adults with Type 2 diabetes

    DEFF Research Database (Denmark)

    Browne, Jessica L; Nefs, Giesje; Pouwer, F

    2015-01-01

    diabetes with two matched control groups. METHODS: Using cross-sectional survey data from the Australian and Dutch Diabetes Management and Impact for Long-term Empowerment and Success (MILES) studies, we matched 93 young adults (aged 18-39 years) with Type 2 diabetes (case group) with: (i) 93 older adults...... more likely to have clinically meaningful depressive symptoms (Cramer's V = 0.23) than those in the Type 2 diabetes control group. Participants in the case group had statistically equivalent depression scores to the Type 1 diabetes control group. The groups did not differ in anxiety scores. Those...... psychological and self-care support than their older counterparts....

  6. The association between different types of exercise and energy expenditure in young nonoverweight and overweight adults

    OpenAIRE

    Drenowatz, Clemens; Hand, Gregory A; Robin P. Shook; Jakicic, John M.; Hebert, James R.; Burgess, Stephanie; Blair, Steven N.

    2014-01-01

    With decades of trends for decreasing activity during work and travel, exercise becomes an important contributor to total physical activity (PA) and energy expenditure. The purpose of this study was to examine the contribution of different types of exercise to the variability in energy expenditure and time spent at different PA intensities in young adults. Four hundred and seventeen adults (49.9% male; 46.2 overweight/obese) between 21 and 36 years of age provided valid objective PA and energ...

  7. Reproducible isolation of type II pneumocytes from fetal and adult rat lung using nycodenz density gradients.

    Science.gov (United States)

    Viscardi, R M; Ullsperger, S; Resau, J H

    1992-01-01

    Isolating fresh, relatively pure type II pneumocytes from the lung, particularly of fetal origin, is a difficult process. Separation by buoyant density gradient centrifugation has been used successfully to isolate adult type II cells. There is concern, however, that Percoll, a gradient medium that is commonly used for type II cell isolation, may be toxic to cells. We evaluated a new gradient medium, Nycodenz, that is (1) a true solution, (2) transparent, (3) not metabolized by cells, and (4) nontoxic to cells. Type II pneumocytes were isolated from 19- and 21-day gestation fetal and adult rat lung by elastase digestion and separated on preformed isotonic Nycodenz gradients (2 mL each of 27.6, 20.7, 13.8, and 4.6 (w/v) solutions). Type II pneumocytes were recovered from the density range 1.057-1.061 and identified by binding of FITC-conjugated and gold-complexed Maclura pomifera lectin. Cells derived from 19-day fetal lung contained abundant glycogen and reacted with a monoclonal antibody to the cytokeratins 8 and 18, which are markers of the fetal type II cell. Adult type II cells reacted with antibodies to cytokeratins 8, 18, and 19. Type II cell purity was 79.7 +/- 2.4%, 83.8 +/- 2.8%, and 82.6 +/- 1.8% (means +/- SEM) for 19- and 21-day gestation fetal and adult lung preparations, respectively. Cell viability was greater than 95%. The final cell yield for adult preparations was 17.8 +/- 2.7 x 10(6)/rat (means +/- SEM). To determine if the freshly isolated type II pneumocytes were functionally active, the incorporation of [3H]choline into phosphatidylcholine was measured. The percent saturation of phosphatidylcholine was high for both populations of freshly isolated cells. However, adult type II pneumocytes incorporated [3H]choline into phosphatidylcholine more rapidly than 21-day gestation fetal cells (5.97 x 10(-3) dpm/10(6) cells/h vs. 0.32 x 10(-3) dpm/10(6) cells/h, P less than .005). We have demonstrated that, using the Nycodenz isolation method, it is

  8. Factors Predicting Glycemic Control in Middle-Aged and Older Adults With Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Ching-Ju Chiu, PhD

    2010-01-01

    Full Text Available IntroductionFew studies have prospectively assessed the explanatory effects of demographics, clinical conditions, treatment modality, and general lifestyle behaviors on glycemic control in large heterogeneous samples of middle-aged and older adults with type 2 diabetes. We hierarchically examined these factors, focused especially on the effects of modifiable factors (ie, general lifestyle behaviors, and compared predictive patterns between middle-aged and older adults.MethodsWe used nationally representative data from the 1998 and 2000 Health and Retirement Study (HRS and the HRS 2003 Diabetes Study. We analyzed data from 379 middle-aged adults (aged 51-64 y and 430 older adults (aged ≥65 y who self-reported having type 2 diabetes at baseline.ResultsAmong middle-aged adults, demographic factors and clinical conditions were the strongest predictors of hemoglobin A1c (HbA1c levels. However, among older adults, treatment modality (diet only, oral medication, or insulin only or in combination with other regimens significantly affected HbA1c levels. Lifestyle (physical activity, smoking, drinking, and body weight control, independent of the effects of demographics, clinical conditions, and treatment modality, significantly affected HbA1c levels. An increase of 1 healthy behavior was associated with a decrease in HbA1c levels of more than 1 percentage point.ConclusionOur findings provide support for current diabetes guidelines that recommend a lifestyle regimen across the entire span of diabetes care and highlight the need to help both sociodemographically and clinically disadvantaged middle-aged adults with type 2 diabetes as well as older adults who exhibit poor adherence to medication recommendations to achieve better glycemic control.

  9. Gut microbiota in human adults with type 2 diabetes differs from non-diabetic adults

    DEFF Research Database (Denmark)

    Larsen, Nadja; Vogensen, Finn Kvist; van der Berg, Franciscus Winfried J;

    2010-01-01

    Background Recent evidence suggests that there is a link between metabolic diseases and bacterial populations in the gut. The aim of this study was to assess the differences between the composition of the intestinal microbiota in humans with type 2 diabetes and non-diabetic persons as control...... to control metabolic diseases by modifying the gut microbiota....... = 0.04). Conclusions The results of this study indicate that type 2 diabetes in humans is associated with compositional changes in intestinal microbiota. The level of glucose tolerance should be considered when linking microbiota with metabolic diseases such as obesity and developing strategies...

  10. X-Linked and Autosomal Recessive Alport Syndrome: Pathogenic Variant Features and Further Genotype-Phenotype Correlations.

    Science.gov (United States)

    Savige, Judith; Storey, Helen; Il Cheong, Hae; Gyung Kang, Hee; Park, Eujin; Hilbert, Pascale; Persikov, Anton; Torres-Fernandez, Carmen; Ars, Elisabet; Torra, Roser; Hertz, Jens Michael; Thomassen, Mads; Shagam, Lev; Wang, Dongmao; Wang, Yanyan; Flinter, Frances; Nagel, Mato

    2016-01-01

    Alport syndrome results from mutations in the COL4A5 (X-linked) or COL4A3/COL4A4 (recessive) genes. This study examined 754 previously- unpublished variants in these genes from individuals referred for genetic testing in 12 accredited diagnostic laboratories worldwide, in addition to all published COL4A5, COL4A3 and COL4A4 variants in the LOVD databases. It also determined genotype-phenotype correlations for variants where clinical data were available. Individuals were referred for genetic testing where Alport syndrome was suspected clinically or on biopsy (renal failure, hearing loss, retinopathy, lamellated glomerular basement membrane), variant pathogenicity was assessed using currently-accepted criteria, and variants were examined for gene location, and age at renal failure onset. Results were compared using Fisher's exact test (DNA Stata). Altogether 754 new DNA variants were identified, an increase of 25%, predominantly in people of European background. Of the 1168 COL4A5 variants, 504 (43%) were missense mutations, 273 (23%) splicing variants, 73 (6%) nonsense mutations, 169 (14%) short deletions and 76 (7%) complex or large deletions. Only 135 of the 432 Gly residues in the collagenous sequence were substituted (31%), which means that fewer than 10% of all possible variants have been identified. Both missense and nonsense mutations in COL4A5 were not randomly distributed but more common at the 70 CpG sequences (pAla substitutions were underrepresented in all three genes (p< 0.0001) probably because of an association with a milder phenotype. The average age at end-stage renal failure was the same for all mutations in COL4A5 (24.4 ±7.8 years), COL4A3 (23.3 ± 9.3) and COL4A4 (25.4 ± 10.3) (COL4A5 and COL4A3, p = 0.45; COL4A5 and COL4A4, p = 0.55; COL4A3 and COL4A4, p = 0.41). For COL4A5, renal failure occurred sooner with non-missense than missense variants (p<0.01). For the COL4A3 and COL4A4 genes, age at renal failure occurred sooner with two non

  11. Type D personality, suboptimal health behaviors and emotional distress in adults with diabetes

    DEFF Research Database (Denmark)

    Nefs, Giesje; Speight, Jane; Pouwer, F

    2015-01-01

    and standard biomedical risk factors as potential risk mechanisms in adults with diabetes. METHODS: 3314 Dutch adults with self-reported type 1 or 2 diabetes completed an online survey, including the DS14 Type D Scale. AN(C)OVAs and X(2) tests were used to compare participants scoring (i) low on NA and SI; (ii...... component. They also reported more barriers surrounding medication use, diabetes-specific social anxiety, loneliness and symptoms of depression and anxiety. There were no differences in standard biomedical risk factors (body mass index, blood pressure, cholesterol, HbA1c). After adjustment for demographics...

  12. Impact of behavioral interventions in the management of adults with type 2 diabetes mellitus.

    Science.gov (United States)

    Cox, Daniel J; Gill Taylor, Ann; Dunning, Elizabeth S; Winston, Mary C; Luk Van, Ingrid L; McCall, Anthony; Singh, Harsimran; Yancy, William S

    2013-12-01

    Research on the role of behavior change as an efficacious intervention for adults with type 2 diabetes is evolving. Searching PubMed and Ovid Medline, we identified and reviewed primarily randomized controlled trials from 2010 to 2013 of adults managing type 2 diabetes without insulin. All studies are evaluated in terms of the rigor of their design and their impact on glycosylated hemoglobin. The most efficacious interventions appear to be low-carbohydrate/glycemic load diets, combined aerobic and resistance training, and self-monitoring of blood glucose, which educates patients about the impact of their food selections and physical activity on their blood glucose.

  13. Are there differential relationships between different types of childhood maltreatment and different types of adult personality pathology?

    Science.gov (United States)

    Cohen, Lisa Janet; Tanis, Thachell; Bhattacharjee, Reetuparna; Nesci, Christina; Halmi, Winter; Galynker, Igor

    2014-01-30

    While considerable data support the relationship between childhood trauma and adult personality pathology in general, there is little research investigating the specific relationships between different types of childhood maltreatment and adult personality disorders. The present study tested a model incorporating five a priori hypotheses regarding the association between distinct forms of childhood maltreatment and personality pathology in 231 psychiatric patients using multiple self-report measures (Personality Diagnostic Questionnaire-4th Edition, Child Trauma Questionnaire, Conflict in Tactics Scale Parent-Child Child-Adult, and Multidimensional Neglectful Behavior Scale). Step-wise linear regressions supported three out of five hypotheses, suggesting independent relationships between: physical abuse and antisocial personality disorder traits; emotional abuse and Cluster C personality disorder traits; and maternal neglect and Cluster A personality disorder traits after controlling for co-occurring maltreatment types and personality disorder traits. Results did not support an independent relationship between sexual abuse and borderline personality traits nor between emotional abuse and narcissistic personality disorder traits. Additionally, there were three unexpected findings: physical abuse was independently and positively associated with narcissistic and paranoid traits and negatively associated with Cluster C traits. These findings can help refine our understanding of adult personality pathology and support the future development of clinical tools for survivors of childhood maltreatment.

  14. Adult onset glycogen storage disease type II (adult onset Pompe disease): report and magnetic resonance images of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Del Gaizo, Andrew [Emory University School of Medicine, Radiology Resident, Atlanta, GA (United States); Banerjee, Sima [Emory University School of Medicine, Musculoskeletal Radiology Department, Atlanta, GA (United States); Terk, Michael [Emory University School of Medicine, Radiology, Division of Musculoskeletal Imaging, Atlanta, GA (United States)

    2009-12-15

    Glycogen storage disease type II (GSDII), also referred to as Pompe disease or acid maltase deficiency, is a rare inherited condition caused by a deficiency in acid alpha-glucosidase (GAA) enzyme activity. The condition is often classified by age of presentation, with infantile and late onset variants (Laforet et al. J Neurology 55:1122-8, 2000). Late onset tends to present with progressive proximal muscle weakness and respiratory insufficiency (Winkel et al. J Neurology 252:875-84, 2005). We report two cases of biopsy confirmed adult onset GSDII, along with key Magnetic Resonance (MR) images. (orig.)

  15. Associations Between Physical Activity and Depressive Symptoms by Weight Status Among Adults With Type 2 Diabetes

    DEFF Research Database (Denmark)

    Craike, Melinda J; Mosely, Kylie; Browne, Jessica L

    2017-01-01

    BACKGROUND: To examine associations between physical activity (PA) and depressive symptoms among adults with type 2 diabetes mellitus (Type 2 DM), and whether associations varied according to weight status. METHODS: Diabetes MILES - Australia is a national survey of adults with diabetes, focused...... on behavioral and psychosocial issues. Data from 705 respondents with Type 2 DM were analyzed, including: demographic and clinical characteristics, PA (IPAQ-SF), depressive symptoms (PHQ-9), and BMI (self-reported height and weight). Data analysis was performed using ANCOVA. RESULTS: Respondents were aged 59...... with Type 2DM, however the amount of PA associated with fewer depressive symptoms varies according to weight status. Lower amounts of PA might be required for people who are obese to achieve meaningful reductions in depressive symptoms compared to those who are healthy weight or overweight. Further research...

  16. European consensus table on the use of botulinum toxin type A in adult spasticity.

    NARCIS (Netherlands)

    Wissel, J.; Ward, A.B.; Erztgaard, P.; Bensmail, D.; Hecht, M.J.; Lejeune, T.M.; Schnider, P.; Altavista, M.C.; Cavazza, S.; Deltombe, T.; Duarte, E.; Geurts, A.C.H.; Gracies, J.M.; Haboubi, N.H.; Juan, F.J.; Kasch, H.; Katterer, C.; Kirazli, Y.; Manganotti, P.; Parman, Y.; Paternostro-Sluga, T.; Petropoulou, K.; Prempeh, R.; Rousseaux, M.; Slawek, J.; Tieranta, N.

    2009-01-01

    A group of clinicians from across Europe experienced in the use of botulinum toxin type A for the treatment of spasticity following acquired brain injury gathered to develop a consensus statement on best practice in managing adults with spasticity. This consensus table summarizes the current publish

  17. Ataxia, dystonia and myoclonus in adult patients with Niemann-Pick type C

    NARCIS (Netherlands)

    Koens, L. H.; Kuiper, A.; Coenen, M. A.; Elting, J. W. J.; de Vries, J. J.; Engelen, M.; Koelman, J. H. T. M.; van Spronsen, F. J.; Spikman, J. M.; de Koning, T. J.; Tijssen, M. A. J.

    2016-01-01

    Background: Niemann-Pick type C (NP-C) is a rare autosomal recessive progressive neurodegenerative disorder caused by mutations in the NP-C 1 or 2 gene. Besides visceral symptoms, presentation in adolescent and adult onset variants is often with neurological symptoms. The most frequently reported pr

  18. Volunteering among Older Spanish Adults: Does the Type of Organization Matter?

    Science.gov (United States)

    Celdran, Montserrat; Villar, Feliciano

    2007-01-01

    This study in Spain explored three aspects of older adult volunteering (motivations, satisfaction, and perceptions of benefits and drawbacks) and examines to what extent these aspects are influenced by the type of organization and other factors (sociodemographic variables and level of volunteering). The sample consisted of 88 older adults…

  19. Adults Living with Type 2 Diabetes: Kept Personal Health Information Items as Expressions of Need

    Science.gov (United States)

    Whetstone, Melinda

    2013-01-01

    This study investigated personal information behavior and information needs that 21 adults managing life with Type 2 diabetes identify explicitly and implicitly during discussions of item acquisition and use of health information items that are kept in their homes. Research drew upon a naturalistic lens, in that semi-structured interviews were…

  20. Sex Differences in the Association Between Birth Weight and Adult Type 2 Diabetes

    DEFF Research Database (Denmark)

    Zimmermann, Esther; Gamborg, Michael; Sørensen, Thorkild I.A.;

    2015-01-01

    Low birth weight is a well-established risk factor for type 2 diabetes, but the risk at high birth weight levels remains uncertain. Potential sex differences in the associations are unexplored. We investigated whether sex influences the association of birth weight and adult type 2 diabetes, using....... Future search for sex-specific causal mechanisms may provide new insights into the early origins of type 2 diabetes.......Low birth weight is a well-established risk factor for type 2 diabetes, but the risk at high birth weight levels remains uncertain. Potential sex differences in the associations are unexplored. We investigated whether sex influences the association of birth weight and adult type 2 diabetes, using...... a cohort of 113,801 men and 109,298 women, born 1936-1983, from the Copenhagen School Health Records Register, Denmark. During 5.6 million person-years of follow-up, 7,750 men and 4,736 women had a diagnosis of adult type 2 diabetes (30 years of age or older) obtained from national registers. When birth...

  1. A nonsense mutation in the COL4A5 collagen gene in a family with X-linked juvenile Alport syndrome

    DEFF Research Database (Denmark)

    Hertz, Jens Michael; Heiskari, N; Zhou, J;

    1995-01-01

    . The mutation was found to co-segregate with the disease in the family. The information of the sequence variation in this family was used to perform carrier detection and prenatal diagnosis by allele-specific oligonucleotide hybridization analysis and direct sequencing of PCR amplified exon 47. Prenatal...... diagnosis on chorionic villi tissue, obtained from one of the female carriers in the family, revealed a male fetus hemizygous for the mutated allele. A subsequent prenatal test in her next pregnancy revealed a normal male fetus. Prenatal diagnosis of Alport syndrome has not previously been reported....

  2. Sudden death syndrome in adult cows associated with Clostridium perfringens type E.

    Science.gov (United States)

    Redondo, L M; Farber, M; Venzano, A; Jost, B H; Parma, Y R; Fernandez-Miyakawa, M E

    2013-04-01

    Clostridium perfringens type E is considered a rare toxinotype and an infrequent cause of enterotoxemia of lambs, calves, and rabbits. Until now, only cases of young animal of C. perfringens type E bovine enterotoxemia, characterized by hemorrhagic enteritis and sudden death, have been reported. The present report details the genotypic characterization of C. perfringens type E isolates obtained from intestinal samples of adult cattle during an outbreak of enterotoxemia in Argentina. The sequences of several housekeeping genes of these isolates were analyzed and compared with those obtained from calves in North America showing a clonal unique lineage.

  3. No evidence of seasonality of birth in adult type 2 diabetes in Denmark

    DEFF Research Database (Denmark)

    Jensen, Camilla Bjørn; Zimmermann, Esther; Gamborg, Michael;

    2015-01-01

    AIMS/HYPOTHESIS: The season of birth might influence prenatal circumstances, which may influence the risk of developing type 2 diabetes. The aim of this study was to determine whether the diagnosis of type 2 diabetes in Denmark changed with the season of birth. METHODS: This study used data from...... on the risk of type 2 diabetes was assessed using Cox regression, with month or season of birth as the predictor. The underlying time variable was age, and follow-up started in 1977 or at age 30 years. RESULTS: The study population consisted of 223,099 people, of whom 12,486 developed adult type 2 diabetes....... Using January as the reference month, the risk of type 2 diabetes by month of birth was not statistically different for any of the 11 comparative birth months. Grouping month of birth into seasons (spring was the reference) gave essentially similar results, showing no difference in the risk of type 2...

  4. Adult lifetime reproductive value in fish depends on size and fecundity type

    DEFF Research Database (Denmark)

    Tsoukali, Stavroula; Olsson, Karin H.; Visser, André W.

    2016-01-01

    , the expected proportionality falls off if mortality increases to include fishing. Furthermore, we find that the fecundity type (determinate or indeterminate) affects the predicted adult reproductive value, which is significantly (10-fold) higher for an indeterminate spawner than for a determinate spawner......In a stable population, the adult lifetime reproductive value must be balanced against early life survival. Although delaying maturity may increase fecundity, it also reduces survival. Larger size at maturity therefore not only allows for higher fecundity, but requires it. Using simple arguments...... from life history, we derive a direct proportionality relationship between the adult lifetime reproductive value and weight at maturation and find that this relationship is consistent with empirical evidence from 28 stocks and species of bony fish from temperate–boreal environments. However...

  5. Relationship between systemic inflammation and delayed-type hypersensitivity response to Candida antigen in older adults.

    Directory of Open Access Journals (Sweden)

    Brandt D Pence

    Full Text Available Research has shown that aging is associated with increased systemic inflammation as well as a reduction in the strength of immune responses. However, little evidence exists linking the decrease in cell-mediated immunity in older adults with other health parameters. We sought to examine the relationship between cell-mediated immunity as measured in vivo by the delayed-type hypersensitivity (DTH response to candida antigen and demographic and physiological variables in older (65-80 y.o. adults. Candida antigen response was not related to gender or obesity, or to a number of other physiological variables including fitness and body composition. However, positive responders had significantly lower serum C-reactive protein levels (CRP, p4.75 mg•L(-1. Therefore, positive responses to candida antigen in older adults appears to be related to lower levels of systemic inflammation.

  6. Outbreak of type 1 wild poliovirus infection in adults, Namibia, 2006.

    Science.gov (United States)

    Yusuf, Nasir; de Wee, Rosalina; Foster, Norbert; Watkins, Margaret A; Tiruneh, Desta; Chauvin, Claire; Bossarte, Robert; Mandlhate, Custodia; Jack, Abdoulie; Gumede, Nicksy; Mawela, Alfred; Burns, Cara C; Pallansch, Mark A; Allies, Tina; Rainey, Jeannette; Mataruse, Noah; Nshimirimana, Deo

    2014-11-01

    A paralytic poliomyelitis outbreak occurred in Namibia in 2006, almost exclusively among adults. Nineteen cases were virologically confirmed as due to wild poliovirus type 1 (WPV1), and 26 were classified as polio compatible. Eleven deaths occurred among confirmed and compatible cases (24%). Of the confirmed cases, 97% were aged 15-45 years, 89% were male, and 71% lived in settlement areas in Windhoek. The virus was genetically related to a virus detected in 2005 in Angola, which had been imported earlier from India. The outbreak is likely due to immunity gaps among adults who were inadequately vaccinated during childhood. This outbreak underscores the ongoing risks posed by poliovirus importations, the importance of maintaining strong acute flaccid paralysis surveillance even in adults, and the need to maintain high population immunity to avoid polio outbreaks in the preeradication period and outbreaks due to vaccine-derived polioviruses in the posteradication era.

  7. A systematic review of interventions to improve outcomes for young adults with Type 1 diabetes.

    LENUS (Irish Health Repository)

    O'Hara, M C

    2016-10-20

    Many young adults with Type 1 diabetes experience poor outcomes. The aim of this systematic review was to synthesize the evidence regarding the effectiveness of interventions aimed at improving clinical, behavioural or psychosocial outcomes for young adults with Type 1 diabetes.

  8. Stem cell sources for clinical islet transplantation in type 1 diabetes: embryonic and adult stem cells.

    Science.gov (United States)

    Miszta-Lane, Helena; Mirbolooki, Mohammadreza; James Shapiro, A M; Lakey, Jonathan R T

    2006-01-01

    Lifelong immunosuppressive therapy and inadequate sources of transplantable islets have led the islet transplantation benefits to less than 0.5% of type 1 diabetics. Whereas the potential risk of infection by animal endogenous viruses limits the uses of islet xeno-transplantation, deriving islets from stem cells seems to be able to overcome the current problems of islet shortages and immune compatibility. Both embryonic (derived from the inner cell mass of blastocysts) and adult stem cells (derived from adult tissues) have shown controversial results in secreting insulin in vitro and normalizing hyperglycemia in vivo. ESCs research is thought to have much greater developmental potential than adult stem cells; however it is still in the basic research phase. Existing ESC lines are not believed to be identical or ideal for generating islets or beta-cells and additional ESC lines have to be established. Research with ESCs derived from humans is controversial because it requires the destruction of a human embryo and/or therapeutic cloning, which some believe is a slippery slope to reproductive cloning. On the other hand, adult stem cells are already in some degree specialized, recipients may receive their own stem cells. They are flexible but they have shown mixed degree of availability. Adult stem cells are not pluripotent. They may not exist for all organs. They are difficult to purify and they cannot be maintained well outside the body. In order to draw the future avenues in this field, existent discrepancies between the results need to be clarified. In this study, we will review the different aspects and challenges of using embryonic or adult stem cells in clinical islet transplantation for the treatment of type 1 diabetes.

  9. Functional expression of T-type Ca2+ channels in spinal motoneurons of the adult turtle.

    Directory of Open Access Journals (Sweden)

    Martha Canto-Bustos

    Full Text Available Voltage-gated Ca2+ (CaV channels are transmembrane proteins comprising three subfamilies named CaV1, CaV2 and CaV3. The CaV3 channel subfamily groups the low-voltage activated Ca2+ channels (LVA or T-type a significant role in regulating neuronal excitability. CaV3 channel activity may lead to the generation of complex patterns of action potential firing such as the postinhibitory rebound (PIR. In the adult spinal cord, these channels have been found in dorsal horn interneurons where they control physiological events near the resting potential and participate in determining excitability. In motoneurons, CaV3 channels have been found during development, but their functional expression has not yet been reported in adult animals. Here, we show evidence for the presence of CaV3 channel-mediated PIR in motoneurons of the adult turtle spinal cord. Our results indicate that Ni2+ and NNC55-0396, two antagonists of CaV3 channel activity, inhibited PIR in the adult turtle spinal cord. Molecular biology and biochemical assays revealed the expression of the CaV3.1 channel isotype and its localization in motoneurons. Together, these results provide evidence for the expression of CaV3.1 channels in the spinal cord of adult animals and show also that these channels may contribute to determine the excitability of motoneurons.

  10. Dados clínicos e da audição em indivíduos com Síndrome de Alport Clinical data and hearing of individuals with Alport syndrome

    Directory of Open Access Journals (Sweden)

    Fatima Regina Abreu Alves

    2008-12-01

    Full Text Available A Síndrome de Alport (SA é uma desordem hereditária, caracterizada por nefropatia, muitas vezes, com perda auditiva sensorioneural e com defeitos oculares. OBJETIVO: Analisar os dados clínicos e da audição em indivíduos com SA, com ênfase na correlação entre alteração renal e perda auditiva (PA. FORMA DE ESTUDO: clínico prospectivo com coorte transversal. CASUÍSTICA E MÉTODO: 37 indivíduos realizaram avaliação otorrinolaringológica e testes audiológicos. Foram considerados para a análise estatística da PA os resultados das audiometrias de tons puros. RESULTADOS: Nos 28 indivíduos que apresentavam alterações clínicas foram encontrados 46,4% de DLX e 53,6% de AD. A PA ocorreu em 46,1% dos avaliados. 12 pacientes tinham PA no exame audiométrico 11,5%, leve e 34,6%, moderada. Comparados os familiares normais aos que tinham alteração renal, todos os que apresentavam PA mostravam comprometimento renal. Em 30,8% a configuração era descendente suave em agudos e em 11,5% era plana. CONCLUSÕES: A distribuição dos padrões de herança não coincide com o descrito na literatura. A PA é um achado extra-renal freqüente. Existe associação entre acometimento renal e PA (p= 0,009. As configurações mais freqüentes foram: descendente suave em agudos e plana. Não há associação entre a PA e a idade. Não existe correlação entre PA e sexo neste grupo.Alport Syndrome (AS is a hereditary disease, characterized by nephropathy, often times with sensorineural hearing loss and ocular defects. AIM: to analyze the clinical and hearing information from individuals with AS, more specifically the correlation between renal disorder and hearing loss (HL. STUDY DESIGN: clinical prospective with cross-sectional cohort. MATERIALS AND METHODS: 37 individuals underwent otorhinolaryngological evaluation and were submitted to audiologic tests. For HL statistical analysis we considered only the results from the pure tone audiometries

  11. Yoga for Adults with Type 2 Diabetes: A Systematic Review of Controlled Trials

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    Kim E. Innes

    2016-01-01

    Full Text Available A growing body of evidence suggests yogic practices may benefit adults with type 2 diabetes (DM2. In this systematic review, we evaluate available evidence from prospective controlled trials regarding the effects of yoga-based programs on specific health outcomes pertinent to DM2 management. To identify qualifying studies, we searched nine databases and scanned bibliographies of relevant review papers and all identified articles. Controlled trials that did not target adults with diabetes, included only adults with type 1 diabetes, were under two-week duration, or did not include quantitative outcome data were excluded. Study quality was evaluated using the PEDro scale. Thirty-three papers reporting findings from 25 controlled trials (13 nonrandomized, 12 randomized met our inclusion criteria (N = 2170 participants. Collectively, findings suggest that yogic practices may promote significant improvements in several indices of importance in DM2 management, including glycemic control, lipid levels, and body composition. More limited data suggest that yoga may also lower oxidative stress and blood pressure; enhance pulmonary and autonomic function, mood, sleep, and quality of life; and reduce medication use in adults with DM2. However, given the methodological limitations of existing studies, additional high-quality investigations are required to confirm and further elucidate the potential benefits of yoga programs in populations with DM2.

  12. Yoga for Adults with Type 2 Diabetes: A Systematic Review of Controlled Trials.

    Science.gov (United States)

    Innes, Kim E; Selfe, Terry Kit

    2016-01-01

    A growing body of evidence suggests yogic practices may benefit adults with type 2 diabetes (DM2). In this systematic review, we evaluate available evidence from prospective controlled trials regarding the effects of yoga-based programs on specific health outcomes pertinent to DM2 management. To identify qualifying studies, we searched nine databases and scanned bibliographies of relevant review papers and all identified articles. Controlled trials that did not target adults with diabetes, included only adults with type 1 diabetes, were under two-week duration, or did not include quantitative outcome data were excluded. Study quality was evaluated using the PEDro scale. Thirty-three papers reporting findings from 25 controlled trials (13 nonrandomized, 12 randomized) met our inclusion criteria (N = 2170 participants). Collectively, findings suggest that yogic practices may promote significant improvements in several indices of importance in DM2 management, including glycemic control, lipid levels, and body composition. More limited data suggest that yoga may also lower oxidative stress and blood pressure; enhance pulmonary and autonomic function, mood, sleep, and quality of life; and reduce medication use in adults with DM2. However, given the methodological limitations of existing studies, additional high-quality investigations are required to confirm and further elucidate the potential benefits of yoga programs in populations with DM2.

  13. Structural myocardial involvement in adult patients with type 1 myotonic dystrophy

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    Upinder K. Dhand

    2013-03-01

    Full Text Available Myotonic dystrophy type 1 (DM1 is the commonest muscular dystrophy in adults, affecting multiple organs in addition to skeletal muscles. Cardiac conduction system abnormalities are well recognized as an important component of DM1 phenotype; however, primary structural myocardial abnormalities, which may predispose these patients to congestive heart failure, are not as well characterized. We reviewed the retrospective analysis of the clinical and echocardiographic findings in adult patients with DM1. Among 27 patients (16 male; age 19-61 years with DM1, the echocardiogram (ECHO was abnormal in 10 (37% including one of 6 patients (16% with congenital myotonic dystrophy. Reduced left ventricular ejection fraction (LVEF ≤50% was noted in 5, diastolic dysfunction in 4, left atrial dilatation in 3, left ventricular hypertrophy in 2, apical hypokinesia in 1 and mitral valve prolapse in 3 patients. One patient had paradoxical septal movement in the setting of left bundle branch block. Echocardiographic abnormalities significantly correlated with older age; however, patients with systolic dysfunction on echocardiogram ranged in age from 27 to 52 years including 2 patients aged 27 and 34 years. We can conclude that echocardiographic abnormalities are frequent in adult patients with DM1. The incidence is similar in the classical and congenital type of DM1. Overall, echocardiographic abnormalities in DM1 correlate with increasing age; however, reduced LVEF is observed even at young age. Cardiac assessment and monitoring in adult patients with DM1 should include evaluation for primary myocardial involvement.

  14. Sex-typed personality traits and gender identity as predictors of young adults' career interests.

    Science.gov (United States)

    Dinella, Lisa M; Fulcher, Megan; Weisgram, Erica S

    2014-04-01

    Gender segregation of careers is still prominent in the U.S. workforce. The current study was designed to investigate the role of sex-typed personality traits and gender identity in predicting emerging adults' interests in sex-typed careers. Participants included 586 university students (185 males, 401 females). Participants reported their sex-typed personality traits (masculine and feminine traits), gender identities (gender typicality, contentment, felt pressure to conform, and intergroup bias), and interests in sex-typed careers. Results indicated both sex-typed personality traits and gender identity were important predictors of young adults' career interests, but in varying degrees and differentially for men and women. Men's sex-typed personality traits and gender typicality were predictive of their masculine career interests even more so when the interaction of their masculine traits and gender typicality were considered. When gender typicality and sex-typed personality traits were considered simultaneously, gender typicality was negatively related to men's feminine career interests and gender typicality was the only significant predictor of men's feminine career interests. For women, sex-typed personality traits and gender typicality were predictive of their sex-typed career interests. The level of pressure they felt to conform to their gender also positively predicted interest in feminine careers. The interaction of sex-typed personality traits and gender typicality did not predict women's career interests more than when these variables were considered as main effects. Results of the multidimensional assessment of gender identity confirmed that various dimensions of gender identity played different roles in predicting career interests and gender typicality was the strongest predictor of career interests.

  15. THE MEANING OF INSULIN PUMPE THERAPY TO ADULT PATIENTS WITH TYPE 1 DIABETES

    DEFF Research Database (Denmark)

    Nissen, Heidi; Aagaard, Hanne

    and meaningfulness in relation to diabetes self-care and self-management. The bolus guide, as a rather new feature, seem to play an important role. Conclusion: Based on The Shifting Perspectives Model of Chronic Illness, we concluded that a well established insulin pump therapy lead to changing the patients......Background: Insulin pump therapy is an increasing field. Studies have documented a clinical relevant decrease in HbA1c, especially among adults type 1 diabetes patients with initial high HbA1c. However, only few studies investigate the lived experience with and the meaning of the insulin pump...... therapy in adulthood. Aim: The study explore the lived experiences and the meaning of insulin pump therapy in adulthood. Method: The study is based on a phenomenological – hermeneutic approach. Four adult type 1 diabetes patients were interviewed about their insulin pump therapy. The interviews were based...

  16. Identifying Mobility Types in Cognitively Heterogeneous Older Adults Based on GPS-Tracking: What Discriminates Best?

    Science.gov (United States)

    Wettstein, Markus; Wahl, Hans-Werner; Shoval, Noam; Auslander, Gail; Oswald, Frank; Heinik, Jeremia

    2015-12-01

    Heterogeneity in older adults' mobility and its correlates have rarely been investigated based on objective mobility data and in samples including cognitively impaired individuals. We analyzed mobility profiles within a cognitively heterogeneous sample of N = 257 older adults from Israel and Germany based on GPS tracking technology. Participants were aged between 59 and 91 years (M = 72.9; SD = 6.4) and were either cognitively healthy (CH, n = 146), mildly cognitively impaired (MCI, n = 76), or diagnosed with an early-stage dementia of the Alzheimer's type (DAT, n = 35). Based on cluster analysis, we identified three mobility types ("Mobility restricted," "Outdoor oriented," "Walkers"), which could be predicted based on socio-demographic indicators, activity, health, and cognitive impairment status using discriminant analysis. Particularly demented individuals and persons with worse health exhibited restrictions in mobility. Our findings contribute to a better understanding of heterogeneity in mobility in old age.

  17. Antibody titers for canine parvovirus type-2, canine distemper virus, and canine adenovirus type-1 in adult household dogs.

    Science.gov (United States)

    Taguchi, Masayuki; Namikawa, Kazuhiko; Maruo, Takuya; Orito, Kensuke; Lynch, Jonathan; Sahara, Hiroeki

    2011-09-01

    Serum antibody titers for canine parvovirus type-2 (CPV-2), canine distemper virus (CDV) and canine adenovirus type-1 (CAV-1) were investigated in 1031 healthy adult household dogs (2 to 18 years old) given an annual inoculation in the previous 11 to 13 months. The number of dogs retaining significant titers of antibodies against CPV-2, CDV, and CAV-1 were 888 (86%), 744 (72%), and 732 (71%), respectively. There were no differences between males and females in antibody titers against the 3 viruses. Antibody titer for CPV-2 was significantly higher in younger dogs than in older dogs, CDV antibody was significantly higher in older dogs than in younger dogs, and CAV titer was not associated with age.

  18. Feasibility Study of a Bio-inspired Artificial Pancreas in Adults with Type 1 Diabetes

    OpenAIRE

    Reddy, Monika; Herrero, Pau; El Sharkawy, Mohamed; Pesl, Peter; Jugnee, Narvada; Thomson, Hazel; Pavitt, Darrell; Toumazou, Christofer; Johnston, Desmond; Georgiou, Pantelis; Oliver, Nick

    2014-01-01

    Background: This study assesses proof of concept and safety of a novel bio-inspired artificial pancreas (BiAP) system in adults with type 1 diabetes during fasting, overnight, and postprandial conditions. In contrast to existing glucose controllers in artificial pancreas systems, the BiAP uses a control algorithm based on a mathematical model of β-cell physiology. The algorithm is implemented on a miniature silicon microchip within a portable hand-held device that interfaces the components of...

  19. Social cognitive theory correlates of moderate-intensity exercise among adults with type 2 diabetes.

    Science.gov (United States)

    Heiss, Valerie J; Petosa, R L

    2016-01-01

    The purpose of this study was to identify social cognitive theory (SCT) correlates of moderate- to vigorous-intensity exercise (MVPA) among adults with type 2 diabetes. Adults with type 2 diabetes (N = 181) participated in the study. Participants were recruited through ResearchMatch.org to complete an online survey. The survey used previously validated instruments to measure dimensions of self-efficacy, self-regulation, social support, outcome expectations, the physical environment, and minutes of MVPA per week. Spearman Rank Correlations were used to determine the relationship between SCT variables and MVPA. Classification and Regression Analysis using a decision tree model was used to determine the amount of variance in MVPA explained by SCT variables. Due to low levels of vigorous activity, only moderate-intensity exercise (MIE) was analyzed. SCT variables explained 42.4% of the variance in MIE. Self-monitoring, social support from family, social support from friends, and self-evaluative outcome expectations all contributed to the variability in MIE. Other contributing variables included self-reward, task self-efficacy, social outcome expectations, overcoming barriers, and self-efficacy for making time for exercise. SCT is a useful theory for identifying correlates of MIE among adults with type 2 diabetes. The SCT correlates can be used to refine diabetes education programs to target the adoption and maintenance of regular exercise.

  20. Reduced physical activity in adults at risk for type 2 diabetes who curtail their sleep.

    Science.gov (United States)

    Booth, John N; Bromley, Lindsay E; Darukhanavala, Amy P; Whitmore, Harry R; Imperial, Jacqueline G; Penev, Pamen D

    2012-02-01

    Adults with parental history of type 2 diabetes have high metabolic morbidity, which is exacerbated by physical inactivity. Self-reported sleep diabetes, which may be mediated in part by sleep-loss-related reduction in physical activity. We examined the relationship between habitual sleep curtailment and physical activity in adults with parental history of type 2 diabetes. Forty-eight young urban adults with parental history of type 2 diabetes (27 F/21 M; mean (s.d.) age 26 (4) years; BMI 23.8 (2.5) kg/m(2)) each completed 13 (2) days of sleep and physical activity monitoring by wrist actigraphy and waist accelerometry while following their usual lifestyle at home. Laboratory polysomnography was used to screen for sleep disorders. The primary outcome of the study was the comparison of total daily activity counts between participants with habitual sleep diabetes who habitually curtail their sleep have less daily physical activity and more sedentary living, which may enhance their metabolic risk.

  1. Predictors of Hazardous Alcohol Consumption Among Young Adult Amphetamine-Type Stimulant Users

    Directory of Open Access Journals (Sweden)

    Ellen M. Leslie

    2016-02-01

    Full Text Available Background: Very high levels of alcohol consumption have been observed in young adult amphetamine-type stimulant (i.e., ecstasy and methamphetamine users. The reasons for this association are poorly understood. Objective: To examine predictors of hazardous alcohol consumption in a sample of young adult amphetamine-type stimulant users after 30 months of follow-up, controlling for potential confounders. Method: Analysis of longitudinal data from a population-derived sample of Australian young adult amphetamine-type stimulant users (n = 292. A prediction model of alcohol use at 30 months was developed using generalized linear latent and mixed modeling (GLLAMM. Results: Concurrently using ecstasy (Adjusted Odds Ratio [AOR] = 2.67, 95% Confidence Interval [CI] = [1.41, 5.07], frequently attending nightclubs (AOR = 2.53, 95% CI = [1.04, 6.16], high baseline alcohol use patterns (AOR = 2.06, 95% CI = [1.32, 3.20], and being male (AOR = 3.60, 95% CI = [1.48, 8.78] were associated with an increased likelihood of hazardous alcohol use at 30 months. Conclusion: Concurrent, but not baseline, ecstasy use was associated with hazardous alcohol use, suggesting that combined use of these substances may have an instrumental role in terms of the social functions of drug use (e.g., increasing capacity to drink. Integration of educational interventions concerning alcohol and stimulants is warranted.

  2. Sleep and eating behavior in adults at risk for type 2 diabetes

    OpenAIRE

    Kilkus, J.M.; Booth, J. N.; Bromley, L.E.; Darukhanavala, A.P.; Imperial, J. G.; Penev, P. D.

    2011-01-01

    Insufficient quantity and quality of sleep may modulate eating behavior, everyday physical activity, overall energy balance, and individual risk of obesity and type 2 diabetes. We examined the association of habitual sleep quantity and quality with the self-reported pattern of eating behavior in 53 healthy urban adults with parental history of type 2 diabetes (30F/23M; mean [SD] age: 27 [4] y; BMI: 23.9 [2.3] kg/m2) while taking into consideration the amount of their everyday physical activit...

  3. Social network types and functional dependency in older adults in Mexico

    Directory of Open Access Journals (Sweden)

    Espinosa-Alarcón Patricia

    2010-02-01

    Full Text Available Abstract Background Social networks play a key role in caring for older adults. A better understanding of the characteristics of different social networks types (TSNs in a given community provides useful information for designing policies to care for this age group. Therefore this study has three objectives: 1 To derive the TSNs among older adults affiliated with the Mexican Institute of Social Security; 2 To describe the main characteristics of the older adults in each TSN, including the instrumental and economic support they receive and their satisfaction with the network; 3 To determine the association between functional dependency and the type of social network. Methods Secondary data analysis of the 2006 Survey of Autonomy and Dependency (N = 3,348. The TSNs were identified using the structural approach and cluster analysis. The association between functional dependency and the TSNs was evaluated with Poisson regression with robust variance analysis in which socio-demographic characteristics, lifestyle and medical history covariates were included. Results We identified five TSNs: diverse with community participation (12.1%, diverse without community participation (44.3%; widowed (32.0%; nonfriends-restricted (7.6%; nonfamily-restricted (4.0%. Older adults belonging to widowed and restricted networks showed a higher proportion of dependency, negative self-rated health and depression. Older adults with functional dependency more likely belonged to a widowed network (adjusted prevalence ratio 1.5; 95%CI: 1.1-2.1. Conclusion The derived TSNs were similar to those described in developed countries. However, we identified the existence of a diverse network without community participation and a widowed network that have not been previously described. These TSNs and restricted networks represent a potential unmet need of social security affiliates.

  4. The Impact of Neurofibromatosis Type 1 on the Health and Wellbeing of Australian Adults.

    Science.gov (United States)

    Crawford, Hilda A; Barton, Belinda; Wilson, Meredith J; Berman, Yemima; McKelvey-Martin, Valerie J; Morrison, Patrick J; North, Kathryn N

    2015-12-01

    The complications of neurofibromatosis type 1 (NF1) are widespread, unpredictable and variable and each person's experience of this disorder is unique. However, few studies have addressed the impact of NF1 from an individual's perspective. This qualitative study aims to identify the ways in which NF1 impacts upon affected Australian adults. Sixty adults with NF1, with a range of disease severity and visibility participated in a semi-structured interview about the ways in which NF1 impacted upon their life and health. Data were analyzed using grounded theory methodology. Results indicated that NF1 impacts upon affected adults in five major ways: 1) cosmetic burden of disease 2) learning difficulties 3) concerns about the risk of passing NF1 to offspring 4) uncertain disease progression, and 5) pain. Participants identified the aspects of NF1 that bothered them the most, creating a hierarchy of NF1 concerns within the cohort. Importantly, mildly affected adults shared many of the same concerns as those more severely affected. This study enhances our current understanding of the impact of NF1 in adulthood, and augments existing recommendations for the care of these patients.

  5. Associations of HLA-A, -B and -DRB1 types with oral diseases in Swiss adults.

    Directory of Open Access Journals (Sweden)

    Matti Mauramo

    Full Text Available Human leukocyte antigens (HLA are crucial components of host defense against microbial challenge but the associations of HLA types with oral infectious diseases have not been studied in detail. This prospective cross-sectional study examined associations of HLA-A, -B and -DRB1 types with common oral diseases in a healthy Swiss adult population. 257 subjects (107 m, 150 f, mean age: 43.5 yr; range: 21-58 yr with known HLA-A, -B and -DRB1 profiles and comprehensive medical records were included. A thorough anamnesis was followed by oral examinations including saliva flow measurements, the DMFT score for cariological status, complete periodontal status with plaque and bleeding indexes as well as assessment of mucosal alterations and temporomandibular dysfunction (TMD. Student's t-test and Pearson chi-square test were utilized to compare the oral diseases between HLA positive and negative subjects. Bonferroni correction for multiple comparisons was used and PBonf<0.05 was considered statistically significant. HLA types -B15 (PBonf = 0.002, -B51 (PBonf = 0.02 and -DRB1*12 (PBonf = 0.02 were associated with less periodontal disease manifestations. HLA-A32 had a positive association with TMD dysfunction (PBonf = 0.012. No other statistically significant associations were observed. In conclusion, HLA types may contribute to the development of oral diseases in generally healthy Caucasian adults.

  6. Comparison of three trap types for adult catching of whitefly Bemisia tabaci and its parasitoid Eretmocerus mundus in tomato greenhouse

    OpenAIRE

    Nombela, Gloria; Chu, CC.; Heneberry, T.; Muñiz, M.

    2003-01-01

    The attractiveness of three trap types to Bemisia tabaci (Gennadius) B-biotype (= Bemisia argentifolii Bellows & Perring) and Eretmocerus mundus Mercet adult was compared in two choice experiments in a greenhouse at the Centro de Ciencias Medioambientales, Madrid, Spain.  Yellow sticky cards equipped with light-emitting-diodes (LED-YC) caught more adults per trap per day than yellow sticky card (YC) traps.YC traps caught significantly more B. tabaci and E. mundus adults than plastic cup traps...

  7. Adolescent social defeat disturbs adult aggression-related impulsivity in wild-type rats.

    Science.gov (United States)

    Coppens, Caroline M; Coolen, Alex; de Boer, Sietse F; Koolhaas, Jaap M

    2014-10-01

    Adolescence is generally considered as a developmental period during which adverse social experiences may have lasting consequences in terms of an increased vulnerability to affective disorders. This study aimed at determining the individual susceptibility to adolescent social stress using a rat model. We used rats of the Wild-type Groningen strain, which are characterized by a broad variation in adult levels of aggression and impulsivity. We hypothesized that experience of social defeat in adolescence results in heightened aggression and impulsivity levels in adulthood. In contrast to our expectation, adolescent social defeat did not lead to a difference in the average adult level of aggression and impulsivity, but the significant correlation between offensive aggression and impulsivity found in control animals was not present in animals defeated during adolescence.

  8. Niemann-Pick type C: focus on the adolescent/adult onset form.

    Science.gov (United States)

    Di Lazzaro, Vincenzo; Marano, Massimo; Florio, Lucia; De Santis, Stefano

    2016-11-01

    Niemann-Pick disease type C (NP-C) is an inherited sphingolipidosis characterized by progressive neurological deterioration and early mortality. The symptomatology and disease progression of NP-C are markedly affected by the age at onset of neurological manifestations, and categorization into early-infantile, late-infantile, juvenile, adolescent/adult neurological onset forms can aid evaluation of disease course and responses to therapy. Here, we review current information on the detection, diagnosis, monitoring and treatment of NP-C, with a focus on the adolescent/adult-onset form. A recent analysis indicated that the combined incidence of NP-C related to NPC1 gene mutations (NPC1) and NP-C related to NPC2 gene mutations (NPC2) is approximately 1 case in every 89 000 live births. In particular, late-onset phenotypes might well provide a greater contribution to the overall incidence than has previously been reported. Some neuropathological features in NP-C are held in common with other advanced age-onset diseases such as Alzheimer's disease. Visceral symptoms such as splenomegaly are frequently asymptomatic in patients with adolescent/adult-onset NP-C, and are only occasionally detected during routine ultrasound assessments. In contrast, most patients with adolescent/adult-onset exhibit some degree of slowly progressive, non-disease-specific movement disorders (e.g. cerebellar ataxia), and/or more pathognomonic neurological signs such as vertical supranuclear gaze palsy. An increasing number of adolescent/adult-onset cases have been reported following initial recognition of cognitive impairment and/or psychiatric signs. The recent development and implementation of new clinical screening tools (e.g. the NP-C suspicion index) and biomarkers (e.g. plasma oxysterols) should help identify patients who warrant further investigation and possible treatment.

  9. Evaluation of type 2 diabetes genetic risk variants in Chinese adults

    DEFF Research Database (Denmark)

    Gan, Wei; Walters, Robin G; Holmes, Michael V

    2016-01-01

    , demonstrated significant interactions with several measures of adiposity (BMI, waist circumference [WC], WHR and percentage body fat [PBF]; all p interaction ...AIMS/HYPOTHESIS: Genome-wide association studies (GWAS) have discovered many risk variants for type 2 diabetes. However, estimates of the contributions of risk variants to type 2 diabetes predisposition are often based on highly selected case-control samples, and reliable estimates of population......-level effect sizes are missing, especially in non-European populations. METHODS: The individual and cumulative effects of 59 established type 2 diabetes risk loci were measured in a population-based China Kadoorie Biobank (CKB) study of 93,000 Chinese adults, including >7,100 diabetes cases. RESULTS...

  10. Fear of hypoglycaemia in adults with Type 1 diabetes

    DEFF Research Database (Denmark)

    Nefs, Giesje; Bevelander, S; Hendrieckx, Christel;

    2015-01-01

    , history of severe hypoglycaemia (irrespective of number of events) was associated with (greater) fear of hypoglycaemia, whereas diabetes duration, pump therapy and HbA1c were not. Type D personality was positively correlated (model 3), as were symptoms of depression, but not anxiety (model 4). Adding......AIMS: To examine sociodemographic, clinical and psychological factors associated with fear of hypoglycaemia in adults with Type 1 diabetes. METHODS: Data were obtained from Diabetes MILES - The Netherlands, an online self-report national survey. This cross-sectional analysis focused on participants...... with Type 1 diabetes who completed the 18-item Hypoglycaemia Fear Survey - Second Version Worry subscale (HFS-II-W; possible total score range 0-72, higher scores indicating higher fear) (n = 288). To explore correlates of fear of hypoglycaemia, a hierarchical linear regression analysis was performed...

  11. Current data with inulin-type fructans and calcium, targeting bone health in adults.

    Science.gov (United States)

    Coxam, Véronique

    2007-11-01

    In humans, there is increasing evidence that the colon can absorb nutritionally significant amounts of calcium, and this process may be susceptible to dietary manipulation by fermentable substrates, especially inulin-type fructans. Inulin-type fructans can modulate calcium absorption because they are resistant to hydrolysis by mammalian enzymes and are fermented in the large intestine to produce short-chain fatty acids, which in turn reduce luminal pH and modify calcium speciation, and hence solubility, or exert a direct effect on the mucosal transport pathway. Quite a few intervention studies showed an improvement of calcium absorption in adolescents or young adults by inulin-type fructans. In the same way, a positive effect has been reported in older women.

  12. Risk of asthma in adult twins with type 2 diabetes and increased body mass index

    DEFF Research Database (Denmark)

    Thomsen, S F; Duffy, D L; Kyvik, K O;

    2011-01-01

    AIM: To examine the relationship between asthma, type 2 diabetes and increased body mass index (BMI) in adult twins. METHODS: We performed record linkage between questionnaire-defined asthma and BMI, and hospital discharge diagnoses of type 2 diabetes in 34,782 Danish twins, 20-71 years of age....... RESULTS: The risk of asthma was increased in subjects with type 2 diabetes relative to nondiabetic subjects both in men (13.5%vs 7.5%), P = 0.001 and in women (16.6%vs 9.6%), P = 0.001. The result remained significant after adjustment for age, BMI, smoking, symptoms of chronic bronchitis, marital status...... and zygosity, men: OR = 1.70 (1.07-2.70), P = 0.026; women: OR = 1.88 (1.24-2.85), P = 0.003. In this analysis, BMI remained a highly significant predictor for asthma independently of diabetes status in women, P

  13. Comparative analysis of the noncollagenous NC1 domain of type IV collagen: identification of structural features important for assembly, function, and pathogenesis.

    OpenAIRE

    Netzer, K. O.; Suzuki, K; Itoh, Y.; Hudson, B.G.; Khalifah, R. G.

    1998-01-01

    Type IV collagen alpha1-alpha6 chains have important roles in the assembly of basement membranes and are implicated in the pathogenesis of Goodpasture syndrome, an autoimmune disorder, and Alport syndrome, a hereditary renal disease. We report comparative sequence analyses and structural predictions of the noncollagenous C-terminal globular NC1 domain (28 sequences). The inferred tree verified that type IV collagen sequences fall into two groups, alpha1-like and alpha2-like, and suggested tha...

  14. Speech-in-Noise Perception Deficit in Adults with Dyslexia: Effects of Background Type and Listening Configuration

    Science.gov (United States)

    Dole, Marjorie; Hoen, Michel; Meunier, Fanny

    2012-01-01

    Developmental dyslexia is associated with impaired speech-in-noise perception. The goal of the present research was to further characterize this deficit in dyslexic adults. In order to specify the mechanisms and processing strategies used by adults with dyslexia during speech-in-noise perception, we explored the influence of background type,…

  15. Association between Serum 25-hydroxyvitamin D Levels and Type 2 Diabetes in Korean Adults

    Science.gov (United States)

    Nam, Hyun; Choi, Jin-Su; Kweon, Sun-Seog; Lee, Young-Hoon; Nam, Hae-Sung; Park, Kyeong-Soo; Ryu, So-Yeon; Choi, Seong-Woo; Oh, Su-Hyun; Kim, Sun A; Shin, Min-Ho

    2017-01-01

    Previous studies have suggested that a vitamin D deficiency increases the risk of type 2 diabetes. This study evaluated the association between serum vitamin D levels and type 2 diabetes in Korean adults. This study included 9,014 subjects (3,600 males and 5,414 females) aged ≥50 years who participated in the Dong-gu Study. The subjects were divided into groups in whom the serum vitamin D level was severely deficient (<10 ng/mL), deficient (10 to <20 ng/mL), insufficient (20 to <30 ng/mL) and sufficient (≥30 ng/mL). Type 2 diabetes was defined by a fasting blood glucose level of ≥126 mg/dL and/or an HbA1c proportion of ≥6.5% and/or self-reported current use of diabetes medication. Multiple logistic regression was performed to evaluate the association between vitamin D status and type 2 diabetes. The age- and sex-adjusted prevalence of type 2 diabetes was 22.6%, 22.5% and 18.4% and 12.7% for severely deficient, deficient, insufficient, and sufficient, respectively. Multivariate modeling revealed that subjects with insufficient or sufficient vitamin D levels were at a lower risk of type 2 diabetes than were subjects with deficient vitamin D levels [odds ratio (OR), 0.82; 95% confidence interval (CI), 0.71–0.94 and OR, 0.51; 95% CI, 0.35–0.74, respectively]. Higher serum vitamin D levels were associated with a reduced risk of diabetes in Korean adults, suggesting that vitamin D may play a role in the pathogenesis of diabetes.

  16. Type 1 diabetes complicated with uncontrollable adult cyclic vomiting syndrome: a case report

    OpenAIRE

    Ogiso, Kazuma; Koriyama, Nobuyuki; Akao, Ayako; Otsuji, Mayumi; Goto, Takahiko; Fujisaki, Natsuko; Minobe, Machiko; Kinowaki, Mayumi; Matsuki, Shigeru

    2015-01-01

    We herein describe the case of a 29-year-old woman with type 1 diabetes from 10 years of age who developed adult cyclic vomiting syndrome. Beginning at 25 years of age, she was frequently hospitalized for stress-induced vomiting. Her vomiting episodes developed acutely and remitted after severe vomiting of more than 30 times a day for a few days. The vomiting periods were accompanied by leukocytosis with a predominance of neutrophils, high blood pressure and fever. In addition, it was noted t...

  17. Self-care behaviors and health indicators in adults with type 2 diabetes.

    Science.gov (United States)

    Compeán Ortiz, Lidia Guadalupe; Gallegos Cabriales, Esther Carlota; González González, José Gerardo; Gómez Meza, Marco Vinicio

    2010-01-01

    This descriptive correlational study aimed to analyze self-care behaviors and their relationship with health indicators represented by glycemic control, lipid profile, Body Mass Index [BMI], waist circumference and body fat percentage in a sample of 98 adults with type 2 diabetes in an area of Nuevo Leon, Mexico (August 2005/May 2006). The results showed a low self-care behaviors index (X = 36.94, SD=15.14). A significant relationship was found between self-care behaviors and glycosilated hemoglobin [HbA1c] (r s=-.379, pdiet was the most predictive for health indicators, moderated by gender and understanding of diabetes contents (p< .05).

  18. Validation of an information–motivation–behavioral skills model of self-care among Chinese adults with type 2 diabetes

    OpenAIRE

    Gao, Junling; Wang, Jingli; Zhu, Yaocheng; Yu, Jinming

    2013-01-01

    Background Self-care is a crucial component of diabetes management. But comprehensive behavior change frameworks are needed to provide guidance for the design, implementation, and evaluation of diabetes self-care programs in diverse populations. We tested the Information–Motivation–Behavioral Skills (IMB) model in a sample of Chinese adults with Type 2 diabetes. Methods A cross-sectional study of 222 Chinese adults with type 2 diabetes was conducted in a primary care center. We collected info...

  19. Everyday Living with Diabetes Described by Family Members of Adult People with Type 1 Diabetes

    Directory of Open Access Journals (Sweden)

    Tuula-Maria Rintala

    2013-01-01

    Full Text Available The aim of this study was to explore family members’ experiences of everyday life in families with adult people living with type 1 diabetes. The grounded theory method was used to gather and analyse data from the interviews of nineteen family members. Six concepts describing the family members’ views on everyday living with diabetes were generated on the basis of the data. Everyday life with diabetes is described as being intertwined with hypoglycemia. Becoming acquainted with diabetes takes place little by little. Being involved in the management and watching self-management from the sidelines are concepts describing family members’ participation in the daily management of diabetes. The family members are also integrating diabetes into everyday life. Living on an emotional roller-coaster tells about the thoughts and feelings that family members experience. Family members of adult people with diabetes are involved in the management of the diabetes in many ways and experience many concerns. The family members’ point of view is important to take into consideration when developing education for adults with diabetes.

  20. Strong Associations Between the Pesticide Hexachlorocyclohexane and Type 2 Diabetes in Saudi Adults

    Directory of Open Access Journals (Sweden)

    Abdulaziz Al-Othman

    2014-08-01

    Full Text Available Pesticide exposure has been implicated as an environmental risk factor for the development of type 2 diabetes mellitus (T2DM. The aim of this study was to investigate the association of the body burden of the pesticide hexachlorocyclohexane (HCH with the risk of T2DM in a sample of adults from Saudi Arabia. Serum samples were obtained from 280 adult subjects. Hexachlorocyclohexane isomer residues were measured by high-resolution gas chromatography-mass spectrometry. Data on lifestyle, dietary habits, and health status were gathered. Associations between exposure and T2DM were analyzed by logistic regression. Around 49% of adults enrolled in this study were diagnosed with T2DM. Among various HCH isomers, serum concentrations of the pesticides β and γ-HCH were most strongly and consistently linked to T2DM in our studied subjects. Associations of HCH varied across five components of the metabolic syndrome. It positively and significantly associated with four out of the five components, especially elevated triglycerides, high fasting glucose, high blood pressure and HOMA-IR but negatively and significantly with HDL-cholesterol. This study in line with earlier ones about diabetes associated with HCH pesticide exposure and proposes possible hormonal pathways worthy of further investigation.

  1. High prevalence of type 2 diabetes and pre-diabetes in adult offspring of women with gestational diabetes mellitus or type 1 diabetes: the role of intrauterine hyperglycemia

    DEFF Research Database (Denmark)

    Clausen, Tine D; Mathiesen, Elisabeth R; Hansen, Torben;

    2008-01-01

    OBJECTIVE: The role of intrauterine hyperglycemia and future risk of type 2 diabetes in human offspring is debated. We studied glucose tolerance in adult offspring of women with either gestational diabetes mellitus (GDM) or type 1 diabetes, taking the impact of both intrauterine hyperglycemia...

  2. Molecularly defined adult-type hypolactasia among working age people with reference to milk consumption and gastrointestinal symptoms

    Institute of Scientific and Technical Information of China (English)

    Sari R Anthoni; Heli A Rasinper(a); Antti J Kotamies; Hanna A Komu; Harri K Pihlajam(a)ki; Kaija-Leena Kolho; Irma E J(a)rvel(a)

    2007-01-01

    AIM: To study milk consumption and subjective milkrelated symptoms in adults genotyped for adult-type hypolactasia.METHODS: A total of 1900 Finnish adults were genotyped for the C/T-13910 variant of adult-type hypolactasia and filled in a structured questionnaire concerning milk consumption and gastrointestinal problems.RESULTS: The C/C-13910 genotype of adult-type hypolactasia was present in 18% of the study population. The prevalence of the C/C-13910 genotype was higher among subjects who were undergoing investigations because of abdominal symptoms (24%,P < 0.05). Those with the C/C-13910 genotype drank less milk than subjects with either the C/T-13910 or the T/T-13910genotype of lactase persistence (18% vs 38%; 18% vs36%, P < 0.01). Subjects with the C/C-13910 genotype had experienced more gastrointestinal symptoms (84%)during the preceding three-month period than those with the C/T-13910 (79%, P < 0.05) or the T/T-13910 genotype (78 %, P < 0.05). Only 9% (29/338) of the subjects with the C/C-13910 genotype consumed milk and reported no symptoms from it.CONCLUSION: Gastrointestinal symptoms are more common among adults with the C/C-13910 genotype of adult-type hypolactasia than in those with genotypes of lactase persistence.

  3. Sugar Sweetened Beverage Consumption among Adults with Gout or Type 2 Diabetes.

    Directory of Open Access Journals (Sweden)

    Rinki Murphy

    Full Text Available Current guidelines for the management of type 2 diabetes and gout recommend that people with these conditions limit their sugar sweetened beverage (SSB intake. We examined self-reported SSB intake among New Zealand adults with gout or type 2 diabetes, including those on hemodialysis.1023 adults with gout and 580 adults (including 206 receiving hemodialysis with type 2 diabetes, participated in this study of between 2009 and 2012. Participants completed an interviewer-administered SSB intake question "how many sugar sweetened drinks (including fruit juice, but not including diet drinks, do you normally drink per day?" SSB consumption was recorded as a circled number 0, 1, 2, 3, 4, 5, or >5, cans or large glasses (300 mL per day.Consuming one or more SSB per day was reported by 64% (622/1023 of subjects with gout, 49% (176/374 with type 2 diabetes without dialysis, and 47% (96/206 with diabetes on dialysis. Consuming four or more SSBs per day was reported by 18% (179/1023, 9% (31/374 and 9% (18/206, respectively. Such high consumers of SSB were characterized after multivariable analysis to be more likely to be male (adjusted odds ratio (OR 1.8; 95% confidence interval 1.1-2.9, younger in age (40 vs 65 years: 1.6; 1.1-2.3, current smoker (5.2; 2.7-10.1, obese (BMI 41 vs 26 kg/m(2: 1.4; 1-1.9, and report Māori (1.8; 1.2-2.8 or Pacific (1.6; 1.1-2.5 ancestry, compared to Caucasian. People with gout were more likely to report heavy SSB intake compared to people with diabetes (OR 2.4, 95% CI 1.5-3.9. Heavy SSB consumption reported by people with diabetes was similar if they did or did not require dialysis.A high proportion of patients with gout and type 2 diabetes, including those on haemodialysis, are not responding to health messages to abstain from SSB consumption.

  4. Diabetes update: injectable therapies for type 2 diabetes: practical applications for older adults with pancreatic failure.

    Science.gov (United States)

    Raterink, Ginger

    2007-03-01

    The goal of therapy for older adults who have type 2 diabetes and pancreatic failure is to provide the best management program that meets his/her individual needs and lifestyle. The goals are to maintain blood sugar control, but more importantly, to prevent complications and to provide the patient with a better quality of life through a more natural metabolic state. Decisions about when to add insulin to the regimen, the goals of therapy, what types of insulin to use, and how to monitor response are based on the pathophysiologic mechanisms, which ensures overall treatment success. The information that patients gather and record will assist in decisions about therapy that maximize the benefits and eliminate the problems that patients often experience when therapies are modified without a careful plan.

  5. D-type cyclins in adult human testis and testicular cancer

    DEFF Research Database (Denmark)

    Bartkova, J; Rajpert-de Meyts, E; Skakkebaek, N E

    1999-01-01

    on immunohistochemical and immunochemical analysis of human adult testis and 32 testicular tumours to examine the differential expression and abundance of cyclins D1, D2, and D3 in relation to cell type, proliferation, differentiation, and malignancy. In normal testis, the cell type-restricted expression patterns were...... D2 but not D1 or D3, while the invasive testicular tumours showed variable positivity for cyclins D2 and D3, but rarely D1. An unexpected correlation with differentiation rather than proliferation was found particularly for cyclin D3 in teratomas, a conceptually significant observation confirmed...... by massive up-regulation of cyclin D3 in the human teratocarcinoma cell line NTera2/D1 induced to differentiate along the neuronal lineage. These results suggest a possible involvement of cyclin D2 in the early stages of testicular oncogenesis and the striking examples of proliferation-independent expression...

  6. Alport综合征患儿临床表型及基因型单中心分析%Features of clinical phenotype and genotype in Alport syndrome: a monocentric study

    Institute of Scientific and Technical Information of China (English)

    孙蕾; 匡新宇; 郝胜; 王平; 钮小玲; 朱光华; 周君梅; 黄文彦

    2015-01-01

    next-generation sequencing in these patients,and gene mutations of related family members were identified by Sanger method.Result Of these 25 cases,19(76%) had X-linked Alport syndromes (XL-AS),6 had autosomal recessive Alport syndromes (AR-AS).Twenty five patients had an onset of hematuria and proteinuria and in 8 cases the disease was induced by upper respiratory tract infections.Hearing loss was present in 2 of 25 (8%) cases and ocular lesions in 1 of 25 (4%).Renal pathology showed that 16 of them had minimal change disease (MCD),8 mesangial proliferative glomerulonephritis (MsPNG),1 focal segmental glomerulo-sclerosis (FSGS).Extensive lamination and split of glomerular basement membrane (GBM) dense layers were found in 2 (8%) of 25 patients.Twenty one of 25 patients (84%) showed abnormal renal α-chain distribution.COL4A5,COL4A4 and COL4A3 genes of 25 patients (23 families) were analyzed and 24 pathogenic mutations were identified:18 in COL4AS,1 in COL4A3 and 5 in COL4A4.It was observed that 13 patients inherited the mutation from the mother,3 patients inherited from the father,2 patients inherited 1 mutation from the mother and another mutation from the father,and 7 patients carried the novel mutations.Conclusion XL is the main inherited type in AS.Most of patients showed MCD and MsPNG in renal biopsy.This research examined 24 mutations and 16 mutations were not reported previously.

  7. Fecundity and egg hatchability of Dastarcus helophoroides adults fed on different types of artificial diets

    Institute of Scientific and Technical Information of China (English)

    Xiao-juan Li; Guang-ping Dong; Li Yang; Wan-lin Guo

    2015-01-01

    Both fecundities and egg hatchabilities were compared among three populations of Dastarcus helop-horoides Fairmaire adults (Coleoptera: Bothrideridae) fed on three types of artificial diets (Diet of formula 1 com-posed of silkworm pupa powder, dried yeast powder, sucrose, peptone, egg yolk powder and poplar branch powder. Diet of formula 2 composed of silkworm pupa powder, dried yeast powder, sucrose, egg yolk powder, poplar branch powder, cricket powder, benzoic acid and distilled water. Diet of formula 3 composed of pine bark powder and Monochamus alternatus larva powder). for 90 days. The three diets showed no significant difference regarding the average number of eggs deposited by all D. helophoroides females (16622.3–23874.7);the average number of eggs per female (1278.6–1836.5); and the average number of eggs per female per day (14.2–20.4). The number of eggs one cluster contained mainly (82.06–82.66%) lied in 1–100 eggs, and the average number of eggs per cluster ranged from 61.7 to 63.1. In the first 10-day period, the number of eggs deposited by all females fed on formula 1 was significantly larger than that on formula 3. The eggs deposited in the last four 10-day periods were more than in the former five 10-day periods, on formula 3. There were no significant differences in hatchability of total eggs among the three artificial diets, and the average corrected egg hatchability ranged from 82.85 to 84.78%. No significant differences in the adult mortality and mean weight gain of D. helophoroides were found after feeding on three artificial diets. Our results suggest that D. helophoroides adults were not specialized on the diet, and the diet types might have little effect on fecundity and egg hatchability in D. helophoroides, as long as sufficient nutrition was supplied.

  8. Development of skeletal system for mesh-type ICRP reference adult phantoms

    Science.gov (United States)

    Yeom, Yeon Soo; Wang, Zhao Jun; Tat Nguyen, Thang; Kim, Han Sung; Choi, Chansoo; Han, Min Cheol; Kim, Chan Hyeong; Lee, Jai Ki; Chung, Beom Sun; Zankl, Maria; Petoussi-Henss, Nina; Bolch, Wesley E.; Lee, Choonsik

    2016-10-01

    The reference adult computational phantoms of the international commission on radiological protection (ICRP) described in Publication 110 are voxel-type computational phantoms based on whole-body computed tomography (CT) images of adult male and female patients. The voxel resolutions of these phantoms are in the order of a few millimeters and smaller tissues such as the eye lens, the skin, and the walls of some organs cannot be properly defined in the phantoms, resulting in limitations in dose coefficient calculations for weakly penetrating radiations. In order to address the limitations of the ICRP-110 phantoms, an ICRP Task Group has been recently formulated and the voxel phantoms are now being converted to a high-quality mesh format. As a part of the conversion project, in the present study, the skeleton models, one of the most important and complex organs of the body, were constructed. The constructed skeleton models were then tested by calculating red bone marrow (RBM) and endosteum dose coefficients (DCs) for broad parallel beams of photons and electrons and comparing the calculated values with those of the original ICRP-110 phantoms. The results show that for the photon exposures, there is a generally good agreement in the DCs between the mesh-type phantoms and the original voxel-type ICRP-110 phantoms; that is, the dose discrepancies were less than 7% in all cases except for the 0.03 MeV cases, for which the maximum difference was 14%. On the other hand, for the electron exposures (⩽4 MeV), the DCs of the mesh-type phantoms deviate from those of the ICRP-110 phantoms by up to ~1600 times at 0.03 MeV, which is indeed due to the improvement of the skeletal anatomy of the developed skeleton mesh models.

  9. Strength training improves muscle quality and insulin sensitivity in Hispanic older adults with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Naomi Brooks, Jennifer E. Layne, Patricia L. Gordon , Ronenn Roubenoff , Miriam E. Nelson , Carmen Castaneda-Sceppa

    2007-01-01

    Full Text Available Hispanics are at increased risk of morbidity and mortality due to their high prevalence of diabetes and poor glycemic control. Strength training is the most effective lifestyle intervention to increase muscle mass but limited data is available in older adults with diabetes. We determined the influence of strength training on muscle quality (strength per unit of muscle mass, skeletal muscle fiber hypertrophy, and metabolic control including insulin resistance (Homeostasis Model Assessment –HOMA-IR, C-Reactive Protein (CRP, adiponectin and Free Fatty Acid (FFA levels in Hispanic older adults. Sixty-two community-dwelling Hispanics (>55 y with type 2 diabetes were randomized to 16 weeks of strength training plus standard care (ST group or standard care alone (CON group. Skeletal muscle biopsies and biochemical measures were taken at baseline and 16 weeks. The ST group show improved muscle quality (mean±SE: 28±3 vs CON (-4±2, p2 and type II fiber cross-sectional area (720±285µm2 compared to CON (type I: -164±290µm2, p=0.04; and type II: -130±336µm2, p=0.04. This was accompanied by reduced insulin resistance [ST: median (interquartile range -0.7(3.6 vs CON: 0.8(3.8, p=0.05]; FFA (ST: -84±30µmol/L vs CON: 149±48µmol/L, p=0.02; and CRP [ST: -1.3(2.9mg/L vs CON: 0.4(2.3mg/L, p=0.05]. Serum adiponectin increased with ST [1.0(1.8µg/mL] compared to CON [-1.2(2.2µg/mL, p

  10. Impacts of different types of insoles on postural stability in older adults.

    Science.gov (United States)

    Qu, Xingda

    2015-01-01

    The objective of this study was to examine the effects of different types of insoles on postural stability in older adults. Four types of commercially available insoles were selected including the cupped insoles, textured insoles, rigid insoles, and soft insoles. The experiment included a static stance session and a walking session. In the static stance session, the participants stood upright on a force platform as still as possible, with feet together, arms by the side and looking straight ahead. The mean velocity of center-of-pressure time series obtained from the force platform was used to assess static postural stability. In the walking session, the participants walked on a treadmill at their self-selected comfortable speed for 4.5 min in each insole condition. Dynamic postural stability was assessed using the margin of stability. It was found that static postural stability was not affected by insoles, but cupped insoles improved dynamic postural stability, and rigid insole was associated with better dynamic postural stability compared to soft insoles. These findings can aid in better understanding the insole design features associated with improved postural stability in older adults.

  11. Overexpression of SMPX in adult skeletal muscle does not change skeletal muscle fiber type or size.

    Directory of Open Access Journals (Sweden)

    Einar Eftestøl

    Full Text Available Mechanical factors such as stretch are thought to be important in the regulation of muscle phenotype. Small muscle protein X-linked (SMPX is upregulated by stretch in skeletal muscle and has been suggested to serve both as a transcription factor and a mechanosensor, possibly giving rise to changes in both fiber size and fiber type. We have used in vivo confocal imaging to study the subcellular localization of SMPX in skeletal muscle fibers of adult rats using a SMPX-EGFP fusion protein. The fusion protein was localized predominantly in repetitive double stripes flanking the Z-disc, and was excluded from all nuclei. This localization would be consistent with SMPX being a mechanoreceptor, but not with SMPX playing a role as a transcription factor. In vivo overexpression of ectopic SMPX in skeletal muscle of adult mice gave no significant changes in fiber type distribution or cross sectional area, thus a role of SMPX in regulating muscle phenotype remains unclear.

  12. Type IIA Monteggia Fracture Dislocation with Ipsilateral Distal Radius Fracture in Adult – A Rare Association

    Science.gov (United States)

    James, Boblee

    2016-01-01

    Monteggia fracture constitutes about 5-10% of the forearm fractures. Monteggia fracture by definition is proximal ulnar fracture with disruption of proximal radioulnar joint. Bado classified Monteggia fracture dislocation into four types and Jupiter subclassified type II Bado’s fractures into four types. The associated injury in the form of distal radial fractures and distal humerus fractures are rare though many cases of distal radial physeal injuries have been reported in paediatric population. Hereby we report a rare association of type IIA Monteggia fracture dislocation with ipsilateral distal radius fracture in an adult patient. This case report also highlights on proper examination and full length radiographs of forearm to avoid missing injury at wrist in cases of elbow injuries. Management of such complex injuries included open reduction and internal fixation of olecronon fracture, distal radius fracture and radial head resection. Functional outcome at six months was good at wrist whereas at elbow, stiffness was a major concern with elbow range of movement from 40°-110°. PMID:27656518

  13. Sleep and eating behavior in adults at risk for type 2 diabetes.

    Science.gov (United States)

    Kilkus, Jennifer M; Booth, John N; Bromley, Lindsay E; Darukhanavala, Amy P; Imperial, Jacqueline G; Penev, Plamen D

    2012-01-01

    Insufficient quantity and quality of sleep may modulate eating behavior, everyday physical activity, overall energy balance, and individual risk of obesity and type 2 diabetes. We examined the association of habitual sleep quantity and quality with the self-reported pattern of eating behavior in 53 healthy urban adults with parental history of type 2 diabetes (30 F/23 M; mean (s.d.) age: 27 (4) years; BMI: 23.9 (2.3) kg/m(2)) while taking into consideration the amount of their everyday physical activity. Participants completed 13 (3) days of sleep and physical activity monitoring by wrist actigraphy and waist accelerometry while following their usual lifestyle at home. Overnight laboratory polysomnography was used to screen for sleep disorders. Subjective sleep quality was measured with the Pittsburgh Sleep Quality Index. Eating behavior was assessed using the original 51-item and the revised 18-item version of the Three-Factor Eating Questionnaire including measures of cognitive restraint, disinhibition, hunger, and uncontrolled and emotional eating. In multivariable regression analyses adjusted for age, BMI, gender, race/ethnicity, level of education, habitual sleep time measured by wrist actigraphy and physical activity measured by waist accelerometry, lower subjective sleep quality was associated with increased hunger, more disinhibited, uncontrolled and emotional eating, and higher cognitive restraint. There was no significant association between the amount of sleep measured by wrist actigraphy and any of these eating behavior factors. Our findings indicate that small decrements in self-reported sleep quality can be a sensitive indicator for the presence of potentially problematic eating patterns in healthy urban adults with familial risk for type 2 diabetes.

  14. Analysis of epidemiological indices of type 2 diabetes mellitus in the adult population of Moscow

    Directory of Open Access Journals (Sweden)

    Marina Fedorovna Kalashnikova

    2014-07-01

    Full Text Available Diabetes mellitus is a disease that presents a global medical problem. It is necessary to implement an in-depth analysis of the epidemiological situation of type 2 diabetes mellitus for planning and organizing specialized medical help to patients with type 2 diabetes mellitus.AimTo rate the basic epidemiological indices of type 2 diabetes mellitus in actual clinical practice using the informational database of national registry of diabetic patients.Materials and methodsEpidemiological analyses were performed in two administrative districts of Moscow. From 1999 to 2011 48978 adult patients with type 2 diabetes mellitus who were aged 18 years and older were registered. We used methods of clinical, analytical and statistical epidemiology with elements of descriptive research.ResultsThe prevalence rate of type 2 diabetes mellitus was 1590 per hundred thousand, most patients were in the 60–64 and 70–74 age groups, and approximately 80% of patients were older than 55 years. The morbidity rate of type 2 diabetes mellitus was 138,72 per hundred thousand and was found to be higher in women at 1,89. The mortality rate of adult patients with diabetes mellitus was 0,83, mostly in men of all ages. Cardiovascular diseases accounted for most of the registered cases of deaths (34,4%. The average life expectancy appeared to be 75,24±0,45 years, although women lived 6 years longer than men. The average duration of the disease was 10,04±0,34 years. A total of 0,4% of patients underwent hospital treatment and the average length of treatment was 17–18 days. The total number of days of disablement was an average of 307,33±30,13 days (80% of patients were older than 55 years. In the study group, a mean grade of НbА1c <7% was observed in 56,6% of patients. The prevalence rate of detected chronic complications was considerably lower compared to other epidemiological studies.ConclusionsOur epidemiological analyses revealed a number of features and consistent

  15. Personality and illness adaptation in adults with Type 1 diabetes : The intervening role of illness coping and perceptions

    NARCIS (Netherlands)

    Rassart, J.; Luyckx, K.; Klimstra, T.A.; Moons, P.; Weets, I.

    2014-01-01

    Inspired by the common sense model, the present cross-sectional study examined illness perceptions and coping as intervening mechanisms in the relationship between Big Five personality traits and illness adaptation in adults with Type 1 diabetes. A total of 368 individuals with Type 1 diabetes (18–3

  16. Impaired Fasting Glucose in Omani Adults with no Family History of Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Sawsan Al-Sinani

    2014-05-01

    Full Text Available Objectives: The aim of this study was to estimate the prevalence of impaired fasting glucose (IFG among Omani adults with no family history (FH of diabetes and to investigate the factors behind the risk of developing type 2 diabetes (T2D, while excluding a FH of diabetes. Methods: A total of 1,182 Omani adults, aged ≥40 years, visited the Family Medicine & Community Health Clinic at Sultan Qaboos University Hospital, Oman, on days other than the Diabetes Clinic days, from July 2010 to July 2011. The subjects were interviewed and asked if they had T2D or a FH of T2D. Results: Only 191 (16% reported no personal history of T2D or FH of the disease. Of these, anthropometric and biochemical data was complete in 159 subjects. Of these a total of 42 (26% had IFG according to the American Diabetes Association criteria. Body mass index, fasting insulin, haemoglobin A1C and blood pressure (BP, were significantly higher among individuals with IFG (P <0.01, P <0.05, P <0.01 and P <0.01, respectively. In addition, fasting insulin, BP and serum lipid profile were correlated with obesity indices (P <0.05. Obesity indices were strongly associated with the risk of IFG among Omanis, with waist circumference being the strongest predictor. Conclusion: Despite claiming no FH of diabetes, a large number of Omani adults in this study had a high risk of developing diabetes. This is possibly due to environmental factors and endogamy. The high prevalence of obesity combined with genetically susceptible individuals is a warning that diabetes could be a future epidemic in Oman.

  17. Fetal development and risk of cardiovascular diseases and diabetes type 2 in adult life.

    Science.gov (United States)

    Szostak-Węgierek, Dorota; Szamotulska, Katarzyna

    2011-01-01

    The fetal origin hypothesis of adult cardiovascular diseases, type 2 diabetes, hypertension and dyslipidemia in persons born with low birthweight, independently of their extrauterine risk factors, has been well established in the last decade of the twentieth century. However, mechanisms responsible for this relationship are still under investigation. Insulin resistance resulting from the restriction of intrauterine development of skeletal muscles and other organs is considered as the most important cause of metabolic disturbances and their cardiovascular complications in adult subjects born with intrauterine growth retardation (IUGR). Decline of insulin secretion, overactivation of the hypothalamo-pituitary-adrenal axis, reduced glucose uptake in the liver and raised lipid oxidation in the muscles may also explain this association. On the other hand, abnormal vascular development , increased activity of the sympathetic nervous system, defective endothelial function and/or impaired renal function in growth restricted newborns may contribute to hypertension in their later life. With respect to maternal conditions and life-style factors that may increase cardiovascular risk in adult offspring born with IUGR, the most consistent results concern pregnancy induced hypertension, preeclampsia, undernutrition, smoking during pregnancy, hypercholesterolemia, inflammation and/or enhanced glucocorticoid secretion. Macrosomia of the newborn, a frequent sequel to maternal diabetes and/or obesity, also increases the risk of diabetes and cardiovascular diseases in adulthood. Maternal overnutrition, and particularly high fat and sugar intake, seem to play a key role in fetal programming of cardiovascular risk in subjects born with macrosomia. Epigenetic imprinting underlies the described pathomechanisms. The presented associations are illustrated, among others, with the results of studies performed by the authors of this review.

  18. Human oocytes reprogram adult somatic nuclei of a type 1 diabetic to diploid pluripotent stem cells.

    Science.gov (United States)

    Yamada, Mitsutoshi; Johannesson, Bjarki; Sagi, Ido; Burnett, Lisa Cole; Kort, Daniel H; Prosser, Robert W; Paull, Daniel; Nestor, Michael W; Freeby, Matthew; Greenberg, Ellen; Goland, Robin S; Leibel, Rudolph L; Solomon, Susan L; Benvenisty, Nissim; Sauer, Mark V; Egli, Dieter

    2014-06-26

    The transfer of somatic cell nuclei into oocytes can give rise to pluripotent stem cells that are consistently equivalent to embryonic stem cells, holding promise for autologous cell replacement therapy. Although methods to induce pluripotent stem cells from somatic cells by transcription factors are widely used in basic research, numerous differences between induced pluripotent stem cells and embryonic stem cells have been reported, potentially affecting their clinical use. Because of the therapeutic potential of diploid embryonic stem-cell lines derived from adult cells of diseased human subjects, we have systematically investigated the parameters affecting efficiency of blastocyst development and stem-cell derivation. Here we show that improvements to the oocyte activation protocol, including the use of both kinase and translation inhibitors, and cell culture in the presence of histone deacetylase inhibitors, promote development to the blastocyst stage. Developmental efficiency varied between oocyte donors, and was inversely related to the number of days of hormonal stimulation required for oocyte maturation, whereas the daily dose of gonadotropin or the total number of metaphase II oocytes retrieved did not affect developmental outcome. Because the use of concentrated Sendai virus for cell fusion induced an increase in intracellular calcium concentration, causing premature oocyte activation, we used diluted Sendai virus in calcium-free medium. Using this modified nuclear transfer protocol, we derived diploid pluripotent stem-cell lines from somatic cells of a newborn and, for the first time, an adult, a female with type 1 diabetes.

  19. Pharmacological approaches to the management of type 2 diabetes in fasting adults during Ramadan

    Directory of Open Access Journals (Sweden)

    Al Sifri S

    2012-08-01

    Full Text Available Saud Al SifriEndocrinology Department, Alhada Armed Forces Hospital, Taif, Saudi ArabiaI read with great interest the recent review article by AlMaatouq regarding the pharmacological approaches to the management of type 2 diabetes in fasting adults during Ramadan.1 This article stated that "A recent prospective study of more than 1000 patients with T2DMwho fasted during Ramadan found that the risk of hypoglycemia associated with a vildagliptin-based regimen (vildagliptin 100 mg once daily was lower than that of a sulfonylurea-based regimen (both with and without metformin."1 This statement needs to be corrected.Ramadan is the lunar month observed each year in which Muslim adults will fast. This fast includes abstinence from eating, drinking, and smoking from sunrise to sunset. Hypoglycemia during this period represents the greatest health risk for these patients. Recently introduced modulators of the incretin system are the dipeptidylpeptidase-4 inhibitors, which include sitagliptin, vildagliptin, alogliptin, saxagliptin, and linagliptin. These agents are not associated with hypoglycemia.View original paper by AlMaatouq

  20. Resistance Training and Older Adults with Type 2 Diabetes Mellitus: Strength of the Evidence

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    Nina Hovanec

    2012-01-01

    Full Text Available Objective. This paper analyzes the effects of resistance training (RT on metabolic, neuromuscular, and cardiovascular functions in older adults (mean age ≥ 65 years with type 2 diabetes (T2DM. Research Design and Methods. A systematic review conducted by two reviewers of the published literature produced 3 records based on 2 randomized controlled trials that assessed the effect of RT on disease process measures and musculoskeletal/body composition measures. Statistical, Comprehensive Meta-Analysis (version 2 software was used to compute Hedge’s g, and results were calculated using the random effects model to account for methodological differences amongst studies. Results. Largest effect of RT was seen on muscle strength; especially lower body strength, while the point estimate effect on body composition was small and not statistically significant. The cumulative point estimate for the T2DM disease process measures was moderate and statistically significant. Conclusions. RT generally had a positive effect on musculoskeletal, body composition, and T2DM disease processes measures, with tentative conclusions based on a low number of completed RCTs. Thus, more research is needed on such programs for older adults (≥65 years with T2DM.

  1. Is type-D personality trait(s or state? An examination of type-D temporal stability in older Israeli adults in the community

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    Ada H. Zohar

    2016-02-01

    Full Text Available Background. Type D personality was suggested as a marker of poorer prognosis for patients of cardiovascular disease. It is defined by having a score of 10 or more on both sub-scales of the DS14 questionnaire, Social Inhibition (SI and Negative Affectivity (NA. As Type D was designed to predict risk, its temporal stability is of prime importance. Methods. Participants in the current study were 285 community volunteers, who completed the DS14, and other personality scales, at a mean interval of six years. Results. The prevalence of Type D did not change. The component traits of Type D showed rank order stability. Type D caseness temporal stability was improved by using the sub-scales product as a criterion. Logistic hierarchical regression predicting Type D classification from Time1 demonstrated that the best predictors were Time1 scores on NA and SI, with the character trait of Cooperation, and the alexithymia score adding some predictive power. Conclusions. The temporal stability of the component traits, and of the prevalence of Type D were excellent. Temporal stability of Type D caseness may be improved by using a product threshold, rather than the current rule. Research is required in order to formulate the optimal timing for Type D measurement for predictive purposes.

  2. Spiritual Well-Being and Quality of Life of Iranian Adults with Type 2 Diabetes

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    Najmeh Jafari

    2014-01-01

    Full Text Available Introduction. Diabetes is a major public health problem. Little is known about the spiritual well-being and its relationship with quality of life (QOL in Iranian Muslim patients with diabetes. This study investigated the spiritual well-being and QOL of Iranian adults with type 2 diabetes and the association between spiritual well-being, QOL, and depression. Methods. A cross-sectional study was done among 203 patients with type 2 diabetes mellitus in Isfahan, Iran. Quality of life and spiritual well-being were measured using the functional assessment of chronic illness therapy-spiritual well-being (FACIT-Sp. Depression was assessed using the Patient Health Questionnaire-2 (PHQ-2. Descriptive analysis, Pearson’s correlation, and multiple regression analysis were performed for statistical assessment. Results. The mean QOL was 61.00 (SD = 9.97 and the mean spiritual well-being was 30.59 (SD = 6.14. Sixty-four percent of our studied population had depressive disorders. There was a significant positive correlation between all QOL subscales and meaning, peace, and total spiritual well-being score. Conclusion. The results of this study showed poor QOL and spiritual well-being and high prevalence of depression in Iranian patients with type 2 diabetes compared to other studies’ findings especially western studies. This indicates the need for psychosocial and spiritual support in caring for Iranian patients with diabetes.

  3. Does social problem solving differ from other types of problem solving during the adult years?

    Science.gov (United States)

    Heidrich, S M; Denney, N W

    1994-01-01

    One hundred thirteen individuals, ages 18-81, were presented with a test of social problem solving, a test of practical problem solving, the Twenty Questions task (a test of traditional problem solving), the Wechsler Adult Intelligence Scale--Revised Vocabulary subtest (a measure of crystallized intelligence), and Raven's Progressive Matrices (a measure of fluid intelligence). The effects of age, sex, education, and intellectual abilities on problem-solving performance were examined. Social problem solving was positively related to higher education and higher Vocabulary scores, but it was not related to age. Social problem solving and practical problem solving were significantly related to each other and to scores on the Vocabulary subtest, whereas traditional problem solving was significantly related to scores on Raven's Progressive Matrices. These results suggest that different types of problem solving are differentially related to other intellectual abilities and to age.

  4. Ibuprofen for acute treatment of episodic tension-type headache in adults

    DEFF Research Database (Denmark)

    Derry, Sheena; Wiffen, Philip J; Moore, R Andrew

    2015-01-01

    2015. We sought unpublished studies by asking personal contacts and searching on-line clinical trial registers and manufacturers' websites. SELECTION CRITERIA: We included randomised, placebo-controlled studies (parallel-group or cross-over) using oral ibuprofen for symptomatic relief of an acute......BACKGROUND: Tension-type headache (TTH) affects about one person in five worldwide. It is divided into infrequent episodic TTH (fewer than one headache per month), frequent episodic TTH (1 to 14 headaches per month), and chronic TTH (15 headaches a month or more). Ibuprofen is one of a number...... of analgesics suggested for acute treatment of headaches in frequent episodic TTH. OBJECTIVES: To assess the efficacy and safety of oral ibuprofen for treatment of acute episodic TTH in adults. SEARCH METHODS: We searched CENTRAL (The Cochrane Library), MEDLINE, EMBASE, and our own in-house database to January...

  5. Psychosocial factors impacting on life transitions among young adults with type 2 diabetes

    DEFF Research Database (Denmark)

    Lorentzen, Vibeke; Rasmussen, B; Maindal, Helle Terkildsen;

    2016-01-01

    BACKGROUND: Type 2 diabetes (T2DM) prevalence is increasing rapidly worldwide with a significant increase in young adults. There is limited information about psychosocial and service needs of this group. AIM: To explore similarities and differences in how psychosocial factors impact on Australian....... FINDINGS: Eligible participants were from Australia (12) and Denmark (14), aged 19-42 years who had T2DM for more than 10 months. In general, they reported diabetes management was difficult during transitions and diabetes self-care routines had to change to accommodate life changes. The underpinning sense......, and the need for flexible access to health professionals, age-specific tailored support and lower costs for Australians. Australian participants were more concerned than Danish participants about the cost associated with diabetes care and their ability to stay employed; hence, they were reluctant to disclose...

  6. Fenofibrate treatment in two adults with Crigler-Najjar syndrome type II.

    Science.gov (United States)

    Yilmaz, Serif; Dursun, Mehmet; Canoruç, Fikri; Kidir, Veysel; Beştaş, Remzi

    2006-03-01

    Crigler-Najjar syndrome type II is a rare familial disorder of bilirubin conjugation with consecutive life-long unconjugated hyperbilirubinemia. In the presence of severe hyperbilirubinemia, a fetus or an adult is at risk for neurological defects in this syndrome. This paper is the first report emphasizing details about this disorder in two patients from Turkey. The diagnosis was made on the basis of history and laboratory findings excluding other causes of unconjugated hyperbilirubinemia. Phenobarbital loading test and C bile analysis also supported the diagnosis. There was a study in the literature in which treatment with chlofibrate had been recommended in this syndrome. Based on the results of that study, we administered fenofibrate treatment to our patients for one month and analyzed serum bilirubin levels before and after this procedure. No improvement in bilirubin levels was observed in either case.

  7. Global Coherence in Younger and Older Adults: Influence of Cognitive Processes and Discourse Type

    Science.gov (United States)

    Wright, Heather Harris; Koutsoftas, Anthony D.; Capilouto, Gilson J.; Fergadiotis, Gerasimos

    2013-01-01

    The purpose of the present research was to examine the influence of cognitive processes on discourse global coherence ability measured across different discourse tasks and collected from younger (n = 40; 20–39 y.o.) and older (n = 40; 70–87 y.o.) cognitively healthy adults. Study participants produced oral language samples in response to five commonly used discourse elicitation tasks and they were analyzed for maintenance of global coherence. Participants also completed memory and attention measures. Group differences on the global coherence scale were found for only one type of discourse – recounts. Across discourse elicitation tasks the lowest global coherence scores were found for recounts compared to the other discourse elicitation tasks. The influence of cognitive processes on maintenance of global coherence differed for the two age groups. For the younger group, there were no observed significant relationships. For the older group, cognitive measures were related to global coherence of stories and procedures. PMID:23656430

  8. Renal histology in two adult patients with type I glycogen storage disease.

    Science.gov (United States)

    Obara, K; Saito, T; Sato, H; Ogawa, M; Igarashi, Y; Yoshinaga, K

    1993-02-01

    Two adult patients with type I glycogen storage disease (I-GSD) had chronic renal disease with heavy proteinuria. Renal biopsies showed focal glomerular sclerosis, interstitial fibrosis, tubular atrophy or vacuolation, and prominent arteriosclerosis. Marked glomerular hypertrophy was demonstrated histometrically. Oil red O staining in one patient revealed numerous lipid deposits in the glomerular mesangium, tubular epithelial cells and interstitium. Electron microscopy in the other patient revealed diffuse thickening of the glomerular basement membrane (GBM) and lipid droplets within the mesangium. The glomerular hypertrophy, thickening of the GBM, and subsequent sclerosis were similar to those in insulin-dependent diabetes mellitus. These findings may explain the similarities between the natural histories of renal involvement in the two disorders. Particularly, glomerular hypertrophy may be a key step leading to glomerular sclerosis, which is the predominant finding I-GSD. Hyperlipidemia, which is commonly seen in I-GSD, may also accelerate the glomerular sclerosing process.

  9. Urinary sialyloligosaccharides in adult type sialidosis: occurrence of two positional isomers.

    Science.gov (United States)

    Kuriyama, M; Ariga, T; Ando, S; Suzuki, M; Yamada, T; Miyatake, T

    1981-04-01

    Two positional isomers of sialyloligosaccharides were isolated from the urine of a patient with adult type sialidosis with partial deficiency of beta-galactosidase. From structural studies including sugar analysis, enzyme degradation and methylation analysis, the following structures are deduced; 1. alpha-AcNeu-(2 leads to 3)-beta-Gal-(1 leads to 4)-beta-GlcNAc-(1 leads to 2)-alpha-Man-(1 leads to 3)-beta-Man-(1 leads to 4)-GlcNAc 2. alpha-AcNeu-(2 leads to 3)-beta-Gal-(1 leads to 4)-beta-GlcNAc-(1 leads to 2)-alpha-Man-(1 leads to 6)-beta-Man-(1 leads to 4)-GlcNAc The sialyloligosaccharide 1 has previously been reported to be present in liver and urine of patients with mucolipidosis I, II and variant forms. The sialyloligosaccharide 2 was first demonstrated in human urine.

  10. Magnesium sulfate enhances non-depolarizing muscle relaxant vecuronium action at adult muscle-type nicotinic acetylcholine receptor in vitro

    Institute of Scientific and Technical Information of China (English)

    Hong WANG; Qi-sheng LIANG; Lan-ren CHENG; Xiao-hong LI; Wei FU; Wen-tao DAI; Shi-tong LI

    2011-01-01

    To investigate the effect of magnesium sulfate and its interaction with the non-depolarizing muscle relaxant vecuronium at adult muscle-type acetylcholine receptors in vitro.Methods:Adult muscle-type acetylcholine receptors were expressed in HEK293 cells.Drug-containing solution was applied via a gravity-driven perfusion system.The inward currents were activated by brief application of acetylcholine (ACh),and recorded using whole-cell voltage-clamp technique.Results:Magnesium sulfate (1-100 mmol/L) inhibited the inward currents induced ACh (10 μmol/L) in a concentration-dependent manner (IC5o=29.2 mmol/L).The inhibition of magnesium sulfate was non-competitive.In contrast,vecuronium produced a potent inhibition on the adult muscle-type acetylcholine receptor (IC50=8.7 nmol/L) by competitive antagonism.Magnesium sulfate at the concentrations of 1,3,and 6 mmol/L markedly enhanced the inhibition of vecuronium (10 nmol/L) on adult muscle-type acetylcholine receptors.Conclusion:Clinical enhancement of vecuronium-induced muscle relaxation by magnesium sulfate can be attributed partly to synergism between magnesium sulfate and non-depolarizing muscle relaxants at adult muscle-type acetylcholine receptors.

  11. Patient perspectives on peer support for adults with type 1 diabetes: a need for diabetes-specific social capital

    Science.gov (United States)

    Joensen, Lene E; Filges, Tine; Willaing, Ingrid

    2016-01-01

    Aim To explore the function of peer support from the perspective of adults with type 1 diabetes in Denmark. Methods The study population consisted of 20 adults with type 1 diabetes. The sample was diverse in relation to educational background, age, sex, and cohabitation status. Inspired by action research, several methods and perspectives on peer support were explored and tested. Workshops and group and individual interviews were performed. Systematic text condensation was used to analyze data, supplemented with theory-based interpretive analysis. Results Adults with type 1 diabetes found peer support highly relevant to reduce a burdensome feeling of diabetes-specific loneliness. Peer support showed potential to create diabetes-specific social capital not only by creating reciprocal social support between peers but also, more importantly, by creating space for genuine trust and a feeling of communality. There was a widespread feeling of the pervasive impact of diabetes on daily life and thus the relevance of discussing all aspects of life. However, participants perceived peer support as particularly relevant in relation to big changes in life, for example, in family life, at work, or through treatment events such as getting an insulin pump. Conclusion Peer support programs focusing on creating and establishing diabetes-specific social capital using participatory approaches seem highly relevant among adults with type 1 diabetes. Content, methods, and effects of peer support need further exploration in collaboration with adults with type 1 diabetes. PMID:27536076

  12. Galectin-1 is expressed in early-type neural progenitor cells and down-regulates neurogenesis in the adult hippocampus

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    Imaizumi Yoichi

    2011-01-01

    Full Text Available Abstract Background In the adult mammalian brain, neural stem cells (NSCs proliferate in the dentate gyrus (DG of the hippocampus and generate new neurons throughout life. A multimodal protein, Galectin-1, is expressed in neural progenitor cells (NPCs and implicated in the proliferation of the NPCs in the DG. However, little is known about its detailed expression profile in the NPCs and functions in adult neurogenesis in the DG. Results Our immunohistochemical and morphological analysis showed that Galectin-1 was expressed in the type 1 and 2a cells, which are putative NSCs, in the subgranular zone (SGZ of the adult mouse DG. To study Galectin-1's function in adult hippocampal neurogenesis, we made galectin-1 knock-out mice on the C57BL6 background and characterized the effects on neurogenesis. In the SGZ of the galectin-1 knock-out mice, increased numbers of type 1 cells, DCX-positive immature progenitors, and NeuN-positive newborn neurons were observed. Using triple-labeling immunohistochemistry and morphological analyses, we found that the proliferation of the type-1 cells was increased in the SGZ of the galectin-1 knock-out mice, and we propose that this proliferation is the mechanism for the net increase in the adult neurogenesis in these knock-out mice DG. Conclusions Galectin-1 is expressed in the neural stem cells and down-regulates neurogenesis in the adult hippocampus.

  13. Clinical significance of TOAST typing of ischemic stroke in young adults

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Ischemic stroke in young adults brings extremely hurts for their families and society, and the etiological factors and risk factors are different in the world.OBJECTIVE: To analyze and evaluate clinical significance of ischemic stroke in young adults by using TOAST typing.DESIGN: Case analysis.SETTING: Department of Neurology, the First Affiliated Hospital, Guangxi Medical University.PARTICIPANTS: A total of 64 young adults with acute ischemic stroke were selected from the Department of Neurology, the First Affiliated Hospital, Guangxi Medical University from September 2005 to June 2006.There were 44 males and 20 females and their age ranged from 15 to 45 years. All patients met with the diagnostic criteria of the Fourth National Cerebrovarscular Academic Meeting and certainly diagnosed with CT or MRI examination. In addition, all patients provided the confirmed consent.METHODS: ① TOAST typing: Based on X-ray of thoracic part, electrocardiography, blood routine, blood glucose, electrolure, lipid, blood coagulation test, anticardiolipin antibody, antinuclear antibody, anti-double chain DNA, antineutrophil cytoplasmic antibody, crook agglutination test, syphilis antibody and human immunodeficiency virus (HIV) antibody test, patients received TOAST typing, including large-artery atherosclerotic stroke (LA), small-artery occlusion lacunar (SA), cardioembolism (CE), stroke of other demonstrated etiology (SOE), and stroke of other undemonstrated etiology (SUE). ② Risk factors: Stages of hypertension, diabetes mellitus, hyperlipemia, smoking and drinking of patients were observed. Blood pressure was measured twice after onset of acute stroke, and values of total cholesterol (TC) and/or triacylglycerol (TG) were measured more than twice to finally diagnose hyperlipemia. Diagnostic criteria of diabetes mellitus: fasting≥7.0 mmol/L; 2 hours after administrating glucose ≥ 11.1 mmol/L. Risk factor of smoking defined as more than 10 smokes every day in the

  14. [Pervasive developmental disorder in adults; importance of diagnosis in concern to the type of ego structure with PDD].

    Science.gov (United States)

    Hirosawa, Masataka

    2011-01-01

    Most adult patients with pervasive developmental disorder (PDD) who consult with psychiatrists for the first time may have normal intelligence. In diagnosing high-functioning PDD to adult patients, we should pay much attention to psychological consistency which exists between developmental problems in childhood, developed personality, recent problems in social adjustment, and manifested psychiatric symptoms. In order to understand these relationships, considering the patients' type of ego structure ("PDD ego type") seems to be useful. "PDD ego type" is characterized by their unique self-universe image which takes form of grid one (just like a touch panel), which is decisively different from the form of a radial or concentric circle held by most people (Jung, C.G). This self-universe image characterizes adult PDD patients' psychiatric symptoms, unsuitable social performance, and their "personality."

  15. Patient perspectives on peer support for adults with type 1 diabetes: a need for diabetes-specific social capital

    Directory of Open Access Journals (Sweden)

    Joensen LE

    2016-08-01

    Full Text Available Lene E Joensen,1 Tine Filges,2 Ingrid Willaing1 1Health Promotion Research, Steno Diabetes Center, Gentofte, 2Filges Analysis, Hellerup, Denmark Aim: To explore the function of peer support from the perspective of adults with type 1 diabetes in Denmark. Methods: The study population consisted of 20 adults with type 1 diabetes. The sample was diverse in relation to educational background, age, sex, and cohabitation status. Inspired by action research, several methods and perspectives on peer support were explored and tested. Workshops and group and individual interviews were performed. Systematic text condensation was used to analyze data, supplemented with theory-based interpretive analysis. Results: Adults with type 1 diabetes found peer support highly relevant to reduce a burdensome feeling of diabetes-specific loneliness. Peer support showed potential to create diabetes-specific social capital not only by creating reciprocal social support between peers but also, more importantly, by creating space for genuine trust and a feeling of communality. There was a widespread feeling of the pervasive impact of diabetes on daily life and thus the relevance of discussing all aspects of life. However, participants perceived peer support as particularly relevant in relation to big changes in life, for example, in family life, at work, or through treatment events such as getting an insulin pump. Conclusion: Peer support programs focusing on creating and establishing diabetes-specific social capital using participatory approaches seem highly relevant among adults with type 1 diabetes. Content, methods, and effects of peer support need further exploration in collaboration with adults with type 1 diabetes. Keywords: type 1 diabetes mellitus, adult, psychosocial support systems, patient preferences, peer support, diabetes-specific social capital, diabetes-specific loneliness

  16. MR imaging in adults with Gaucher disease type I: evulation of marrow involvement and disease activity

    Energy Technology Data Exchange (ETDEWEB)

    Hermann, G. (Dept. of Radiology, Mount Sinai Medical Center, City Univ. of New York, NY (United States)); Shaprio, R.S. (Dept. of Radiology, Mount Sinai Medical Center, City Univ. of New York, NY (United States)); Abdelwahab, I.F. (Dept. of Radiology, Mount Sinai Medical Center, City Univ. of New York, NY (United States)); Grabowski, G. (Dept. of Pediatrics, Mount Sinai Medical Center, City Univ. of New York, NY (United States))

    1993-05-01

    An investigation was conducted to determine the usefulness of magnetic resonance imaging (MRI) in the evaluation of bone marrow involvement in patients with Gaucher disease type I. T1- and T2-weighted images were obtained of the lower extremities of 29 adult patients. Patients were classified into one of three groups based on marrow signal patterns on T1- and T2-weighted images as well as change in signal intensity from T1- to T2-weighted images. An increase in signal intensity from T1- to T2-weighted images was the criterion for an 'active process' within the bone marrow. Classification of the 29 patients produced the following results: Group A: Normal, 4 patients; group B: Marrow infiltration, 16 patients; group C: Marrow infiltration plus active marrow process, 9 patients. Correlation with clinical findings revealed that all nine patients with evidence of an active marrow process on MRI (group C) had acute bone pain. Conversely, only one of the remaining 20 patients (groups A and B) had bone pain. There was no correlation between disease activity and findings on conventional radiographs. We conclude the MRI provides an excellent noninvasive assessment of the extent and activity of marrow involvement in type I Gaucher disease. (orig.)

  17. Abnormal motor phenotype at adult stages in mice lacking type 2 deiodinase.

    Directory of Open Access Journals (Sweden)

    Soledad Bárez-López

    Full Text Available BACKGROUND: Thyroid hormones have a key role in both the developing and adult central nervous system and skeletal muscle. The thyroid gland produces mainly thyroxine (T4 but the intracellular concentrations of 3,5,3'-triiodothyronine (T3; the transcriptionally active hormone in the central nervous system and skeletal muscle are modulated by the activity of type 2 deiodinase (D2. To date no neurological syndrome has been associated with mutations in the DIO2 gene and previous studies in young and juvenile D2-knockout mice (D2KO did not find gross neurological alterations, possibly due to compensatory mechanisms. AIM: This study aims to analyze the motor phenotype of 3-and-6-month-old D2KO mice to evaluate the role of D2 on the motor system at adult stages in which compensatory mechanisms could have failed. RESULTS: Motor abilities were explored by validated tests. In the footprint test, D2KO showed an altered global gait pattern (mice walked slower, with shorter strides and with a hindlimb wider base of support than wild-type mice. No differences were detected in the balance beam test. However, a reduced latency to fall was found in the rotarod, coat-hanger and four limb hanging wire tests indicating impairment on coordination and prehensile reflex and a reduction of muscle strength. In histological analyses of cerebellum and skeletal muscle, D2KO mice did not present gross structural abnormalities. Thyroid hormones levels and deiodinases activities were also determined. In D2KO mice, despite euthyroid T3 and high T4 plasma levels, T3 levels were significantly reduced in cerebral cortex (48% reduction and skeletal muscle (33% reduction, but not in the cerebellum where other deiodinase (type 1 is expressed. CONCLUSIONS: The motor alterations observed in D2KO mice indicate an important role for D2 in T3 availability to maintain motor function and muscle strength. Our results suggest a possible implication of D2 in motor disorders.

  18. Shared decision-making: the perspectives of young adults with type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Wiley J

    2014-04-01

    Full Text Available Janice Wiley,1 Mary Westbrook,1 Jerry R Greenfield,2,3 Richard O Day,4 Jeffrey Braithwaite11Centre for Clinical Governance Research in Health, Australian Institute of Health Innovation, University of New South Wales, 2Diabetes and Obesity Program, Garvan Institute of Medical Research, 3Department of Endocrinology, St Vincent's Hospital, University of New South Wales, Sydney, NSW, Australia; 4Department of Clinical Pharmacology, St Vincent's Hospital, University of New South Wales, Sydney, NSW, AustraliaBackground: Shared decision-making (SDM is at the core of patient-centered care. We examined whether young adults with type 1 diabetes perceived the clinician groups they consulted as practicing SDM.Methods: In a web-based survey, 150 Australians aged 18–35 years and with type 1 diabetes rated seven aspects of SDM in their interactions with endocrinologists, diabetes educators, dieticians, and general practitioners. Additionally, 33 participants in seven focus groups discussed these aspects of SDM.Results: Of the 150 respondents, 90% consulted endocrinologists, 60% diabetes educators, 33% dieticians, and 37% general practitioners. The majority of participants rated all professions as oriented toward all aspects of SDM, but there were professional differences. These ranged from 94.4% to 82.2% for "My clinician enquires about how I manage my diabetes"; 93.4% to 82.2% for "My clinician listens to my opinion about my diabetes management"; 89.9% to 74.1% for "My clinician is supportive of my diabetes management"; 93.2% to 66.1% for "My clinician suggests ways in which I can improve my self-management”; 96.6% to 85.7% for “The advice of my clinician can be understood”; 98.9% to 82.2% for “The advice of my clinician can be trusted”; and 86.5% to 67.9% for “The advice of my clinician is consistent with other members of the diabetes team". Diabetes educators received the highest ratings on all aspects of SDM. The mean weighted average of

  19. Differences in Amounts and Types of Physical Activity by Obesity Status in US Adults

    Science.gov (United States)

    Spees, Colleen K.; Scott, Jonathan M.; Taylor, Christopher A.

    2012-01-01

    Objectives: To describe the physical activity patterns across levels of obesity among US adults. Methods: The frequency, intensity, and duration of physical activities were compared across obesity status in 7695 adults from NHANES, 1999-2006. Results: Significantly more normal-weight adults engaged in moderate- and vigorous- intensity activities…

  20. The Effects of Intensive Nutrition Education on Late Middle-Aged Adults with Type 2 Diabetes

    Science.gov (United States)

    Li, Ye; Xu, Meihong; Fan, Rui; Ma, Xiaotao; Gu, Jiaojiao; Cai, Xiaxia; Liu, Rui; Chen, Qihe; Ren, Jinwei; Mao, Ruixue; Bao, Lei; Zhang, Zhaofeng; Wang, Junbo; Li, Yong

    2016-01-01

    no statistical significance between groups. Conclusions: Intensive nutrition education has significant effects on blood glucose control in late middle-aged adults with type 2 diabetes. Intensive education can cultivate good diet habits and increase physical activity, which are important for diabetes patients in the short and long terms. These findings may contribute to improving education methodology and nutrition therapy in patients with type 2 diabetes. PMID:27618080

  1. The Effects of Intensive Nutrition Education on Late Middle-Aged Adults with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Ye Li

    2016-09-01

    , there was no statistical significance between groups. Conclusions: Intensive nutrition education has significant effects on blood glucose control in late middle-aged adults with type 2 diabetes. Intensive education can cultivate good diet habits and increase physical activity, which are important for diabetes patients in the short and long terms. These findings may contribute to improving education methodology and nutrition therapy in patients with type 2 diabetes.

  2. Heterogeneous pattern of bone disease in adult type 1 Gaucher disease: clinical and pathological correlates.

    Science.gov (United States)

    van Dussen, L; Lips, P; van Essen, H W; Hollak, C E M; Bravenboer, N

    2014-09-01

    Gaucher disease (GD) is a lysosomal storage disorder characterized by accumulation of glucosylceramide in macrophages, so-called Gaucher cells, as a result of a deficiency of the lysosomal enzyme glucocerebrosidase. Bone complications are an important cause of morbidity of GD and are thought to result from imbalance in bone remodeling. Bone manifestations among GD patients demonstrate a large variation including increased osteoclastic bone resorption, low bone formation and osteonecrosis. The purpose of the current case series is to describe the histological features observed in undecalcified bone samples, obtained from three GD patients, and evaluate the relationship with clinical features in these patients. Bone fragments were obtained from three adult type 1 GD patients with variable degrees of bone disease during orthopedic surgery. Specimens were embedded without prior decalcification in methylmethacrylate and prepared for histology according to standardized laboratory procedures. Histology revealed a heterogeneous pattern of bone involvement. High cellularity of bone marrow, abundant presence of Gaucher cells (GCs) and high turnover were observed in a patient with a history of multiple bone complications, while minimal bone turnover and few GCs were detected in the mildest affected patient in this series. An intermediate picture with relatively low bone turnover and a substantial amount of Gaucher cells was demonstrated in the third, moderately affected patient. No gross abnormalities in three biochemical markers of bone turnover (osteocalcin, N-terminal propeptide of type 1 procollagen and type 1 collagen C-terminal telopeptide) were noted. Plastic embedding and subsequent Goldner and TRAP staining offered a unique possibility to study bone histological findings in GD. Our data show that bone manifestations in GD may vary both clinically as well as histologically and bone disease in GD will likely require a personalized approach.

  3. Beta Cell Formation in vivo Through Cellular Networking, Integration and Processing (CNIP) in Wild Type Adult Mice.

    Science.gov (United States)

    Doiron, Bruno; Hu, Wenchao; DeFronzo, Ralph A

    2016-01-01

    Insulin replacement therapy is essential in type 1 diabetic individuals and is required in ~40- 50% of type 2 diabetics during their lifetime. Prior attempts at beta cell regeneration have relied upon pancreatic injury to induce beta cell proliferation, dedifferentiation and activation of the embryonic pathway, or stem cell replacement. We report an alternative method to transform adult non-stem (somatic) cells into pancreatic beta cells. The Cellular Networking, Integration and Processing (CNIP) approach targets cellular mechanisms involved in pancreatic function in the organ's adult state and utilizes a synergistic mechanism that integrates three important levels of cellular regulation to induce beta cell formation: (i) glucose metabolism, (ii) membrane receptor function, and (iii) gene transcription. The aim of the present study was to induce pancreatic beta cell formation in vivo in adult animals without stem cells and without dedifferentiating cells to recapitulate the embryonic pathway as previously published (1-3). Our results employing CNIP demonstrate that: (i) insulin secreting cells can be generated in adult pancreatic tissue in vivo and circumvent the problem of generating endocrine (glucagon and somatostatin) cells that exert deleterious effects on glucose homeostasis, and (ii) longterm normalization of glucose tolerance and insulin secretion can be achieved in a wild type diabetic mouse model. The CNIP cocktail has the potential to be used as a preventative or therapeutic treatment or cure for both type 1 and type 2 diabetes.

  4. Negative appraisals of insulin therapy are common among adults with Type 2 diabetes using insulin

    DEFF Research Database (Denmark)

    Holmes-Truscott, Elizabeth; Skinner, Timothy Chas; Pouwer, F

    2015-01-01

    AIM: To identify insulin therapy appraisals among adults with Type 2 diabetes using insulin and how negative appraisals relate to clinical, self-care and psychosocial outcomes. METHODS: Diabetes MILES - Australia 2011 was a national survey of adults with diabetes, focused on behavioural and psych......AIM: To identify insulin therapy appraisals among adults with Type 2 diabetes using insulin and how negative appraisals relate to clinical, self-care and psychosocial outcomes. METHODS: Diabetes MILES - Australia 2011 was a national survey of adults with diabetes, focused on behavioural...... and psychosocial issues. Subgroup analyses were conducted on the responses of 273 adults with Type 2 diabetes using insulin (46% women; mean ± sd age: 59 ± 9 years; diabetes duration: 12 ± 7 years; years using insulin: 4 ± 4). They completed validated measures of insulin therapy appraisals (ITAS), depression (PHQ......-9), anxiety (GAD-7), diabetes distress (PAID) and diabetes-specific self-efficacy (DES-SF). RESULTS: Insulin was perceived to be very important, and its benefits (e.g. improves health) were endorsed by most (82%). Fifty-one per cent believed that taking insulin means their diabetes has become worse...

  5. 儿童Alport综合征的听力学特征多样性研究%Audiological features in children with alport syndrome

    Institute of Scientific and Technical Information of China (English)

    王蓬鹏; 王华; 张亚梅; 刘世琳; 郑军; 刘海红; 张莉; 张杰

    2015-01-01

    Objective To assess audiological features in children with Alport Syndrome and hearing loss prognosis. Methods Audiologic, nephrologic and opthalmologic findings in 43 cases of Alport syndrome be-tween 2007 and 2013 were reviewed. Their progress was followed up by telephone interview. Results For-ty-three individuals (36 males, 7 females, aged from 22 months to 13 years) underwent audiologic tests, which showed normal hearing in 33 and hearing loss in 10. Of these children with AS, 23.2%(all male) had sensori-neural hearing loss (70%at moderate hearing loss level). Audiometric configuration was“U”-shaped in 7, slop-ing in 2 or flat in 1 patient, respectively. Sensorineural hearing loss was asymmetric in 30%of these patients. For AS children with abnormal hearing, there were more severe podocyte injury as compared with those with normal hearing. Telephone follow-up found that one-third of AS children with normal hearing gradually devel-oped hearing loss, and hearing in those with abnormal hearing became progressively worse. One child with se-vere hearing loss developed end stage renal disease (ESRD). Conclusion Hearing loss is a common symptom of AS, which may reflect the severity of podocyte lesions. Audiometric configuration distribution in AS may vary and can be asymmetric. Children with AS all showed continuing progressive hearing loss.%目的:探讨儿童Alport综合征(Alport Syndrome AS)听力学特点多样性及预后。方法分析2007-2013年北京儿童医院确诊的43例AS患者的听力学特点,病理改变及临床特点并进行电话随访,并进行统计学分析。结果43例诊断为AS儿童中男性36例,女性7例,年龄22个月-13岁,中位数年龄8岁,听力正常组33例,听力异常组10例。①23.2%AS患儿合并感音神经性聋,并且全部为男性,中度聋最常见占70%;②听力曲线图包括谷型7例(70%)、陡降型2例(20%)、平坦型1例(10%);其中有30%听力曲线呈非对称分

  6. Changes in Insulin Secretion and Action in Adults With Familial Risk for Type 2 Diabetes Who Curtail Their Sleep

    OpenAIRE

    Darukhanavala, Amy; Booth, John N.; Bromley, Lindsay; Whitmore, Harry; Imperial, Jacqueline; Penev, Plamen D.

    2011-01-01

    OBJECTIVE Experimental sleep deprivation is accompanied by changes in glucose regulation. However, the effects of chronic sleep insufficiency on insulin secretion and action in populations at high risk for type 2 diabetes are not known. This study examined the relationship between objectively documented habitual sleep curtailment and measures of insulin sensitivity, insulin secretion, and oral glucose tolerance in free-living adults with parental history of type 2 diabetes. RESEARCH DESIGN AN...

  7. A case of adult Pompe disease presenting with severe fatigue and selective involvement of type 1 muscle fibers.

    Science.gov (United States)

    van den Berg, Linda E M; de Vries, Juna M; Verdijk, Robert M; van der Ploeg, Ans T; Reuser, Arnold J J; van Doorn, Pieter A

    2011-03-01

    We present a case of adult Pompe disease (acid maltase deficiency) with an uncommon clinical presentation characterized by severe fatigue and myalgia prior to the onset of limb girdle weakness. Remarkably, the muscle biopsy demonstrated selective involvement of type 1 muscle fibers. The cause and clinical effects of fiber type specific involvement are currently unknown, but the phenomenon might contribute to the clinical heterogeneity in Pompe disease and the variable response to enzyme replacement therapy.

  8. Association of dietary pattern with biochemical blood profiles and bodyweight among adults with Type 2 diabetes mellitus in Tehran, Iran

    OpenAIRE

    Darani Zad, Nasrin; Mohd Yusof, Rokiah; Esmaili, Haleh; Jamaluddin, Rosita; Mohseni, Fariba

    2015-01-01

    Background This study was conducted to identify dietary patterns and evaluated their association with biochemical blood profiles and body weight among adults with type 2 diabetes mellitus. Methods This was a cross sectional study conducted among 400 patients with type 2 diabetes mellitus in Tehran from March to August 2013. Biochemical blood profiles, socio-demographic, lifestyle, anthropometric measurements, and dietary data were obtained. Dietary data from food frequency questionnaire were ...

  9. Diabetes-Related distress, depression and Distress-Depression among adults with type 2 diabetes mellitus in Malaysia

    NARCIS (Netherlands)

    Chew, Boon How; Vos, Rimke; Mohd-Sidik, Sherina; Rutten, Guy E H M

    2016-01-01

    Type 2 diabetes mellitus (T2DM) brings about an increasing psychosocial problem in adult patients. Prevalence data on and associated factors of diabetes related distress (DRD) and depression have been lacking in Asia. This study aimed to examine the prevalence of DRD and depression, and their associ

  10. Alport Syndrome Diagnosis

    Science.gov (United States)

    ... Groups Support ASF Donate Fundraising & Events Team ASF Online Shopping Annual Campaign Donors Annual Campaign for Healthy Kidneys ... Groups Support ASF Donate Fundraising & Events Team ASF Online Shopping Annual Campaign Donors Annual Campaign for Healthy Kidneys ...

  11. Alport Syndrome Foundation

    Science.gov (United States)

    ... Groups Support ASF Donate Fundraising & Events Team ASF Online Shopping Annual Campaign Donors Annual Campaign for Healthy Kidneys ... Groups Support ASF Donate Fundraising & Events Team ASF Online Shopping Annual Campaign Donors Annual Campaign for Healthy Kidneys ...

  12. Intensive Treatment and Severe Hypoglycemia Among Adults With Type 2 Diabetes

    Science.gov (United States)

    McCoy, Rozalina G.; Lipska, Kasia J.; Yao, Xiaoxi; Ross, Joseph S.; Montori, Victor M.; Shah, Nilay D.

    2017-01-01

    Importance Intensive glucose-lowering treatment among patients with non–insulin-requiring type 2 diabetes may increase the risk of hypoglycemia. Objectives To estimate the prevalence of intensive treatment and the association between intensive treatment, clinical complexity, and incidence of severe hypoglycemia among adults with type 2 diabetes who are not using insulin. Design, Setting, and Participants Retrospective analysis of administrative, pharmacy, and laboratory data from the OptumLabs Data Warehouse from January 1, 2001, through December 31, 2013. The study included nonpregnant adults 18 years or older with type 2 diabetes who achieved and maintained a hemoglobin A1c (HbA1c) level less than 7.0% without use of insulin and had no episodes of severe hypoglycemia or hyperglycemia in the prior 12 months. Main Outcomes and Measures Risk-adjusted probability of intensive treatment and incident severe hypoglycemia, stratified by patient clinical complexity. Intensive treatment was defined as use of more glucose-lowering medications than recommended by practice guidelines at specific index HbA1c levels. Severe hypoglycemia was ascertained by ambulatory, emergency department, and hospital claims for hypoglycemia during the 2 years after the index HbA1c test. Patients were categorized as having high vs low clinical complexity if they were 75 years or older, had dementia or end-stage renal disease, or had 3 or more serious chronic conditions. Results Of 31 542 eligible patients (median age, 58 years; interquartile range, 51–65 years; 15 483 women [49.1%]; 18 188 white [57.7%]), 3910 (12.4%) had clinical complexity. The risk-adjusted probability of intensive treatment was 25.7% (95% CI, 25.1%–26.2%) in patients with low clinical complexity and 20.8% (95% CI, 19.4%–22.2%) in patients with high clinical complexity. In patients with low clinical complexity, the risk-adjusted probability of severe hypoglycemia during the subsequent 2 years was 1.02% (95% CI, 0

  13. Arnold-Chiari Malformation Type I and II in Iranian Adults: Clinical and Radiologic Features

    Directory of Open Access Journals (Sweden)

    M. Masuomian

    2008-01-01

    Full Text Available Background/Objective: To evaluate clinical and ra-diological presentations of Arnold chiari malforma-tion in Iranian adults."nPatients and Methods: eighty patients with the clini-cal and radiological features of the chiari malforma-tions were evaluated by using computed tomography scan (CT scan or MRI, from 2001 to 2005 in our uni-versity-affiliated hospital. Surgical confirmation of the diagnosis was obtained in all patients."nResults: The mean age of our cases was 26.7 years (18-58 years.Our patients consisted of 14 (77.7% male and four (22.3% female. The most common presenting symptom was sensory complaints in eight patients (44.5%. Headache, gait disturbances, vertigo and cerebellar dysfunction (vertigo and nystagmus, were seen in 6 (33.3%, 4 (22.2%, 3 (16.6% and 2 (11.1% patients respectively. According to surgery, 15 (83.3% were classified as chiari I malformation, while three patients (16.7% fulfilled the anatomic criteria of chiari II. Imaging showed that all patients had cerebellar herniation. Hydrocephaly, Meningo-myelocele, syringomyelia, cerebellar atrophy and corpus callosum agenesis were seen in five (27.7%, 3 (16.7%, 6 (33.3%, 2 (11.1% and one (5.1% patients respectively. "nConclusion: Chiari type I was more common than type II in our patients such as others and syringemye-lia was the most common imaging abnormality after cerebellar herniation.

  14. Schmallenberg virus infection of adult type I interferon receptor knock-out mice.

    Science.gov (United States)

    Wernike, Kerstin; Breithaupt, Angele; Keller, Markus; Hoffmann, Bernd; Beer, Martin; Eschbaumer, Michael

    2012-01-01

    Schmallenberg virus (SBV), a novel orthobunyavirus, was discovered in Europe in late 2011. It causes mild and transient disease in adult ruminants, but fetal infection can lead to abortion or severe malformations. There is considerable demand for SBV research, but in vivo studies in large animals are complicated by their long gestation periods and the cost of high containment housing. The goal of this study was to investigate whether type I interferon receptor knock-out (IFNAR(-/-)) mice are a suitable small animal model for SBV. Twenty IFNAR(-/-) mice were inoculated with SBV, four were kept as controls. After inoculation, all were observed and weighed daily; two mice per day were sacrificed and blood, brain, lungs, liver, spleen, and intestine were harvested. All but one inoculated mouse lost weight, and two mice died spontaneously at the end of the first week, while another two had to be euthanized. Real-time RT-PCR detected large amounts of SBV RNA in all dead or sick mice; the controls were healthy and PCR-negative. IFNAR(-/-) mice are susceptible to SBV infection and can develop fatal disease, making them a handy and versatile tool for SBV vaccine research.

  15. Schmallenberg virus infection of adult type I interferon receptor knock-out mice.

    Directory of Open Access Journals (Sweden)

    Kerstin Wernike

    Full Text Available Schmallenberg virus (SBV, a novel orthobunyavirus, was discovered in Europe in late 2011. It causes mild and transient disease in adult ruminants, but fetal infection can lead to abortion or severe malformations. There is considerable demand for SBV research, but in vivo studies in large animals are complicated by their long gestation periods and the cost of high containment housing. The goal of this study was to investigate whether type I interferon receptor knock-out (IFNAR(-/- mice are a suitable small animal model for SBV. Twenty IFNAR(-/- mice were inoculated with SBV, four were kept as controls. After inoculation, all were observed and weighed daily; two mice per day were sacrificed and blood, brain, lungs, liver, spleen, and intestine were harvested. All but one inoculated mouse lost weight, and two mice died spontaneously at the end of the first week, while another two had to be euthanized. Real-time RT-PCR detected large amounts of SBV RNA in all dead or sick mice; the controls were healthy and PCR-negative. IFNAR(-/- mice are susceptible to SBV infection and can develop fatal disease, making them a handy and versatile tool for SBV vaccine research.

  16. Incidence of diabetes mellitus type 2 complications among Saudi adult patients at primary health care center.

    Science.gov (United States)

    Alsenany, Samira; Al Saif, Amer

    2015-06-01

    [Purpose] This study analyzed type 2 diabetes and its role in complications among adult Saudi patients. [Subjects] Patients attending four primary health care centers in Jeddah were enrolled. [Methods] A cross-sectional design study among Saudi patients attending Ministry of Health primary health care centers in Jeddah was selected for use by the Primary Health Care administration. Patients were interviewed with structured questionnaires to determine the presence of diabetes and risk factors using questions about the history of any disease. [Results] Diabetes mellitus was present in 234 subjects during the data collection period (March-June 2014). Mean patient age was 58 years; diabetes prevalence was 42% in males and 58% in females. The mean age for diabetes onset in males and females was 34 and 39 years, respectively. There was a higher incidence of obesity (75%) associated with a sedentary lifestyle (body mass index ≥25) in females (N= 96; 40%) compared with males (N= 87; 36%). In this study, >44% of individuals aged 55 or older had severe to uncontrolled diabetes with long-term complications. The age-adjusted incidence of hypertension and coronary heart disease was 38% and 24%, respectively, showing a clear incidence of diabetes associated with cardiovascular disease in Saudi Arabia. [Conclusion] This study found that a multifactorial approach to managing diabetes complication risks is needed.

  17. Dental caries prevalence among type II diabetic and nondiabetic adults attending a hospital

    Science.gov (United States)

    Malvania, Ekta A.; Sheth, Sona A.; Sharma, Ashish S.; Mansuri, Saloni; Shaikh, Faizan; Sahani, Saloni

    2016-01-01

    Objectives: Diabetes mellitus (DM) is a common chronic metabolic disorder which affects millions of people. At present, India has the highest incidence of diabetes worldwide. Several oral lesions and conditions are associated with diabetes. However, there is a lack of consensus among researchers regarding the relationship between DM and dental caries. Hence, the present study was carried out to assess the dental caries prevalence among type II diabetic and nondiabetic adults attending a hospital in Ahmedabad city. Materials and Methods: A hospital-based cross-sectional study was conducted. One hundred and twenty diabetics individuals attending the diabetic Outpatient Department (OPD) and age and sex-matched 120 nondiabetic individuals from general OPD were included in the study. The data were gathered through semi-close-ended questionnaire and clinical examination. Dental caries was assessed by using the World Health Organization's 2013 proforma. Data was analyzed by applying Student's independent t-test or one-way analysis of variance. Results: Dental caries prevalence among the diabetic group was 73.33% and 33.33% among the nondiabetic group. Dental caries prevalence and mean dental caries was significantly higher among uncontrolled diabetic individuals than that among controlled diabetic individuals. Duration of the disease and dental caries prevalence did not show any significant difference. Conclusion: Dental caries prevalence was significantly high among diabetic individuals compared with nondiabetic individuals. Close collaboration between the patients, healthcare units, and oral health professionals could be a way of improving diabetic patients' general and oral health. PMID:28217542

  18. RNAi silencing of P/Q-type calcium channels in Purkinje neurons of adult mouse leads to episodic ataxia type 2.

    Science.gov (United States)

    Salvi, Julie; Bertaso, Federica; Mausset-Bonnefont, Anne-Laure; Metz, Alexandra; Lemmers, Céline; Ango, Fabrice; Fagni, Laurent; Lory, Philippe; Mezghrani, Alexandre

    2014-08-01

    Episodic ataxia type-2 (EA2) is a dominantly inherited human neurological disorder caused by loss of function mutations in the CACNA1A gene, which encodes the CaV2.1 subunit of P/Q-type voltage-gated calcium channels. It remains however unknown whether the deficit of cerebellar CaV2.1 in adult is in direct link with the disease. To address this issue, we have used lentiviral based-vector RNA interference (RNAi) to knock-down CaV2.1 expression in the cerebellum of adult mice. We show that suppression of the P/Q-type channels in Purkinje neurons induced motor abnormalities, such as imbalance and ataxic gait. Interestingly, moderate channel suppression caused no basal ataxia, while β-adrenergic activation and exercise mimicked stress induced motor disorders. Moreover, stress-induced ataxia was stable, non-progressive and totally abolished by acetazolamide, a carbonic anhydrase inhibitor used to treat EA2. Altogether, these data reveal that P/Q-type channel suppression in adult mice supports the episodic status of EA2 disease.

  19. Invasive pneumococcal disease in healthy adults: increase of empyema associated with the clonal-type Sweden(1-ST306.

    Directory of Open Access Journals (Sweden)

    Imma Grau

    Full Text Available BACKGROUND: Adult invasive pneumococcal disease (IPD occurs mainly in the elderly and patients with co-morbidities. Little is known about the clinical characteristics, serotypes and genotypes causing IPD in healthy adults. METHODS: We studied 745 culture-proven cases of IPD in adult patients aged 18-64 years (1996-2010. Patients were included in two groups: 1. adults with co-morbidities, and 2. healthy adults, who had no prior or coincident diagnosis of a chronic or immunosuppressive underlying disease. Microbiological studies included pneumococcal serotyping and genotyping. RESULTS: Of 745 IPD episodes, 525 (70% occurred in patients with co-morbidities and 220 (30% in healthy adults. The healthy adults with IPD were often smokers (56% or alcohol abusers (18%. As compared to patients with co-morbidities, the healthy adults had (P<0.05: younger age (43.5+/-13.1 vs. 48.7+/-11.3 years; higher proportions of women (45% vs. 24%, pneumonia with empyema (15% vs. 7% and infection with non-PCV7 serotypes including serotypes 1 (25% vs. 5%, 7F (13% vs. 4%, and 5 (7% vs. 2%; and lower mortality (5% vs. 20%. Empyema was more frequently caused by serotype 1. No death occurred among 79 patients with serotype 1 IPD. There was an emergence of virulent clonal-types Sweden(1-ST306 and Netherlands(7F-ST191. The vaccine serotype coverage with the PCV13 was higher in healthy adults than in patients with co-morbidities: 82% and 56%, respectively, P<0.001. CONCLUSION: In this clinical study, one-third of adults with IPD had no underlying chronic or immunosuppressive diseases (healthy adults. They were often smokers and alcohol abusers, and frequently presents with pneumonia and empyema caused by virulent clones of non-PCV7 serotypes such as the Sweden(1-ST306. Thus, implementing tobacco and alcohol abuse-cessation measures and a proper pneumococcal vaccination, such as PCV13 policy, in active smokers and alcohol abusers may diminish the burden of IPD in adults.

  20. Uptake of health monitoring and disease self-management in Australian adults with neurofibromatosis type 1: strategies to improve care.

    Science.gov (United States)

    Crawford, H A; Barton, B; Wilson, M J; Berman, Y; McKelvey-Martin, V J; Morrison, P J; North, K N

    2016-03-01

    Lifelong health monitoring is recommended in neurofibromatosis type 1 (NF1) because of the progressive and unpredictable range of disabling and potentially life-threatening symptoms that arise. In Australia, strategies for NF1 health surveillance are less well developed for adults than they are for children, resulting in inequalities between pediatric and adult care. The aims of this study were to determine the uptake of health monitoring and capacity of adults with NF1 to self-manage their health. Australian adults with NF1 (n = 94, 18-40 years) participated in a semi-structured interview. Almost half reported no regular health monitoring. Thematic analysis of interviews identified four main themes as to why: (i) did not know where to seek care, (ii) unaware of the need for regular monitoring, (iii) futility of health monitoring as nothing can be done for NF1, and (iv) feeling healthy, therefore monitoring unnecessary. Overall, there were low levels of patient activation, indicating that adults with NF1 lacked knowledge and confidence to manage their health and health care. Findings are discussed in the context of service provision for adults with NF1 in New South Wales, Australia.

  1. Management of cardiovascular disease risk factors in older adults with type 2 diabetes mellitus: 2002-2012 literature review.

    Science.gov (United States)

    Moreno, Gerardo; Mangione, Carol M

    2013-11-01

    Type 2 diabetes mellitus (DM) is one of the most common chronic conditions in older adults and is often accompanied by comorbidities and geriatric syndromes. The management of cardiovascular disease risk factors in older adults with DM is important to clinicians. The literature was reviewed from 2002 to 2012 to provide an American Geriatrics Society expert panel with an evidence base for updating and making new recommendations for improving the care of older adults with type 2 DM. This review includes only the domains of the management of blood pressure, lipid control, glycemic control, and use of aspirin. Over the last 10 years, new randomized controlled trials (RCT) designed to study different blood pressure treatment targets did not find evidence that intensive systolic blood pressure control (older adults, but data on niacin and fibrates is limited. Trials of statins and other lipid-lowering agents do not evaluate the cardiovascular effects on outcomes from treating lipids to different low-density lipoprotein cholesterol targets. No RCTs of lipid-lowering drugs enrolled significant numbers of adults aged 80 and older with or without DM. Three major RCTs that investigated intensive glycemic control did not find reductions in primary cardiovascular endpoints, and one study reported greater mortality with glycosylated hemoglobin of less than 6%. Two recently published RCTs were designed to study the cardiovascular benefits of aspirin use by individuals with DM. Neither trial found significantly fewer primary cardiovascular endpoints with aspirin than in control groups. Overall, RCTs enrolled few adults aged 80 and older or with significant comorbidities. More research is needed for clinicians to effectively customize care to older adults with DM because of heterogeneity in health status, comorbidities, duration of disease, frailty and functional status, and differences in life expectancy.

  2. Bone mineral density in children and young adults with neurofibromatosis type 1.

    Science.gov (United States)

    Lodish, Maya B; Dagalakis, Urania; Sinaii, Ninet; Bornstein, Ethan; Kim, Aerang; Lokie, Kelsey B; Baldwin, Andrea M; Reynolds, James C; Dombi, Eva; Stratakis, Constantine A; Widemann, Brigitte C

    2012-12-01

    Concern for impaired bone health in children with neurofibromatosis type 1 (NF-1) has led to increased interest in bone densitometry in this population. Our study assessed bone mineral apparent density (BMAD) and whole-body bone mineral content (BMC)/height in pediatric patients with NF-1 with a high plexiform neurofibroma burden. Sixty-nine patients with NF-1 (age range 5.2-24.8; mean 13.7 ± 4.8 years) were studied. Hologic dual-energy X-ray absorptiometry scans (Hologic, Inc., Bedford, MA, USA) were performed on all patients. BMD was normalized to derive a reference volume by correcting for height through the use of the BMAD, as well as the BMC. BMAD of the lumbar spine (LS 2-4), femoral neck (FN), and total body BMC/height were measured and Z-scores were calculated. Impaired bone mineral density was defined as a Z-score ≤-2. Forty-seven percent of patients exhibited impaired bone mineral density at any bone site, with 36% at the LS, 18% at the FN, and 20% total BMC/height. BMAD Z-scores of the LS (-1.60 ± 1.26) were more impaired compared with both the FN (-0.54 ± 1.58; P=0.0003) and the whole-body BMC/height Z-scores (-1.16 ± 0.90; P=0.036). Plexiform neurofibroma burden was negatively correlated with LS BMAD (r(s)=-0.36, P=0.01). In pediatric and young adult patients with NF-1, LS BMAD was more severely affected than the FN BMAD or whole-body BMC/height.

  3. Acute Resveratrol Consumption Improves Neurovascular Coupling Capacity in Adults with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Rachel H.X. Wong

    2016-07-01

    Full Text Available Background: Poor cerebral perfusion may contribute to cognitive impairment in type 2 diabetes mellitus (T2DM. We conducted a randomized controlled trial to test the hypothesis that resveratrol can enhance cerebral vasodilator function and thereby alleviate the cognitive deficits in T2DM. We have already reported that acute resveratrol consumption improved cerebrovascular responsiveness (CVR to hypercapnia. We now report the effects of resveratrol on neurovascular coupling capacity (CVR to cognitive stimuli, cognitive performance and correlations with plasma resveratrol concentrations. Methods: Thirty-six T2DM adults aged 40–80 years were randomized to consume single doses of resveratrol (0, 75, 150 and 300 mg at weekly intervals. Transcranial Doppler ultrasound was used to monitor changes in blood flow velocity (BFV during a cognitive test battery. The battery consisted of dual-tasking (finger tapping with both Trail Making task and Serial Subtraction 3 task and a computerized multi-tasking test that required attending to four tasks simultaneously. CVR to cognitive tasks was calculated as the per cent increase in BFV from pre-test basal to peak mean blood flow velocity and also as the area under the curve for BFV. Results: Compared to placebo, 75 mg resveratrol significantly improved neurovascular coupling capacity, which correlated with plasma total resveratrol levels. Enhanced performance on the multi-tasking test battery was also evident following 75 mg and 300 mg of resveratrol. Conclusion: a single 75 mg dose of resveratrol was able to improve neurovascular coupling and cognitive performance in T2DM. Evaluation of benefits of chronic resveratrol supplementation is now warranted.

  4. Steatogenesis in adult-onset type II citrullinemia is associated with down-regulation of PPARα.

    Science.gov (United States)

    Komatsu, Michiharu; Kimura, Takefumi; Yazaki, Masahide; Tanaka, Naoki; Yang, Yang; Nakajima, Takero; Horiuchi, Akira; Fang, Zhong-Ze; Joshita, Satoru; Matsumoto, Akihiro; Umemura, Takeji; Tanaka, Eiji; Gonzalez, Frank J; Ikeda, Shu-Ichi; Aoyama, Toshifumi

    2015-03-01

    SLC25A13 (citrin or aspartate-glutamate carrier 2) is located in the mitochondrial membrane in the liver and its genetic deficiency causes adult-onset type II citrullinemia (CTLN2). CTLN2 is one of the urea cycle disorders characterized by sudden-onset hyperammonemia due to reduced argininosuccinate synthase activity. This disorder is frequently accompanied with hepatosteatosis in the absence of obesity and ethanol consumption. However, the precise mechanism of steatogenesis remains unclear. The expression of genes associated with fatty acid (FA) and triglyceride (TG) metabolism was examined using liver samples obtained from 16 CTLN2 patients and compared with 7 healthy individuals. Although expression of hepatic genes associated with lipogenesis and TG hydrolysis was not changed, the mRNAs encoding enzymes/proteins involved in FA oxidation (carnitine palmitoyl-CoA transferase 1α, medium- and very-long-chain acyl-CoA dehydrogenases, and acyl-CoA oxidase 1), very-low-density lipoprotein secretion (microsomal TG transfer protein), and FA transport (CD36 and FA-binding protein 1), were markedly suppressed in CTLN2 patients. Serum concentrations of ketone bodies were also decreased in these patients, suggesting reduced mitochondrial β-oxidation activity. Consistent with these findings, the expression of peroxisome proliferator-activated receptor α (PPARα), a master regulator of hepatic lipid metabolism, was significantly down-regulated. Hepatic PPARα expression was inversely correlated with severity of steatosis and circulating ammonia and citrulline levels. Additionally, phosphorylation of c-Jun-N-terminal kinase was enhanced in CTLN2 livers, which was likely associated with lower hepatic PPARα. Collectively, down-regulation of PPARα is associated with steatogenesis in CTLN2 patients. These findings provide a novel link between urea cycle disorder, lipid metabolism, and PPARα.

  5. Elbow dislocation with ipsilateral diaphyseal fractures of radius and ulna in an adult-is it type 1 or type 2 Monteggia equivalent lesion?

    Directory of Open Access Journals (Sweden)

    Modi Prashant

    2012-11-01

    Full Text Available 【Abstract】 Elbow dislocation with concomitant dia-physeal fractures of radius and ulna has been reported rarely. This injury could be included in Monteggia equivalent le-sions based on the mechanism of injury, radiographic pat-tern and method of treatment as described by Bado. We report a rare case of Monteggia equivalent lesion in an adult with unclear mechanism of injury. The possible mechanism of injury, its management and the follow-up results were described. An attempt to solve the controversy regarding whether labeling it as type 1 or type 2 was made. Key words: Elbow; Dislocations; Monteggia’s fracture; Fracture fixation, internal

  6. Elbow dislocation with ipsilateral diaphyseal fractures of radius and ulna in an adult-is it type 1 or type 2 Monteggia equivalent lesion?

    Institute of Scientific and Technical Information of China (English)

    Prashant Modi; Ish Kumar Dhammi; Ashish Rustagi; Anil K Jain

    2012-01-01

    Elbow dislocation with concomitant diaphyseal fractures of radius and ulna has been reported rarely.This injury could be included in Monteggia equivalent lesions based on the mechanism of injury,radiographic pattern and method of treatment as described by Bado.We report a rare case of Monteggia equivalent lesion in an adult with unclear mechanism of injury.The possible mechanism of injury,its management and the follow-up results were described.An attempt to solve the controversy regarding whether labeling it as type 1 or type 2 was made.

  7. Comparison Study of the Stuttered Words Type in Stuttering Children and Adults

    Directory of Open Access Journals (Sweden)

    Maryam Mokhlessin

    2006-06-01

    Full Text Available Background and Aim: Since knowing the mechanisms which evoke non-fluency is the first step in the treatment of stuttering, and there are very few researches in Persian which consider the role of the linguistic factors behind stuttering, this study is an attempt to provide answers to some of numerous questions about stuttering by comparing the stuttered words` type in stuttered children and adults. Materials and Methods: In this study stuttered people were divided into 5 age groups as follows: 3-6, 7-9, 10-12, 13-16, and older than 17 years old. Each group had ten participants. Forty-two of the 50 participants were male, and the youngest person was 3 years old and the eldest one was 32 years old. The study method involved recording at least 5 minuets of spontaneous speech of every one who was diagnosed of suffering from stuttering by two speech and language pathologists. The percent of non-fluency on every word's type was determined where a content word was followed or preceded by a function word (Function-Function-Content words and Function-Content words contexts. Then these findings were analyzed by Kruskal-Wallis and Mann-Whitney tests. Results: The results of this study show while function words are dominantly more stuttered than content words in children less than 13 years old in Function-Function-Content words context, we consider more disfluency on content words and second function word by getting old. We consider more stuttering on function words in children less that 13 years old in Function-Content words context too and increased non-fluency on content word by growing up. Results also show meaningful differences between the fifth group and others in the amount of stuttering on second function word in the Function-Function-Content words contexts and also between the first group and the others in amount of non-fluency both on function and content words in Function-Content words context. Conclusion: People who stutter from Farsi speakers

  8. The Type I Interferon Response Determines Differences in Choroid Plexus Susceptibility between Newborns and Adults in Herpes Simplex Virus Encephalitis

    Directory of Open Access Journals (Sweden)

    Douglas R. Wilcox

    2016-04-01

    Full Text Available Newborns are significantly more susceptible to severe viral encephalitis than adults, with differences in the host response to infection implicated as a major factor. However, the specific host signaling pathways responsible for differences in susceptibility and neurologic morbidity have remained unknown. In a murine model of HSV encephalitis, we demonstrated that the choroid plexus (CP is susceptible to herpes simplex virus 1 (HSV-1 early in infection of the newborn but not the adult brain. We confirmed susceptibility of the CP to HSV infection in a human case of newborn HSV encephalitis. We investigated components of the type I interferon (IFN response in the murine brain that might account for differences in cell susceptibility and found that newborns have a dampened interferon response and significantly lower basal levels of the alpha/beta interferon (IFN-α/β receptor (IFNAR than do adults. To test the contribution of IFNAR to restricting infection from the CP, we infected IFNAR knockout (KO adult mice, which showed restored CP susceptibility to HSV-1 infection in the adult. Furthermore, reduced IFNAR levels did not account for differences we found in the basal levels of several other innate signaling proteins in the wild-type newborn and the adult, including protein kinase R (PKR, that suggested specific regulation of innate immunity in the developing brain. Viral targeting of the CP, a region of the brain that plays a critical role in neurodevelopment, provides a link between newborn susceptibility to HSV and long-term neurologic morbidity among survivors of newborn HSV encephalitis.

  9. Molecular Characterization of Wild Type Measles Virus from Adult Patients in Northern China, 2014

    Directory of Open Access Journals (Sweden)

    Wen Xu

    2016-04-01

    Conclusions: Important factors contributing to outbreaks could include weak vaccination coverage, poor vaccination strategies, and migration of adult workers between cities, countries, and from rural areas to urban areas.

  10. Interactional power: observing and identifying power in interaction analyses of adult education situations depending on power notions and data types

    Directory of Open Access Journals (Sweden)

    Sigrid Nolda

    2014-04-01

    Full Text Available Since the 1970s, various aspects of power have been at the focus of theoretical and empirical adult education research. Despite the actual interest in political and discursive aspects of power, this article emphasizes the importance of interactional studies when observing and identifying power based on various types of data. As for German interaction studies, three phases can be distinguished, characterized by a observations of failed participation based on records of classroom behaviour, b the identification of mutual power negotiation in classroom and counselling situations based on transcriptions, and c the identification of the power of physical settings in adult education classrooms and in counselling sessions based on visual data. It is presumed that observing/identifying power in adult education classrooms and counselling sessions generally depends not only on the notions of power underlying the studies but also on the data types produced and the methods applied for their interpretation. In addition, the question is raised whether the identification of power can be considered a power practice used by adult education researchers.

  11. Emergent severe acute respiratory distress syndrome caused by adenovirus type 55 in immunocompetent adults in 2013: a prospective observational study

    OpenAIRE

    Sun, Bing; He, Hangyong; Wang, Zheng; Qu, Jiuxin; Li, Xuyan; Chengjun BAN; Wan, Jun; Cao, Bin; Tong, Zhaohui; Wang, Chen

    2014-01-01

    Introduction Since 2008, severe cases of emerging human adenovirus type 55 (HAdV-55) in immunocompetent adults have been reported sporadically in China. The clinical features and outcomes of the most critically ill patients with severe acute respiratory distress syndrome (ARDS) caused by HAdV-55 requiring invasive mechanical ventilation (IMV) and/or extracorporeal membrane oxygenation (ECMO) are lacking. Methods We conducted a prospective, single-center observational study of pneumonia with A...

  12. ACHIEVING LIPID TARGETS IN ADULTS WITH TYPE 2 DIABETES--THE SANDS STUDY

    Science.gov (United States)

    Russell, Marie; Silverman, Angela; Fleg, Jerome L.; Lee, Elisa T.; Mete, Mihriye; Weir, Matthew; Wilson, Charlton; Yeh, Fawn; Howard, Barbara V.; Howard, Wm. James

    2010-01-01

    Background Although lipid management in diabetes is standard practice, goals often are neither met nor maintained. Strategies for achieving lower targets have not been explored. The Stop Atherosclerosis in Native Diabetics Study (SANDS) randomized patients with diabetes to standard versus aggressive lipid and blood pressure goals for 36 months. Objective To report strategies used to achieve and maintain lipid goals and to report adverse events (AEs). Methods Adults with type 2 diabetes and no history of cardiovascular disease (N=499) were randomized to standard (low-density lipoprotein cholesterol [LDL-C]≤100 mg/dL, non-high-density lipoprotein cholesterol [non-HDL-C]≤130 mg/dL) or aggressive (LDL-C≤70 mg/dL, non-HDL-C≤100 mg/dL) targets. An algorithm started with statin monotherapy, adding intestinally acting agents as required to reach LDL-C targets. Triglyceride [TG]-lowering agents were next used to reach non-HDL-C goals. Lipid management was performed by mid-level practitioners, with physician consultation, using point-of-care lipid determinations. Results On average, both groups achieved the LDL-C and non-HDL-C goals within 12 months and maintained them throughout the study. At 36 months, mean (SD) LDL-C and non-HDL-C were 72 (24) and 102 (29) mg/dL in the aggressive group (AGG) and 104 (20) and 138 (26) mg/dL, respectively, in the standard group (STD); systolic blood pressure targets were 115 and 130 mmHg, respectively. 68% of participants reached target LDL-C for >50% of the visits and 46% for >75% of visits. At 36 months, the AGG averaged 1.5 lipid lowering medications and the STD 1.2. Statins were used in 91% and 68% of the AGG and STD; ezetimibe by 31% and 10%; fibrates by 8% and 18%. No serious adverse events (SAEs) were observed; AEs occurred in 18% of the AGG and 14% of the STD. Conclusion Standard and aggressive lipid targets can be safely maintained in diabetic patients. Standardized algorithms, point-of-care lipid testing, and non

  13. Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services

    Science.gov (United States)

    Ewen, Heidi H.; Washington, Tiffany R.; Emerson, Kerstin G.; Carswell, Andrew T.; Smith, Matthew Lee

    2017-01-01

    Background: The majority of older adults prefer to remain in their homes, or to “age-in-place.” To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults’ residential environment is associated with their health status and HCBS utilization. Building upon the Person–Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs

  14. Adding chemo after radiation treatment improves survival for adults with a type of brain tumor

    Science.gov (United States)

    Adults with low-grade gliomas, a form of brain tumor, who received chemotherapy following completion of radiation therapy lived longer than patients who received radiation therapy alone, according to long-term follow-up results from a NIH-supported random

  15. Severe hypoglycemia, impaired awareness of hypoglycemia, and self-monitoring in adults with type 1 diabetes

    DEFF Research Database (Denmark)

    Hendrieckx, Christel; Hagger, Virginia; Jenkins, Alicia;

    2016-01-01

    AIMS: To assess prevalence of severe hypoglycemia, awareness and symptoms of hypoglycemia, and their associations with self-monitoring of blood glucose. METHODS: Diabetes MILES-Australia Study participants completed validated questionnaires and study-specific items. RESULTS: Of 642 adults with ty...

  16. Becoming an Australian Citizen: Some Dimensions of Assessing a Citizenship-Type Literacy amongst Adults

    Science.gov (United States)

    Athanasou, James A.

    2010-01-01

    This paper evaluates a 20-item assessment of citizenship literacy in an adult sample comprising 179 persons of English-speaking and non-English speaking background. The results indicated that the assessment was internally consistent and that as expected it distinguished English-speaking from non-English speaking participants. The pattern of…

  17. Two types of recollection-based monitoring in younger and older adults: Recall-to-reject and the distinctiveness heuristic.

    Science.gov (United States)

    Gallo, David A; Bell, Deborah M; Beier, Jonathan S; Schacter, Daniel L

    2006-08-01

    People often use recollection to avoid false memories. At least two types of recollection-based monitoring processes can be identified in the literature. Recall-to-reject is based on the recall of logically inconsistent information (which disqualifies the false event from having occurred), whereas the distinctiveness heuristic is based on the failure to recall to-be-expected information (which is diagnostic of non-occurrence). We attempted to investigate these hypothetical monitoring processes in a single task, as a first step at delineating the functional relationship between them. By design, participants could reject familiar lures by (1) recalling them from a to-be-excluded list (recall-to-reject) or (2) realising the absence of expected picture recollections (the distinctiveness heuristic). Both manipulations reduced false recognition in young adults, suggesting that these two types of monitoring were deployed on the same test. In contrast, older adults had limited success in reducing false recognition with either manipulation, indicating deficits in recollection-based monitoring processes. Depending on how a retrieval task is structured, attempts to use one monitoring process might interfere with another, especially in older adults.

  18. The interaction of disrupted type II neuregulin 1 and chronic adolescent stress on adult anxiety- and fear-related behaviors.

    Science.gov (United States)

    Taylor, S B; Taylor, A R; Koenig, J I

    2013-09-26

    The incidence of anxiety, mood, substance abuse disorders and schizophrenia increases during adolescence. Epidemiological evidence confirms that exposure to stress during sensitive periods of development can create vulnerabilities that put genetically predisposed individuals at increased risk for psychiatric disorders. Neuregulin 1 (NRG1) is a frequently identified schizophrenia susceptibility gene that has also been associated with the psychotic features of bipolar disorder. Previously, we established that Type II NRG1 is expressed in the hypothalamic-pituitary-adrenal (HPA) axis neurocircuitry. We also found, using a line of Nrg1 hypomorphic rats (Nrg1(Tn)), that genetic disruption of Type II NRG1 results in altered HPA axis function and environmental reactivity. The present studies used the Nrg1(Tn) rats to test whether Type II NRG1 gene disruption and chronic stress exposure during adolescence interact to alter adult anxiety- and fear-related behaviors. Male and female Nrg1(Tn) and wild-type rats were exposed to chronic variable stress (CVS) during mid-adolescence and then tested for anxiety-like behavior, cued fear conditioning and basal corticosterone secretion in adulthood. The disruption of Type II NRG1 alone significantly impacts rat anxiety-related behavior by reversing normal sex-related differences and impairs the ability to acquire cued fear conditioning. Sex-specific interactions between genotype and adolescent stress also were identified such that CVS-treated wild-type females exhibited a slight reduction in anxiety-like behavior and basal corticosterone, while CVS-treated Nrg1(Tn) females exhibited a significant increase in cued fear extinction. These studies confirm the importance of Type II NRG1 in anxiety and fear behaviors and point to adolescence as a time when stressful experiences can shape adult behavior and HPA axis function.

  19. Utilization of 3-Month Yoga Program for Adults at High Risk for Type 2 Diabetes: A Pilot Study

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    Kyeongra Yang

    2011-01-01

    Full Text Available Various modes of physical activity, combined with dieting, have been widely recommended to prevent or delay type 2 diabetes. Among these, yoga holds promise for reducing risk factors for type 2 diabetes by promoting weight loss, improving glucose levels and reducing blood pressure and lipid levels. This pilot study aimed to assess the feasibility of implementing a 12-week yoga program among adults at high risk for type 2 diabetes. Twenty-three adults (19 Whites and 4 non-Whites were randomly assigned to the yoga intervention group or the educational group. The yoga group participated in a 3-month yoga intervention with sessions twice per week and the educational group received general health educational materials every 2 weeks. All participants completed questionnaires and had blood tests at baseline and at the end of 3 months. Effect sizes were reported to summarize the efficacy of the intervention. All participants assigned to the yoga intervention completed the yoga program without complication and expressed high satisfaction with the program (99.2%. Their yoga session attendance ranged from 58.3 to 100%. Compared with the education group, the yoga group experienced improvements in weight, blood pressure, insulin, triglycerides and exercise self-efficacy indicated by small to large effect sizes. This preliminary study indicates that a yoga program would be a possible risk reduction option for adults at high risk for type 2 diabetes. In addition, yoga holds promise as an approach to reducing cardiometabolic risk factors and increasing exercise self-efficacy for this group.

  20. The prevalence of type 2 diabetes and glucose intolerance in the adult population of the Moscow region

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    A V Dreval'

    2008-06-01

    Full Text Available Currently in Russia, as well as throughout the world, has been steadily increasing prevalence of type 2 diabetes and early disorders of carbohydrate metabolism - impaired glucose tolerance and impaired fasting glucose. It is shown that in the first year after diagnosis "prediabetes" in 5-10% of patients becomes type 2 diabetes, in five years - at 20-35%. If impaired glucose tolerance combined with impaired fasting glucose, the type 2 diabetes within 5 years develops in 38-65%. The true prevalence of overt type 2 diabetes several times higher than registered, from time to onset of the disease before its detection can reach 7-12 years. Up to 50% of patients with type 2 diabetes at diagnosis already have those or other complications. In this case, early detection of type 2 diabetes and early disorders of carbohydrate metabolism contributes to the timely initiation of treatment and prevention of complications of diabetes, can lead to disability of the patient. The aim of this study was to determine the results of oral glucose tolerance test the prevalence of type 2 diabetes and early disorders of carbohydrate metabolism among a select group of the adult population of the Moscow region.

  1. Writing for Health: Rationale and Protocol for a Randomized Controlled Trial of Internet-Based Benefit-Finding Writing for Adults With Type 1 or Type 2 Diabetes

    Science.gov (United States)

    Wilhelm, Kay; Robins, Lisa; Proudfoot, Judy

    2017-01-01

    Background Diabetes mellitus is Australia’s fastest growing chronic disease, and has high comorbidity with depression. Both subthreshold depression and diabetes distress are common amongst people with type 1 or type 2 diabetes, and are associated with poorer diabetes self-care. A need exists for low-intensity self-help interventions for large numbers of people with diabetes and diabetes distress or subthreshold depression, as part of a stepped-care approach to meeting the psychological needs of people with diabetes. Benefit-finding writing is a very brief intervention that involves writing about any positive thoughts and feelings about a stressful experience, such as an illness. Benefit-finding writing has been associated with increases in positive affect and positive growth, and has demonstrated promising results in trials amongst other clinical populations. However, benefit-finding writing has not yet been examined in people with diabetes. Objective The aim of this randomized controlled trial (RCT) is to evaluate the efficacy of an Internet-based benefit-finding writing (iBFW) intervention for adults with type 1 or type 2 diabetes (compared to a control writing condition) for reducing diabetes distress and increasing benefit-finding in diabetes, and also improving a range of secondary outcomes. Methods A two-arm RCT will be conducted, using the online program Writing for Health. Adults with type 1 or type 2 diabetes living in Australia will be recruited using diabetes-related publications and websites, and through advertisements in diabetes services and general practitioners’ offices. Potential participants will be referred to the study-specific website for participant information and screening. All data will be collected online. Participants will be randomized to either iBFW about diabetes, or a control writing condition of writing about use-of-time. Both conditions involve three daily sessions (once per day for three consecutive days) of 15-minute online

  2. Evaluating health-related quality of life in type 1 diabetes: a systematic literature review of utilities for adults with type 1 diabetes

    Science.gov (United States)

    Smith-Palmer, Jayne; Bae, Jay P; Boye, Kristina S; Norrbacka, Kirsi; Hunt, Barnaby; Valentine, William J

    2016-01-01

    Background and aims Type 1 diabetes is a chronic condition associated with micro- and macrovascular complications that have a notable impact on health-related quality of life, the magnitude of which can be quantified via the use of utility values. The aim of this review was to conduct a systematic literature review to identify and compare published health state utility values for adults with type 1 diabetes both, with and without diabetes-related complications. Methods Literature searches of the PubMed, EMBASE, and Cochrane Library databases were performed to identify English language studies on adults with type 1 diabetes, published from 2000 onward, reporting utility values for patients with or without diabetes-related complications or assessing the impact of changes in HbA1c or body mass index on quality of life. For inclusion, studies were required to report utilities elicited using validated methods. Results A total of 20 studies were included in the final review that included utility values elicited using the EuroQuol five dimensions questionnaire (n=9), 15D questionnaire (n=2), Quality of Well-Being scale (n=4), time trade-off (n=3), and standard gamble (n=2) methods. For patients with no complications, reported utility values ranged from 0.90 to 0.98. Complications including stroke (reported disutility range, −0.105 to −0.291), neuropathy (range, −0.055 to −0.358), and blindness (range, −0.132 to −0.208) were associated with the largest decrements in utility values. The magnitude of utility values and utility decrements was influenced by the assessment method used. Conclusion Complications lead to impaired health-related quality of life in patients with type 1 diabetes, the magnitude of which is influenced by the method used to determine utilities. There is currently a lack of utility data for certain complications of type 1 diabetes, meaning that many economic evaluations have relied on a combination of type 1 and type 2 diabetes utilities

  3. Nail involvement in adult patients with plaque-type psoriasis: prevalence and clinical features

    OpenAIRE

    Schons,Karen Regina Rosso; Beber,André Avelino Costa; Beck, Maristela de Oliveira; Monticielo, Odirlei André

    2015-01-01

    Abstract BACKGROUND: Psoriasis is a disease of worldwide distribution with a prevalence of 1 to 3%. Nail psoriasis is estimated in 50% of patients with psoriasis, and in the presence of joint involvement, it can reach 80%. OBJECTIVE: To study the nail changes - and their clinical implications - presented by patients with psoriasis vulgaris under surveillance in a university hospital from the south of Brazil. METHODS: his cross-sectional study evaluated 65 adult patients from January 2012 to M...

  4. The Effects of Tai Chi on Peripheral Somatosensation, Balance, and Fitness in Hispanic Older Adults with Type 2 Diabetes: A Pilot and Feasibility Study

    Directory of Open Access Journals (Sweden)

    Elisabeth I. Cavegn

    2015-01-01

    Full Text Available Peripheral neuropathy and loss of somatosensation in older adults with type 2 diabetes can increase risk of falls and disability. In nondiabetic older adult population Tai Chi has been shown to enhance balance and fitness through improvements in somatosensation and neuromuscular control, and it is unclear if Tai Chi would elicit similar benefits in older adults with diabetes. Therefore, the purpose of this study was to investigate the effects of an 8-week, three-hour-per-week Tai Chi intervention on peripheral somatosensation in older adults with type 2 diabetes. Participants were eight Hispanic older adults with type 2 diabetes who participated in the Tai Chi intervention and a convenience sample of Hispanic older adults as a referent group. Baseline and postintervention assessments included ankle proprioception, foot tactile sense, plantar pressure distribution, balance, and fitness. After intervention, older adults with type 2 diabetes showed significant improvements in ankle proprioception and fitness and decreased plantar pressure in the forefoot, with no statistical effect noted in balance or tactile sensation. Study results suggest that Tai Chi may be beneficial for older adults with diabetes as it improves ankle proprioception; however, study findings need to be confirmed in a larger sample size randomized controlled trial.

  5. Immunity status of adults and children against poliomyelitis virus type 1 strains CHAT and Sabin (LSc-2ab in Germany

    Directory of Open Access Journals (Sweden)

    Diedrich Sabine

    2010-12-01

    Full Text Available Abstract Background In October 2007, the working group CEN/TC 216 of the European Committee for standardisation suggested that the Sabin oral poliovirus vaccine type 1 strain (LSc-2ab presently used for virucidal tests should be replaced by another attenuated vaccine poliovirus type 1 strain, CHAT. Both strains were historically used as oral vaccines, but the Sabin type 1 strain was acknowledged to be more attenuated. In Germany, vaccination against poliomyelitis was introduced in 1962 using the oral polio vaccine (OPV containing Sabin strain LSc-2ab. The vaccination schedule was changed from OPV to an inactivated polio vaccine (IPV containing wild polio virus type 1 strain Mahoney in 1998. In the present study, we assessed potential differences in neutralising antibody titres to Sabin and CHAT in persons with a history of either OPV, IPV, or OPV with IPV booster. Methods Neutralisation poliovirus antibodies against CHAT and Sabin 1 were measured in sera of 41 adults vaccinated with OPV. Additionally, sera from 28 children less than 10 years of age and immunised with IPV only were analysed. The neutralisation assay against poliovirus was performed according to WHO guidelines. Results The neutralisation activity against CHAT in adults with OPV vaccination history was significantly lower than against Sabin poliovirus type 1 strains (Wilcoxon signed-rank test P Conclusion The lack of neutralising antibodies against the CHAT strain in persons vaccinated with OPV might be associated with an increased risk of reinfection with the CHAT polio virus type 1, and this implies a putative risk of transmission of the virus to polio-free communities. We strongly suggest that laboratory workers who were immunised with OPV receive a booster vaccination with IPV before handling CHAT in the laboratory.

  6. Effects of body weight on antibody titers against canine parvovirus type 2, canine distemper virus, and canine adenovirus type 1 in vaccinated domestic adult dogs.

    Science.gov (United States)

    Taguchi, Masayuki; Namikawa, Kazuhiko; Maruo, Takuya; Saito, Miyoko; Lynch, Jonathan; Sahara, Hiroeki

    2012-10-01

    The objective of this study was to determine whether post-vaccination antibody titers vary according to body weight in adult dogs. Antibody titers against canine parvovirus type 2 (CPV-2), canine distemper virus (CDV), and canine adenovirus type 1 (CAdV-1) were measured for 978 domestic adult dogs from 2 to 6 y of age. The dogs had been vaccinated approximately 12 mo earlier with a commercial combination vaccine. The dogs were divided into groups according to their weight. It was found that mean antibody titers in all weight groups were sufficient to prevent infection. Intergroup comparison, however, revealed that CPV-2 antibody titers were significantly higher in the Super Light ( 20 kg) groups and were also significantly higher in the Light (5 to 9.9 kg) group than in the Heavy group. Antibody titers against CDV were significantly higher in the Super Light, Light, and Medium groups than in the Heavy group. There were no significant differences among the groups for the CAdV-1 antibody titers.

  7. Sources of Caffeine in Diets of US Children and Adults: Trends by Beverage Type and Purchase Location

    Directory of Open Access Journals (Sweden)

    Adam Drewnowski

    2016-03-01

    Full Text Available New sources of caffeine, besides coffee and tea, have been introduced into the US food supply. Data on caffeine consumption age and purchase location can help guide public health policy. National Health and Nutrition Examination Surveys (NHANES were used to estimate population-level caffeine intakes, using data from 24-h dietary recall. First, caffeine intakes by age-group and beverage type were estimated using the most recent 2011–2012 data (n = 7456. Second, fourteen years trends in caffeine consumption, overall and by beverage type, were evaluated for adults and children. Trend analyses were conducted by age groups. Last, trends in caffeine intakes by purchase location and beverage type were estimated. In 2011–2012, children aged four to eight years consumed the least caffeine (15 mg/day, and adults aged 51–70 years consumed the most (213 mg/day. The population mean (age ≥ four years was 135 mg/day, driven largely by coffee (90 mg/day, tea (25 mg/day, and soda (21 mg/day. For the 14–19 years and 20–34 years age-groups, energy drinks contributed 6 mg/day (9.9% and 5 mg/day (4.5%, respectively. The bulk of caffeine came from store-bought coffee and tea. Among both children and adults combined, caffeine intakes declined from 175 mg/day (1999–2000 to 142 mg/day (2011–2012, largely driven by a drop in caffeine from soda (41 mg/day to 21 mg/day. Store-bought coffee and tea remain principal drivers of caffeine intake in the US. Sodas and energy drinks make minor contributions to overall caffeine intakes.

  8. Sources of Caffeine in Diets of US Children and Adults: Trends by Beverage Type and Purchase Location.

    Science.gov (United States)

    Drewnowski, Adam; Rehm, Colin D

    2016-03-10

    New sources of caffeine, besides coffee and tea, have been introduced into the US food supply. Data on caffeine consumption age and purchase location can help guide public health policy. National Health and Nutrition Examination Surveys (NHANES) were used to estimate population-level caffeine intakes, using data from 24-h dietary recall. First, caffeine intakes by age-group and beverage type were estimated using the most recent 2011-2012 data (n = 7456). Second, fourteen years trends in caffeine consumption, overall and by beverage type, were evaluated for adults and children. Trend analyses were conducted by age groups. Last, trends in caffeine intakes by purchase location and beverage type were estimated. In 2011-2012, children aged four to eight years consumed the least caffeine (15 mg/day), and adults aged 51-70 years consumed the most (213 mg/day). The population mean (age ≥ four years) was 135 mg/day, driven largely by coffee (90 mg/day), tea (25 mg/day), and soda (21 mg/day). For the 14-19 years and 20-34 years age-groups, energy drinks contributed 6 mg/day (9.9%) and 5 mg/day (4.5%), respectively. The bulk of caffeine came from store-bought coffee and tea. Among both children and adults combined, caffeine intakes declined from 175 mg/day (1999-2000) to 142 mg/day (2011-2012), largely driven by a drop in caffeine from soda (41 mg/day to 21 mg/day). Store-bought coffee and tea remain principal drivers of caffeine intake in the US. Sodas and energy drinks make minor contributions to overall caffeine intakes.

  9. Integrating theory and data to create an online self-management programme for adults with type 2 diabetes: HeLP-Diabetes

    Directory of Open Access Journals (Sweden)

    Kingshuk Pal

    2015-10-01

    This protocol demonstrates a multi-disciplinary approach to combining evidence from multiple sources to create ’HeLP-Diabetes’: a theory and evidence based online self-management intervention for adults with type 2 diabetes.

  10. Adolescent Sexual Debut and Initiation into New-Type Drug Use among a Sample of Young Adults.

    Science.gov (United States)

    Ding, Yingying; He, Na; Detels, Roger

    2015-01-01

    We examined the association between adolescent sexual debut and age at new-type drug initiation among a sample of young adult new-type drug users. A total of 276 participants were recruited using respondent-driven sampling (RDS) in Shanghai, China. The analyses were restricted to a total of 201 participants aged between 18 and 30 years. The average age at sexual debut and age at first new-type drug use were 18.8 and 20.9 years, respectively. About 94% of participants reported having sexual experience (n=188); of those, 137 (72.9%) had sexual debut before they first used new-type drugs, while 32 (17.0%) initiated both events at the same age. After adjustment for age, income, education, and sexual orientation, adolescent sexual debut was independently associated with younger age at new-type drug initiation. Adolescent sexual debut is associated with early onset of new-type drug use. Our findings underscore the importance of implementing sex-education programs for adolescents in schools in China.

  11. Diabetes-Related Distress, Depression and Distress-Depression among Adults with Type 2 Diabetes Mellitus in Malaysia.

    Directory of Open Access Journals (Sweden)

    Boon-How Chew

    Full Text Available Type 2 diabetes mellitus (T2DM brings about an increasing psychosocial problem in adult patients. Prevalence data on and associated factors of diabetes related distress (DRD and depression have been lacking in Asia. This study aimed to examine the prevalence of DRD and depression, and their associated factors in Asian adult T2DM patients. This study was conducted in three public health clinics measuring DRD (Diabetes Distress Scale, DDS, and depression (Patient Health Questionnaire, PHQ. Patients who were at least 30 years of age, had T2DM for more than one year, with regular follow-up and recent laboratory results ( 130/80 mmHg (OR 0.53, 95% CI 0.32 to 0.89 were less likely to experience both DRD and depression. DRD and depression were common and correlated in Asian adults with T2DM at primary care level. Socio-demographic more than clinical characteristics were related to DRD and depression.

  12. Diabetes-Related Distress, Depression and Distress-Depression among Adults with Type 2 Diabetes Mellitus in Malaysia

    Science.gov (United States)

    Chew, Boon-How; Vos, Rimke; Mohd-Sidik, Sherina; Rutten, Guy E. H. M.

    2016-01-01

    Type 2 diabetes mellitus (T2DM) brings about an increasing psychosocial problem in adult patients. Prevalence data on and associated factors of diabetes related distress (DRD) and depression have been lacking in Asia. This study aimed to examine the prevalence of DRD and depression, and their associated factors in Asian adult T2DM patients. This study was conducted in three public health clinics measuring DRD (Diabetes Distress Scale, DDS), and depression (Patient Health Questionnaire, PHQ). Patients who were at least 30 years of age, had T2DM for more than one year, with regular follow-up and recent laboratory results ( 130/80 mmHg (OR 0.53, 95% CI 0.32 to 0.89) were less likely to experience both DRD and depression. DRD and depression were common and correlated in Asian adults with T2DM at primary care level. Socio-demographic more than clinical characteristics were related to DRD and depression. PMID:27002728

  13. Prevalence of tension-type headache in adult general population: the PACE study and review of the literature.

    Science.gov (United States)

    Ferrante, T; Manzoni, G C; Russo, M; Camarda, C; Taga, A; Veronesi, L; Pasquarella, C; Sansebastiano, G; Torelli, P

    2013-05-01

    The mean global prevalence of tension-type headache (TTH) in adult is 42 %. To date, there have been no Italian studies on TTH prevalence in the adult general population. Therefore, we conducted a cross-sectional study, called PACE (PArma CEfalea, or "Headache in Parma"), aimed at detecting the prevalence and clinical features of primary headaches in the city of Parma's adult general population. Crude past-year prevalence for definite TTH was 19.4 % (95 % CI 16.8-21.9), namely 9.0 % (95 % CI 7.1-10.8) for infrequent TTH, 9.8 % (95 % CI 7.9-11.8) for frequent TTH, and 0.6 % (95 % CI 0.1-1) for chronic TTH. Crude prevalence for probable TTH was 2.3 % (95 % CI 1.3-3.3). Our study results indicate a TTH prevalence rate (19.4 %) at the lower limit of data ranges currently available for Western countries, and prevalence rates for infrequent forms (9 %) do not appear much different from those of frequent forms (9.8 %).

  14. Principles of connectivity among morphologically defined cell types in adult neocortex.

    Science.gov (United States)

    Jiang, Xiaolong; Shen, Shan; Cadwell, Cathryn R; Berens, Philipp; Sinz, Fabian; Ecker, Alexander S; Patel, Saumil; Tolias, Andreas S

    2015-11-27

    Since the work of Ramón y Cajal in the late 19th and early 20th centuries, neuroscientists have speculated that a complete understanding of neuronal cell types and their connections is key to explaining complex brain functions. However, a complete census of the constituent cell types and their wiring diagram in mature neocortex remains elusive. By combining octuple whole-cell recordings with an optimized avidin-biotin-peroxidase staining technique, we carried out a morphological and electrophysiological census of neuronal types in layers 1, 2/3, and 5 of mature neocortex and mapped the connectivity between more than 11,000 pairs of identified neurons. We categorized 15 types of interneurons, and each exhibited a characteristic pattern of connectivity with other interneuron types and pyramidal cells. The essential connectivity structure of the neocortical microcircuit could be captured by only a few connectivity motifs.

  15. Accumulation of Major Life Events in Childhood and Adult Life and Risk of Type 2 Diabetes Mellitus.

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    Jolene Masters Pedersen

    Full Text Available The aim of the study was to estimate the effect of the accumulation of major life events (MLE in childhood and adulthood, in both the private and working domains, on risk of type 2 diabetes mellitus (T2DM. Furthermore, we aimed to test the possible interaction between childhood and adult MLE and to investigate modification of these associations by educational attainment.The study was based on 4,761 participants from the Copenhagen City Heart Study free of diabetes at baseline and followed for 10 years. MLE were categorized as 0, 1, 2, 3 or more events. Multivariate logistic regression models adjusted for age, sex, education and family history of diabetes were used to estimate the association between MLE and T2DM.In childhood, experiencing 3 or more MLE was associated with a 69% higher risk of developing T2DM (Odds Ratio (OR 1.69; 95% Confidence Interval (CI 1.60, 3.27. The accumulation of MLE in adult private (p-trend = 0.016 and work life (p-trend = 0.049 was associated with risk of T2DM in a dose response manner. There was no evidence that experiencing MLE in both childhood and adult life was more strongly associated with T2DM than experiencing events at only one time point. There was some evidence that being simultaneously exposed to childhood MLE and short education (OR 2.28; 95% C.I. 1.45, 3.59 and work MLE and short education (OR 2.86; 95% C.I. 1.62, 5.03 was associated with higher risk of T2DM, as the joint effects were greater than the sum of their individual effects.Findings from this study suggest that the accumulation of MLE in childhood, private adult life and work life, respectively, are risk factors for developing T2DM.

  16. Personality and illness adaptation in adults with type 1 diabetes: the intervening role of illness coping and perceptions.

    Science.gov (United States)

    Rassart, Jessica; Luyckx, Koen; Klimstra, Theo A; Moons, Philip; Groven, Chris; Weets, Ilse

    2014-03-01

    Inspired by the common sense model, the present cross-sectional study examined illness perceptions and coping as intervening mechanisms in the relationship between Big Five personality traits and illness adaptation in adults with Type 1 diabetes. A total of 368 individuals with Type 1 diabetes (18-35 years old) completed questionnaires on personality, diabetes-related problems, illness perceptions, and illness coping. First, Neuroticism, Agreeableness, and Conscientiousness predicted patients' illness adaptation, above and beyond the effects of sex, age, and illness duration. Second, illness coping was found to be an important mediating mechanism in the relationship between the Big Five and illness adaptation. Finally, perceived consequences and perceived personal control partially mediated the relationship between the Big Five and illness coping. These findings underscore the importance of examining patients' personality to shed light on their daily functioning and, hence, call for tailored intervention programs which take into account the personality of the individual patient.

  17. The association between types of eating behaviour and dispositional mindfulness in adults with diabetes. Results from Diabetes MILES. The Netherlands

    DEFF Research Database (Denmark)

    Tak, Sanne R; Hendrieckx, Christel; Nefs, Giesje

    2015-01-01

    high levels of dispositional mindfulness have been associated with greater awareness of healthy dietary practices in students and in the general population, it is relevant to study the association between dispositional mindfulness and eating behaviour in people with type 1 or 2 diabetes. We analysed...... data from Diabetes MILES - The Netherlands, a national observational survey in which 634 adults with type 1 or 2 diabetes completed the Dutch Eating Behaviour Questionnaire (to assess restrained, external and emotional eating behaviour) and the Five Facet Mindfulness Questionnaire-Short Form (to assess...... dispositional mindfulness), in addition to other psychosocial measures. After controlling for potential confounders, including demographics, clinical variables and emotional distress, hierarchical linear regression analyses showed that higher levels of dispositional mindfulness were associated with eating...

  18. Relationship of food security with Type 2 diabetes and its risk factors in Tehranian adults

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    Majid Hasan-Ghomi

    2015-01-01

    Conclusions: There were no significant differences in food security levels of diabetic and non-diabetic groups. However, some risk factors of type 2 diabetes including sex, marital status, educational level, and obesity were associated with food insecurity.

  19. Socioeconomic Gradients in Different Types of Tobacco Use in India: Evidence from Global Adult Tobacco Survey 2009-10.

    Science.gov (United States)

    Singh, Ankur; Arora, Monika; English, Dallas R; Mathur, Manu R

    2015-01-01

    Socioeconomic differences in tobacco use have been reported, but there is a lack of evidence on how they vary according to types of tobacco use. This study explored socioeconomic differences associated with cigarette, bidi, smokeless tobacco (SLT), and dual use (smoking and smokeless tobacco use) in India and tested whether these differences vary by gender and residential area. Secondary analysis of Global Adult Tobacco Survey (GATS) 2009-10 (n = 69,296) was conducted. The primary outcomes were self-reported cigarette, bidi smoking, SLT, and dual use. The main explanatory variables were wealth, education, and occupation. Associations were assessed using multinomial logistic regressions. 69,030 adults participated in the study. Positive association was observed between wealth and prevalence of cigarette smoking while inverse associations were observed for bidi smoking, SLT, and dual use after adjustment for potential confounders. Inverse associations with education were observed for all four types after adjusting for confounders. Significant interactions were observed for gender and area in the association between cigarette, bidi, and smokeless tobacco use with wealth and education. The probability of cigarette smoking was higher for wealthier individuals while the probability of bidi smoking, smokeless tobacco use, and dual use was higher for those with lesser wealth and education.

  20. Socioeconomic Gradients in Different Types of Tobacco Use in India: Evidence from Global Adult Tobacco Survey 2009-10

    Directory of Open Access Journals (Sweden)

    Ankur Singh

    2015-01-01

    Full Text Available Socioeconomic differences in tobacco use have been reported, but there is a lack of evidence on how they vary according to types of tobacco use. This study explored socioeconomic differences associated with cigarette, bidi, smokeless tobacco (SLT, and dual use (smoking and smokeless tobacco use in India and tested whether these differences vary by gender and residential area. Secondary analysis of Global Adult Tobacco Survey (GATS 2009-10 (n=69,296 was conducted. The primary outcomes were self-reported cigarette, bidi smoking, SLT, and dual use. The main explanatory variables were wealth, education, and occupation. Associations were assessed using multinomial logistic regressions. 69,030 adults participated in the study. Positive association was observed between wealth and prevalence of cigarette smoking while inverse associations were observed for bidi smoking, SLT, and dual use after adjustment for potential confounders. Inverse associations with education were observed for all four types after adjusting for confounders. Significant interactions were observed for gender and area in the association between cigarette, bidi, and smokeless tobacco use with wealth and education. The probability of cigarette smoking was higher for wealthier individuals while the probability of bidi smoking, smokeless tobacco use, and dual use was higher for those with lesser wealth and education.

  1. Factors affecting smile esthetics in adults with different types of anterior overjet malocclusion

    Science.gov (United States)

    Cheng, Pei-Chin

    2017-01-01

    Objective This study aimed to quantitatively assess the relationship of smile esthetic variables with various types of malocclusion, and identify the cephalometric factors affecting smile measurements. Methods This retrospective study included 106 patients who were treated with retention at the orthodontic department of Taipei Medical University Hospital. Hard-tissue variables were measured using lateral cephalographic tracings, and nine smile esthetic variables were measured using facial photographs. The patients were divided into three groups according to their overjet ( 4 mm). An analysis of variance was conducted to compare the pretreatment cephalometric variables and smile esthetic variables among the three groups. Multiple linear regression analysis was performed to identify the cephalometric factors affecting the smile measurements in each group. Results Except the upper midline and buccal corridor ratio, all of the smile measurements differed significantly among the three groups before orthodontic treatment. Some of the smile characteristics were correlated with the cephalometric measurements in different types of malocclusion. The overjet was the major factor influencing the smile pattern in all three types of malocclusion. Conclusions Smile characteristics differ between different types of malocclusion; the smile may be influenced by skeletal pattern, dental procumbency, or facial type. These findings indicate that establishment of an optimal horizontal anterior teeth relationship is the key to improving the smile characteristics in different types of malocclusion. PMID:28127537

  2. Distinct clinical and laboratory characteristics of latent autoimmune diabetes in adults in relation to type 1 and type 2 diabetes mellitus.

    Science.gov (United States)

    Pipi, Elena; Marketou, Marietta; Tsirogianni, Alexandra

    2014-08-15

    Ever since its first appearance among the multiple forms of diabetes, latent autoimmune diabetes in adults (LADA), has been the focus of endless discussions concerning mainly its existence as a special type of diabetes. In this mini-review, through browsing important peer-reviewed publications, (original articles and reviews), we will attempt to refresh our knowledge regarding LADA hoping to enhance our understanding of this controversial diabetes entity. A unique combination of immunological, clinical and metabolic characteristics has been identified in this group of patients, namely persistent islet cell antibodies, high frequency of thyroid and gastric autoimmunity, DR3 and DR4 human leukocyte antigen haplotypes, progressive loss of beta cells, adult disease onset, normal weight, defective glycaemic control, and without tendency to ketoacidosis. Although anthropomorphic measurements are useful as a first line screening, the detection of C-peptide levels and the presence of glutamic acid decarboxylase (GAD) autoantibodies is undoubtedly the sine qua non condition for a confirmatory LADA diagnosis. In point of fact, GAD autoantibodies are far from being solely a biomarker and the specific role of these autoantibodies in disease pathogenesis is still to be thoroughly studied. Nevertheless, the lack of diagnostic criteria and guidelines still puzzle the physicians, who struggle between early diagnosis and correct timing for insulin treatment.

  3. Orthodontic treatment in adult with type I temporomandibular dysfunction : A case report

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    A Sai Prakash

    2012-01-01

    Full Text Available The relationship between occlusion and TMJ has been the subject of considerable controversy. It is widely believed that the TMJ signs and symptoms such as Joint pain, clicking, locking and headaches are secondary to abnormalities of occlusion, with actual derangement being uncommon. This case report is to put forward the hypothesis that, type I TMD is often due primarily to occlusal interferences for which orthodontic treatment is generally effective. This case report underlines the significance of fixed orthodontic appliance along with the anterior bite plane splint used in correction of type I TMD.

  4. Neonatal infection with neurotropic influenza A virus affects working memory and expression of type III Nrg1 in adult mice.

    Science.gov (United States)

    Asp, Linnéa; Beraki, Simret; Kristensson, Krister; Ogren, Sven Ove; Karlsson, Håkan

    2009-08-01

    Epidemiological studies suggest that early life infections may contribute to the development of psychiatric disorders characterized by cognitive deficits. Here, we studied the effects of a neonatal influenza A/WSN/33 virus infection on locomotor activity, working memory and emotional behavior in adult mice. In addition to wild type mice, immunodeficient (Tap1(-/-)) mice lacking functional CD8(+) T cells, were included in the study to model the potential influence of a genetic deficit relating to virus clearance. Three to four months after the infection, infected Tap1(-/-) mice, but not wild type mice, exhibited deficits in working memory as well as increased rearing activity and anxiety. In the medial prefrontal cortices of these infected Tap1(-/-) mice reduced levels of type III Nrg1 transcripts were observed supporting a role for neuregulin 1 signaling in neuronal circuits involved in working memory. Virus replication, distribution or clearance did not differ between the two genotypes. The lack of CD8(+) T cells, however, appeared to contribute to a more pronounced glia response in Tap1(-/-) than in wild type mice. Thus, the present study suggest that the risk of developing deficits in cognitive and emotional behavior following a CNS infection during brain development is influenced by genetic variation in genes involved in the immune response.

  5. Cardiac abnormalities in adults with the attenuated form of mucopolysaccharidosis type I

    NARCIS (Netherlands)

    O.I.I. Soliman (Osama Ibrahim Ibrahim); R.G.M. Timmermans (Remco); A. Nemes (Attila); W.B. Vletter (Wim); J.H.P. Wilson (Paul); F.J. ten Cate (Folkert); M.L. Geleijnse (Marcel)

    2007-01-01

    textabstractBackground: Cardiac involvement in mucopolysaccharidosis type I (MPS I) has been studied primarily in its most severe forms. Cardiac involvement, particularly left ventricular (LV) systolic and diastolic function, in the attenuated form of MPS I is less well known. Methods: Cardiac funct

  6. Associations between economic hardship and markers of self-management in adults with type 2 diabetes

    DEFF Research Database (Denmark)

    O'Neil, Adrienne; Williams, Emily D; Browne, Jessica L;

    2014-01-01

    OBJECTIVE: A socioeconomic gradient exists in Australia for type 2 diabetes mellitus (T2DM). It remains unclear whether economic hardship is associated with T2DM self-management behaviours. METHODS: Cross-sectional data from a subset of the Diabetes MILES - Australia study were used (n=915). The ...

  7. Chiari Type I Malformations in Young Adults: Implications for the College Health Practitioner

    Science.gov (United States)

    Elam, Mary Jane; Vaughn, John A.

    2011-01-01

    In this article, the authors describe 2 cases of Chiari type I malformation (CM-I) in students presenting to a college health center within a 6-month period. A review of CM-I, including epidemiology, typical presentation, evaluation, and management, is followed by a discussion of the clinical and functional implications of the disorder in an…

  8. Response to Comment on "Principles of connectivity among morphologically defined cell types in adult neocortex".

    Science.gov (United States)

    Jiang, Xiaolong; Shen, Shan; Sinz, Fabian; Reimer, Jacob; Cadwell, Cathryn R; Berens, Philipp; Ecker, Alexander S; Patel, Saumil; Denfield, George H; Froudarakis, Emmanouil; Li, Shuang; Walker, Edgar; Tolias, Andreas S

    2016-09-01

    The critique of Barth et al centers on three points: (i) the completeness of our study is overstated; (ii) the connectivity matrix we describe is biased by technical limitations of our brain-slicing and multipatching methods; and (iii) our cell classification scheme is arbitrary and we have simply renamed previously identified interneuron types. We address these criticisms in our Response.

  9. Epidermal growth factor regulation in adult rat alveolar type II cells of amiloride-sensitive cation channels.

    Science.gov (United States)

    Kemp, P J; Borok, Z; Kim, K J; Lubman, R L; Danto, S I; Crandall, E D

    1999-12-01

    Using the patch-clamp technique, we studied the effects of epidermal growth factor (EGF) on whole cell and single channel currents in adult rat alveolar epithelial type II cells in primary culture in the presence or absence of EGF for 48 h. In symmetrical sodium isethionate solutions, EGF exposure caused a significant increase in the type II cell whole cell conductance. Amiloride (10 microM) produced approximately 20-30% inhibition of the whole cell conductance in both the presence and absence of EGF, such that EGF caused the magnitude of the amiloride-sensitive component to more than double. Northern analysis showed that alpha-, beta- and gamma-subunits of rat epithelial Na(+) channel (rENaC) steady-state mRNA levels were all significantly decreased by EGF. At the single channel level, all active inside-out patches demonstrated only 25-pS channels that were amiloride sensitive and relatively nonselective for cations (P(Na(+))/P(K(+)) approximately 1.0:0.48). Although the biophysical characteristics (conductance, open-state probability, and selectivity) of the channels from EGF-treated and untreated cells were essentially identical, channel density was increased by EGF; the modal channel per patch was increased from 1 to 2. These findings indicate that EGF increases expression of nonselective, amiloride-sensitive cation channels in adult alveolar epithelial type II cells. The contribution of rENaC to the total EGF-dependent cation current under these conditions is quantitatively less important than that of the nonselective cation channels in these cells.

  10. Yoga Practice for the Management of Type II Diabetes Mellitus in Adults: A systematic Review

    Directory of Open Access Journals (Sweden)

    Badr Aljasir

    2010-01-01

    Full Text Available The effect of practicing yoga for the management of type II Diabetes was assessed in this systematic review through searching related electronic databases and the grey literature to the end of May 2007 using Ovid. All randomized controlled clinical trials (RCTs comparing yoga practice with other type of intervention or with regular practice or both, were included regardless of language or type of publication. Each study was assessed for quality by two independent reviewers. Mean difference was used for summarizing the effect of each study outcomes with 95% confidence intervals. Pooling of the studies did not take place due to the wide clinical variation between the studies. Publication bias was assessed by statistical methods. Five trials with 363 participants met the inclusion criteria with medium to high risk of bias and different intervention characteristics. The studies’ results show improvement in outcomes among patients with diabetes type II. These improvements were mainly among short term or immediate diabetes outcomes and not all were statistically significant. The results were inconclusive and not significant for the long-term outcomes. No adverse effects were reported in any of the included studies. Short-term benefits for patients with diabetes may be achieved from practicing yoga. Further research is needed in this area. Factors like quality of the trials and other methodological issues should be improved by large randomized control trials with allocation concealment to assess the effectiveness of yoga on diabetes type II. A definitive recommendation for physicians to encourage their patients to practice yoga cannot be reached at present.

  11. Trends in hypertension prevalence, awareness, treatment and control in an adult type 2 diabetes Spanish population between 2003 and 2009.

    Directory of Open Access Journals (Sweden)

    Carmen de Burgos-Lunar

    Full Text Available In patients with type 2 diabetes, the prevalence of hypertension is higher than in non-diabetic subjects. Despite the high cardiovascular risk involving hypertension in these patients, its prevalence and control are not well known. The aims of this study were: to estimate the hypertension prevalence, awareness, treatment and control in Spanish adults with type 2 diabetes attended in Primary Care; and to analyse its time trend from 2003 to 2009. A serial cross-sectional study from 2003 to 2009 was performed in 21 Primary Care Centres in Madrid. The study population comprised all patients with diagnosed type 2 diabetes in their computerised medical history. Overall annual prevalence during the period 2003-2009 was calculated from and according to sex and age groups. Linear trend tests, regression lines and coefficients of determination were used. In 2003 89.78% (CI 87.92-91.64 of patients with type 2 diabetes suffered hypertension and 94.76% (CI: 92.85-96.67 in 2009. This percentage was greater for women and for patients over 65 years old. 30% of patients suffered previously undiagnosed hypertension in 2003 and 23.1% in 2009. 97% of diagnosed patients received pharmacological treatment and 28.79% reached the blood pressure objective in 2009. The average number of antihypertensive drugs taken was 2.72 in 2003 and 3.27 in 2009. Only 5.2% of patients with type 2 diabetes show blood pressure levels below 130/80 mmHg. Although significant improvements have been achieved in the diagnosis and control of hypertension in people with type 2 diabetes, these continue to remain far from optimum.

  12. Prevalence of Type 2 Diabetes among High-Risk Adults in Shanghai from 2002 to 2012

    Science.gov (United States)

    Hou, Xuhong; Lu, Huijuan; Shen, Yixie; Chen, Ruihua; Fang, Pingyan; Yu, Hong; Li, Ming; Zhang, Feng; Chen, Haibing; Yu, Haoyong; Zhou, Jian; Liu, Fang; Bao, Yuqian; Jia, Weiping

    2014-01-01

    Objective The objective of this study was to evaluate the trend and prevalence of prediabetes and diabetes among high-risk adults in Shanghai from 2002 to 2012. Methods From 2002 to 2012, 10043 subjects with known risk factors for diabetes participated in the diabetes-screening project at the Shanghai Sixth People’s Hospital of Shanghai Jiao Tong University. All participants were asked to complete a nurse-administered standard questionnaire concerning age, sex, smoking status, and personal and family histories of diabetes, cardiovascular disease, stroke, hypertension and other diseases. The participants’ body mass index scores, blood pressures and blood glucose levels at 0, 30, 60, 120 and 180 min were measured in response to a 75 g oral glucose tolerance test. Results The overall prevalence of diabetes increased from 27.93% to 34.78% between 2002 and 2012 in high-risk subjects. The study also showed that the prevalence increased much faster in male compared to female subjects. Specifically, an increased rate was seen in middle-aged men, with no change observed in middle-aged females over the eleven-year period. Conclusion This study showed that sex, age, parental diabetic history, and being overweight were associated with an increased risk for diabetes in high-risk people. Therefore, as prediabetes and diabetes are highly prevalent in people with multiple diabetes risk factors in Shanghai, screening programs targeting these individuals may be beneficial. PMID:25047241

  13. Prevalence of type 2 diabetes among high-risk adults in Shanghai from 2002 to 2012.

    Directory of Open Access Journals (Sweden)

    Congrong Wang

    Full Text Available The objective of this study was to evaluate the trend and prevalence of prediabetes and diabetes among high-risk adults in Shanghai from 2002 to 2012.From 2002 to 2012, 10043 subjects with known risk factors for diabetes participated in the diabetes-screening project at the Shanghai Sixth People's Hospital of Shanghai Jiao Tong University. All participants were asked to complete a nurse-administered standard questionnaire concerning age, sex, smoking status, and personal and family histories of diabetes, cardiovascular disease, stroke, hypertension and other diseases. The participants' body mass index scores, blood pressures and blood glucose levels at 0, 30, 60, 120 and 180 min were measured in response to a 75 g oral glucose tolerance test.The overall prevalence of diabetes increased from 27.93% to 34.78% between 2002 and 2012 in high-risk subjects. The study also showed that the prevalence increased much faster in male compared to female subjects. Specifically, an increased rate was seen in middle-aged men, with no change observed in middle-aged females over the eleven-year period.This study showed that sex, age, parental diabetic history, and being overweight were associated with an increased risk for diabetes in high-risk people. Therefore, as prediabetes and diabetes are highly prevalent in people with multiple diabetes risk factors in Shanghai, screening programs targeting these individuals may be beneficial.

  14. Chromium Exposure in the Adult Population, Consuming Different Types of Smokeless Tobacco Products in Pakistan.

    Science.gov (United States)

    Akhtar, Asma; Afridi, Hasan Imran; Kazi, Tasneem Gul; Talpur, Farah Naz; Arain, Sadaf Sadia; Baig, Jameel Ahmed; Khan, Noman; Khan, Mustafa; Bilal, Muhammad

    2017-02-01

    The pervasive smokeless tobacco (SLT) consumption and diseases related to its use is a hot topic for the public discussion. In this study, concentrations of chromium (Cr) were measured in different SLT products [snuff (dry and moist), mainpuri, and gutkha] offered and used in Pakistan. The current study was also designed to assess the Cr levels in the biological (scalp hair and blood) samples of male and female subjects, age ranged from 25 to 60 years, chewing different SLT products. For comparative purpose, the healthy persons of the same age group, who did not consume any SLT products, were selected as referents. The concentrations of Cr in SLT products and biological samples were measured by electrothermal atomic absorption spectrophotometer after microwave-assisted acid digestion. The validity and accuracy of the methodology were checked by certified reference materials (CRMs). The resulted data indicated that the adult persons, who consumed different SLT products, have 2-3 fold higher levels of Cr in biological samples as compared to referent subjects (p consumption of various kinds of SLT products (snuff, mainpuri, and gutkha) may subsidize 21.2-220, 17.7-122, and 18.4-273 % of the recommended daily intake of Cr, respectively.

  15. Higher body mass index in adults at diagnosis of the slowly progressive form of type 1 diabetes mellitus is associated with lower risk HLA genes.

    Science.gov (United States)

    Fourlanos, S; Elkassaby, S; Varney, M D; Colman, P G; Harrison, L C

    2014-06-01

    We hypothesised that higher body weight, a proposed risk factor for type 1 diabetes mellitus, would be associated with increased penetrance of lower risk genes. In adults at diagnosis of the slowly progressive form of type 1 diabetes mellitus we found that higher body mass index was associated with the absence of the highest risk HLA genes.

  16. Children's, adolescents', and young adults' thinking about different types of disagreements.

    Science.gov (United States)

    Wainryb, C; Shaw, L A; Laupa, M; Smith, K R

    2001-05-01

    Individuals' thinking about different types of disagreements was examined. Ninety-six participants in third grade (mean age = 8 years 9 months), seventh grade (mean age = 13 years 2 months), and college (mean age = 21 years 10 months) judged the acceptability of believing and acting on different types of beliefs with which they disagree, the attributes of the persons with whom they disagree, and the relative importance of cultural uniformity or diversity of belief. Findings indicated that participants' thinking did not simply become more tolerant with age; their thinking at all ages was constrained by both the realm over which there was disagreement and the form of the disagreement. At all ages, participants judged that some disagreements were acceptable and some unacceptable, described disagreeing others in terms of different (more or less positive) attributes, and judged that diversity of belief was important in some realms but uniformity was preferable in others.

  17. Exosome-like vesicles derived by Schistosoma japonicum adult worms mediates M1 type immune- activity of macrophage.

    Science.gov (United States)

    Wang, Lifu; Li, Zhitao; Shen, Jia; Liu, Zhen; Liang, Jinyi; Wu, Xiaoying; Sun, Xi; Wu, Zhongdao

    2015-05-01

    Exosomes are 30-100-nm membrane vesicles of endocytic origin that are released into the extracellular space upon fusion of the multi-vesicular bodies (MVB) with the plasma membrane, while initial studies described that the role of exosomes was a reticulocyte cargo-disposal mechanism allowing remodeling of the plasma membrane during the maturation of reticulocytes to erythrocytes. Recent studies indicate that exosomes are secreted by most cells and pathogens and play an important role in intercellular signaling and exert regulatory function by carrying bioactive molecules. As numerous pathogens, adult worm of Schistosoma japonicum (S. japonicum) reside in mesenteric veins of definitive host including man and mammal animals. It was reported that the worms or the eggs also have specialized secretion systems to export effector proteins or other molecules into host target cells. However, the mechanisms involved remained unclear. This study investigated the isolation of the exosome-like vesicles secreted by S. japonicum adult worms and its immune activity on microphage in vitro. In this report, we identified exosome-based secretion as a new mechanism for protein secretion by S. japonicum. Electron microscopy tomography revealed the previously unidentified ultrastructural detail of exosome-like vesicles with high resolution; they were found to be typical spherical shape and to have a diverse population that varies in size of 30-100 nm. Exosome-like vesicles isolated from S. japonicum contained a significantly different protein compared with debris pelleted and the apoptosis body. We also demonstrate that macrophages were preferentially differentiated into the M1 subtype while being treated with S. japonicum exosome-like vesicles. This study reveals there are exosome-like vesicles derived by S. japonicum adult worms, and the exosome-like vesicles can mediate M1-type immune- activity of macrophage.

  18. Glucocorticoids, feto-placental 11 beta-hydroxysteroid dehydrogenase type 2, and the early life origins of adult disease.

    Science.gov (United States)

    Seckl, J R

    1997-01-01

    Increasing human epidemiological data suggest that events that subtly retard intrauterine growth may determine common disorders, such as hypertension and non-insulin-dependent diabetes, in adult life. The underlying mechanisms are unknown. However, excessive fetal exposure to glucocorticoids retards growth and "programs" adult hypertension in rats. 11 beta-Hydroxysteroid dehydrogenase type 2 (11 beta-HSD2) catalyzes the rapid inactivation of cortisol and corticosterone to inert 11 keto-products. Normally, 11 beta-HSD2 in the placenta and some fetal tissues is thought to protect the fetus from excess maternal glucocorticoids. In both rats and humans there is considerable natural variation in placental 11 beta-HSD2, and enzyme activity correlates with birth weight. Moreover, inhibition of feto-placental 11 beta-HSD2 in the rat reduces birth weight and produces hypertensive and hyperglycaemic adult offspring, many months after prenatal treatment; effects are dependent upon intact maternal adrenals, suggesting a direct action on the fetus or placenta. Maternal protein restriction during pregnancy also produces hypertensive offspring and selectively attenuates placental 11 beta-HSD2 activity. These data suggest that feto-placental 11 beta-HSD2, by regulating fetal exposure to maternal glucocorticoids, crucially determines fetal growth and the programming of later disorders. Deficiency of the barrier to maternal glucocorticoids may represent a common pathway between the maternal environment and feto-placental programming of later disease. These data may, at least in part, explain the human observations linking early life events to the risk of subsequent disease.

  19. Outcome of surgical treatment of type IV capitellum fractures in adults

    Institute of Scientific and Technical Information of China (English)

    Ajay Pal Singh; Ish Kumar Dhammi; Vipul Garg; Arun Pal Singh

    2012-01-01

    Objective:Fractures of the capitellum and trochlea constitute less than 1% of all elbow fractures and a shear fracture involving the capitellum and extending medially into most of the trochlea is rarely reported.Type IV capitellum fracture is still controversial in regard to its radiographic appearance,surgical approach and osteosynthesis.We report 10 cases of type IV capitellum fracture with a view to elucidating its clinical features and treatment outcome.Methods:We treated 10 patients of type IV capitellum fracture with a mean age of 32 years.A uniform surgical approach and postoperative rehabilitation were followed.Results:Nine patients presented to us after a mean of 4 days of injury and one patient was nonunion after 6 months of injury who had been treated conservatively by a bone setter.Double arc sign was absent in 6 cases.Intraoperatively 6 capitellotrochlear fragments were devoid of soft tissue attachments.By Mayo Elbow Performance Score evaluation,7 patients got excellent,2 good and l fair results.One patient with associated elbow dislocation developed heterotopic ossification.There was no case of avascular necrosis,osteoarthrosis or fixation failures.Conclusions:Type IV capitellum fractures are rare and belong to complex articular injuries.A good functional outcome can only be achieved with open reduction and stable internal fixation followed by early mobilization.Preoperative radiographic assessment and computed tomography help surgeons in choosing the right surgical approach and implants.Good surgical technique and stable internal fixation are the keys to early mobilization and good functional outcome.

  20. Patient-reported outcome following nonsurgical management of type II odontoid process fractures in adults

    Science.gov (United States)

    Fam, Maged D; Zeineddine, Hussein A; Nassir, Rafiq Muhammed; Bhatt, Pragnesh; Kamel, Mahmoud H

    2017-01-01

    Background: Transverse (type II) odontoid process fracture is among the most commonly encountered cervical spine fractures. Nonsurgical management through external immobilization is occasionally preferred to surgical management but is criticized for its higher rates of failure and lower patient satisfaction. Our aim is to analyze patient-reported outcomes in patients who underwent nonsurgical treatment for type II odontoid fractures. Methods: We identified patients >18-year-old who underwent external immobilization as a treatment for isolated type II odontoid fracture between 2007 and 2012. We collected demographic parameters, clinical presentation, mode of injury, imaging studies and modality and duration of treatment (soft collar, halo-vest, or both). Patients were contacted by telephone to participate in a 15-min survey addressing their recovery including their subjective rate of return to preinjury level of functioning. Results: Fifteen patients met the inclusion/exclusion criteria and participated in our survey. Patients were followed up for an average of 19 months after injury. Overall mean age was 61 years. Injury followed a mechanical fall or a road traffic accident in 11 and 4 cases, respectively. External immobilization was achieved by halo vest only in nine patients, soft collar only in two patients (13%), and through a sequential combination in the remaining 4 (27%). This was deployed for a mean of 7.8 months. Radiological studies at the last follow-up showed bony healing (27%), fibrous nonunion (60%), and persistent instability (13%). Patients reported gradual recovery of function throughout the 1st year after injury with levels above 70% of preinjury functioning achieved by 13% of patients at 6 months, 33% at 9 months, and 47% at 12 months. Overall satisfaction with nonsurgical management was 68%. Conclusion: In selected patients with type II odontoid fractures, external immobilization represents a good option with acceptable course of recovery. PMID

  1. Eliglustat tartrate for the treatment of adults with type 1 Gaucher disease.

    Science.gov (United States)

    Bennett, Lunawati L; Turcotte, Kelsey

    2015-01-01

    The purpose of this article is to review eliglustat tartrate, a substrate reduction therapy, for the treatment of Gaucher disease type 1 (GD1). GD is an rare inborn error of metabolism caused by accumulation of lipid substrates such as glucosylceramide within the monocyte-macrophage system that affects the body by causing enlargement of the spleen and liver, destruction of bone, and abnormalities of the lungs and blood, such as anemia, thrombocytopenia, and leukopenia. GD is classified into three types: GD1, a chronic and non-neuronopathic disease accounting for 95% of GD cases; and types 2 and 3 (GD2 GD3) which are more progressive diseases with no approved drugs available at this time. Treatment options for GD1 include enzyme replacement therapy and substrate reduction therapy. Eliglustat works by inhibiting UDP-glucosylceramide synthase, the first enzyme that catalyzes the biosynthesis of glycosphingolipids, thus reducing the load of glucosylceramide influx into the lysosome. Eliglustat was approved by the US Food and Drug Administration after three Phase I, two Phase II, and two Phase III clinical trials. The dose of eliglustat is 84 mg twice a day or once daily depending on the cytochrome P450 2D6 genotype of the patient.

  2. Eliglustat tartrate for the treatment of adults with type 1 Gaucher disease

    Directory of Open Access Journals (Sweden)

    Bennett LL

    2015-08-01

    Full Text Available Lunawati L Bennett, Kelsey TurcotteSchool of Pharmacy, Union University, Jackson, TN, USA Abstract: The purpose of this article is to review eliglustat tartrate, a substrate reduction therapy, for the treatment of Gaucher disease type 1 (GD1. GD is an rare inborn error of metabolism caused by accumulation of lipid substrates such as glucosylceramide within the monocyte-macrophage system that affects the body by causing enlargement of the spleen and liver, destruction of bone, and abnormalities of the lungs and blood, such as anemia, thrombocytopenia, and leukopenia. GD is classified into three types: GD1, a chronic and non-neuronopathic disease accounting for 95% of GD cases; and types 2 and 3 (GD2 GD3 which are more progressive diseases with no approved drugs available at this time. Treatment options for GD1 include enzyme replacement therapy and substrate reduction therapy. Eliglustat works by inhibiting UDP-glucosylceramide synthase, the first enzyme that catalyzes the biosynthesis of glycosphingolipids, thus reducing the load of glucosylceramide influx into the lysosome. Eliglustat was approved by the US Food and Drug Administration after three Phase I, two Phase II, and two Phase III clinical trials. The dose of eliglustat is 84 mg twice a day or once daily depending on the cytochrome P450 2D6 genotype of the patient. Keywords: Gaucher disease, glucocerebrosidase, glucosylceramide synthase, eliglustat tartrate, substrate reduction therapy

  3. Advanced BrainAGE in older adults with type 2 diabetes mellitus

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    Katja eFranke

    2013-12-01

    Full Text Available Aging alters brain structure and function and diabetes mellitus (DM may accelerate this process. This study investigated the effects of type 2 DM on individual brain aging as well as the relationships between individual brain aging, risk factors and functional measures. To differentiate a pattern of brain atrophy that deviates from normal brain aging, we used the novel BrainAGE approach, which determines the complex multidimensional aging pattern within the whole brain by applying established kernel regression methods to anatomical brain MRIs. The Brain Age Gap Estimation (i.e., BrainAGE score was then calculated as the difference between chronological age and estimated brain age. 185 subjects (98 with type 2 DM completed an MRI at 3T, laboratory and clinical assessments. Twenty-five subjects (12 with type 2 DM also completed a follow-up visit after 3.8 ± 1.5 years. The estimated brain age of DM subjects was 4.6 ± 7.2 years greater than their chronological age (p = 0.0001, whereas within the control group, estimated brain age was similar to chronological age. As compared to baseline, the average BrainAGE scores of DM subjects increased by 0.2 years per follow-up year (p = 0.034, whereas the BrainAGE scores of controls did not change between baseline and follow-up. At baseline, across all subjects, higher BrainAGE scores were associated with greater smoking and alcohol consumption, higher tumor necrosis factor (TNFα levels, lower verbal fluency scores and more severe depression. Within the DM group, higher BrainAGE scores were associated with longer diabetes duration (r = 0.31, p = 0.019 and increased fasting blood glucose levels (r = 0.34, p = 0.025. In conclusion, type 2 DM is independently associated with structural changes in the brain that reflect advanced aging. The BrainAGE approach may thus serve as a clinically relevant biomarker for the detection of abnormal patterns of brain aging associated with type 2 DM.

  4. Bread type intake is associated with lifestyle and diet quality transition among Bedouin Arab adults.

    Science.gov (United States)

    Abu-Saad, Kathleen; Shai, Iris; Kaufman-Shriqui, Vered; German, Larissa; Vardi, Hillel; Fraser, Drora

    2009-11-01

    The traditionally semi-nomadic Bedouin Arabs in Israel are undergoing urbanisation with concurrent lifestyle changes, including a shift to using unfortified white-flour bread instead of wholewheat bread as the main dietary staple. We explored associations between the transition from wholewheat to white-flour bread and (1) lifestyle factors, (2) overall diet quality, and (3) health status. We conducted a nutrition survey among 451 Bedouin adults, using a modified 24 h recall questionnaire. Bread intake accounted for 32.7 % of the total energy intake. Those consuming predominantly white bread (PWB) (n 327) were more likely to be urban (OR 2.79; 95 % CI 1.70, 4.58), eating store-bought rather than homemade bread (OR 8.18; 95 % CI 4.34, 15.41) and currently dieting (OR 4.67; 95 % CI 1.28, 17.11) than those consuming predominantly wholewheat bread (PWWB) (n 124). PWB consumption was associated with a lower intake of dietary fibre (23.3 (se 0.6) v. 41.8 (se 1.0) g/d; P or = 40 years, PWB consumption was associated with a 9.85-fold risk (95 % CI 2.64, 36.71; P = 0.001) of having one or more chronic conditions, as compared with PWWB consumption, after controlling for other risk factors. White bread intake was associated with a less traditional lifestyle and poorer diet quality, and may constitute a useful marker for at-risk subgroups to target for nutritional interventions.

  5. Association of Toll-Like Receptor 4 Gene Polymorphism and Expression with Urinary Tract Infection Types in Adults

    Science.gov (United States)

    Yin, Xiaolin; Hou, Tianwen; Liu, Ying; Chen, Jing; Yao, Zhiyan; Ma, Cuiqing; Yang, Lijuan; Wei, Lin

    2010-01-01

    Background Innate immunity of which Toll-like receptor (TLR) 4 and CXCR1 are key elements plays a central role in the development of urinary tract infection (UTI). Although the relation between the genetics of TLR4 and CXCR1 and UTI is investigated partly, the polymorphisms and expression of TLR4 and CXCR1 in different types of UTI in adults are not extremely clear. Methodology/Principal Findings This study investigates the presence of TLR4 A (896) G and CXCR1 G (2608) C polymorphisms in 129 UTI patients using RFLP-PCR. Gene and allelic prevalence were compared with 248 healthy controls. Flow cytometry was used to detect TLR4 and CXCR1 expression in the monocytes of UTI patients and healthy controls. TLR4 (896) AG genotype and TLR4 (896) G allele had higher prevalence in UTI (especially in acute cystitis and urethritis) patients, whereas CXCR1 (2608) GC genotype and CXCR1 (2608) C allele had lower prevalence in UTI patients than controls. TLR4 expression was significantly lower in chronic UTI patients than in acute pyelonephritis or healthy controls. CXCR1 expression was similar in both controls and patients. TLR4 expression in chronic UTI patients after astragalus treatment was higher than pre-treatment. Conclusions The results indicate the relationship between the carrier status of TLR4 (896) G alleles and the development of UTI, especially acute cystitis and urethritis, in adults. TLR4 expression levels are correlated with chronic UTI. PMID:21151974

  6. Selection of approach and fixation in the treatment of type C fracture of distal humerus in adults

    Institute of Scientific and Technical Information of China (English)

    QI Xin; LIU Jian-guo; GONG Yu-bao; YANG Chen; LI Shu-qiang; FENG Wei

    2010-01-01

    Objective:To study the surgical treatment for distal humeral fractures in adults according to the follow-up results.Methods: Twenty-one cases (16 males and 5 females)of distal humeral fracture were included in this study. The average age was 42.5 years (range: 37-52 years). Fractures were classified according to the AO classification system.Nine cases of C1,8 C2 and 4 C3-type fractures were identified.Open reduction and internal fixation were performed in all cases. A tricep-reflecting approach was adopted, and either the AO orthogonal plating or parallel plating technique was chosen,based on the fracture type. The plaster cast was removed 3 weeks after operation. Rehabilitation was encouraged during this period and afterwards. The average follow-up time was 12.2 months (range: 8-28 months). The outcome was scored according to Aitken and Rorabeek system.Results:No nerve injury,nonunion or failure of fixation was encountered during the operation and follow-up.However, ossifying myosifis occurred in one case.Conclusions:A triceps-reflecting approach can provide adequate exposure to the joint. The use of AO orthogohal plating or parallel plating techniques based on the type of fractures can provide rigid fixation for the fracture.

  7. Original article Exploring somatization types among patients in Indonesia: latent class analysis using the Adult Symptom Inventory

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    Wahyu Widhiarso

    2014-12-01

    Full Text Available Background The aim of this study was to explore somatization types by reducing patient complaints to their most basic and parsimonious characteristics. We hypothesized that there were latent groups representing distinct types of somatization. Participants and procedure Data were collected from patients undergoing both inpatient and outpatient treatment at two hospitals in Yogyakarta, Indonesia (N = 212. Results Results from latent class analysis revealed four classes of somatization: two classes (Classes 1 and 2 referring to levels of somatization and two classes (Classes 3 and 4 referring to unique types of somatization. The first two classes (Classes 1 and 2; low and high levels of somatization, respectively corresponded to the number of different symptoms that patients reported out of the list of physical symptoms in the Adult Symptom Inventory. The second two classes (Classes 3 and 4; non-serious and critical complaints, respectively corresponded to two different sets of symptoms. Patients in Class 3 tended to report temporary mild complaints that are common in daily life, such as dizziness, nausea, and stomach pain. Patients in Class 4 tended to report severe complaints and medical problems that require serious treatment or medication, such as deafness or blindness. Conclusions The present study do confirm somatization as a unidimensional experience reflecting a general tendency to report somatic symptoms, but rather support the understanding of somatization as a multidimensional construct.

  8. Bean and rice meals reduce postprandial glycemic response in adults with type 2 diabetes: a cross-over study

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    Thompson Sharon V

    2012-04-01

    Full Text Available Abstract Background Around the world, beans and rice are commonly consumed together as a meal. With type 2 diabetes increasing, the effect of this traditional diet pattern on glycemic response has not been studied fully. Methods We evaluated the glycemic response of bean and rice traditional meals compared to rice alone in adults with type 2 diabetes. Seventeen men and women with type 2 diabetes controlled by metformin (n = 14 or diet/exercise (n = 3 aged 35–70 years participated in the randomized 4 × 4 crossover trial. The white long grain rice control, pinto beans/rice, black beans/rice, red kidney beans/rice test meals, matched for 50 grams of available carbohydrate, were consumed at breakfast after a 12 hour fast. Capillary blood glucose concentrations at baseline and at 30 minute intervals up to 180 minutes postprandial were collected. MANOVA for repeated measures established glucose differences between treatments. Paired t tests identified differences between bean types and the rice control following a significant MANOVA. Results Postprandial net glucose values were significantly lower for the three bean/rice treatments in contrast to the rice control at 90, 120 and 150 minutes. Incremental area under the curve values were significantly lower for the pinto and black bean/rice meals compared to rice alone, but not for kidney beans. Conclusions Pinto, dark red kidney and black beans with rice attenuate the glycemic response compared to rice alone. Promotion of traditional foods may provide non-pharmaceutical management of type 2 diabetes and improve dietary adherence with cultural groups. Trial registration Clinical Trials number NCT01241253

  9. Serum Gamma-glutamyltransferase Levels Predict the Progression of Coronary Artery Calcification in Adults With Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Gang, Li; Wei-Hua, Lu; Rong, Ai; Jian-Hong, Yang; Zi-Hua, Zhou; Zhong-Zhi, Tang

    2015-08-01

    Progression of coronary artery calcification (CAC) may be more predictive of future coronary heart disease events than a baseline CAC score. We determined whether serum gamma-glutamyltransferase (GGT) activity can independently predict the progression of CAC in adults with type 2 diabetes mellitus (T2DM). Patients (n = 326) without symptomatic cardiovascular (CV) disease were evaluated by CAC imaging. The CAC scores were assessed at baseline and after 20 ± 4 months. Serum GGT activities were significantly higher in progressors compared with nonprogressors (39 ± 16 vs. 27 ± 11 U/L, P < .001). Multivariable analyses demonstrated that GGT activity retained a strong association with CAC progression after adjustment for CV risk factors. Additionally, there was a graded association between GGT activity quartile and annualized CAC progression. In asymptomatic patients with T2DM, we prospectively found that serum GGT activity may be an independent predictor of CAC progression but not a predictor of CAC incidence.

  10. Amount and type of alcohol consumption and missing teeth among community-dwelling older adults

    DEFF Research Database (Denmark)

    Heegaard, Karen; Avlund, Kirsten; Holm-Pedersen, Poul;

    2011-01-01

    confidence interval (CI) 0.22-0.76] in women drinking 1-14 drinks per week and 0.34 (95 percent CI 0.16-0.74) in women with an intake of more than 14 drinks per week compared with abstainers. Similar relations could also be obtained for type-specific alcohol intake of wine and for wine and spirits preference...... among women. Men who preferred beer showed a decreased risk for a low number of teeth compared with men with other alcohol preferences. Conclusion: In this study, alcohol consumption, wine drinking, and wine and spirits preference among women were associated with a higher number of teeth compared...

  11. Spontaneous complete remission of type 1 diabetes mellitus in an adult – review and case report

    OpenAIRE

    Moole, Harsha; Moole, Vishnu; Mamidipalli, Adrija; Dharmapuri, Sowmya; Boddireddy, Raghuveer; Taneja, Deepak; Sfeir, Hady; Gajula, Sonia

    2015-01-01

    Type 1 diabetes mellitus (T1DM) is an autoimmune condition that results in low plasma insulin levels by destruction of beta cells of the pancreas. As part of the natural progression of this disease, some patients regain beta cell activity transiently. This period is often referred to as the ‘honeymoon period’ or remission of T1DM. During this period, patients manifest improved glycemic control with reduced or no use of insulin or anti-diabetic medications. The incidence rates of remission and...

  12. Evaluation of a Mobile Phone Image-Based Dietary Assessment Method in Adults with Type 2 Diabetes

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    Megan E. Rollo

    2015-06-01

    Full Text Available Image-based dietary records have limited evidence evaluating their performance and use among adults with a chronic disease. This study evaluated the performance of a 3-day mobile phone image-based dietary record, the Nutricam Dietary Assessment Method (NuDAM, in adults with type 2 diabetes mellitus (T2DM. Criterion validity was determined by comparing energy intake (EI with total energy expenditure (TEE measured by the doubly-labelled water technique. Relative validity was established by comparison to a weighed food record (WFR. Inter-rater reliability was assessed by comparing estimates of intake from three dietitians. Ten adults (6 males, age: 61.2 ± 6.9 years old, BMI: 31.0 ± 4.5 kg/m2 participated. Compared to TEE, mean EI (MJ/day was significantly under-reported using both methods, with a mean ratio of EI:TEE 0.76 ± 0.20 for the NuDAM and 0.76 ± 0.17 for the WFR. Correlations between the NuDAM and WFR were mostly moderate for energy (r = 0.57, carbohydrate (g/day (r = 0.63, p < 0.05, protein (g/day (r = 0.78, p < 0.01 and alcohol (g/day (rs = 0.85, p < 0.01, with a weaker relationship for fat (g/day (r = 0.24. Agreement between dietitians for nutrient intake for the 3-day NuDAM (Intra-class Correlation Coefficient (ICC = 0.77–0.99 was lower when compared with the 3-day WFR (ICC = 0.82–0.99. These findings demonstrate the performance and feasibility of the NuDAM to assess energy and macronutrient intake in a small sample. Some modifications to the NuDAM could improve efficiency and an evaluation in a larger group of adults with T2DM is required.

  13. Molecularly defined adult-type hypolactasia in school-aged children with a previous history of cow's milk allergy

    Institute of Scientific and Technical Information of China (English)

    Heli Rasinper(a); Kristiina Saarinen; Anna Pelkonen; Irma J(a)rvel(a); Erkki Savilahti; Kaija-Leena Kolho

    2006-01-01

    AIM: To assess the role of lactase non-persistence/persistence in school-aged children and their milk-related sYmptoms.METHODS: The genotypes for the C/T-13910 variant associated with lactase non-persistence/ persistence were determined using PCR-minisequencing in a group of 172 children with a mean age of 8.6 years (SE = 0.02,93 boys) participating in a follow-up study for cow's milk allergy. The parents were asked to assess their children's milk consumption and abdominal symptoms.RESULTS: The presence of allergy to cow's milk was not associated with the C/G13910 genotype related with a decline of lactase enzyme activity during childhood (lactase non-persistence). The frequency of the C/G13910genotype (16%) was similar to published figures for the prevalence of adult-type hypolactasia in Finland. The majority of the children (90%) in this series consumed milk but 26% of their families suspected that their children had milk-related symptoms. Forty-eight percent of the children with the C/G13910 genotype did not drink milk at all or consumed a low lactose containing diet prior to the genotyping (P<0.004 when compared to the other genotypes).CONCLUSION: Analysis of the C/T-13910 polymorphism is an easy and reliable method for excluding adult-type hypolactasia in children with milk-related symptoms.Genotyping for this variant can be used to advise diets for children with a previous history of cow's milk allergy.

  14. Can the genetics of type 1 and type 2 diabetes shed light on the genetics of latent autoimmune diabetes in adults?

    Science.gov (United States)

    Grant, Struan F A; Hakonarson, Hakon; Schwartz, Stanley

    2010-04-01

    The pathophysiology of latent autoimmune diabetes in adults (LADA) is considered less understood than its much better characterized counterparts of type 1 and type 2 diabetes (T1D and T2D), where its clinical presentation exhibits some features of each of these two main diseases, earning it a reputation as being "type 1.5 diabetes". The etiology of LADA remains unknown, but a genetic component has been implicated from recent reports of T1D and T2D genes playing a role in its pathogenesis. One way to shed much needed light on the classification of LADA is to determine the discrete genetic factors conferring risk to the pathogenesis of this specific phenotype and to determine to what extent LADA shares genetic similarities with T1D and T2D. For instance, no conclusive support for a role of the T1D-associated INS gene has been reported in T2D; conversely, but similarly, no evidence has been found for the role of the T2D-associated genes IDE/HHEX, SLC30A8, CDKAL1, CDKN2A/B, IGF2BP2, FTO, and TCF7L2 in T1D. However, and somewhat at odds with current thinking, TCF7L2, the most strongly associated gene with T2D to date, is strongly associated with LADA, a disorder considered by the World Health Organization to be a slowly progressing form of T1D. In this review, we address recent advances in the genetics of T1D and T2D and how such discoveries have in turn shed some light on the genetics of LADA as being potentially at the "genetic intersection" of these two major diseases.

  15. Pharmacological approaches to the management of type 2 diabetes in fasting adults during Ramadan

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    AlMaatouq MA

    2012-05-01

    Full Text Available Mohamed A AlMaatouqEndocrine Unit, Department of Medicine, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi ArabiaAbstract: More than 50 million Muslims throughout the world with type 2 diabetes mellitus (T2DM fast for one lunar month (Ramadan each year. Health care providers within and outside the Muslim world need to be aware of the nature of these partial days of fasting and their risks (and potential benefits to people with T2DM, and need to provide Ramadan-adjusted diabetes care. Hypoglycemia during the fasting days represents the greatest health risk for these patients; hence, diabetes-related pharmacotherapy needs to be tailored and adjusted with this risk in mind. With limited trial data available, this review proposes practical modifications to the usual pre-Ramadan antidiabetic regimens that are based on pathophysiological principles, clinical trial evidence (where available, expert opinion, and extended practical experience. Individualization of care is paramount in this regard to take into consideration the patient and societal, cultural, and economic variables.Keywords: type 2 diabetes mellitus, Ramadan, fasting, hypoglycemia, oral antidiabetic agents, insulin

  16. Inflammatory Cytokine Profile Associated with Metabolic Syndrome in Adult Patients with Type 1 Diabetes

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    Aldo Ferreira-Hermosillo

    2015-01-01

    Full Text Available Objective. To compare the serum concentration of IL-6, IL-10, TNF, IL-8, resistin, and adiponectin in type 1 diabetic patients with and without metabolic syndrome and to determine the cut-off point of the estimated glucose disposal rate that accurately differentiated these groups. Design. We conducted a cross-sectional evaluation of all patients in our type 1 diabetes clinic from January 2012 to January 2013. Patients were considered to have metabolic syndrome when they fulfilled the joint statement criteria and were evaluated for clinical, biochemical, and immunological features. Methods. We determined serum IL-6, IL-8, IL-10, and TNF with flow cytometry and adiponectin and resistin concentrations with enzyme linked immunosorbent assay in patients with and without metabolic syndrome. We also compared estimated glucose disposal rate between groups. Results. We tested 140 patients. Forty-four percent fulfilled the metabolic syndrome criteria (n=61, 54% had central obesity, 30% had hypertriglyceridemia, 29% had hypoalphalipoproteinemia, and 19% had hypertension. We observed that resistin concentrations were higher in patients with MS. Conclusion. We found a high prevalence of MS in Mexican patients with T1D. The increased level of resistin may be related to the increased fat mass and could be involved in the development of insulin resistance.

  17. Case Report Serious pulmonary infection in a splenectomized patient with adult type 1 Gaucher disease.

    Science.gov (United States)

    Zhang, Y; Mao, Y F; Du, J M

    2015-04-13

    A 49-year-old man with a history of Gaucher disease type 1, resulting in serious splenomegaly and eating disorder, was referred to our department and underwent a splenectomy under general anesthesia. Gaucher disease is very rare, and its first signs are unexplained splenomegaly and hypersplenism. On preoperative examination, the patient's platelet count was slightly low, and his other test results were normal. Surprisingly, on the first postoperative day, the patient developed a lung infection. This gradually progressed to acute respiratory distress syndrome with respiratory failure, requiring intubation and mechanical ventilation. The patient eventually recovered, and he was discharged after receiving antibiotics and other treatments to enhance immunity. However, his postoperative lung infection led to a significantly prolonged and expensive hospital stay. This case suggests that we must pay close attention to the immune dysfunction of patients with Gaucher disease type 1. Anesthesia and surgery with accompanying post-traumatic stress can weaken patients' immunity and cause susceptibility to severe lung infections. Pulmonary signs and functions should be monitored closely during the perioperative period, and, if necessary, gamma globulin and thymosin should be administered early in the preoperative or postoperative period to enhance immunity.

  18. Testing mediator variables in a resistance training intervention for obese adults with type 2 diabetes.

    Science.gov (United States)

    Lubans, David R; Plotnikoff, Ronald C; Jung, Mary; Eves, Neil; Sigal, Ron

    2012-01-01

    A poor understanding of behaviour change mechanisms has hindered the development of effective physical activity interventions. The aim of this study was to identify potential mediators of change in a home-based resistance training (RT) program for obese individuals with type 2 diabetes. Obese individuals with type 2 diabetes (N = 48) were randomly allocated to either an RT intervention (n = 27) or a control group (n = 21) for the 16-week study period. The study sample included 16 men and 32 women and the mean age of participants was 54.4 (±11.7) years. Participants in the RT group received a multi-gym and dumbbells and home supervision from a certified personal trainer. RT behaviour was measured using a modified Godin Leisure Time Questionnaire. Social-cognitive constructs were measured and tested in a mediating variable framework using a product-of-coefficients test. The intervention had a significant effect on RT behaviour (p < 0.001) and muscular strength (p < 0.001). The intervention had a significant effect on RT planning strategies (p < 0.01), which mediated the effect of the intervention on RT behaviour. The home-based RT program successfully targeted participants' RT planning strategies which contributed to their exercise adherence.

  19. Inflammatory Cytokine Profile Associated with Metabolic Syndrome in Adult Patients with Type 1 Diabetes

    Science.gov (United States)

    Ferreira-Hermosillo, Aldo; Molina-Ayala, Mario; Ramírez-Rentería, Claudia; Vargas, Guadalupe; Gonzalez, Baldomero; Isibasi, Armando; Archundia-Riveros, Irma; Mendoza, Victoria

    2015-01-01

    Objective. To compare the serum concentration of IL-6, IL-10, TNF, IL-8, resistin, and adiponectin in type 1 diabetic patients with and without metabolic syndrome and to determine the cut-off point of the estimated glucose disposal rate that accurately differentiated these groups. Design. We conducted a cross-sectional evaluation of all patients in our type 1 diabetes clinic from January 2012 to January 2013. Patients were considered to have metabolic syndrome when they fulfilled the joint statement criteria and were evaluated for clinical, biochemical, and immunological features. Methods. We determined serum IL-6, IL-8, IL-10, and TNF with flow cytometry and adiponectin and resistin concentrations with enzyme linked immunosorbent assay in patients with and without metabolic syndrome. We also compared estimated glucose disposal rate between groups. Results. We tested 140 patients. Forty-four percent fulfilled the metabolic syndrome criteria (n = 61), 54% had central obesity, 30% had hypertriglyceridemia, 29% had hypoalphalipoproteinemia, and 19% had hypertension. We observed that resistin concentrations were higher in patients with MS. Conclusion. We found a high prevalence of MS in Mexican patients with T1D. The increased level of resistin may be related to the increased fat mass and could be involved in the development of insulin resistance. PMID:26273680

  20. NPM1 Gene Type A Mutation in Bulgarian Adults with Acute Myeloid Leukemia: A Single-Institution Study

    Science.gov (United States)

    Balatzenko, Gueorgui; Spassov, Branimir; Stoyanov, Nikolay; Ganeva, Penka; Dikov, Tihomit; Konstantinov, Spiro; Hrischev, Vasil; Romanova, Malina; Toshkov, Stavri; Guenova, Margarita

    2014-01-01

    Objective: Mutations of the nucleophosmin (NPM1) gene are considered as the most frequent acute myeloid leukemia (AML)-associated genetic lesion, reported with various incidences in different studies, and type A (NPM1-A) is the most frequent type. However, since most series in the literature report on the features of all patients regardless of the type of mutation, NPM1-A(+) cases have not been well characterized yet. Therefore, we evaluated the prevalence of NPM1-A in Bulgarian AML patients and searched for an association with clinical and laboratory features. Materials and Methods: One hundred and four adults (51 men, 53 women) were included in the study. NPM1-A status was determined using allele-specific reverse-transcription polymerase chain reaction with co-amplification of NPM1-A and β-actin and real-time quantitative TaqMan-based polymerase chain reaction. Patients received conventional induction chemotherapy and were followed for 13.2±16.4 months. Results: NPM1-A was detected in 26 (24.8%) patients. NPM1-A mutation was detected in all AML categories, including in one patient with RUNX1-RUNX1T1. There were no differences associated with the NPM1-A status with respect to age, sex, hemoglobin, platelet counts, percentage of bone marrow blasts, splenomegaly, complete remission rates, and overall survival. NPM1-A(+) patients, compared to NPM1-A(-) patients, were characterized by higher leukocyte counts [(75.4±81.9)x109/L vs. (42.5±65.9)x109/L; p=0.049], higher frequency of normal karyotype [14/18 (77.8%) vs. 26/62 (41.9%); p=0.014], higher frequency of FLT3-ITD [11/26 (42.3%) vs. 8/77 (10.4%); p=0.001], and lower incidence of CD34(+) [6/21 (28.8%) vs. 28/45 (62.2%); p=0.017]. Within the FLT3-ITD(-) group, the median overall survival of NPM1-A(-) patients was 14 months, while NPM1-A(+) patients did not reach the median (p=0.10). Conclusion: The prevalence of NPM1-A mutation in adult Bulgarian AML patients was similar to that reported in other studies. NPM1-A

  1. NPM1 Gene Type A Mutation in Bulgarian Adults with Acute Myeloid Leukemia: A Single-Institution Study

    Directory of Open Access Journals (Sweden)

    Gueorgui Balatzenko

    2014-03-01

    Full Text Available OBJECTIVE: Mutations of the nucleophosmin (NPM1 gene are considered as the most frequent acute myeloid leukemia (AML- associated genetic lesion, reported with various incidences in different studies, and type A (NPM1-A is the most frequent type. However, since most series in the literature report on the features of all patients regardless of the type of mutation, NPM1-A(+ cases have not been well characterized yet. Therefore, we evaluated the prevalence of NPM1-A in Bulgarian AML patients and searched for an association with clinical and laboratory features. METHODS: One hundred and four adults (51 men, 53 women were included in the study. NPM1-A status was determined using allele-specific reverse-transcription polymerase chain reaction with co-amplification of NPM1-A and β-actin and real-time quantitative TaqMan-based polymerase chain reaction. Patients received conventional induction chemotherapy and were followed for 13.2±16.4 months. RESULTS: NPM1-A was detected in 26 (24.8% patients. NPM1-A mutation was detected in all AML categories, including in one patient with RUNX1-RUNX1T1. There were no differences associated with the NPM1-A status with respect to age, sex, hemoglobin, platelet counts, percentage of bone marrow blasts, splenomegaly, complete remission rates, and overall survival. NPM1-A(+ patients, compared to NPM1-A(- patients, were characterized by higher leukocyte counts [(75.4±81.9x109/L vs. (42.5±65.9x109/L; p=0.049], higher frequency of normal karyotype [14/18 (77.8% vs. 26/62 (41.9%; p=0.014], higher frequency of FLT3-ITD [11/26 (42.3% vs. 8/77 (10.4%; p=0.001], and lower incidence of CD34(+ [6/21 (28.8% vs. 28/45 (62.2%; p=0.017]. Within the FLT3-ITD(- group, the median overall survival of NPM1-A(- patients was 14 months, while NPM1-A(+ patients did not reach the median (p=0.10. CONCLUSION: The prevalence of NPM1-A mutation in adult Bulgarian AML patients was similar to that reported in other studies. NPM1-A(+ patients

  2. Potatoes and risk of obesity, type 2 diabetes, and cardiovascular disease in apparently healthy adults

    DEFF Research Database (Denmark)

    Borch, Daniel; Juul-Hindsgaul, Nicole; Veller, Mette

    2016-01-01

    , and measured adiposity (body weight, body mass index, or waist circumference), cases of T2D, cases of cardiovascular events, or risk markers thereof. RESULTS: In total, 13 studies were deemed eligible; 5 studies were related to obesity, 7 studies were related to T2D, and one study was related to CVD. Only......BACKGROUND: Potatoes have been related to increased risks of obesity, type 2 diabetes (T2D), and cardiovascular disease (CVD) mainly because of their high glycemic index. OBJECTIVE: We conducted a systematic review to evaluate the relation between intake of potatoes and risks of obesity, T2D...... observational studies were identified; there were 3 studies with moderate, 9 studies with serious, and one study with critical risk of bias. The association between potatoes (not including french fries) and adiposity was neutral in 2 studies and was positive in 2 studies. French fries were positively associated...

  3. The role of Emotional Intelligence in mental health and Type D personality among young adults.

    Science.gov (United States)

    Branscum, Paul; Bhochhibhoya, Amir; Sharma, Manoj

    2013-01-01

    The concept of Emotional Intelligence (EI) was developed as a way to evaluate and highlight the importance of emotional health as it relates to overall quality of life. This study examines the predictive nature of EI with standardized measures of mental health to create a model that can be utilized to create more effective health promotion interventions. Step-wise multiple regression was used to predict mental health (Kessler K-6 scale) and Type D personality (Denollett's Scale of Negative Affectivity and Social Inhibition) with five dimensions of EI. The results revealed that while not all of the dimensions of EI regressed significantly in each model, mood management was highly predictive of all mental health measures under investigation. Cut-off points for each scale were also helpful in interpreting the relatedness of EI to mental health.

  4. Social Disorder in Adults with Type 2 Diabetes: Building on Race, Place, and Poverty.

    Science.gov (United States)

    Steve, Shantell L; Tung, Elizabeth L; Schlichtman, John J; Peek, Monica E

    2016-08-01

    The recent resurgence of social and civic disquiet in the USA has contributed to increasing recognition that social conditions are meaningfully connected to disease and death. As a "lifestyle disease," control of diabetes requires modifications to daily activities, including healthy dietary practices, regular physical activity, and adherence to treatment regimens. One's ability to develop the healthy practices necessary to prevent or control type 2 diabetes may be influenced by a context of social disorder, the disruptive social and economic conditions that influence daily activity and, consequently, health status. In this paper, we report on our narrative review of the literature that explores the associations between social disorder and diabetes-related health outcomes within vulnerable communities. We also propose a multilevel ecosocial model for conceptualizing social disorder, specifically focusing on its role in racial disparities and its pathways to mediating diabetes outcomes.

  5. Comparison of Different Adult Stem Cell Types for Treatment of Myocardial Ischemia

    Science.gov (United States)

    van der Bogt, Koen E.A.; Sheikh, Ahmad Y.; Schrepfer, Sonja; Hoyt, Grant; Cao, Feng; Ransohoff, Katie; Swijnenburg, Rutger-Jan; Pearl, Jeremy; Fischbein, Michael; Contag, Christopher H.; Robbins, Robert C.; Wu, Joseph C.

    2013-01-01

    Introduction A comparative analysis of the efficacy of different cell candidates for the treatment of heart disease remains to be described. This study is designed to evaluate the therapeutic efficacy of 4 cell types in a murine model of myocardial infarction. Methods Bone marrow mononuclear cells (MN), mesenchymal stem cells (MSC), skeletal myoblasts (SkMb) and fibroblasts (Fibro) were isolated from male L2G transgenic mice (FVB background) that constitutively express firefly luciferase (Fluc) and green fluorescence protein (GFP). Cells were characterized by flow cytometry, bioluminescence imaging (BLI), and luminometry. Female FVB mice (n=60) underwent LAD ligation and were randomized into 5 groups to intramyocardially receive one cell type (5 × 105) or PBS as control. Cell survival was measured in vivo by BLI and ex vivo by TaqMan PCR at week 6. Cardiac function was assessed by echocardiography and invasive hemodynamic measurements were made at week 6. Results Fluc expression correlated with the cell number in all groups (r2 >0.93). In vivo BLI revealed acute donor cell death of MSC, SkMb, and Fibro within 3 weeks after transplantation. By contrast, cardiac signals were still present after 6 weeks in the MN group, as confirmed by TaqMan PCR (P<0.01). Echocardiography showed significant preservation of fractional shortening in the MN group compared to controls (P<0.05). Measurements of left ventricular end-systolic/diastolic volumes revealed that the least amount of ventricular dilatation occurred in the MN group (P<0.05). Histology confirmed the presence of MN, although there was no evidence of transdifferentiation by donor MN into cardiomyocytes. Conclusion This is the first study to directly compare a variety of cell candidates for myocardial therapy. Compared to MSC, SkMB, and Fibro, our results suggest that MN cells exhibit a more favorable survival pattern, which translates into a more robust preservation of cardiac function. PMID:18824743

  6. The Additive Effects of Type-2 Diabetes on Cognitive Function in Older Adults with Heart Failure

    Directory of Open Access Journals (Sweden)

    Michael L. Alosco

    2012-01-01

    Full Text Available Background. Medical comorbidity has been theorized to contribute to cognitive impairment in heart failure (HF patients. Specifically, type-2 diabetes mellitus (T2DM, a common coexisting condition among HF patients, may be an independent predictor of cognitive impairment. Nonetheless, the relationships between T2DM and other risk factors for cognitive impairment among persons with HF are unclear. Methods. Persons with HF (N=169, 34.3% women, age 68.57±10.28 years completed neuropsychological testing within a framework of an ongoing study. History of T2DM, along with other medical characteristics, was ascertained through a review of participants’ medical charts and self-report. Results. Many participants (34.9% had a comorbid T2DM diagnosis. After adjustment for demographic and medical characteristics, HF patients with T2DM evidenced significantly greater impairments across multiple cognitive domains than HF patients without T2DM: λ=.92, F(5,156=2.82, P=.018. Post hoc tests revealed significant associations between T2DM and attention (P=.003, executive function (P=.032, and motor functioning (P=.008. Conclusion. The findings suggest additive contributions of T2DM and HF to impairments in attention, executive function, and motor function. Future work is needed to elucidate the mechanisms by which T2DM exacerbates cognitive impairment in HF.

  7. [A genetic systemic disease: clinical description of type 1 myotonic dystrophy in adults].

    Science.gov (United States)

    Kaminsky, P; Pruna, L

    2012-09-01

    Type 1 myotonic dystrophy is an autosomal dominant inherited disorder related to the expansion of a trinucleotide (CTG) repeat in the exon 15 in the 3'-untranslated region of the myotonic dystrophy protein kinase (DMPK) gene. Mutant transcripts containing an expanded CUG repeat are retained in nuclear foci and cause numerous dysfunctions by interfering with biogenesis of other mRNAs. Prominent clinical features are progressive muscular weakness and myotonia, which affect skeletal muscles but also white muscles leading to digestive, urinary and obstetrical disorders. Functional prognosis correlates with motor handicap and vital prognosis is linked to cardiac rhythm disturbances and conduction defects due to progressive subendocardial fibrosis, and to complex respiratory dysfunctions, which associate restrictive lung disease, involvement of the central inspiratory pathway, and sleep apnea. Other clinical features are lens opacity, glucose intolerance, metabolic syndrome, several endocrine disorders (gonadal deficiency, hyperparathydoidism), or immunoglobulin deficiency due to immunoglobulin G hypercatabolism. Life expectancy is reduced in myotonic dystrophy, and death is mainly caused by respiratory complications, but also by cardiac arrhythmias. Moreover, an abnormal incidence of tumors has been reported. Therefore, myotonic dystrophy does not only concern neurologists but a multidisciplinary approach is necessary, including at least pneumologist, cardiologist, and physiotherapist. General internists should also be implicated, not only in the initial diagnosis step, but also in the diagnosis of complications and their treatments.

  8. High rates of diabetes reversal in newly diagnosed Asian Indian young adults with type 2 diabetes mellitus with intensive lifestyle therapy

    Science.gov (United States)

    Sarathi, Vijaya; Kolly, Anish; Chaithanya, H. B.; Dwarakanath, C. S.

    2017-01-01

    Aims: There are variable reports on the reversibility of type 2 diabetes mellitus (type 2 DM) with higher rates among younger patients with short duration of diabetes. Hence, we studied the reversibility of diabetes among young adults with newly diagnosed type 2 DM. Methods: This prospective study included 32 patients with newly diagnosed type 2 DM. All type 2 DM patients were initially treated with intensive lifestyle therapy (ILT) (low-calorie diet [1500 kcal/day] and brisk walking for 1 h/day]). Four patients who with HbA1C diabetes reversal and should receive ILT to achieve reversal of diabetes.

  9. Recommendations for the use of eliglustat in the treatment of adults with Gaucher disease type 1 in the United States.

    Science.gov (United States)

    Balwani, Manisha; Burrow, Thomas Andrew; Charrow, Joel; Goker-Alpan, Ozlem; Kaplan, Paige; Kishnani, Priya S; Mistry, Pramod; Ruskin, Jeremy; Weinreb, Neal

    2016-02-01

    In Gaucher disease, deficient activity of acid β-glucosidase results in accumulation of its substrates, glucosylceramide and glucosylsphingosine, within the lysosomes of cells primarily in the spleen, liver, bone marrow, and occasionally the lung. The multisystem disease is predominantly characterized by hepatosplenomegaly, anemia, thrombocytopenia, and skeletal disease. Enzyme replacement therapy with recombinant human acid β-glucosidase has been the first-line therapy for Gaucher disease type 1 for more than two decades. Eliglustat, a novel oral substrate reduction therapy, was recently approved in the United States and the European Union as a first-line treatment for adults with Gaucher disease type 1. Eliglustat inhibits glucosylceramide synthase, thereby decreasing production of the substrate glucosylceramide and reducing its accumulation. Although existing recommendations for the care of patients with Gaucher disease remain in effect, unique characteristics of eliglustat require additional investigation and monitoring. A panel of physicians with expertise in Gaucher disease and experience with eliglustat in the clinical trials provide guidance regarding the use of eliglustat, including considerations before starting therapy and monitoring of patients on eliglustat therapy.

  10. Associations between Psychosocial and Physiological Factors and Diabetes Health Indicators in Asian and Pacific Islander Adults with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Dongmei Li

    2013-01-01

    Full Text Available The associations between psychosocial and physiological factors and diabetes’ health indicators have not been widely investigated among Asians and Pacific Islanders. We hypothesize that health behaviour and depression are directly or indirectly associated with diabetes’ health indicators such as BMI, glycemic control, general health, and diabetes quality of life. Our hypothesis was tested through a structural equation modelling (SEM approach. Questionnaires that assessed health behaviour, depression, general health, diabetes quality of life, and haemoglobin A1c (HbA1c, along with patients’ demographic information, were obtained from 207 Asian and Pacific Islander adults with type 2 diabetes. IBM SPSS Amos 20 was used for the SEM analysis at 5% level of significance, and the goodness fit of the SEM model was also evaluated. The final SEM model showed that diet and exercise and foot care had positive associations, while depression had a negative association with diabetes’ health indicators. The results highlighted the importance of exercise and depression in diabetes patients’ BMI, glycemic control, general health, and quality of life, which provide evidence for the need to alleviate patients’ depression besides education and training in diet and exercise in future intervention studies among Asians and Pacific Islanders with type 2 diabetes.

  11. Motivational Profiles for Physical Activity Practice in Adults with Type 2 Diabetes: A Self-Determination Theory Perspective.

    Science.gov (United States)

    Gourlan, Mathieu; Trouilloud, David; Boiché, Julie

    2016-01-01

    Drawing on Self-Determination Theory, this study explored the motivational profiles toward Physical Activity (PA) among adults with type 2 diabetes and the relationships between motivational profile, perceived competence and PA. Participants were 350 men and women (Mean age 62.77 years) who were interviewed on their motivations toward PA, perceived level of competence to practice, and PA practice. Cluster analyses reveal the existence of three distinct profiles: "High Combined" (ie, high scores on motivations ranging from intrinsic to external regulation, moderate level on amotivation), "Self-Determined" (ie, high scores on intrinsic, integrated, and identified regulations; low scores on other regulations), and "Moderate" (ie, moderate scores on all regulations). Participants with "High Combined" and "Self-Determined" profiles reported higher perceived competence and longer leisure-time PA practice in comparison to those with a "Moderate" profile. This study highlights the necessity of adopting a person-centered approach to better understand motivation toward PA among type 2 diabetics.

  12. Adherence in adults with type 1 diabetes mellitus correlates with treatment satisfaction but not with adverse events

    Directory of Open Access Journals (Sweden)

    Hendrychova T

    2013-09-01

    Full Text Available Tereza Hendrychova,1 Magda Vytrisalova,1 Alena Smahelova,2 Jiri Vlcek,1 Ales Antonin Kubena1 1Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Hradec Králové, Czech Republic; 2Diabetes Center, Department of Gerontology and Metabolism, University Hospital and Faculty of Medicine in Hradec Králové, Charles University in Prague, Hradec Králové, Czech Republic Purpose: Diabetes self-care and self-monitoring adherence has a positive effect on the metabolic control of the disease. The aim of this study was to analyze the adherence to self-care recommendations and to identify its correlates in adults with type 1 diabetes mellitus. Patients and methods: One hundred and eleven patients with type 1 diabetes were enrolled in an observational cross-sectional study conducted at the Diabetes Center of the University Hospital in Hradec Králové, Czech Republic. Diabetes self-care adherence was measured by the Self Care Inventory-Revised, and treatment satisfaction by the Diabetes Treatment Satisfaction Questionnaire-status version. Additional data were collected from self-administered questionnaires and medical records. The Mann–Whitney test, Spearman correlations, and multiple linear regressions were used in the statistical analysis. Results: The mean age of patients was 42.4 years; 59.5% of them were females and 53.2% of all patients used an insulin pump. The mean glycosylated hemoglobin (HbA1c was 66.2 ± 15.3 mmol/mol and the mean insulin dosage was 0.6 ± 0.3 IU insulin/kg/day. The number of hypoglycemic episodes (including severe that patients had in the last month before taking the survey was 3.6 ± 3.2. Self-care adherence was associated with treatment satisfaction (0.495; P = 0.004 along with frequency of self-monitoring of before meal blood glucose (0.267; P = 0.003. It was not associated with the incidence of hypoglycemic events or any other insulin therapy-related problems

  13. Prevalence and clustering of metabolic risk factors for type 2 diabetes among Chinese adults in Shanghai, China

    Directory of Open Access Journals (Sweden)

    Greenland Sander

    2010-11-01

    Full Text Available Abstract Background Type 2 diabetes is becoming an epidemic in China. To evaluate the prevalence, clustering of metabolic risk factors and their impact on type 2 diabetes, we conducted a population-based study in Shanghai, China's largest metropolitan area. Methods From 2006 to 2007, 2,113 type 2 diabetes cases and 2,458 comparable controls of adults aged 40 to 79 years were enrolled. Demographic, lifestyle, and dietary factors were assessed via standardized questionnaires. Plasma, red and white blood cells were collected and stored for future studies. Anthropometric indices and biochemical intermediates (including blood pressure, fasting glucose, glycosylated hemoglobin, and blood lipids were measured. The prevalence of metabolic syndrome were also compared following two criteria recommended by the Chinese Diabetes Society (CDS, 2004 and the National Cholesterol Education Program's Adult Treatment Panel III (ATP III, 2002. Results Prevalence of metabolic syndrome (62% vs. 15% using CDS criteria and its individual components, including obesity (51% vs. 42%, hypertension (54% vs. 41%, hypertriglyceridemia (42% vs. 32%, and low high-density lipoprotein-cholesterol (HDL levels (36% vs. 25% were higher in diabetes cases than controls. Regardless of criteria used, those with impaired fasting glucose (IFG had similarly high prevalence of metabolic syndrome as did diabetes cases. In a multiple logistic regression model adjusted for demographics and lifestyle risk factors, the odds ratios of diabetes (95% CI were 1.23 (1.04-1.45 for overweight (28 >= BMI >= 24, 1.81 (1.45-2.25 for obesity (BMI > 28, 1.53 (1.30-1.80 for central obesity (waist circumference > 80 cm for woman or waist circumference > 85 cm for man, 1.36 (1.17-1.59 for hypertension (sbp/dbp >= 140/90 mmHg, 1.55 (1.32-1.82 for high triglycerides (triglycerides > 1.70 mmol/l and 1.52 (1.23-1.79 for low HDL-C (HDL-C Conclusions These data indicate that multiple metabolic risk factors

  14. Day and Night Closed-Loop Control in Adults With Type 1 Diabetes

    Science.gov (United States)

    Luijf, Yoeri M.; DeVries, J. Hans; Zwinderman, Koos; Leelarathna, Lalantha; Nodale, Marianna; Caldwell, Karen; Kumareswaran, Kavita; Elleri, Daniela; Allen, Janet M.; Wilinska, Malgorzata E.; Evans, Mark L.; Hovorka, Roman; Doll, Werner; Ellmerer, Martin; Mader, Julia K.; Renard, Eric; Place, Jerome; Farret, Anne; Cobelli, Claudio; Del Favero, Simone; Dalla Man, Chiara; Avogaro, Angelo; Bruttomesso, Daniela; Filippi, Alessio; Scotton, Rachele; Magni, Lalo; Lanzola, Giordano; Di Palma, Federico; Soru, Paola; Toffanin, Chiara; De Nicolao, Giuseppe; Arnolds, Sabine; Benesch, Carsten; Heinemann, Lutz

    2013-01-01

    OBJECTIVE To compare two validated closed-loop (CL) algorithms versus patient self-control with CSII in terms of glycemic control. RESEARCH DESIGN AND METHODS This study was a multicenter, randomized, three-way crossover, open-label trial in 48 patients with type 1 diabetes mellitus for at least 6 months, treated with continuous subcutaneous insulin infusion. Blood glucose was controlled for 23 h by the algorithm of the Universities of Pavia and Padova with a Safety Supervision Module developed at the Universities of Virginia and California at Santa Barbara (international artificial pancreas [iAP]), by the algorithm of University of Cambridge (CAM), or by patients themselves in open loop (OL) during three hospital admissions including meals and exercise. The main analysis was on an intention-to-treat basis. Main outcome measures included time spent in target (glucose levels between 3.9 and 8.0 mmol/L or between 3.9 and 10.0 mmol/L after meals). RESULTS Time spent in the target range was similar in CL and OL: 62.6% for OL, 59.2% for iAP, and 58.3% for CAM. While mean glucose level was significantly lower in OL (7.19, 8.15, and 8.26 mmol/L, respectively) (overall P = 0.001), percentage of time spent in hypoglycemia (<3.9 mmol/L) was almost threefold reduced during CL (6.4%, 2.1%, and 2.0%) (overall P = 0.001) with less time ≤2.8 mmol/L (overall P = 0.038). There were no significant differences in outcomes between algorithms. CONCLUSIONS Both CAM and iAP algorithms provide safe glycemic control. PMID:24170747

  15. Comparison of trap types and colors for capturing emerald ash borer adults at different population densities.

    Science.gov (United States)

    Poland, Therese M; Mccullough, Deborah G

    2014-02-01

    Results of numerous trials to evaluate artificial trap designs and lures for detection of Agrilus planipennis Fairmaire, the emerald ash borer, have yielded inconsistent results, possibly because of different A. planipennis population densities in the field sites. In 2010 and 2011, we compared 1) green canopy traps, 2) purple canopy traps, 3) green double-decker traps, and 4) purple double-decker traps in sites representing a range of A. planipennis infestation levels. Traps were baited with cis-3-hexenol in both years, plus an 80:20 mixture of Manuka and Phoebe oil (2010) or Manuka oil alone (2011). Condition of trees bearing canopy traps, A. planipennis infestation level of trees in the vicinity of traps, and number of A. planipennis captured per trap differed among sites in both years. Overall in both years, more females, males, and beetles of both sexes were captured on double-decker traps than canopy traps, and more beetles of both sexes (2010) or females (2011) were captured on purple traps than green traps. In 2010, detection rates were higher for purple (100%) and green double-decker traps (100%) than for purple (82%) or green canopy traps (64%) at sites with very low to low A. planipennis infestation levels. Captures of A. planipennis on canopy traps consistently increased with the infestation level of the canopy trap-bearing trees. Differences among trap types were most pronounced at sites with low A. planipennis densities, where more beetles were captured on purple double-decker traps than on green canopy traps in both years.

  16. Spontaneous complete remission of type 1 diabetes mellitus in an adult – review and case report

    Directory of Open Access Journals (Sweden)

    Harsha Moole

    2015-10-01

    Full Text Available Type 1 diabetes mellitus (T1DM is an autoimmune condition that results in low plasma insulin levels by destruction of beta cells of the pancreas. As part of the natural progression of this disease, some patients regain beta cell activity transiently. This period is often referred to as the ‘honeymoon period’ or remission of T1DM. During this period, patients manifest improved glycemic control with reduced or no use of insulin or anti-diabetic medications. The incidence rates of remission and duration of remission is extremely variable. Various factors seem to influence the remission rates and duration. These include but are not limited to C-peptide level, serum bicarbonate level at the time of diagnosis, duration of T1DM symptoms, haemoglobin A1C (HbA1C levels at the time of diagnosis, sex, and age of the patient. Mechanism of remission is not clearly understood. Extensive research is ongoing in regard to the possible prevention and reversal of T1DM. However, most of the studies that showed positive results were small and uncontrolled. We present a 32-year-old newly diagnosed T1DM patient who presented with diabetic ketoacidosis (DKA and HbA1C of 12.7%. She was on basal bolus insulin regimen for the first 4 months after diagnosis. Later, she stopped taking insulin and other anti-diabetic medications due to compliance and logistical issues. Eleven months after diagnosis, her HbA1C spontaneously improved to 5.6%. Currently (14 months after T1DM diagnosis, she is still in complete remission, not requiring insulin therapy.

  17. Spontaneous complete remission of type 1 diabetes mellitus in an adult - review and case report.

    Science.gov (United States)

    Moole, Harsha; Moole, Vishnu; Mamidipalli, Adrija; Dharmapuri, Sowmya; Boddireddy, Raghuveer; Taneja, Deepak; Sfeir, Hady; Gajula, Sonia

    2015-01-01

    Type 1 diabetes mellitus (T1DM) is an autoimmune condition that results in low plasma insulin levels by destruction of beta cells of the pancreas. As part of the natural progression of this disease, some patients regain beta cell activity transiently. This period is often referred to as the 'honeymoon period' or remission of T1DM. During this period, patients manifest improved glycemic control with reduced or no use of insulin or anti-diabetic medications. The incidence rates of remission and duration of remission is extremely variable. Various factors seem to influence the remission rates and duration. These include but are not limited to C-peptide level, serum bicarbonate level at the time of diagnosis, duration of T1DM symptoms, haemoglobin A1C (HbA1C) levels at the time of diagnosis, sex, and age of the patient. Mechanism of remission is not clearly understood. Extensive research is ongoing in regard to the possible prevention and reversal of T1DM. However, most of the studies that showed positive results were small and uncontrolled. We present a 32-year-old newly diagnosed T1DM patient who presented with diabetic ketoacidosis (DKA) and HbA1C of 12.7%. She was on basal bolus insulin regimen for the first 4 months after diagnosis. Later, she stopped taking insulin and other anti-diabetic medications due to compliance and logistical issues. Eleven months after diagnosis, her HbA1C spontaneously improved to 5.6%. Currently (14 months after T1DM diagnosis), she is still in complete remission, not requiring insulin therapy.

  18. Visual outcome after phacoemulsification with intraocular lens implantation in patients with anterior lenticonus due to Alport syndrome%超声乳化联合IOL植入治疗前圆锥晶状体伴有Alport综合征的视觉效果

    Institute of Scientific and Technical Information of China (English)

    Mohammad Ali Zare; Mohammad Taher Rajabi; Syed Jafar Oskouee; Mohammad Nili

    2006-01-01

    · AIM: We describe visual improvement after phacoemulsification with intraocular lens (IOL) implantation in 7 eyes with anterior lenticonus secondary to Alport syndrome.· METHODS: 7 eyes from 4 patients with Alport syndrome underwent phacoemulsification with IOL implantation due to anterior lenticonus.· RESULTS: All of the patients resumed excellent visual acuity after surgery.· CONCLUSION: We recommend the phacoemulsification with IOL implantation as a safe procedure in anterior lenticonus due to Alport syndrome.%目的:观察超声乳化联合IOL植入治疗7眼前圆锥晶状体伴有Alport综合征患者的手术效果.方法:Alport综合征患者4例,7眼因前圆锥晶状体行超声乳化联合IOL植入手术.结果:所有患者的术后视力均有明显提高.结论:我们认为对于前圆锥晶状体伴有Alport综合征患者采用超声乳化联合IOL植入手术治疗,是一种安全的疗法.

  19. Emotional and neutral declarative memory impairments and associated white matter microstructural abnormalities in adults with type 2 diabetes.

    Science.gov (United States)

    Yau, Po Lai; Javier, David; Tsui, Wai; Sweat, Victoria; Bruehl, Hannah; Borod, Joan C; Convit, Antonio

    2009-12-30

    Declarative memory impairment is frequently reported among adults with type 2 diabetes mellitus (T2DM), who also demonstrate hippocampal volume reduction. Our goals were to ascertain whether emotional memory, which is mediated by neural circuits overlapping those of declarative memory, is also affected. In addition we wanted to characterize cerebral white matter (WM) involvement in T2DM. We studied 24 middle-aged and elderly patients with T2DM who were free of obvious vascular pathology or a psychiatric disorder, and 17 age- and education-matched healthy individuals with no evidence of insulin resistance. We examined emotional and neutral memory and performed a whole-brain voxelwise WM assessment utilizing diffusion tensor imaging (DTI). We found clear evidence of impairment in declarative memory among diabetic subjects and in addition found some preliminary support to suggest a possible blunting of the memory facilitation by emotional material among female but not male diabetics. This report is also the first DTI assessment among individuals with T2DM, which after accounting for overt WM damage, revealed diffuse but predominantly frontal and temporal WM microstructural abnormalities, with extensive involvement of the temporal stem. Hierarchical regression analyses demonstrated that immediate, but not delayed, emotional memory performance was explained by temporal stem FA, independent of age, poor metabolic regulation, and systolic blood pressure. Given that the temporal lobe memory networks appear to be particularly vulnerable to the deleterious effects of T2DM, this may help explain the observed memory impairments among diabetics. Future efforts should better clarify, with a larger sample, whether emotional memory is affected in adults with T2DM and whether there are clear gender effects.

  20. Influence of media type and moisture on adult development and pupal mortality in Rhagoletis indifferens (Diptera: Tephritidae).

    Science.gov (United States)

    Yee, Wee L

    2013-06-01

    The influence of media type and moisture on adult development and pupal mortality in western cherry fruit fly, Rhagoletis indifferens Curran (Diptera:Tephritidae), was assessed using the pupal-adult and the larval-pupal stage. Inside containers, a higher percent of flies that emerged from dry loam was deformed (44.2%, 1-cm-depth loam; 84.4%, 5-cm-depth loam) than flies from 16% moist loam and dry and 16% moist lab soil (peat moss-sand mix) (0-14.9%). Percent of flies deformed from dry sand (22.1%, 1-cm depth; 49.5%, 5-cm depth) was greater than from 16% moist sand and dry and 16% moist peat moss (0-10.5%). Percents of flies deformed from 8% moist loam, lab soil, sand, and peat moss (0-5.8%) did not differ. Pupae suffered higher mortality at 7 and 14 d after larvae were dropped onto dry loam and dry sand (68.2-94.0%) than dry lab soil and dry peat moss (3.0-53.0%); respective mortalities at 21 and 28 d were similar (81.3-96.0 versus 64.7-97.9%). Pupal mortality in moist media was lower (0.5-40.3%) than in dry media. In outdoor tests, pupal mortality was also higher in dry loam than other dry media. In nature, 60.9% of pupae in dry sandy loams in late summer were dead. Results suggest R. indifferens has not yet evolved to fully cope with dry soils and that pupation in media with traits similar to those of peat moss or a peat moss-sand mix could reduce negative effects of dry environments on fly survival.

  1. 成年人皱眉纹的分型及治疗%Typing and treatment of adults knit supercilium

    Institute of Scientific and Technical Information of China (English)

    王忠杰; 王春红; 张玫; 张春燕

    2016-01-01

    Objective To analyze the form and classification of adult knit supercilium,at the same time,to explore the principle and clinical effects of botulinum toxin type A injections in knit supercilium treatment.Methods Retrospective analysis of morphology and treatment was carried out in 104 Chinese adults knit supercilium.The patients were randomly enrolled in study group that were subjected to botulinum toxin type A injection for the first time in treatment of glabella wrinkles.Forms of wrinkle supercilium were classified;Targeted point injection of botulinum toxin type A was adapted,with the minimum dose to achieve satisfied effect.The treatment interval was over 4-6 months.treatment methods and effects were explored.Results Chinese knit supercilium according to the form was divided into 6 different types:U-shaped (19 cases),"Ⅲ" shaped (30 cases),V-shaped (20 cases),hanging needle shaped (19 cases),Ω shaped (10 cases),and reverse Ω shaped (6 cases).During observation period,there was no serious adverse reactions after treatment.Conclusions Stand ardization of personalized botulinum toxin type A injections for patients with knit supercilium plays a positive role.%目的 探讨成年人的皱眉纹形态和分型,以及A型肉毒毒素注射治疗皱眉纹的原则和临床效果.方法 回顾性分析入组104名成年人皱眉纹形态,入组成年人均为首次A型肉毒毒素治疗眉间皱纹者.采用靶向注射点位注射A型肉毒毒素,以最小注射剂量,2次治疗间隔均为4~6个月,对皱眉纹形态进行分型并探讨治疗方法及效果.结果 皱眉纹按形态不同分为6种类型,分别为U形19名、川字形30名、V形20名、悬针φ形19名、Ω形10名、倒Ω形6名.104名均达到满意治疗效果.治疗后观察期内未发生严重不良反应.结论 成年人皱眉纹形态分型对个性化A型肉毒毒素注射治疗规范的统一有积极作用.

  2. Different types of additional somatosensory information do not promote immediate benefits on gait in patients with Parkinson's disease and older adults

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    Ellen Lirani-Silva

    2015-09-01

    Full Text Available AbstractPlantar cutaneous stimulation has been shown to improve gait in Parkinson's disease (PD, but the effects of different types of insoles have not been tested. We evaluated the immediate effect of different types of insoles on gait in PD patients and healthy older adults. Nineteen PD patients and nineteen healthy older adults performed and performed a walking task at their self-selected speed in three conditions: conventional insole, insole with a raised ridge around the foot perimeter, and insole with half-spheres. Plantar sensation was evaluated before and after the walking protocol. There were no differences between groups for plantar sensation before and after the walking task. PD patients demonstrated reduced stride length and stride velocity. There were no immediate benefits offered by the insoles on gait of either group. The increased plantar cutaneous stimulation does not promote immediate benefits on gait in PD patients and healthy older adults.

  3. The Efficacy of Single Barrel Superficial Temporal Artery-middle Cerebral Artery Bypass in Treatment of Adult Patients with Ischemic-type Moyamoya Disease

    Science.gov (United States)

    Ha, Mahnjeong; Choi, Chang Hwa; Lee, Jae Il; Cha, Seung Heon; Lee, Sang Weon

    2016-01-01

    Objective So far, there is no study answering the question of which type of surgical technique is practically the most useful in the treatment of adult patients with ischemic type moyamoya disease (MMD). We evaluated the efficacy of single barrel superficial temporal artery (STA)-middle cerebral artery (MCA) bypass in the treatment of adult patients with ischemic type MMD by retrospectively collecting clinical and radiological data. Materials and Methods A retrospective review identified 31 adult patients who underwent 43 single barrel STA-MCA bypass procedures performed for treatment of ischemic-type MMD between 2006 and 2014. The male to female ratio was 17:14 and the mean age was 41 years (range, 21-65 years). Peri-operative complications, angiographic and clinical outcomes were analyzed retrospectively. Results The permanent neurological morbidity and mortality rates were 2.3% and 0%, respectively. During the observation period of a mean of 35 months (range, 12-73 months), 29 patients (93.5%) had no further cerebrovascular events and transient ischemic attack occurred in two patients (6.5%), resulting in an annual stroke risk of 2.2%. Follow-up computed tomography perfusion (CTP) (mean, 18.4 months after surgery) documented improved cerebral hemodynamics in the revascularized hemispheres (p < 0.001). Post-operative patency was clearly verified in 38 bypasses (88.4%) of 43 bypasses on follow-up imaging (mean, 16.5 months). Conclusion Our results suggest that single barrel STA-MCA bypass with wide dural opening is safe and durable method of cerebral revascularization in adult patients with ischemic type MMD and can be considered as a potential treatment option for adult patients with ischemic type MMD. PMID:27847768

  4. Clostridium perfringens type A netF and netE positive and Clostridium difficile co-infection in two adult dogs.

    Science.gov (United States)

    Diniz, Amanda Nádia; Silva, Rodrigo Otávio Silveira; Oliveira Junior, Carlos Augusto; Pierezan, Felipe; Lobato, Francisco Carlos Faria

    2016-04-01

    The aim of this study was to report two cases of Clostridium perfringens type A and Clostridium difficile co-infection in adult dogs. Both animals were positive for A/B toxin. Toxigenic C. difficile and C. perfringens type A positive for NetE and NetF-encoding genes were isolated. This report reinforces the necessity of studying a possible synergism of C. difficile and C. perfringens in enteric disorders.

  5. An inulin-type fructan enhances calcium absorption in young adults throughout the GI tract with the largest effect occurring in the colon

    Science.gov (United States)

    Calcium absorption efficiency and bone mineral mass are increased in adolescents who receive inulin-type fructans (ITF). The mechanism of action is unknown, but in animal models appears to be related to increased colonic calcium absorption. We conducted a calcium kinetic study in young adults after...

  6. Construct Validation of a Program to Increase Use of Self-Regulation for Physical Activity among Overweight and Obese Adults with Type 2 Diabetes Mellitus

    Science.gov (United States)

    Petosa, R. Lingyak; Silfee, Valerie

    2016-01-01

    Background: Studies have revealed that overweight adults with type 2 diabetes have low rates of physical activity and are resistant to change. Purpose: The purpose of this study was to use construct validation of intervention methods to examine the impact of a 4-week behavioral intervention on the use of self-regulation skills for physical…

  7. Association of depression with newly diagnosed type 2 diabetes among adults aged between 25 to 60 years in Karachi, Pakistan

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    Perveen Shazia

    2010-03-01

    Full Text Available Abstract Background The combination of depression with type 2 diabetes is a public health problem. If diabetes is managed in its initial phase, the morbidity and mortality due to this combination may be prevented at an early stage. Therefore, we aimed to determine the association of depression with newly diagnosed type 2 diabetes among adults aged between 25 to 60 years in Karachi, Pakistan. Methods From July 2006 to September 2007, a matched case control study (n = 592 was conducted in Civil Hospital, Karachi. Incident cases of type 2 diabetes (n = 296 diagnosed within one month were recruited from diabetic Out Patient Department (OPD of Civil Hospital, Karachi. They were matched on age and sex with controls (n = 296, who were attendants sitting in the medical out patient department of the same hospital, recruited on the basis of absence of classical symptoms of polyuria and polydispia along with random blood glucose level of Results The study comprised of 592 subjects with 432(73% males and 160(27% females. Depression was significantly associated with newly diagnosed type 2 diabetes having mild level (mOR: 3.86; 95%CI: 2.22,6.71 and moderate to severe level (mOR: 3.41; 95%CI: 2.07,5.61. History of (h/o gestational diabetes (mOR: 2.83; 95%CI: 1.05,7.64, family h/o diabetes (mOR: 1.59; 95%CI: 1.04,2.43, nuclear family (mOR: 1.75; 95%CI: 1.14,2.69, BMI (mOR: 1.62; 95%CI: 1.01,2.60 for obese and mOR: 2.12; 95%CI: 1.19,3.79 for overweight vs healthy to underweight were also significantly associated with outcome, adjusting for age, sex, marital status, h/o smoking and h/o high BP. Conclusions Diabetics should be screened simultaneously for depression and concomitant preventive strategies for gestational diabetes, nuclear family and high BMI should also be used to prevent mortality/morbidity among patients between 25 to 60 years of age.

  8. Determinants of uncontrolled hypertension in adult type 2 diabetes mellitus: an analysis of the Malaysian diabetes registry 2009

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    Chew Boon How

    2012-05-01

    Full Text Available Abstract Background Uncontrolled blood pressure (BP is a significant contributor of morbidity and even mortality in type 2 diabetes (T2D patients. This study was done to determine the significant determinants of uncontrolled blood pressure in T2D patients in Malaysia. Methods Between 1st January 2009 to 31st December 2009, data from 70 889 patients with Type 2 diabetes was obtained from the Adult Diabetes Control and Management Registry for analysis; 303 centers participated in the study. Their demographic characteristics, the nature of their diabetes, their state of hypertension, treatment modalities, risk factors, and complications are described. Based on their most recent BP values, subjects were divided into controlled BP and uncontrolled BP and their clinical determinants compared. Independent determinants were identified using multivariate logistic regression. Results The mean age of patients at diagnosis of diabetes was 52.3 ± 11.1 years old. Most were women (59.0 % and of Malay ethnicity (61.9 %. The mean duration of diabetes was 5.9 ± 5.6 years. A total of 57.4 % were hypertensive. Of the 56 503 blood pressure (BP measured, 13 280 (23.5 % patients had BP two anti-hypertensive agents. Health clinics without doctor, older age (≥ 50 years old, shorter duration of diabetes ( Conclusions Major independent determinants of uncontrolled BP in our group of T2D patients were Malay ethnicity, older age, recent diagnosis of diabetes, overweight and follow-up at health clinics without a doctor and possibly the improper use of anti hypertensive agent. More effort, education and resources, especially in the primary health care centres are needed to improve hypertensive care among our patients with diabetes.

  9. Food Intake and Dietary Glycaemic Index in Free-Living Adults with and without Type 2 Diabetes Mellitus

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    Alexandra M. Johnstone

    2011-06-01

    Full Text Available A recent Cochrane review concluded that low glycaemic index (GI diets are beneficial in glycaemic control for patients with type 2 diabetes mellitus (T2DM. There are limited UK data regarding the dietary GI in free-living adults with and without T2DM. We measured the energy and macronutrient intake and the dietary GI in a group (n = 19 of individuals with diet controlled T2DM and a group (n = 19 without diabetes, matched for age, BMI and gender. Subjects completed a three-day weighed dietary record. Patients with T2DM consumed more daily portions of wholegrains (2.3 vs. 1.1, P = 0.003, more dietary fibre (32.1 vs. 20.9 g, P < 0.001 and had a lower diet GI (53.5 vs. 57.7, P = 0.009 than subjects without T2DM. Both groups had elevated fat and salt intake and low fruit and vegetable intake, relative to current UK recommendations. Conclusions: Patients with T2DM may already consume a lower GI diet than the general population but further efforts are needed to reduce dietary GI and achieve other nutrient targets.

  10. Comparison of del Nido cardioplegia and St. Thomas Hospital solution – two types of cardioplegia in adult cardiac surgery

    Science.gov (United States)

    Mishra, Prashant; Jadhav, Ranjit B.; Khandekar, Jayant; Raut, Chaitanya; Ammannaya, Ganesh Kumar; Seth, Harsh S.; Singh, Jaskaran; Shah, Vaibhav

    2016-01-01

    Introduction St. Thomas’ cardioplegic solution No. 2 (ST), although most widely used in adult cardiac surgery, needs to be given at short intervals, causing additional myocardial injury. Aim To determine whether del Nido (DN) cardioplegia, with longer periods of arrest, provides equivalent myocardial protection as compared to ST. Material and methods The study population comprised 100 patients who underwent elective coronary artery bypass grafting (CABG) or double valve replacement (DVR) surgery between January 2015 and January 2016. The patients were divided into two groups based on the type of cardioplegia administered during surgery: 1) intermittent ST (ST, n = 50) and 2) DN cardioplegia (DN, n = 50). We compared the aortic cross clamp (CC) and cardiopulmonary bypass (CPB) times, number of intra-operative DC shocks required, and postoperative changes in left ventricular ejection fraction (LVEF) in the two groups. Results The aortic cross clamp and bypass times were shorter with DN (110.15 ±36.84 vs. 133.56 ±35.66 and 158.60 ±39.92 vs. 179.81 ±42.36 min respectively, p CPB times, reduces cardioplegia dosage, and provides potentially better myocardial protection in terms of LVEF preservation, with a safety profile comparable to ST cardioplegia. PMID:28096823

  11. Levels of diphtheria and tetanus specific IgG of Portuguese adult women, before and after vaccination with adult type Td. Duration of immunity following vaccination

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    Santos Maria

    2007-06-01

    Full Text Available Abstract Background The need for tetanus toxoid decennial booster doses has been questioned by some experts. Several counter arguments have been presented, supporting the maintenance of decennial adult booster doses with tetanus and diphtheria toxoids (adult formulation of the vaccine: Td. This study aimed to evaluate the use of Td in Portuguese adult women under routine conditions. For that purpose we selected a group of women 30+ years of age to which vaccination was recommended. We intended to know if pre-vaccination antibody concentrations were associated with factors as age at first and last vaccination, number of doses and time since last revaccination. We also intended to assess the serological efficacy of Td booster. Methods Following the Portuguese guidelines 100 women were vaccinated with Td. Antitetanus toxin IgG (ATT IgG and antidiphtheria toxin IgG (ADT IgG levels were measured (mIU/ml in 100 pre-vaccination and 91 post-vaccination sera. Detailed vaccination records were available from 88 participants. Results Twenty-two women (Group A began vaccination with DPT/DT in their early childhood and their pre-vaccination ATT IgG levels increased with the number of doses received (p = 0.022 and decreased with time since last vaccination (p = 0.016. Among the 66 women who began vaccination in adolescence and adulthood (Group B, with monovalent TT, ATT IgG levels decreased with age at first dose (p Conclusion Our study suggests that, to protect against tetanus, there is no need to administer decennial boosters to the Portuguese adults who have complied with the childhood/adolescent schedule (6 doses of tetanus toxoid. The adult booster intervals could be wider, probably of 20 years. This also seems to apply to protection against diphtheria, but issues on the herd immunity and on the circulation of toxigenic strains need to be better understood.

  12. Toward a Customized Program to Promote Physical Activity by Analyzing Exercise Types in Adolescent, Adult, and Elderly Koreans

    OpenAIRE

    In Sangwoo; So Wi-Young

    2015-01-01

    The purpose of this study was to examine the relationship between the perceived physical health status of Korean adolescents, adults, and elderly adults and their frequency, intensity, time, and duration of exercise. In 2012, 1,144 adolescents (under 18 years old), 6,474 adults (19–64 years old), and 1,382 elderly adults (over 65 years old) participated in the Korean Survey on Citizens’ Sports Participation Project (N = 9,000). The association between self-reported health status and exercise ...

  13. Correlation Between Dietary Fat Intake and Atherogenic Indices in Normal, Overweight and Obese Adults with or Without Type 2 Diabetes

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    Diaf Mustapha

    2015-12-01

    Full Text Available Background and aims: We investigated the association of dietary intake, particularly fat and its constituent fatty acids, with atherogenic indices in adult patients with overweight, obesity and/or type 2 diabetes (T2D. Material and Methods: Two hundred eighty-five outpatients were selected in two cities located in the Northwestern region of Algeria. Anthropometric measurements for body weight, height, body mass index (BMI and waist circumference were performed. Relationships between dietary intakes, estimated by a 3- days food record, and fasting blood atherogenic indices - total cholesterol-to-high-density lipoprotein cholesterol ratio (TC/HDL-c and apolipoprotein (apo B-to-apo A1 ratio, were analysed. Results: Study group included 58.59% overweight/obese T2D patients, 24.91% normal weight T2D patients and 16.49 % overweight/obese patients without diabetes. Higher dietary consumption (p= 0.003 of total fat, saturated fatty acids (SFAs and polyunsaturated fatty acids (PUFAs, was recorded in the group of overweight/obese T2D patients. Significant positive correlations were observed between apo B/apo A1 and total fat (p= 0.035, total SFAs (p= 0.042 and palmitic acid (p= 0.042 in the group of overweight/obese T2D patients and with ω6 fatty acid (p= 0.030 in the group of overweight/obese patients without diabetes. In the two groups of T2D patients, whether normal weight, overweight/obese, numerous positive correlations with TC/HDL-c were disclosed for PUFAs, ω6 and fatty acids ratios, namely, ω6/ω3, monounsaturated fatty acids (MUFA/SFAs and (MUFAs+PUFAs/SFAs. Conclusion: Most adults, whom are either affected by an excess weight or T2D or both together, are prone to cardiovascular risk. Dietary intakes, particularly in fat and its constituent fatty acids, have an important effect on blood lipid atherogenic indices (TC/HDL-c and apo B/apo A1 ratios.

  14. WJD 5th Anniversary Special Issues(3): Type 1 diabetes Distinct clinical and laboratory characteristics of latent autoimmune diabetes in adults in relation to type 1 and type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Elena; Pipi; Marietta; Marketou; Alexandra; Tsirogianni

    2014-01-01

    Ever since its first appearance among the multiple forms of diabetes,latent autoimmune diabetes in adults(LADA),has been the focus of endless discussions concerning mainly its existence as a special type of diabetes.In this mini-review,through browsing important peer-reviewed publications,(original articles and reviews),we will attempt to refresh our knowledge regarding LADA hoping to enhance our understanding of this controversial diabetes entity.A unique combination of immunological,clinical and metabolic characteristics has been identified in this group of patients,namely persistent islet cell antibodies,high frequency of thyroid and gastric autoimmunity,DR3 and DR4 human leukocyte antigen haplotypes,progressive loss of beta cells,adult disease onset,normal weight,defective glycaemic control,and without tendency to ketoacidosis.Although anthropomorphic measurements are useful as a first line screening,the detection of C-peptide levels and the presence of glutamic acid decarboxylase(GAD)autoantibodies is undoubtedly the sine qua non condi-tion for a confirmatory LADA diagnosis.In point of fact,GAD autoantibodies are far from being solely a biomarker and the specific role of these autoantibodies in disease pathogenesis is still to be thoroughly studied.Nevertheless,the lack of diagnostic criteria and guidelines still puzzle the physicians,who struggle between early diagnosis and correct timing for insulin treatment.

  15. Overweight and the metabolic syndrome in adult offspring of women with diet-treated gestational diabetes mellitus or type 1 diabetes

    DEFF Research Database (Denmark)

    Clausen, Tine D; Mathiesen, Elisabeth R; Hansen, Torben;

    2009-01-01

    Overweight and the metabolic syndrome in adult offspring of women with diet-treated gestational diabetes mellitus or type 1 diabetes Context: In animal studies exposure to intrauterine hyperglycemia increases the risk of cardiovascular disease through only partly understood epigenetic mechanisms....... Human long-term follow-up studies on the same topic are few. Objective: To study the risk of overweight and the metabolic syndrome in adult offspring of women with diet-treated gestational diabetes mellitus (GDM) or type 1 diabetes, and additionally to study associations between estimates of maternal...... of women with type 1 diabetes (n=160) and offspring from the background population representing an un-exposed reference group (n=128). Follow-up rate was 56% (597/1,066). Main outcome measures: Overweight: body mass index (BMI) >/= 25kg/m(2). The metabolic syndrome: the International Diabetes Federation...

  16. In vivo expression and variation of Escherichia coli type 1 and P pili in the urine of adults with acute urinary tract infections.

    Science.gov (United States)

    Kisielius, P. V.; Schwan, W. R.; Amundsen, S. K.; Duncan, J. L.; Schaeffer, A. J.

    1989-01-01

    In vivo expression of pili by Escherichia coli in the urine of 41 adults with lower urinary tract infections was analyzed by immunostaining with polyclonal antiserum to type 1 and P pili. Type 1 pili were detected in 31 of 41 urine specimens, while P pili were detected in 6 of 18 specimens. The piliation status of bacterial populations in urine was heterogeneous, varying from predominantly piliated to a mixture of piliated and nonpiliated cells. Bacteria frequently adhered to exfoliated uroepithelial cells and leukocytes in urine. Expression of pili in vivo did not always correlate with the hemagglutination phenotype after growth in vitro. Strains isolated from different sites in the urogenital tract of two individuals showed phenotypic variation in the state of piliation. The results demonstrate that E. coli type 1 and P pili are expressed and are subject to variation in vivo during acute urinary tract infections in adults. Images PMID:2566580

  17. ZnT8-Specific CD4+ T cells display distinct cytokine expression profiles between type 1 diabetes patients and healthy adults.

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    Daisuke Chujo

    Full Text Available Determination of antigen-specific T cell repertoires in human blood has been a challenge. Here, we show a novel integrated approach that permits determination of multiple parameters of antigen-specific T cell repertoires. The approach consists of two assays: the Direct assay and the Cytokine-driven assay. Briefly, human PBMCs are first stimulated with overlapping peptides encoding a given antigen for 48 hours to measure cytokine secretion (Direct assay. Peptide-reactive T cells are further expanded by IL-2 for 5 days; and after overnight starvation, expanded cells are stimulated with the same peptides from the initial culture to analyze cytokine secretion (Cytokine-driven assay. We first applied this integrated approach to determine the type of islet-antigen-specific T cells in healthy adults. Out of ten donors, the Direct assay identified GAD65-specific CD4(+ T cells in three adults and zinc transporter 8 (ZnT8-specific CD4(+ T cells in five adults. The intracytoplasmic cytokine staining assay showed that these islet-antigen-specific CD4(+ T cells belonged to the CD45RO(+ memory compartment. The Cytokine-driven assay further revealed that islet-antigen-specific CD4(+ T cells in healthy adults were capable of secreting various types of cytokines including type 1 and type 2 cytokines as well as IL-10. We next applied our integrated assay to determine whether the type of ZnT8-specific CD4(+ T cells is different between Type 1 diabetes patients and age/gender/HLA-matched healthy adults. We found that ZnT8-specific CD4(+ T cells were skewed towards Th1 cells in T1D patients, while Th2 and IL-10-producing cells were prevalent in healthy adults. In conclusion, the Direct assay and the Cytokine-driven assay complement each other, and the combination of the two assays provides information of antigen-specific T cell repertoires on the breadth, type, and avidity. This strategy is applicable to determine the differences in the quality of antigen-specific T

  18. Alport syndrome. Molecular genetic aspects

    DEFF Research Database (Denmark)

    Hertz, Jens Michael

    2009-01-01

    41A and 41B were directly sequenced. The PCR-SSCP method was compared to direct sequencing in 15 of the cases. No difference in mutation detection rates were found. Finally, a method based on RT-PCR analysis of mRNA extracted from cultured skin fibroblasts was established. A mutation in a patient...... previously screened by PCR-SSCP analysis with normal result, was detected. Another advantage of analysing a skin biopsy is that it is also possible to perform immunostaining for the alpha 5(IV)-chain in the epidermal basement membrane on sections from the biopsy. Absence of the alpha 5(IV)-chain support......-linked dominant in about 85% of the families. The autosomal recessive and dominant forms constitute about 15% of the cases. In the first part of the study is a multipoint linkage analysis of 12 families suspected of X-linked AS. The aim of that part of the study was to map a number of X-chromosomal polymorphic...

  19. Liver transplantation versus conservative treatment for adult-onset type II citrullinemia: our experience and a review of the literature.

    Science.gov (United States)

    Kimura, N; Kubo, N; Narumi, S; Toyoki, Y; Ishido, K; Kudo, D; Umehara, M; Yakoshi, Y; Hakamada, K

    2013-11-01

    Adult-onset type II citrullinemia (CTLN2), an autosomal recessive disorder caused by a mutation in the SLC25A13 gene, is characterized by increased serum citrulline and ammonia levels. Patients with CTLN2 also display various neuropsychiatric symptoms. Many individuals with CTLN2 are fond of protein-rich and/or lipid-rich foods with an aversion to carbohydrate-rich foods. We herein report two cases of CTLN2 treated with living donor liver transplantation (LDLT) and provide a review of the pertinent literature. Case 1 was a 43-year-old man admitted to our hospital for repetitive episodes of consciousness disturbance. Case 2 was a 37-year-old man admitted to our hospital because of abnormal behavior associated with hyperammonemia. A definitive diagnosis of CTLN2 was accomplished by DNA analysis in both patients, who successfully underwent LDLT using liver segments from donor siblings with confirmed heterozygous gene expression. Case 2 also underwent conservative therapy with arginine and a high-fat, carbohydrate-restricted diet prior to LDLT. Postoperative recovery was uneventful and food was unrestricted in both patients. We also identified 77 cases of CTLN2 in the literature and reviewed them in terms of outcome of both liver transplantation and conservative therapy. The survival rate in patients treated by liver transplantation was 100%, whereas that in patients treated by conservative treatment showed improvement from 39.5% to 76.5% over the years. Liver transplantation is a practical treatment that fundamentally improves patient quality of life after transplantation. However, recent studies have suggested that arginine and sodium pyruvate administration combined with intensive nutritional support is also an effective therapy for CTLN2. Further development of conservative therapy may provide a safer, more affordable alternative to liver transplantation in the near future.

  20. Knowledge, assessment, and management of adults with joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type among Flemish physiotherapists.

    Science.gov (United States)

    Rombaut, Lies; Deane, Janet; Simmonds, Jane; De Wandele, Inge; De Paepe, Anne; Malfait, Fransiska; Calders, Patrick

    2015-03-01

    Physiotherapy plays a fundamental role in managing adults with the joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type (JHS/EDS-HT). However, it is a challenge for both the patient and the physiotherapist as the condition is poorly understood and treatment for JHS/EDS-HT is currently undefined. Insight into current practice is, therefore, necessary in order to establish baseline knowledge in this area and in the long term to improve the standard of patient care. Therefore, the purpose of this study was to evaluate current physiotherapists' knowledge of JHS/EDS-HT and to gain insight into current physiotherapy practice with emphasis on assessment, management, and treatment efficacy. Three hundred twenty-five Flemish physiotherapists participated in the study by filling out electronically a modified version of the "Hypermobility and Hypermobility Syndrome Questionnaire" (HHQ), which covered theoretical constructs such as general knowledge, assessment, management, and learning in relation to generalized joint hypermobility and JHS/EDS-HT. The results show that physiotherapists report a low level of confidence with regard to assessment and management of JHS/EDS-HT. Knowledge of hypermobility and JHS/EDS-HT is weak, especially regarding the features associated with JHS/EDS-HT. Many treatment approaches are used by physiotherapists with the majority showing preference for education, reassurance, muscle strengthening, proprioceptive and core stability training. Almost all approaches were perceived as being clinically effective by the physiotherapists, highlighting a lack of consensus. In conclusion, this study in Flemish physiotherapists confirms that JHS/EDS-HT is under-recognized, not well known and deemed difficult to treat. Further education is required and sought by the physiotherapists surveyed, and future research is needed.

  1. Skeletal muscle sodium glucose co-transporters in older adults with type 2 diabetes undergoing resistance training

    Directory of Open Access Journals (Sweden)

    Francisco Castaneda, Jennifer E. Layne, Carmen Castaneda

    2006-01-01

    Full Text Available We examined the expression of the sodium-dependent glucose co-transporter system (hSGLT3 in skeletal muscle of Hispanic older adults with type 2 diabetes. Subjects (65±8 yr were randomized to resistance training (3x/wk, n=13 or standard of care (controls, n=5 for 16 weeks. Skeletal muscle hSGLT3 and GLUT4 mRNA transcript levels were determined by real time RT-PCR. hSGLT3 transcripts increased by a factor of ten following resistance training compared to control subjects (0.10, P=0.03. There were no differences in GLUT4 mRNA expression levels between groups. Protein expression levels of these transporters were confirmed by immunohistochemistry and Western blotting. hSGLT3 after resistance exercise was found not to be co-localized with the nicotinic acetylcholine receptor. The change in hSGLT3 transcript levels in the vastus lateralis muscle was positively correlated with glucose uptake, as measured by the change in muscle glycogen stores (r=0.53, P=0.02; and with exercise intensity, as measured by the change in muscle strength (r=0.73, P=0.001. Group assignment was be the only independent predictor of hSGLT3 transcript levels, explaining 68% of its variability (P=0.01. Our data show that hSGLT3, but not GLTU4, expression was enhanced in skeletal muscle after 16 weeks of resistance training. This finding suggests that hSGLT3, an insulin-independent glucose transporter, is activated with exercise and it may play a significant role in glycemic control with muscle contraction. The hSGLT3 exact mechanism is not well understood and requires further investigation. However its functional significance regarding a reduction of glucose toxicity and improvement of insulin resistance is the subject of ongoing research.

  2. Adult Type Granulosa Cell Tumor: A Very Rare Case of Sex-Cord Tumor of the Testis with Review of the Literature

    Directory of Open Access Journals (Sweden)

    Dimosthenis Miliaras

    2013-01-01

    Full Text Available Granulosa cell tumor (GST is a sex-cord/stromal neoplasm of the gonads, more commonly arising in the ovaries, while approximately 80 cases have been reported in the testes. Out of these, 30 cases were of the adult type, while the remainder 50 cases were of the juvenile type. The latter mostly concerned infants and followed a benign course. However, the adult type testicular GCTs may be potentially malignant as it also happens in female patients with such neoplasms. We present a case of an adult type GCT located at the left testis. The patient was subjected to total orchiectomy and received no further treatment. Histology showed typical GCT histomorphology with Call-Exner bodies in some places. The immunoprofile of the tumor was CD99 (+, calretinin (+, inhibin (+, alpha smooth muscle actin (+, vimentin (+, ER (−, PR (−, keratin AE1/AE3 (−, alpha fetoprotein (−, CD117 (−, and placental alkaline phosphatase (−. Two years after surgery, the patient is alive and well with no signs of recurrence.

  3. Larval Population Density Alters Adult Sleep in Wild-Type Drosophila melanogaster but Not in Amnesiac Mutant Flies

    OpenAIRE

    Chi, Michael W.; Leslie C. Griffith; Vecsey, Christopher G.

    2014-01-01

    Sleep has many important biological functions, but how sleep is regulated remains poorly understood. In humans, social isolation and other stressors early in life can disrupt adult sleep. In fruit flies housed at different population densities during early adulthood, social enrichment was shown to increase subsequent sleep, but it is unknown if population density during early development can also influence adult sleep. To answer this question, we maintained Drosophila larvae at a range of pop...

  4. Toward a Customized Program to Promote Physical Activity by Analyzing Exercise Types in Adolescent, Adult, and Elderly Koreans

    Science.gov (United States)

    In, Sangwoo; So, Wi-Young

    2015-01-01

    The purpose of this study was to examine the relationship between the perceived physical health status of Korean adolescents, adults, and elderly adults and their frequency, intensity, time, and duration of exercise. In 2012, 1,144 adolescents (under 18 years old), 6,474 adults (19–64 years old), and 1,382 elderly adults (over 65 years old) participated in the Korean Survey on Citizens’ Sports Participation Project (N = 9,000). The association between self-reported health status and exercise was assessed using multivariate logistic regression analyses, controlling for sex and age. The study found that the health status of adolescents showed little or no association with the frequency, intensity, time, or duration of exercise. However, the health status of adults and elderly Koreans was associated with the frequency, intensity, time, and duration of exercise. The physical condition and health status of adolescents was better than that of adults and the elderly, many of whom had declining health. Our findings show the need for exercise-promotion programs customized for particular age groups. The limitations and strengths of the study are discussed, as well as the implications for future research and managerial applications for promoting exercise in each age group. PMID:25964829

  5. Risk of cardiovascular disease and total mortality in adults with type 1 diabetes: Scottish registry linkage study.

    Directory of Open Access Journals (Sweden)

    Shona J Livingstone

    Full Text Available BACKGROUND: Randomized controlled trials have shown the importance of tight glucose control in type 1 diabetes (T1DM, but few recent studies have evaluated the risk of cardiovascular disease (CVD and all-cause mortality among adults with T1DM. We evaluated these risks in adults with T1DM compared with the non-diabetic population in a nationwide study from Scotland and examined control of CVD risk factors in those with T1DM. METHODS AND FINDINGS: The Scottish Care Information-Diabetes Collaboration database was used to identify all people registered with T1DM and aged ≥20 years in 2005-2007 and to provide risk factor data. Major CVD events and deaths were obtained from the national hospital admissions database and death register. The age-adjusted incidence rate ratio (IRR for CVD and mortality in T1DM (n = 21,789 versus the non-diabetic population (3.96 million was estimated using Poisson regression. The age-adjusted IRR for first CVD event associated with T1DM versus the non-diabetic population was higher in women (3.0: 95% CI 2.4-3.8, p<0.001 than men (2.3: 2.0-2.7, p<0.001 while the IRR for all-cause mortality associated with T1DM was comparable at 2.6 (2.2-3.0, p<0.001 in men and 2.7 (2.2-3.4, p<0.001 in women. Between 2005-2007, among individuals with T1DM, 34 of 123 deaths among 10,173 who were <40 years and 37 of 907 deaths among 12,739 who were ≥40 years had an underlying cause of death of coma or diabetic ketoacidosis. Among individuals 60-69 years, approximately three extra deaths per 100 per year occurred among men with T1DM (28.51/1,000 person years at risk, and two per 100 per year for women (17.99/1,000 person years at risk. 28% of those with T1DM were current smokers, 13% achieved target HbA(1c of <7% and 37% had very poor (≥9% glycaemic control. Among those aged ≥40, 37% had blood pressures above even conservative targets (≥140/90 mmHg and 39% of those ≥40 years were not on a statin. Although many of these risk

  6. Antibody titers against vaccine and contemporary wild poliovirus type 1 in children immunized with IPV+OPV and young adults immunized with OPV.

    Science.gov (United States)

    Lukashev, Alexander N; Yarmolskaya, Maria S; Shumilina, Elena Yu; Sychev, Daniil A; Kozlovskaya, Liubov I

    2016-02-02

    In 2010, a type 1 poliovirus outbreak in Congo with 445 lethal cases was caused by a virus that was neutralized by sera of German adults vaccinated with inactivated polio vaccine with a reduced efficiency. This seroprevalence study was done in two cohorts immunized with other vaccination schedules. Russian children aged 3-6 years immunized with a combination of inactivated and live polio vaccines were reasonably well protected against any wild type poliovirus 1, including the Congolese isolate. Adults aged 20-29 years immunized only with live vaccine were apparently protected against the vaccine strain (92% seropositive), but only 50% had detectable antibodies against the Congo-2010 isolate. Both waning immunity and serological divergence of the Congolese virus could contribute to this result.

  7. Determinants of medication adherence among adults with type 2 diabetes mellitus in three Malaysian public health clinics: a cross-sectional study

    OpenAIRE

    2015-01-01

    Boon-How Chew,1 Noor-Hasliza Hassan,2 Mohd-Sidik Sherina3 1Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 2Klinik Kesihatan Dengkil, Ministry of Health, 3Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia Abstract: Medication adherence (MA) in adults with type 2 diabetes mellitus (T2D) is associated with improved disease control (glycated hemoglobin, blood pressure, and lipid pro...

  8. Urinary bisphenol A and type-2 diabetes in U.S. adults: data from NHANES 2003-2008.

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    Monica K Silver

    Full Text Available OBJECTIVE: Bisphenol A (BPA is found in plastics and other consumer products; exposure may lead to insulin resistance and development of type-2 diabetes mellitus (T2DM through over-activation of pancreatic β-cells. Previous studies using data from the National Health and Nutrition Examination Survey (NHANES showed an inconsistent association between prevalence of self-reported T2DM and urinary BPA. We used a different diagnosis method of T2DM (hemoglobin A1c (HbA1c with a larger subset of NHANES. METHODS AND FINDINGS: We analyzed data from 4,389 adult participants who were part of a sub-study of environmental phenol measurements in urine from three NHANES cycles from 2003 to 2008. T2DM was defined as having a HbA1c ≥ 6.5% or use of diabetes medication. The weighted prevalence of T2DM was 9.2%. Analysis of the total sample revealed that a two-fold increase in urinary BPA was associated with an odds ratio (OR of 1.08 of T2DM (95% confidence interval (CI, 1.02 to 1.16, after controlling for potential confounders. However, when we examined each NHANES cycle individually, we only found a statistically significant association in the 2003/04 cycle (n = 1,364, OR = 1.23 (95% CI, 1.07 to 1.42 for each doubling in urinary BPA. We found no association in either the NHANES cycle from 2005/06 (n = 1,363, OR = 1.05 (95% CI, 0.94 to 1.18; or 2007/08 (n = 1,662, OR = 1.06 (95% CI, 0.91 to 1.23. Similar patterns of associations between BPA and continuous HbA1c were also observed. CONCLUSIONS: Although higher urinary BPA was associated with elevated HbA1c and T2DM in the pooled analysis, it was driven by data from only one NHANES cycle. Additional studies, especially of a longitudinal design with repeated BPA measurements, are needed to further elucidate the association between BPA and T2DM.

  9. Determinants of medication adherence among adults with type 2 diabetes mellitus in three Malaysian public health clinics: a cross-sectional study.

    Science.gov (United States)

    Chew, Boon-How; Hassan, Noor-Hasliza; Sherina, Mohd-Sidik

    2015-01-01

    Medication adherence (MA) in adults with type 2 diabetes mellitus (T2D) is associated with improved disease control (glycated hemoglobin, blood pressure, and lipid profile), lower rates of death and diabetes-related complications, increased quality of life, and decreased health care resource utilization. However, there is a paucity of data on the effect of diabetes-related distress, depression, and health-related quality of life on MA. This study examined factors associated with MA in adults with T2D at the primary care level. This was a cross-sectional study conducted in three Malaysian public health clinics, where adults with T2D were recruited consecutively in 2013. We used the 8-item Morisky Medication Adherence Scale (MMAS-8) to assess MA as the main dependent variable. In addition to sociodemographic data, we included diabetes-related distress, depressive symptoms, and health-related quality of life as independent variables. Independent association between the MMAS-8 score and its determinants was done using generalized linear models with a gamma distribution and log link function. The participant response rate was 93.1% (700/752). The majority were female (52.8%), Malay (52.9%), and married (79.1%). About 43% of patients were classified as showing low MA (MMAS-8 score <6). Higher income (adjusted odds ratio 0.90) and depressive symptoms (adjusted odds ratio 0.99) were significant independent determinants of medication non-adherence in young adults with T2D. Low MA in adults with T2D is a prevalent problem. Thus, primary health care providers in public health clinics should focus on MA counselling for adult T2D patients who are younger, have a higher income, and symptoms of depression.

  10. Larval Population Density Alters Adult Sleep in Wild-Type Drosophila melanogaster but Not in Amnesiac Mutant Flies

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    Michael W. Chi

    2014-08-01

    Full Text Available Sleep has many important biological functions, but how sleep is regulated remains poorly understood. In humans, social isolation and other stressors early in life can disrupt adult sleep. In fruit flies housed at different population densities during early adulthood, social enrichment was shown to increase subsequent sleep, but it is unknown if population density during early development can also influence adult sleep. To answer this question, we maintained Drosophila larvae at a range of population densities throughout larval development, kept them isolated during early adulthood, and then tested their sleep patterns. Our findings reveal that flies that had been isolated as larvae had more fragmented sleep than those that had been raised at higher population densities. This effect was more prominent in females than in males. Larval population density did not affect sleep in female flies that were mutant for amnesiac, which has been shown to be required for normal memory consolidation, adult sleep regulation, and brain development. In contrast, larval population density effects on sleep persisted in female flies lacking the olfactory receptor or83b, suggesting that olfactory signals are not required for the effects of larval population density on adult sleep. These findings show that population density during early development can alter sleep behavior in adulthood, suggesting that genetic and/or structural changes are induced by this developmental manipulation that persist through metamorphosis.

  11. Larval Population Density Alters Adult Sleep in Wild-Type Drosophila melanogaster but Not in Amnesiac Mutant Flies.

    Science.gov (United States)

    Chi, Michael W; Griffith, Leslie C; Vecsey, Christopher G

    2014-08-11

    Sleep has many important biological functions, but how sleep is regulated remains poorly understood. In humans, social isolation and other stressors early in life can disrupt adult sleep. In fruit flies housed at different population densities during early adulthood, social enrichment was shown to increase subsequent sleep, but it is unknown if population density during early development can also influence adult sleep. To answer this question, we maintained Drosophila larvae at a range of population densities throughout larval development, kept them isolated during early adulthood, and then tested their sleep patterns. Our findings reveal that flies that had been isolated as larvae had more fragmented sleep than those that had been raised at higher population densities. This effect was more prominent in females than in males. Larval population density did not affect sleep in female flies that were mutant for amnesiac, which has been shown to be required for normal memory consolidation, adult sleep regulation, and brain development. In contrast, larval population density effects on sleep persisted in female flies lacking the olfactory receptor or83b, suggesting that olfactory signals are not required for the effects of larval population density on adult sleep. These findings show that population density during early development can alter sleep behavior in adulthood, suggesting that genetic and/or structural changes are induced by this developmental manipulation that persist through metamorphosis.

  12. A Randomized Trial about Glycemic Index and Glycemic Load Improves Outcomes among Adults with Type 2 Diabetes

    Science.gov (United States)

    Miller, Carla K.; Gutschall, Melissa

    2009-01-01

    Glycemic index (GI) represents the postprandial glucose response of carbohydrate foods, and glycemic load (GL) represents the quantity and quality of carbohydrate consumed. A diet lower in GI and GL may improve diabetes management. A 9-week intervention regarding GI and GL was evaluated among adults in the age range of 40-70 years who had had type…

  13. What type, or combination of exercise can improve preferred gait speed in older adults? A meta-analysis

    NARCIS (Netherlands)

    Van Abbema, Renske; De Greef, Mathieu; Craje, Celine; Krijnen, Wim; Hobbelen, Hans; van der Schans, Cornelis

    2015-01-01

    Background: Improved preferred gait speed in older adults is associated with increased survival rates. There are inconsistent findings in clinical trials regarding effects of exercise on preferred gait speed, and heterogeneity in interventions in the current reviews and meta-analyses. Objective: to

  14. The effectiveness of health literacy oriented programs on physical activity behaviour in middle aged and older adults with type 2 diabetes: a systematic review

    Directory of Open Access Journals (Sweden)

    Michael Huen Sum Lam

    2016-06-01

    Full Text Available Health literacy is the first step to self-management of type II diabetes mellitus, of which physical activity is the least compliant behavior. However, no reviews have summarized the effect and the process of interventions of health literacy oriented programs on physical activity behavior among middle aged and older adults with type II diabetes mellitus. This article is the first to examine the effectiveness of health literacy oriented programs on physical activity behavior among middle aged and older adults with type II diabetes mellitus. This systematic review extracted articles from nine electronic databases between 1990 and 2013. Six interventional studies were extracted and reported in accordance with the guidance of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Findings demonstrated that health literacy oriented programs increased the frequency and duration of physical activity among patients with high health literacy. Although some studies effectively improved the health literacy of physical activity, gap in literature remains open for the indistinct and unreliable measurement of physical activity within self-management programs of type II diabetes mellitus, and the questionable cross-culture generalizability of findings. Further studies with well-knit theorybased intervention with respect to patients’ cultural background, duration of intervention and objective measurements are encouraged to elucidate the relationship between health literacy oriented programs and physical activity behavior.

  15. The Effectiveness of Health Literacy Oriented Programs on Physical Activity Behaviour in Middle Aged and Older Adults with Type 2 Diabetes: A Systematic Review.

    Science.gov (United States)

    Lam, Michael Huen Sum; Leung, Angela Yee-Man

    2016-06-23

    Health literacy is the first step to self-management of type II diabetes mellitus, of which physical activity is the least compliant behavior. However, no reviews have summarized the effect and the process of interventions of health literacy oriented programs on physical activity behavior among middle aged and older adults with type II diabetes mellitus. This article is the first to examine the effectiveness of health literacy oriented programs on physical activity behavior among middle aged and older adults with type II diabetes mellitus. This systematic review extracted articles from nine electronic databases between 1990 and 2013. Six interventional studies were extracted and reported in accordance with the guidance of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Findings demonstrated that health literacy oriented programs increased the frequency and duration of physical activity among patients with high health literacy. Although some studies effectively improved the health literacy of physical activity, gap in literature remains open for the indistinct and unreliable measurement of physical activity within self-management programs of type II diabetes mellitus, and the questionable cross-culture generalizability of findings. Further studies with well-knit theory-based intervention with respect to patients' cultural background, duration of intervention and objective measurements are encouraged to elucidate the relationship between health literacy oriented programs and physical activity behavior.

  16. Cav2-type calcium channels encoded by cac regulate AP-independent neurotransmitter release at cholinergic synapses in adult Drosophila brain.

    Science.gov (United States)

    Gu, Huaiyu; Jiang, Shaojuan Amy; Campusano, Jorge M; Iniguez, Jorge; Su, Hailing; Hoang, Andy An; Lavian, Monica; Sun, Xicui; O'Dowd, Diane K

    2009-01-01

    Voltage-gated calcium channels containing alpha1 subunits encoded by Ca(v)2 family genes are critical in regulating release of neurotransmitter at chemical synapses. In Drosophila, cac is the only Ca(v)2-type gene. Cacophony (CAC) channels are localized in motor neuron terminals where they have been shown to mediate evoked, but not AP-independent, release of glutamate at the larval neuromuscular junction (NMJ). Cultured embryonic neurons also express CAC channels, but there is no information about the properties of CAC-mediated currents in adult brain nor how these channels regulate transmission in central neural circuits where fast excitatory synaptic transmission is predominantly cholinergic. Here we report that wild-type neurons cultured from late stage pupal brains and antennal lobe projection neurons (PNs) examined in adult brains, express calcium currents with two components: a slow-inactivating current sensitive to the spider toxin Plectreurys toxin II (PLTXII) and a fast-inactivating PLTXII-resistant component. CAC channels are the major contributors to the slow-inactivating PLTXII-sensitive current based on selective reduction of this component in hypomorphic cac mutants (NT27 and TS3). Another characteristic of cac mutant neurons both in culture and in whole brain recordings is a reduced cholinergic miniature excitatory postsynaptic current frequency that is mimicked in wild-type neurons by acute application of PLTXII. These data demonstrate that cac encoded Ca(v)2-type calcium channels regulate action potential (AP)-independent release of neurotransmitter at excitatory cholinergic synapses in the adult brain, a function not predicted from studies at the larval NMJ.

  17. Effectiveness of technology-assisted case management in low income adults with type 2 diabetes (TACM-DM: study protocol for a randomized controlled trial

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    Strom Joni L

    2011-10-01

    Full Text Available Abstract Background An estimated 1 in 3 American adults will have diabetes by the year 2050. Nationally, South Carolina ranks 10th in cases of diagnosed diabetes compared to other states. In adults, type 2 diabetes (T2DM accounts for approximately 90-95% of all diagnosed cases of diabetes. Clinically, provider and health system factors account for Methods We describe a four-year prospective, randomized clinical trial, which will test the effectiveness of technology-assisted case management in low income rural adults with T2DM. Two-hundred (200 male and female participants, 18 years of age or older and with an HbA1c ≥ 8%, will be randomized into one of two groups: (1 an intervention arm employing the innovative FORA system coupled with nurse case management or (2 a usual care group. Participants will be followed for 6-months to ascertain the effect of the interventions on glycemic control. Our primary hypothesis is that among indigent, rural adult patients with T2DM treated in FQHC's, participants randomized to the technology-assisted case management intervention will have significantly greater reduction in HbA1c at 6 months of follow-up compared to usual care. Discussion Results from this study will provide important insight into the effectiveness of technology-assisted case management intervention (TACM for optimizing diabetes care in indigent, rural adult patients with T2DM treated in FQHC's. Trial Registration National Institutes of Health Clinical Trials Registry (http://ClinicalTrials.gov identifier# NCT01373489

  18. Shoulder function, pain and health related quality of life in adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type.

    Science.gov (United States)

    Johannessen, Elise Christine; Reiten, Helle Sundnes; Løvaas, Helene; Maeland, Silje; Juul-Kristensen, Birgit

    2016-07-01

    Purpose To investigate shoulder function, pain and Health-Related Quality of life (HRQoL) among adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type (JHS/EDS-HT), compared with the general population (controls). Method In a cross-sectional study using postal survey, 110 patients diagnosed with JHS/EDS-HT and 140 gender- and age-matched healthy controls from Statistics Norway participated. Shoulder function, pain and HRQol were registered by Western Ontario Shoulder Instability Index (WOSI), Numerical Rating Scale (NRS), pain drawings, 36-item Short Form (SF-36). Results Eighty-one individuals responded, with response rate 34% (JHS/EDS-HT: 53%, controls: 21%). JHS/EDS-HT had lower shoulder function (WOSI total: 49.9 versus 83.3; p pain intensity (NRS: 6.4 versus 2.7; p shoulder joints were rated as primary painful areas in both groups, with significantly higher frequency in JHS/EDS-HT (neck: 90% versus 27%; shoulder: 80% versus 37%). Further, JHS/EDS-HT most often reported generalized pain (96%). Conclusions Adults with JHS/EDS-HT have impaired shoulder function, increased pain intensity, as well as reduced physical HRQoL compared with controls. Although neck and shoulder were most frequently rated as painful, significantly more JHS/EDS-HT also reported generalized pain compared to controls. Implications for Rehabilitation Adults with JHS/EDS-HT have impaired shoulder function, and most often painful areas in the neck and shoulder joints, which need to be targeted in the treatment strategy. Compared with the general population adults with JHS/EDS-HT have reduced physical HRQoL, supporting a physical approach for this group. Adults with JHS/EDS-HT may present with both specific painful joints and generalized pain.

  19. 11beta-hydroxysteroid dehydrogenase type 2 expression in the newly formed Leydig cells after ethane dimethanesulphonate treatment of adult rats.

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    Katerina Georgieva

    2008-01-01

    Full Text Available The enzyme 11beta-hydroxysteroid dehydrogenase (11beta-HSD catalyzes the reversible conversion of physiologically active corticosterone to the biologically inert 11beta-dehydrocorticosterone in rat testis and protect the Leydig cells (LCs against the suppressive effect of glucocorticoids. The developmental pathway of the adult LCs population is accompanied with an increase in the 11beta-HDS activity. Thus, 11beta-HDS together with its role in controlling the toxicological effect of glucocorticoids on LCs can be used as a marker for their functional maturity. Ethane 1,2-dimethanesulphonate (EDS treatment of adult rats become unique appropriate model, which enable to answer many questions related to the differentiation of adult LCs in the prepubertal rat testis. The aim of the present study was to investigate the specific changes in the 11beta-HDS type 2 immunoreactivity in tandem with the expression of androgen receptor (AR during renewal of LCs population after EDS treatment. In the present study, we observed the first appearance of immunostaining for 11beta-HSD2 in new LCs population on day 14 after EDS administration when the progenitor LCs were detected. Our immunohistochemical analysis revealed progressive increases in the 11beta-HSD2 reaction intensity on 21 days after EDS treatment and reached a maximum on day 35. AR immunoexpression was found in new LCs on day 14 and 21 after EDS injection with an increasing curve of intensity. The most prominent AR immunostaining in new population LCs was evident by 35 days after EDS and that coincided with the increased number of LCs and restoration of adult LCs population. Our results demonstrated similar pattern of immunoreactivity for 11beta-HSD2 and AR in new LCs population after EDS treatment and suggested that the changes in 11beta-HSD2 expression can be used for evaluation of adult LCs differentiation in rat testis.

  20. Determinants of medication adherence among adults with type 2 diabetes mellitus in three Malaysian public health clinics: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Chew BH

    2015-05-01

    Full Text Available Boon-How Chew,1 Noor-Hasliza Hassan,2 Mohd-Sidik Sherina3 1Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 2Klinik Kesihatan Dengkil, Ministry of Health, 3Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia Abstract: Medication adherence (MA in adults with type 2 diabetes mellitus (T2D is associated with improved disease control (glycated hemoglobin, blood pressure, and lipid profile, lower rates of death and diabetes-related complications, increased quality of life, and decreased health care resource utilization. However, there is a paucity of data on the effect of diabetes-related distress, depression, and health-related quality of life on MA. This study examined factors associated with MA in adults with T2D at the primary care level. This was a cross-sectional study conducted in three Malaysian public health clinics, where adults with T2D were recruited consecutively in 2013. We used the 8-item Morisky Medication Adherence Scale (MMAS-8 to assess MA as the main dependent variable. In addition to sociodemographic data, we included diabetes-related distress, depressive symptoms, and health-related quality of life as independent variables. Independent association between the MMAS-8 score and its determinants was done using generalized linear models with a gamma distribution and log link function. The participant response rate was 93.1% (700/752. The majority were female (52.8%, Malay (52.9%, and married (79.1%. About 43% of patients were classified as showing low MA (MMAS-8 score <6. Higher income (adjusted odds ratio 0.90 and depressive symptoms (adjusted odds ratio 0.99 were significant independent determinants of medication non-adherence in young adults with T2D. Low MA in adults with T2D is a prevalent problem. Thus, primary health care providers in public health clinics should focus on MA counselling for adult T2D patients who are

  1. Accumulation of Major Life Events in Childhood and Adult Life and Risk of Type 2 Diabetes Mellitus

    DEFF Research Database (Denmark)

    Masters Pedersen, Jolene; Hulvej Rod, Naja; Andersen, Ingelise;

    2015-01-01

    logistic regression models adjusted for age, sex, education and family history of diabetes were used to estimate the association between MLE and T2DM. RESULTS: In childhood, experiencing 3 or more MLE was associated with a 69% higher risk of developing T2DM (Odds Ratio (OR) 1.69; 95% Confidence Interval...... (CI) 1.60, 3.27). The accumulation of MLE in adult private (p-trend = 0.016) and work life (p-trend = 0.049) was associated with risk of T2DM in a dose response manner. There was no evidence that experiencing MLE in both childhood and adult life was more strongly associated with T2DM than experiencing...

  2. Stability is maintained in adults with Gaucher disease type 1 switched from velaglucerase alfa to eliglustat or imiglucerase: A sub-analysis of the eliglustat ENCORE trial.

    Science.gov (United States)

    Pleat, Rebecca; Cox, Timothy M; Burrow, T Andrew; Giraldo, Pilar; Goker-Alpan, Ozlem; Rosenbloom, Barry E; Croal, Laura R; Underhill, Lisa H; Gaemers, Sebastiaan J M; Peterschmitt, M Judith

    2016-12-01

    Gaucher disease type 1 is an autosomal recessive disorder caused by deficient activity of the lysosomal enzyme acid β-glucosidase resulting in accumulation of glucosylceramide and clinical manifestations of anemia, thrombocytopenia, hepatosplenomegaly, and skeletal disease. The historic standard of care is intravenous recombinant enzyme therapy with imiglucerase. Eliglustat, an oral substrate reduction therapy, is a first-line treatment for adults with Gaucher disease type 1 who have a compatible CYP2D6-metabolizer phenotype (≈ 95% of patients). The 12-month ENCORE trial (NCT00943111) found eliglustat non-inferior to imiglucerase in maintaining stability in adult Gaucher patients previously stabilized after ≥ 3 years of enzyme therapy (imiglucerase or velaglucerase alfa). This post-hoc analysis examined safety and efficacy in the 30 ENCORE patients who were receiving velaglucerase alfa at study entry and were randomized to eliglustat (n = 22) or imiglucerase (n = 8). Efficacy and safety in velaglucerase alfa-transitioned patients were consistent with the full ENCORE trial population; 90% of patients switched to eliglustat and 88% of patients switched to imiglucerase met the composite endpoint (stable hemoglobin concentration, platelet count, spleen volume, and liver volume). Clinical stability was maintained for 12 months in Gaucher disease type 1 patients in the ENCORE trial who switched from velaglucerase alfa to either eliglustat or imiglucerase.

  3. Impact of a brief intervention on self-regulation, self-efficacy and physical activity in older adults with type 2 diabetes.

    Science.gov (United States)

    Olson, Erin A; McAuley, Edward

    2015-12-01

    Despite evidence of the benefits of physical activity, most individuals with type 2 diabetes do not meet physical activity recommendations. The purpose of this study was to test the efficacy of a brief intervention targeting self-efficacy and self-regulation to increase physical activity in older adults with type 2 diabetes. Older adults (Mage = 61.8 ± 6.4) with type 2 diabetes or metabolic syndrome were randomized into a titrated physical activity intervention (n = 58) or an online health education course (n = 58). The intervention included walking exercise and theory-based group workshops. Self-efficacy, self-regulation and physical activity were assessed at baseline, post-intervention, and a follow-up. Results indicated a group by time effect for self-regulation [F(2,88) = 14.021, p self-efficacy [F(12,77) = 2.322, p self-efficacy and self-regulation. Future research warrants adjusting intervention strategies to increase long-term change.

  4. Predicting Noninsulin Antidiabetic Drug Adherence Using a Theoretical Framework Based on the Theory of Planned Behavior in Adults With Type 2 Diabetes: A Prospective Study.

    Science.gov (United States)

    Zomahoun, Hervé Tchala Vignon; Moisan, Jocelyne; Lauzier, Sophie; Guillaumie, Laurence; Grégoire, Jean-Pierre; Guénette, Line

    2016-04-01

    Understanding the process behind noninsulin antidiabetic drug (NIAD) nonadherence is necessary for designing effective interventions to resolve this problem. This study aimed to explore the ability of the theory of planned behavior (TPB), which is known as a good predictor of behaviors, to predict the future NIAD adherence in adults with type 2 diabetes. We conducted a prospective study of adults with type 2 diabetes. They completed a questionnaire on TPB variables and external variables. Linear regression was used to explore the TPB's ability to predict future NIAD adherence, which was prospectively measured as the proportion of days covered by at least 1 NIAD using pharmacy claims data. The interaction between past NIAD adherence and intention was tested. The sample included 340 people. There was an interaction between past NIAD adherence and intention to adhere to the NIAD (P = 0.032). Intention did not predict future NIAD adherence in the past adherers and nonadherers groups, but its association measure was high among past nonadherers (β = 5.686, 95% confidence interval [CI] -10.174, 21.546). In contrast, intention was mainly predicted by perceived behavioral control both in the past adherers (β = 0.900, 95% CI 0.796, 1.004) and nonadherers groups (β = 0.760, 95% CI 0.555, 0.966). The present study suggests that TPB is a good tool to predict intention to adhere and future NIAD adherence. However, there was a gap between intention to adhere and actual adherence to the NIAD, which is partly explained by the past adherence level in adults with type 2 diabetes.

  5. Self-esteem and illness self-concept in emerging adults with Type 1 diabetes: Long-term associations with problem areas in diabetes.

    Science.gov (United States)

    Luyckx, Koen; Rassart, Jessica; Aujoulat, Isabelle; Goubert, Liesbet; Weets, Ilse

    2016-04-01

    This long-term prospective study examined whether illness self-concept (or the degree to which chronic illness becomes integrated in the self) mediated the pathway from self-esteem to problem areas in diabetes in emerging adults with Type 1 diabetes. Having a central illness self-concept (i.e. feeling overwhelmed by diabetes) was found to relate to lower self-esteem, and more treatment, food, emotional, and social support problems. Furthermore, path analyses indicated that self-esteem was negatively related to both levels and relative changes in these problem areas in diabetes over a period of 5 years. Illness self-concept fully mediated these associations.

  6. A cross-sectional study of glycaemic control, complications and psychosocial functioning among 18- to 35-year-old adults with type 1 diabetes

    DEFF Research Database (Denmark)

    Zoffmann, V; Vistisen, D; Due-Christensen, M

    2014-01-01

    , HbA1c and complications for 710 younger adults (18-35 years) with type 1 diabetes. A questionnaire with wide-ranging psychometric scales was used to measure various aspects of psychosocial functioning: the burden of diabetes-related problems, well-being, self-esteem, perceived competence in managing...... diabetes, perceived autonomy support from health professionals and self-management motivations. Furthermore, patients reported weekly self-monitored blood glucose measurements and insulin administration. Associations between HbA1c , complication and psychosocial indicators were tested using linear...

  7. Comorbidity in Adult Patients Hospitalized with Type 2 Diabetes in Northeast China: An Analysis of Hospital Discharge Data from 2002 to 2013.

    Science.gov (United States)

    Chen, Hui; Zhang, Yaoyun; Wu, Di; Gong, Chunxiu; Pan, Qing; Dong, Xiao; Wu, Yonghui; Zhang, Kuan; Wang, Shiping; Lei, Jianbo; Xu, Hua

    2016-01-01

    This study aims to evaluate the comorbidity burden and patterns among adult patients hospitalized with a diagnosis of type 2 diabetes mellitus (T2DM) in Northeast China using hospital discharge data derived from the electronic medical record database between 2002 and 2013. 12.8% of 4,400,892 inpatients aged ≥18 had a diagnosis of T2DM. Sex differences in prevalence varied among those aged data can be used to estimate disease prevalence and identify comorbidities. The findings provided comprehensive information on comorbidity patterns, helping policy makers and programs in public health domains to estimate and evaluate the epidemic of chronic diseases.

  8. Consumption of sweet beverages and type 2 diabetes incidence in European adults : Results from EPIC-InterAct

    NARCIS (Netherlands)

    Romaguera, D.; Norat, T.; Wark, P. A.; Vergnaud, A. C.; Schulze, M. B.; van Woudenbergh, G. J.; Drogan, D.; Amiano, P.; Molina-Montes, E.; Sanchez, M.J.; Balkau, B.; Barricarte, A.; Beulens, J. W. J.; Clavel-Chapelon, F.; Crispim, S. P.; Fagherazzi, G.; Franks, P. W.; Grote, V. A.; Huybrechts, I.; Kaaks, R.; Key, T. J.; Khaw, K. T.; Nilsson, P.; Overvad, K.; Palli, D.; Panico, S.; Quiros, J. R.; Rolandsson, O.; Sacerdote, C.; Sieri, S.; Slimani, N.; Spijkerman, A.M.W.; Tjonneland, A.; Tormo, M. J.; Tumino, R.; van den Berg, S. W.; Wermeling, P. R.; Zamora-Ros, R.; Feskens, E. J. M.; Langenberg, C.; Sharp, S. J.; Forouhi, N. G.; Riboli, E.; Wareham, N. J.

    2013-01-01

    Consumption of sugar-sweetened beverages has been shown, largely in American populations, to increase type 2 diabetes incidence. We aimed to evaluate the association of consumption of sweet beverages (juices and nectars, sugar-sweetened soft drinks and artificially sweetened soft drinks) with type 2

  9. Development of the pediatric quality of life inventory neurofibromatosis type 1 module items for children, adolescents and young adults: qualitative methods.

    Science.gov (United States)

    Nutakki, Kavitha; Varni, James W; Steinbrenner, Sheila; Draucker, Claire B; Swigonski, Nancy L

    2017-01-11

    Health-related quality of life (HRQOL) is arguably one of the most important measures in evaluating effectiveness of clinical treatments. At present, there is no disease-specific outcome measure to assess the HRQOL of children, adolescents and young adults with Neurofibromatosis Type 1 (NF1). This study aimed to develop the items and support the content validity for the Pediatric Quality of Life Inventory™ (PedsQL™) NF1 Module for children, adolescents and young adults. The iterative process included multiphase qualitative methods including a literature review, survey of expert opinions, semi-structured interviews, cognitive interviews and pilot testing. Fifteen domains were derived from the qualitative methods, with content saturation achieved, resulting in 115 items. The domains include skin, pain, pain impact, pain management, cognitive functioning, speech, fine motor, balance, vision, perceived physical appearance, communication, worry, treatment, medicines and gastrointestinal symptoms. This study is limited because all participants are recruited from a single-site. Qualitative methods support the content validity for the PedsQL™ NF1 Module for children, adolescents and young adults. The PedsQL™ NF1 Module is now undergoing national multisite field testing for the psychometric validation of the instrument development.

  10. The putative Notch ligand HyJagged is a transmembrane protein present in all cell types of adult Hydra and upregulated at the boundary between bud and parent

    Directory of Open Access Journals (Sweden)

    Tischer Susanne

    2011-09-01

    Full Text Available Abstract Background The Notch signalling pathway is conserved in pre-bilaterian animals. In the Cnidarian Hydra it is involved in interstitial stem cell differentiation and in boundary formation during budding. Experimental evidence suggests that in Hydra Notch is activated by presenilin through proteolytic cleavage at the S3 site as in all animals. However, the endogenous ligand for HvNotch has not been described yet. Results We have cloned a cDNA from Hydra, which encodes a bona-fide Notch ligand with a conserved domain structure similar to that of Jagged-like Notch ligands from other animals. Hyjagged mRNA is undetectable in adult Hydra by in situ hybridisation but is strongly upregulated and easily visible at the border between bud and parent shortly before bud detachment. In contrast, HyJagged protein is found in all cell types of an adult hydra, where it localises to membranes and endosomes. Co-localisation experiments showed that it is present in the same cells as HvNotch, however not always in the same membrane structures. Conclusions The putative Notch ligand HyJagged is conserved in Cnidarians. Together with HvNotch it may be involved in the formation of the parent-bud boundary in Hydra. Moreover, protein distribution of both, HvNotch receptor and HyJagged indicate a more widespread function for these two transmembrane proteins in the adult hydra, which may be regulated by additional factors, possibly involving endocytic pathways.

  11. Psychometric and screening properties of the WHO-5 well-being index in adult outpatients with Type 1 or Type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Hajós, Tibor R S; Pouwer, F; Skovlund, S E;

    2013-01-01

    OBJECTIVE: The 5-item World Health Organization well-being index is a commonly used measure of emotional well-being, but research on psychometric properties in outpatients with diabetes is scarce. We examined psychometric and screening properties for depression of this index in a large sample...... of Dutch outpatients with diabetes. METHODS: Patients with Type 1 (n = 384) and Type 2 (n = 549) diabetes from three outpatient clinics completed the WHO-5 index, the nine-item Patient Health Questionnaire, the Problem Areas in Diabetes survey and the Short Form-12 health survey. Internal consistency...... of the WHO-5 index was determined by Cronbach's alpha. The factor structure was tested by confirmatory factor analysis. Concurrent validity was assessed by correlations with the Patient Health Questionnaire, Problem Areas in Diabetes and the Short Form-12 mental component scores. Sensitivity and specificity...

  12. Depression, anxiety and cognitive dysfunction in patients with type 2 diabetes mellitus--a study of adult patients with type 2 diabetes mellitus in Osijek, Croatia.

    Science.gov (United States)

    Degmecić, Dunja; Bacun, Tatjana; Kovac, Vlatka; Mioc, Josipa; Horvat, Jasna; Vcev, Aleksandar

    2014-06-01

    Aim of the study was to determine the rate of depression and anxiety in the patients with diagnosed Type 2 Diabetes mellitus (DM), and also to determine the state of the congnitive functions in patients with Type 2 Diabetes mellitus compared with the control group. Study was designed as a epidemiological cross sectional study, sample consisted of 108 patients, 66 of the patients were diagnosed with Type 2 Diabetes mellitus, and 42 were control group. All of them were interviewed by psychiatrist and tested through clinical interview with Hamilton depression rating scale, Hamilton Anxiety rating scale, Mini mental state examination and questionnaire about sociodemografic data. Results show that group of patients with DM were statistically significant more depressed than the control group of the patients (p = 0.035). Pathological anxiety measured by Hamilton Anxiety Rating Scale (HAM-A) appeared in 34 DM patients and 7 of the patients in control group, which is also statistically significant difference (p = 0.002). Evaluation of the cognitive status done with Mini Mental State Examination (MMSE showed us the patients with DM presented more cognitive dysfunctions compared with the control group. We can conclude that the high prevalence of psychiatric disorders in diabetic patients points to the need for greater investment in appropriate diagnostic evaluation of patients that consider mental issues.

  13. Reversion to subgroup J avian leukosis virus viremia in seroconverted adult meat-type chickens exposed to chronic stress by adrenocorticotrophin treatment.

    Science.gov (United States)

    Pandiri, A R; Gimeno, I M; Mays, J K; Reed, W M; Fadly, A M

    2012-09-01

    Chickens infected with subgroup J avian leukosis virus (ALV J) early in posthatch life develop viremia followed by a neutralizing antibody (Nab) response that may or may not be able to clear the viremia. Occasionally, chickens that do clear viremia by developing an efficient Nab response revert to viremia, and the factors responsible for this reversion are not clear. In this study, it was hypothesized that stress can cause seroconverted viremia-free chickens to revert to viremia. Adult (52-wk-old) male commercial meat-type chickens that were exposed to ALV J at hatch and had since cleared viremia and remained viremia-free for up to 40 wk, when subjected to chronic stress (for 14 days) induced by porcine adrenocorticotrophin (ACTH), reverted to viremia and cloacal shedding (2/6 [33%]). However, chickens that were contact-exposed to ALV J at 32 wk of age and had seroconverted failed to revert to viremia when subjected to similar chronic stress. Stress did not increase the susceptibility of adult meat-type chickens to ALV J infection by contact exposure. The lack of statistical significance due to the small sample size is a limitation of this study. However, in general, the results suggest that treatment of chickens with ACTH can cause reversion of viremia and cloacal shedding in ALV J-seroconverted adult male chickens that had been exposed to the virus at hatch, but not in chickens that were contact-exposed at 32 wk of age. The results warrant further studies with greater sample size to examine the role of stress in ALV J epidemiology.

  14. Physiotherapy for pain and disability in adults with complex regional pain syndrome (CRPS) types I and II

    OpenAIRE

    2016-01-01

    Background   Complex regional pain syndrome (CRPS) is a painful and disabling condition that usually manifests in response to trauma or surgery. When it occurs, it is associated with significant pain and disability. It is thought to arise and persist as a consequence of a maladaptive pro-inflammatory response and disturbances in sympathetically-mediated vasomotor control, together with maladaptive peripheral and central neuronal plasticity. CRPS can be classified into two types: type I (CRPS ...

  15. GAD65 autoantibodies and its role as biomarker of Type 1 diabetes and Latent Autoimmune Diabetes in Adults (LADA)

    OpenAIRE

    Towns, Roberto; Pietropaolo, Massimo

    2011-01-01

    One of the hallmarks of autoimmune diabetes is the presence of adaptive responses directed to neuroendocrine proteins. One of these proteins is glutamic acid decarboxylase (GAD). While GAD is widely distributed in neuroendocrine tissues, its specific significance in diabetes has paralleled the advances in understanding humoral and cellular immunity in Type 1 diabetes (T1D) and in a subset of Type 2 diabetes (T2D), going from the seminal discoveries of islet autoantibodies to the development a...

  16. Evaluation of a combined blood glucose monitoring and gaming system (Didget®) for motivation in children, adolescents, and young adults with type 1 diabetes.

    Science.gov (United States)

    Klingensmith, Georgeanna J; Aisenberg, Javier; Kaufman, Francine; Halvorson, Mary; Cruz, Eric; Riordan, Mary Ellen; Varma, Chandrasekhar; Pardo, Scott; Viggiani, Maria T; Wallace, Jane F; Schachner, Holly C; Bailey, Timothy

    2013-08-01

    The purpose of this study was to assess the performance and acceptability of a blood glucose meter coupled with a gaming system for children, adolescents, and young adults with type 1 diabetes. During an in-clinic visit, duplicate blood samples were tested by subjects (N = 147; aged 5-24 yr) and health care providers (HCPs) to evaluate the accuracy and precision of the Didget® system. Subjects' meter results were compared against Yellow Springs Instruments (YSI) reference results and HCP results using least squares regression and error grid analyses. Precision was measured by average within-subject and within-HCP coefficient of variation (CV). During the home-use component of this study, subjects (n = 58) tested their blood glucose at least two to three times daily for 3-5 d to evaluate routine use of the system. Subjects' meter results showed significant correlations with both YSI (r(2) = 0.94; p motivating, and helpful for building good blood glucose monitoring habits. Most HCPs agreed that the system fulfilled a need in diabetes management. In conclusion, the Didget® system was precise and clinically accurate in the hands of children, adolescents, and young adults with type 1 diabetes.

  17. Blood glucose control and medication adherence among adult type 2 diabetic Nigerians attending a primary care clinic in under-resourced environment of eastern Nigeria

    Directory of Open Access Journals (Sweden)

    Iloh GU Pascal

    2012-01-01

    Full Text Available Background: Despite the evidence that goal blood glucose control reduces preventable emergency hospitalizations, the control of blood glucose has been variable in Nigeria. Aim: The study was designed to determine the blood glucose control and medication adherence among adult type 2 diabetic Nigerians attending a primary care clinic in under-resourced environment of Eastern Nigeria. Materials and Methods: A cross-sectional study was carried out on 120 adult type 2 diabetic patients who were on treatment for at least 3 months at the primary care clinic of Federal Medical Centre, Umuahia. A patient was said to have a goal blood glucose control if the fasting blood glucose was 70-130 mg/dL. Adherence was assessed in the previous 30 days using pretested, interviewer-administered questionnaire on self-reported therapy. Operationally, an adherent patient was one who scored 4 points in the previous 30 days. The reasons for non-adherence were documented. Results: The blood glucose control and medication adherence rates were 61.7% and 72.5%, respectively. Blood glucose control was significantly associated with adherence to treatment (P=0.025 and medication duration ≥3 years (P=0.045. The most common reason for non-adherence was financial constraints (P=0.033. Conclusion: Glycaemic control and medication adherence among the study population were good and should constitute logical targets for intervention.

  18. Population-Based Estimates of Physical Activity for Adults with Type 2 Diabetes: A Cautionary Tale of Potential Confounding by Weight Status

    Directory of Open Access Journals (Sweden)

    Ronald C. Plotnikoff

    2011-01-01

    Full Text Available At a population level, the method used to determine those meeting physical activity guidelines has important implications, as estimating “sufficient” physical activity might be confounded by weight status. The objective of this study was to test the difference between three methods in estimating the prevalence of “sufficient activity” among Canadian adults with type 2 diabetes in a large population sample (N=1614 while considering the role of weight status as a potential confounder. Our results revealed that estimates of physical activity levels vary by BMI categories, depending on the methods examined. Although physical activity levels were lower in the obese, their energy expenditure estimates were not different from those who were overweight or of a healthy weight. The implications of these findings are that biased estimates of physical activity at a population level may result in inappropriate classification of adults with type 2 diabetes as “sufficiently active” and that the inclusion of body weight in estimating physical activity prevalence should be approached with caution.

  19. Brief maternal exposure of rats to the xenobiotics dibutyl phthalate or diethylstilbestrol alters adult-type Leydig cell development in male offspring

    Institute of Scientific and Technical Information of China (English)

    Richard Ivell; Kee Heng; Helen Nicholson; Ravinder Anand-Ivell

    2013-01-01

    Maternal exposure to estrogenic xenobiotics or phthalates has been implicated in the distortion of early male reproductive development,referred to in humans as the testicular dysgenesis syndrome.It is not known,however,whether such early gestational and/or lactational exposure can influence the later adult-type Leydig cell phenotype.In this study,Sprague-Dawley rats were exposed to dibutyl phthalate (DBP; from gestational day (GD) 14.5 to postnatal day (PND) 6) or diethylstilbestrol (DES; from GD14.5 to GD16.5) during a short gestational/lactational window,and male offspring subsequently analysed for various postnatal testicular parameters.All offspring remained in good health throughout the study.Maternal xenobiotic treatment appeared to modify specific Leydig cell gene expression in male offspring,particularly during the dynamic phase of mid-puberty,with serum INSL3 concentrations showing that these compounds led to a faster attainment of peak values,and a modest acceleration of the pubertal trajectory.Part of this effect appeared to be due to a treatment-specific impact on Leydig cell proliferation during puberty for both xenobiotics.Taken together,these results support the notion that maternal exposure to certain xenobiotics can also influence the development of the adult-type Leydig cell population,possibly through an effect on the Leydig stem cell population.

  20. Assessing fear of hypoglycemia among adults with type 1 diabetes – psychometric properties of the Norwegian version of the Hypoglycemia Fear Survey II questionnaire

    Directory of Open Access Journals (Sweden)

    Marit Graue

    2013-06-01

    Full Text Available Background: Hypoglycemia is common in type 1 diabetes, but the overall frequency of both mild and severe hypoglycemia is difficult to estimate. The Hypoglycemia Fear Survey II (HFS-II is often used to assess the fear of hypoglycemia. Material and methods: The aim of this study was to assess the psychometric properties of the Norwegian version of the HFS-II for adults, including the behavior (HFS-B and worry (HFS-W subscales, among 235 adults in Norway with type 1 diabetes. We assessed associations between HFS-II scores and other rating scales and demographic and clinical variables. Results: The Norwegian version of HFS-II had an acceptable factor structure in relation to HFS-W, whereas the structure within HFS-B was more questionable. The expected relationships between HFS-II subscales and measures of related constructs administered concurrently demonstrated adequate convergent and discriminant validity. Internal consistency and test-retest reliability were satisfactory. Conclusion: Access to reliable and valid self-report instruments enables the early detection of psychosocial problems. HFS-W performs well, whereas HFS-B needs to be further examined and developed.

  1. The effect of genetic counseling for adult offspring of patients with type 2 diabetes on attitudes toward diabetes and its heredity: a randomized controlled trial.

    Science.gov (United States)

    Nishigaki, M; Tokunaga-Nakawatase, Y; Nishida, J; Kazuma, K

    2014-10-01

    The aim of this study is to investigate the effect of diabetes genetic counseling on attitudes toward diabetes and its heredity in relatives of type 2 diabetes patients. This study was an unmasked, randomized controlled trial at a medical check-up center in Japan. Subjects in this study are healthy adults between 30 and 60 years of age who have a family history of type 2 diabetes in their first degree relatives. Participants in the intervention group received a brief genetic counseling session for approximately 10 min. Genetic counseling was structured based on the Health Belief Model. Both intervention and control groups received a booklet for general diabetes prevention. Risk perception and recognition of diabetes, and attitude towards its prevention were measured at baseline, 1 week and 1 year after genetic counseling. Participants who received genetic counseling showed significantly higher recognition about their sense of control over diabetes onset than control group both at 1 week and 1 year after the session. On the other hand, anxiety about diabetes did not change significantly. The findings show that genetic counseling for diabetes at a medical check center helped adults with diabetes family history understand they are able to exert control over the onset of their disease through lifestyle modification.

  2. Revealing the mechanisms behind adult-type hypolactasia by studies of the regulation of the lactase phlorizin hydrolase gene

    DEFF Research Database (Denmark)

    Troelsen, Jesper Thorvald

    2008-01-01

       The human population can be divided in two main groups based on their intestinal expression of lactase as adult individuals. Lactase persistent individuals express lactase throughout their lifespan, whereas lactase non-persistent individuals lose their lactase expression between the ages of 2......-10 years. Lactase non-persistence is often associated with an inability to efficiently digest lactose, resulting in lactose intolerance. The lactase persistent phenotype is frequently found among northern Europeans and their descendants, but is also found among some African and Arabic populations (e.......g., Tuareg, Fulbe, Beja, and Bedouin people).    The aim of this project is to investigate the molecular mechanisms behind the spatial and temporal expression of LPH.  The human and the pig lactase promoter have therefore been cloned and functionally analyzed in order to understand the mechanisms behind...

  3. Condom use negotiation in heterosexual African American adults: responses to types of social power-based strategies.

    Science.gov (United States)

    Otto-Salaj, Laura; Reed, Barbara; Brondino, Michael J; Gore-Felton, Cheryl; Kelly, Jeffrey A; Stevenson, L Yvonne

    2008-01-01

    This study examined gender differences and preferences in the use of and response to six different styles of condom use negotiation with a hypothetical sexual partner of the opposite gender. Participants were 51 heterosexually active African American adults attending an inner-city community center. Participants completed a semistructured qualitative interview in which they were presented with six negotiation strategies based on Raven's 1992 Power/Interaction Model of Interpersonal Influence. Results showed that female participants responded best to referent, reward, and legitimate strategies, and worst to informational tactics. Male participants responded best to reward strategies, and worst to coercion to use condoms. Further, responses given by a subset of participants indicated that use of negotiation tactics involving coercion to use condoms may result in negative or angry reactions. Response to strategies may vary with the value of the relationship as viewed by the target of negotiation. Implications for HIV prevention efforts are discussed.

  4. Temporal discrimination thresholds in adult-onset primary torsion dystonia: an analysis by task type and by dystonia phenotype.

    LENUS (Irish Health Repository)

    Bradley, D

    2012-01-01

    Adult-onset primary torsion dystonia (AOPTD) is an autosomal dominant disorder with markedly reduced penetrance. Sensory abnormalities are present in AOPTD and also in unaffected relatives, possibly indicating non-manifesting gene carriage (acting as an endophenotype). The temporal discrimination threshold (TDT) is the shortest time interval at which two stimuli are detected to be asynchronous. We aimed to compare the sensitivity and specificity of three different TDT tasks (visual, tactile and mixed\\/visual-tactile). We also aimed to examine the sensitivity of TDTs in different AOPTD phenotypes. To examine tasks, we tested TDT in 41 patients and 51 controls using visual (2 lights), tactile (non-painful electrical stimulation) and mixed (1 light, 1 electrical) stimuli. To investigate phenotypes, we examined 71 AOPTD patients (37 cervical dystonia, 14 writer\\'s cramp, 9 blepharospasm, 11 spasmodic dysphonia) and 8 musician\\'s dystonia patients. The upper limit of normal was defined as control mean +2.5 SD. In dystonia patients, the visual task detected abnormalities in 35\\/41 (85%), the tactile task in 35\\/41 (85%) and the mixed task in 26\\/41 (63%); the mixed task was less sensitive than the other two (p = 0.04). Specificity was 100% for the visual and tactile tasks. Abnormal TDTs were found in 36 of 37 (97.3%) cervical dystonia, 12 of 14 (85.7%) writer\\'s cramp, 8 of 9 (88.8%) blepharospasm, 10 of 11 (90.1%) spasmodic dysphonia patients and 5 of 8 (62.5%) musicians. The visual and tactile tasks were found to be more sensitive than the mixed task. Temporal discrimination threshold results were comparable across common adult-onset primary torsion dystonia phenotypes, with lower sensitivity in the musicians.

  5. Diabetes MILES--Australia (management and impact for long-term empowerment and success: methods and sample characteristics of a national survey of the psychological aspects of living with type 1 or type 2 diabetes in Australian adults

    Directory of Open Access Journals (Sweden)

    Speight Jane

    2012-02-01

    Full Text Available Abstract Background Successful management of diabetes requires attention to the behavioural, psychological and social aspects of this progressive condition. The Diabetes MILES (Management and Impact for Long-term Empowerment and Success Study is an international collaborative. Diabetes MILES--Australia, the first Diabetes MILES initiative to be undertaken, was a national survey of adults living with type 1 or type 2 diabetes in Australia. The aim of this study was to gather data that will provide insights into how Australians manage their diabetes, the support they receive and the impact of diabetes on their lives, as well as to use the data to validate new diabetes outcome measures. Methods/design The survey was designed to include a core set of self-report measures, as well as modules specific to diabetes type or management regimens. Other measures or items were included in only half of the surveys. Cognitive debriefing interviews with 20 participants ensured the survey content was relevant and easily understood. In July 2011, the survey was posted to 15,000 adults (aged 18-70 years with type 1 or type 2 diabetes selected randomly from the National Diabetes Services Scheme (NDSS database. An online version of the survey was advertised nationally. A total of 3,338 eligible Australians took part; most (70.4% completed the postal survey. Respondents of both diabetes types and genders, and of all ages, were adequately represented in both the postal and online survey sub-samples. More people with type 2 diabetes than type 1 diabetes took part in Diabetes MILES--Australia (58.8% versus 41.2%. Most respondents spoke English as their main language, were married/in a de facto relationship, had at least a high school education, were occupied in paid work, had an annual household income > $AUS40,000, and lived in metropolitan areas. Discussion A potential limitation of the study is the under-representation of respondents from culturally and

  6. Differences in B7 and CD28 family gene expression in the peripheral blood between newly diagnosed young-onset and adult-onset type 1 diabetes patients.

    Science.gov (United States)

    Pruul, K; Kisand, K; Alnek, K; Metsküla, K; Reimand, K; Heilman, K; Peet, A; Varik, K; Peetsalu, M; Einberg, Ü; Tillmann, V; Uibo, R

    2015-09-05

    Type-1 diabetes (T1D) is a heterogeneous autoimmune disease, and there are pathogenetic differences between young- and adult-onset T1D patients. We hypothesized that the expressions of genes involved in costimulatory immune system pathways in peripheral blood are differently regulated in young- and adult-onset T1D. Study group I consisted of 80 children, adolescents, and young adults (age range 1.4-21.4 y; 31 controls and 49 T1D patients). Study group II consisted of 48 adults (age range 22.0-78.4 y; 30 controls and 18 T1D patients). The mRNA expression levels of CD86, CD28, CD25, CD226, CD40, BTLA, GITR, PDCD1, FoxP3, TGF-β, ICOS, sCTLA4, flCTLA4, and CD80 were measured in peripheral blood. Genetic polymorphisms (HLA haplotypes; rs231806, rs231775, and rs3087243 in CTLA4; rs763361 in CD226; and rs706778 in CD25) and T1D-associated autoantibodies were analyzed. In group I, there was significantly lower expression of CD226 in T1D patients than in the controls. In group II, there were significantly higher expression levels of CD86 and TGF-β in T1D patients than in the controls. In the T1D patients in group I, the upregulated CD80 expression correlated with the expression of both CTLA4 splice variants (sCTLA4 and flCTLA4). In contrast, in group II, upregulated CD86 correlated with TGF-β and CD25. In group I, the inhibitory CD80-CTLA4 pathway was activated, whereas, in group II, the activation CD86-CD28 pathway and TGF-β production were activated. These results emphasize the differences between young-onset and adult-onset T1D in the regulation of costimulatory pathways. These differences should be considered when developing novel treatments for T1D.

  7. Readability, Subjective Preference and Mental Workload Studies on Young Indian Adults for Selection of Optimum Font Type and Size during Onscreen Reading

    Directory of Open Access Journals (Sweden)

    Jayeeta Banerjee, Deepti Majumdar, Madhu Sudan Pal and Dhurjati Majumdar

    2011-04-01

    Full Text Available Font type and size characteristics play an important role in understanding the complexities of visual information in human-computer interface. India has emerged as the fastest growing personal computer (PC user in the Asia pacific region. Studies and guidelines on the use of font type and size on screen for computer users are limited in the literature. Present work evaluates the influence of font type and size on reading on a computer screen in a group of young adults. Forty subjects volunteered for the study. Two types of fonts were used. Serif fonts included Times New Roman (TNR, Georgia and Courier New. Sans serif fonts included Arial, Verdana and Tahoma. These fonts were presented in 10, 12 and 14 point sizes. Subjects read eighteen passages (same length and reading level. Reading time, ranking and mental workload were measured. Readability was better for Serif compared to Sans serif. Reading time was minimum for Courier New 14 point. Sans serif fonts were preferred more than Serif fonts. Subjects’ ranking was highest and mental workload was least for Verdana 14 point. The present study recommends using 14 point sized fonts for reading on computer screen. Courier New is recommended based on reading time while for making onscreen presentation more attractive, Verdana is recommended based on subjects’ ranking and mental workload scoring.

  8. Body composition in adults with Type 1 diabetes at onset and during the first year of insulin therapy

    DEFF Research Database (Denmark)

    Rosenfalck, A M; Almdal, Thomas Peter; Hilsted, J

    2002-01-01

    . RESULTS: During the first year after onset of diabetes body weight (BW) increased 4.3 +/- 2.9 (0.1-8.3) kg (P = 0.0012) distributed as a 13.3% (1.6 kg) increase in total fat mass (FM) and 4.9% (2.5 kg) increase in lean body soft tissue mass (LBM). The self-reported weight loss at onset was 6.3 +/- 2.5 kg......AIMS: To describe body composition in patients with Type 1 diabetes at diagnosis and during the first year after initiation of insulin therapy. RESEARCH DESIGN AND METHODS: In 10 (eight male and two female) newly onset Type 1 patients, age 31.5 +/- 3.2 years (27-37 years) (sd and range), body mass...... was within the expected range. CONCLUSIONS: During the first year after onset of Type 1 diabetes the mean increase in BW is 6.5% with a 13.3% increase in FM and a 4.9% increase in LBM. Self-reported data on premorbid BW suggest an approximately 10% reduction in BW at onset of Type 1 diabetes. Compared...

  9. Effectiveness of a brief theory-based health promotion intervention among adults at high risk of type 2 diabetes

    DEFF Research Database (Denmark)

    Juul, Lise; Andersen, Vibeke Just; Arnoldsen, Jette;

    2016-01-01

    Dette studie evaluerer effekten af et kort gruppebaseret kommunalt kursusforløb til personer med høj risiko for at udvikle type 2-diabetes. Deltagerne blev rekrutteret via almen praksis og randomiseret til at deltage i kurset (intervention) eller efter 12 måneder (kontrol). Effekten blev målt eft...

  10. Human Development and the Use of Health Education Media among Adult Type 2 Diabetics in Rural Appalachia

    Science.gov (United States)

    Meyer, Michael Glenn

    2009-01-01

    This study conducted in Meigs County, Ohio between January 2009 and June 2009 employed grounded theory to investigate the use of health education media by rural Appalachian individuals with type 2 diabetes in middle and late adulthood. Persons in middle adulthood were 34- to 60-years-old, and persons in late adulthood were 61- to 75-years-old.…

  11. Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct

    NARCIS (Netherlands)

    Romaguera, D.; Norat, T.; Wark, P.A.; Vergnaud, A.C.; Schulze, M.B.; Woudenbergh, van G.J.; Beulens, J.W.J.; Feskens, E.J.M.; The InterAct Consortium, A.

    2013-01-01

    Aims/hypothesis Consumption of sugar-sweetened beverages has been shown, largely in American populations, to increase type 2 diabetes incidence. We aimed to evaluate the association of consumption of sweet beverages (juices and nectars, sugar-sweetened soft drinks and artificially sweetened soft dri

  12. Symptoms of Eating Disorders and Depression in Emerging Adults with Early-Onset, Long-Duration Type 1 Diabetes and Their Association with Metabolic Control.

    Directory of Open Access Journals (Sweden)

    Christina Bächle

    Full Text Available This study analyzed the prevalence of and association between symptoms of eating disorders and depression in female and male emerging adults with early-onset, long-duration type 1 diabetes and investigated how these symptoms are associated with metabolic control.In a nationwide population-based survey, 211 type 1 diabetes patients aged 18-21 years completed standardized questionnaires, including the SCOFF questionnaire for eating disorder symptoms and the Patient Health Questionnaire (PHQ-9 for symptoms of depression and severity of depressive symptoms (PHQ-9 score. Multiple linear and logistic regression models were used to analyze the association between eating disorder and depressive symptoms and their associations with HbA1c.A total of 30.2% of the women and 9.5% of the men were screening positive for eating disorders. The mean PHQ-9 score (standard deviation was 5.3 (4.4 among women and 3.9 (3.6 among men. Screening positive for an eating disorder was associated with more severe depressive symptoms among women (βwomen 3.8, p<0.001. However, neither eating disorder symptoms nor severity of depressive symptoms were associated with HbA1c among women, while HbA1c increased with the severity of depressive symptoms among men (βmen 0.14, p=0.006.Because of the high prevalence of eating disorder and depressive symptoms, their interrelationship, and their associations with metabolic control, particularly among men, regular mental health screening is recommended for young adults with type 1 diabetes.

  13. Reexamining age, race, site, and thermometer type as variables affecting temperature measurement in adults – A comparison study

    Directory of Open Access Journals (Sweden)

    Smith Linda S

    2003-06-01

    Full Text Available Abstract Background As a result of the recent international vigilance regarding disease assessment, accurate measurement of body temperature has become increasingly important. Yet, trusted low-tech, portable mercury glass thermometers are no longer available. Thus, comparing accuracy of mercury-free thermometers with mercury devices is essential. Study purposes were 1 to examine age, race, site as variables affecting temperature measurement in adults, and 2 to compare clinical accuracy of low-tech Galinstan-in-glass device to mercury-in-glass at oral, axillary, groin, and rectal sites in adults. Methods Setting 176 bed accredited healthcare facility, rural northwest US Participants Convenience sample (N = 120 of hospitalized persons ≥ 18 years old. Instruments Temperatures (°F measured at oral, skin (simultaneous, immediately followed by rectal sites with four each mercury-glass (BD and Galinstan-glass (Geratherm thermometers; 10 minute dwell times. Results Participants averaged 61.6 years (SD 17.9, 188 pounds (SD 55.3; 61% female; race: 85% White, 8.3% Native Am., 4.2% Hispanic, 1.7 % Asian, 0.8% Black. For both mercury and Galinstan-glass thermometers, within-subject temperature readings were highest rectally; followed by oral, then skin sites. Galinstan assessments demonstrated rectal sites 0.91°F > oral and ≅ 1.3°F > skin sites. Devices strongly correlated between and across sites. Site difference scores between devices showed greatest variability at skin sites; least at rectal site. 95% confidence intervals of difference scores by site (°F: oral (0.142 – 0.265, axilla (0.167 – 0.339, groin (0.037 – 0.321, and rectal (-0.111 – 0.111. Race correlated with age, temperature readings each site and device. Conclusion Temperature readings varied by age, race. Mercury readings correlated with Galinstan thermometer readings at all sites. Site mean differences between devices were considered clinically insignificant. Still considered

  14. Mediation of autophagic cell death by type 3 ryanodine receptor (RyR3 in adult hippocampal neural stem cells

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    Kyung Min eChung

    2016-05-01

    Full Text Available Cytoplasmic Ca2+ actively engages in diverse intracellular processes from protein synthesis, folding and trafficking to cell survival and death. Dysregulation of intracellular Ca2+ levels is observed in various neuropathological states including Alzheimer’s and Parkinson’s diseases. Ryanodine receptors (RyRs and IP3 receptors (IP3Rs, the main Ca2+ release channels located in endoplasmic reticulum (ER membranes, are known to direct various cellular events such as autophagy and apoptosis. Here we investigated the intracellular Ca2+-mediated regulation of survival and death of adult hippocampal neural stem (HCN cells utilizing an insulin withdrawal model of autophagic cell death. Despite comparable expression levels of RyR and IP3R transcripts in HCN cells at normal state, the expression levels of RyRs — especially RyR3 — were markedly upregulated upon insulin withdrawal. While treatment with the RyR agonist caffeine significantly promoted the autophagic death of insulin-deficient HCN cells, treatment with its inhibitor dantrolene prevented the induction of autophagy following insulin withdrawal. Furthermore, CRISPR/Cas9-mediated knockout of the RyR3 gene abolished autophagic cell death of HCN cells. This study delineates a distinct, RyR3-mediated ER Ca2+ regulation of autophagy and programmed cell death in neural stem cells. Our findings provide novel insights into the critical, yet understudied mechanisms underlying the regulatory function of ER Ca2+ in neural stem cell biology.

  15. Factors Influencing Self-Management in Chinese Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis

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    Xiaoping Luo

    2015-09-01

    Full Text Available Diabetes is a major public health problem in China. Diabetes self-management is critical for patients to achieved better health outcomes, however, previous studies have shown suboptimal diabetes self-management performance. We conducted a systematic review and meta-analysis to identify factors associated with diabetes self-management in Chinese adults. The results showed that confrontation, resignation, overall health beliefs, perceived susceptibility, perceived barriers, and self-efficacy were factors associated with overall diabetes self-management performance and six aspects of diabetes self-management behaviors. There is some limited evidence to suggest that provider-patient communication, married individuals, higher educational level, and higher household income level may also be linked to better diabetes self-management practice. Having healthcare insurance and utilizing chronic illness resources generally appeared to have a favorable effect on diabetes self-management performance. In addition, there were a number of factors for which the evidence is too limited to be able to ascertain its strength of association with diabetes self-management practice. The findings of this review suggest that diabetes self-management behaviors are affected by a wide range of personal and environmental factors, which allow health care providers to develop theory-based strategies to improve diabetes-self-management behaviors in this population.

  16. THE SURGICAL TREATMENT FOR TYPE I CHOLEDOCHAL CYSTS IN THE ADULT%成人I型胆总管囊肿的手术治疗

    Institute of Scientific and Technical Information of China (English)

    邹波

    2011-01-01

    Object To sum up the experience of surgical treatment of type I choledoehal cyst (CC) in the adult. Methods The clinical data of 21 adult patients with type I CC who underwent excision of the cyst with a Roux-en-Y hepaticojejunostomy in our department was analysed retrospectively. Results Three patients developed postoperative early complications ( 14. 3% ) , including leakage of bile 2 ^pancreatic leak 1. All patients recovered completely with conservative management. None of the patients died during the first 30 postoperative days. Cholangiocarcinoma was found in the resected specimen in 2 case. The time of following - up was 9 months ~ 5 years (average 36 months). One patient developed cholangitis 3 years after operation. No patient developed cancer of biliary tree and other late complications. Conclusions The coexistent pancreatobiliary disease and the previous operations on the biliary tree increase the risk and difficulty of the reoperation. The diagnosis is once identified,the surgical treatment should perform as possible as early. The treatment of choice for type 1 CC in the adult is still complete cyst excision with Roux - en - Y hepatojejunostomy.%目的 总结成人I型胆总管囊肿手术治疗经验.方法 回顾性分析经我科囊肿切除+肝管空肠Roux-en-Y吻合术的21例I型成人胆总管囊肿的临床资料.结果 3例发生术后早期并发症包括胆漏2例,胰瘘1例,均经非手术处理治愈.无手术死亡,2例切除标本发现胆管癌.随访9个月~5年,平均36个月,1例术后3年发生胆管炎,其余病人无胆管癌和其他晚期并发症.结论 同时伴有的肝胆胰疾病和既往的胆道手术增加了再手术的危险性和难度.胆总管囊肿一旦诊断应尽早手术治疗.成人I型胆总管囊肿的首选治疗仍是囊肿完全切除十肝管空肠Roux-en-Y吻合术.

  17. Body composition in adults with Type 1 diabetes at onset and during the first year of insulin therapy

    DEFF Research Database (Denmark)

    Rosenfalck, A M; Almdal, Thomas Peter; Hilsted, J;

    2002-01-01

    index (BMI) 20.8 +/- 1.6 (19.2-23.4) kg/m2, body composition was estimated by means of dual-energy X-ray absorptiometry (DXA) whole body scanning supplemented by estimation of total body water (TBW) (isotope dilution technique with 3H2O) at diagnosis and after 1, 3, 6 and 12 months of insulin therapy......AIMS: To describe body composition in patients with Type 1 diabetes at diagnosis and during the first year after initiation of insulin therapy. RESEARCH DESIGN AND METHODS: In 10 (eight male and two female) newly onset Type 1 patients, age 31.5 +/- 3.2 years (27-37 years) (sd and range), body mass...

  18. Kidney Dysfunction in Adult Offspring Exposed In Utero to Type 1 Diabetes Is Associated with Alterations in Genome-Wide DNA Methylation.

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    Jean-François Gautier

    Full Text Available Fetal exposure to hyperglycemia impacts negatively kidney development and function.Our objective was to determine whether fetal exposure to moderate hyperglycemia is associated with epigenetic alterations in DNA methylation in peripheral blood cells and whether those alterations are related to impaired kidney function in adult offspring.Twenty nine adult, non-diabetic offspring of mothers with type 1 diabetes (T1D (case group were matched with 28 offspring of T1D fathers (control group for the study of their leukocyte genome-wide DNA methylation profile (27,578 CpG sites, Human Methylation 27 BeadChip, Illumina Infinium. In a subset of 19 cases and 18 controls, we assessed renal vascular development by measuring Glomerular Filtration Rate (GFR and Effective Renal Plasma Flow (ERPF at baseline and during vasodilatation produced by amino acid infusion.Globally, DNA was under-methylated in cases vs. controls. Among the 87 CpG sites differently methylated, 74 sites were less methylated and 13 sites more methylated in cases vs. controls. None of these CpG sites were located on a gene known to be directly involved in kidney development and/or function. However, the gene encoding DNA methyltransferase 1 (DNMT1--a key enzyme involved in gene expression during early development--was under-methylated in cases. The average methylation of the 74 under-methylated sites differently correlated with GFR in cases and controls.Alterations in methylation profile imprinted by the hyperglycemic milieu of T1D mothers during fetal development may impact kidney function in adult offspring. The involved pathways seem to be a nonspecific imprinting process rather than specific to kidney development or function.

  19. DDT and its metabolites are linked to increased risk of type 2 diabetes among Saudi adults: a cross-sectional study.

    Science.gov (United States)

    Al-Othman, AbdulAziz A; Abd-Alrahman, Sherif H; Al-Daghri, Nasser M

    2015-01-01

    Organochlorine (OC) pesticides have recently been associated with type 2 diabetes in several non-Asian general populations. As there is currently an epidemic of type 2 diabetes mellitus in Asia. The prevalence and incidence of diabetes is increasing rapidly worldwide including many Arab Gulf countries. According to a community-based national epidemiological health survey, the overall prevalence of diabetes mellitus in Saudi adults (age group of 30-50 years) is 23.7%. A recent study by Al-Daghri et al. (BMC Med 9:76, 2011) reported that the prevalence of diabetes mellitus in the Kingdom of Saudi Arabia (KSA) is 31.6%. We investigated the associations between OC pesticides and type 2 diabetes in Saudi Arabia using a simple, sensitive, rapid, and selective gas chromatography coupled with mass spectrometry (GC-MS) method that has been recently developed. A total of 280 Saudi adults (136 diabetes mellitus (DM) patients and 144 non-DM controls) were randomly selected from the Riyadh Cohort Study for inclusion. The diagnosis of diabetes was based on established diagnosis and medications taken. Blood dichlorodiphenyltrichloroethane (DDT) and its derivatives were quantified using GC-MS. Residues of DDT and its derivatives were analyzed in serum by means of gas chromatography with a mass spectrometry detector. Associations between DDT exposure and T2DM were analyzed by logistic regression. DDT and its derivatives and serum concentrations of DDT and its derivative DDE showed the strongest and most significant association to type 2 diabetes in both cross-sectional and prospective studies. Associations of DDT and its derivatives varied across different diabetes-related components of the metabolic syndrome. It positively and significantly associated with four of the five of these components especially elevated triacylglycerol, high fasting glucose, high blood pressure, and HOMA-IR but negatively and significantly with HDL. Possible biological mechanisms are discussed. This study

  20. Quality of Life, Depression, and Healthcare Resource Utilization among Adults with Type 2 Diabetes Mellitus and Concomitant Hypertension and Obesity: A Prospective Survey

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    Andrew J. Green

    2012-01-01

    Full Text Available Background. This study compared quality of life, depression, and healthcare resource utilization among adults with type 2 diabetes mellitus (T2DM and comorbid hypertension (HTN and obesity with those of adults reporting T2DM alone. Methods. Respondents to the US SHIELD survey self-reported their height, weight, comorbid conditions, hospitalizations, and outpatient visits and completed the Short Form-12 (SF-12 and Patient Health Questionnaire (PHQ-9. Respondents reporting T2DM and HTN and obesity (body mass index, BMI, ≥30 kg/m2 were compared with a T2DM-alone group. Results. Respondents with T2DM, HTN, and obesity (n=1292 had significantly lower SF-12 Physical and Mental Component Summary scores (37.3 and 50.9, resp. than T2DM-alone respondents (n=349 (45.8 and 53.5, resp., P<0.0001. Mean PHQ-9 scores were significantly higher among T2DM respondents with comorbid HTN and obesity (5.0 versus 2.5, P<0.0001, indicating greater depression burden. Respondents with T2DM, HTN, and obesity had significantly more resource utilization with respect to physician visits and emergency room visits but not hospitalizations than respondents with T2DM alone (P=0.03. Conclusions. SHIELD respondents with comorbid conditions of T2DM, HTN, and obesity reported greater healthcare resource utilization, more depression symptoms, and lower quality of life than the T2DM-alone group.

  1. Forebrain microglia from wild-type but not adult 5xFAD mice prevent amyloid-β plaque formation in organotypic hippocampal slice cultures.

    Science.gov (United States)

    Hellwig, Sabine; Masuch, Annette; Nestel, Sigrun; Katzmarski, Natalie; Meyer-Luehmann, Melanie; Biber, Knut

    2015-01-01

    The role of microglia in amyloid-β (Aβ) deposition is controversial. In the present study, an organotypic hippocampal slice culture (OHSC) system with an in vivo-like microglial-neuronal environment was used to investigate the potential contribution of microglia to Aβ plaque formation. We found that microglia ingested Aβ, thereby preventing plaque formation in OHSCs. Conversely, Aβ deposits formed rapidly in microglia-free wild-type slices. The capacity to prevent Aβ plaque formation was absent in forebrain microglia from young adult but not juvenile 5xFamilial Alzheimer's disease (FAD) mice. Since no loss of Aβ clearance capacity was observed in both wild-type and cerebellar microglia from 5xFAD animals, the high Aβ1-42 burden in the forebrain of 5xFAD animals likely underlies the exhaustion of microglial Aβ clearance capacity. These data may therefore explain why Aβ plaque formation has never been described in wild-type mice, and point to a beneficial role of microglia in AD pathology. We also describe a new method to study Aβ plaque formation in a cell culture setting.

  2. Cross-sectional study of older adults with type 2 diabetes mellitus in two rural public primary healthcare facilities in Malaysia.

    Science.gov (United States)

    Ooi, C P; Loke, S C; Zaiton, A; Tengku-Aizan, H; Zaitun, Y

    2011-06-01

    Knowledge of the characteristics of older adults with type 2 diabetes mellitus (T2DM) is indispensible for improvement of their care. A cross-sectional study in two rural public primary healthcare centres in Malaysia identified 170 actively engaged older patients with T2DM, with suboptimal glycaemic control and frequent hypoglycaemia. The prevalence of multiple co-morbidities, complications of T2DM, high cardiovascular risk, neurological, musculoskeletal and visual deficits suggested high risk of disabilities and dependency but not yet disabled. This short window for interventions presents as an opportunity for development of a more comprehensive approach extending beyond glycaemia control to risk management, preventing functional loss and continuity of social participation.

  3. Shoulder function, pain and health related quality of life in adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type

    DEFF Research Database (Denmark)

    Johannessen, Elise Christine; Reiten, Helle Sundnes; Løvaas, Helene

    2016-01-01

    Purpose To investigate shoulder function, pain and Health-Related Quality of life (HRQoL) among adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type (JHS/EDS-HT), compared with the general population (controls). Method In a cross-sectional study using postal survey......). Results Eighty-one individuals responded, with response rate 34% (JHS/EDS-HT: 53%, controls: 21%). JHS/EDS-HT had lower shoulder function (WOSI total: 49.9 versus 83.3; p ..., 110 patients diagnosed with JHS/EDS-HT and 140 gender- and age-matched healthy controls from Statistics Norway participated. Shoulder function, pain and HRQol were registered by Western Ontario Shoulder Instability Index (WOSI), Numerical Rating Scale (NRS), pain drawings, 36-item Short Form (SF-36...

  4. Self-reported diabetes self-management competence and support from healthcare providers in achieving autonomy are negatively associated with diabetes distress in adults with Type 1 diabetes

    DEFF Research Database (Denmark)

    Mohn, J; Graue, M; Assmus, J;

    2015-01-01

    AIM: To investigate the associations of self-perceived competence in diabetes management and autonomy support from healthcare providers with diabetes distress in adults with Type 1 diabetes mellitus that is not optimally controlled [HbA(1c) ≥ 64 mmol/mol (8.0%)]. METHODS: This cross-sectional study...... comprised blood sampling and three self-report questionnaires, the Problem Areas in Diabetes scale, the Perceived Competence in Diabetes Scale and a measure of autonomy support by healthcare providers, the Health Care Climate Questionnaire. We fitted blockwise linear regression models to assess...... the associations between Problem Areas in Diabetes score and the variables of interest (autonomy support and perceived diabetes competence), controlling for clinical and sociodemographic variables. RESULTS: Of the study sample [n = 178; mean age 36.7 (±10.7) years], 31.5% had long-term complications and 43...

  5. Program ACTIVE II: Design and Methods for a Multi-Center Community-Based Depression Treatment for Rural and Urban Adults with Type 2 Diabetes

    Science.gov (United States)

    de Groot, Mary; Shubrook, Jay; Schwartz, Frank; Hornsby, W. Guyton; Pillay, Yegan; Saha, Chandan

    2015-01-01

    Objective Depression affects one in four adults with type 2 diabetes (T2DM) and is associated with worsened diabetes complications, increased health care costs and early mortality. Rural and low-income urban areas, including the Appalachian region, represent an epicenter of the T2DM epidemic. Program ACTIVE II is a comparative effectiveness treatment trial designed to test whether a combination of cognitive behavioral therapy (CBT) and community-based exercise (EXER) will offer greater improvements in diabetes and depression outcomes compared to individual treatment approaches and usual care (UC). The secondary aims are to assess changes in cardiovascular risk factors across groups and to conduct a cost-effectiveness analysis of predicted incidence of cardiovascular complications across groups. Methods The study is a 2-by-2 factorial randomized controlled trial consisting of 4 treatment groups: CBT alone, EXER alone, combination of CBT and EXER, and UC. Adults with T2DM for > 1 year and who meet DSM-IVTR criteria for Major Depressive Disorder (MDD) are eligible to participate at two rural Appalachian sites (southeastern Ohio and West Virginia) and one urban site (Indianapolis). This type II behavioral translation study uses a community-engaged research (CEnR) approach by incorporating community fitness centers and mental health practices as interventionists. Conclusions This is the first study to evaluate the comparative effectiveness of combined CBT and exercise in the treatment of depression using community-based intervention delivery. This approach may serve as a national model for expanding depression treatment for patients with T2DM. PMID:27500279

  6. Frequency of LCT -13910C>T single nucleotide polymorphism associated with adult-type hypolactasia/lactase persistence among Brazilians of different ethnic groups

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    Silva Joyce MK

    2009-10-01

    Full Text Available Abstract Background Adult-type hypolactasia, the physiological decline of lactase some time after weaning, was previously associated with the LCT -13910C>T polymorphism worldwide except in Africa. Lactase non-persistence is the most common phenotype in humans, except in northwestern Europe with its long history of pastoralism and milking. We had previously shown association of LCT -13910C>T polymorphism with adult-type hypolactasia in Brazilians; thus, we assessed its frequency among different Brazilian ethnic groups. Methods We investigated the ethnicity-related frequency of this polymorphism in 567 Brazilians [mean age, 42.1 ± 16.8 years; 157 (27.7% men]; 399 (70.4% White, 50 (8.8% Black, 65 (11.5% Brown, and 53 (9.3% Japanese-Brazilian. DNA was extracted from leukocytes; LCT -13910C>T polymorphism was analyzed by PCR-restriction fragment length polymorphism. Results Prevalence of the CC genotype associated with hypolactasia was similar (57% among White and Brown groups; however, prevalence was higher among Blacks (80% and those of Japanese descent (100%. Only 2 (4% Blacks had TT genotype, and 8 (16% had the CT genotype. Assuming an association between CC genotype and hypolactasia, and CT and TT genotypes with lactase persistence, 356 (62.8% individuals had hypolactasia and 211 (37.2% had lactase persistence. The White and Brown groups had the same hypolactasia prevalence (~57%; nevertheless, was 80% among Black individuals and 100% among Japanese-Brazilians (P Conclusion The lactase persistence allele, LCT -13910T, was found in about 43% of both White and Brown and 20% of the Black Brazilians, but was absent among all Japanese Brazilians studied.

  7. Differential effect of elevated blood pressure on left ventricular geometry types in black and white young adults in a community (from the Bogalusa Heart Study).

    Science.gov (United States)

    Wang, Jian; Chen, Wei; Ruan, Litao; Toprak, Ahmet; Srinivasan, Sathanur R; Berenson, Gerald S

    2011-03-01

    Hypertension and left ventricular (LV) hypertrophy are both more common in blacks than in whites. The aim of the present study was to test the hypothesis that blood pressure (BP) has a differential effect on the LV geometry types in black versus white asymptomatic young adults. As a part of the Bogalusa Heart Study, echocardiography and cardiovascular risk factor measurements were performed in 780 white and 343 black subjects (aged 24 to 47 years). Four LV geometry types were identified as normal, concentric remodeling, eccentric, and concentric hypertrophy. Compared to the white subjects, the black subjects had a greater prevalence of eccentric (15.7% vs 9.1%, p <0.001) and concentric (9.3% vs 4.1%, p <0.001) hypertrophy. On multivariate logistic regression analyses, adjusting for age, gender, body mass index, lipids, and glucose, the black subjects showed a significantly stronger association of LV concentric hypertrophy with BP (systolic BP, odds ratio [OR] 3.74, p <0.001; diastolic BP, OR 2.86, p <0.001) than whites (systolic BP, OR 1.50, p = 0.037; and diastolic BP, OR 1.35, p = 0.167), with p values for the race difference of 0.007 for systolic BP and 0.026 for diastolic BP. LV eccentric hypertrophy showed similar trends for the race difference in the ORs; however, the association between eccentric hypertrophy and BP was not significant in the white subjects. With respect to LV concentric remodeling, its association with BP was not significant in either blacks or whites. In conclusion, elevated BP levels have a greater detrimental effect on LV hypertrophy patterns in the black versus white young adults. These findings suggest that blacks might be more susceptible than whites to BP-related adverse cardiac remodeling.

  8. Coronary artery disease in Chinese adults with type 2 diabetes mellitus estimated by electron beam computed tomography and electron beam computed tomography angiography

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To assess the prevalence and risk of coronary artery disease (CAD) in Chinese adults with type 2 diabetes mellitus (T2DM) using electron beam computed tomography (EBCT) and EBCT angiography (EBCTA). Methods: Ninety-four cases were enrolled in this study including diabetes (n=28), impaired glucose tolerance (IGT, n=30), coronary heart disease (CHD, n=11), and control (n=25). Cardiac EBCT plain scanning and EBCTA were performed on all of these subjects to evaluate coronary artery calcification (CAC) scores, and number of segments of stenosed coronary arteries. Both CAC and/or coronary artery stenosis were defined as patients with coronary artery lesions (CAL). Results CAC scores were not different with the control, diabetes, IGT, or CHD (P>0.05)groups. Compared to control (0.520±1.295), more stenosed coronary arteries segments (P<0.05) were detected in diabetes (2.964±1.915), IGT (2.200±2.024), and CHD (2.273±1.679). Number of stenosed artery segments were correlated with age (r=0.215, P=0.019),postprandial glucose (r=0.224, P=0.015), total cholesterol (r=0.323, P=0.000), and duration of diabetes (r=0.208, P=0.004). The incidences of CAL in diabetes (96.43%), IGT (93.33%), and CHD (90.91%) was substantially higher than that in normal control (56.00%, P<0.01).The odds ratio of CAL associated with having diabetes was estimated to be 7.514 (95% CI: 1.885-63.778). Conclusions Coronary artery lesions are prevalent in Chinese adults with type 2 diabetes, implying a high CAD risk. EBCTA holds potential in depicting the details of CAL and can be used to track the progression of CAD in diabetes patients.

  9. Short-term high-intensity interval and moderate-intensity continuous training reduce leukocyte TLR4 in inactive adults at elevated risk of type 2 diabetes.

    Science.gov (United States)

    Robinson, Emily; Durrer, Cody; Simtchouk, Svetlana; Jung, Mary E; Bourne, Jessica E; Voth, Elizabeth; Little, Jonathan P

    2015-09-01

    Exercise can have anti-inflammatory effects in obesity, but the optimal type and intensity of exercise are not clear. This study compared short-term high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) in terms of improvement in cardiorespiratory fitness, markers of inflammation, and glucose control in previously inactive adults at elevated risk of developing type 2 diabetes. Thirty-nine inactive, overweight/obese adults (32 women) were randomly assigned to 10 sessions over 2 wk of progressive HIIT (n = 20, four to ten 1-min sessions at ∼90% peak heart rate, 1-min rest periods) or MICT (n = 19, 20-50 min at ∼65% peak heart rate). Before and 3 days after training, participants performed a peak O2 uptake test, and fasting blood samples were obtained. Both HIIT (1.8 ± 0.4 vs. 1.9 ± 0.4 l/min, pre vs. post) and MICT (1.8 ± 0.5 vs. 1.9 ± 0.5 l/min, pre vs. post) improved peak O2 uptake (P training in both groups, but MICT led to a reduction in fasting plasma glucose (P < 0.05, 5.9 ± 1.0 vs. 5.6 ± 1.0 mmol/l, pre vs. post). Ten days of either HIIT or MICT can improve cardiorespiratory fitness and glucose control and lead to reductions in TLR2 and TLR4 expression. MICT, which involved a longer duration of exercise, may be superior for reducing fasting glucose.

  10. The association between indices of obesity and common clinical measures in adults with and without type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Shivananda B. Nayak

    2015-01-01

    Full Text Available Background: The aim of this study was to determine the differences amongst the anthropometric measurements, lipid profile, blood pressure and body shape in diabetics as well as non-diabetics. Methods: This was a cross-sectional study comprised of 309 subjects with 91 males and 218 females. Of this, there were 217 diabetics and 92 non-diabetics. The sample was taken from three hospitals in Trinidad. Lipid profile and blood pressure were taken from each facility's physician's notes while anthropometric measurements were taken from the patients themselves. Results: The diabetic group had elevated body mass index and waist to hip ratios were significant (P <0.05 when compared to non-diabetics. There was no significant association of lipid profile, blood pressure, waist circumference and waist to height ratios between diabetics and non-diabetics. As age increased, the prevalence of type 2 diabetes mellitus was more common. Out of 217 diabetics, 173 were of East Indian descent. With regards to gender, more males were found to be diabetics resulting from having an android body shape as compared to females (gynoid body shape. Conclusion: It was found that of all the anthropometric measurements used, waist to hip ratio was found to be the most effective indicator of type 2 diabetes mellitus in Trinidadians, while body mass index was found to be the least effective indicator. [Int J Res Med Sci 2015; 3(1.000: 256-259

  11. Older Adults and Depression

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    ... find more information? Reprints Share Older Adults and Depression Download PDF Download ePub Order a free hardcopy ... depression need treatment to feel better. Types of Depression There are several types of depression. The most ...

  12. Expressed sequence tag analysis of adult human optic nerve for NEIBank: Identification of cell type and tissue markers

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    Peterson Katherine

    2009-09-01

    Full Text Available Abstract Background The optic nerve is a pure white matter central nervous system (CNS tract with an isolated blood supply, and is widely used in physiological studies of white matter response to various insults. We examined the gene expression profile of human optic nerve (ON and, through the NEIBANK online resource, to provide a resource of sequenced verified cDNA clones. An un-normalized cDNA library was constructed from pooled human ON tissues and was used in expressed sequence tag (EST analysis. Location of an abundant oligodendrocyte marker was examined by immunofluorescence. Quantitative real time polymerase chain reaction (qRT-PCR and Western analysis were used to compare levels of expression for key calcium channel protein genes and protein product in primate and rodent ON. Results Our analyses revealed a profile similar in many respects to other white matter related tissues, but significantly different from previously available ON cDNA libraries. The previous libraries were found to include specific markers for other eye tissues, suggesting contamination. Immune/inflammatory markers were abundant in the new ON library. The oligodendrocyte marker QKI was abundant at the EST level. Immunofluorescence revealed that this protein is a useful oligodendrocyte cell-type marker in rodent and primate ONs. L-type calcium channel EST abundance was found to be particularly low. A qRT-PCR-based comparative mammalian species analysis reveals that L-type calcium channel expression levels are significantly lower in primate than in rodent ON, which may help account for the class-specific difference in responsiveness to calcium channel blocking agents. Several known eye disease genes are abundantly expressed in ON. Many genes associated with normal axonal function, mRNAs associated with axonal transport, inflammation and neuroprotection are observed. Conclusion We conclude that the new cDNA library is a faithful representation of human ON and EST data

  13. Attitudes toward homosexuality among young adults: connections to gender role identity, gender-typed activities, and religiosity.

    Science.gov (United States)

    Harbaugh, Evan; Lindsey, Eric W

    2015-01-01

    Individual differences in attitudes toward homosexuality have been linked to numerous personality and demographic variables. This study investigated the influence that gender role identity, involvement in gender-typed activities, and religiosity plays in this relationship. The sample included 194 undergraduate students from a Northeastern university. Analyses revealed that both males and females who held a more masculine gender role identity and individual commitment to religion scored higher on measures of homophobia and heteronormativity, whereas there was no association between spiritual meaning in life and attitudes toward homosexuality. Among males, but not females, more masculine gender identity and less spiritual meaning in life was associated with greater homophobia. The importance of the findings for research on the origins of attitudes toward individuals with a homosexual orientation are discussed, as well as the potential directions for future research on connections between gender role identity, religious affiliation, and attitudes toward gays and lesbians.

  14. Impact of Demographic, Socioeconomic, and Psychological Factors on Glycemic Self-Management in Adults with Type 2 Diabetes Mellitus

    Science.gov (United States)

    Gonzalez-Zacarias, Alicia A.; Mavarez-Martinez, Ana; Arias-Morales, Carlos E.; Stoicea, Nicoleta; Rogers, Barbara

    2016-01-01

    Diabetes mellitus (DM) is reported as one of the most complex chronic diseases worldwide. In the United States, Type 2 DM (T2DM) is the seventh leading cause of morbidity and mortality. Individuals with diabetes require lifelong personal care to reduce the possibility of developing long-term complications. A good knowledge of diabetes risk factors, including obesity, dyslipidemia, hypertension, family history of DM, and sedentary lifestyle, play an essential role in prevention and treatment. Also, sociodemographic, economic, psychological, and environmental factors are directly and indirectly associated with diabetes control and health outcomes. Our review intends to analyze the interaction between demographics, knowledge, environment, and other diabetes-related factors based on an extended literature search, and to provide insight for improving glycemic control and reducing the incidence of chronic complications. PMID:27672634

  15. Disease history and medication use as risk factors for the clinical manifestation of type 1 diabetes in children and young adults: an explorative case control study.

    Directory of Open Access Journals (Sweden)

    Soulmaz Fazeli Farsani

    Full Text Available BACKGROUND: There is a highly variable asymptomatic period of beta cell destruction prior to the clinical presentation of type1 diabetes. It is not well known what triggers type 1 diabetes to become a clinically overt disease. This explorative study aimed to identify the association between disease history/medication use and the clinical manifestation of type 1 diabetes. METHODOLOGY/PRINCIPAL FINDINGS: An explorative case control study was conducted in the Dutch PHARMO Record Linkage System. Cases (n = 1,107 were younger than 25 years and had at least 2 insulin prescriptions between 1999 and 2009. For each case, up to 4 controls (without any prescription for the glucose lowering medications (n = 4,424 were matched by age and sex. Conditional logistic regression analysis was used to evaluate the association between disease history/medication use in the year prior to the diagnosis of type 1 diabetes and clinical manifestation of this disease. Type1 diabetes was significantly associated with a history of mental disorder (odds ratio (OR 8.0, 95% confidence interval (CI 1.5-43.7, anemia (OR 5.1, 95% CI 1.1-22.9, and disease of digestive system (OR 2.6, 95% CI 1.2-5.5. The following drug exposures were significantly associated with the clinical manifestation of type 1 diabetes: "systemic hormonal preparations" (OR 1.7, 95% CI 1.1-2.6, medications for "blood and blood forming organs" (OR 1.6, 95% CI 1.1-2.6, "alimentary tract and metabolism" (OR 1.3, 95% CI 1.1-1.6, and "anti-infectives for systemic use" (OR 1.2, 95% CI 1.01-1.4. CONCLUSIONS: Our explorative study demonstrated that in the year prior to the presentation of type 1 diabetes in children and young adults, hospitalization for a diverse group of diseases and drug exposures were significantly more prevalent compared with age- and sex-matched diabetes-free controls.

  16. Comparative analysis of the noncollagenous NC1 domain of type IV collagen: identification of structural features important for assembly, function, and pathogenesis.

    Science.gov (United States)

    Netzer, K O; Suzuki, K; Itoh, Y; Hudson, B G; Khalifah, R G

    1998-06-01

    Type IV collagen alpha1-alpha6 chains have important roles in the assembly of basement membranes and are implicated in the pathogenesis of Goodpasture syndrome, an autoimmune disorder, and Alport syndrome, a hereditary renal disease. We report comparative sequence analyses and structural predictions of the noncollagenous C-terminal globular NC1 domain (28 sequences). The inferred tree verified that type IV collagen sequences fall into two groups, alpha1-like and alpha2-like, and suggested that vertebrate alpha3/alpha4 sequences evolved before alpha1/alpha2 and alpha5/alpha6. About one fifth of NC1 residues were identified to confer either the alpha1 or alpha2 group-specificity. These residues accumulate opposite charge in subdomain B of alpha1 (positive) and alpha2 (negative) sequences and may play a role in the stoichiometric chain selection upon type IV collagen assembly. Neural network secondary structure prediction on multiple aligned sequences revealed a subdomain core structure consisting of six hydrophobic beta-strands and one short alpha-helix with a significant hydrophobic moment. The existence of opposite charges in the alpha-helices may carry implications for intersubdomain interactions. The results provide a rationale for defining the epitope that binds Goodpasture autoantibodies and a framework for understanding how certain NC1 mutations may lead to Alport syndrome. A search algorithm, based entirely on amino acid properties, yielded a possible similarity of NC1 to tissue inhibitor of metalloproteinases (TIMP) and prompted an investigation of a possible functional relationship. The results indicate that NC1 preparations decrease the activity of matrix metalloproteinases 2 and 3 (MMP-2, MMP-3) toward a peptide substrate, though not to [14C]-gelatin. We suggest that an ancestral NC1 may have been incorporated into type IV collagen as an evolutionarily mobile domain carrying proteinase inhibitor function.

  17. Clinical practice guideline for the prevention, early detection, diagnosis, management and follow up of type 2 diabetes mellitus in adults

    Science.gov (United States)

    Muñoz, Oscar Mauricio; Girón, Diana; García, Olga Milena; Fernández-Ávila, Daniel Gerardo; Casas, Luz Ángela; Bohórquez, Luisa Fernanda; Arango T, Clara María; Carvajal, Liliana; Ramírez, Doris Amanda; Sarmiento, Juan Guillermo; Colon, Cristian Alejandro; Correa G, Néstor Fabián; Alarcón R, Pilar; Bustamante S, Álvaro Andrés

    2016-01-01

    In Colombia, diabetes mellitus is a public health program for those responsible for creating and implementing strategies for prevention, diagnosis, treatment, and follow-up that are applicable at all care levels, with the objective of establishing early and sustained control of diabetes. A clinical practice guide has been developed following the broad outline of the methodological guide from the Ministry of Health and Social Welfare, with the aim of systematically gathering scientific evidence and formulating recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. The current document presents in summary form the results of this process, including the recommendations and the considerations taken into account in formulating them. In general terms, what is proposed here is a screening process using the Finnish Diabetes Risk Score questionnaire adapted to the Colombian population, which enables early diagnosis of the illness, and an algorithm for determining initial treatment that can be generalized to most patients with diabetes mellitus type 2 and that is simple to apply in a primary care context. In addition, several recommendations have been made to scale up pharmacological treatment in those patients that do not achieve the objectives or fail to maintain them during initial treatment. These recommendations also take into account the evolution of weight and the individualization of glycemic control goals for special populations. Finally, recommendations have been made for opportune detection of micro- and macrovascular complications of diabetes. PMID:27546934

  18. Epstein-Barr virus DNA loads in adult human immunodeficiency virus type 1-infected patients receiving highly active antiretroviral therapy

    Science.gov (United States)

    Ling, Paul D.; Vilchez, Regis A.; Keitel, Wendy A.; Poston, David G.; Peng, Rong Sheng; White, Zoe S.; Visnegarwala, Fehmida; Lewis, Dorothy E.; Butel, Janet S.

    2003-01-01

    Patients with human immunodeficiency virus type 1 (HIV-1) infection are at high risk of developing Epstein-Barr virus (EBV)-associated lymphoma. However, little is known of the EBV DNA loads in patients receiving highly active antiretroviral therapy (HAART). Using a real-time quantitative polymerase chain reaction assay, we demonstrated that significantly more HIV-1-infected patients receiving HAART than HIV-1-uninfected volunteers had detectable EBV DNA in blood (57 [81%] of 70 vs. 11 [16%] of 68 patients; P=.001) and saliva (55 [79%] of 68 vs. 37 [54%] of 68 patients; P=.002). The mean EBV loads in blood and saliva samples were also higher in HIV-1-infected patients than in HIV-1-uninfected volunteers (P=.001). The frequency of EBV detection in blood was associated with lower CD4+ cell counts (P=.03) among HIV-1-infected individuals, although no differences were observed in the EBV DNA loads in blood or saliva samples in the HIV-1-infected group. Additional studies are needed to determine whether EBV-specific CD4+ and CD8+ cells play a role in the pathogenesis of EBV in HIV-1-infected patients receiving HAART.

  19. Clinical practice guideline for the prevention, early detection, diagnosis, management and follow up of type 2 diabetes mellitus in adults.

    Science.gov (United States)

    Aschner, Pablo M; Muñoz, Oscar Mauricio; Girón, Diana; García, Olga Milena; Fernández-Ávila, Daniel Gerardo; Casas, Luz Ángela; Bohórquez, Luisa Fernanda; Arango T, Clara María; Carvajal, Liliana; Ramírez, Doris Amanda; Sarmiento, Juan Guillermo; Colon, Cristian Alejandro; Correa G, Néstor Fabián; Alarcón R, Pilar; Bustamante S, Álvaro Andrés

    2016-06-30

    In Colombia, diabetes mellitus is a public health program for those responsible for creating and implementing strategies for prevention, diagnosis, treatment, and follow-up that are applicable at all care levels, with the objective of establishing early and sustained control of diabetes. A clinical practice guide has been developed following the broad outline of the methodological guide from the Ministry of Health and Social Welfare, with the aim of systematically gathering scientific evidence and formulating recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. The current document presents in summary form the results of this process, including the recommendations and the considerations taken into account in formulating them. In general terms, what is proposed here is a screening process using the Finnish Diabetes Risk Score questionnaire adapted to the Colombian population, which enables early diagnosis of the illness, and an algorithm for determining initial treatment that can be generalized to most patients with diabetes mellitus type 2 and that is simple to apply in a primary care context. In addition, several recommendations have been made to scale up pharmacological treatment in those patients that do not achieve the objectives or fail to maintain them during initial treatment. These recommendations also take into account the evolution of weight and the individualization of glycemic control goals for special populations. Finally, recommendations have been made for opportune detection of micro- and macrovascular complications of diabetes.

  20. Type 2 diabetes mellitus and severe periodontal disease in an adult population; effect of a new local delivery approach

    Directory of Open Access Journals (Sweden)

    Mahmoud Helmy Belal

    2015-06-01

    Full Text Available Objective: The aim of this study is to clarify association between diabetes mellitus and periodontitis, and assess the effect of metronidazole and chlorhexidine mixture as a local delivery. Methods: Sixty patients constituted three groups: (I type 2 diabetes with advanced periodontitis; (II diabetes mellitus without periodontitis; and (III periodontitis without diabetes. Clinical attachment loss (CAL and bleeding index (BI were recorded. Periodontitis received first non-surgical therapy, and then metronidazole and chlorhexidine gel. Diabetics undertook blood analysis for diabetic factors. Results: Statistical differences were noticed between groups I and II at all periods (three and six month except few sites, and between groups I and III at all sites of CAL and most sites of BI. Group I had the worst measurements at baseline and 3 month which reversed with less measurements at 6 month (following therapy by demonstrating significant intergroup positive changes, without significance prior to therapy. No significant differences were noticed within groups I and III for CAL prior to therapy except few sites, but were present at 6 month at all sites in group III and except two sites in group I. For BI, no differences were noticed except three sites. Conclusion: The present study suggested evidence on improvement of periodontal parameters following treatment with the local mixture of metronidazole and chlorhexidine gel. [J Exp Integr Med 2015; 5(2.000: 93-99

  1. Brain MRI abnormalities in the adult form of myotonic dystrophy type 1: A longitudinal case series study.

    Science.gov (United States)

    Conforti, Renata; de Cristofaro, Mario; Cristofano, Adriana; Brogna, Barbara; Sardaro, Angela; Tedeschi, Gioacchino; Cirillo, Sossio; Di Costanzo, Alfonso

    2016-02-01

    This study aimed to verify whether brain abnormalities, previously described in patients with myotonic dystrophy type 1 (DM1) by magnetic resonance imaging (MRI), progressed over time and, if so, to characterize their progression. Thirteen DM1 patients, who had at least two MRI examinations, were retrospectively evaluated and included in the study. The mean duration (± standard deviation) of follow-up was 13.4 (±3.8) years, over a range of 7-20 years. White matter lesions (WMLs) were rated by semi-quantitative method, the signal intensity of white matter poster-superior to trigones (WMPST) by reference to standard images and brain atrophy by ventricular/brain ratio (VBR). At the end of MRI follow-up, the scores relative to lobar, temporal and periventricular WMLs, to WMPST signal intensity and to VBR were significantly increased compared to baseline, and MRI changes were more evident in some families than in others. No correlation was found between the MRI changes and age, onset, disease duration, muscular involvement, CTG repetition and follow-up duration. These results demonstrated that white matter involvement and brain atrophy were progressive in DM1 and suggested that progression rate varied from patient to patient, regardless of age, disease duration and genetic defect.

  2. Short-term environmental enrichment enhances adult neurogenesis, vascular network and dendritic complexity in the hippocampus of type 1 diabetic mice.

    Directory of Open Access Journals (Sweden)

    Juan Beauquis

    Full Text Available BACKGROUND: Several brain disturbances have been described in association to type 1 diabetes in humans. In animal models, hippocampal pathological changes were reported together with cognitive deficits. The exposure to a variety of environmental stimuli during a certain period of time is able to prevent brain alterations and to improve learning and memory in conditions like stress, aging and neurodegenerative processes. METHODOLOGY/PRINCIPAL FINDINGS: We explored the modulation of hippocampal alterations in streptozotocin-induced type 1 diabetic mice by environmental enrichment. In diabetic mice housed in standard conditions we found a reduction of adult neurogenesis in the dentate gyrus, decreased dendritic complexity in CA1 neurons and a smaller vascular fractional area in the dentate gyrus, compared with control animals in the same housing condition. A short exposure -10 days- to an enriched environment was able to enhance proliferation, survival and dendritic arborization of newborn neurons, to recover dendritic tree length and spine density of pyramidal CA1 neurons and to increase the vascular network of the dentate gyrus in diabetic animals. CONCLUSIONS/SIGNIFICANCE: The environmental complexity seems to constitute a strong stimulator competent to rescue the diabetic brain from neurodegenerative progression.

  3. HLA-B7-restricted islet epitopes are differentially recognized in type 1 diabetic children and adults and form weak peptide-HLA complexes

    DEFF Research Database (Denmark)

    Scotto, Matthieu; Afonso, Georgia; Østerbye, Thomas;

    2012-01-01

    The cartography of β-cell epitopes targeted by CD8(+) T cells in type 1 diabetic (T1D) patients remains largely confined to the common HLA-A2 restriction. We aimed to identify β-cell epitopes restricted by the HLA-B7 (B*07:02) molecule, which is associated with mild T1D protection. Using DNA...... immunization on HLA-B7-transgenic mice and prediction algorithms, we identified GAD and preproinsulin candidate epitopes. Interferon-γ (IFN-γ) enzyme-linked immunospot assays on peripheral blood mononuclear cells showed that most candidates were recognized by new-onset T1D patients, but not by type 2 diabetic...... and healthy subjects. Some epitopes were highly immunodominant and specific to either T1D children (GAD(530-538); 44% T cell-positive patients) or adults (GAD(311-320); 38%). All epitopes displayed weak binding affinity and stability for HLA-B7 compared with HLA-A2-restricted ones, a general feature of HLA-B7...

  4. Development and feasibility of a text messaging and interactive voice response intervention for low-income, diverse adults with type 2 diabetes mellitus.

    Science.gov (United States)

    Osborn, Chandra Y; Mulvaney, Shelagh A

    2013-05-01

    Low-income, racial/ethnic minorities are often nonadherent to diabetes medications, have uncontrolled glycemia, and have high rates of diabetes-related morbidity. Cell phones provide a viable modality to support medication adherence, but few cell phone-based interventions have been designed for low-income persons, a population with more feature phone penetration than smartphone penetration. In an effort to reach the broadest range of patients, we leveraged the voice and text messaging capabilities shared by all cell phones to design the MEssaging for Diabetes intervention. We specifically advanced and adapted an existing tailored text messaging system to include interactive voice response functionality and support the medication adherence barriers of low-income, diverse adults with type 2 diabetes mellitus. We report on the design process and feasibility testing results (i.e., technical use patterns and subjective user experiences) from patients from the target population who used the intervention in one of three user-centered design iterations. The types of challenges encountered in design were related to providing text message content with valued information and support that engages patients. The design process also highlighted the value of obtaining mixed methods data to provide insight into legitimate versus illegitimate missing data, patterns of use, and subjective user experiences. The iterative testing process and results outlined here provide a potential template for other teams seeking to design technology-based self-care support solutions for comparable patient populations.

  5. Aerobic physical activity and resistance training: an application of the theory of planned behavior among adults with type 2 diabetes in a random, national sample of Canadians

    Directory of Open Access Journals (Sweden)

    Karunamuni Nandini

    2008-12-01

    Full Text Available Abstract Background Aerobic physical activity (PA and resistance training are paramount in the treatment and management of type 2 diabetes (T2D, but few studies have examined the determinants of both types of exercise in the same sample. Objective The primary purpose was to investigate the utility of the Theory of Planned Behavior (TPB in explaining aerobic PA and resistance training in a population sample of T2D adults. Methods A total of 244 individuals were recruited through a random national sample which was created by generating a random list of household phone numbers. The list was proportionate to the actual number of household telephone numbers for each Canadian province (with the exception of Quebec. These individuals completed self-report TPB constructs of attitude, subjective norm, perceived behavioral control and intention, and a 3-month follow-up that assessed aerobic PA and resistance training. Results TPB explained 10% and 8% of the variance respectively for aerobic PA and resistance training; and accounted for 39% and 45% of the variance respectively for aerobic PA and resistance training intentions. Conclusion These results may guide the development of appropriate PA interventions for aerobic PA and resistance training based on the TPB.

  6. Prevalence and Risk Factors of Type 2 Diabetes in the Adults in Haikou City, Hainan Island, China

    Directory of Open Access Journals (Sweden)

    Zhenfang Xia

    2013-03-01

    Full Text Available Background: Type 2 diabetes mellitus (T2DM occurs around the world with high prevalence and causes serious physical harm and economic burden to the afflicted. Haikou City is China’s southernmost tropical island city, which has not been previously studied for its T2DM prevalence. The objective of the study in employing a cross-sectional survey is to discuss the epidemiologic status of T2DM in Haikou City and to analyze the possible determinants.Methods: A total of 12,000 community residents over 18 years old from four districts in Haikou City were stratified-randomly sampled. A questionnaire survey and physical examination were conducted. Data entry and statistical analysis were performed using SPSS17.0 software.Results: The prevalence of T2DM in Haikou City was 5.3% (5.15% for males and 5.46% for females. According to the multivariate analysis, the positive factors mainly associated with T2DM in the city included family history, Waist-to-Hip Ratio (WHR, triglycerides, low high-density lipoproteins (HDL, and blood pressure. For both men and women, family history was the highest independent risk factor associated with T2DM (OR= 47.128. The T2DM risk increased with increasing metabolic aggregate.Conclusion: The prevalence of T2DM for the community population of Haikou City was low. The possible risk factors included age, occupation, BMI, waist circumference, WHR, overweight, systemic obesity, central obesity, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, low-density lipoproteins, family history, and HDL.

  7. Pravastatin-induced improvement in coronary reactivity and circulating ATP and ADP levels in young adults with type 1 diabetes

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    Tuomas Oskari Kiviniemi

    2012-08-01

    Full Text Available Aims: Extracellular ATP and ADP regulate diverse inflammatory, prothrombotic and vasoactive responses in the vasculature. Statins have been shown to modulate their signaling pathways in vitro. We hypothesized that altered intravascular nucleotide turnover modulates vasodilation in patients with type 1 diabetes (T1DM, and this can be partly restored with pravastatin therapy. Methods: In this randomized double blind study, plasma ATP and ADP levels and echocardiography-derived coronary flow velocity response to cold pressor test (CPT were concurrently assessed in 42 normocholesterolemic patients with T1DM (age 30±6 years, LDL cholesterol 2.5±0.6 mmol/L before and after four-month treatment with pravastatin 40 mg/day or placebo (n=22 and n=20, respectively, and in 41 healthy control subjects. Results: Compared to controls, T1DM patients had significantly higher concentrations of ATP (p<0.01 and ADP (p<0.01 and these levels were partly restored after treatment with pravastatin (p=0.002 and p=0.007, respectively, but not after placebo (p=0.06 and p=0.14, respectively. Coronary flow velocity acceleration was significantly lower in T1DM patients compared to control subjects, and it increased from pre- to post-intervention in the pravastatin (p=0.02, but not in placebo group (p=0.15. Conclusions: Pravastatin treatment significantly reduces circulating ATP and ADP levels of T1DM patients, and concurrently improves coronary flow response to CPT. This study provides a novel insight in purinergic mechanisms involved in pleiotropic effects of pravastatin.

  8. The effect of interleukin-13 (IL-13 and interferon-γ (IFN-γ on expression of surfactant proteins in adult human alveolar type II cells in vitro

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    Mason Robert J

    2010-11-01

    Full Text Available Abstract Background Surfactant proteins are produced predominantly by alveolar type II (ATII cells, and the expression of these proteins can be altered by cytokines and growth factors. Th1/Th2 cytokine imbalance is suggested to be important in the pathogenesis of several adult lung diseases. Recently, we developed a culture system for maintaining differentiated adult human ATII cells. Therefore, we sought to determine the effects of IL-13 and IFN-γ on the expression of surfactant proteins in adult human ATII cells in vitro. Additional studies were done with rat ATII cells. Methods Adult human ATII cells were isolated from deidentified organ donors whose lungs were not suitable for transplantation and donated for medical research. The cells were cultured on a mixture of Matrigel and rat-tail collagen for 8 d with differentiation factors and human recombinant IL-13 or IFN-γ. Results IL-13 reduced the mRNA and protein levels of surfactant protein (SP-C, whereas IFN-γ increased the mRNA level of SP-C and proSP-C protein but not mature SP-C. Neither cytokine changed the mRNA level of SP-B but IFN-γ slightly decreased mature SP-B. IFN-γ reduced the level of the active form of cathepsin H. IL-13 also reduced the mRNA and protein levels of SP-D, whereas IFN-γ increased both mRNA and protein levels of SP-D. IL-13 did not alter SP-A, but IFN-γ slightly increased the mRNA levels of SP-A. Conclusions We demonstrated that IL-13 and IFN-γ altered the expression of surfactant proteins in human adult ATII cells in vitro. IL-13 decreased SP-C and SP-D in human ATII cells, whereas IFN-γ had the opposite effect. The protein levels of mature SP-B were decreased by IFN-γ treatment, likely due to the reduction in active form cathpesin H. Similarly, the active form of cathepsin H was relatively insufficient to fully process proSP-C as IFN-γ increased the mRNA levels for SP-C and proSP-C protein, but there was no increase in mature SP-C. These observations

  9. Association between oral health status and type 2 diabetes mellitus among Sudanese adults: a matched case-control study.

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    Hasaan G Mohamed

    Full Text Available AIM: The purpose of this study was to compare the clinical and subjective oral health indicators of type 2 diabetic patients (T2DM with age and gender matched non-diabetic controls. A second aim was to identify clinical and subjective oral health indicators that discriminate between well-controlled and poorly controlled T2DM patients as well as between patients with long and short duration of the disease. METHODS: A total of 457 individuals participated in the study (154 T2DM cases and 303 non-diabetic controls. The T2DM group was sub-divided according to metabolic control [(well-controlled: glycosylated haemoglobin test 8%, (poorly controlled: glycosylated haemoglobin test > 8%] and according to duration of T2DM [(long duration: >10 years, (short duration: 10 years]. Participants were interviewed using a structured questionnaire including socio-demographics, lifestyle and oral health related quality of life factors. The clinical examination comprised full mouth probing depths, plaque index, tooth mobility index, furcation involvement and coronal and root surface caries. RESULTS: The T2DM patients presented with more probing depths 4 mm, furcation involvement, tooth mobility, missing teeth, and oral impacts on daily performance (OIDP. The corresponding adjusted odds ratios and their 95% confidence intervals were 4.07 (1.74-9.49, 2.96 (1.36-6.45, 5.90 (2.26-15.39, 0.23 (0.08-0.63 and 3.46 (1.61-7.42, respectively. Moreover, the odds ratio was 2.60 (1.21-5.55 for the poorly controlled T2DM patients to have high levels of mobility index and 2.94 (1.24-6.94 for those with long duration of T2DM to have high decayed, missed and filled teeth (DMFT values. CONCLUSION: This study revealed that chronic periodontitis, tooth mobility, furcation involvement and OIDP were more prevalent among T2DM patients compared to their non-diabetic controls.

  10. Rationale and study design for a randomised controlled trial to reduce sedentary time in adults at risk of type 2 diabetes mellitus: project stand (Sedentary Time ANd diabetes

    Directory of Open Access Journals (Sweden)

    Wilmot Emma G

    2011-12-01

    Full Text Available Abstract Background The rising prevalence of Type 2 Diabetes Mellitus (T2DM is a major public health problem. There is an urgent need for effective lifestyle interventions to prevent the development of T2DM. Sedentary behaviour (sitting time has recently been identified as a risk factor for diabetes, often independent of the time spent in moderate-to-vigorous physical activity. Project STAND (Sedentary Time ANd Diabetes is a study which aims to reduce sedentary behaviour in younger adults at high risk of T2DM. Methods/Design A reduction in sedentary time is targeted using theory driven group structured education. The STAND programme is subject to piloting and process evaluation in line with the MRC framework for complex interventions. Participants are encouraged to self-monitor and self-regulate their behaviour. The intervention is being assessed in a randomised controlled trial with 12 month follow up. Inclusion criteria are a aged 18-40 years with a BMI in the obese range; b 18-40 years with a BMI in the overweight range plus an additional risk factor for T2DM. Participants are randomised to the intervention (n = 89 or control (n = 89 arm. The primary outcome is a reduction in sedentary behaviour at 12 months as measured by an accelerometer (count Conclusions This is the first UK trial to address sedentary behaviour change in a population of younger adults at risk of T2DM. The results will provide a platform for the development of a range of future multidisciplinary interventions in this rapidly expanding high-risk population. Trial registration Current controlled trials ISRCTN08434554, MRC project 91409.

  11. Evaluation of the effect of structured exercise therapy on neurophysiological and cognitive functions of young adults with type 2 diabetes mellitus: Study protocol

    Directory of Open Access Journals (Sweden)

    Harpreet Kour

    2015-01-01

    Full Text Available Background: This randomized controlled trial (RCT aims to evaluate the effect of structured exercise therapy on different mentioned neurophysiological and cognitive functions of patients diagnosed with type 2 diabetes mellitus (T2DM. It is well known from the literature that neurophysiological and cognitive disturbances are of the complications of diabetes mellitus. Although studies have shown that exercise enhances cognitive abilities in normal individuals, previous studies that have found improvement in cognitive dysfunctions in older T2DM patients with exercise regimens were not conclusive. The earlier studies were limited to a single measure of cognitive function or short follow-up times; also there is almost no evidence of the effect of exercise on cognitive function in young adult T2DM patients. Methods/Design: This is an RCT that has enrolled a total of 146 patients with T2DM divided equally into a diabetic group and an interventional group. Seventy-three sex-, age-, and mean education level-matched subjects have been enrolled as healthy controls, comparing mentioned parameters evaluating neurophysiological and cognitive functions. The intervention therapy will be delivered at the Physiology Research Laboratory as an individually designed program of regular exercise consisting of aerobic and resistance exercises. Discussion: The results of this trial will provide novel data to indicate whether exercise improves cognition for a vulnerable group of young adults, and will set the stage for larger trials to further examine potential protective and disease-modifying effects of exercise on the brain. Ethical Clearance No: Ref. No.KLEU/Ethic/2012-13/D-4570

  12. The effect of prebiotic supplementation with inulin on cardiometabolic health: Rationale, design, and methods of a controlled feeding efficacy trial in adults at risk of type 2 diabetes.

    Science.gov (United States)

    Mitchell, Cassie M; Davy, Brenda M; Halliday, Tanya M; Hulver, Mathew W; Neilson, Andrew P; Ponder, Monica A; Davy, Kevin P

    2015-11-01

    Prediabetes is associated with low-grade chronic inflammation that increases the risk for developing type 2 diabetes (T2D) and cardiovascular disease (CVD). An elevated lipopolysaccharide concentration, associated with dysbiosis of the intestinal microbiota, has been implicated in the development of both T2D and CVD. Selective modulation of the intestinal microbiota with prebiotics reduces intestinal permeability and endotoxin concentrations, inflammation, and metabolic dysfunction in rodents. The effect of prebiotic supplementation on cardio-metabolic function in humans at risk for T2D is not known. The primary aim of this trial is to determine the influence of prebiotic supplementation with inulin on insulin sensitivity and skeletal muscle metabolic flexibility in adults at risk for T2D. We hypothesize that prebiotic supplementation with inulin will improve insulin sensitivity and skeletal muscle metabolic flexibility. We will randomize 48 adults (40-75 yrs) with prediabetes or a score ≥ 5 on the American Diabetes Association (ADA) risk screener to 6 weeks of prebiotic supplementation with inulin (10 g/day) or placebo. Subjects will be provided with all food for the duration of the study, to avoid potential confounding through differences in dietary intake between individuals. Intestinal permeability, serum endotoxin concentrations, insulin sensitivity, skeletal muscle metabolic flexibility, endothelial function, arterial stiffness, and fecal bacterial composition will be measured at baseline and following treatment. The identification of prebiotic supplementation with inulin as an efficacious strategy for reducing cardio-metabolic risk in individuals at risk of T2D could impact clinical practice by informing dietary recommendations and increasing acceptance of prebiotics by the scientific and medical community.

  13. The fate of the hip in spondylo-epi-metaphyseal dysplasia: clinical and radiological evaluation of adults with SEMD Handigodu type

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    Siddesh, N.D.; Shah, Hitesh; Joseph, Benjamin [Kasturba Medical College, Paediatric Orthopaedic Service, Manipal, Karnataka State (India)

    2012-08-15

    This study was undertaken to document the fate of the hip with reference to its structure and function in patients with spondylo-epi-metaphyseal dysplasia tarda Handigodu type (SEMD{sub HG}). Radiographs of 271 adult patients with SEMD{sub HG} were studied to identify the pattern of long-term sequelae in the hips. Several measurements of the proximal femur and acetabulum were made to quantify morphological alterations in the hip. Fifty-four adult patients were examined and administered a questionnaire to evaluate the extent of disability attributable to the hips. Three patterns of changes in the hips were noted: 35% had acetabular protrusio, 33% had subluxation of the hip, and 32% had no protrusio or subluxation. Distinctly different anthropometric measurements and dimensional alterations around the hip were noted in these three patterns. Patients with protrusio were relatively tall while those with subluxation were the shortest. All the patients had developed degenerative arthritis of the hips by the fourth decade of life irrespective of the pattern of hip involvement. The reduction in the range of hip motion and fixed deformities were most severe in patients with protrusio. All the patients had significant disability and very low functional hip scores. Degenerative arthritis of the hip develops in the majority of patients with SEMD{sub HG}; the symptoms are severe enough to warrant reconstructive surgery by the fourth decade of life. Protrusio or subluxation develops in a third of the patients each; both these complications will influence the surgical approach if total hip arthroplasty is planned. (orig.)

  14. Is type 2 diabetes mellitus in mechanically ventilated adult trauma patients potentially related to the occurrence of ventilator-associated pneumonia?

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    Hadi Darvishi Khezri

    2016-01-01

    Full Text Available Background: Ventilator-associated pneumonia (VAP is a type of lung infection that typically affects critically ill patients undergoing mechanical ventilation (MV in the intensive care unit (ICU. Patients with type 2 diabetes mellitus (T2DM are considered to be more susceptible to several types of infections including community-acquired pneumonia. However, it is not clear whether T2DM is a risk factor for the development of VAP. The purpose of this study was to determine the risk of VAP for diabetic and nondiabetic mechanically ventilated trauma patients. Materials and Methods: This study is a secondary analysis of a prospective observational study of the history of T2DM in the ICU over a period of 1 year at Imam Khomeini Hospital in Iran. A total of 186 critically ill trauma patients who required at least 48 h of MV were monitored for the occurrence of VAP by their clinical pulmonary infection score (CPIS until ICU discharge, VAP diagnosis, or death. Results: Forty-one of the 186 patients developed VAP. The median time from hospitalization to VAP was 29.09 days (95% CI: 26.27-31.9. The overall incidence of VAP was 18.82 cases per 1,000 days of intubation (95% CI: 13.86-25.57. Risk of VAP in diabetic patients was greater than nondiabetic patients after adjustments for other potential factors [hazard ratio (HR: 10.12 [95% confidence interval (CI: 5.1-20.2; P < 0.0001]. Conclusion: The findings show that T2DM is associated with a significant increase in the occurrence of VAP in mechanically ventilated adult trauma patients.

  15. Evaluation of Multiplex Type-Specific Real-Time PCR Assays Using the LightCycler and Joint Biological Agent Identification and Diagnostic System Platforms for Detection and Quantitation of Adult Human Respiratory Adenoviruses

    Science.gov (United States)

    2010-04-01

    causing bacteria . These assays have the potential to be useful as clinical diagnostic tools for the detection of HAdV infection in adult populations...conjunctivitis, genitouri- nary infections, and gastroenteritis , and specific types of ade- novirus are associated with specific types of disease (18, 21...react with other adenoviruses, influenza virus, respiratory syncytial virus, or respiratory disease-causing bacteria . These assays have the

  16. Medidas faciais antropométricas de adultos segundo tipo facial e sexo Adult facial anthropometric measurements according to facial type and gender

    Directory of Open Access Journals (Sweden)

    Rossana Ribeiro Ramires

    2011-04-01

    Full Text Available OBJETIVO: descrever medidas antropométricas faciais de adultos, segundo tipo facial e sexo. MÉTODOS: participaram 105 adultos leucodermas, 34 (32,4% homens e 71 (67,6% mulheres, com idades entre 20 e 40 anos, de uma clínica particular de ortodontia de Belo Horizonte, Minas Gerais. Foram comparados os achados da análise cefalométrica para determinação do tipo de face com sete medidas antropométricas faciais diretas: altura facial anterior- násio ao mentoniano; distância bizigomática- zigomático esquerdo ao direito; altura do terço facial inferior- subnasal ao mentoniano; altura da face média- násio ao estômio; altura do queixo- supramentoniano ao mentoniano; altura da face inferior- estômio ao mentoniano; e altura facial posterior- condílio ao gônio. RESULTADOS: para o sexo masculino, os tipos faciais classificados por meio da cefalometria apresentaram diferenças estatisticamente significantes para os valores médios das medidas antropométricas: altura facial anterior, altura do terço facial inferior, altura da face média e altura da face inferior. Para o sexo feminino, diferenças estatisticamente significantes foram encontradas nas medidas: altura facial anterior, altura do terço facial inferior, altura da face média, altura da face inferior e altura facial posterior. CONCLUSÃO: houve dimorfismo sexual para todas as medidas antropométricas obtidas, as quais tiveram valores médios maiores para o sexo masculino quando comparados ao feminino. Os tipos faciais classificados por meio da cefalometria apresentaram diferenças estatisticamente significantes para quatro medidas antropométricas do sexo masculino e cinco do feminino.PURPOSE: to describe anthropometric measurements in adults according to facial type and gender. METHODS: 105 Caucasian adults took part, 34 male (32.4% and 71 female (67.6% with ages between 20 and 40-year old, in a private orthodontic clinic in Belo Horizonte, Minas Gerais, Brazil. The findings

  17. Early signs of atherosclerosis are associated with insulin resistance in non-obese adolescent and young adults with type 1 diabetes

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    Rathsman Björn

    2012-11-01

    Full Text Available Abstract Background Patients with type 1 diabetes have a substantial risk of developing cardiovascular complications early in life. We aimed to explore the role of insulin sensitivity (Si as an early factor of atherosclerosis in young type 1 diabetes vs. non-diabetic subjects. Methods Forty adolescent and young adult individuals (20 type 1 diabetics and 20 non-diabetics, age 14–20 years, without characteristics of the metabolic syndrome, participated in this cross-sectional study. After an overnight fast, Si was measured by hyperinsulinemic euglycemic clamp (40 mU/m2 and calculated by glucose infusion rate (GIR. Carotid intima-media thickness (cIMT was measured in the common carotid artery with high-resolution ultrasonography. Risk factors of atherosclerosis (Body mass index [BMI], waist circumference, systolic blood pressure [sBP], triglycerides, low HDL-cholesterol and HbA1c were also investigated. Results cIMT was increased (0.52 ± 0.1 vs. 0.47 ± 0.1 mm, P vs. 7.1 ± 2.2 mg/kg/min, P vs. non-diabetics. The differences in cIMT were negatively associated with Si (r = −0.4, P r = 0.34, P = 0.03, with no such associations between BMI (r = 0.15, P = 0.32, sBP (r = 0.09, P = 0.58, triglycerides (r = 0.07, P = 0.66, HDL-cholesterol (r = 0.10, P = 0.55 and HbA1c (r = 0.24, P = 0.13. In a multivariate regression model, between cIMT (dependent and group (explanatory, only adjustment for Si affected the significance (ß = 0.08, P = 0.11 vs. (ß = 0.07, P i was observed. Conclusions cIMT is increased and associated with insulin resistance in adolescent, non-obese type 1 diabetic subjects. Although, no conclusions toward a causal relationship can be drawn from current findings, insulin resistance emerges as an important factor reflecting early signs of atherosclerosis in this small cohort.

  18. Race/Ethnicity and gender differences in health intentions and behaviors regarding exercise and diet for adults with type 2 diabetes: A cross-sectional analysis

    Directory of Open Access Journals (Sweden)

    Fox Kathleen M

    2011-07-01

    Full Text Available Abstract Background Self-management is the cornerstone of diabetes control and prevention of complications; however, it is undetermined whether differences in intention to adopt healthy lifestyles and actual healthy behavior exist across race/ethnic groups. This study evaluated the differences across racial-ethnic groups in self-reported medical advice received and health intentions and behaviors among adults with type 2 diabetes mellitus. Methods A cross-sectional analysis of the 2007 SHIELD US survey ascertained self-reported health intentions and behaviors for regular exercise, diet, and weight management among Non-Hispanic Caucasian (n = 2526, Non-Hispanic African-American (n = 706, and Hispanic (n = 179 respondents with type 2 diabetes. Results A similar proportion of respondents from each race-gender group (43%-56% reported receiving healthcare advice to increase their exercise (P = 0.32. Significantly more minorities reported an intention to follow the exercise recommendation compared with Non-Hispanic Caucasians (P = 0.03. More Non-Hispanic African-American (29% and Hispanic (27% men reported exercising regularly compared with other race-gender groups (P = 0.02. Significantly more Non-Hispanic Caucasian women (74% and Hispanic women (79% reported trying to lose weight compared with other groups (P Conclusions Differences in health intentions and healthy behaviors were noted across race-gender groups. More Non-Hispanic African-American men reported an intention to follow advice on exercising and self-report of exercising regularly was also higher compared with other race-gender groups. More Hispanic men reported high physical activity levels than other groups. Despite an increased willingness to follow healthcare recommendations for diet, >50% of respondents were obese among all race-gender groups.

  19. Spinocerebellar ataxia type 1 and Machado-Joseph disease: Incidence of CAG expansions among adult-onset ataxia patients from 311 families with dominant, recessive, or sporadic ataxia

    Energy Technology Data Exchange (ETDEWEB)

    Ranum, L.P.W.; Gomez, C.; Orr, H.T. [Univ. of Minnesota, Minneapolis, MN (United States)] [and others

    1995-09-01

    The ataxias are a complex group of diseases with both environmental and genetic causes. Among the autosomal dominant forms of ataxia the genes for two, spinocerebellar ataxia type 1 (SCA1) and Machado-Joseph disease (MJD), have been isolated. In both of these disorders the molecular basis of disease is the expansion of an unstable CAG trinucleotide repeat. To assess the frequency of the SCA1 and MJD trinucleotide repeat expansions among individuals diagnosed with ataxia, we have collected DNA from individuals representing 311 families with adult-onset ataxia of unknown etiology and screened these samples for trinucleotide repeat expansions within the SCA1 and MJD genes. Within this group there are 149 families with dominantly inherited ataxia. Of these, 3% have SCA1 trinucleotide repeat expansions, whereas 21% were positive for the MJD trinucleotide expansion. Thus, together SCA1 and MJD represent 24% of the autosomal dominant ataxias in our group, and the frequency of MJD is substantially greater than that of SCA1. For the 57 patients with MJD trinucleotide repeat expansions, a strong inverse correlation between CAG repeat size and age at onset was observed (r = -.838). Among the MJD patients, the normal and affected ranges of CAG repeat size are 14-40 and 68-82 repeats, respectively. For SCA1 the normal and affected ranges are much closer, containing 19-38 and 40-81 CAG repeats, respectively. 30 refs., 1 fig., 3 tabs.

  20. [Modification of fasting blood glucose in adults with diabetes mellitus type 2 after regular soda and diet soda intake in the State of Querétaro, Mexico].

    Science.gov (United States)

    Olalde-Mendoza, Liliana; Moreno-González, Yazmín Esmeralda

    2013-06-01

    The objective of the study was to compare the modification of fasting blood glucose in adults with diabetes mellitus type 2 after intake of regular soda and diet soda. We conducted a randomized clinical trial in clinics of Instituto Mexicano del Seguro Social in Querétaro, México. We included 80 patients with diabetes (mean weight 74.2 +/- 13.66, BMI 30.5 +/- 4.305, waist 98.2 +/- 12.9 and time evolution of diabetes 3.8 +/- 3.009) who were asked to come with fasting for 8 hours and without taking any medicine before testing. They were divided into two groups of 40 subjects, to whom was measured fasting blood glucose after the ingestion of 200 ml of diet soda (with aspartame and acesulfame potassium) or regular soda (without sweetener) we measure glucose at 10, 15 and 30 minutes. For statistical analysis performed we used Student's t-test for dependent and independent samples, and paired t-test, and chi square test (chi2). Capillary glucose levels at 10 minutes were -34.52 and -25.41%, at 15 minutes -48.8 and -36.2% and at 30 minutes 57.75 and 43.6% of absolute and relative differences, with p = 0.000. In conclusion, according to the observations, diet soda doesn't increased blood glucose levels, with a significant difference in fasting decreased at 30 minutes.

  1. Comorbidity in Adult Patients Hospitalized with Type 2 Diabetes in Northeast China: An Analysis of Hospital Discharge Data from 2002 to 2013

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    Hui Chen

    2016-01-01

    Full Text Available This study aims to evaluate the comorbidity burden and patterns among adult patients hospitalized with a diagnosis of type 2 diabetes mellitus (T2DM in Northeast China using hospital discharge data derived from the electronic medical record database between 2002 and 2013. 12.8% of 4,400,892 inpatients aged ≥18 had a diagnosis of T2DM. Sex differences in prevalence varied among those aged <50, 50–59, and ≥60. Twenty-seven diseases were determined as major comorbidities of T2DM. Essential hypertension was the most common comorbidity of T2DM (absolute cooccurrence risk, 58.4%, while T2DM was also the most popular comorbidity of essential hypertension. Peripheral and visceral atherosclerosis showed the strongest association (relative cooccurrence risk, RCoR 4.206. For five leading comorbidities among patients aged ≥40, male patients had a stronger association with disorders of lipid metabolism than female patients (RCoR 2.779 versus 2.099, and female patients had a stronger association with chronic renal failure than male patients (RCoR 2.461 versus 2.155. Leading comorbidities, except chronic renal failure, had declining associations with T2DM with increased age. Collectively, hospital discharge data can be used to estimate disease prevalence and identify comorbidities. The findings provided comprehensive information on comorbidity patterns, helping policy makers and programs in public health domains to estimate and evaluate the epidemic of chronic diseases.

  2. Comorbidity in Adult Patients Hospitalized with Type 2 Diabetes in Northeast China: An Analysis of Hospital Discharge Data from 2002 to 2013

    Science.gov (United States)

    Zhang, Yaoyun; Wu, Di; Gong, Chunxiu; Pan, Qing; Dong, Xiao; Wu, Yonghui; Wang, Shiping

    2016-01-01

    This study aims to evaluate the comorbidity burden and patterns among adult patients hospitalized with a diagnosis of type 2 diabetes mellitus (T2DM) in Northeast China using hospital discharge data derived from the electronic medical record database between 2002 and 2013. 12.8% of 4,400,892 inpatients aged ≥18 had a diagnosis of T2DM. Sex differences in prevalence varied among those aged <50, 50–59, and ≥60. Twenty-seven diseases were determined as major comorbidities of T2DM. Essential hypertension was the most common comorbidity of T2DM (absolute cooccurrence risk, 58.4%), while T2DM was also the most popular comorbidity of essential hypertension. Peripheral and visceral atherosclerosis showed the strongest association (relative cooccurrence risk, RCoR 4.206). For five leading comorbidities among patients aged ≥40, male patients had a stronger association with disorders of lipid metabolism than female patients (RCoR 2.779 versus 2.099), and female patients had a stronger association with chronic renal failure than male patients (RCoR 2.461 versus 2.155). Leading comorbidities, except chronic renal failure, had declining associations with T2DM with increased age. Collectively, hospital discharge data can be used to estimate disease prevalence and identify comorbidities. The findings provided comprehensive information on comorbidity patterns, helping policy makers and programs in public health domains to estimate and evaluate the epidemic of chronic diseases. PMID:27847807

  3. Predictive factors of follow-up non-attendance and mortality among adults with type 2 diabetes mellitus- an analysis of the Malaysian diabetes registry 2009.

    Science.gov (United States)

    Chew, Boon-How; Lee, Ping-Yein; Shariff-Ghazali, Sazlina; Cheong, Ai-Theng; Ismail, Mastura; Taher, Sri-Wahyu

    2015-01-01

    This study examined the factors associated with follow-up non-attendance (FUNA) and mortality among the adult patients with type 2 diabetes mellitus (T2DM). Data on 57780 T2DM patients from the 2009 diabetes registry were analyzed using multinomial logistic mixed model. Out of 57780 patients, 3140 (5.4%) were lost to follow-up and 203 (0.4%) patients had died. Compared with patients who were under active follow-up, men (OR 1.37), neither on insulin (OR 1.72), nor on antiplatelet agents (OR 1.47), having higher HbA1c (OR 1.15), higher LDL-C (OR 1.18) and complications (OR 1.33) were associated with FUNA. Older age (OR 1.09) and higher LDL-C (OR 2.27) have higher mortality. Across the four different health facilities, medication use (insulin and anti-platelet agents) to achieve better disease control in the younger age when diabetes complication is absent would not cause FUNA and might reduce mortality.

  4. Liver Disease and Adult Vaccination

    Science.gov (United States)

    ... Resources for Healthcare Professionals Liver Disease and Adult Vaccination Recommend on Facebook Tweet Share Compartir Vaccines are ... have immunity to this disease Learn about adult vaccination and other health conditions Asplenia Diabetes Type 1 ...

  5. Renal Disease and Adult Vaccination

    Science.gov (United States)

    ... Resources for Healthcare Professionals Renal Disease and Adult Vaccination Recommend on Facebook Tweet Share Compartir Vaccines are ... have immunity to this disease Learn about adult vaccination and other health conditions Asplenia Diabetes Type 1 ...

  6. HIV Infection and Adult Vaccination

    Science.gov (United States)

    ... Resources for Healthcare Professionals HIV Infection and Adult Vaccination Recommend on Facebook Tweet Share Compartir Vaccines are ... percentage is less than 15%. Learn about adult vaccination and other health conditions Asplenia Diabetes Type 1 ...

  7. Usefulness of {sup 18}F-FDG-PET/CT in Evaluating a Brainstem Glioma in an Adult Patient with Neurofibromatosis Type 1

    Energy Technology Data Exchange (ETDEWEB)

    Treglia, Giorgio [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Muoio, Barbara; Del Ciello, Annemilia [Univ. of the Sacred, Rome (Italy); Bertagna, Francesco [Univ. of Brescia, Brescia (Italy)

    2013-09-15

    We describe a case of a brainstem glioma (BSG) occurred in an adult patient with neurofibromatosis type 1 (NF1) and evaluated by Flourine-18-Fluorodeoxyglucose-positron emission tomography/computed tomography ({sup 18}F-FDG-PET/CT). A 32-year-old male patient with NF1 underwent brain magnetic resonance imaging (MRI) for the onset of diplopia, facial paresis and cerebellar signs and symptoms. MRI showed a brainstem lesion compatible with BSG. Biopsy was not performed. {sup 18}F-FDG-PET/CT demonstrated intense {sup 18}F-FDG uptake in the brainstem lesion, suggesting an aggressive neoplasm. The patient was referred to radiotherapy but he developed rapid disease progression. In this case, {sup 18}F-FDG-PET/CT provided useful information about this rare NF1-associated tumor. Subsequently, the patient was referred to radiotherapy, but he developed rapid disease progression and died 3 months later. NF-1 is an autosomal dominant disorder characterized by multiple cafe-au-lait spots, axillary and inguinal freckling, multiple cutaneous neurofibromas, and iris Lisch nodules. NF-1 is also characterized by low-grade tumors of the central and peripheral nervous system. There is also an increased risk of developing malignant tumors such as malignant peripheral nerve sheath tumors or central nervous system high-grade gliomas. NF1-associated BSGs are less common than NF1-associated optic gliomas (OGs) and seem to represent a particular entity which tend, as a whole, to have a more favorable prognosis and a more indolent course than BSGs in patients without NF1; nevertheless, some NF1-associted BSG may rapidly progress. {sup 18}F-FDG-PET/CT has demonstrated to provide useful information to the surveillance of OGs in children with NF1, particularly to identify progressive, symptomatic tumors. To the best of our knowledge, there are no data about the usefulness of {sup 18}F-FDG-PET/CT in adult patients with NF1-associated BSG. In our case, {sup 18}F-FDG-PET/CT has been useful in

  8. Alberta Diabetes and Physical Activity Trial (ADAPT: A randomized theory-based efficacy trial for adults with type 2 diabetes - rationale, design, recruitment, evaluation, and dissemination

    Directory of Open Access Journals (Sweden)

    Birkett Nicholas

    2010-01-01

    Full Text Available Abstract Background The primary aim of this study was to compare the efficacy of three physical activity (PA behavioural intervention strategies in a sample of adults with type 2 diabetes. Method/Design Participants (N = 287 were randomly assigned to one of three groups consisting of the following intervention strategies: (1 standard printed PA educational materials provided by the Canadian Diabetes Association [i.e., Group 1/control group]; (2 standard printed PA educational materials as in Group 1, pedometers, a log book and printed PA information matched to individuals' PA stage of readiness provided every 3 months (i.e., Group 2; and (3 PA telephone counseling protocol matched to PA stage of readiness and tailored to personal characteristics, in addition to the materials provided in Groups 1 and 2 (i.e., Group 3. PA behaviour measured by the Godin Leisure Time Exercise Questionnaire and related social-cognitive measures were assessed at baseline, 3, 6, 9, 12 and 18-months (i.e., 6-month follow-up. Clinical (biomarkers and health-related quality of life assessments were conducted at baseline, 12-months, and 18-months. Linear Mixed Model (LMM analyses will be used to examine time-dependent changes from baseline across study time points for Groups 2 and 3 relative to Group 1. Discussion ADAPT will determine whether tailored but low-cost interventions can lead to sustainable increases in PA behaviours. The results may have implications for practitioners in designing and implementing theory-based physical activity promotion programs for this population. Clinical Trials Registration ClinicalTrials.gov identifier: NCT00221234

  9. The role of flow cytometry in celiac disease screening using human leukocyte antigen in adult patients with type 1 diabetes mellitus

    Science.gov (United States)

    Arregui, Miren Vicuña; Urmeneta, Jose Manuel Zozaya; Brito, Helena León; De Esteban, Juan Pablo Martínez; Martínez, Carlos Prieto; Llenas, Lluis Forga; Urtasun, Erkuden Aranburu; Pericas, Francisco Sala; Musgo, Ramón Angós; Gutierrez, Maria Rosario Mercado; Sarrasqueta, Mercedes Palacios

    2017-01-01

    Background Patients with type 1 diabetes mellitus (DM1) have an increased risk of celiac disease (CD). Since CD can be seronegative, more sensible tests for detection are needed. In seronegative patients, CD diagnosis may be difficult because of a lack of specificity. Flow cytometry analysis of lymphocyte populations can be useful in this situation. We aimed to study the prevalence of CD in adult DM1 using human leukocyte antigen (HLA) compatibility-based screening. A secondary goal was to study the role of flow cytometry as a complementary tool in these patients. Methods We selected 200 patients with DM1, of whom 190 (95%) had HLA DQ2, DQ8 or both. Of these, 136 agreed to participate and provided epidemiological data. All patients underwent blood tests and gastroscopy. Results Sixteen patients had a histology consistent with CD. After ruling out other diagnoses, 6 patients were diagnosed with CD, 2 of whom had negative antibodies. All were DQ2.5 homozygous, with a CD prevalence of 9.8% in this group. In the flow cytometry analysis of duodenal biopsy samples, when we compared all non-CD with CD patients, we found that the γ/δ intraepithelial lymphocyte (IEL) percentage was significantly higher and the CD3 negative IEL percentage significantly lower in the CD group. We found similar results when we compared only those with histological lesions. Conclusions Screening of CD in patients with DM1 by HLA detects only 1% of seronegative patients with CD. DQ2.5 homozygous patients are at most risk of developing CD. The study of lymphocyte populations in the duodenal biopsy by flow cytometry discriminates patients with CD from those without CD with high sensitivity and specificity. PMID:28243038

  10. Impact of a physical activity intervention program on cognitive predictors of behaviour among adults at risk of Type 2 diabetes (ProActive randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Sutton Stephen

    2009-03-01

    Full Text Available Abstract Background In the ProActive Trial an intensive theory-based intervention program was no more effective than theory-based brief advice in increasing objectively measured physical activity among adults at risk of Type 2 diabetes. We aimed to illuminate these findings by assessing whether the intervention program changed cognitions about increasing activity, defined by the Theory of Planned Behaviour, in ways consistent with the theory. Methods N = 365 sedentary participants aged 30–50 years with a parental history of Type 2 diabetes were randomised to brief advice alone or to brief advice plus the intervention program delivered face-to-face or by telephone. Questionnaires at baseline, 6 and 12 months assessed cognitions about becoming more physically active. Analysis of covariance was used to test intervention impact. Bootstrapping was used to test multiple mediation of intervention impact. Results At 6 months, combined intervention groups (face-to-face and telephone reported that they found increasing activity more enjoyable (affective attitude, d = .25, and they perceived more instrumental benefits (e.g., improving health (d = .23 and more control (d = .32 over increasing activity than participants receiving brief advice alone. Stronger intentions (d = .50 in the intervention groups than the brief advice group at 6 months were partially explained by affective attitude and perceived control. At 12 months, intervention groups perceived more positive instrumental (d = .21 and affective benefits (d = .29 than brief advice participants. The intervention did not change perceived social pressure to increase activity. Conclusion Lack of effect of the intervention program on physical activity over and above brief advice was consistent with limited and mostly small short-term effects on cognitions. Targeting affective benefits (e.g., enjoyment, social interaction and addressing barriers to physical activity may strengthen intentions, but

  11. A four year longitudinal sero-epidemiological study of bovine herpesvirus type-1 (BHV-1 in adult cattle in 107 unvaccinated herds in south west England

    Directory of Open Access Journals (Sweden)

    Ramirez-Villaescusa Ana M

    2009-01-01

    Full Text Available Abstract Background Bovine herpesvirus type-1 (BHV-1 is an important pathogen of cattle that presents with a variety of clinical signs, including the upper respiratory tract infection infectious bovine rhinotracheitis (IBR. A seroepidemiological study of BHV-1 antibodies was conducted in England from 2002 – 2004: 29,782 blood samples were taken from 15,736 cattle from 114 herds which were visited on up to three occasions. Antibody concentration was measured using a commercial ELISA. Farm management information was collected using an interview questionnaire, and herd size and cattle movements were obtained from the cattle tuberculosis testing database and the British Cattle Movement Service. Hierarchical statistical models were used to investigate associations between cattle and herd variables and the continuous outcome percentage positive (PP values from the ELISA test in unvaccinated herds. Results There were 7 vaccinated herds, all with at least one seropositive bovine. In unvaccinated herds 83.2% had at least one BHV-1 seropositive bovine, and the mean cattle and herd BHV-1 seroprevalence were 42.5% and 43.1% respectively. There were positive associations between PP value, age, herd size, presence of dairy cattle. Adult cattle in herds with grower cattle had lower PP values than those in herds without grower cattle. Purchased cattle had significantly lower PP values than homebred cattle, whereas cattle in herds that were totally restocked after the foot-and-mouth epidemic in 2001 had significantly higher PP values than those in continuously stocked herds. Samples taken in spring and summer had significantly lower PP values than those taken in winter, whereas those taken in autumn had significantly higher PP values than those taken in winter. The risks estimated from a logistic regression model with a binary outcome (seropositive yes/no were similar. Conclusion The prevalence of BHV-1 seropositivity in cattle and herds has increased since

  12. The Design, Usability, and Feasibility of a Family-Focused Diabetes Self-Care Support mHealth Intervention for Diverse, Low-Income Adults with Type 2 Diabetes

    Science.gov (United States)

    Berg, Cynthia A.; Harper, Kryseana J.; Osborn, Chandra Y.

    2016-01-01

    Family members' helpful and harmful actions affect adherence to self-care and glycemic control among adults with type 2 diabetes (T2D) and low socioeconomic status. Few family interventions for adults with T2D address harmful actions or use text messages to reach family members. Through user-centered design and iterative usability/feasibility testing, we developed a mHealth intervention for disadvantaged adults with T2D called FAMS. FAMS delivers phone coaching to set self-care goals and improve patient participant's (PP) ability to identify and address family actions that support/impede self-care. PPs receive text message support and can choose to invite a support person (SP) to receive text messages. We recruited 19 adults with T2D from three Federally Qualified Health Centers to use FAMS for two weeks and complete a feedback interview. Coach-reported data captured coaching success, technical data captured user engagement, and PP/SP interviews captured the FAMS experience. PPs were predominantly African American, 83% had incomes <$35,000, and 26% were married. Most SPs (n = 7) were spouses/partners or adult children. PPs reported FAMS increased self-care and both PPs and SPs reported FAMS improved support for and communication about diabetes. FAMS is usable and feasible and appears to help patients manage self-care support, although some PPs may not have a SP. PMID:27891524

  13. Political participation of older adults in Scandinavia - the civic voluntarism model revisited? A multi-level analysis of three types of political participatio

    Directory of Open Access Journals (Sweden)

    Mikael Nygård

    2013-02-01

    Full Text Available This article examines political participation among older adults in Österbotten, Finland, and Västerbotten, Sweden. Two specific hypotheses are tested. First, we anticipate that older adults are loyal voters but less avid in engaging in politics between elections. Second, we expect individuallevel resources to explain why older people participate in politics. The article offers two contributions to the literature on political participation of older adults. First, it corroborates earlier findings by showing that older adults indeed have a higher inclination to vote than to engage in political activities between elections, but it also shows that the latter engagement is more diversified than one could expect. Second, although the findings largely support the resource model, they suggest that we need to consider also other factors such as the overall attitude towards older people.

  14. Self-Care Behaviors and Glycemic Control in Low-Income Adults in México With Type 2 Diabetes Mellitus May Have Implications for Patients of Mexican Heritage Living in the United States.

    Science.gov (United States)

    Compeán Ortiz, Lidia G; Del Ángel Pérez, Beatriz; Reséndiz González, Eunice; Piñones Martínez, Socorro; González Quirarte, Nora H; Berry, Diane C

    2016-04-01

    This study examined self-care behaviors and their relationship to glycemic control in low-income Mexican adults with type 2 diabetes in Southeastern Tamaulipas, México. A total of 135 patients were enrolled from 17 community health centers. The most frequent self-care behavior was medication management (80%), and the least frequent self-care behavior was self blood glucose monitoring (7%). All the patients demonstrated poor glycemic control, with glycated hemoglobin > 7%. Self-care behaviors were associated with fasting blood glucose (rs = .223, p = .005). Medication management was influenced by cognitive performance, F(1, 130) = 4.49, p = .036, and depression, F(1, 130) = 8.22, p = .005. Dietary behaviors were influenced by previous diabetes education, F(1, 130) = 6.73, p = .011. These findings indicate that education and cognitive behavioral interventions in Spanish for Mexican adults with type 2 diabetes are urgently needed.

  15. Adult attachment styles

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    Maša Žvelc

    2007-01-01

    Full Text Available Theory of attachment primarily described early relationships between a child and his caretakers. In the last twenty years there is a growing interest in adult attachment research. Theories and research findings of adult attachment stem from two different methodological approaches. The first approach measures adult attachment through Adult Attachment Interview (AAI; Main, 1991 where the attachment is assessed through the narratives of adult people of their early child experiences with their primary caretakers. The second approach measures adult attachment with the help of self-evaluative questionnaires, developed by (a Hazan and Shaver (1987 who started this approach in the field of personality and social psychology, and (b Bartholomew and Horowitz (1991. Research shows that there is significant correlation between early and adult attachment style. Attachment styles are passed from generation to generation. Basic adult attachment styles are: securely attached, preoccupied, fearful-avoidant, dismissing-avoidant and disorganized. Previous research using Barholomew and Horowitz (1991 Relationship Questionnaire on 176 Slovenian students showed that 48% students are securely attached, 29% are fearful-avoidant, 10% are dismissing-avoidant, and 13% have preoccupied attachment style. Theory of attachment is very useful for understanding the behavior and subjective experiences of children and adults. It is applicable to different contexts (psychotherapy, counseling, education .... The paper proposes further research focused on integration of adult attachment styles and types of object relations measured by Test of object relations (Žvelc, 1998 and Pictorial test of Separation and Individuation (Žvelc, 2003.

  16. Five-year incidence of type 2 diabetes mellitus among cardiovascular disease-free Greek adults: Findings from the ATTICA study

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    Demosthenes B Panagiotakos

    2008-06-01

    Full Text Available Demosthenes B Panagiotakos1, Christos Pitsavos2, Yannis Skoumas2, Yannis Lentzas2, Christodoulos Stefanadis21Department of Nutrition Science-Dietetics, Harokopio University, Athens, Greece; 2First Cardiology Clinic, School of Medicine, University of Athens, Athens, GreeceObjective: We evaluated the 5-year incidence of diabetes in an adult population from Greece.Research design and methods: 3042 individuals (>18 years, free of cardiovascular disease, participated in the baseline examination (during 2001–2002. Of this sample, 1012 men and 1035 women were found alive at the time of follow-up, while 32 (2.1% men and 22 (1.4% women died during this period. The rest were lost to follow-up. Incidence of type 2 diabetes mellitus was evaluated in 1806 participants who did not have diabetes at baseline.Results: The age-adjusted 5-year incidence of diabetes was 5.5% (men, 5.8%; women, 5.2%. A linear trend was observed between diabetes incidence and age (5.6% increases in incidence per 1-year difference in age, p < 0.001. Multiple logistic regression analysis revealed that age (OR per 1 yr = 1.04, 95% CI 1.02–1.06, waist (OR per 1 cm = 1.02, 95% CI 1.01–1.003, physical activity (OR = 0.62, 95% CI 0.35–1.02 and family history of diabetes (OR = 2.65, 95% CI 1.58–4.53, as well as fasting glucose levels (OR per 1 mg/dl = 1.05, 95% CI 1.03–1.07, were the most significant baseline predictors for diabetes, after adjusting for various potential confounders. Additionally, presence of metabolic syndrome at baseline evaluation 2.95-fold the risk of diabetes (95% CI 1.89–4.61, and showed better classification ability than the model that contained the components of the syndrome (ie, correct classification rate: 94.5% vs. 92.3%.Conclusion: Our findings show that a 5.5% incidence rate of diabetes within a 5-year period, which suggests that the prevalence of this disorder in Greece is rising. Aging, heredity, and metabolic syndrome were the most significant

  17. Control and Treatment Profiles of 70,889 Adult Type 2 Diabetes Mellitus Patients in Malaysia - A Cross Sectional Survey in 2009

    Directory of Open Access Journals (Sweden)

    Ismail Mastura

    2011-01-01

    Full Text Available Background: Understanding the current diabetes care in Malaysia is the first step towards successful control. Many local studies have contributed toward knowledge of diabetes control and treatment profile but none had reported from such a large cohort of patients as in this registry.Aim & Objectives: To describe glycaemic control, risk factors, and treatment profile for quality assessment of diabetes care in Malaysia.Methods: This is a descriptive study based on secondary data from the online Adult Diabetes Control and Management (ADCM looking into the control and treatment profiles of type 2 diabetes mellitus patients aged 18 years old and above from 1st January until 31st December 2009. Clinical characteristics included were age, sex, diabetes duration and treatment, glycaemic control, blood pressure, body mass index, and treatment for co-morbidity. Results: A total of 303 centres contributed a total of 70889 patients. Fifty-nine percent was female. The study population included 61.9% Malay, 19% Chinese and 18% Indian. The mean age at diagnosis was 52.3 years old (SD 11.10 and the mean duration of diabetes was 5.9 years (SD 5.56. The mean of HbA1c was 8.3% (SD 2.10; only 18.1% attained HbA1c < 6.5%. There were 61.8% diabetic hypertensive patients based on blood pressure measurements and about one third were treated to target BP ≤ 130/80 mmHg. The mean of low density lipoprotein-cholesterol was 3.2 mmol/L (SD 1.10; one-third achieved the target of ≤ 2.6 mmol/L. Eighteen percent was on more than two anti-hypertensive agents and 41.6% were on anti-lipid agents. Metformin (83.2%, angiotensin-converting enzyme inhibitors (63.9% and statin (89.8% were the mostly prescribed anti-diabetic, anti-hypertensive and anti-lipid agents respectively.Conclusion: Diabetes and its co-morbidities (hypertension and hyperlipidaemia were less satisfactorily controlled. The choice of drugs was appropriate but probably inadequate. More effort and resources are

  18. Adult Strabismus

    Science.gov (United States)

    ... cause. Is eye straightening as an adult strictly cosmetic? No. Eye alignment surgery is performed in adults for several reasons. Adults ... this surgery? Eye muscle surgery is reconstructive (not cosmetic). In ... will cover strabismus surgery in adults, however, one should check with their ...

  19. Adult Education and Adult Learning

    DEFF Research Database (Denmark)

    Illeris, Knud

    Kort beskrivelse Bogen, 'Adult Education og Adult Learning', giver et fyldestgørende overblik over forståelsen af voksenuddannelse og læring. Abstract I "Adult Education and Adult Learning' ser Knud Illeris på voksenuddannelse fra to perspektiver. På den ene side beskrives de aktuelle udfordringer...

  20. Similarity of HLA-DQ profiles in adult-onset type 1 insulin-dependent diabetic patients with and without extra-pancreatic auto-immune disease.

    Science.gov (United States)

    Gu, X F; Larger, E; Clauser, E; Assan, R

    1992-01-01

    Some insulin-dependent diabetic patients present with auto-immune diseases involving extra pancreatic tissues (type 1b diabetes mellitus). The genetic specificity of this syndrome, as opposed to insulin dependent diabetes mellitus (IDDM) free of such associations (Type 1a IDDM) is not clearly established. We have analyzed the HLA-DQB1 and DQA1, loci, after PCR amplification of genomic DNA, in 44 Type 1b IDDM patients, 78 Type 1a IDDM patients and 105 control subjects. No essential difference in HLA-DQ profiles appeared between Type 1b and Type 1a IDDM patients. Both diabetic groups displayed a significant enrichment in DQB1 alleles negative for aspartate at position 57 (Type 1b: 83%; Type 1a: 89%; controls 48%; p < 0.001 vs both patient groups) and in DQB1 Asp 57 negative homozygosity: 71% of Type 1b; 80% of Type 1a; 25% of controls (p < 0.01). This enrichment in DQB1 Asp 57 negative alleles was accounted for by DQB1* 0201 in the Type 1b group, and by DQB1 % 0201 and 0302 in the Type 1a patients. Conversely, alleles DQB1* 0602 and 0301 (DQB1 Asp 57 positive) were protective. Both diabetic groups also displayed a significant enrichment in DQA1 alleles positives for arginine at position 52 (65% of Type 1b; 76% of Type 1a; 50% of control subjects; p < 0.01 and 0.001, respectively, vs controls), and in DQA1 Arg 52 positive homozygotes (48% of Type 1b, 58% of Type 1a, 22% of control subjects; p < 0.01). All differences between diabetic groups and the control group were more pronounced in the case of Type 1a than of Type 1b patients. The HLA-DQ genes shared by Type 1a and Type 1b patients must therefore be closely associated with islet autoimmunity. Genetic differences between Type 1a and Type 1b syndromes, if any, must be investigated in other MHC and non-MHC regions of the genome.

  1. Dealing with Disruptive Behavior of Adult Learners

    Science.gov (United States)

    Dobmeier, Robert; Moran, Joseph

    2008-01-01

    The adult education literature on disruptive behavior of adult learners was reviewed and a survey on disruptive behavior of adult learners was conducted with adult educators. The findings are synthesized in a conceptual framework for understanding the types and causes of disruptive behavior, which fall into the categories of inattention,…

  2. Polymyositis - adult

    Science.gov (United States)

    ... rash is a sign of a similar condition, dermatomyositis . Common symptoms include: Muscle weakness in the shoulders ... in the treatment of refractory adult and juvenile dermatomyositis and adult polymyositis: a randomized, placebo-phase trial. ...

  3. English in Adult Education

    OpenAIRE

    Ostrowska, Katarzyna, 1985-

    2014-01-01

    The study was conducted in order to investigate the effectiveness of a specialized program to meet the needs of adults who have diverse English skills and use English as a Lingua Franca. The program was developed for Menntastoðir, an adult education program in Reykjanesbær. Menntastoðir is an adult education institution that provides opportunities for improving adults’ knowledge and competences. The purpose of the study is to map out the type and amount of English exposure among Menntastoðir ...

  4. Short communication: Severe symptomatic hyperlactatemia among HIV type 1-infected adults on antiretroviral therapy in Côte d'Ivoire.

    Science.gov (United States)

    Minga, Albert; Lewden, Charlotte; Dohoun, Lambert; Abo, Yao; Emieme, Arlette; Coulibaly, Ali; Salamon, Roger; Eholié, Serge; Anglaret, Xavier; Danel, Christine

    2010-09-01

    Stavudine is no longer recommended for use in first-line antiretroviral therapy (ART), but it remains in high demand worldwide because it is affordable. We report the clinical presentation and incidence of severe hyperlactatemia (SL) in HIV-infected adults who initiated ART between April 2005 and May 2009 in Côte d'Ivoire, West Africa. In a prospective cohort study at the HIV care center affiliated with the National Centre for Blood Transfusion, we used standardized forms to record baseline and follow-up data. We measured serum lactate levels for all adults on ART who showed signs of hyperlactatemia. SL was defined as serum lactate >2.5 mmol/liter. Overall, 806 adults initiated ART. Among the 591 patients (73%) on stavudine-containing regimens, 394 were women (67%); the median pre-ART CD4 count was 150/mm3 and the median body mass index was 20.9 kg/m2. These patients were followed for a median of 28 months. We detected SL only among patients taking stavudine. The incidence of SL was 0.55/100 person-years (PY) (95% CI 0.47-0.63) overall and 0.85/100 PY among women (95% CI 0.75-0.95). Among the eight patients with SL, 100% lost >9% of body weight before diagnosis, 100% had serum lactate >4 mmol/liter (range 4.2-12.1), 50% had pre-ART BMI >25 kg/m2, and three patients died (38%), accounting for 6.4% of deaths among patients taking stavudine. As long as HIV clinicians continue to use stavudine in sub-Saharan Africa, they should watch out for acute unexplained weight loss in patients taking ART, particularly among women and patients with high pre-ART BMI.

  5. Relationship of cardiac structure and function to cardiorespiratory fitness and lean body mass in adolescents and young adults with Type 2 Diabetes

    Science.gov (United States)

    To investigate the relationships of cardiac structure and function with body composition and cardiorespiratory fitness (CRF) among adolescents with type 2 diabetes in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) Study Group. Cross-sectional evaluation of 233 participant...

  6. Disease history and medication use as risk factors for the clinical manifestation of type 1 diabetes in children and young adults : an explorative case control study

    NARCIS (Netherlands)

    Fazelifarsani, Soulmaz; Souverein, Patrick C; van der Vorst, Marja M J; Mantel-Teeuwisse, Aukje K; Knibbe, Catherijne A J; de Boer, Anthonius

    2014-01-01

    BACKGROUND: There is a highly variable asymptomatic period of beta cell destruction prior to the clinical presentation of type1 diabetes. It is not well known what triggers type 1 diabetes to become a clinically overt disease. This explorative study aimed to identify the association between disease

  7. Adult type 3 Gaucher disease as manifestation of R463C/Rec Nci I mutation: first reported case in the world literature.

    Science.gov (United States)

    Chauhan, V; Kumar, R V; Mahesh, D M; Kashyap, R; Thakur, S

    2013-05-01

    Gaucher disease is the most common lysosomal storage disorder. It is autosomal recessive in nature and results from mutations in the GBA gene coding for acid beta glucosidase. It is classified into three types based on CNS involvement and its severity. Type 3, or chronic neuronopathic Gaucher disease, generally has an onset in childhood and by definition, includes all patients with any form of neurologic involvement who have survived the first few years of life. Here we present a 36 year old male patient presenting with hip pain showing bilateral avascular necrosis of femoral head with massive splenomegaly and on evaluation, showed mental retardation, seizures, bilateral vertical and horizontal gaze palsies and eventually turned out to be type 3b Gaucher disease. This is the first case of Type 3 Gaucher disease being reported from India with mutation analysis and only case of Type 3 Gaucher disease in world literature showing R463C/Rec Nci I mutation.

  8. Effect of maternal and post weaning folate supply on gene-specific DNA methylation in the small intestine of weaning and adult Apc+/Min and wild type mice.

    Directory of Open Access Journals (Sweden)

    Jill Ann Mckay

    2011-05-01

    Full Text Available Increasing evidence supports the developmental origins of adult health and disease hypothesis which argues for a causal relationship between adverse early life nutrition and increased disease risk in adulthood. Modulation of epigenetic marks, e.g. DNA methylation and consequential altered gene expression, has been proposed as a mechanism mediating these effects. Via its role as a methyl donor, dietary folate supply may influence DNA methylation. As aberrant methylation is an early event in colorectal cancer (CRC pathogenesis, we hypothesised low maternal and/or post-weaning folate intake may influence methylation of genes involved in CRC development. We investigated the effects of maternal folate depletion during pregnancy and lactation on selected gene methylation in the small intestine (SI of wild type (WT and Apc+/Min mice at weaning and as adults. We also investigated the effects of folate depletion post-weaning on gene methylation in adult mice. Female C57Bl6/J mice were fed low or normal folate diets from mating with Apc+/Min males to the end of lactation. A sub set of offspring were killed at weaning. Remaining offspring were weaned on to low or normal folate diets, resulting in 4 treatment groups of Apc+/Min and WT mice. p53 was more methylated in weaning and adult WT compared with Apc+/Min mice (p>0.001. Igf2 and Apc were hypermethylated in adult Apc+/Mi n compared with WT mice (p=0.004 & p=0.012 respectively. Low maternal folate reduced p53 methylation in adults (p=0.04. Low post-weaning folate increased Apc methylation in Apc+/Min mice only (p=0.008 for interaction. These observations demonstrate that folate depletion in early life can alter epigenetic marks in a gene specific manner. Also, the differential effects of altered folate supply on DNA methylation in WT and Apc+/Min mice suggest that genotype may modulate epigenetic responses to environmental cues and may have implications for the development of personalised nutrition.

  9. Spinocerebellar ataxia type 7 (SCA7) : widespread brain damage in an adult-onset patient with progressive visual impairments in comparison with an adult-onset patient without visual impairments

    NARCIS (Netherlands)

    Rueb, U.; Brunt, E. R.; Seidel, K.; Gierga, K.; Mooy, C. M.; Kettner, M.; Van Broeckhoven, C.; Bechmann, I.; La Spada, A. R.; Schoels, L.; den Dunnen, W.; de Vos, R. A. I.; Deller, T.

    2008-01-01

    Spinocerebellar ataxia type 7 (SCA7) represents a rare and severe autosomal dominantly inherited ataxic disorder and is among the known CAG-repeat, or polyglutamine, diseases. In contrast to other currently known autosomal dominantly inherited ataxic disorders, SCA7 may manifest itself with differen

  10. Weakened Immune System and Adult Vaccination

    Science.gov (United States)

    ... for Healthcare Professionals Weakened Immune System and Adult Vaccination Recommend on Facebook Tweet Share Compartir Vaccines are ... up to age 26 years Learn about adult vaccination and other health conditions Asplenia Diabetes Type 1 ...

  11. Associations of objectively measured moderate-to-vigorous-intensity physical activity and sedentary time with all-cause mortality in a population of adults at high risk of type 2 diabetes mellitus.

    Science.gov (United States)

    Bakrania, Kishan; Edwardson, Charlotte L; Khunti, Kamlesh; Henson, Joseph; Stamatakis, Emmanuel; Hamer, Mark; Davies, Melanie J; Yates, Thomas

    2017-03-01

    The relationships of physical activity and sedentary time with all-cause mortality in those at high risk of type 2 diabetes mellitus (T2DM) are unexplored. To address this gap in knowledge, we examined the associations of objectively measured moderate-to-vigorous-intensity physical activity (MVPA) and sedentary time with all-cause mortality in a population of adults at high risk of T2DM. In 2010-2011, 712 adults (Leicestershire, U.K.), identified as being at high risk of T2DM, consented to be followed up for mortality. MVPA and sedentary time were assessed by accelerometer; those with valid data (≥ 10 hours of wear-time/day with ≥ 4 days of data) were included. Cox proportional hazards regression models, adjusted for potential confounders, were used to investigate the independent associations of MVPA and sedentary time with all-cause mortality. 683 participants (250 females (36.6%)) were included and during a mean follow-up period of 5.7 years, 26 deaths were registered. Every 10% increase in MVPA time/day was associated with a 5% lower risk of all-cause mortality [Hazard Ratio (HR): 0.95 (95% Confidence Interval (95% CI): 0.91, 0.98); p = 0.004]; indicating that for the average adult in this cohort undertaking approximately 27.5 minutes of MVPA/day, this benefit would be associated with only 2.75 additional minutes of MVPA/day. Conversely, sedentary time showed no association with all-cause mortality [HR (every 10-minute increase in sedentary time/day): 0.99 (95% CI: 0.95, 1.03); p = 0.589]. These data support the importance of MVPA in adults at high risk of T2DM. The association between sedentary time and mortality in this population needs further investigation.

  12. Using Electronic Health Records Data for Substance Use Screening, Brief Intervention, and Referral to Treatment among Adults with Type 2 Diabetes: Design of a National Drug Abuse Treatment Clinical Trials Network Study

    Science.gov (United States)

    Wu, Li-Tzy; Brady, Kathleen T.; Spratt, Susan E.; Dunham, Ashley A.; Heidenfelder, Brooke; Batch, Bryan C.; Lindblad, Robert; VanVeldhuisen, Paul; Rusincovitch, Shelley A.; Killeen, Therese K.; Ghitza, Udi E.

    2015-01-01

    Background The Affordable Care Act encourages healthcare systems to integrate behavioral and medical healthcare, as well as to employ electronic health records (EHRs) for health information exchange and quality improvement. Pragmatic research paradigms that employ EHRs in research are needed to produce clinical evidence in real-world medical settings for informing learning healthcare systems. Adults with comorbid diabetes and substance use disorders (SUDs) tend to use costly inpatient treatments; however, there is a lack of empirical data on implementing behavioral healthcare to reduce health risk in adults with high-risk diabetes. Given the complexity of high-risk patients' medical problems and the cost of conducting randomized trials, a feasibility project is warranted to guide practical study designs. Methods We describe the study design, which explores the feasibility of implementing substance use Screening, Brief Intervention, and Referral to Treatment (SBIRT) among adults with high-risk type 2 diabetes mellitus (T2DM) within a home-based primary care setting. Our study includes the development of an integrated EHR datamart to identify eligible patients and collect diabetes healthcare data, and the use of a geographic health information system to understand the social context in patients' communities. Analysis will examine recruitment, proportion of patients receiving brief intervention and/or referrals, substance use, SUD treatment use, diabetes outcomes, and retention. Discussion By capitalizing on an existing T2DM project that uses home-based primary care, our study results will provide timely clinical information to inform the designs and implementation of future SBIRT studies among adults with multiple medical conditions. PMID:26563446

  13. Surgical Treatment of Adult Degenerative Scoliosis

    OpenAIRE

    Cho, Kyu-Jung; Kim, Young-tae; Shin, Sang-hyun; Suk, Se-Il

    2014-01-01

    The rapid increase of elderly population has resulted in increased prevalence of adult scoliosis. Adult scoliosis is divided into adult idiopathic scoliosis and adult degenerative scoliosis. These two types of scoliosis vary in patient age, curve pattern and clinical symptoms, which necessitate different surgical indications and options. Back pain and deformity are major indications for surgery in adult idiopathic scoliosis, whereas radiating pain to the legs due to foraminal stenosis is what...

  14. Flexible guided self-determination intervention for younger adults with poorly controlled Type 1 diabetes, decreased HbA1c and psychosocial distress in women but not in men

    DEFF Research Database (Denmark)

    Zoffmann, V; Vistisen, D; Due-Christensen, M

    2015-01-01

    AIM: To report results from an 18-month randomized controlled trial (RCT) testing the effectiveness of a flexible guided self-determination (GSD) intervention on glycaemic control and psychosocial distress in younger adults with poorly controlled Type 1 diabetes. METHODS: Between January 2010...... and February 2012, we randomly allocated two hundred 18-35-year-olds [mean age 25.7 (5.1) years, 50% men] with Type 1 diabetes for ≥ 1 year [mean duration 13.7 (6.8) years] and HbA1c ≥ 64 mmol/mol (8.0%) to either an immediate GSD (intervention; n = 134) or 18-months delayed GSD group (control; n = 66). Group...

  15. The effect of a novel probiotic on metabolic biomarkers in adults with prediabetes and recently diagnosed type 2 diabetes mellitus: study protocol for a randomized controlled trial

    OpenAIRE

    Palacios, Talia; Vitetta, Luis; Coulson, Samantha; Madigan, Claire D; Denyer, Gareth S.; Caterson, Ian D.

    2017-01-01

    Background Shifts in the gastrointestinal microbiome have been shown to contribute to the progression of metabolic diseases including prediabetes and type 2 diabetes mellitus. Research suggests that in-vivo modulation of the gut microbiome by specific probiotic microorganisms may improve insulin sensitivity and blood sugar management, preventing or delaying the development of type 2 diabetes mellitus. However, further research is needed to understand the effect of probiotics as a therapy for ...

  16. Diagnosis of adult-type hypolactasia/lactase persistence: genotyping of single nucleotide polymorphism (SNP C/T-13910 is not consistent with breath test in Colombian Caribbean population

    Directory of Open Access Journals (Sweden)

    Evelyn Mendoza Torres

    2012-03-01

    Full Text Available CONTEXT: Genotyping of single nucleotide polymorphism (SNP C/T-13910 located upstream of the lactase gene is used to determine adult-type hypolactasia/lactase persistence in North-European Caucasian subjects. The applicability of this polymorphism has been studied by comparing it with the standard diagnostic methods in different populations. OBJECTIVE: To compare the lactose hydrogen breath test with the genetic test in a sample of the Colombian Caribbean population. METHODS: Lactose hydrogen breath test and genotyping of SNP C/T-13910 were applied to 128 healthy individuals (mean age 35 ± 1. A positive lactose hydrogen breath test was indicative of hypolactasia. Genotyping was done using polymerase chain reaction/restriction fragment length polymorphism. The kappa index was used to establish agreement between the two methods. RESULTS: Seventy-six subjects (59% were lactose-maldigesters (hypolactasia and 52 subjects (41% were lactose-digesters (lactase persistence. The frequencies of the CC, CT and TT genotypes were 80%, 20% and 0%, respectively. Genotyping had 97% sensitivity and 46% specificity. The kappa index = 0.473 indicates moderate agreement between the genotyping of SNP C/T-13910 and the lactose hydrogen breath test. CONCLUSION: The moderate agreement indicates that the genotyping of the SNP C/T-13910 is not applicable to determine adult-type hypolactasia/lactase persistence in the population participating in this study.

  17. 浅析老年人外伤型脊柱骨折的临床特点%The Clinical Characteristics of SC Type Traumatic Spinal Fractures in Older Adults

    Institute of Scientific and Technical Information of China (English)

    戴财

    2016-01-01

    objective to study the clinical characteristics of type traumatic spinal fractures in older adults, and to provide basis for clinical treatment and prevention. Methods analyze the clinical characteristics of type traumatic spinal fractures in older adults. The re-sults in the elderly trauma patients with spinal fractures in women than men, patients with spinal fractures in the elderly trauma ratio of 55-69 years old was obviously higher than that of other age groups. Trauma type spine fractures in older adults in women in life and hurt more, men falling injury and heavy parts, see more at high proportion of female life hurt significantly higher than the male, male, falling injury and heavy parts Ratio is significantly higher than women. Life and high falling injury and heavy parts cause trauma type spine fractures in older adults in male patients with ISS score and the proportion of spinal cord injury than women, comparative differences are statistically significant (P<0.05). Conclusion traumatic type spine fractures in older adults is given priority to with life fall and fall injury, good hair at 55 -69 years old, so at ordinary times in life to win to prevention.%目的:探讨老年人外伤型脊柱骨折的临床特点,为临床治疗及预防提供依据。方法分析总结老年人外伤型脊柱骨折的临床特点。结果老年人外伤型脊柱骨折患者中女性明显高于男性,老年人外伤型脊柱骨折患者发于55~69岁的比率明显高于其他各年龄段。老年人外伤型脊柱骨折中女性多见于生活中摔伤,男性多见于高处坠落伤及重物砸伤,女性生活中地摔伤所占比率明显高于男性,男性高处坠落伤及重物砸伤比率明显高于女性。生活中地摔伤,高处坠落伤及重物砸伤导致老年人外伤型脊柱骨折中男性患者在ISS评分及脊髓损伤所占比率高于女性,比较差异均有统计学意义(P<0.05)。结论老年人外伤型脊柱骨折以生

  18. The adult cystic fibrosis airway microbiota is stable over time and infection type, and highly resilient to antibiotic treatment of exacerbations.

    Directory of Open Access Journals (Sweden)

    Anthony A Fodor

    Full Text Available Cystic fibrosis (CF is characterized by defective mucociliary clearance and chronic airway infection by a complex microbiota. Infection, persistent inflammation and periodic episodes of acute pulmonary exacerbation contribute to an irreversible decline in CF lung function. While the factors leading to acute exacerbations are poorly understood, antibiotic treatment can temporarily resolve pulmonary symptoms and partially restore lung function. Previous studies indicated that exacerbations may be associated with changes in microbial densities and the acquisition of new microbial species. Given the complexity of the CF microbiota, we applied massively parallel pyrosequencing to identify changes in airway microbial community structure in 23 adult CF patients during acute pulmonary exacerbation, after antibiotic treatment and during periods of stable disease. Over 350,000 sequences were generated, representing nearly 170 distinct microbial taxa. Approximately 60% of sequences obtained were from the recognized CF pathogens Pseudomonas and Burkholderia, which were detected in largely non-overlapping patient subsets. In contrast, other taxa including Prevotella, Streptococcus, Rothia and Veillonella were abundant in nearly all patient samples. Although antibiotic treatment was associated with a small decrease in species richness, there was minimal change in overall microbial community structure. Furthermore, microbial community composition was highly similar in patients during an exacerbation and when clinically stable, suggesting that exacerbations may represent intrapulmonary spread of infection rather than a change in microbial community composition. Mouthwash samples, obtained from a subset of patients, showed a nearly identical distribution of taxa as expectorated sputum, indicating that aspiration may contribute to colonization of the lower airways. Finally, we observed a strong correlation between low species richness and poor lung function

  19. The adult cystic fibrosis airway microbiota is stable over time and infection type, and highly resilient to antibiotic treatment of exacerbations.

    Science.gov (United States)

    Fodor, Anthony A; Klem, Erich R; Gilpin, Deirdre F; Elborn, J Stuart; Boucher, Richard C; Tunney, Michael M; Wolfgang, Matthew C

    2012-01-01

    Cystic fibrosis (CF) is characterized by defective mucociliary clearance and chronic airway infection by a complex microbiota. Infection, persistent inflammation and periodic episodes of acute pulmonary exacerbation contribute to an irreversible decline in CF lung function. While the factors leading to acute exacerbations are poorly understood, antibiotic treatment can temporarily resolve pulmonary symptoms and partially restore lung function. Previous studies indicated that exacerbations may be associated with changes in microbial densities and the acquisition of new microbial species. Given the complexity of the CF microbiota, we applied massively parallel pyrosequencing to identify changes in airway microbial community structure in 23 adult CF patients during acute pulmonary exacerbation, after antibiotic treatment and during periods of stable disease. Over 350,000 sequences were generated, representing nearly 170 distinct microbial taxa. Approximately 60% of sequences obtained were from the recognized CF pathogens Pseudomonas and Burkholderia, which were detected in largely non-overlapping patient subsets. In contrast, other taxa including Prevotella, Streptococcus, Rothia and Veillonella were abundant in nearly all patient samples. Although antibiotic treatment was associated with a small decrease in species richness, there was minimal change in overall microbial community structure. Furthermore, microbial community composition was highly similar in patients during an exacerbation and when clinically stable, suggesting that exacerbations may represent intrapulmonary spread of infection rather than a change in microbial community composition. Mouthwash samples, obtained from a subset of patients, showed a nearly identical distribution of taxa as expectorated sputum, indicating that aspiration may contribute to colonization of the lower airways. Finally, we observed a strong correlation between low species richness and poor lung function. Taken together, these

  20. Effect of troxerutin on insulin signaling molecules in the gastrocnemius muscle of high fat and sucrose-induced type-2 diabetic adult male rat.

    Science.gov (United States)

    Sampath, Sathish; Karundevi, Balasubramanian

    2014-10-01

    Troxerutin is a trihydroxyethylated derivative of the flavonoid, rutin. It has been reported to possess the hepatoprotective, nephroprotective, antioxidant, anti-inflammatory, and antihyperlipidemic activities. Troxerutin treatment reduced the blood glucose and glycosylated hemoglobin levels in high-cholesterol-induced insulin-resistant mice and in type-2 diabetic patients. However, the mechanism by which it exhibits antidiabetic property was unknown. Therefore, the present study was designed to evaluate the effect of troxerutin on insulin signaling molecules in gastrocnemius muscle of high fat and sucrose-induced type-2 diabetic rats. Wistar male albino rats were selected and divided into five groups. Group I: Control. Group II: High fat and sucrose-induced type-2 diabetic rats. Group III: Type-2 diabetic rats treated with troxerutin (150 mg/kg body weight/day orally). Group IV: Type-2 diabetic rats treated with metformin (50 mg/kg body weight/day orally). Group V: Normal rats treated with troxerutin (150 mg/kg body weight/day orally). After 30 days of treatment, fasting blood glucose, oral glucose tolerance, serum lipid profile, and the levels of insulin signaling molecules, glycogen, glucose uptake, and oxidation in gastrocnemius muscle were assessed. Diabetic rats showed impairment in insulin signaling molecules (IR, p-IRS-1(Tyr632), p-Akt(Ser473), β-arrestin-2, c-Src, p-AS160(Thr642), and GLUT4 proteins), glycogen concentration, glucose uptake, and oxidation. Oral administration of troxerutin showed near normal levels of blood glucose, serum insulin, lipid profile, and insulin signaling molecules as well as GLUT4 proteins in type-2 diabetic rats. It is concluded from the present study that troxerutin may play a significant role in the management of type-2 diabetes mellitus, by improving the insulin signaling molecules and glucose utilization in the skeletal muscle.

  1. Benzophenone-type UV filters in urine and blood from children, adults, and pregnant women in China: Partitioning between blood and urine as well as maternal and fetal cord blood

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Tao; Sun, Hongwen; Qin, Xiaolei [College of Environmental Sciences and Engineering, Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, Tianjin Key Laboratory of Environmental Remediation and Pollution Control, Nankai University, Tianjin 300071 (China); Wu, Qian [Wadsworth Center, New York State Department of Health, Albany, NY 12201 (United States); Department of Environmental Health Sciences, School of Public Health, State University of New York at Albany, Albany, NY 12201 (United States); Zhang, Yanfeng [College of Environmental Sciences and Engineering, Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, Tianjin Key Laboratory of Environmental Remediation and Pollution Control, Nankai University, Tianjin 300071 (China); Ma, Jing [Applied Radiation Institute, School of Environmental and Chemical Engineering, Shanghai University, 99 Shangda Road, P.O. Box 144, Shanghai 200444 (China); Kannan, Kurunthachalam, E-mail: kkannan@wadsworth.org [Wadsworth Center, New York State Department of Health, Albany, NY 12201 (United States); Department of Environmental Health Sciences, School of Public Health, State University of New York at Albany, Albany, NY 12201 (United States); International Joint Research Center for Persistent Toxic Substances, State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, Harbin 150090 (China)

    2013-09-01

    Limited information exists on the exposure of benzophenone (BP)-type UV filters (i.e., sunscreen compounds) in children, adults, and pregnant women in China. In this study, we determined the concentrations of five BP derivatives, BP-1, BP-2, BP-3, BP-8, and 4OH-BP in urine (n = 101) as well as paired specimens of blood and urine (n = 24 pairs) collected from adults; in matched maternal and fetal cord blood (n = 20 pairs) collected from pregnant women; and in blood collected from children (n = 10). 4OH-BP, BP-1, and BP-3 were found in 61%, 57%, and 25%, respectively, of the urine samples analyzed. 4OH-BP was found in all blood samples; BP-3 was found more frequently in the blood of adults (83%), followed, in decreasing order, by pregnant women (35%) and children (30%). Among all adults, urinary BP-3 concentrations were significantly (p < 0.001) positively correlated with urinary BP-1 concentrations. Nevertheless, no significant correlations were found between urinary concentrations of BP-3 (or BP-1) and 4OH-BP. Our results suggest that human exposure to BP-3 and BP-1 is related, whereas 4OH-BP originates from a discrete source. Females had higher urinary concentrations of BP-3, BP-1 and 4OH-BP than males. The distribution profiles of BP-1 and its parent compound (i.e., BP-3) in urine decreased with increasing age of donors (p < 0.05). The ratio of concentrations of BP-3 between blood and urine was 0.21 in adults, which was significantly lower than that for 4OH-BP (0.36). The concentration ratio of BPs between cord blood and maternal blood was higher for 4OH-BP (0.61) than that for BP-3 (0.48), which suggested greater trans-placental transfer potential of 4OH-BP. This is the first study to document the occurrence of BPs in paired urine and blood, and in matched maternal and fetal cord blood. Highlights: • Benzophenone (BP) concentrations are determined in paired blood and urine for the first time. • BP-3 and 4OH-BP partition preferentially into urine. • Cord to

  2. Sibling Status Effects: Adult Expectations.

    Science.gov (United States)

    Baskett, Linda Musun

    1985-01-01

    This study attempted to determine what expectations or beliefs adults might hold about a child based on his or her sibling status alone. Ratings on 50 adjective pairs for each of three sibling status types, only, oldest, and youngest child, were assessed in relation to adult expectations, birth order, and parental status of rater. (Author/DST)

  3. Adult Learning, Economy and Society

    DEFF Research Database (Denmark)

    Olesen, Henning Salling

    2010-01-01

    The article relates the different types of adult education, continuing education and training to an overall societal context of socio-economic modernization by focussing on the multiple functions of adult learning. Each of well known empirical categories is seen in its historical relation to mode...

  4. Panic Disorder among Adults

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    ... Among Adults - Anorexia Nervosa Eating Disorders Among Adults - Binge Eating Disorder Eating Disorders Among Adults - Bulimia Nervosa Eating Disorders ... Among Adults - Anorexia Nervosa Eating Disorders Among Adults - Binge Eating Disorder Eating Disorders Among Adults - Bulimia Nervosa Eating Disorders ...

  5. Major Depression Among Adults

    Science.gov (United States)

    ... Among Adults - Anorexia Nervosa Eating Disorders Among Adults - Binge Eating Disorder Eating Disorders Among Adults - Bulimia Nervosa Eating Disorders ... Among Adults - Anorexia Nervosa Eating Disorders Among Adults - Binge Eating Disorder Eating Disorders Among Adults - Bulimia Nervosa Eating Disorders ...

  6. Do breakfast skipping and breakfast type affect energy intake, nutrient intake, nutrient adequacy, and diet quality in young adults? NHANES 1999-2002

    Science.gov (United States)

    The objective of this study was to assess the impact of breakfast skipping and type of breakfast consumed on energy/nutrient intake, nutrient adequacy, and diet quality using a cross-sectional design. The setting was The National Health and Nutrition Examination Survey (NHANES), 1999-2002. The sub...

  7. Influence of Type 2 Diabetes on Prevalence of Key Periodontal Pathogens, Salivary Matrix Metalloproteinases, and Bone Remodeling Markers in Sudanese Adults with and without Chronic Periodontitis

    Directory of Open Access Journals (Sweden)

    Hasaan Gassim Mohamed

    2016-01-01

    Full Text Available This study compared the influence of type 2 diabetes on the occurrence of six periodontal pathogens in plaque samples of patients with and without chronic periodontitis. Levels of salivary MMP-8, MMP-9, RANKL, and OPG were also investigated. The study enrolled 31 patients with type 2 diabetes and chronic periodontitis (DM + CP, 29 with chronic periodontitis (CP, and 20 with type 2 diabetes (DM. Questionnaire-guided interviews were conducted and plaque index, bleeding on probing, and pocket depth were recorded. Polymerase chain reaction (PCR was utilized to determine the prevalence of the bacteria. The levels of salivary molecules were determined by enzyme immunosorbent assay (ELISA. The CP group had the highest prevalence of P. gingivalis (81.5%, followed by the DM + CP (59.3% and DM (55.0% groups (P>0.05. Similar trends were observed for P. intermedia and T. denticola. The prevalence of T. forsythia was 100% in both periodontitis groups compared to 90% in the DM group. There were no significant differences between the groups regarding the concentrations of MMP-8, MMP-9, or OPG. RANKL concentrations were below the detection limit. Our data show that type 2 diabetes has no significant influence on the prevalence of the investigated periodontal pathogens, or the levels of salivary MMP-8, MMP-9, and OPG.

  8. STUDY OF PREVALENCE OF DIABETES MELLITUS TYPE-2 AND IMPAIRED GLUCOSE TOLERANCE AMONG ADULTS IN A RURAL AREA OF KATIHAR, BIHAR

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    Sazid Hussain

    2016-07-01

    Full Text Available The prevalence of type-2 diabetes mellitus is increasing globally particularly in developing countries. Previously, diabetes mellitus type-2 was disease of middle aged and elderly, but recently it is affecting younger age group including adolescents especially in the high risk population. OBJECTIVES 1. To determine the prevalence of diabetes mellitus type-2 in a rural population of age 30 years and above, 2. To determine the prevalence of Impaired Glucose Tolerance in a rural population of age 30 year and above, and 3. To study the association of various risk factors with diabetes mellitus type-2 and Impaired Glucose Tolerance. METHODOLOGY A community-based cross-sectional study was carried out in population 30 years and above at Chanpi village in the district of Katihar in Bihar during the study period of 1st January to 31st December 2014. This was a community-based study in which all persons aged 30 years or more living in this village were eligible for participation. After taking early morning fasting sample, the study subjects were given 75 gm of anhydrous glucose in 200 mL of water to drink in 5 minutes and blood samples were collected exactly after 2 hours to estimate oral glucose tolerance. Samples were tested in the laboratory on the same day. RESULTS Total sample size in this study was 916 and out of this 31 were found to have type-2 diabetes mellitus and 75 were Impaired Glucose Tolerance (IGT. Distribution of type 2 diabetes among non-vegetarians was found to be 77.42% and 85.33% in IGT. 54.84% males and 45.16% females were found to be type-2 diabetes mellitus and almost same percentage of males and females were found in IGT. Distribution of DM-2 according to literacy level was found to be 29.03%, 41.94%, 19.35%, 6.45%, 3.23% are illiterate, just literate, primary, secondary, higher secondary school person respectively. CONCLUSIONS This study shows that the prevalence of diabetes and IGT is high in the subjects having sedentary

  9. Complete genome sequence and comparative analysis of the wild-type commensal Escherichia coli strain SE11 isolated from a healthy adult.

    Science.gov (United States)

    Oshima, Kenshiro; Toh, Hidehiro; Ogura, Yoshitoshi; Sasamoto, Hiroyuki; Morita, Hidetoshi; Park, Sang-Hee; Ooka, Tadasuke; Iyoda, Sunao; Taylor, Todd D; Hayashi, Tetsuya; Itoh, Kikuji; Hattori, Masahira

    2008-12-01

    We sequenced and analyzed the genome of a commensal Escherichia coli (E. coli) strain SE11 (O152:H28) recently isolated from feces of a healthy adult and classified into E. coli phylogenetic group B1. SE11 harbored a 4.8 Mb chromosome encoding 4679 protein-coding genes and six plasmids encoding 323 protein-coding genes. None of the SE11 genes had sequence similarity to known genes encoding phage- and plasmid-borne virulence factors found in pathogenic E. coli strains. The comparative genome analysis with the laboratory strain K-12 MG1655 identified 62 poorly conserved genes between these two non-pathogenic strains and 1186 genes absent in MG1655. These genes in SE11 were mostly encoded in large insertion regions on the chromosome or in the plasmids, and were notably abundant in genes of fimbriae and autotransporters, which are cell surface appendages that largely contribute to the adherence ability of bacteria to host cells and bacterial conjugation. These data suggest that SE11 may have evolved to acquire and accumulate the functions advantageous for stable colonization of intestinal cells, and that the adhesion-associated functions are important for the commensality of E. coli in human gut habitat.

  10. Effects of Traumatic Stress Induced in the Juvenile Period on the Expression of Gamma-Aminobutyric Acid Receptor Type A Subunits in Adult Rat Brain

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    Cui Yan Lu

    2017-01-01

    Full Text Available Studies have found that early traumatic experience significantly increases the risk of posttraumatic stress disorder (PTSD. Gamma-aminobutyric acid (GABA deficits were proposed to be implicated in development of PTSD, but the alterations of GABA receptor A (GABAAR subunits induced by early traumatic stress have not been fully elucidated. Furthermore, previous studies suggested that exercise could be more effective than medications in reducing severity of anxiety and depression but the mechanism is unclear. This study used inescapable foot-shock to induce PTSD in juvenile rats and examined their emotional changes using open-field test and elevated plus maze, memory changes using Morris water maze, and the expression of GABAAR subunits (γ2, α2, and α5 in subregions of the brain in the adulthood using western blotting and immunohistochemistry. We aimed to observe the role of GABAAR subunits changes induced by juvenile trauma in the pathogenesis of subsequent PTSD in adulthood. In addition, we investigated the protective effects of exercise for 6 weeks and benzodiazepine (clonazepam for 2 weeks. This study found that juvenile traumatic stress induced chronic anxiety and spatial memory loss and reduced expression of GABAAR subunits in the adult rat brains. Furthermore, exercise led to significant improvement as compared to short-term BZ treatment.

  11. HLA Class II Alleles Susceptibility Markers of Type 1 Diabetes Fail to Specify Phenotypes of Ketosis-Prone Diabetes in Adult Tunisian Patients

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    Lilia Laadhar

    2011-01-01

    Full Text Available We aimed to characterize the different subgroups of ketosis-prone diabetes (KPD in a sample of Tunisian patients using the Aβ scheme based on the presence or absence of β-cell autoantibodies (A+ or A− and β-cell functional reserve (β+ or β− and we investigated whether HLA class II alleles could contribute to distinct KPD phenotypes. We enrolled 43 adult patients with a first episode of ketosis. For all patients we evaluated clinical parameters, β-cell autoimmunity, β-cell function and HLA class II alleles. Frequency distribution of the 4 subgroups was 23.3% A+β−, 23.3% A−β−, 11.6% A+β+ and 41.9% A−β+. Patients from the group A+β− were significantly younger than those from the group A−β− (P=.002. HLA susceptibility markers were significantly more frequent in patients with autoantibodies (P=.003. These patients also had resistance alleles but they were more frequent in A+β+ than A+β− patients (P=.04. Insulin requirement was not associated to the presence or the absence of HLA susceptibility markers. HLA class II alleles associated with susceptibility to autoimmune diabetes have not allowed us to further define Tunisian KPD groups. However, high prevalence of HLA resistance alleles in our patients may reflect a particular genetic background of Tunisian KPD population.

  12. Development and psychometric evaluation of a new team effectiveness scale for all types of community adult mental health teams: a mixed-methods approach.

    Science.gov (United States)

    El Ansari, Walid; Lyubovnikova, Joanne; Middleton, Hugh; Dawson, Jeremy F; Naylor, Paul B; West, Michael A

    2016-05-01

    Defining 'effectiveness' in the context of community mental health teams (CMHTs) has become increasingly difficult under the current pattern of provision required in National Health Service mental health services in England. The aim of this study was to establish the characteristics of multi-professional team working effectiveness in adult CMHTs to develop a new measure of CMHT effectiveness. The study was conducted between May and November 2010 and comprised two stages. Stage 1 used a formative evaluative approach based on the Productivity Measurement and Enhancement System to develop the scale with multiple stakeholder groups over a series of qualitative workshops held in various locations across England. Stage 2 analysed responses from a cross-sectional survey of 1500 members in 135 CMHTs from 11 Mental Health Trusts in England to determine the scale's psychometric properties. Based on an analysis of its structural validity and reliability, the resultant 20-item scale demonstrated good psychometric properties and captured one overall latent factor of CMHT effectiveness comprising seven dimensions: improved service user well-being, creative problem-solving, continuous care, inter-team working, respect between professionals, engagement with carers and therapeutic relationships with service users. The scale will be of significant value to CMHTs and healthcare commissioners both nationally and internationally for monitoring, evaluating and improving team functioning in practice.

  13. Psychological characteristics and subjective intolerance for xenobiotic agents of normal young adults with trait shyness and defensiveness. A parkinsonian-like personality type?

    Science.gov (United States)

    Bell, I R; Schwartz, G E; Amend, D; Peterson, J M; Kaszniak, A W; Miller, C S

    1994-07-01

    The present study examines the psychological characteristics and self-reported responses to xenobiotic agents such as tobacco smoke and pesticide of normal young adults with personality traits similar to those claimed for Parkinsonian patients. Previous research, though controversial, has suggested that persons with idiopathic Parkinson's disease (PD) have premorbid personality traits that may include shyness and repressive defensiveness. Other epidemiological evidence indicates that PD patients may have premorbidly increased prevalence of anxiety, affective, and/or somatoform disorders; decreased rates of smoking and alcohol consumption; and elevated exposure to herbicides or pesticides. A total of 783 college students enrolled in an introductory psychology course completed the Cheek-Buss Scale (shyness), the Marlowe-Crowne Social Desirability Scale (defensiveness), Symptom Checklist 90 (revised), the Mastery Scale, a health history checklist, and rating scales for frequency of illness from alcohol and 10 common environmental chemicals. Subjects were divided into four groups on the basis of above- versus below-median scores on the Cheek-Buss and Marlowe-Crowne scales (persons high in shyness and defensiveness, those high only in shyness, those high only in defensiveness, and those low in both shyness and defensiveness). The group high in shyness but low in defensiveness had the highest, whereas the group low in shyness but high in defensiveness had the lowest, total scores on the SCL-90-R; the two shyest groups were lowest in sense of mastery.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Human T Lymphotropic Virus Type I (HTLV-I Oncogenesis: Molecular Aspects of Virus and Host Interactions in Pathogenesis of Adult T cell Leukemia/Lymphoma (ATL

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    Sanaz Ahmadi Ghezeldasht

    2013-03-01

    Full Text Available     The study of tumor viruses paves the way for understanding the mechanisms of virus pathogenesis, including those involved in establishing infection and dissemination in the host tumor affecting immune-compromised patients. The processes ranging from viral infection to progressing malignancy are slow and usually insufficient for establishment of transformed cells that develop cancer in only a minority of infected subjects. Therefore, viral infection is usually not the only cause of cancer, and further environmental and host factors, may be implicated. HTLV-I, in particular, is considered as an oncovirus cause of lymphoproliferative disease such as adult T cell leukemia/lymphoma (ATL and disturbs the immune responses which results in HTLV-I associated meylopathy/tropical spastic parapresis (HAM/TSP. HTLV-I infection causes ATL in a small proportion of infected subjects (2-5% following a prolonged incubation period (15-30 years despite a strong adaptive immune response against the virus.   Overall, these conditions offer a prospect to study the molecular basis of tumorgenicity in mammalian cells. In this review, the oncogencity of HTLV-I is being considered as an oncovirus in context of ATL.    

  15. Understanding Adult Overweight and Obesity

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    ... resources ​​. Alternate Language URL Understanding Adult Overweight and Obesity Page Content How can I tell if I ... type 2 diabetes. [ Top ] How are overweight and obesity treated? The best way to control your weight ...

  16. Mapping the association between back pain and type 2 diabetes: A cross-sectional and longitudinal study of adult Spanish twins

    Science.gov (United States)

    Ordoñana, Juan; Ferreira, Paulo

    2017-01-01

    Background Back pain and type 2 diabetes often co-occur, resulting in greater impact on people’s health and complexity in their care. Plausible causal mechanisms for this association have been proposed, yet the nature of the link remains unclear. We therefore explored the direction of the association between type 2 diabetes and chronic back pain in twins, controlling for genetics and early environmental confounding. Methods 2,096 and 1,098 twins were included in the cross-sectional and longitudinal analyses, respectively. Any or severe (≥ 9) low back pain (LBP), neck pain (NP), and spinal pain (concurrent LBP and NP) and type 2 diabetes were investigated. Sequential analyses were performed using logistic regression. Firstly, twins were analysed unpaired (adjusted age and gender): total sample analyses. Then, to control for genetic and shared environmental factors, a co-twin case-control analysis was performed including monozygotic and dizygotic twin pairs discordant for back pain (cross-sectional only). Results In the cross-sectional total sample analyses, type 2 diabetes was associated with chronic spinal pain (OR 1.61; 95%CI 1.12 to 2.31), severe chronic spinal pain (OR 3.33; 95%CI 1.47 to 7.53), chronic NP (OR 1.37; 95%CI 1.01 to 1.85), severe chronic NP (OR 2.28; 95%CI 1.24 to 4.21), and severe chronic LBP (OR 1.63; 95%CI 1.00 to 2.64). After further adjustment for genetic and shared environmental factors, none of the associations remained significant. The longitudinal analyses indicated that the presence of type 2 diabetes did not increase the risk of future back pain, or vice-versa, after two to four years. Conclusions Chronic back pain (spinal pain, NP, or LBP) was associated with the prevalence of type 2 diabetes. Associations are stronger for severe cases of pain. Future research should investigate the temporal relationships between these conditions with longer follow up in twins. PMID:28369107

  17. Effects of combined calcium and vitamin D supplementation on insulin secretion, insulin sensitivity and β-cell function in multi-ethnic vitamin D-deficient adults at risk for type 2 diabetes: a pilot randomized, placebo-controlled trial.

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    Claudia Gagnon

    Full Text Available To examine whether combined vitamin D and calcium supplementation improves insulin sensitivity, insulin secretion, β-cell function, inflammation and metabolic markers.6-month randomized, placebo-controlled trial.Ninety-five adults with serum 25-hydroxyvitamin D [25(OHD] ≤55 nmol/L at risk of type 2 diabetes (with prediabetes or an AUSDRISK score ≥15 were randomized. Analyses included participants who completed the baseline and final visits (treatment n = 35; placebo n = 45.Daily calcium carbonate (1,200 mg and cholecalciferol [2,000-6,000 IU to target 25(OHD >75 nmol/L] or matching placebos for 6 months.Insulin sensitivity (HOMA2%S, Matsuda index, insulin secretion (insulinogenic index, area under the curve (AUC for C-peptide and β-cell function (Matsuda index x AUC for C-peptide derived from a 75 g 2-h OGTT; anthropometry; blood pressure; lipid profile; hs-CRP; TNF-α; IL-6; adiponectin; total and undercarboxylated osteocalcin.Participants were middle-aged adults (mean age 54 years; 69% Europid at risk of type 2 diabetes (48% with prediabetes. Compliance was >80% for calcium and vitamin D. Mean serum 25(OHD concentration increased from 48 to 95 nmol/L in the treatment group (91% achieved >75 nmol/L, but remained unchanged in controls. There were no significant changes in insulin sensitivity, insulin secretion and β-cell function, or in inflammatory and metabolic markers between or within the groups, before or after adjustment for potential confounders including waist circumference and season of recruitment. In a post hoc analysis restricted to participants with prediabetes, a significant beneficial effect of vitamin D and calcium supplementation on insulin sensitivity (HOMA%S and Matsuda was observed.Daily vitamin D and calcium supplementation for 6 months may not change OGTT-derived measures of insulin sensitivity, insulin secretion and β-cell function in multi-ethnic adults with low vitamin D status at risk of type 2 diabetes

  18. Association of Self-Reported Weight Change and Quality of Life, and Exercise and Weight Management Behaviors Among Adults with Type 2 Diabetes Mellitus: The SHIELD Study

    OpenAIRE

    Susan Grandy; Fox, Kathleen M; Debbra D. Bazata

    2012-01-01

    Purpose. This study examined the association between self-reported weight change and quality of life, and exercise and weight management behaviors among individuals with type 2 diabetes mellitus (T2DM). Methods. In the US SHIELD study, respondents reported whether they had lost or gained weight compared with 1 year earlier and completed the SHIELD-WQ-9 quality of life questionnaire as well as provided information on their exercise and weight management behaviors in the past 12 months. Results...

  19. Motivation to physical activity among adults with high risk of type 2 diabetes who participated in the Oulu substudy of the Finnish Diabetes Prevention Study.

    Science.gov (United States)

    Korkiakangas, Eveliina; Taanila, Anja M; Keinänen-Kiukaanniemi, Sirkka

    2011-01-01

    Type 2 diabetes can be prevented by lifestyle changes such as sufficient level of physical activity. The number of persons at high risk of or diagnosed with type 2 diabetes is increasing all over the world. In order to prevent type 2 diabetes and develop exercise counselling, more studies on motivators and barriers to physical activity are needed. Thus, the aim of this qualitative study was to describe the motivators and barriers to physical activity among individuals with high risk of type 2 diabetes who participated in a substudy of the Finnish Diabetes Prevention Study in Oulu and to consider whether the motivators or barriers changed during the follow-up from 2003 to 2008. Questionnaires with open-ended questions were conducted twice: in the first follow-up in 2003 altogether 63 participants answered the questionnaire (n = 93), and in the second follow-up in 2008 altogether 71 participants answered the questionnaire (n = 82). Thus, response rate was 68% in 2003 and 87% in 2008. The study was conducted in the city of Oulu in Finland. Qualitative data were analysed by inductive content analysis using the QSR NVivo 8 software. The results of this study showed that motivators to physical activity included weight management, feelings of physical and mental well being. In addition, social relationships associated with exercise were also motivators. In conclusion, we present that regular counselling is important in order to promote exercise among older people, and that motivators to exercise are strengthened by positive experiences of exercise as one grows older.

  20. Relationships between glucose, energy intake and dietary composition in obese adults with type 2 diabetes receiving the cannabinoid 1 (CB1 receptor antagonist, rimonabant

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    Heppenstall Charlotte

    2012-07-01

    Full Text Available Abstract Background Weight loss is often difficult to achieve in individuals with type 2 diabetes and anti-obesity drugs are often advocated to support dietary intervention. Despite the extensive use of centrally acting anti-obesity drugs, there is little evidence of how they affect dietary composition. We investigated changes in energy intake and dietary composition of macro- and micronutrients following therapy with the endocannabinoid receptor blocker, rimonabant. Methods 20 obese patients with type 2 diabetes were studied before and after 6 months dietary intervention with rimonabant. Dietary intervention was supervised by a diabetes dietician. Five-day food diaries were completed at baseline and at 6 months and dietary analysis was performed using computer software (Dietplan 6. Results After 6 months, (compared with baseline there were reductions in weight (107 ± 21Kg versus 112 ± 21, p  Conclusions In obese patients with type 2 diabetes, rimonabant in combination with dietary intervention led to reduced intake of energy and most macronutrients. Despite this, macronutrient composition of the diet was unaltered. These dietary changes (especially carbohydrate restriction were associated with weight loss and favourable metabolic effects.

  1. Attitudes and barriers to exercise in adults with type 1 diabetes (T1DM and how best to address them: a qualitative study.

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    Nadia Lascar

    Full Text Available Regular physical activity has recognised health benefits for people with T1DM. However a significant proportion of them do not undertake the recommended levels of activity. Whilst questionnaire-based studies have examined barriers to exercise in people with T1DM, a formal qualitative analysis of these barriers has not been undertaken. Our aims were to explore attitudes, barriers and facilitators to exercise in patients with T1DM.A purposeful sample of long standing T1DM patients were invited to participate in this qualitative study. Twenty-six adults were interviewed using a semi-structured interview schedule to determine their level of exercise and barriers to initiation and maintenance of an exercise programme.Six main barriers to exercise were identified: lack of time and work related factors; access to facilities; lack of motivation; embarrassment and body image; weather; and diabetes specific barriers (low levels of knowledge about managing diabetes and its complications around exercise. Four motivators to exercise were identified: physical benefits from exercise; improvements in body image; enjoyment and the social interaction of exercising at gym or in groups. Three facilitators to exercise were identified: free or reduced admission to gyms and pools, help with time management, and advice and encouragement around managing diabetes for exercise.Many of the barriers to exercise in people with T1DM are shared with the non-diabetic population. The primary difference is the requirement for education about the effect of exercise on diabetes control and its complications. There was a preference for support to be given on a one to one basis rather than in a group environment. This suggests that with the addition of the above educational requirements, one to one techniques that have been successful in increasing activity in patients with other chronic disease and the general public should be successful in increasing activity in patients with T1DM.

  2. Adult teachers

    DEFF Research Database (Denmark)

    Larsen, Lea Lund

    2011-01-01

    In this paper I examine the research into the process of adult teachers’ practice-based learning as a part of an on-going project titled “Competence development through practice-based learning – a study of adult teacher’s learning processes”. The project relies on the notion of the adult teacher...... as a 'reflective practitioner’, who develops 'the language of practice’, through experience and learns when she is exposed to 'disjuncture’. Research done on continuing professional development and the inquiries done in the field of teacher thinking and within this the research on novices becoming expert...

  3. Bone geometry, density, and microarchitecture in the distal radius and tibia in adults with osteogenesis imperfecta type I assessed by high-resolution pQCT.

    Science.gov (United States)

    Folkestad, Lars; Hald, Jannie Dahl; Hansen, Stinus; Gram, Jeppe; Langdahl, Bente; Abrahamsen, Bo; Brixen, Kim

    2012-06-01

    Osteogenesis imperfecta (OI) is a hereditary disorder characterized by decreased biosynthesis or impaired morphology of type I collagen that leads to decreased bone mass and increased bone fragility. We hypothesized that patients with OI have altered bone microstructure and bone geometry. In this cross-sectional study we compared patients with type I OI to age- and gender-matched healthy controls. A total of 39 (13 men and 26 women) patients with OI, aged 53 (range, 21-77) years, and 39 controls, aged 53 (range, 21-77) years, were included in the study. Twenty-seven of the patients had been treated with bisphosphonates. High-resolution peripheral quantitative computed tomography (HR-pQCT) at the distal radius and distal tibia and dual-energy X-ray absorptiometry of total hip, femoral neck, trochanteric region, and the lumbar spine (L1-L4) were performed. The patients were shorter than the controls (159 ± 10 cm versus 170 ± 9 cm, p radius (p radius, total bone area was 5% lower in OI than in controls (p radius and tibia the number of trabeculae was lower in patients compared to the controls (35% and 38%, respectively, p radius (p < 0.001 at both sites) when compared with controls. We conclude that patients with type I OI have lower aBMD, vBMD, bone area, and trabecular number when compared with healthy age- and gender-matched controls.

  4. Bone geometry, density, and microarchitecture in the distal radius and tibia in adults with osteogenesis imperfecta type I assessed by high-resolution pQCT

    DEFF Research Database (Denmark)

    Folkestad, Lars; Hald, Jannie Dahl; Hansen, Stinus

    2012-01-01

    Osteogenesis Imperfecta (OI) is a hereditary disorder characterized by decreased biosynthesis or impaired morphology of collagen type-1 that leads to decreased bone mass and increased bone fragility. We hypothesized that patients with OI have altered bone microstructure and bone geometry. In this...... treated with bisphosphonates. HR-pQCT at the distal radius and distal tibia and dual-energy X-ray absorptiomentry of total hip, femoral neck, trochanteric region and the lumbar spine (L1-L4) were performed. The patients were shorter than the controls (159¿±¿10¿cm vs. 170¿±¿9¿cm, p¿...

  5. Efficacy and cost-effectiveness of a web-based intervention with mobile phone support to treat depressive symptoms in adults with diabetes mellitus type 1 and type 2: design of a randomised controlled trial

    OpenAIRE

    Nobis, Stephanie; Lehr, Dirk; Ebert, David Daniel; Berking, Matthias; Heber, Elena; Baumeister, Harald; Becker, Annette; Snoek, Frank; Riper, Heleen

    2013-01-01

    Background A diagnosis of diabetes mellitus types 1 or 2 doubles the odds of a comorbid depressive disorder. The combined diseases have a wide range of adverse outcomes, such as a lower quality of life, poorer diabetes outcomes and increased healthcare utilisation. Diabetes patients with depression can be treated effectively with psychotherapy, but access to psychological care is limited. In this study we will examine the efficacy and cost-effectiveness of a newly developed web-based interven...

  6. Y型锁定钢板置入治疗成人肱骨髁间骨折36例%Y-type locking plate for intercondylar fractures of the adult hunmerus in 36 cases

    Institute of Scientific and Technical Information of China (English)

    程煜方; 魏忠民; 黄方敏; 张克良; 李子熙

    2011-01-01

    背景:肱骨髁间骨折是一种复杂的关节内骨折,骨折端的显露及固定均比较困难.目的:观察经尺骨鹰嘴截骨入路Y型解剖型锁定钢板治疗肱骨髁间骨折的效果.方法:采用尺骨鹰嘴截骨入路,Y型解剖型锁定钢板治疗肱骨髁间骨折36例,男22例,女14例,年龄19-76岁,平均47岁,按AO/OTA分型:C1型8例,C2型15例,C3型13例.结果与结论:32例获得随访,随访时间为10~26个月.用改良的Cassebaum评分标准评分,优15例,良13例,中3例,差1例,优良率89.6%.尺骨鹰嘴截骨入路切口无一例感染,骨折愈合时间为2.5~4.5个月,平均3.5个月.固定后钢板未出现松动现象.结果显示用尺骨鹰嘴截骨入路Y型解削型锁定钢板治疗肱骨髁间骨折,显露范围广,固定牢靠,能有效防止骨折不愈合,可指导患者早期在CPM机上进行肘关节功能锻炼,肘关节功能恢复良好,是治疗肱骨髁间骨折的有效方法.%BACKGROUND: Jnlercondylar fracture of the humerus is a hind of complex intra-articular fractures. Fracture exposure andfixation are difficult.OBJECTIVE: To explore the surgical effect of Y-type locking plate through the approach of olecranon osterolomy onintercondylar fracture of Ihe adult humerus.METHODS: Thirty-six adult patients with intercondylar fractures of the hunmerus were treated with Y-type locking plale Ihroughthe approach of olecranon osterotomy. Including 22 mates and 14 females, aged 19-76 years. Averagely47year. According lothe AO/OTA dassificaiton. Type C1 fracture was found in 8 cases, type C2 in 15, and type C3 in 13.RESULTS AND CONCLUSION: Thirty-two cases received a follow-up of 10-26 months. According to Cassebaum scale, thefunction of the elbow showed excellent in 15 cases, good in 13 cases, fair in 3 cases and poor in 1 case, and the excellent-goodrate was 89.6%. No infection occurred. The mean time for fracture healing was 2.4 to 4.5 months, averagely 3.5 months. Thetechnique of Y-type locking plate for

  7. Interaction between β-hexachlorocyclohexane and ADIPOQ genotypes contributes to the risk of type 2 diabetes mellitus in East Chinese adults

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    Li, Shushu; Wang, Xichen; Yang, Lu; Yao, Shen; Zhang, Ruyang; Xiao, Xue; Zhang, Zhan; Wang, Li; Xu, Qiujin; Wang, Shou-Lin

    2016-11-01

    Growing evidence links environmental exposure to hexachlorocyclohexanes (HCHs) to the risk of type 2 diabetes mellitus (T2DM), and ADIPOQ that encodes adiponectin is considered as an important gene for T2DM. However, the role of ADIPOQ-HCH interaction on T2DM risk remains unclear. Thus, a paired case-control study was conducted in an East Chinese community. A total of 1446 subjects, including 723 cases and 723 controls matched on age, gender and residence, were enrolled, and 4 types of HCH isomers were measured in serum samples using GC-MS/MS. Additionally, 4 candidate ADIPOQ SNPs (rs182052, rs266729, rs6810075, and rs16861194) were genotyped by TaqMan assay, and plasma adiponectin was measured using ELISA. No associations between 4 SNPs and T2DM risk were found, but T2DM risk significantly increased with serum levels of β-HCH (P < 0.001). Furthermore, the synergistic interaction between β-HCH and rs182052 significantly increased T2DM risk (OR I-additive model = 2.20, OR I-recessive model = 2.13). Additionally, individuals carrying only rs182052 (A allele) with high levels of β-HCH had significant reduction in adiponectin levels (P = 0.016). These results indicate that the interaction between rs182052 and β-HCH might increase the risk of T2DM by jointly decreasing the adiponectin level and potentially trigger T2DM development.

  8. Distinct Niemann-Pick Disease Type C Clinical, Cytological, and Biochemical Phenotype in an Adult Patient With 1 Mutated, Overexpressed NPC1 Allele

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    Julia Jecel MD

    2015-11-01

    Full Text Available Niemann-Pick disease type C (NP-C is a rare autosomal-recessive neurovisceral lysosomal storage disease. We report on a juvenile onset, now 25-year-old female patient with typical neurologic symptoms, including vertical gaze palsy, of NP-C. The diagnosis was supported by a positive filipin test (“variant biochemical phenotype” of cholesterol accumulation in cultured fibroblasts, high numbers of “Niemann-Pick cells” in the bone marrow, and 1 positive out of 3 NP-C biomarkers tested, but NP-C was not definitely confirmed genetically. She showed only 1 known NPC1 variant (3 bp deletion in exon 18; p.N916del; this allele, however, being distinctly overexpressed at the messenger RNA level as compared to the wild-type allele, as a not as yet clarified (copathogenic? phenomenon. The patient’s mother, also carrying the p.N916del allele but without overexpression, has a chronic inflammatory disease of the central nervous system classified as multiple sclerosis. However, her severe clinical phenotype includes some signs also consistent with NP-C. The laboratory diagnosis of NP-C can be challenging in detecting novel disease constellations.

  9. Association of diabetes-related distress, depression, medication adherence, and health-related quality of life with glycated hemoglobin, blood pressure, and lipids in adult patients with type 2 diabetes: a cross-sectional study

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    Chew BH

    2015-04-01

    Full Text Available Boon-How Chew,1 Mohd-Sidik Sherina,2 Noor-Hasliza Hassan3 1Department of Family Medicine, 2Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang; 3Klinik Kesihatan Dengkil, Jalan Dengkil, Malaysia Abstract: This study examined the associations of diabetes-related distress (DRD, depressive symptoms, health-related quality of life (HRQoL, and medication adherence with glycemia, blood pressure (BP, and lipid biomarkers in adults with type 2 diabetes mellitus (T2D. This cross-sectional study was conducted in three Malaysian public health clinics in 2012–2013, recruited adult patients (aged ≥30 years with T2D who had been diagnosed for more than one year, were on active follow-up, and had recent blood test results. Univariable and multivariable analyses were performed to identify significant associated factors for glycated hemoglobin (HbA1c BP, and lipids. The response rate was 93.1% (700/752. The majority were females (52.8%, Malay (52.4%, and married (78.7%. DRD correlated with systolic BP (r= -0.16; depressive symptoms correlated with low-density lipoprotein cholesterol (r=0.12 and total cholesterol (r=0.13; medication adherence correlated with HbA1c (r= -0.14 and low-density lipoprotein cholesterol (r= -0.11; and HRQoL correlated with casual blood glucose (r= -0.11, high-density lipoprotein cholesterol (r= -0.13, and total cholesterol (r= -0.08. Multivariable analyses showed that HRQoL was significantly associated with casual blood glucose (adjusted B= -0.06, P=0.024; DRD was associated with systolic BP (adjusted B= -0.08, P=0.066; depressive symptoms were associated with low-density lipoprotein cholesterol (adjusted B=0.02, P=0.061, and medication adherence was associated with HbA1c (adjusted B= -0.11, P=0.082 and total cholesterol (adjusted B= -0.06, P=0.086. There were significant and distinctive associations of DRD, depressive symptoms, HRQoL, and medication adherence with

  10. The benefits of yoga for adults with type 2 diabetes: a review of the evidence and call for a collaborative, integrated research initiative.

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    de G R Hansen, Elizabeth; Innes, Kim E

    2013-01-01

    Type 2 diabetes (T2DM) is a global public health crisis. Research suggests that yoga holds promise for T2DM management. This article summarizes evidence regarding the efficacy of yoga for T2DM management and encourages the development of an integrated research agenda and a collaborative work group to test it. We present a brief overview of the global rise in T2DM and its consequences and costs, review the evidence regarding the potential benefits of yoga for T2DM management, outline limitations in the literature, discuss possible mechanisms underlying the effects of yoga on T2DM, and suggest how a collaborative, multinational effort by yoga therapist and research communities might contribute to research and inform clinical practice. Yoga protocols that serve T2DM patients and a research framework for creating an evidence base to support the use of yoga for T2DM management are clearly needed.

  11. Adult siblings with homozygous G6PC3 mutations expand our understanding of the severe congenital neutropenia type 4 (SCN4 phenotype

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    Fernandez Bridget A

    2012-11-01

    Full Text Available Abstract Background Severe congenital neutropenia type 4 (SCN4 is an autosomal recessive disorder caused by mutations in the third subunit of the enzyme glucose-6-phosphatase (G6PC3. Its core features are congenital neutropenia and a prominent venous skin pattern, and affected individuals have variable birth defects. Oculocutaneous albinism type 4 (OCA4 is caused by autosomal recessive mutations in SLC45A2. Methods We report a sister and brother from Newfoundland, Canada with complex phenotypes. The sister was previously reported by Cullinane et al., 2011. We performed homozygosity mapping, next generation sequencing and conventional Sanger sequencing to identify mutations that cause the phenotype in this family. We have also summarized clinical data from 49 previously reported SCN4 cases with overlapping phenotypes and interpret the medical histories of these siblings in the context of the literature. Results The siblings’ phenotype is due in part to a homozygous mutation in G6PC3, [c.829C > T, p.Gln277X]. Their ages are 38 and 37 years respectively and they are the oldest SCN4 patients published to date. Both presented with congenital neutropenia and later developed Crohn disease. We suggest that the latter is a previously unrecognized SCN4 manifestation and that not all affected individuals have an intellectual disability. The sister also has a homozygous mutation in SLC45A2, which explains her severe oculocutaneous hypopigmentation. Her brother carried one SLC45A2 mutation and was diagnosed with “partial OCA” in childhood. Conclusions This family highlights that apparently novel syndromes can in fact be caused by two known autosomal recessive disorders.

  12. Four adult hemoglobin types in one mulatto family Quatro tipos de hemoglobina em uma família adulta de mulatos

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    João Targino de Araújo

    1996-06-01

    Full Text Available The studied family showed the presence of four different types of hemoglobin. The family member who gave rise to this study (=propositus presented Hb C and the hybrid Hb CG-phila. The propositus has three children, all of which have Hb AC; none of the family members showed any clinical symptoms. The investigation of the hemoglobin arose from the finding of target red cells in a blood test done during the pre-operatory examination for lower limb varicose vein stripping. The hybrid Hb CG-phila is due to two gene pairs, each of which with individual expression, determining the synthesis and the particular type subunits. The hybrid Hb CG-phila is formed by the combination velocity of the subunits alpha2G-philabeta2; therefore the proportion of the hybrid Hb CG-phila is lower than Hb G-phila and Hb C. The identification and molecular characterization of Hb G-phila showed the position alpha268 Asn->Lys beta2 and Hb C showed alpha2beta26 Glu->Lys.A família em estudo mostrou a presença de quatro diferentes tipos de hemoglobinas. O membro da família que deu origem ao estudo (propositus foi identificado como Hb C e o híbrido com Hb CG-phila. O propositus tem três filhos todos portadores de Hb AC; nenhum membro da família apresentou sintomas clínicos. A pesquisa da hemoglobina resultou da existência de hemácias em alvo, no pré-operatório de varizes de membros inferiores. O híbrido Hb CG-phila é constituído por dois pares de genes, mas cada um com expressão inidividual, determinando a síntese e o tipo particular das subunidades. O híbrido Hb CG-phila é formado pela velocidade de combinação das subunidades alfa2G-philabeta2C assim sendo a proporção do híbrido Hb CG-phila é menor do que a Hb G-phila e Hb C. A identificação e caracterização molecular da Hb G-phila mostrou a posição alfa268 Asn->Lys beta2 a Hb C alfa2beta26 Glu->Lys.

  13. Impact of "Conversation Maps" on diabetes distress and self-efficacy of Chinese adult patients with type 2 diabetes: a pilot study

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    Li F

    2016-05-01

    Full Text Available Fan Li,1,* Ping Yao,2,* Cunyi Hsue,3 Jin Xu,4 Qingqing Lou11Department of Health Education, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, Jiangsu, People’s Republic of China; 2Department of Endocrinology, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, Jiangsu, People’s Republic of China; 3Hangzhou 9th Middle School, Hangzhou, Zhejiang, People’s Republic of China; 4Department of Bioengineering, University of Washington, Seattle, WA, USA*These authors contributed equally to this workAbstract: The objective was to compare Diabetes Conversation Maps-based education and traditional education in Chinese patients with type 2 diabetes. A total of 53 outpatients were randomized to the intervention group (Diabetes Conversation Maps-based education and control group (traditional education. In the intervention group, six 1-hour sessions covering diabetes overview, living with diabetes, risk factors and complications of diabetes, starting insulin treatment, foot care, and healthy eating and exercise were provided during 4 weeks. The participants had to attend at least four sessions, followed by a monthly follow-up telephone call in the subsequent 3 months. In the control group, six 1-hour diabetes classes covering similar topics as those in the intervention group were provided over 4 weeks. Each participant needed to attend at least four sessions. A1C was assessed at baseline, 3 months and 6 months after the last educational session/class. Psychosocial metrics and self-care activities were evaluated at baseline and 6 months after the last educational session/class. Forty-six participants finished the study. After 6 months, the total score of diabetes distress scale was significantly lower and total score of diabetes empowerment scale-short form was significantly higher in the intervention group than the control group. The 3 months A1C was significantly lower in the intervention

  14. Clinical review: the misreporting of logbook, download, and verbal self-measured blood glucose in adults and children with type I diabetes.

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    Blackwell, Miranda; Wheeler, Benjamin J

    2017-01-01

    Despite advances in technology, the frequent self-measurement of blood glucose (SMBG) remains fundamental to the management of 1 diabetes mellitus (T1DM). Once measured, SMBG results are routinely reported back to health professionals and other interested parties, either verbally, via a logbook, or electronically downloaded from a pump or meter. The misreporting of SMBG using various techniques represents a classic non-adherence behavior and carries with it both acute and chronic dangers. In addition, while this behavior appears very prevalent, many aspects remain largely unstudied. With this in mind, we aimed to summarize literature addressing the misreporting of SMBG in T1DM via a detailed literature search. This produced both recent and past literature. While most of these studies examined the prevalence of deliberate misreporting in a verbal or logbook context, others focused on the motivations behind this behavior, and alternative forms of misreporting, including deliberate manipulation of meters to produce inaccurate results and true technological errors. This timely review covers all aspects of misreporting and highlights multiple patient techniques, which are clearly adapting to advances in technology. We believe that further understanding and attention to this aspect of adherence may lead not only to improvements in glycemic control and safety, but also to the psychological well-being of those affected by type 1 diabetes.

  15. Pomegranate Polyphenols Lower Lipid Peroxidation in Adults with Type 2 Diabetes but Have No Effects in Healthy Volunteers: A Pilot Study

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    Arpita Basu

    2013-01-01

    Full Text Available Aims. To examine the antioxidant and anti-inflammatory effects of pomegranate polyphenols in obese patients with type 2 diabetes (T2DM (n=8 and in healthy nondiabetic controls (n=9. Methods. Participants received 2 capsules of pomegranate polyphenols (POMx, 1 capsule = 753 mg polyphenols daily for 4 weeks. Blood draws and anthropometrics were performed at baseline and at 4 weeks of the study. Results. Pomegranate polyphenols in healthy controls and in T2DM patients did not significantly affect body weight and blood pressure, glucose and lipids. Among clinical safety profiles, serum electrolytes, renal function tests, and hematological profiles were not significantly affected by POMx supplementation. However, aspartate aminotransferase (AST showed a significant increase in healthy controls, while alanine aminotransferase (ALT was significantly decreased in T2DM patients at 4 weeks (P<0.05, though values remained within the normal ranges. Among the biomarkers of lipid oxidation and inflammation, oxidized LDL and serum C-reactive protein (CRP did not differ at 4 weeks in either group, while pomegranate polyphenols significantly decreased malondialdehyde (MDA and hydroxynonenal (HNE only in the diabetic group versus baseline (P<0.05. Conclusions. POMx reduces lipid peroxidation in patients with T2DM, but with no effects in healthy controls, and specifically modulates liver enzymes in diabetic and nondiabetic subjects. Larger clinical trials are merited.

  16. High prevalence of type 2 diabetes and pre-diabetes in adult Zoroastrians in Yazd, Iran: a cross-sectional study

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    Khalilzadeh, Saeedhossein; Afkhami-Ardekani, Mohammad; Afrand, Mohammadhosain

    2015-01-01

    Background: The prevalence of type 2 diabetes mellitus (T2DM) varies among ethnic groups. We aimed to estimate the prevalence of diagnosed and undiagnosed diabetes mellitus, impaired fasting glucose (IFG), and impaired glucose tolerance (IGT) for the first time in an ethnic population, specifically Zoroastrian citizens in Yazd, Iran whose ages were 30 or older. Methods: In a cross-sectional study, participants aged≥30 years were selected using systematic random sampling. An inventory, including socio-demographic data, was completed. Weight, height, body mass index (BMI), and blood pressure (BP) were measured using standard methods. Also, blood levels of glucose, triglycerides (TG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), urea, creatinine (Cr), and uric acid were measured. The latest criteria established by the American Diabetes Association (ADA) were used to diagnose DM. Results: The mean age of the participants (n=403) was 56.9±12.8 years. The total prevalence of diabetes, including previously diagnosed and undiagnosed diabetes, IFG, and IGT was 26.1%, 18.6%, 7.5%, 34.7% and 25.8%, respectively. Participants with diabetes had higher fasting blood sugar (FBS) (PZoroastrian population of Yazd, Iran. One-third of the total cases with diabetes were undiagnosed. PMID:26052411

  17. The effect of expressive and instrumental touch on the behavior states of older adults with late-stage dementia of the Alzheimer's type and on music therapist's perceived rapport.

    Science.gov (United States)

    Belgrave, Melita

    2009-01-01

    The purpose of this study was to examine the effect of music therapy interventions utilizing two types of touch, expressive touch and instrumental touch, on the behavior states of older adults who have late-stage dementia of the Alzheimer's type. A secondary purpose of this study was to examine the perceived effectiveness of the music therapist when expressive and instrumental touch was employed during music therapy sessions. A within-subject design was used with 9 participants receiving 3 sessions in each of the experimental conditions: no touch, expressive touch, and instrumental touch. Results of a one-way ANOVA revealed that expressive touch was significantly more effective during the initial session in eliciting and maintaining alert behavior states than the instrumental and control conditions; however, there were no significant differences between the experimental and control conditions during the first and second session repetitions. Rapport ratings revealed that the therapist's client rapport was perceived to be significantly higher during both the expressive touch and instrumental touch conditions than during the control condition. These findings have important implications for music therapy practice and the effective use of nonverbal communication.

  18. Organ doses, effective doses, and risk indices in adult CT: Comparison of four types of reference phantoms across different examination protocols

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Yakun; Li Xiang; Paul Segars, W.; Samei, Ehsan [Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 and Carl E. Ravin Advanced Imaging Laboratories, Duke University, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Duke University, Durham, North Carolina 27705 and Department of Radiology, Duke University, Durham, North Carolina 27705 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Duke University, Durham, North Carolina 27705 (United States) and Department of Radiology, Duke University, Durham, North Carolina 27705 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Duke University, Durham, North Carolina 27705 (United States); Department of Radiology, Duke University, Durham, North Carolina 27705 (United States) and Departments of Physics, Biomedical Engineering, and Electrical and Computer Engineering, Duke University, Durham, North Carolina 27705 (United States)

    2012-06-15

    Purpose: Radiation exposure from computed tomography (CT) to the public has increased the concern among radiation protection professionals. Being able to accurately assess the radiation dose patients receive during CT procedures is a crucial step in the management of CT dose. Currently, various computational anthropomorphic phantoms are used to assess radiation dose by different research groups. It is desirable to better understand how the dose results are affected by different choices of phantoms. In this study, the authors assessed the uncertainties in CT dose and risk estimation associated with different types of computational phantoms for a selected group of representative CT protocols. Methods: Routinely used CT examinations were categorized into ten body and three neurological examination categories. Organ doses, effective doses, risk indices, and conversion coefficients to effective dose and risk index (k and q factors, respectively) were estimated for these examinations for a clinical CT system (LightSpeed VCT, GE Healthcare). Four methods were used, each employing a different type of reference phantoms. The first and second methods employed a Monte Carlo program previously developed and validated in our laboratory. In the first method, the reference male and female extended cardiac-torso (XCAT) phantoms were used, which were initially created from the Visible Human data and later adjusted to match organ masses defined in ICRP publication 89. In the second method, the reference male and female phantoms described in ICRP publication 110 were used, which were initially developed from tomographic data of two patients and later modified to match ICRP 89 organ masses. The third method employed a commercial dosimetry spreadsheet (ImPACT group, London, England) with its own hermaphrodite stylized phantom. In the fourth method, another widely used dosimetry spreadsheet (CT-Expo, Medizinische Hochschule, Hannover, Germany) was employed together with its associated

  19. Evaluating HIV Prevention Programs: Herpes Simplex Virus Type 2 Antibodies as Biomarker for Sexual Risk Behavior in Young Adults in Resource-Poor Countries.

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    Juliane Behling

    Full Text Available Measuring effectiveness of HIV prevention interventions is challenged by bias when using self-reported knowledge, attitude or behavior change. HIV incidence is an objective marker to measure effectiveness of HIV prevention interventions, however, because new infection rates are relatively low, prevention studies require large sample sizes. Herpes simplex virus type 2 (HSV-2 is similarly transmitted and more prevalent and could thus serve as a proxy marker for sexual risk behavior and therefore HIV infection.HSV-2 antibodies were assessed in a sub-study of 70,000 students participating in an education intervention in Western Province, Kenya. Feasibility of testing for HSV-2 antibodies was assessed comparing two methods using Fisher's exact test. Three hundred and ninety four students (aged 18 to 22 years were randomly chosen from the cohort and tested for HIV, Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Out of these, 139 students were tested for HSV-2 with ELISA and surveyed for sexual risk behavior and 89 students were additionally tested for HSV-2 with a point-of-contact (POC test.Prevalence rates were 0.5%, 1.8%, 0.3% and 2.3% for HIV, Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis, respectively. Prevalence of HSV-2 antibodies was 3.4 % as measured by POC test (n=89 and 14.4 % by ELISA (n=139. Specificity of the POC test compared with ELISA was 100%, and the sensitivity only 23.1%. Associations between self-reported sexual behavior and HSV-2 serostatus could not be shown.Associations between self-reported sexual risk behavior and HSV-2 serostatus could not be shown, probably due to social bias in interviews since its transmission is clearly linked. HSV-2 antibody testing is feasible in resource-poor settings and shows higher prevalence rates than other sexually transmitted diseases thus representing a potential biomarker for evaluation of HIV prevention interventions.

  20. Safety, pharmacokinetics, and antiretroviral activity of multiple doses of ibalizumab (formerly TNX-355), an anti-CD4 monoclonal antibody, in human immunodeficiency virus type 1-infected adults.

    Science.gov (United States)

    Jacobson, Jeffrey M; Kuritzkes, Daniel R; Godofsky, Eliot; DeJesus, Edwin; Larson, Jeffrey A; Weinheimer, Steven P; Lewis, Stanley T

    2009-02-01

    Ibalizumab (formerly TNX-355) is a humanized monoclonal antibody that binds CD4, the primary receptor for human immunodeficiency virus type 1 (HIV-1), and inhibits the viral entry process. A phase lb multidose study of the safety, pharmacokinetics, and antiviral activity of ibalizumab was conducted with 22 HIV-1-infected patients. Nineteen patients were randomized to receive either 10 mg/kg of body weight weekly (arm A) or a 10-mg/kg loading dose followed by 6 mg/kg every 2 weeks (arm B) intravenously for 9 weeks. Three patients were assigned to receive 25 mg/kg every 2 weeks for five doses (arm C). During the study, the patients remained off other antiretrovirals or continued a stable failing regimen. Treatment with ibalizumab resulted in substantial reductions in HIV-1 RNA levels (0.5 to 1.7 log(10)) in 20 of 22 subjects. In most patients, HIV-1 RNA fell to nadir levels after 1 to 2 weeks of treatment and then returned to baseline despite continued treatment. Baseline viral isolates were susceptible to ibalizumab in vitro, regardless of coreceptor tropism. Emerging resistance to ibalizumab was manifested by reduced maximal percent inhibition in a single-cycle HIV infectivity assay. Resistant isolates remained CD4 dependent and were susceptible to enfuvirtide in vitro. Complete coating of CD4(+) T-cell receptors was correlated with serum ibalizumab concentrations. There was no evidence of CD4(+) T-cell depletion in ibalizumab-treated patients. Ibalizumab was not immunogenic, and no serious drug-related adverse effects occurred. In conclusion, ibalizumab administered either weekly or biweekly was safe and well tolerated and demonstrated antiviral activity. Further studies with ibalizumab in combination with standard antiretroviral treatments are warranted.

  1. Impact of Chronic Periodontitis on Levels of Glucoregulatory Biomarkers in Gingival Crevicular Fluid of Adults with and without Type 2 Diabetes.

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    Hasaan G Mohamed

    Full Text Available The relationship between diabetes and periodontal disease is bidirectional, but information about the effect of chronic periodontitis on the levels of the glucoregulatory biomarkers locally in gingival crevicular fluid (GCF is limited. The aim of this study was to compare the levels of 10 glucoregulatory biomarkers in GCF, firstly in subjects with type 2 diabetes (T2DM presenting with and without chronic periodontitis and secondly, in subjects without diabetes, with and without chronic periodontitis. The material comprised a total of 152 subjects, stratified as: 54 with T2DM and chronic periodontitis (G1, 24 with T2DM (G2, 30 with chronic periodontitis (G3 and 44 without T2DM or periodontitis (G4. The levels of the biomarkers were measured using multiplex biometric immunoassays. Periodontal pocket depths were recorded in mm. Subsets G1 and G2 and subsets G3 and G4 were compared independently. Among T2DM subjects, GIP, GLP-1 and glucagon were significantly up-regulated in G1 compared to G2. Moreover, there were no statistical differences between the two groups regarding C-peptide, insulin, ghrelin, leptin and PAI-1. Comparisons among individuals without T2DM revealed significantly lower amounts of C-peptide and ghrelin in G3 than in G4. The number of sites with pocket depth ≥ 4mm correlated negatively with C-peptide (Spearman's correlation co-efficient: -0.240, P < 0.01 and positively with GIP and visfatin (Spearman's correlation co-efficient: 0.255 and 0.241, respectively, P < 0.01. The results demonstrate that chronic periodontitis adversely influences the GCF levels of glucoregulatory biomarkers, as it is associated with disturbed levels of biomarkers related to the onset of T2DM and its medical complications.

  2. Amount, type, and timing of recreational physical activity in relation to colon and rectal cancer in older adults: the Cancer Prevention Study II Nutrition Cohort.

    Science.gov (United States)

    Chao, Ann; Connell, Cari J; Jacobs, Eric J; McCullough, Marjorie L; Patel, Alpa V; Calle, Eugenia E; Cokkinides, Vilma E; Thun, Michael J

    2004-12-01

    Physical activity has consistently been associated with lower risk of colon cancer, but information is limited on the amount, type, and timing of activities. The relationship between physical activity and rectal cancer is unclear. We examined characteristics of recreational physical activity in relation to colon and rectal cancer in the Cancer Prevention Study II Nutrition Cohort of 70,403 men and 80,771 women (median age, 63 years); 940 colon and 390 rectal cancers were identified from enrollment in 1992 to 1993 through August 1999. The multivariate-adjusted rate ratios (95% confidence intervals) associated with any recreational physical activity compared with none were 0.87 (0.71-1.06) for colon cancer and 0.70 (0.53-0.93) for rectal cancer. Colon cancer risk decreased significantly with increasing total hours (P for trend without reference group = 0.007) and metabolic equivalent hours (P for trend = 0.006) per week of activities. No clear decrease in rectal cancer risk was seen with increasing hours per week of physical activity. Rate ratios (95% confidence intervals) were 0.72 (0.52-0.98) for /=7 hours per week of physical activity compared with none. Past exercise, as reported in 1982, was not associated with risk of either colon or rectal cancer. We conclude that increasing amounts of time spent at recreational physical activity are associated with substantially lower risk of colon cancer and that recreational physical activity is associated with lower risk of rectal cancer in older men and women.

  3. Heterogeneous responses of personalised high intensity interval training on type 2 diabetes mellitus and cardiovascular disease risk in young healthy adults.

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    Higgins, Timothy P; Baker, Matthew D; Evans, Shelley-Ann; Adams, Rachel A; Cobbold, Christian

    2015-01-01

    Hypertension, decreased glucose tolerance, adverse lipid profiles and low physical activity levels are associated with increased type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) risk. High intensity interval training (HIIT), a low volume, reduced time, high intensity programme, may be a useful alternative to current government guidelines which specify a minimum of 150 minutes of physical activity per week. We describe a personalised programme of high intensity exercise which provides significant improvements in CVD risk markers. Healthy volunteers undertook 6 weeks of HIIT. T2DM and CVD risk predictors including glucose tolerance, VO2max, blood pressure (BP), and lipids were measured before and after HIIT. HIIT training was associated with beneficial changes in a range of predictors of blood flow and cardiovascular risk. There was a heterogeneous response to HIIT, with some subjects responding with favourable changes and others being non-responders to HIIT. In responders, HIIT was associated with a statistically significant (p = 0.023) increase in VO2max, from 45.4 (38.4,52.5) to 56.9 (51.2,65.7) (median (interquartile range)(ml/min/kg)). In responders HIIT resulted in a decrease in systolic BP from 127 (126,129) to 116 (106,122) (mmHg) with p = 0.026 and a decrease is diastolic blood pressure from 72 (69,74) to 57 (56,66) with p = 0.026. There was also some evidence of a beneficial change in blood lipid and glucose concentrations with HIIT. In conclusion, personalised HIIT has potential as an intervention to improve blood flow and cardiovascular health.

  4. Impact of Chronic Periodontitis on Levels of Glucoregulatory Biomarkers in Gingival Crevicular Fluid of Adults with and without Type 2 Diabetes.

    Science.gov (United States)

    Mohamed, Hasaan G; Idris, Shaza B; Mustafa, Manal; Ahmed, Mutaz F; Åstrøm, Anne N; Mustafa, Kamal; Ibrahim, Salah O

    2015-01-01

    The relationship between diabetes and periodontal disease is bidirectional, but information about the effect of chronic periodontitis on the levels of the glucoregulatory biomarkers locally in gingival crevicular fluid (GCF) is limited. The aim of this study was to compare the levels of 10 glucoregulatory biomarkers in GCF, firstly in subjects with type 2 diabetes (T2DM) presenting with and without chronic periodontitis and secondly, in subjects without diabetes, with and without chronic periodontitis. The material comprised a total of 152 subjects, stratified as: 54 with T2DM and chronic periodontitis (G1), 24 with T2DM (G2), 30 with chronic periodontitis (G3) and 44 without T2DM or periodontitis (G4). The levels of the biomarkers were measured using multiplex biometric immunoassays. Periodontal pocket depths were recorded in mm. Subsets G1 and G2 and subsets G3 and G4 were compared independently. Among T2DM subjects, GIP, GLP-1 and glucagon were significantly up-regulated in G1 compared to G2. Moreover, there were no statistical differences between the two groups regarding C-peptide, insulin, ghrelin, leptin and PAI-1. Comparisons among individuals without T2DM revealed significantly lower amounts of C-peptide and ghrelin in G3 than in G4. The number of sites with pocket depth ≥ 4mm correlated negatively with C-peptide (Spearman's correlation co-efficient: -0.240, P chronic periodontitis adversely influences the GCF levels of glucoregulatory biomarkers, as it is associated with disturbed levels of biomarkers related to the onset of T2DM and its medical complications.

  5. Association of diabetes-related distress, depression, medication adherence, and health-related quality of life with glycated hemoglobin, blood pressure, and lipids in adult patients with type 2 diabetes: a cross-sectional study.

    Science.gov (United States)

    Chew, Boon-How; Sherina, Mohd-Sidik; Hassan, Noor-Hasliza

    2015-01-01

    This study examined the associations of diabetes-related distress (DRD), depressive symptoms, health-related quality of life (HRQoL), and medication adherence with glycemia, blood pressure (BP), and lipid biomarkers in adults with type 2 diabetes mellitus (T2D). This cross-sectional study was conducted in three Malaysian public health clinics in 2012-2013, recruited adult patients (aged ≥30 years) with T2D who had been diagnosed for more than one year, were on active follow-up, and had recent blood test results. Univariable and multivariable analyses were performed to identify significant associated factors for glycated hemoglobin (HbA1c) BP, and lipids. The response rate was 93.1% (700/752). The majority were females (52.8%), Malay (52.4%), and married (78.7%). DRD correlated with systolic BP (r= -0.16); depressive symptoms correlated with low-density lipoprotein cholesterol (r=0.12) and total cholesterol (r=0.13); medication adherence correlated with HbA1c (r= -0.14) and low-density lipoprotein cholesterol (r= -0.11); and HRQoL correlated with casual blood glucose (r= -0.11), high-density lipoprotein cholesterol (r= -0.13), and total cholesterol (r= -0.08). Multivariable analyses showed that HRQoL was significantly associated with casual blood glucose (adjusted B= -0.06, P=0.024); DRD was associated with systolic BP (adjusted B= -0.08, P=0.066); depressive symptoms were associated with low-density lipoprotein cholesterol (adjusted B=0.02, P=0.061), and medication adherence was associated with HbA1c (adjusted B= -0.11, P=0.082) and total cholesterol (adjusted B= -0.06, P=0.086). There were significant and distinctive associations of DRD, depressive symptoms, HRQoL, and medication adherence with glycemia, BP, and lipid biomarkers. Unexpected beneficial therapeutic effects of DRD on BP require further study. A multidisciplinary approach may be needed for risk management in adults with T2D at the primary care level.

  6. Interpretations of Child Behavior by Older Adults.

    Science.gov (United States)

    Forrest, Constance R.; Docherty, Edward M., Jr.

    This study examined sex-role typing in older adults' interpretations of young children's behavior. Participants were 48 older adults averaging 64.7 years of age. Videotapes were made of the play behavior of each of two toddlers, a female and a male matched in body type, hair length, dress (plain tee shirt and shorts), and in the activities in…

  7. Effects of Low-Fat Diets Differing in Protein and Carbohydrate Content on Cardiometabolic Risk Factors during Weight Loss and Weight Maintenance in Obese Adults with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Nerylee Watson

    2016-05-01

    Full Text Available Despite evidence for the benefits of higher-protein (HP diets in weight loss, their role in type 2 diabetes mellitus (T2DM management and weight maintenance is not clear. This randomised study compared the effects of a HP diet (38% carbohydrate, 30% protein, 29% fat to a isocaloric higher-carbohydrate diet (HC: 53%:21%:23% on cardiometabolic risk factors for 12 weeks in energy restriction (~30% reduction followed by 12 weeks of energy balance whilst performing regular exercise. Outcomes were measured at baseline and the end of each phase. Sixty-one overweight/obese adults (BMI (body mass index 34.3 ± 5.1 kg/m2, aged 55 ± 8 years with T2DM who commenced the study were included in the intention-to-treat analysis including the 17 participants (HP n = 9, HC n = 8 who withdrew. Following weight loss (M ± SEM: −7.8 ± 0.6 kg, there were significant reductions in HbA1c (−1.4% ± 0.1%, p < 0.001 and several cardiometabolic health risk factors. Improvements were sustained for 12 weeks when weight was stabilised and weight loss maintained. Both the HP and HC dietary patterns with concurrent exercise may be effective strategies for weight loss and weight maintenance in T2DM although further studies are needed to determine the longer term effects of weight maintenance.

  8. Healthy eating and active living for diabetes in primary care networks (HEALD-PCN: rationale, design, and evaluation of a pragmatic controlled trial for adults with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Johnson Steven T

    2012-06-01

    Full Text Available Abstract Background While strong and consistent evidence supports the role of lifestyle modification in the prevention and management of type 2 diabetes (T2DM, the best strategies for program implementation to support lifestyle modification within primary care remain to be determined. The objective of the study is to evaluate the implementation of an evidence-based self- management program for patients with T2DM within a newly established primary care network (PCN environment. Method Using a non-randomized design, participants (total N = 110 per group will be consecutively allocated in bi-monthly blocks to either a 6-month self-management program lead by an Exercise Specialist or to usual care. Our primary outcome is self-reported physical activity and pedometer steps. Discussion The present study will assess whether a diabetes self-management program lead by an Exercise Specialist provided within a newly emerging model of primary care and linked to available community-based resources, can lead to positive changes in self-management behaviours for adults with T2DM. Ultimately, our work will serve as a platform upon which an emerging model of primary care can incorporate effective and efficient chronic disease management practices that are sustainable through partnerships with local community partners. Clinical Trials Registration ClinicalTrials.gov identifier: NCT00991380

  9. Clinical and genetic features of X-linked Alport syndrome in men positive for the collagen Ⅳ a5 chain in epidermal basement membrane%皮肤基底膜Ⅳ型胶原α5链染色正常的男性X连锁Alport综合征基因型和表型分析

    Institute of Scientific and Technical Information of China (English)

    张琰琴; 丁洁; 王芳; 张宏文; 肖慧捷; 姚勇; 钟旭辉; 管娜; 刘晓宇

    2016-01-01

    目的 分析皮肤基底膜Ⅳ型胶原α5[α5(Ⅳ)]链染色正常的男性x连锁Alport综合征(XLAS)的基因突变和临床特点.方法 回顾性分析1998年1月至2014年12月北京大学第一医院儿科诊断为Alport综合征的725个家系,其中男性XLAS患者450例,通过入选标准:(1)有皮肤基底膜Ⅳ型胶原α5链染色检查,(2)存在COI4A5基因突变,筛选出α5(Ⅳ)染色正常及α5(Ⅳ)染色阴性的男性XLAS患者,比较、分析两组基因突变和临床特点的差异.组间比较采用Mann-Whitney检验或x2检验.结果 共140例男性XLAS患者既进行了皮肤基底膜Ⅳ型胶原α5链染色检查又检测到了COI4A5基因突变.其中α5(Ⅳ)染色正常组18例,α5(Ⅳ)染色阴性组122例.两组患者就诊中位数年龄分别为11.0、7.2岁(Z=-1.839,P=0.066),就诊时24h尿蛋白定量中位数分别是1.50、0.57 g/d(Z=-1.212,P=0.226),合并听力减退28%、53%(x2=3.619,P=0.067),进展至终末期肾脏病(ESRD)的分别为4、12例(x2=2.377,P=0.128),ESRD发生的中位数年龄分别是31.0、16.6岁(Z=-2.554,P=0.011),COL4A5基因错义突变分别为12例(67%)、63例(52%)(x2=1.424,P=0.313).结论 皮肤基底膜α5(Ⅳ)染色正常的男性XLAS患者与α5(Ⅳ)染色阴性的男性XLAS患者在尿蛋白定量、听力减退发生率、COL4A5基因型差别不明显,但α5(Ⅳ)染色正常组患者发生ESRD的年龄明显较晚.%Objective To analyze the clinical and genetic features of X-linked Alport syndrome (XLAS) in men positive for the collagen α5 (Ⅳ) chain in epidermal basement membrane.Method This was