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Sample records for aggrecan type results

  1. A missense mutation in the aggrecan C-type lectin domain disrupts extracellular matrix interactions and causes dominant familial osteochondritis dissecans

    DEFF Research Database (Denmark)

    Stattin, Eva-Lena; Wiklund, Fredrik; Lindblom, Karin

    2010-01-01

    proteins in the cartilage extracellular matrix. Binding studies with recombinant mutated and wild-type G3 proteins showed loss of fibulin-1, fibulin-2, and tenascin-R interactions for the V2303M protein. Mass spectrometric analyses of aggrecan purified from patient cartilage verified that V2303M aggrecan...... is produced and present in the tissue. Our results provide a molecular mechanism for the etiology of familial osteochondritis dissecans and show the importance of the aggrecan C-type lectin interactions for cartilage function in vivo....

  2. Limitations of using aggrecan and type X collagen as markers of chondrogenesis in mesenchymal stem cell differentiation.

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    Mwale, Fackson; Stachura, Dorothy; Roughley, Peter; Antoniou, John

    2006-08-01

    The study was initially designed to differentiate human bone marrow-derived mesenchymal stem cells (MSC) into chondrocyte-like cells, for use in tissue engineering. We cultured MSCs in defined chondrogenic medium as pellet cultures supplemented with transforming growth factor (TGF)-beta1 or -beta3 and dexamethazone, as they are commonly used to promote in vitro chondrogenesis. Markers of chondrogenesis used were type II collagen and aggrecan, with type X collagen being used as a marker of late-stage chondrocyte hypertrophy (associated with endochondral ossification). Our results show that aggrecan is constitutively expressed by MSCs and that type X collagen is expressed as an early event. Furthermore, we found that type X collagen was expressed before type II collagen in some cases. This is surprising because it is understood that stem cells have to be differentiated into chondrocytes before they can become hypertrophic. Thus, caution must be exercised when using aggrecan and type X collagen as markers for chondrogenesis and chondrocyte hypertrophy, respectively, in association with stem cell differentiation from this source.

  3. Immunohistochemistry Evaluation of TGF-β1, SOX-9, Type II Collagen and Aggrecan in Cartilage Lesions Treated with Conditioned Medium of Umbilical Cord Mesencyhmal Stem Cells in Wistar Mice (Rattus novergicus

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    Bintang Soetjahjo

    2018-01-01

    Full Text Available Currently, umbilical cord mesenchymal stem cells have the potential to be used as treatment options for any cartilage lesion. This research aimed to evaluate the effects of conditioned medium from umbilical cord mesenchymal stem cells (UC-MSC on damaged cartilage through the expression of proteins TGF-β1, SOX-9, type II collagen and aggrecan, which are known to be related to chondrogenesis. UC-MSC were isolated from 19-days-pregnant Wistar mice and were cultured using the standard procedure to obtain 80% confluence. Subsequently, the culture was confirmed through a microscopic examination that was driven to be an embryoid body to obtain a pre-condition medium. This research utilized 3-month-old male Wistar mice and was categorized into 6 groups (3 control and 3 treatment groups. Each animal had surgery performed to create a femur condyle cartilage defect. The treatment groups were administered a dose of stem cells at 1 mL/kg. Next, immunohistochemical (IHC staining was performed to examine the expression of TGF-β1, SOX-9, type II collagen and aggrecan in the 2nd, 3rd, and 4th month of evaluation. The results were analyzed statistically using ANOVA test. For each of the treatment groups, there was increased expression (p < 0.05 in all proteins TGF-β1, SOX-9, type II collagen and aggrecan when compared with control groups at the 2nd, 3rd, and 4th month of evaluation. Pre-conditioned medium from UC-MSC potentially increases the expression of TGF-β1, SOX-9, type II collagen and aggrecan in the damaged cartilage of Wistar mice.

  4. Aggrecan structure in amphibian cartilage

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    Covizi D.Z.

    2000-01-01

    Full Text Available The structure of the large proteoglycan present in the bullfrog epiphyseal cartilage was studied by immunochemical and biochemical methods. The isolated monomer showed a polydisperse behavior on Sepharose CL2B, with a peak at Kav = 0.14. Chondroitin sulfate chains were identified by HPLC analysis of the products formed by chondroitinase digestion and mercuric acetate treatment. These chains have approximately 38 disaccharides, a Di45:Di68 ratio of 1.6 and GalNAc4S + GalNAc4,6S are the main non-reducing terminals. Keratan sulfate was identified by the use of two monoclonal antibodies in Western blots after chondroitinase ABC treatment. A keratan sulfate-rich region (~110 kDa was isolated by sequential treatment with chondroitinase ABC and proteases. We also employed antibodies in Western blotting experiments and showed that the full length deglycosylated core protein is about 300 kDa after SDS-PAGE. Domain-specific antibodies revealed the presence of immunoreactive sites corresponding to G1/G2 and G3 globular domains and the characterization of this large proteoglycan as aggrecan. The results indicate the high conservation of the aggrecan domain structure in this lower vertebrate.

  5. Bone morphogenetic protein (BMP)-2 enhances the expression of type II collagen and aggrecan in chondrocytes embedded in alginate beads.

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    Gründer, Tatiana; Gaissmaier, Christoph; Fritz, Jürgen; Stoop, Reinout; Hortschansky, Peter; Mollenhauer, Jürgen; Aicher, Wilhelm K

    2004-07-01

    For autologous chondrocyte transplantation (ACT) chondrocytes are expanded in vitro. During expansion these cells may dedifferentiate. This change in phenotype is characterized by a raised expression of type I collagen and a decrease in type II collagen expression. Since high expression of type II collagen is of central importance for the properties of hyaline cartilage, we investigated if the growth factor bone morphogenetic protein-2 (BMP-2) may modulate the chondrogenic phenotype in monolayer cell cultures and in three-dimensional culture systems. Chondrocytes from articular knee cartilage of 11 individuals (average age: 39.8 years) with no history of joint disease were isolated and seeded either in monolayer cultures or embedded in alginate beads in presence or absence of human recombinant BMP-2 (hr-BMP-2). Then, cells were harvested and analysis of the chondrogenic phenotype was performed using quantitative RT-PCR, immunocytochemistry and ELISA. Addition of BMP-2 to chondrocytes expanded in two-dimensional (2D) cultures during the first subculture (P1) had no effect on mRNA amounts encoding type II collagen and interleukin-1beta (IL-1beta). In contrast, seeding chondrocytes in three-dimensional (3D) alginate cultures raised type II collagen expression significantly and addition of BMP-2 enhanced this effect. We conclude that chondrocytes during expansion for ACT may benefit from BMP-2 activation only when seeded in an appropriate 3D culture system. Copyright 2004 OsteoArthritis Research Society International

  6. Extraction of aggrecan-peptide from cartilage by tissue autolysis.

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    Nakano, Takuo; Srichamroen, Anchalee; Ozimek, Lech

    2014-01-01

    Aggrecan is a cartilage specific proteoglycan containing chondroitin sulfate (CS) and keratan sulfate (KS). CS is an acidic polysaccharide having wide range of applications in pharmaceutical, cosmetic, and food industries. CS is extracted from cartilage by tissue proteolysis with an exogenous proteinase or by activating endogenous proteinases (autolysis) to release aggrecan-peptides from the tissue. This review is focused on the latter technique. Bovine nasal and tracheal cartilages, and broiler chicken sternum cartilage have been used for autolysis studies. To extract aggrecan-peptide, cartilage tissues are cut into small pieces, and incubated in a monovalent or divalent salt solution (e.g., 0.1 M sodium or calcium acetate) at pH 4.5 and 37 °C for 7 - 24 h. Most (~80% or more) of total tissue uronic acid, a constituent sugar of aggrecan, is extracted and released into the salt solution during incubation. Reextraction of the tissue residue results in release of a small amount of uronic acid. Aggrecan-peptides purified using anion exchange chromatography are large compounds containing CS and KS. On gel chromatography, they are excluded from the column of Sephacryl S-300. Chemical composition analysis demonstrated that aggrecan-peptides from either bovine or chicken cartilage contain >90% CS with small amount (autolysis has been used as a plate coating antigen in enzyme- linked immunosorbent assay (ELISA) to determine KS.

  7. Probing Aggrecan Interactions with Ions by AFM

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    Chandran, Preethi; Dimitriadis, Emilios; Basser, Peter; Horkay, Ferenc

    2010-03-01

    Aggrecan (MW 2 MDa) is a highly charged bottle-brush shape biological polymer found in the extracellular matrix of tissues. It consists of a protein backbone (400nm long), to which about 100 linear chains of negatively-charged glucosaminoglycans are attached approximately 4 nm apart. The high charge density of the aggrecan bottle-brush allows it to imbibe water, thereby maintaining tissue hydration and permeability, while also binding to cell-signaling molecules. In solution, aggrecan molecules respond differently to varying salt conditions, than other charged biological and synthetic polyelectrolytes like DNA and poly(acrylic acid) (Horkay, 2008). To probe the nature of its interactions with charged surfaces, we looked at the absorption patterns of aggrecan assemblies on controlled surfaces (polylysine, mica) under different ionic conditions, using Atomic Force Microscopy. We propose a simple model of the charge interactions, which relates the surface-adsorption patterns to the solution structures. The study may help understanding how aggrecan loss or degradation with age and joint disease affects tissue microstructure and physical properties.

  8. The different roles of aggrecan interaction domains

    DEFF Research Database (Denmark)

    Aspberg, Anders

    2012-01-01

    glycosaminoglycan chains, that provide the basis for the viscoelastic properties necessary for load distribution over the articular surface. This review is focused on the globular domains of aggrecan and their role in anchoring the proteoglycans to other extracellular matrix components. The N-terminal G1 domain...

  9. TIMP-3 inhibition of ADAMTS-4 (Aggrecanase-1) is modulated by interactions between aggrecan and the C-terminal domain of ADAMTS-4.

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    Wayne, Gareth J; Deng, Su-Jun; Amour, Augustin; Borman, Satty; Matico, Rosalie; Carter, H Luke; Murphy, Gillian

    2007-07-20

    ADAMTS-4 (aggrecanase-1) is a glutamyl endopeptidase capable of generating catabolic fragments of aggrecan analogous to those released from articular cartilage during degenerative joint diseases such as osteoarthritis. Efficient aggrecanase activity requires the presence of sulfated glycosaminoglycans attached to the aggrecan core protein, implying the contribution of substrate recognition/binding site(s) to ADAMTS-4 activity. In this study, we developed a sensitive fluorescence resonance energy transfer peptide assay with a K(m) in the 10 microm range and utilized this assay to demonstrate that inhibition of full-length ADAMTS-4 by full-length TIMP-3 (a physiological inhibitor of metalloproteinases) is enhanced in the presence of aggrecan. Our data indicate that this interaction is mediated largely through the binding of glycosaminoglycans (specifically chondroitin 6-sulfate) of aggrecan to binding sites in the thrombospondin type 1 motif and spacer domains of ADAMTS-4 to form a complex with an improved binding affinity for TIMP-3 over free ADAMTS-4. The results of this study therefore indicate that the cartilage environment can modulate the function of enzyme-inhibitor systems and could have relevance for therapeutic approaches to aggrecanase modulation.

  10. Roles of metalloproteinase-3 and aggrecanase 1 and 2 in aggrecan cleavage during human meniscus degeneration

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    Naoki Ishiguro

    2009-10-01

    Full Text Available The meniscus plays important roles in proper knee function. It was recently reported that meniscus degeneration was associated with progression of osteoarthritis (OA. However, little is known about the effects of degradative enzymes on the meniscus matrix, primarily collagen type I and aggrecan, during OA. This study examined the effects of metalloproteinase (MMP and aggrecanase on the destruction of aggrecan in the human meniscus. Eighteen trimmed meniscus portions were collected during partial menisectomy. Specimens were categorized into 3 groups according to the modified Copenhaver classification based on the degrees of damage to collagen bundles. Histological and immunohistochemical studies were conducted. Sections were stained with antibodies against MMP-3, aggrecanase 1 and 2, and their specific cleavage sites of aggrecan. Their localizations and staining ratios in the inner superficial and outer deep zones of the meniscus were determined separately. The population of chondrocyte-like cells increased with degeneration of the meniscus. MMP-3 and aggrecanase 1 and 2 are primarily expressed and activated in chondrocyte-like cells. MMP-3 expression and activation increased with degeneration and the population of chondrocyte-like cells. Changes in aggrecanase 1 expression with the degeneration were not clearly detected, whereas the expression of aggrecanase 2 was associated with progression of degeneration. MMP-3 and aggrecanases, particularly aggrecanase 2, expressed in chondrocyte-like cells could play important roles in aggrecan degradation in the human meniscus.

  11. The Effect of Soy Isoflavone on the Proliferation and Differentiation of Adipose-Derived Mesenchymal Stem Cells into Chondrocytes and Expression of Collagen II and Aggrecan Genes

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    Fatemeh Bamdadpasand Shekarsarayi

    2017-03-01

    Full Text Available Background and Objectives: Due to the lack of blood vessels in cartilage tissue, its damage is not repairable. This study was conducted to investigate the effect of soy isoflavone on proliferation and differentiation of adipose-derived mesenchymal stem cells into chondrocytes and expression of collagen II and aggrecan genes. Methods: In this experimental study, human subcutaneous fat was obtained during liposuction and incubated with collagenase enzyme (type 1 for the breakdown of collagen, and collagenase was deactivated by DMEM medium, and was cultured in the cell sediment after centrifugation, the cells were isolated after the third passage, were placed in chondrogenic medium for differentiate into the cartilage, and were divided into three groups, including control, treatment with TGF-β1, and treatment with soy isoflavones tablets. The tablets were dissolved in distilled water, sterilized by passing through a 0.2 um filter and were added to the culture medium. After 48 hours, cell viability was determined by MTT assay, and after 14 days, collagen II and aggrecan gene expressions were assessed by real-time PCR technique. Data were statistically analyzed by one-way ANOVA and Tukey's post-hoc test using SPSS 20 and p<0.05. Results: The results of MTT assay showed a significant increase in viability in the TGF-β1 group compared to the control and soy isoflavone groups (p<0.05. The RT-PCR indicated a significant increase in the expression of collagen II and aggrecan genes in isoflavones and TGF-β1 groups compared to the control group, and also, the mean CT associated with collagen II gene had a significant increase in isoflavone and TGF-β1groups compared to the control group (p<0.05. Conclusion: Soy in culture medium increases the expression of collagen II and aggrecan genes and cell proliferation, but this increase is not high compared to the TGF-β1 group.

  12. An ARGS-aggrecan assay for analysis in blood and synovial fluid

    DEFF Research Database (Denmark)

    Larsson, S; Lohmander, Stefan; Struglics, A

    2014-01-01

    ) on the Meso Scale Discovery (MSD) platform for detection of ARGS-aggrecan was validated, using a standard made from recombinant human aggrecan. Matched samples of SF, serum, plasma, and urine were obtained from 36 subjects at different time points after knee injury, and analysed for ARGS-aggrecan content...

  13. Up-regulation of niacinamide in intervertebral disc aggrecan in vitro.

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    Xiong, Xiaoqian; Yang, Shuhua; Shao, Zengwu; Liu, Xin; Zhan, Zirui; Duan, Deyu

    2006-01-01

    The regulatory effects of niacinamide (Nia) on intervertebral disc (IVD) aggrecan in vitro was investigated. Chiba's 10 ng/mL interleukin-1 (IL-1)-induced rabbit IVD degeneration model in vitro was established. 0.5, 0.25 and 0.05 mg/mL Nia was added to normal and degenerated IVDs for intervention. On the first and second week after intervention, safranin O-fast green staining intensity and glycosaminoglycan (GS) content were measured. The expression of aggrecan core protein was detected by RT-PCR. The results showed: (1) After treatment with 0.5 mg/mL Nia for one week, the GS content in nucleus pulposus (NP) was increased by 44.8% as compared with control group (P < 0 01); The GS content in IL-1 induction groups was increased with the increase of Nia concentrations: After treatment with 0.5 mg/mL for one week, the GS content in NP was increased by 68.3% as compared with control group (P < 0.01). After two weeks, GS content in NP and fibrous rings was still higher than in control group at the same period (P < 0.01) and untreated group (P < 0.01). (2) Safranin O-fast green staining revealed that with the increase of Nia concentrations, staining density in NP and fibrous rings was increased and histological structure damage to IVDs by IL-1beta was alleviated. (3) RT-PCR showed that the expression of core protein gene in IL-1beta-induced degenerated IVDS was increased with the increase of Nia concentrations. It was concluded that under conditions in vitro, Nia could up-regulate the expression of aggrecan in IVDs and protect IVDs from IL-1beta-induced degeneration at least partially, which offers a potential choice for IVD degeneration clinical therapy.

  14. Prediction of progression of damage to articular cartilage 2 years after anterior cruciate ligament reconstruction: use of aggrecan and type II collagen biomarkers in a retrospective observational study.

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    Sobue, Yasumori; Kojima, Toshihisa; Kurokouchi, Kazutoshi; Takahashi, Shigeo; Yoshida, Hiroaki; Poole, Robin; Ishiguro, Naoki

    2017-12-06

    We aimed to determine whether synovial fluid (SF) biomarkers can predict the progression of articular cartilage damage as determined by arthroscopic evaluation during and after anterior cruciate ligament (ACL) reconstruction. Arthroscopic assessment of articular cartilage damage was performed twice in 62 patients, first during ACL reconstruction and then approximately 2 years later during implant removal for ligament fixation. SF levels of the collagenase-generated cleavage neoepitope of type II collagen (C2C) and proteoglycan glycosaminoglycans keratan sulfate (KS), chondroitin-4-sulfate (Δdi-C4S), and chondroitin-6-sulfate (Δdi-C6S) were measured at ACL reconstruction. Associations between baseline biomarker levels and subsequent progression of cartilage damage were determined using receiver operating characteristic analysis and multivariable logistic regression analysis. No radiographic changes were observed in any of the patients. Progression of high-grade cartilage damage, observed arthroscopically, was negatively correlated with levels of Δdi-C6S and KS, as well as the ratio of Δdi-C6S to Δdi-C4S (C6S/C4S). Logistic regression analysis revealed significant associations of Δdi-C6S (cut-off: 55.7 nmol/ml, odds ratio (OR) 0.231, 95% confidence interval (CI) 0.061-0.879), KS (cut-off: 10.6 μg/ml, OR 0.114, 95% CI 0.024-0.529), and C6S/C4S ratio (cut-off: 4.6, OR 0.060, 95% CI 0.005-0.737) with the progression of high-grade cartilage damage after adjusting for age, the duration from injury to first surgery, sex, and the number of high-grade lesions (grades III and IV) at baseline. The progression of high-grade cartilage damage was significantly associated with baseline levels of proteoglycan glycosaminoglycan biomarkers; namely, Δdi-C6S, KS, and C6S/C4S ratio.

  15. Heterozygous aggrecan variants are associated with short stature and brachydactyly: Description of 16 probands and a review of the literature.

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    Sentchordi-Montané, Lucía; Aza-Carmona, Miriam; Benito-Sanz, Sara; Barreda-Bonis, Ana C; Sánchez-Garre, Consuelo; Prieto-Matos, Pablo; Ruiz-Ocaña, Pablo; Lechuga-Sancho, Alfonso; Carcavilla-Urquí, Atilano; Mulero-Collantes, Inés; Martos-Moreno, Gabriel A; Del Pozo, Angela; Vallespín, Elena; Offiah, Amaka; Parrón-Pajares, Manuel; Dinis, I; Sousa, Sergio B; Ros-Pérez, Purificación; González-Casado, Isabel; E Heath, Karen

    2018-02-21

    Mutations in the aggrecan gene (ACAN) have been identified in two autosomal dominant skeletal dysplasias, Spondyloepiphyseal dysplasia, Kimberley type (SEDK) and osteochondritis dissecans, as well as in a severe recessive dysplasia, Spondyloepimetaphyseal dysplasia, aggrecan type. Next generation sequencing (NGS) has aided the identification of heterozygous ACAN mutations in individuals with short stature, minor skeletal defects and mild facial dysmorphisms, some of whom have advanced bone age (BA), poor pubertal spurt and early growth cessation as well as precocious osteoarthritis. Clinical and genetic characterization of 16 probands with heterozygous ACAN variants, 14 with short stature and mild skeletal defects (group 1) and two with SEDK (group 2). Subsequently, we reviewed the literature to determine the frequency of the different clinical characteristics in ACAN positive individuals. A total of 16 ACAN variants were located throughout the gene, six pathogenic mutations and 10 variants of unknown significance (VUS). Interestingly, brachydactyly was observed in all probands. Probands from group 1, with a pathogenic mutation tended to be shorter and 60% had an advanced BA compared to 0% in those with a VUS. A higher incidence of coxa valga was observed in individuals with a VUS (37% v 0%). Nevertheless, other features were present at similar frequencies. ACAN should be considered as a candidate gene in patients with short stature and minor skeletal defects, particularly those with brachydactyly, and in patients with spondyloepiphyseal dysplasia. It is also important to note that advanced BA and osteoarticular complications are not obligatory conditions for aggrecanopathies/aggrecan-associated dysplasias. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  16. The Development and Activity-Dependent Expression of Aggrecan in the Cat Visual Cortex

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    Sengpiel, F.; Beaver, C. J.; Crocker-Buque, A.; Kelly, G. M.; Matthews, R. T.; Mitchell, D. E.

    2013-01-01

    The Cat-301 monoclonal antibody identifies aggrecan, a chondroitin sulfate proteoglycan in the cat visual cortex and dorsal lateral geniculate nucleus (dLGN). During development, aggrecan expression increases in the dLGN with a time course that matches the decline in plasticity. Moreover, examination of tissue from selectively visually deprived cats shows that expression is activity dependent, suggesting a role for aggrecan in the termination of the sensitive period. Here, we demonstrate for the first time that the onset of aggrecan expression in area 17 also correlates with the decline in experience-dependent plasticity in visual cortex and that this expression is experience dependent. Dark rearing until 15 weeks of age dramatically reduced the density of aggrecan-positive neurons in the extragranular layers, but not in layer IV. This effect was reversible as dark-reared animals that were subsequently exposed to light showed normal numbers of Cat-301-positive cells. The reduction in aggrecan following certain early deprivation regimens is the first biochemical correlate of the functional changes to the γ-aminobutyric acidergic system that have been reported following early deprivation in cats. PMID:22368089

  17. Suppression of MMP activity in bovine cartilage explants cultures has little if any effect on the release of aggrecanase-derived aggrecan fragments

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    Sondergaard Bodil-Cecilie

    2009-12-01

    Full Text Available Abstract Background Progressive loss of articular cartilage is a central hallmark in many joint disease, however, the relative importance of individual proteolytic pathways leading to cartilage erosion is at present unknown. We therefore investigated the time-dependant release ex vivo of MMP- and aggrecanase-derived fragments of aggrecan and type II collagen into the supernatant of bovine cartilage explants cultures using neo-epitope specific immunoassays, and to associate the release of these fragments with the activity of proteolytic enzymes using inhibitors. Findings Bovine cartilage explants were cultured in the presence or absence of the catabolic cytokines oncostatin M (OSM and tumor necrosis factor alpha (TNFα. In parallel, explants were co-cultured with protease inhibitors such as GM6001, TIMP1, TIMP2 and TIMP3. Fragments released into the supernatant were determined using a range of neo-epitope specific immunoassays; (1 sandwich 342FFGVG-G2 ELISA, (2 competition NITEGE373ELISA (3 sandwich G1-NITEGE373 ELISA (4 competition 374ARGSV ELISA, and (5 sandwich 374ARGSV-G2 ELISA all detecting aggrecan fragments, and (6 sandwich CTX-II ELISA, detecting C-telopeptides of type II collagen. We found that (1 aggrecanase-derived aggrecan fragments are released in the early (day 2-7 and mid phase (day 9-14 into the supernatant from bovine explants cultures stimulated with catabolic cytokines, (2 the release of NITEGE373 neo-epitopes are delayed compared to the corresponding 374ARGSV fragments, (3 the MMP inhibitor GM6001 did not reduce the release of aggrecanase-derived fragment, but induced a further delay in the release of these fragments, and finally (4 the MMP-derived aggrecan and type II collagen fragments were released in the late phase (day 16-21 only. Conclusion Our data support the model, that aggrecanases and MMPs act independently in the processing of the aggrecan molecules, and furthermore that suppression of MMP-activity had little if

  18. The interaction between aggrecan gene VNTR polymorphism and obesity in predicting incident symptomatic lumbar disc herniation.

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    Cong, Lin; Zhu, Yue; Pang, Hao; Guanjun, T U

    2014-01-01

    An association between aggrecan gene variable number of tandem repeats polymorphism (VNTR) and symptomatic lumbar disc herniation (LDH) has been reported in Chinese Han of Northern China, and obesity had previously been suspected of causing severe LDH. However, the interaction between aggrecan VNTR and obesity in symptomatic LDH has not been well studied. To examine the interaction between aggrecan VNTR and obesity in the susceptibility of symptomatic LDH, 259 participants participated in this study and donated a blood sample. The disease group comprised 61 patients already diagnosed with symptomatic LDH. The control group consisted of 198 healthy blood donors without symptoms of LDH who were not diagnosed with LDH. The aggrecan gene VNTR region was analyzed using polymerase chain reaction. The data indicated that between the two groups, participants carrying one or two alleles ≤25 repeats who were non-obese people showed a 1.057-fold increase in risk for symptomatic LDH (p = 0.895, changing the number of repeat alleles to 25 repeats who were obese people showed an 1.061-fold higher risk (p = 0.885, adding obesity to the mix alone did not demonstrably increase the risk of LDH), while participants carrying one or two alleles ≤25 repeats who were obese people showed a 4.667-fold increase in risk for symptomatic LDH (p = 0.0003, adding obesity plus changing the repeat allele number significantly increased the risk of LDH by 4.667). Overall, the findings suggest an underlying interaction between aggrecan VNTR and obesity in symptomatic LDH.

  19. Hyaluronan-binding region of aggrecan from pig laryngeal cartilage. Amino acid sequence, analysis of N-linked oligosaccharides and location of the keratan sulphate.

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    Barry, F P; Gaw, J U; Young, C N; Neame, P J

    1992-09-15

    The hyaluronan-binding region (HABR) was prepared from pig laryngeal cartilage aggrecan and the amino acid sequence was determined. The HABR had two N-termini: one N-terminal sequence was Val-Glu-Val-Ser-Glu-Pro (367 amino acids in total), and a second N-terminal sequence (Ala-Ile-Ser-Val-Glu-Val; 370 amino acids in total) was found to arise due to alternate cleavage by the signal peptidase. The N-linked oligosaccharides were analysed by examining their reactivity with a series of lectins. It was found that the N-linked oligosaccharide on loop A was of the mannose type, while that on loop B was of the complex type. No reactivity was detected between the N-linked oligosaccharide on loop B' and any of the lectins. The location of keratan sulphate (KS) in the HABR was determined by Edman degradation of the immobilized KS-containing peptide. The released amino acid derivatives were collected and tested for the presence of epitope to antibody 5-D-4. On the basis of 5-D-4 reactivity and sequencing yields, the KS chains are attached to threonine residues 352 and 357. There is no KS at threonine-355. This site is not in fact in G1, but about 16 amino acid residues into the interglobular domain. Comparison of the structure of the KS chain from the HABR and from the KS domain of pig laryngeal cartilage aggrecan was made by separation on polyacrylamide gels of the oligosaccharides arising from digestion with keratanase. Comparison of the oligosaccharide maps suggests that the KS chains from both parts of the aggrecan molecule have the same structure.

  20. Effect of polystyrene and polyether imide cell culture inserts with different roughness on chondrocyte metabolic activity and gene expression profiles of aggrecan and collagen.

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    König, Josephine; Kohl, Benjamin; Kratz, Karl; Jung, Friedrich; Lendlein, Andreas; Ertel, Wolfgang; Schulze-Tanzil, Gundula

    2013-01-01

    In vitro cultured autologous chondrocytes can be used for implantation to support cartilage repair. For this purpose, a very small number of autologous cells harvested from a biopsy have to be expanded in monolayer culture. Commercially available polymer surfaces lead to chondrocyte dedifferentiation. Hence, the demanding need for optimized polymers and surface topologies supporting chondrocytes' differentiated phenotypes in vitro arises. In this study we explored the effect of tailored cell culture plate inserts prepared from polystyrene (PS) and polyether imide (PEI) exhibiting three different roughness levels (R0, RI, RII) on chondrocyte morphology, metabolism and gene expression profile. As a control, commercially available tissue culture plastic (TCP) dishes were included. Primary porcine articular chondrocytes were seeded on tailored PS and PEI inserts with three different roughness levels. The metabolic activity of the chondrocytes was determined after 24 hours using alamar blue assay. Chondrocyte gene expression profiles (aggrecan, type I and type II collagen) were monitored after 48 hours using Real Time Detection (RTD)-PCR. Chondrocytes cultured on PS and PEI surfaces formed cell clusters after 24 and 48 hours, which was not observed on TCP. The metabolic activity of chondrocytes cultured on PS was lower than of chondrocytes cultured on PEI, but also lower than on TCP. Gene expression analyses revealed an elevated expression of cartilage-specific aggrecan and an impaired expression of both collagen types by chondrocytes on PS and PEI compared with TCP. In summary, PEI is a biocompatible biomaterial suitable for chondrocyte culturing, which can be further chemically functionalized for generating specific surface interactions or covalent binding of biomolecules.

  1. Suppression of MMP activity in bovine cartilage explants cultures has little if any effect on the release of aggrecanase-derived aggrecan fragments

    DEFF Research Database (Denmark)

    Wang, Bijue; Chen, Pingping; Jensen, Anne-Christine Bay

    2009-01-01

    BACKGROUND: Progressive loss of articular cartilage is a central hallmark in many joint disease, however, the relative importance of individual proteolytic pathways leading to cartilage erosion is at present unknown. We therefore investigated the time-dependant release ex vivo of MMP- and aggreca......BACKGROUND: Progressive loss of articular cartilage is a central hallmark in many joint disease, however, the relative importance of individual proteolytic pathways leading to cartilage erosion is at present unknown. We therefore investigated the time-dependant release ex vivo of MMP...... cultured in the presence or absence of the catabolic cytokines oncostatin M (OSM) and tumor necrosis factor alpha (TNFalpha). In parallel, explants were co-cultured with protease inhibitors such as GM6001, TIMP1, TIMP2 and TIMP3. Fragments released into the supernatant were determined using a range of neo......-epitope specific immunoassays; (1) sandwich (342)FFGVG-G2 ELISA, (2) competition NITEGE(373)ELISA (3) sandwich G1-NITEGE(373 )ELISA (4) competition (374)ARGSV ELISA, and (5) sandwich (374)ARGSV-G2 ELISA all detecting aggrecan fragments, and (6) sandwich CTX-II ELISA, detecting C-telopeptides of type II collagen...

  2. Enriched housing enhances recovery of limb placement ability and reduces aggrecan-containing perineuronal nets in the rat somatosensory cortex after experimental stroke.

    Directory of Open Access Journals (Sweden)

    Alexandre Madinier

    Full Text Available Stroke causes life long disabilities where few therapeutic options are available. Using electrical and magnetic stimulation of the brain and physical rehabilitation, recovery of brain function can be enhanced even late after stroke. Animal models support this notion, and housing rodents in an enriched environment (EE several days after experimental stroke stimulates lost brain function by multisensory mechanisms. We studied the dynamics of functional recovery of rats with a lesion to the fore and hind limb motor areas induced by photothrombosis (PT, and with subsequent housing in either standard (STD or EE. In this model, skilled motor function is not significantly enhanced by enriched housing, while the speed of recovery of sensori-motor function substantially improves over the 9-week study period. In particular, this stroke lesion completely obliterates the fore and hind limb placing ability when visual and whisker guidance is prevented, a deficit that persists for up to 9 weeks of recovery, but that is markedly restored within 2 weeks by enriched housing. Enriched housing after stroke also leads to a significant loss of perineuronal net (PNN immunoreactivity; detection of aggrecan protein backbone with AB1031 antibody was decreased by 13-22%, and labelling of a glycan moiety of aggrecan with Cat-315 antibody was reduced by 25-30% in the peri-infarct area and in the somatosensory cortex, respectively. The majority of these cells are parvalbumin/GABA inhibitory interneurons that are important in sensori-information processing. We conclude that damage to the fore and hind limb motor areas provides a model of loss of limb placing response without visual guidance, a deficit also seen in more than 50% of stroke patients. This loss is amenable to recovery induced by multiple sensory stimulation and correlates with a decrease in aggrecan-containing PNNs around inhibitory interneurons. Modulating the PNN structure after ischemic damage may provide new

  3. Hyaluronan-binding region of aggrecan from pig laryngeal cartilage. Amino acid sequence, analysis of N-linked oligosaccharides and location of the keratan sulphate.

    OpenAIRE

    Barry, F P; Gaw, J U; Young, C N; Neame, P J

    1992-01-01

    The hyaluronan-binding region (HABR) was prepared from pig laryngeal cartilage aggrecan and the amino acid sequence was determined. The HABR had two N-termini: one N-terminal sequence was Val-Glu-Val-Ser-Glu-Pro (367 amino acids in total), and a second N-terminal sequence (Ala-Ile-Ser-Val-Glu-Val; 370 amino acids in total) was found to arise due to alternate cleavage by the signal peptidase. The N-linked oligosaccharides were analysed by examining their reactivity with a series of lectins. It...

  4. Predicted continuum spectra of type II supernovae - LTE results

    Science.gov (United States)

    Shaviv, G.; Wehrse, R.; Wagoner, R. V.

    1985-01-01

    The continuum spectral energy distribution of the flux emerging from type II supernovae is calculated from quasi-static radiative transfer through a power-law density gradient, assuming radiative equilibrium and LTE. It is found that the Balmer jump disappears at high effective temperatures and low densities, while the spectrum resembles that of a dilute blackbody but is flatter with a sharper cutoff at the short-wavelength end. A significant UV excess is found in all models calculated. The calculation should be considered exploratory because of significant effects which are anticipated to arise from departure from LTE.

  5. Circulating levels of interleukin-6, vascular endothelial growth factor, YKL-40, matrix metalloproteinase-3, and total aggrecan in spondyloarthritis patients during 3 years of treatment with TNFα inhibitors

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Hetland, Merete Lund; Sørensen, Inge Juul

    2010-01-01

    The objectives of the study were to investigate short and long-term changes and relations to treatment response of plasma interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), YKL-40, matrix metalloproteinase-3 (MMP-3), and total aggrecan in patients with spondyloarthritis (SpA) treated...... changes of plasma IL-6, VEGF, YKL-40, MMP-3, and total aggrecan and a potential value for monitoring disease activity and treatment response in SpA patients. Larger prospective studies are required to clarify clinical utility of these biomarkers....

  6. Effect of nitrogen-rich cell culture surfaces on type X collagen expression by bovine growth plate chondrocytes

    Directory of Open Access Journals (Sweden)

    Wertheimer Michael R

    2011-01-01

    Full Text Available Abstract Background Recent evidence indicates that osteoarthritis (OA may be a systemic disease since mesenchymal stem cells (MSCs from OA patients express type X collagen, a marker of late stage chondrocyte hypertrophy (associated with endochondral ossification. We recently showed that the expression of type X collagen was suppressed when MSCs from OA patients were cultured on nitrogen (N-rich plasma polymer layers, which we call "PPE:N" (N-doped plasma-polymerized ethylene, containing up to 36 atomic percentage (at.% of N. Methods In the present study, we examined the expression of type X collagen in fetal bovine growth plate chondrocytes (containing hypertrophic chondrocytes cultured on PPE:N. We also studied the effect of PPE:N on the expression of matrix molecules such as type II collagen and aggrecan, as well as on proteases (matrix metalloproteinase-13 (MMP-13 and molecules implicated in cell division (cyclin B2. Two other culture surfaces, "hydrophilic" polystyrene (PS, regular culture dishes and nitrogen-containing cation polystyrene (Primaria®, were also investigated for comparison. Results Results showed that type X collagen mRNA levels were suppressed when cultured for 4 days on PPE:N, suggesting that type X collagen is regulated similarly in hypertrophic chondrocytes and in human MSCs from OA patients. However, the levels of type X collagen mRNA almost returned to control value after 20 days in culture on these surfaces. Culture on the various surfaces had no significant effects on type II collagen, aggrecan, MMP-13, and cyclin B2 mRNA levels. Conclusion Hypertrophy is diminished by culturing growth plate chondrocytes on nitrogen-rich surfaces, a mechanism that is beneficial for MSC chondrogenesis. Furthermore, one major advantage of such "intelligent surfaces" over recombinant growth factors for tissue engineering and cartilage repair is potentially large cost-saving.

  7. [Idiopathic type 1 diabetes: a heterogenous disease or result of our ignorance?].

    Science.gov (United States)

    Wegner, Olga; Młynarski, Wojciech; Bodalski, Jerzy

    2008-01-01

    Based on etiology a new classification for diabetes mellitus was proposed by the Experts of WHO in 1999. According to the classification, type 1 diabetes was subclassified as type 1A (autoimmune) and type 1B (idiopathic). Both forms result from the destruction of beta cells, however in type 1A the process is immune-mediated but in type 1B the origin of the beta cells impairment is still unknown. Moreover, subtype B is considered to be very heterogeneous and the diagnostic criteria are still not clear. The purpose of this article was to review studies on the pathogenesis of idiopathic type 1 diabetes.

  8. Formalizing and proving a typing result for security protocols in Isabelle/HOL

    DEFF Research Database (Denmark)

    Hess, Andreas Viktor; Modersheim, Sebastian

    2017-01-01

    or the positive output of a verification tool. However several of these works have used a typed model, where the intruder is restricted to "well-typed" attacks. There also have been several works that show that this is actually not a restriction for a large class of protocols, but all these results so far...... are again pen-and-paper proofs. In this work we present a formalization of such a typing result in Isabelle/HOL. We formalize a constraint-based approach that is used in the proof argument of such typing results, and prove its soundness, completeness and termination. We then formalize and prove the typing...... result itself in Isabelle. Finally, to illustrate the real-world feasibility, we prove that the standard Transport Layer Security (TLS) handshake satisfies the main condition of the typing result....

  9. Some Results for Integral Inclusions of Volterra Type in Banach Spaces

    Directory of Open Access Journals (Sweden)

    Nieto JJ

    2010-01-01

    Full Text Available We first present several existence results and compactness of solutions set for the following Volterra type integral inclusions of the form: , where , is the infinitesimal generator of an integral resolvent family on a separable Banach space , and is a set-valued map. Then the Filippov's theorem and a Filippov-Ważewski result are proved.

  10. Integration of molecular typing results into tuberculosis surveillance in Germany—A pilot study

    Science.gov (United States)

    Fiebig, Lena; Priwitzer, Martin; Richter, Elvira; Rüsch-Gerdes, Sabine; Haas, Walter; Niemann, Stefan; Brodhun, Bonita

    2017-01-01

    An integrated molecular surveillance for tuberculosis (TB) improves the understanding of ongoing TB transmission by combining molecular typing and epidemiological data. However, the implementation of an integrated molecular surveillance for TB is complex and requires thoughtful consideration of feasibility, demand, public health benefits and legal issues. We aimed to pilot the integration of molecular typing results between 2008 and 2010 in the German Federal State of Baden-Württemberg (population 10.88 Million) as preparation for a nationwide implementation. Culture positive TB cases were typed by IS6110 DNA fingerprinting and results were integrated into routine notification data. Demographic and clinical characteristics of cases and clusters were described and new epidemiological links detected after integrating typing data were calculated. Furthermore, a cross-sectional survey was performed among local public health offices to evaluate their perception and experiences. Overall, typing results were available for 83% of notified culture positive TB cases, out of which 25% were clustered. Age molecular typing information allowed the identification of previously unknown epidemiological links in 11% of the clusters. In 59% of the clusters it was not possible to identify any epidemiological link. Clusters extending over different counties were less likely to have epidemiological links identified among their cases (OR = 11.53, 95% CI: 3.48–98.23). The majority of local public health offices found molecular typing useful for their work. Our study illustrates the feasibility of integrating typing data into the German TB notification system and depicts its added public health value as complementary strategy in TB surveillance, especially to uncover transmission events among geographically separated TB patients. It also emphasizes that special efforts are required to strengthen the communication between local public health offices in different counties to enhance TB

  11. Integration of molecular typing results into tuberculosis surveillance in Germany-A pilot study.

    Science.gov (United States)

    Andrés, Marta; Göhring-Zwacka, Elke; Fiebig, Lena; Priwitzer, Martin; Richter, Elvira; Rüsch-Gerdes, Sabine; Haas, Walter; Niemann, Stefan; Brodhun, Bonita

    2017-01-01

    An integrated molecular surveillance for tuberculosis (TB) improves the understanding of ongoing TB transmission by combining molecular typing and epidemiological data. However, the implementation of an integrated molecular surveillance for TB is complex and requires thoughtful consideration of feasibility, demand, public health benefits and legal issues. We aimed to pilot the integration of molecular typing results between 2008 and 2010 in the German Federal State of Baden-Württemberg (population 10.88 Million) as preparation for a nationwide implementation. Culture positive TB cases were typed by IS6110 DNA fingerprinting and results were integrated into routine notification data. Demographic and clinical characteristics of cases and clusters were described and new epidemiological links detected after integrating typing data were calculated. Furthermore, a cross-sectional survey was performed among local public health offices to evaluate their perception and experiences. Overall, typing results were available for 83% of notified culture positive TB cases, out of which 25% were clustered. Age molecular typing information allowed the identification of previously unknown epidemiological links in 11% of the clusters. In 59% of the clusters it was not possible to identify any epidemiological link. Clusters extending over different counties were less likely to have epidemiological links identified among their cases (OR = 11.53, 95% CI: 3.48-98.23). The majority of local public health offices found molecular typing useful for their work. Our study illustrates the feasibility of integrating typing data into the German TB notification system and depicts its added public health value as complementary strategy in TB surveillance, especially to uncover transmission events among geographically separated TB patients. It also emphasizes that special efforts are required to strengthen the communication between local public health offices in different counties to enhance TB

  12. Suicidal ideation reported by adults with Type 1 or Type 2 diabetes : Results from Diabetes MILES-Australia

    NARCIS (Netherlands)

    Handley, T.E.; Ventura, A.D.; Browne, J.L.; Rich, J.; Attia, J.R.; Pouwer, F.; Speight, J.

    2016-01-01

    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

  13. OUTCOME OF RESULTS WITH CONSERVATIVE MANAGEMENT OF ROCKWOOD TYPE III ACROMIOCLAVICULAR DISLOCATION

    Directory of Open Access Journals (Sweden)

    Dinesh Mitra R. P

    2017-07-01

    Full Text Available BACKGROUND The acromioclavicular joint is commonly involved in traumatic injuries that affect the shoulder. Treatment of these injuries has been controversial and continues to evolve. The aim of the study is to evaluate clinical outcome in patients with type III acromioclavicular dislocation managed conservatively. MATERIALS AND METHODS Clinical outcome in 12 patients with type III acromioclavicular dislocation treated conservatively is evaluated 6-8 months after injury. Functional outcome was done using Constant-Murley score and pain was measured using Visual Analogue Score (VAS. RESULTS There is 75% excellent result and 25% good functional outcome as assessed by Constant-Murley score. The average pain as assessed by visual analogue score is 1.7 mm. CONCLUSION Conservative management of type III acromioclavicular dislocation gives excellent/good outcome, but the cosmetic appearance is not improved by conservative treatment.

  14. Existence results for degenerate p(x)-Laplace equations with Leray-Lions type operators

    Science.gov (United States)

    Ho, Ky; Sim, Inbo

    2017-01-01

    We show the various existence results for degenerate $p(x)$-Laplace equations with Leray-Lions type operators. A suitable condition on degeneracy is discussed and proofs are mainly based on direct methods and critical point theories in Calculus of Variations. In particular, we investigate the various situations of the growth rates between principal operators and nonlinearities.

  15. COMPARISON OF THERMOELASTIC RESULTS IN TWO TYPES OF FUNCTIONALLY GRADED BRAKE DISCS

    Directory of Open Access Journals (Sweden)

    Z.N. Ismarrubie

    2012-06-01

    Full Text Available A thermoelastic simulation of functionally graded (FG brake discs is performed using finite element (FE ANSYS. The material properties of two types of FG brake discs are assumed to vary in both radial and thickness directions according to a power law distribution. The brake discs are in contact with one hollow pure pad disc. Dry contact friction is considered as the heat source. The proper thicknesses of pad discs are found to have full-contact status. The behaviour of the thermoelastic results for thickness and radial FG brake discs are compared. The results show that the behaviour of temperature and vertical displacement in these two types of FG brake discs are the same. However, the variations of radial displacement for different grading indices are not the same. The behaviour of other results are quite similar. Thus, it can be concluded that the variation direction of material properties in FG brake discs can affect the results.

  16. Initial results from 3D-DDTC detectors on p-type substrates

    Energy Technology Data Exchange (ETDEWEB)

    Zoboli, A., E-mail: zoboli@disi.unitn.i [Dipartimento di Ingegneria e Scienza dell' Informazione, Universita di Trento, and INFN, Sezione di Padova (Gruppo Collegato di Trento), Via Sommarive, 14, I-38100 Povo di Trento (Italy); Boscardin, M. [Fondazione Bruno Kessler, Centro per i Materiali e i Microsistemi, Via Sommarive, 18, I-38100 Povo di Trento (Italy); Bosisio, L. [Dipartimento di Fisica, Universita di Trieste, and INFN, Sezione di Trieste, Via A. Valerio, 2, I-34127 Trieste (Italy); Dalla Betta, G.-F. [Dipartimento di Ingegneria e Scienza dell' Informazione, Universita di Trento, and INFN, Sezione di Padova (Gruppo Collegato di Trento), Via Sommarive, 14, I-38100 Povo di Trento (Italy); Piemonte, C.; Ronchin, S.; Zorzi, N. [Fondazione Bruno Kessler, Centro per i Materiali e i Microsistemi, Via Sommarive, 18, I-38100 Povo di Trento (Italy)

    2010-01-11

    Owing to their superior radiation hardness compared to planar detectors, 3D detectors are one of the most promising technologies for the LHC upgrade foreseen in 2017. Fondazione Bruno Kessler has developed 3D Double-side Double-Type Column (3D-DDTC) detectors providing a technological simplifications with respect to a standard 3D process while aiming at comparable detector performance. We present selected results from the electrical characterization of 3D-DDTC structures from the second batch made on p-type substrates, supported also by TCAD simulations.

  17. PROactive 07: pioglitazone in the treatment of type 2 diabetes: results of the PROactive study

    Directory of Open Access Journals (Sweden)

    Erl

    2007-09-01

    Full Text Available Erland Erdmann1, John Dormandy2, Robert Wilcox3, Massimo Massi-Benedetti4, Bernard Charbonnel51University of Cologne, Cologne, Germany; 2Department of Clinical Vascular Research, St Georges Hospital, London, UK; 3Department of Cardiovascular Medicine, Queen’s Medical Centre, University Hospital, Nottingham, UK; 4University of Perugia, Medicine and Metabolic Diseases, Perugia, Italy; 5Clinique d’Endocrinologie, Hôtel Dieu, Nantes Cedex 1, FranceAbstract: Patients with type 2 diabetes face an increased risk of macrovascular disease compared to those without. Significant reductions in the risk of major cardiovascular events can be achieved with appropriate drug therapy, although patients with type 2 diabetes remain at increased risk compared with non-diabetics. The thiazolidinedione, pioglitazone, is known to offer multiple, potentially antiatherogenic, effects that may have a beneficial impact on macrovascular outcomes, including long-term improvements in insulin resistance (associated with an increased rate of atherosclerosis and improvement in the atherogenic lipid triad (low HDL-cholesterol, raised triglycerides, and a preponderance of small, dense LDL particles that is observed in patients with type 2 diabetes. The recent PROspective pioglitAzone Clinical Trial In macroVascular Events (PROactive study showed that pioglitazone can reduce the risk of secondary macrovascular events in a high-risk patient population with type 2 diabetes and established macrovascular disease. Here, we summarize the key results from the PROactive study and place them in context with other recent outcome trials in type 2 diabetes.Keywords: pioglitazone, macrovascular disease, type 2 diabetes, secondary prevention

  18. 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

    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

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

    NARCIS (Netherlands)

    Nefs, G.; Donga, E.; van Someren, E.J.W.; Bot, M.; Speight, J.; Pouwer, F.

    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

  20. Performance evaluation of type II and type IIA box beam end terminals--volume I : research results and discussion.

    Science.gov (United States)

    2010-01-20

    Two types of guide rail end terminals were constructed and evaluated according to the American Association of State Highway : Transportation Officials (AASHTOs)Manual for Assessing Safety Hardware (MASH). The guide rail end terminals are used w...

  1. Carbide Type Influence on Tribological Properties of Hard Faced Steel Layer Part II- Experimental Results

    Directory of Open Access Journals (Sweden)

    V. Lazic

    2010-09-01

    Full Text Available In this paper is presented a preceding procedure that should be conducted in order to successfully regenerate damaged forging dies by the hard facing process. After the tool damage types identification, as well as their causes, we have chosen the procedure and the parameters of hard facing that we further corrected by conducting the test hard facings on models. Thus, we were able to relate the experimental results outputs with the repair technology, taking as a criterion the quality of the surface layers wear resistance such as friction coefficient and width of hard faced zone, hardness and its distribution in cross section, then microstructure of characteristic of hard faced zones, etc. This research points out significancy of tribological properties of certain types of carbides and their effects on metal matrix, in which carbides are embedded. Our tribological investigations have shown that the working life of the hard faced tool can be longer than that of the new tool.

  2. GLOBULAR CLUSTER POPULATIONS: FIRST RESULTS FROM S{sup 4}G EARLY-TYPE GALAXIES

    Energy Technology Data Exchange (ETDEWEB)

    Zaritsky, Dennis [Steward Observatory, University of Arizona, 933 North Cherry Avenue, Tucson, AZ 85721 (United States); Aravena, Manuel [Núcleo de Astronomía, Facultad de Ingeniería, Universidad Diego Portales, Avenida Ejército 441, Santiago (Chile); Athanassoula, E.; Bosma, Albert [Aix Marseille Université, CNRS, LAM (Laboratoire d' Astrophysique de Marseille) UMR 7326, F-13388 Marseille (France); Comerón, Sébastien; Laine, Jarkko; Laurikainen, Eija; Salo, Heikki [Astronomy Division, Department of Physics, P.O. Box 3000, FI-90014 University of Oulu (Finland); Elmegreen, Bruce G. [IBM T. J. Watson Research Center, 1101 Kitchawan Road, Yorktown Heights, NY 10598 (United States); Erroz-Ferrer, Santiago; Knapen, Johan H. [Instituto de Astrofísica de Canarias, Vía Lácteas, E-38205 La Laguna (Spain); Gadotti, Dimitri A.; Muñoz-Mateos, Juan Carlos [European Southern Observatory, Casilla 19001, Santiago 19 (Chile); Hinz, Joannah L. [MMT Observatory, P.O. Box 210065, Tucson, AZ 85721 (United States); Ho, Luis C. [Kavli Institute for Astronomy and Astrophysics, Peking University, Beijing 100871 (China); Holwerda, Benne [Leiden Observatory, University of Leiden, Niels Bohrweg 4, NL-2333 Leiden (Netherlands); Sheth, Kartik, E-mail: dennis.zaritsky@gmail.com [National Radio Astronomy Observatory/NAASC, 520 Edgemont Road, Charlottesville, VA 22903 (United States)

    2015-02-01

    Using 3.6 μm images of 97 early-type galaxies, we develop and verify methodology to measure globular cluster populations from the S{sup 4}G survey images. We find that (1) the ratio, T {sub N}, of the number of clusters, N {sub CL}, to parent galaxy stellar mass, M {sub *}, rises weakly with M {sub *} for early-type galaxies with M {sub *} > 10{sup 10} M {sub ☉} when we calculate galaxy masses using a universal stellar initial mass function (IMF) but that the dependence of T {sub N} on M {sub *} is removed entirely once we correct for the recently uncovered systematic variation of IMF with M {sub *}; and (2) for M {sub *} < 10{sup 10} M {sub ☉}, there is no trend between N {sub CL} and M {sub *}, the scatter in T {sub N} is significantly larger (approaching two orders of magnitude), and there is evidence to support a previous, independent suggestion of two families of galaxies. The behavior of N {sub CL} in the lower-mass systems is more difficult to measure because these systems are inherently cluster-poor, but our results may add to previous evidence that large variations in cluster formation and destruction efficiencies are to be found among low-mass galaxies. The average fraction of stellar mass in clusters is ∼0.0014 for M {sub *} > 10{sup 10} M {sub ☉} and can be as large as ∼0.02 for less massive galaxies. These are the first results from the S{sup 4}G sample of galaxies and will be enhanced by the sample of early-type galaxies now being added to S{sup 4}G and complemented by the study of later-type galaxies within S{sup 4}G.

  3. Automatically explaining machine learning prediction results: a demonstration on type 2 diabetes risk prediction.

    Science.gov (United States)

    Luo, Gang

    2016-01-01

    Predictive modeling is a key component of solutions to many healthcare problems. Among all predictive modeling approaches, machine learning methods often achieve the highest prediction accuracy, but suffer from a long-standing open problem precluding their widespread use in healthcare. Most machine learning models give no explanation for their prediction results, whereas interpretability is essential for a predictive model to be adopted in typical healthcare settings. This paper presents the first complete method for automatically explaining results for any machine learning predictive model without degrading accuracy. We did a computer coding implementation of the method. Using the electronic medical record data set from the Practice Fusion diabetes classification competition containing patient records from all 50 states in the United States, we demonstrated the method on predicting type 2 diabetes diagnosis within the next year. For the champion machine learning model of the competition, our method explained prediction results for 87.4 % of patients who were correctly predicted by the model to have type 2 diabetes diagnosis within the next year. Our demonstration showed the feasibility of automatically explaining results for any machine learning predictive model without degrading accuracy.

  4. Laboratory results gained from cold worked type 316Ti under simulated PWR primary environment

    International Nuclear Information System (INIS)

    Devrient, B.; Kilian, R.; Koenig, G.; Widera, M.; Wermelinger, T.

    2015-01-01

    Beginning in 2005, intergranular stress corrosion cracking (IGSCC) of barrel bolts made from cold worked type 316Ti (German Material No. 1.4571 K) was observed in several S/KWU type PWRs. This mechanism was so far less understood for PWR primary conditions. Therefore an extended joint research program was launched by AREVA GmbH and VGB e.V. to clarify the specific conditions which contributed to the observed findings on barrel bolts. In the frame of this research program beneath the evaluation of the operational experience also laboratory tests on the general cracking behavior of cold worked type 316Ti material, which followed the same production line as for barrel bolt manufacturing in the eighties, with different cold work levels covering up to 30 % were performed to determine whether there is a specific susceptibility of cold worked austenitic stainless steel specimens to suffer IGSCC under simulated PWR primary conditions. All these slow strain rate tests on tapered specimens and component specimens came to the results that first, much higher cold work levels than used for the existing barrel bolts are needed for IGSCC initiation. Secondly, additional high active plastic deformation is needed to generate and propagate intergranular cracking. And thirdly, all specimens finally showed ductile fracture at the applied strain rates. (authors)

  5. Evaluation of circulation type classifications: overview of the COST733 - Working Group 3 activities and results

    Science.gov (United States)

    Pasqui, M.; Esteban, P.; Beck, C.; Frei, C.; Huth, R.; Konka, K.; Martin-Vide, J.; Schiemann, R.; Tveito, O. E.

    2010-09-01

    The COST action on "Harmonization and applications of weather type classifications for European regions" (COST733) ends its activities after a 5 years period, in 2010. The Working Group 3, responsible for proposing and applying comparison and evaluation techniques on classifications has developed its work in three main blocks: basic, climatological and subjective evaluation. The aim of basic evaluation WG3 was to perform a quantitative evaluation and subsequent comparison of circulation type classifications (CTCs) by means of the estimation of variability within classes and separability between classes using a set of suitable metrics. Climatological evaluation is based on analyse the ability of a classification to properly stratify the values of a surface climate variable. Different methodologies were applied, based on the use of the Kolmogorov-Smirnov test, the Spearman's rank correlation coefficient or the Brier Skill Score. The main objective of the subjective evaluation was, from the expert knowledge point of view, to detect the good/bad classifications for a certain domain, and their capability to reproduce characteristic patterns of different European regions. The results do not highlight any "top" classification, and show that factors, identified as "boundary conditions", such as computing method, domain size, atmospheric variables used, number of types, among others, may change significantly the quality and applicability of classifications. In this presentation, main conclusions of the WG3 are compiled.

  6. [Deleterious Results of Safety Seeking Behaviours in Panic Disorder: Polydipsia and Diabetes Mellitus Type 2].

    Science.gov (United States)

    Kurt, Emel; Karabaş, Özer; Yorguner, Neşe; Wurz, Axel; Topçuoğlu, Volkan

    2016-01-01

    Panic disorder is an anxiety disorder that involves recurrent panic attacks, which emerge when a harmless stimulus is interpreted as "catastrophic". In an attempt to avoid the panic attack or prevent confrontation, the patient exhibits a dysfunctional attitude and behavior, such as evasion and safety-seeking behavior (SSB). Dysfunctional behavior leads to an increase in the recurrence of panic attacks and affects the patient's life in a negative way. According to the cognitive behavioral therapy model, SSB contributes to the continuation of unrealistic beliefs (e.g. physical experiences) regarding and prevents the patient from grasping new information that may potentially contradict the unrealistic cognitions. In this paper, we present a case with a primary diagnosis of panic disorder. Interestingly, this patient developed diabetes mellitus (DM) type 2 and psychogenic polydipsia (PPD) as a consequence of his SSB. PPD is a common occurrence in patients with psychiatric disorders, especially in schizophrenia. Up to now, no case of a panic disorder with either DM or PPD has been reported in the literature. While it is accepted that major depression poses a risk for DM type 2, panic disorder may also increase this risk. Treatment of the panic disorder with cognitive behavioral therapy (CBT) resulted in improvement of PPD and DM type 2. In conclusion, the role of SSB in medical disorders accompanied by psychiatric disorders should be kept in mind when treating these patients.

  7. Uncertainty analysis for results of thermal hydraulic codes of best-estimate-type

    International Nuclear Information System (INIS)

    Alva N, J.

    2010-01-01

    In this thesis, some fundamental knowledge is presented about uncertainty analysis and about diverse methodologies applied in the study of nuclear power plant transient event analysis, particularly related to thermal hydraulics phenomena. These concepts and methodologies mentioned in this work come from a wide bibliographical research in the nuclear power subject. Methodologies for uncertainty analysis have been developed by quite diverse institutions, and they have been widely used worldwide for application to results from best-estimate-type computer codes in nuclear reactor thermal hydraulics and safety analysis. Also, the main uncertainty sources, types of uncertainties, and aspects related to best estimate modeling and methods are introduced. Once the main bases of uncertainty analysis have been set, and some of the known methodologies have been introduced, it is presented in detail the CSAU methodology, which will be applied in the analyses. The main objective of this thesis is to compare the results of an uncertainty and sensibility analysis by using the Response Surface Technique to the application of W ilks formula, apply through a loss coolant experiment and an event of rise in a BWR. Both techniques are options in the part of uncertainty and sensibility analysis of the CSAU methodology, which was developed for the analysis of transients and accidents at nuclear power plants, and it is the base of most of the methodologies used in licensing of nuclear power plants practically everywhere. Finally, the results of applying both techniques are compared and discussed. (Author)

  8. Remarks on the Liouville type results for the compressible Navier–Stokes equations in RN

    International Nuclear Information System (INIS)

    Chae, Dongho

    2012-01-01

    In this paper, we prove Liouville type result for the stationary solutions to the compressible Navier–Stokes equations (NS) and the compressible Navier–Stokes–Poisson (NSP) equations and in R N , N ≥ 2. Assuming suitable integrability and the uniform boundedness conditions for the solutions we are led to the conclusion that v = 0. In the case of (NS) we deduce that the similar integrability conditions imply v = 0 and ρ = constant on R N . This shows that if we impose the the non-vacuum boundary condition at spatial infinity for (NS), v → 0 and ρ → ρ ∞ > 0, then v = 0, ρ = ρ ∞ are the solutions

  9. Long-term quantitative results of an Isshiki type 4 thyroplasty-a case study.

    Science.gov (United States)

    Gibbins, Nicholas; Bray, Dominic; Harries, Meredydd L

    2011-05-01

    We believe that we have described the first instance of long-term follow-up of a bilateral Isshiki type IV thyroplasty in a 58-year-old woman after bilateral superior laryngeal nerve (SLN) damage. Comparison of voice handicap index-10 (VHI-10) questionnaire and electrolaryngographic measurements pre- and post-thyroplasty (type IV). VHI-10 scores reduced from 25 pre-thyroplasty to seven and five at 6 and 34 months, respectively. Mean, mode, and median dynamic frequency range (DFx-1) scores increased from 118, 125, and 124 Hz preoperatively to 144, 172, and 163 Hz at 6 months and 167, 167, and 169 Hz, at 34 months, respectively (a subjectively higher voice). Range of tones produced while speaking reduced from an 80% range of 2.48 octaves and 90% range of 3.52 octaves to scores of 1.46 and 2.75 octaves for 80% and 90%, respectively at 6 months and 0.82 and 1.73 octaves at 34 months (a more defined voice). Ninety percent spectrum of single tone production increased from 0.17 octaves preoperatively to 0.55 octaves at 6 months and 0.49 octaves at 34 months. Type IV thyroplasty is most commonly performed for the male-to-female transsexual patient. Bilateral SLN palsy can be effectively treated with this approach with good long-term results. Three-year follow-up for bilateral type IV thyroplasty reveals increased pitch, definition, and clarity but decreased range overall. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  10. [Molecular pathogenesis of Waardenburg syndrome type II resulting from SOX10 gene mutation].

    Science.gov (United States)

    Zhang, Hua; Chen, Hongsheng; Feng, Yong; Qian, Minfei; Li, Jiping; Liu, Jun; Zhang, Chun

    2016-08-01

    To explore the molecular mechanism of Waardenburg syndrome type II (WS2) resulting from SOX10 gene mutation E248fs through in vitro experiment. 293T cells were transiently transfected with wild type (WT) SOX10 and mutant type (MT) E248fs plasmids. The regulatory effect of WT/MT SOX10 on the transcriptional activity of MITF gene and influence of E248fs on WT SOX10 function were determined with a luciferase activity assay. The DNA binding capacity of the WT/MT SOX10 with the promoter of the MITF gene was determined with a biotinylated double-stranded oligonucleotide probe containing the SOX10 binding sequence cattgtc to precipitate MITF and E248fs, respectively. The stability of SOX10 and E248fs were also analyzed. As a loss-of-function mutation, the E248fs mutant failed to transactivate the MITF promoter as compared with the WT SOX10 (P<0.01), which also showed a dominant-negative effect on WT SOX10. The WT SOX10 and E248fs mutant were also able to bind specifically to the cattgtc motif in the MITF promoter, whereas E248fs had degraded faster than WT SOX10. Despite the fact that the E248fs has a dominant-negative effect on SOX10, its reduced stability may down-regulate the transcription of MITF and decrease the synthesis of melanin, which may result in haploinsufficiency of SOX10 protein and cause the milder WS2 phenotype.

  11. First results with the yin-yang type electron cyclotron resonance ion source

    International Nuclear Information System (INIS)

    Suominen, P.; Ropponen, T.; Koivisto, H.

    2007-01-01

    Highly charged heavy-ion beams are often produced with Electron Cyclotron Resonance Ion Sources (ECRIS). The so-called conventional minimum-B ECRIS design includes two solenoid magnets and a multipole magnet (usually a hexapole). A minimum-B configuration can also be formed with 'yin-yang' ('baseball') type coils. Such a magnetic field configuration has been extensively tested in magnetic fusion experiments but not for the production of highly charged heavy ions. The application of the afore-mentioned coil structure to the production of multiply charged ion beams was studied. In this paper we present a design of a yin-yang type ion source known as the ARC-ECRIS and some preliminary experimental results. As a result of this work it was found that the ARC-ECRIS plasma is stable and capable of producing multiply charged ions. Many compromises were made in order to keep the costs of the prototype low. As a consequence, significant improvement can be expected in performance if the plasma size is increased and magnetic confinement is improved. At the end of this article an evolution model of the ARC-ECRIS and some future prospects are presented

  12. Transcatheter aortic valve implantation in bicuspid anatomy: procedural results with two different types of valves.

    Science.gov (United States)

    Presbitero, Patrizia; Iannetta, Loredana; Pagnotta, Paolo; Reimers, Bernhard; Rossi, Marco L; Zavalloni Parenti, Dennis; Bianchi, Giovanni; Bedogni, Francesco

    2018-04-01

    It is well known that bicuspid valve stenosis can be treated with transcatheter aortic valve implantation (TAVI) even if specific issues can cause problems: dilatation of ascending aorta, possible aorthopathy, eccentricity of the valve and calcium distribution in leaflets and in commissures. We classified Bicuspid aortic valve (BAV) in type 0 (2 cusps and no raphe), and type 1 (2 cusps and one or more raphes). The aim of the present study was to report the results of two types of valve (CoreValve from 2009 to 2016 and Lotus valve from 2014 to 2017) in a consecutive series of BAV patients treated in 2 Italian centers. A total of 30 patients with BAV underwent TAVI from September 2009 to March 2017. Mean age was 78±8 years, 54.5% were males and 7.4% had peripheral vasculopathy, 6.5% previous stroke or TIA, 15.6% previous PCI and 9.4% previous coronary artery bypass grafting. Ten patients (30.3%) had a type 1; mean aortic valvular gradient was 57.7±17.7 mmHg; aortic valvular area was 0.7±0.2 mm2, left ventricular ejection fraction was 51.4±10.0% and ascending aorta was 41.0±5.6 mm. Among these 30 patients, 16 of them (group 1) undergone CoreValve implantation and 14 (group 2) undergone Lotus valve implantation. Patients in the first group had a higher Logistic Euroscore (P<0.001) and higher AVA (P=0.026) and valve area CT (P=0.003). Device size in group1 was more often bigger than in group 2 (P<0.001) and postdilatation was never used in the last group. Group 1 had a significant more frequent aortic regurgitation ≥2 assessed with angiography (28.6% vs. 0%; P=0.05). A non-statistically significant higher rate of second valve implantation (6.2% vs. 0%; P=1.00) was also observed. New permanent pacemaker implantation (40.0% vs. 35.7%; P=0.812) was equal in both valves. Postprocedural aortic regurgitation is still an issue in BAV undergone TAVI when: 1) the annulus is big; 2) when we are using self-expandable valves; and 3) in type 0 valves. Lotus valve, with a

  13. Large deviation result for the empirical locality measure of typed random geometric graphs

    OpenAIRE

    Doku-Amponsah, Kwabena

    2014-01-01

    In this article for a finite typed random geometric graph we define the empirical locality distribution, which records the number of nodes of a given type linked to a given number of nodes of each type. We find large deviation principle (LDP) for the empirical locality measure given the empirical pair measure and the empirical type measure of the typed random geometric graphs. From this LDP, we derive large deviation principles for the degree measure and the proportion of detached nodes in th...

  14. Improving the results of transarterial embolization of type 2 endoleaks with the embolic polymer Onyx

    Directory of Open Access Journals (Sweden)

    Mikolaj Wojtaszek

    2016-12-01

    Full Text Available Introduction : Type 2 endoleaks (T2E occur in 10 to 20% of patients after endovascular abdominal aortic aneurysm repair (EVAR and remain a significant clinical issue. Aim: To evaluate the efficacy and clinical outcomes of transarterial treatment of persistent type II endoleaks after EVAR using the liquid embolic Onyx. Material and methods From February 2012 to August 2015 transarterial T2E embolization was attempted in 22 patients (21 men, median age: 73, range: 62–88 years. Indications for treatment included an increase in the diameter of the aneurysm sac above 5 mm and a persistent endoleak observed for more than 6 months. Mean time from EVAR to endoleak treatment was 43 months (range: 2–125 months. Results: Primary technical success was achieved in 17 (77.3% patients and secondary technical success in 81.8%, with 0% in-hospital mortality. The mean procedure time was 95 ±48 min, with an average fluoroscopy time of 54 ±25 min. The mean amount of Onyx used was 7.5 ±6.6 ml. Clinical success was seen in 17/21 patients with follow-up imaging (80.9%. Mean follow-up time was 17 months (range: 3–38 months. Conclusions : Onyx has been shown to effectively stabilize previous aneurysm growth as a result of the T2E in the majority of our patients. Transarterial embolization of T2E can be significantly improved as compared to previously reported results by using liquid embolic polymers such as Onyx.

  15. [15-year results following implantation of a stem type AML hip prosthesis].

    Science.gov (United States)

    Schwerter, K; Meyenberg, A; Sander, K; Layher, F; Roth, A

    2013-06-01

    The trend in arthroplasty of the hip joint to implement new models is partly based on theoretical considerations. In order to verify to which extent the philosophy of individual models is ultimately successful, the presentation of long-term results is required. In the years 1991 and 1992, 433 patients with primary implantation of an uncemented total hip replacement in primary coxarthrosis with a stem type AML (anatomic medullary locking) were treated surgically. 283 of them got a cementless cup type Duraloc. In 311 (71.8 %) patients the mean survival rate of the prosthesis could be determined at a mean follow-up of 15.5 years. 145 (33.5 %) patients were followed up completely both clinically and radiologically. Radiographically, the stem position, changes of the periprosthetic bone of the stem and the cup, as well as the wear of the cups were examined. The cumulative survival rate of the AML stem after 15.5 years was 97.5 %, of the Duraloc cup 88.2 %. The clinical results of the hip scores according to Harris and Merle d'Aubigné were good and excellent and patient satisfaction was very high. There was no relationship between stem position, stress shielding and surrounding lyses at the femur and the acetabulum and survival of stem or cup. There was no correlation between inlay wear and survival of the Duraloc cup. A subsiding of the stem in 2 cases had no effect on the clinical symptoms and quality of life. The press-fit implanted AML stem and the Duraloc cup revealed very good results during the investigation period. Like other implants, the survival rate is limited at the presented implant mainly by the cup. Georg Thieme Verlag KG Stuttgart · New York.

  16. Hearing results after type III tympanoplasty: incus transpositionversus PORP. A systematic review.

    Science.gov (United States)

    Bartel, Ricardo; Cruellas, Francesc; Hamdan, Miriam; Gonzalez-Compta, Xavier; Cisa, Enric; Domenech, Ivan; Manos, Manel

    2018-01-21

    The objective of this study is to compare hearing improvements in the air-bone gap (ABG) after type III tympanoplasties, comparing between incus transposition (IT) and partial ossicular replacement prosthesis (PORP). Publications in English were searched in PUBMED database and were systematically reviewed. A total of 14 articles were included, obtaining 1055 patients, 614 for the IT group and 441 for the PORP group. Preoperative ABG, postoperative ABG, dB gain and ABG closure rate were compared. IT group: preoperative ABG of 31.74 dB (SD 10.51); postoperative ABG of 18.97 dB (SD 10.6); dB gain of 12.76 dB (SD 14.97); and ABG closure rate of 64.48%. PORP group: preoperative ABG of 28.02 dB (SD 10.47); postoperative ABG of 16.27 dB (SD 10.45); dB gain of 11.75 (SD 15.02); and ABG closure rate of 71.32%. No significant statistical difference was found in dB mean gain between groups (p > .05), although a difference was found in the ABG closure rate between groups favouring PORP series (p < .05). An improvement in hearing results was observed within both groups after type III tympanoplasty. There is no difference in decibels gained between both ossiculoplasty materials, but a better closure rate (%) was observed in the PORP group.

  17. Guideline treatment results in regression of atherosclerosis in type 2 diabetes mellitus

    NARCIS (Netherlands)

    Strang, Aart C.; van Wijk, Diederik F.; Mutsaerts, Henri J. M. M.; Stroes, Erik S. G.; Nederveen, Aart J.; Rotmans, Joris I.; Rabelink, Ton J.; Box, Frieke M. A.

    2015-01-01

    Efficacy of guideline cardiovascular disease prevention regimens may differ between patients with or without type II diabetes mellitus. We therefore compared change in carotid artery wall dimensions in type II diabetes mellitus and non-type II diabetes mellitus patients with a history of a major

  18. Automated detection of discourse segment and experimental types from the text of cancer pathway results sections.

    Science.gov (United States)

    Burns, Gully A P C; Dasigi, Pradeep; de Waard, Anita; Hovy, Eduard H

    2016-01-01

    Automated machine-reading biocuration systems typically use sentence-by-sentence information extraction to construct meaning representations for use by curators. This does not directly reflect the typical discourse structure used by scientists to construct an argument from the experimental data available within a article, and is therefore less likely to correspond to representations typically used in biomedical informatics systems (let alone to the mental models that scientists have). In this study, we develop Natural Language Processing methods to locate, extract, and classify the individual passages of text from articles' Results sections that refer to experimental data. In our domain of interest (molecular biology studies of cancer signal transduction pathways), individual articles may contain as many as 30 small-scale individual experiments describing a variety of findings, upon which authors base their overall research conclusions. Our system automatically classifies discourse segments in these texts into seven categories (fact, hypothesis, problem, goal, method, result, implication) with an F-score of 0.68. These segments describe the essential building blocks of scientific discourse to (i) provide context for each experiment, (ii) report experimental details and (iii) explain the data's meaning in context. We evaluate our system on text passages from articles that were curated in molecular biology databases (the Pathway Logic Datum repository, the Molecular Interaction MINT and INTACT databases) linking individual experiments in articles to the type of assay used (coprecipitation, phosphorylation, translocation etc.). We use supervised machine learning techniques on text passages containing unambiguous references to experiments to obtain baseline F1 scores of 0.59 for MINT, 0.71 for INTACT and 0.63 for Pathway Logic. Although preliminary, these results support the notion that targeting information extraction methods to experimental results could provide

  19. Condom use with different types of sexual partners in Ukraine: results of 2007 survey

    Directory of Open Access Journals (Sweden)

    Barska, Julia

    2012-07-01

    Full Text Available BACKGROUND: Use of condoms is recommended in all risky sexual contacts, as long as a couple becomes monogamous and tests for HIV and other STDs. This research aims to examine whether people in Ukraine follow this recommendation.MATERIAL AND METHODS: Associations between condom use at last sexual intercourse and type of sexual partner were explored separately for men and women based on data of 2007 survey by using regression models adjusted for knowledge about and attitude to STDs and HIV, contraception and pregnancy, risky behaviour and socio-demographic characteristics.RESULTS: Generally, 37.2% of men and 25.2% of women reported using condom at last sexual contact. Overall, use of condoms increased with less intimacy between partners: 22.6% of men and 19.2% of women used condoms with their spouses, 62.8% and 52.4% ― with girl-/boy-friends, somewhat less – 56.6% and 35.3% ― with casual acquaintance, respectively, and 71.4% of men – with commercial sex workers; in multivariate analysis direction of associations remained the same. Moreover, risky sexual behaviour for both genders, and drugs ever-use and alcohol consumption during last sex for men reduces odds of using condoms. Also, men demonstrating correct knowledge of ways of horizontal transmission of HIV and women aware about ways of prevention of HIV transmission had higher odds of using condoms, as well as women confident in their ability to buy condoms. For socio-demographic characteristics, having children, younger age and dwelling in non-Western regions and cities were positively associated with using condoms.DISCUSSION AND CONCLUSIONS: Although condom use in Ukraine is not prevalent enough, there is a tendency to more frequent use of them with high-risk sexual partners. At the same time, people practicing other types of risky behaviour use condoms less, too.

  20. Raman and infrared results on YBa2Cu3Osub(7-x) type materials

    International Nuclear Information System (INIS)

    Burns, G.; Dacol, F.H.; Freitas, P.; Plaskett, T.S.; Koenig, W.

    1987-01-01

    We report both Raman and infrared results on the same semiconducting YBa 2 Cu 3 Osub(7-x) material. With the appropriate heat treatment, this material can be reversibly changed from an orthorhombic superconductor x approx. = 0.0) to a semiconductor (x > 0.5). In the semiconducting material it is easier to measure the phonon features using either technique, and we observe almost the number of modes allowed. By simultaneously considering the modes observed by both techniques, using group theory to sort out the modes in both phases, and using projection operators to determine the symmetry adapted vectors, we arrive at an understanding of some of the modes. We find few differences when comparing our results to other measurements in the superconducting phase. The two general conclusions that we arrive at are: 1) splittings of the modes due to lowering the symmetry from tetragonal to the superconducting orthorhombic phase are not observed; 2) no frequency renormalizations, of the type that have been discussed theoretically, are observed. (author)

  1. Changes in content and synthesis of collagen types and proteoglycans in osteoarthritis of the knee joint and comparison of quantitative analysis with Photoshop-based image analysis.

    Science.gov (United States)

    Lahm, Andreas; Mrosek, Eike; Spank, Heiko; Erggelet, Christoph; Kasch, Richard; Esser, Jan; Merk, Harry

    2010-04-01

    The different cartilage layers vary in synthesis of proteoglycan and of the distinct types of collagen with the predominant collagen Type II with its associated collagens, e.g. types IX and XI, produced by normal chondrocytes. It was demonstrated that proteoglycan decreases in degenerative tissue and a switch from collagen type II to type I occurs. The aim of this study was to evaluate the correlation of real-time (RT)-PCR and Photoshop-based image analysis in detecting such lesions and find new aspects about their distribution. We performed immunohistochemistry and histology with cartilage tissue samples from 20 patients suffering from osteoarthritis compared with 20 healthy biopsies. Furthermore, we quantified our results on the gene expression of collagen type I and II and aggrecan with the help of real-time (RT)-PCR. Proteoglycan content was measured colorimetrically. Using Adobe Photoshop the digitized images of histology and immunohistochemistry stains of collagen type I and II were stored on an external data storage device. The area occupied by any specific colour range can be specified and compared in a relative manner directly from the histogram using the "magic wand tool" in the select similar menu. In the image grow menu gray levels or luminosity (colour) of all pixels within the selected area, including mean, median and standard deviation, etc. are depicted. Statistical Analysis was performed using the t test. With the help of immunohistochemistry, RT-PCR and quantitative RT- PCR we found that not only collagen type II, but also collagen type I is synthesized by the cells of the diseased cartilage tissue, shown by increasing amounts of collagen type I mRNA especially in the later stages of osteoarthritis. A decrease of collagen type II is visible especially in the upper fibrillated area of the advanced osteoarthritic samples, which leads to an overall decrease. Analysis of proteoglycan showed a loss of the overall content and a quite uniform staining in

  2. Results of safety analysis on PWR type nuclear power plants with two and three loops

    International Nuclear Information System (INIS)

    1979-01-01

    The results of safety analysis on PWR type nuclear power plants with two and three loops are presented, which was conducted by the Resource and Energy Agency, in June, 1979. This analysis was made simulating the phenomenon relating to the pressurizer level gauge at the time of the TMI accident. The model plants were the Ikata nuclear power plant with two loops and the Takahama No. 1 nuclear power plant with three loops. The premise conditions for this safety analysis were as follows: 1) the main feed water flow is totally lost suddenly at the full power operation of the plants, and the feed water pump is started manually 15 minutes after the accident initiation, 2) the relief valve on the pressurizer is kept open even after the pressure drop in the primary cooling system, and the primary cooling water flows out into the containment vessel through the rupture disc of the pressurizer relief tank, and 3) the electric circuit, which sends out the signal of safety injection at the abnormal low pressure in the reactor vessel, is added from the view-point of starting the operation of the emergency core cooling system as early as possible. Relating to the analytical results, the pressure in the reactor vessels changes less, the water level in the pressurizers can be regulated, and the water level in the steam generators is recovered safely in both two and three-loop plants. It is recognized that the plants with both two- and three loops show the safe transient phenomena, and the integrity of the cores is kept under the premise conditions. The evaluation for each analyzed result was conducted in detail. (Nakai, Y.)

  3. Polarimetric survey of main-belt asteroids⋆. III. Results for 33 X-type objects

    Science.gov (United States)

    Cañada-Assandri, M.; Gil-Hutton, R.; Benavidez, P.

    2012-06-01

    Aims: We present results of a polarimetric survey of main-belt asteroids at Complejo Astronómico El Leoncito (Casleo), San Juan, Argentina. The aims of this survey are to increase the database of asteroid polarimetry, to estimate diversity in polarimetric properties of asteroids that belong to different taxonomic classes, and to search for objects that exhibit anomalous polarimetric properties. Methods: The data were obtained with the Torino and CASPROF polarimeters at the 2.15 m telescope. The Torino polarimeter is an instrument that allows the simultaneous measurement of polarization in five different bands, and the CASPROF polarimeter is a two-hole aperture polarimeter with rapid modulation. Results: The survey began in 2003, and up to 2009 data of a sample of more than 170 asteroids were obtained. In this paper the results for 33 X-type objects are presented, several of them are being polarimetrically observed for the first time. Using these data we found polarization curves and polarimetric parameters for different groups among this taxonomic class and that there are objects with very different albedo in the sub-classes of the X taxonomic complex. Based on observations carried out at the Complejo Astronómico El Leoncito, operated under agreement between the Consejo Nacional de Investigaciones Científicas y Técnicas de la República Argentina and the National Universities of La Plata, Córdoba, and San Juan.Table 1 is only available at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/542/A11

  4. Spine deformities in patients with Ehlers-Danlos syndrome, type IV - late results of surgical treatment

    Directory of Open Access Journals (Sweden)

    Tesiorowski Maciej

    2010-11-01

    Full Text Available Abstract Background Spinal deformities in Ehlers-Danlos syndrome are usually progressive and may require operative treatment. There is limited number of studies describing late results of surgery in this disease. Methods This is a retrospective study of the records of 11 patients with Ehlers-Danlos syndrome type IV, treated surgically between 1990 and 2007. All patients underwent surgical treatment for spinal deformity. Duration of operation, type of instrumentation, intraoperative blood loss, complications and number of additional surgeries were noted. Radiographic measurement was performed on standing AP and lateral radiographs acquired before surgery, just after and at final follow up. Results The mean follow up period was 5.5 ± 2.9 years (range 1-10 years. The mean preoperative thoracic and lumbar curve were 109.5 ± 19.9° (range 83° - 142° and 75.6 ± 26.7° (range 40° - 108° respectively. Posterior spine fusion alone was performed on 6 patients and combined anterior and posterior fusion (one- or two stage on 5 cases. Posterior segmental spinal instrumentation was applied with use of hooks, screws and wires. The mean postoperative thoracic and lumbar curve improved to 79.3 ± 16.1° (range 56° - 105° and 58.5 ± 27.7° (range 10° - 95° respectively, with a slight loss of correction during follow up. The average thoracic and lumbar correction was 26.4 ± 14.9% (range 5.3 - 50.4% and 26.3 ± 21.2% (range 7.9 - 75%. Postoperatively, the mean kyphosis was 79.5 ± 40.3° (range 21° -170°, and lordosis was 50.8 ± 18.6° (range 20° -79°. Hyperkyphosis increased during follow up while lordosis remained stable. Mean Th12-L2 angle was -3.5 ±9.9° (range -19° - 15° postoperatively and did not change significantly during follow up. Conclusions Huge spinal deformities in patients with Ehlers-Danlos syndrome require complex and extensive surgery. There is a big risk of sagittal imbalance in this group.

  5. Experimental results of current distribution in Rutherford-type LHC cables

    CERN Document Server

    Verweij, A P

    2000-01-01

    Current distribution among the wires of multi-strand superconducting cables is an important item for accelerator magnets. A non-uniform distribution could cause additional field distortions in the magnet bore and can as well be one of the reasons of premature quenching. Since two years electrical measurements on superconducting Rutherford-type cables are performed at CERN as part of the reception tests for the Large Hadron Collider (LHC). Cable samples of 2.4 m length are tested at currents up to 32 kA, temperatures around 1.9 and 4.3 K, and fields up to 10 T, applied perpendicularly as well as parallel to the broad face of the cable. Last year, an array of 24 Hall probes was installed in the test set-up in order to measure the self-field of the cable samples along one cable pitch. Each of the probes measures the local field generated by the current in the strands close by, and the results of the all probes reflect therefore the distribution of the strand currents. Experiments are done varying the applied fie...

  6. Obesity/Type II diabetes alters macrophage polarization resulting in a fibrotic tendon healing response.

    Directory of Open Access Journals (Sweden)

    Jessica E Ackerman

    Full Text Available Type II Diabetes (T2DM dramatically impairs the tendon healing response, resulting in decreased collagen organization and mechanics relative to non-diabetic tendons. Despite this burden, there remains a paucity of information regarding the mechanisms that govern impaired healing of diabetic tendons. Mice were placed on either a high fat diet (T2DM or low fat diet (lean and underwent flexor tendon transection and repair surgery. Healing was assessed via mechanical testing, histology and changes in gene expression associated with collagen synthesis, matrix remodeling, and macrophage polarization. Obese/diabetic tendons healed with increased scar formation and impaired mechanical properties. Consistent with this, prolonged and excess expression of extracellular matrix (ECM components were observed in obese/T2DM tendons. Macrophages are involved in both inflammatory and matrix deposition processes during healing. Obese/T2DM tendons healed with increased expression of markers of pro-inflammatory M1 macrophages, and elevated and prolonged expression of M2 macrophages markers that are involved in ECM deposition. Here we demonstrate that tendons from obese/diabetic mice heal with increased scar formation and increased M2 polarization, identifying excess M2 macrophage activity and matrix synthesis as a potential mechanism of the fibrotic healing phenotype observed in T2DM tendons, and as such a potential target to improve tendon healing in T2DM.

  7. Type 2 Diabetes Mellitus Screening and Risk Factors Using Decision Tree: Results of Data Mining.

    Science.gov (United States)

    Habibi, Shafi; Ahmadi, Maryam; Alizadeh, Somayeh

    2015-03-18

    The aim of this study was to examine a predictive model using features related to the diabetes type 2 risk factors. The data were obtained from a database in a diabetes control system in Tabriz, Iran. The data included all people referred for diabetes screening between 2009 and 2011. The features considered as "Inputs" were: age, sex, systolic and diastolic blood pressure, family history of diabetes, and body mass index (BMI). Moreover, we used diagnosis as "Class". We applied the "Decision Tree" technique and "J48" algorithm in the WEKA (3.6.10 version) software to develop the model. After data preprocessing and preparation, we used 22,398 records for data mining. The model precision to identify patients was 0.717. The age factor was placed in the root node of the tree as a result of higher information gain. The ROC curve indicates the model function in identification of patients and those individuals who are healthy. The curve indicates high capability of the model, especially in identification of the healthy persons. We developed a model using the decision tree for screening T2DM which did not require laboratory tests for T2DM diagnosis.

  8. Speech Recognition for Environmental Control: Effect of Microphone Type, Dysarthria, and Severity on Recognition Results.

    Science.gov (United States)

    Fager, Susan Koch; Burnfield, Judith M

    2015-01-01

    This study examines the use of commercially available automatic speech recognition (ASR) across microphone options as access to environmental control for individuals with and without dysarthria. A study of two groups of speakers (typical speech and dysarthria), was conducted to understand their performance using ASR and various microphones for environmental control. Specifically, dependent variables examined included attempts per command, recognition accuracy, frequency of error type, and perceived workload. A further sub-analysis of the group of participants with dysarthria examined the impact of severity. Results indicated a significantly larger number of attempts were required (P = 0.007), and significantly lower recognition accuracies were achieved by the dysarthric participants (P = 0.010). A sub-analysis examining severity demonstrated no significant differences between the typical speakers and participants with mild dysarthria. However, significant differences were evident (P = 0.007, P = 0.008) between mild and moderate-severe dysarthric participants. No significant differences existed across microphones. A higher frequency of threshold errors occurred for typical participants and no response errors for moderate-severe dysarthrics. There were no significant differences on the NASA Task Load Index.

  9. Training in virtual reality: qualitative results from a comparison of technology types

    International Nuclear Information System (INIS)

    Sebok, Angelia; Nystad, Espen

    2005-08-01

    The study described in HWR-734 consisted of three experiments. The first experiment compared procedural and configuration learning using four display technology types; the second experiment compared these same four technology types in a retention and transfer of training condition, and the third experiment compared assembly learning using three types of displays. The purpose of the study was to determine if the technology types differed in their ability to support learning. Thus, several different types of learning tasks were included (i.e., procedures, configuration and assembly). For all types of learning, short term training effectiveness was evaluated: subjects were tested immediately after the training session, in the same conditions in which they had been trained. In addition, procedural learning was also evaluated in a retention and transfer of training condition, where subjects were tested 24 hours after the initial training, in a real-world talk-through condition. In the Procedural / Configuration knowledge conditions, four technology types were evaluated. These include a desktop monoscopic display (DM), a desktop stereoscopic display (DS), a large-screen stereoscopic display (LS-S), and a head-mounted display with orientation tracking. In the Assembly knowledge condition, three technology types were evaluated: a desktop monoscopic display (DM), a large-screen monoscopic display (LS-M), and a head-mounted display without orientation tracking (HMD-nt). Twenty-four employees at the Halden Boiling Water Reactor (HBWR) participated in the study. The study lasted for one week, so all subjects attended for multiple days. Prior to starting the experiment, subjects attended a briefing where they were given instructions on how to use the equipment. They were allowed 10 minutes practice to get familiar with each technology type before each experimental session. During and after the experimental sessions, data were collected. These included objective data, such as

  10. Mock-up test results of monoblock-type CFC divertor armor for JT-60SA

    Energy Technology Data Exchange (ETDEWEB)

    Higashijima, S. [Japan Atomic Energy Agency, 801-1 Mukoyama, Naka, Ibaraki 311-0193 (Japan)], E-mail: higashijima.satoru@jaea.go.jp; Sakurai, S.; Suzuki, S.; Yokoyama, K.; Kashiwa, Y.; Masaki, K.; Shibama, Y.K.; Takechi, M.; Shibanuma, K.; Sakasai, A.; Matsukawa, M.; Kikuchi, M. [Japan Atomic Energy Agency, 801-1 Mukoyama, Naka, Ibaraki 311-0193 (Japan)

    2009-06-15

    The JT-60 Super Advanced (JT-60SA) tokamak project starts under both the Japanese domestic program and the international program 'Broader Approach'. The maximum heat flux to JT-60SA divertor is estimated to {approx}15 MW/m{sup 2} for 100 s. Japan Atomic Energy Agency (JAEA) has developed a divertor armor facing high heat flux in the engineering R and D for ITER, and it is concluded that monoblock-type CFC divertor armor is promising for JT-60SA. The JT-60SA armor consists of CFC monoblocks, a cooling CuCrZr screw-tube, and a thin oxygen-free high conductivity copper (OFHC-Cu) buffer layer between the CFC monoblock and the screw-tube. CFC/OFHC-Cu and OFHC-Cu/CuCrZr joints are essential for the armor, and these interfaces are brazed. Needed improvements from ITER engineering R and D are good CFC/OFHC-Cu and OFHC-Cu/CuCrZr interfaces and suppression of CFC cracking. For these purposes, metalization inside CFC monoblock is applied, and we confirmed again that the mock-up has heat removal capability in excess of ITER requirement. For optimization of the fabrication method and understanding of the production yield, the mock-ups corresponding to quantity produced in one furnace at the same time is also produced, and the half of the mock-ups could remove 15 MW/m{sup 2} as required. This paper summarizes the recent progress of design and mock-up test results for JT-60SA divertor armor.

  11. Arsenic exposure and type 2 diabetes: results from the 2007–2009 Canadian Health Measures Survey

    Directory of Open Access Journals (Sweden)

    S. K. Feseke

    2015-06-01

    Full Text Available Introduction: Inorganic arsenic and its metabolites are considered dangerous to human health. Although several studies have reported associations between low-level arsenic exposure and diabetes mellitus in the United States and Mexico, this association has not been studied in the Canadian population. We evaluated the association between arsenic exposure, as measured by total arsenic concentration in urine, and the prevalence of type 2 diabetes (T2D in 3151 adult participants in Cycle 1 (2007–2009 of the Canadian Health Measures Survey (CHMS. Methods: All participants were tested to determine blood glucose and glycated hemoglobin. Urine analysis was also performed to measure total arsenic. In addition, participants answered a detailed questionnaire about their lifestyle and medical history. We assessed the association between urinary arsenic levels and T2D and prediabetes using multivariate logistic regression while adjusting for potential confounders. Results: Total urinary arsenic concentration was positively associated with the prevalence of T2D and prediabetes: adjusted odds ratios were 1.81 (95% CI: 1.12–2.95 and 2.04 (95% CI: 1.03–4.05, respectively, when comparing the highest (fourth urinary arsenic concentration quartile with the lowest (first quartile. Total urinary arsenic was also associated with glycated hemoglobin levels in people with untreated diabetes. Conclusion: We found significant associations between arsenic exposure and the prevalence of T2D and prediabetes in the Canadian population. Causal inference is limited due to the cross-sectional design of the study and the absence of long-term exposure assessment.

  12. Insights into optimal basal insulin titration in type 2 diabetes: Results of a quantitative survey.

    Science.gov (United States)

    Berard, Lori; Bonnemaire, Mireille; Mical, Marie; Edelman, Steve

    2018-02-01

    Basal insulin (BI) treatment initiation and dose titration in type 2 diabetes (T2DM) are often delayed. Such "clinical inertia" results in poor glycaemic control and high risk of long-term complications. This survey aimed to determine healthcare professional (HCP) and patient attitudes to BI initiation and titration. An online survey (July-August 2015) including HCPs and patients with T2DM in the USA, France and Germany. Patients were ≥18 years old and had been on BI for 6 to 36 months, or discontinued BI within the previous 12 months. Participants comprised 386 HCPs and 318 people with T2DM. While >75% of HCPs reported discussing titration at the initiation visit, only 16% to 28% of patients remembered such discussions, many (32%-42%) were unaware of the need to titrate BI, and only 28% to 39% recalled mention of the time needed to reach glycaemic goals. Most HCPs and patients agreed that more effective support tools to assist BI initiation/titration are needed; patients indicated that provision of such tools would increase confidence in self-titration. HCPs identified fear of hypoglycaemia, failure to titrate in the absence of symptoms, and low patient motivation as important titration barriers. In contrast, patients identified weight gain, the perception that titration meant worsening disease, frustration over the time to reach HbA1c goals and fear of hypoglycaemia as major factors. A disconnect exists between HCP- and patient-perceived barriers to effective BI titration. To optimize titration, strategies should be targeted to improve HCP-patient communication, and provide support and educational tools. © 2017 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

  13. Results on an integral inequality of the opial- type | Rauf | Global ...

    African Journals Online (AJOL)

    Abstract. We obtain integral inequalities which are Opial-type inequalities, mainly by using Jensen's inequality for the case of convex function. Keywords: Integral inequalities, Opial's inequality, Jensen's inequality and convex functions ...

  14. results

    Directory of Open Access Journals (Sweden)

    Salabura Piotr

    2017-01-01

    Full Text Available HADES experiment at GSI is the only high precision experiment probing nuclear matter in the beam energy range of a few AGeV. Pion, proton and ion beams are used to study rare dielectron and strangeness probes to diagnose properties of strongly interacting matter in this energy regime. Selected results from p + A and A + A collisions are presented and discussed.

  15. The effect of cloud type on earth's energy balance - Results for selected regions

    Science.gov (United States)

    Ockert-Bell, Maureen E.; Hartmann, Dennis L.

    1992-01-01

    International Satellite Cloud Climatology Project (ISCCP) C1 cloud information is compared with planetary albedo, outgoing longwave radiation (OLR), and net radiation measured at the top of the atmosphere by the Earth Radiation Budget Experiment (ERBE). Principal component analysis indicates that the day-to-day variations of the abundances of the 35 cloud types of the C1 data are correlated with each other, so that for many purposes the data set can be well represented by about five cloud types. Using stepwise multiple regression, the ISCCP C1 data can be used to predict the day-to-day variations of the energy balance measured by ERBE for 2.5-deg regions. Total fractional area coverage of cloudiness is a relatively poor predictor of radiation budget quantities. If the total fractional area coverage by clouds is divided into contributions from several distinct cloud types, the fractional coverages by these several cloud types will together form a much better prediction of radiation budget quantities than the single variable of total fractional-area cloud coverage. The regression equations can be used to estimate the net effect of clouds on the radiation balance and the contributions from particular types of clouds to albedo, OLR, and net radiation.

  16. Radiation therapy for wet type age-related macular degeneration. Long term follow-up results

    Energy Technology Data Exchange (ETDEWEB)

    Sasai, Keisuke; Hiraoka, Masahiro; Mandai, Michiyo; Takahashi, Masayo; Honda, Yoshihito [Kyoto Univ. (Japan). Faculty of Medicine

    1998-12-01

    Between April, 1994 and July, 1995, 33 patients with occult type choroidal neovascularization (CNV) with or without the classical type CNV of the wet type age-related macular degeneration ARMD were treated with radiation therapy (10 Gy/5 fx/1 week or 20 Gy/10 fx/2 weeks). This phase I/II study showed that radiation therapy seems to be useful for CNV during the first 12 months. Some eyes which initially showed good response to irradiation began to lose their visual acuity. However, the dose of 20 Gy in 10 fractions seemed useful to maintain the visual acuity better than 0.1 in this long term follow-up study (24 months). (author)

  17. Early Results of Chimney Technique for Type B Aortic Dissections Extending to the Aortic Arch

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Chen [Affiliated Hospital of Nantong University, Department of General Surgery (China); Tang, Hanfei; Qiao, Tong; Liu, Changjian; Zhou, Min, E-mail: 813477618@qq.com [The Affiliated Hospital of Nanjing University Medical School, Department of Vascular Surgery, Nanjing Drum Tower Hospital (China)

    2016-01-15

    ObjectiveTo summarize our early experience gained from the chimney technique for type B aortic dissection (TBAD) extending to the aortic arch and to evaluate the aortic remodeling in the follow-up period.MethodsFrom September 2011 to July 2014, 27 consecutive TBAD patients without adequate proximal landing zones were retrograde analyzed. Chimney stent-grafts were deployed parallel to the main endografts to reserve flow to branch vessels while extending the landing zones. In the follow-up period, aortic remodeling was observed with computed tomography angiography.ResultsThe technical success rate was 100 %, and endografts were deployed in zone 0 (n = 3, 11.1 %), zone 1 (n = 18, 66.7 %), and zone 2 (n = 6, 22.2 %). Immediately, proximal endoleaks were detected in 5 patients (18.5 %). During a mean follow-up period of 17.6 months, computed tomography angiography showed all the aortic stent-grafts and chimney grafts to be patent. Favorable remodeling was observed at the level of maximum descending aorta and left subclavian artery with expansion of true lumen (from 18.4 ± 4.8 to 25 ± 0.86 mm, p < 0.001 and 27.1 ± 0.62 to 28.5 ± 0.37 mm, p < 0.001) and depressurization of false lumen (from 23.7 ± 2.7 to 8.7 ± 3.8 mm, p < 0.001, from 5.3 ± 1.2 to 2.1 ± 2.1 mm, p < 0.001). While at the level of maximum abdominal aorta, suboptimal remodeling of the total aorta (from 24.1 ± 0.4 to 23.6 ± 1.5 mm, p = 0.06) and true lumen (from 13.8 ± 0.6 to 14.5 ± 0.4 mm, p = 0.08) was observed.ConclusionBased on our limited experience, the chimney technique with thoracic endovascular repair is demonstrated to be promising for TBAD extending to the arch with favorable aortic remodeling.

  18. Accumulation of human immunodeficiency virus type 1 DNA in T cells: results of multiple infection events.

    OpenAIRE

    Robinson, H L; Zinkus, D M

    1990-01-01

    Human immunodeficiency virus type 1 DNA synthesis was followed in a CD4+ line of T cells (C8166) grown in the presence or absence of a monoclonal antibody to CD4 that blocks infection By 48 h after infection, cultures grown in the presence of the antibody contained approximately 4 copies of human immunodeficiency virus type 1 DNA per cell, whereas those grown in the absence of the antibody contained approximately 80 copies of viral DNA per cell. Most of the viral DNA in cultures grown in the ...

  19. Hardy type inequalities with kernels: The current status and some new results

    Czech Academy of Sciences Publication Activity Database

    Kufner, Alois; Persson, L. E.; Samko, N.

    2017-01-01

    Roč. 290, č. 1 (2017), s. 57-65 ISSN 0025-584X Institutional support: RVO:67985840 Keywords : Hardy operators with kernels * Hardy type inequalities * new scales of characterizations Subject RIV: BA - General Mathematics OBOR OECD: Pure mathematics Impact factor: 0.742, year: 2016 http://dx. doi . org /10.1002/mana.201500363

  20. Patch test results of hand eczema patients : relation to clinical types

    NARCIS (Netherlands)

    Boonstra, M B; Christoffers, W A; Coenraads, P J; Schuttelaar, M L A

    BACKGROUND: Allergic contact dermatitis is a well-known cause of hand eczema, although the influence of contact allergens on different clinical types of hand eczema remains still unclear. OBJECTIVE: To identify most common positive tested allergens among hand eczema patients and to define the

  1. Hardy type inequalities with kernels: The current status and some new results

    Czech Academy of Sciences Publication Activity Database

    Kufner, Alois; Persson, L. E.; Samko, N.

    2017-01-01

    Roč. 290, č. 1 (2017), s. 57-65 ISSN 0025-584X Institutional support: RVO:67985840 Keywords : Hardy operators with kernels * Hardy type inequalities * new scales of characterizations Subject RIV: BA - General Mathematics OBOR OECD: Pure mathematics Impact factor: 0.742, year: 2016 http://dx.doi.org/10.1002/ mana .201500363

  2. Long-term results with the Kudo type 3 total elbow arthroplasty

    DEFF Research Database (Denmark)

    Thillemann, Theis Muncholm; Olsen, Bo Sanderhoff; Johannsen, Hans Viggo

    2012-01-01

    From 1992 to 1993, 17 elbows were replaced with the unlinked Kudo type 3 total elbow arthroplasty in 16 patients with arthritic joint destruction. Of these elbows, 8 were available for clinical examination after a mean of 9.5 years. Of the 17 elbow implants, 5 were revised: 2 because of loosening...

  3. Circulating levels of interleukin-6, vascular endothelial growth factor, YKL-40, matrix metalloproteinase-3, and total aggrecan in spondyloarthritis patients during 3 years of treatment with TNF alpha inhibitors

    DEFF Research Database (Denmark)

    Pedersen, S.J.; Hetland, M.L.; Sørensen, Inge Juul

    2010-01-01

    excluded. Patients with SpA had compared with healthy subjects elevated IL-6 (median 8.5 ng/l (range, 0.98-64) vs. 1.3 (0.33-26)), VEGF (105 ng/l (22-752) vs. 45 (12-351)), YKL-40 (74 mu g/l (14-572) vs. 43 (20-184)), and MMP-3 (43 mu g/l (9.1-401) vs. 16 (2.5-47), p a parts per thousand currency signa......Euro parts per thousand 0.001), whereas total aggrecan was lower (662 mu g/l (223-2,219) vs. 816 (399-2,190),p a parts per thousand currency signaEuro parts per thousand 0.001). Two weeks after first treatment, all biomarker levels changed towards normal levels (p a parts per thousand currency signa......Euro parts per thousand 0.03) in clinical responders (n = 24), and persistent reductions over 3 years were found in IL-6, VEGF, YKL-40, and MMP-3. Only MMP-3 decreased (p a parts per thousand currency signaEuro parts per thousand 0.02) in non-responders (n = 13). The study demonstrated changes of plasma IL-6...

  4. Obtaining correct compile results by absorbing mismatches between data types representations

    Energy Technology Data Exchange (ETDEWEB)

    Horie, Michihiro; Horii, Hiroshi H.; Kawachiya, Kiyokuni; Takeuchi, Mikio

    2017-11-21

    Methods and a system are provided. A method includes implementing a function, which a compiler for a first language does not have, using a compiler for a second language. The implementing step includes generating, by the compiler for the first language, a first abstract syntax tree. The implementing step further includes converting, by a converter, the first abstract syntax tree to a second abstract syntax tree of the compiler for the second language using a conversion table from data representation types in the first language to data representation types in the second language. When a compilation error occurs, the implementing step also includes generating a special node for error processing in the second abstract syntax tree and storing an error token in the special node. When unparsing, the implementing step additionally includes outputting the error token, in the form of source code written in the first language.

  5. Obtaining correct compile results by absorbing mismatches between data types representations

    Energy Technology Data Exchange (ETDEWEB)

    Horie, Michihiro; Horii, Hiroshi H.; Kawachiya, Kiyokuni; Takeuchi, Mikio

    2017-03-21

    Methods and a system are provided. A method includes implementing a function, which a compiler for a first language does not have, using a compiler for a second language. The implementing step includes generating, by the compiler for the first language, a first abstract syntax tree. The implementing step further includes converting, by a converter, the first abstract syntax tree to a second abstract syntax tree of the compiler for the second language using a conversion table from data representation types in the first language to data representation types in the second language. When a compilation error occurs, the implementing step also includes generating a special node for error processing in the second abstract syntax tree and storing an error token in the special node. When unparsing, the implementing step additionally includes outputting the error token, in the form of source code written in the first language.

  6. Obtaining correct compile results by absorbing mismatches between data types representations

    Energy Technology Data Exchange (ETDEWEB)

    Horie, Michihiro; Horii, Hiroshi H.; Kawachiya, Kiyokuni; Takeuchi, Mikio

    2016-10-04

    Methods and a system are provided. A method includes implementing a function, which a compiler for a first language does not have, using a compiler for a second language. The implementing step includes generating, by the compiler for the first language, a first abstract syntax tree. The implementing step further includes converting, by a converter, the first abstract syntax tree to a second abstract syntax tree of the compiler for the second language using a conversion table from data representation types in the first language to data representation types in the second language. When a compilation error occurs, the implementing step also includes generating a special node for error processing in the second abstract syntax tree and storing an error token in the special node. When unparsing, the implementing step additionally includes outputting the error token, in the form of source code written in the first language.

  7. Ciliary neurotrophic factor for macular telangiectasia type 2: results from a phase 1 safety trial.

    Science.gov (United States)

    Chew, Emily Y; Clemons, Traci E; Peto, Tunde; Sallo, Ferenc B; Ingerman, Avner; Tao, Weng; Singerman, Lawrence; Schwartz, Steven D; Peachey, Neal S; Bird, Alan C

    2015-04-01

    To evaluate the safety and tolerability of intraocular delivery of ciliary neurotrophic factor (CNTF) using an encapsulated cell implant for the treatment of macular telangiectasia type 2. An open-label safety trial conducted in 2 centers enrolling 7 participants with macular telangiectasia type 2. The participant's more severely affected eye (worse baseline visual acuity) received the high-dose implant of CNTF. Patients were followed for a period of 36 months. The primary safety outcome was a change in the parameters of the electroretinogram (ERG). Secondary efficacy outcomes were changes in visual acuity, en face measurements of the optical coherence tomography of the disruption in the ellipsoid zone, and microperimetry when compared with baseline. The ERG findings demonstrated a reduction in the amplitude of the scotopic b-wave in 4 participants 3 months after implantation (month 3). All parameters returned to baseline values by month 12 and remained so at month 36 with no clinical impact on dark adaptation. There was no change in visual acuity compared with baseline. The area of the defect as measured functionally by microperimetry and structurally by the en face OCT imaging of the ellipsoid zone loss appeared unchanged from baseline. The intraocular delivery of CNTF in the encapsulated cell implant appeared to be safe and well tolerated in eyes with macular telangiectasia type 2. Further evaluation in a randomized controlled clinical trial is warranted to test for efficacy. Published by Elsevier Inc.

  8. Morphometric analysis of three normal facial types in mixed dentition using posteroanterior cephalometric radiographs: preliminary results

    Directory of Open Access Journals (Sweden)

    Renato Bigliazzi

    2017-08-01

    Full Text Available The aim of the present investigation was to evaluate the craniofacial features of subjects with normal occlusion with different vertical patterns in the mixed dentition using morphometric analysis (Thin-Plate Spline analysis - TPS applied to posteroanterior (PA films. The sample comprised 39 individuals (18 females and 21 males, all in mixed dentition, aged from 8.4 to 10 years with satisfactory occlusion and balanced profile and with no history of orthodontic or facial orthopedic treatment. The sample was divided into three groups (mesofacial, brachyfacial and dolichofacial according to the facial types proposed by Ricketts (1989. The average craniofacial configurations of each study group were obtained by orthogonal superimposition of Procrustes, thereby eliminating size differences and allowing only shape differences between groups to be analyzed by viewing the TPS deformation grid. Significant differences were found among the three facial types but were more remarkable between mesofacials and dolichofacials than between mesofacials and brachyfacials. TPS morphometric analysis proved efficient for accurate visualization of transverse and vertical differences among facial types even before pubertal growth spurt. These differences cannot be easily detected by traditional posteroanterior cephalometry.

  9. Treatment of Stanford type B aortic dissection with stent-grafts: preliminary results.

    Science.gov (United States)

    Czermak, B V; Waldenberger, P; Fraedrich, G; Dessl, A H; Roberts, K E; Bale, R J; Perkmann, R; Jaschke, W R

    2000-11-01

    To evaluate the feasibility and safety of endovascular stent-graft placement in treating Stanford type B aortic dissection. Seven patients underwent endovascular stent-graft placement for type B aortic dissection. Five patients had acute and two had chronic dissection. In five patients, the proximal entry tear was within 2 cm of the origin of the left subclavian artery, and in two patients it was beyond this site. In three patients, the noncovered proximal portion of the stent-graft was placed across the origin of the left subclavian artery. The efficacy of the procedure was assessed at follow-up studies 3, 6, 12, and 24 months after intervention. The procedure was technically and clinically successful in six patients (86%). The left subclavian artery remained patent in all patients. In two patients with involvement of aortic branches, endovascular stent-graft placement restored adequate blood flow to the compromised branches. One patient was readmitted 1 month later because the dissection extended into the ascending aorta. In all but this patient, closure of the entry tear and thrombosis of the false lumen along the stent-graft were achieved. All false lumina shrank considerably. The mean follow-up time was 14 months (range, 1-25 months). Type B aortic dissections within and beyond 2 cm of the origin of the left subclavian artery can be treated safely and effectively by means of endovascular stent-graft placement.

  10. Comparison of Leishmania typing results obtained from 16 European clinical laboratories in 2014.

    Science.gov (United States)

    Van der Auwera, Gert; Bart, Aldert; Chicharro, Carmen; Cortes, Sofia; Davidsson, Leigh; Di Muccio, Trentina; Dujardin, Jean-Claude; Felger, Ingrid; Paglia, Maria Grazia; Grimm, Felix; Harms, Gundel; Jaffe, Charles L; Manser, Monika; Ravel, Christophe; Robert-Gangneux, Florence; Roelfsema, Jeroen; Töz, Seray; Verweij, Jaco J; Chiodini, Peter L

    2016-12-08

    Leishmaniasis is endemic in southern Europe, and in other European countries cases are diagnosed in travellers who have visited affected areas both within the continent and beyond. Prompt and accurate diagnosis poses a challenge in clinical practice in Europe. Different methods exist for identification of the infecting Leishmania species. Sixteen clinical laboratories in 10 European countries, plus Israel and Turkey, conducted a study to assess their genotyping performance. DNA from 21 promastigote cultures of 13 species was analysed blindly by the routinely used typing method. Five different molecular targets were used, which were analysed with PCR-based methods. Different levels of identification were achieved, and either the Leishmania subgenus, species complex, or actual species were reported. The overall error rate of strains placed in the wrong complex or species was 8.5%. Various reasons for incorrect typing were identified. The study shows there is considerable room for improvement and standardisation of Leishmania typing. The use of well validated standard operating procedures is recommended, covering testing, interpretation, and reporting guidelines. Application of the internal transcribed spacer 1 of the rDNA array should be restricted to Old World samples, while the heat-shock protein 70 gene and the mini-exon can be applied globally. This article is copyright of The Authors, 2016.

  11. Multiplicity results for an impulsive boundary value problem of p(t-Kirchhoff type via critical point theory

    Directory of Open Access Journals (Sweden)

    A. Mokhtari

    2016-01-01

    Full Text Available In this paper we obtain existence results of \\(k\\ distinct pairs nontrivial solutions for an impulsive boundary value problem of \\(p(t\\-Kirchhoff type under certain conditions on the parameter \\(\\lambda\\.

  12. Racial Disparities in Partial Nephrectomy Persist Across Hospital Types: Results From a Population-based Cohort.

    Science.gov (United States)

    Kiechle, Jonathan E; Abouassaly, Robert; Gross, Cary P; Dong, Shan; Cherullo, Edward E; Zhu, Hui; Trinh, Quoc-Dien; Sun, Maxine; Meropol, Neal J; Hoimes, Christopher J; Ialacci, Sarah; Kim, Simon P

    2016-04-01

    To assess the national utilization of partial nephrectomy (PN) for T1a renal masses across different racial groups by hospital type. Although clinical guidelines recommend PN for small renal masses (SRMs), racial disparities persist in the use of PN. High-volume and academic hospitals have been associated with greater use of PN for SRMs. However, it is unknown whether racial disparities persist in the use of PN across different types of hospitals. Using the National Cancer Database, we identified patients with localized T1a renal cancer (≤4 cm) from 1998 to 2011. The primary outcome was receipt of PN among patients surgically treated for SRMs. Multivariable logistic regression analyses were used to assess for racial differences in treatment with PN stratified by hospital characteristics. Among 118,207 patients diagnosed with clinical T1a renal masses, 36.5% underwent PN (n = 43,134). Overall, a greater proportion of white patients underwent PN (37.3%) compared with African-American (32.4%) and Hispanic (33.7%) patients with SRMs (P disparities persisted in the use of PN; African-American patients had lower adjusted odds ratios for being treated with PN when treated at comprehensive community cancer (odds ratio: 0.90; P = .003) and academic (odds ratio: 0.65; P racial disparities persist across all types of hospitals in the use of PN for SRMs. Further research is needed to identify, and target for intervention, the factors contributing to racial disparities in the surgical management of SRMs. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Test results of a counting type SOI device for a new x-ray area detector

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, R., E-mail: ryo.hashimoto@kek.jp; Igarashi, N.; Kumai, R.; Kishimoto, S. [Inst. of Materials Structure Science, KEK, 1-1 Oho, Tsukuba, Ibaraki 305-0801 (Japan); Arai, Y.; Miyoshi, T. [Inst. of Particle and Nuclear Physics. KEK, 1-1 Oho, Tsukuba, Ibaraki 305-0801 (Japan)

    2016-07-27

    Development of a new detector using Silicon-On-Insulator (SOI) technology has been started in the Photon Factory, KEK. The aim of this project is to develop a pulse-counting-type X-ray detector that can be used in synchrotron radiation experiments using soft X-rays. We started to make a Test Element Group of SOI chip, which is called CPIXPTEG1 and evaluated its performance. We succeeded in readout of output signals for 16 keV X-rays from the SOI chips. We also found that the middle-SOI structure was effective against a signal distortion caused by hole traps in the buried oxide layer.

  14. Gastric lymphoma of mucosa associated lymphoid tissue (MALT) type: longterm treatment results

    International Nuclear Information System (INIS)

    Fung, Claire Y.; Kachnic, Lisa A.; Daly, William; Younger, Jerry; Harris, Nancy L.; Graeme-Cook, Fiona

    1995-01-01

    Objective: In recent years, a large proportion of non-Hodgkin's lymphomas of the stomach are recognized as low grade tumors of the mucosa associated lymphoid tissue (MALT) type. Since the MALT morphological subtype has only gained acceptance as a malignant lymphoma after the establishment of the Working Formulation, there is limited information about its natural history, disease pattern, and longterm treatment outcome. This study is an analysis of these parameters in patients with primary MALT lymphoma of the stomach. Materials and Methods: Consecutive patients with primary gastric MALT lymphoma who received definitive treatment at the Massachusetts General Hospital between (4(78)) and (2(95)) were included in the study. The diagnosis was pathologically verified in all cases. Clinical staging studies included chest X-ray +/- chest CT, abdomino-pelvic CT or bipedal lymphangiogram, barium swallow, and bone marrow biopsy. Treatment strategies included combinations of partial or total gastrectomy, radiation (RT) and chemotherapy (chemo). RT was given via multifield technique, with 10-25MV photons, to doses of 36-50.4 Gy (1.1-1.8 Gy per fraction, 5 days a week). Survival analyses were performed by the Kaplan-Meier actuarial method. Results: There were twenty-two patients between the ages of 45 - 93 years, with a mean follow-up of 67 months. Ten were male and 12 female. The most frequent presenting symptoms were epigastric pain (77%), dyspepsia (65%), and melena (41%). The mean duration of symptoms was 27 months. Eighteen cases were clinical stage (cs)I, two csII, one csIII, and one csIV. The treatment approaches were: 1) csI:6 gastrectomy alone, 7 gastrectomy and RT, 1 gastrectomy and chemo, 2 RT alone, 1 chemo and RT, 1 no therapy; 2) csII: 2 gastrectomy and RT; 3) csIII: 1 gastrectomy and chemo; 4) csIV: 1 chemo and RT. Among 16 gastrectomy specimens, multifocal gastric involvement was evident in 50%. The most frequently involved sites were the body (63%) and antrum

  15. Type 2 diabetes mellitus coincident with pulmonary or latent tuberculosis results in modulation of adipocytokines.

    Science.gov (United States)

    Pavan Kumar, Nathella; Nair, Dina; Banurekha, V V; Dolla, Chandrakumar; Kumaran, Paul; Sridhar, Rathinam; Babu, Subash

    2016-03-01

    Type 2 diabetes mellitus (T2DM) is recognized as major risk factor for the progress of active pulmonary tuberculosis (PTB), although the mechanistic link between diabetes and tuberculosis remains poorly characterized. Moreover, the influence of poorly controlled diabetes on the baseline levels of adipocytokines in the context of tuberculosis has not been explored in detail. To characterize the influence of coexistent DM on adipocytokine levels in pulmonary or latent TB (LTB), we examined circulating levels of adipocytokines in the plasma of individuals with PTB-DM or LTB-DM and compared them with those without DM (PTB or LTB). PTB-DM or LTB-DM is characterized by diminished circulating levels of adiponectin and adipsin and/or heightened circulating levels of leptin, visfatin and PAI-1. In addition, adiponectin and adipsin exhibit a significant negative correlation, whereas leptin, visfatin and PAI-1 display a significant positive correlation with HbA1C levels and random blood glucose levels. Therefore, our data reveal that PTB-DM or LTB-DM is characterized by alterations in the systemic levels of adipocytokines, indicating that altered adipose tissue inflammation underlying Type 2 diabetes potentially contributes to pathogenesis of TB disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Ventilation System Type and the Resulting Classroom Temperature and Air Quality During Heating Season

    DEFF Research Database (Denmark)

    Gao, Jie; Wargocki, Pawel; Wang, Yi

    2014-01-01

    The present study investigated how different ventilation system types influence classroom temperature and air quality. Five classrooms were selected in the same school. They were ventilated by manually operable windows, manually operable windows with exhaust fan, automatically operable windows...... with and without exhaust fan and by mechanical ventilation system. Temperature, relative humidity, carbon dioxide (CO2) concentration and opening of windows were continuously monitored for one month during heating season in 2012. Classroom with manually operable windows had the highest carbon dioxide concentration...... levels so that the estimated ventilation rate was the lowest compared with the classrooms ventilated with other systems. Temperatures were slightly lower in classroom ventilated by manually operable windows with exhaust fan. Windows were opened seldom even in the classroom ventilated by manually operable...

  17. A Second look at the first result of Landesman-Lazer type

    Directory of Open Access Journals (Sweden)

    Alan C. Lazer

    2000-10-01

    Full Text Available We discuss some results concerning periodic and almot periodic solutions of ordinary differential equations which are precursors of a result on weak solutions of a semilinear elliptic boundary due to E. M. Landesman and the author. It is observed that in the earliest of these, if one looks for periodic solutions instead of almost peridic solutions, then the conditions can be relaxed.

  18. Results of experiments with flare type igniters on diesel fuel and crude oil emulsions

    International Nuclear Information System (INIS)

    Moffat, C.; Hankins, P.

    1997-01-01

    Development of a hand-deployable igniter that could ignite contained diesel fuel and crude oil emulsions on water was described. The igniter was developed as part of the U.S. Navy Supervisor of Salvage (SUPSALV) In-Situ Burn (ISB) system. It is a manually operated, electrically fired, high temperature flare type igniter. It is 41 cm long, 10 cm in diameter, weighs 1.5 kg, and is packaged and shipped with the ISB system. The chemical and mineral composition of the flair allows for a three minute burn of up to 1370 degrees C (2500 degrees F) at the center. The flare is most effective when used in conjunction with a shroud of sorbent material which traps and holds oil around the burning flare aiding the ignition process by increasing the initial propagation area. In small-scale tank experiments the flare ignited diesel fuel in ambient temperatures of 3 degrees C, with winds of 8 to 10 m/sec. The flare also ignited 22.5 per cent water-in crude oil emulsion in 3 degrees C temperatures. 4 refs., 3 tabs

  19. Improvement of Metabolic Parameters Resulted from Levothyroxine Therapy in Hypothyroid Type 2 Diabetes Mellitus Patient

    Directory of Open Access Journals (Sweden)

    Dante S Harbuwono

    2016-09-01

    Full Text Available This is a case of 51 year-old woman with uncontrolled type 2 diabetes mellitus which was diagnosed 1.5 year earlier, obesity with body mass index 32.2 kg/m2, waist circumference of 113 cm, diffuse goiter with neck circumference 40 cm, and hypertension with blood pressure >140/90 mmHg. Since 6 months ago, she often seemed like having less concentration or daydreaming, chronic fatigue, depression, and low food intake. Her body weight had been increasing over time. Her hypothyroidism clinical scoring Billewicz and Zulewski criterias were 17 and 8 respectively, showing that she tended to experience hypothyroidism. From laboratory examination, fasting blood glucose was 216 mg/dL and 2-hour postprandial blood glucose was 320 mg/dL with level of HbA1c was 9.9%, triglyceride level was 486 mg/dL, HDL cholesterol 46 mg/dL, LDL cholesterol 157 mg/dL, and total cholesterol was 269 mg/dL. Thyroid ultrasound showed a diffuse goiter in both lobes of her thyroid gland.

  20. Haemolytic anaemia resulting from the surgical repair of acute type A aortic dissection.

    Science.gov (United States)

    Sekine, Yuji; Yamamoto, Shin; Fujikawa, Takuya; Oshima, Susumu; Ono, Makoto; Sasaguri, Shiro

    2014-02-01

    Haemolytic anaemia after acute aortic dissection surgery is extremely rare. We report 4 cases of haemolytic anaemia with different aetiologies. Four patients underwent emergency operation for acute type A aortic dissection and subsequently developed haemolytic anaemia. Case 1: a 41-year old man underwent hemiarch replacement. We performed total arch replacement 3 years postoperatively, which revealed that haemolytic anaemia was induced by proximal anastomotic stenosis caused by inverted internal felt strip. Case 2: a 28-year old man diagnosed with Marfan syndrome underwent total arch replacement. Five months postoperatively, we noted severe stenosis at the previous distal anastomotic site, which caused the haemolytic anaemia, and performed descending thoracic aortic replacement for a residual dissecting aneurysm. Case 3: a 49-year old man underwent hemiarch replacement. Three years postoperatively, we performed total arch replacement for a residual dissecting aortic arch aneurysm and repaired a kinked graft responsible for haemolytic anaemia. Case 4: a 42-year old man underwent total arch replacement. Eighteen months later, we performed descending thoracic aortic replacement. We repaired a portion of the ascending aorta as haemolityc anaemia was induced by kinking of a total arch replacement redundant graft. All the haemolityc anaemia patients were successfully released after surgical reintervention.

  1. Extension of Type 2 Diabetes Genome-Wide Association Scan Results in the Diabetes Prevention Program

    Science.gov (United States)

    Moore, Allan F.; Jablonski, Kathleen A.; McAteer, Jarred B.; Saxena, Richa; Pollin, Toni I.; Franks, Paul W.; Hanson, Robert L.; Shuldiner, Alan R.; Knowler, William C.; Altshuler, David; Florez, Jose C.

    2008-01-01

    OBJECTIVE— Genome-wide association scans (GWASs) have identified novel diabetes-associated genes. We evaluated how these variants impact diabetes incidence, quantitative glycemic traits, and response to preventive interventions in 3,548 subjects at high risk of type 2 diabetes enrolled in the Diabetes Prevention Program (DPP), which examined the effects of lifestyle intervention, metformin, and troglitazone versus placebo. RESEARCH DESIGN AND METHODS— We genotyped selected single nucleotide polymorphisms (SNPs) in or near diabetes-associated loci, including EXT2, CDKAL1, CDKN2A/B, IGF2BP2, HHEX, LOC387761, and SLC30A8 in DPP participants and performed Cox regression analyses using genotype, intervention, and their interactions as predictors of diabetes incidence. We evaluated their effect on insulin resistance and secretion at 1 year. RESULTS— None of the selected SNPs were associated with increased diabetes incidence in this population. After adjustments for ethnicity, baseline insulin secretion was lower in subjects with the risk genotype at HHEX rs1111875 (P = 0.01); there were no significant differences in baseline insulin sensitivity. Both at baseline and at 1 year, subjects with the risk genotype at LOC387761 had paradoxically increased insulin secretion; adjustment for self-reported ethnicity abolished these differences. In ethnicity-adjusted analyses, we noted a nominal differential improvement in β-cell function for carriers of the protective genotype at CDKN2A/B after 1 year of troglitazone treatment (P = 0.01) and possibly lifestyle modification (P = 0.05). CONCLUSIONS— We were unable to replicate the GWAS findings regarding diabetes risk in the DPP. We did observe genotype associations with differences in baseline insulin secretion at the HHEX locus and a possible pharmacogenetic interaction at CDKNA2/B. PMID:18544707

  2. Self-Esteem of Rural Teens: Results for Three Family Types.

    Science.gov (United States)

    Hall, Anita M.; Rowe, George P.

    1991-01-01

    A total of 108 (of 200) adolescents completed the Coopersmith Self-Esteem Inventory and family characteristics questionnaire. Results showed that it is not the structure of the family but the degree of discord within the family that influences self-esteem. (Author/JOW)

  3. Safety test results of lithium-thionyl chloride wound-type cells

    Energy Technology Data Exchange (ETDEWEB)

    Vallin, D.; Broussely, M. (British Columbia Univ., Vancouver (Canada))

    1989-05-01

    Increase in the use of spirally-wound, lithium-thionyl chloride cells is currently limited because of unsafe incidents which have been reported during the early stage of development of this product. Today, it is believed that these cells are safe over a wide range of operating conditions if properly designed. The paper describes the external and internal SAFT design of Li-SOCl2LSH series cells, as well as the results of safety tests. 6 refs.

  4. Safety test results of lithium-thionyl chloride wound-type cells

    Science.gov (United States)

    Vallin, D.; Broussely, M.

    1989-05-01

    Increase in the use of spirally-wound, lithium-thionyl chloride cells is currently limited because of unsafe incidents which have been reported during the early stage of development of this product. Today, it is believed that these cells are safe over a wide range of operating conditions if properly designed. The paper describes the external and internal SAFT design of Li-SOCl2LSH series cells, as well as the results of safety tests.

  5. Optimization of crossflow tubular heat exchangers of the parallelepipedic type. Fundamental results

    International Nuclear Information System (INIS)

    Chalot, R.

    1980-01-01

    The results of an internal optimization study of a particular category of heat exchanger run in the most general fashion are presented while taking into account of the three thermal resistances and seven specific exponents for the various technical functions concerned as the fluids can be either liquid or gaseous. The two criteria of internal optimization and the coefficients necessary for approaching the external phase are determined with exactitude. Through analysis of size effect, the author finally states growth laws of the exchanger which suffice in explaining the evolution found in economic competition between tubular air heaters and regenerative heater equipping the large steam generators of thermal plants [fr

  6. Results of investigations of non-specific humoral-type response in workers exposed to beryllium

    International Nuclear Information System (INIS)

    Cianciara, M.; Loch, T.

    1989-12-01

    In the group of 30 workers exposed to beryllium a statistically significant increase in the level of immunoglobulins of class A was found in comparison with the control group (p<0.01). This may be an early indicator of a process taking place in the respiratory system. Results of measurement of immunoglobulins, as non-specific indicators, are of limited value in the evaluation of the influence of the occupational factor; at the same time they point to the usefulness of testing for the specific indicators of humoral reactivity in persons whose work involves contact with beryllium or its compounds. (author)

  7. Normalization of Phenotypic Data from a Clinical Data Warehouse: Case Study of Heterogeneous Blood Type Data with Surprising Results.

    Science.gov (United States)

    Cimino, James J

    2015-01-01

    Clinical data warehouses often contain analogous data from disparate sources, resulting in heterogeneous formats and semantics. We have developed an approach that attempts to represent such phenotypic data in its most atomic form to facilitate aggregation. We illustrate this approach with human blood antigen typing (ABO-Rh) data drawn from the National Institutes of Health's Biomedical Translational Research Information System (BTRIS). In applying the method to actual patient data, we discovered a 2% incidence of changed blood types. We believe our approach can be applied to any institution's data to obtain comparable patient phenotypes. The actual discrepant blood type data will form the basis for a future study of the reasons for blood typing variation.

  8. Fracture risk in women with type II diabetes. Results from a historical cohort with fracture follow-up

    DEFF Research Database (Denmark)

    Holm, Jakob Præst; Jensen, Thomas; Hyldstrup, Lars

    2018-01-01

    with type II diabetes in a cohort of 6285 women followed on average (until major osteoporotic fracture (MOF), death or end of study) for 5.8 years. Information of fracture risk factors was obtained from a clinical database and from national registries. RESULTS: An elevated fracture risk was present......PURPOSE: To examine the independent association between type II diabetes and fracture risk in a population of predominantly postmenopausal women referred to a specialist clinic for osteoporosis evaluation. METHODS: Type II diabetes associated fracture risk were evaluated among to 229 patients....... Prevalent fractures (43.7 vs. 33.2%, p = 0.0010) and prevalent MOF (26.2 vs. 20.5% p = 0.038) were more common among patients with type II diabetes. The unadjusted incident fracture risk was increased with a higher relative risk of 42%. An elevated MOF hazard ratio was present (HR = 1.726, p = 0...

  9. IS BRAIN AMYLOID PRODUCTION A CAUSE OR A RESULT OF DEMENTIA OF THE ALZHEIMER TYPE?

    Science.gov (United States)

    Ala, Tom; Patrylo, Peter R.; Brewer, Gregory J.; Yan, Xiao-Xin

    2011-01-01

    The amyloid cascade hypothesis has guided much of research into Alzheimer disease (AD) over the last 25 years. We argue that the hypothesis of beta amyloid (Aβ) as the primary cause of dementia may not be fully correct. Rather, we propose that decline in brain metabolic activity, which is tightly linked to synaptic activity, actually underlies both the cognitive decline and the deposition of Aβ. Aβ may further exacerbate metabolic decline and result in a downward spiral of cognitive function, leading to dementia. This novel interpretation can tie the disparate risk factors for dementia to a unifying hypothesis and present a roadmap for interventions to decrease the prevalence of dementia in the elderly population. PMID:20847431

  10. Results of using frequency banded SAFT for examining three types of defects

    Science.gov (United States)

    Clayton, Dwight; Barker, Alan; Santos-Villalobos, Hector

    2017-02-01

    A multitude of concrete-based structures are typically part of a light water reactor (LWR) plant to provide the foundation, support, shielding, and containment functions. Concrete has been used in the construction of nuclear power plants (NPPs) because of three primary properties; its low cost, structural strength, and ability to shield radiation. Examples of concrete structures important to the safety of LWR plants include the containment building, spent fuel pool, and cooling towers. This use has made concrete's long-term performance crucial for the safe operation of commercial NPPs. Extending reactor life to 60 years and beyond will likely increase susceptibility and severity of known forms of degradation. Additionally, new mechanisms of materials degradation are also possible. Specially designed and fabricated test specimens can provide realistic flaws that are similar to actual flaws in terms of how they interact with a particular Nondestructive Evaluation (NDE) technique. Artificial test blocks allow the isolation of certain testing problems as well as the variation of certain parameters. Because conditions in the laboratory are controlled, the number of unknown variables can be decreased, making it possible to focus on specific aspects, investigate them in detail, and gain further information on the capabilities and limitations of each method. To minimize artifacts caused by boundary effects, the dimensions of the specimens should not be too compact. In this paper, we apply the frequency banded Synthetic Aperture Focusing Technique (SAFT) technique to a 2.134 m × 2.134 m × 1.016 m concrete test specimen with twenty deliberately embedded defects. These twenty embedded defects simulate voids (honeycombs), delamination, and embedded organic construction debris. Using the time-frequency technique of wavelet packet decomposition and reconstruction, the spectral content of the signal can be divided into two resulting child nodes. The resulting two nodes can then

  11. Is Neurofibromatosis Type 1-Noonan Syndrome a Phenotypic Result of Combined Genetic and Epigenetic Factors?

    Science.gov (United States)

    Yapijakis, Christos; Pachis, Nikos; Natsis, Stavros; Voumvourakis, Costas

    2016-01-01

    Neurofibromatosis 1-Noonan syndrome (NFNS) presents combined characteristics of both autosomal dominant disorders: NF1 and Noonan syndrome (NS). The genes causing NF1 and NS are located on different chromosomes, making it uncertain whether NFNS is a separate entity as previously suggested, or rather a clinical variation. We present a four-membered Greek family. The father was diagnosed with familial NF1 and the mother with generalized epilepsy, being under hydantoin treatment since the age of 18 years. Their two male children exhibited NFNS characteristics. The father and his sons shared R1947X mutation in the NF1 gene. The two children with NFNS phenotype presented with NF1 signs inherited from their father and fetal hydantoin syndrome-like phenotype due to exposure to that anticonvulsant during fetal development. The NFNS phenotype may be the result of both a genetic factor (mutation in the NF1 gene) and an epigenetic/environmental factor (e.g. hydantoin). Copyright © 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  12. Results of research and development for nuclear power plants with WWER-1000 type light water reactors

    International Nuclear Information System (INIS)

    1984-01-01

    The conference met in three sessions: 1. Project designing and construction of nuclear power plants; 2. Materials, technologies and applied mechanics; 3. Physics, thermal physics and control. The proceedings contains 82 papers of which only two have not been inputted in INIS. The final resolutions of session 1 related to the reduction of capital costs for newly built units, processing of project documentation, the introduction of step motors manufactured in Czechoslovakia, in-service diagnostics of nuclear power plants, etc. The final recommendations of session 2 dealt with the centralization of the management of research into the reliability, safety and residual life of nuclear installations, with radiation stability of weld metals, repairs of nuclear power plants by patch welding, with welding in nuclear power plants and stress calculations using mathematical methods. Session 3 centred on questions of the safety, reliability and economy of nuclear power plant operation. It was recommended to make a comparison of the results of theoretical calculations with experiments, to concentrate on the automation of measurement, to extend international division of labour and cooperation of CMEA countries, to extend publishing activities in the field of thermal physics, etc. General recommendations were related to the conception of the construction of nuclear power plants in Czechoslovakia, the implementation of original scientific, research and development work, to the question of personnel for nuclear research, the experimental base of the Czechoslovak nuclear programme and to planning and management of technical development. (E.S.)

  13. In Vitro Neurotoxicity Resulting from Exposure of Cultured Neural Cells to Several Types of Nanoparticles

    Directory of Open Access Journals (Sweden)

    Stephen F Larner

    2017-03-01

    Full Text Available Laboratory and industrial production of various nanoparticles, single-walled nanotubes (SWNTs, fullerene (C60, cadmium selenide (CdSe quantum dots, carbon black (CB, and dye-doped silica nanospheres (NSs, has greatly increased in the past 15 years. However, little research has been done to analyze the toxicity of these materials. With recent studies showing that nano-substances can cross the blood–brain barrier, we examined the neurotoxicity of these manufactured nanoparticles. By employing the rat PC-12 neuronal-like cell line as the basis for our studies, we were able to evaluate the toxicity caused by these five nanoparticles. The level of toxicity was measured by testing for cell viability using the lactate dehydrogenase (LDH cell viability assay, morphological analysis of changes in cellular structures, and Western blot analyses of αII-spectrin breakdown products (SBDP as cell death indicators. Our results showed cytotoxicity in nondifferentiated PC-12 cells exposed to CB (10–100 µg/mL, SWNTs (10–100 µg/mL, C60 (100 µg/mL, CdSe (10 µg/mL, CB (500 µg/mL, and dye-doped silicon NSs (10 µg/mL. Exposure to higher concentrations (100 µg/mL of SWNTs, CB, and C60 increased the formation of SBDP150/145, as well as cell membrane contraction and the formation of cytosolic vacuoles. The incorporations of the nanoparticles into cell cytoplasm were observed using the fluorescent dye-doped NSs in both nondifferentiated and nerve growth factor (NGF-differentiated PC-12 cells. When PC-12 cells are differentiated, they appeared to be even more sensitive to cytotoxicity of nanoparticles such as CB 10 nm (10–100 µg/mL, CB 100 nm (10–100 µg/mL, and CdSe (1–10 µg/mL.

  14. INTERRELATION BETWEEN TYPE AND CULTIVAR OF BERRY-LIKE CROP AND CUTTINGS CRYOPRESERVATION RESULTS

    Directory of Open Access Journals (Sweden)

    L. V. Gorbunov

    2013-04-01

    reproducibility of experimental results. The analysis of reproducibility of indexes of viability of the studied cuttings held by the coefficient of variation, showed that during the cryopreservation this value is changed to blackcurrant cultivars from 5 to 91%, redcurrant — 9–137%, gooseberries, 22–74%, raspberry 18–105%.

  15. First results on the charge collection properties of segmented detectors made with p-type bulk silicon

    International Nuclear Information System (INIS)

    Casse, G.; Allport, P.P.; Bowcock, T.J.V.; Greenall, A.; Hanlon, M.; Jackson, J.N.

    2002-01-01

    Radiation damage of n-type bulk detectors introduces stable defects acting as effective p-type doping and leads to the change of the conductivity type of the silicon substrate (type inversion) after a fluence of a few times 10 13 protons cm -2 . The diode junction after inversion migrates from the original side to the back plane of the detector. The migration of the junction can be prevented using silicon detectors with p-type substrates. Furthermore, the use of n-side readout gives higher charge collection efficiency for segmented devices operated below the full depletion voltage. Large area (∼6.4x6.4 cm 2 ) capacitively coupled 80 μm pitch detectors using polysilicon bias resistors have been fabricated on p-type substrates (n-in-p diode structure). These detectors have been irradiated with 24 GeV/c protons to an integrated fluence of 3x10 14 cm -2 and kept for 7 days at 25 deg. C to reach the broad minimum of the annealing curve. Results are presented on the comparison of their charge collection properties with detectors using p-strip read-out after corresponding dose and annealing

  16. Multi-virulence-locus sequence typing of Staphylococcus lugdunensis generates results consistent with a clonal population structure and is reliable for epidemiological typing.

    Science.gov (United States)

    Didi, Jennifer; Lemée, Ludovic; Gibert, Laure; Pons, Jean-Louis; Pestel-Caron, Martine

    2014-10-01

    Staphylococcus lugdunensis is an emergent virulent coagulase-negative staphylococcus responsible for severe infections similar to those caused by Staphylococcus aureus. To understand its potentially pathogenic capacity and have further detailed knowledge of the molecular traits of this organism, 93 isolates from various geographic origins were analyzed by multi-virulence-locus sequence typing (MVLST), targeting seven known or putative virulence-associated loci (atlLR2, atlLR3, hlb, isdJ, SLUG_09050, SLUG_16930, and vwbl). The polymorphisms of the putative virulence-associated loci were moderate and comparable to those of the housekeeping genes analyzed by multilocus sequence typing (MLST). However, the MVLST scheme generated 43 virulence types (VTs) compared to 20 sequence types (STs) based on MLST, indicating that MVLST was significantly more discriminating (Simpson's index [D], 0.943). No hypervirulent lineage or cluster specific to carriage strains was defined. The results of multilocus sequence analysis of known and putative virulence-associated loci are consistent with a clonal population structure for S. lugdunensis, suggesting a coevolution of these genes with housekeeping genes. Indeed, the nonsynonymous to synonymous evolutionary substitutions (dN/dS) ratio, the Tajima's D test, and Single-likelihood ancestor counting (SLAC) analysis suggest that all virulence-associated loci were under negative selection, even atlLR2 (AtlL protein) and SLUG_16930 (FbpA homologue), for which the dN/dS ratios were higher. In addition, this analysis of virulence-associated loci allowed us to propose a trilocus sequence typing scheme based on the intragenic regions of atlLR3, isdJ, and SLUG_16930, which is more discriminant than MLST for studying short-term epidemiology and further characterizing the lineages of the rare but highly pathogenic S. lugdunensis. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  17. Forensic typing of autosomal SNPs with a 29 SNP-multiplex--results of a collaborative EDNAP exercise

    DEFF Research Database (Denmark)

    Sanchez, Juan Jose; Børsting, C; Balogh, K

    2008-01-01

    We report the results of an inter-laboratory exercise on typing of autosomal single nucleotide polymorphisms (SNP) for forensic genetic investigations in crime cases. The European DNA Profiling Group (EDNAP), a working group under the International Society for Forensic Genetics (ISFG), organised...

  18. Strengths, Risk Factors, and Resilient Outcomes in Adolescents with Type 1 Diabetes: Results from Diabetes MILES Youth – Australia

    DEFF Research Database (Denmark)

    Hillard, M; Hagger, Virginia; Hendrieckx, Crystal

    2017-01-01

    16. Hilliard ME, Hagger V, Hendrieckx C, Anderson BJ, Trawley S, Jack MM, Pouwer F, Skinner TC, Speight J. Strengths, Risk Factors, and Resilient Outcomes in Adolescents with Type 1 Diabetes: Results from Diabetes MILES Youth – Australia. Diabetes Care. 40(7):849-855...

  19. Human papillomavirus prevalence and type-distribution in cervical glandular neoplasias: Results from a European multinational epidemiological study.

    Science.gov (United States)

    Holl, Katsiaryna; Nowakowski, Andrzej M; Powell, Ned; McCluggage, W Glenn; Pirog, Edyta C; Collas De Souza, Sabrina; Tjalma, Wiebren A; Rosenlund, Mats; Fiander, Alison; Castro Sánchez, Maria; Damaskou, Vasileia; Joura, Elmar A; Kirschner, Benny; Koiss, Robert; O'Leary, John; Quint, Wim; Reich, Olaf; Torné, Aureli; Wells, Michael; Rob, Lukas; Kolomiets, Larisa; Molijn, Anco; Savicheva, Alevtina; Shipitsyna, Elena; Rosillon, Dominique; Jenkins, David

    2015-12-15

    Cervical glandular neoplasias (CGN) present a challenge for cervical cancer prevention due to their complex histopathology and difficulties in detecting preinvasive stages with current screening practices. Reports of human papillomavirus (HPV) prevalence and type-distribution in CGN vary, providing uncertain evidence to support prophylactic vaccination and HPV screening. This study [108288/108290] assessed HPV prevalence and type-distribution in women diagnosed with cervical adenocarcinoma in situ (AIS, N = 49), adenosquamous carcinoma (ASC, N = 104), and various adenocarcinoma subtypes (ADC, N = 461) from 17 European countries, using centralised pathology review and sensitive HPV testing. The highest HPV-positivity rates were observed in AIS (93.9%), ASC (85.6%), and usual-type ADC (90.4%), with much lower rates in rarer ADC subtypes (clear-cell: 27.6%; serous: 30.4%; endometrioid: 12.9%; gastric-type: 0%). The most common HPV types were restricted to HPV16/18/45, accounting for 98.3% of all HPV-positive ADC. There were variations in HPV prevalence and ADC type-distribution by country. Age at diagnosis differed by ADC subtype, with usual-type diagnosed in younger women (median: 43 years) compared to rarer subtypes (medians between 57 and 66 years). Moreover, HPV-positive ADC cases were younger than HPV-negative ADC. The six years difference in median age for women with AIS compared to those with usual-type ADC suggests that cytological screening for AIS may be suboptimal. Since the great majority of CGN are HPV16/18/45-positive, the incorporation of prophylactic vaccination and HPV testing in cervical cancer screening are important prevention strategies. Our results suggest that special attention should be given to certain rarer ADC subtypes as most appear to be unrelated to HPV. © 2015 The Authors. Published by Wiley Periodicals, Inc. on behalf of UICC.

  20. Patient-clinician agreement on treatment type and helpfulness: results from a WTC rescue and recovery worker cohort.

    Science.gov (United States)

    Leikauf, John; Schechter, Clyde B; Marrone, Kathryn; Ozbay, Fatih; Rapoport, Alison; Sharma, Vanshdeep; Katz, Craig L

    2013-11-01

    This study assessed patient and clinician agreement about treatment type and its association with treatment helpfulness among World Trade Center rescue and recovery workers. A total of 187 outpatients and 280 clinicians completed a survey, which gathered information on patient characteristics, treatment types, and treatment helpfulness. Kappa statistics and sensitivity and specificity analyses were used, and the association between patient-clinician agreement and reported treatment benefit was determined. Patient-clinician agreement was highest for group therapy, medication management, eye movement desensitization and reprocessing, and couples therapy. Agreement about medication management, individual psychotherapy, and workers' compensation evaluation was associated with higher reported treatment benefits. Findings support the hypothesis that agreement regarding treatment type is associated with higher reported benefit and extend findings of previous studies to a linguistically diverse, naturalistic sample exposed to a disaster trauma. Results also highlight the need for better understanding of eclectic therapies offered in real-world clinical practice.

  1. Analysis of Transcriptional Signatures in Response to Listeria monocytogenes Infection Reveals Temporal Changes That Result from Type I Interferon Signaling

    Science.gov (United States)

    Potempa, Krzysztof; Graham, Christine M.; Moreira-Teixeira, Lucia; McNab, Finlay W.; Howes, Ashleigh; Stavropoulos, Evangelos; Pascual, Virginia; Banchereau, Jacques; Chaussabel, Damien; O’Garra, Anne

    2016-01-01

    Analysis of the mouse transcriptional response to Listeria monocytogenes infection reveals that a large set of genes are perturbed in both blood and tissue and that these transcriptional responses are enriched for pathways of the immune response. Further we identified enrichment for both type I and type II interferon (IFN) signaling molecules in the blood and tissues upon infection. Since type I IFN signaling has been reported widely to impair bacterial clearance we examined gene expression from blood and tissues of wild type (WT) and type I IFNαβ receptor-deficient (Ifnar1-/-) mice at the basal level and upon infection with L. monocytogenes. Measurement of the fold change response upon infection in the absence of type I IFN signaling demonstrated an upregulation of specific genes at day 1 post infection. A less marked reduction of the global gene expression signature in blood or tissues from infected Ifnar1-/- as compared to WT mice was observed at days 2 and 3 after infection, with marked reduction in key genes such as Oasg1 and Stat2. Moreover, on in depth analysis, changes in gene expression in uninfected mice of key IFN regulatory genes including Irf9, Irf7, Stat1 and others were identified, and although induced by an equivalent degree upon infection this resulted in significantly lower final gene expression levels upon infection of Ifnar1-/- mice. These data highlight how dysregulation of this network in the steady state and temporally upon infection may determine the outcome of this bacterial infection and how basal levels of type I IFN-inducible genes may perturb an optimal host immune response to control intracellular bacterial infections such as L. monocytogenes. PMID:26918359

  2. Homocysteine levels are associated with the results of 123I-metaiodobenzylguanidine myocardial scintigraphy in type 2 diabetic patients

    International Nuclear Information System (INIS)

    Anan, Futoshi; Yonemochi, Hidetoshi; Nakagawa, Mikiko; Saikawa, Tetsunori; Masaki, Takayuki; Takahashi, Naohiko; Yoshimatsu, Hironobu; Eshima, Nobuoki

    2007-01-01

    Elevated total plasma homocysteine (tHcy) levels and cardiovascular autonomic dysfunction are associated with a high mortality in type 2 diabetic patients. We tested the hypothesis that hyperhomocysteinemia is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients not receiving insulin treatment. The study group consisted of 17 type 2 diabetic patients with high tHcy levels (>15 mmol/l, age 58±5 years, high tHcy group). The control group consisted of 23 age-matched type 2 diabetic patients with normal tHcy levels (≤15 mmol/l, age 58±9 years, normal tHcy group). Cardiovascular autonomic function was assessed by baroreflex sensitivity, heart rate variability, plasma norepinephrine concentrations, and cardiac 123 I-metaiodobenzylguanidine (MIBG) scintigraphy. Early and delayed 123 I-MIBG myocardial uptake values were lower (p 123 I-MIBG was higher (p 123 I-MIBG at the delayed phase. Our results demonstrate that high levels of tHcy are associated with depressed cardiovascular autonomic function and insulin resistance in patients with type 2 diabetes mellitus. (orig.)

  3. Lack of the nucleoside transporter ENT1 results in the Augustine-null blood type and ectopic mineralization.

    Science.gov (United States)

    Daniels, Geoff; Ballif, Bryan A; Helias, Virginie; Saison, Carole; Grimsley, Shane; Mannessier, Lucienne; Hustinx, Hein; Lee, Edmond; Cartron, Jean-Pierre; Peyrard, Thierry; Arnaud, Lionel

    2015-06-04

    The Augustine-negative alias At(a-) blood type, which seems to be restricted to people of African ancestry, was identified half a century ago but remains one of the last blood types with no known genetic basis. Here we report that a nonsynonymous single nucleotide polymorphism in SLC29A1 (rs45458701) is responsible for the At(a-) blood type. The resulting p.Glu391Lys variation in the last extracellular loop of the equilibrative nucleoside transporter 1 (ENT1; also called SLC29a1) is known not to alter its ability to transport nucleosides and nucleoside analog drugs. Furthermore, we identified 3 individuals of European ancestry who are homozygous for a null mutation in SLC29A1 (c.589+1G>C) and thus have the Augustine-null blood type. These individuals lacking ENT1 exhibit periarticular and ectopic mineralization, which confirms an important role for ENT1/SLC29A1 in human bone homeostasis as recently suggested by the skeletal phenotype of aging Slc29a1(-/-) mice. Our results establish Augustine as a new blood group system and place SLC29A1 as a new candidate gene for idiopathic disorders characterized with ectopic calcification/mineralization. © 2015 by The American Society of Hematology.

  4. Is HLA the cause of the high incidence of type 1 diabetes in the Canary Islands? Results from the Type 1 Diabetes Genetics Consortium (T1DGC).

    Science.gov (United States)

    Santana Del Pino, Angelo; Medina-Rodríguez, Nathan; Hernández-García, Marta; Nóvoa-Mogollón, Francisco J; Wägner, Ana M

    2017-03-01

    Incidence of childhood-onset type 1 diabetes mellitus in the Canary Islands is the highest reported so far in Spain, and among the highest worldwide. The HLA region accounts for approximately half the genetic risk of type 1 diabetes. Our aim was to assess distribution of high-risk and protective HLA haplotypes in the Canarian families included in the T1DGC, as compared to the rest of Spain. The T1DGC study, an international project to study the genetics and pathogenesis of type 1 diabetes, enrolled more than 3000 families with type 1 diabetes worldwide. Spain provided 149 of these families, of whom 42 were from Tenerife and Gran Canaria. HLA was genotyped centrally using a PCR-based, sequence-specific oligonucleotide probe system. Haplotypes were reconstructed using the deterministic algorithm alleHap in the R programming environment. Based on prior T1DGC results in Caucasian population, haplotypes DRB1*0405-DQA1*0301-DQB1*0302, DRB1*0401-DQA1*0301-DQB1*0302, DRB1*0301-DQA1*0501-DQB1*0201, DRB1*0402-DQA1*0301-DQB1*0302 and DRB1*0404-DQA1*0301-DQB1*0302 were considered high-risk. DRB1*0701-DQA1*0201-DQB1*0303, DRB1*1401-DQA1*0101-DQB1*0503, DRB1*1501-DQA1*0102-DQB1*0602, DRB1*1101-DQA1*0501-DQB1*0301, DRB1*1104-DQA1*0501-DQB1*0301, DRB1*1303-DQA1*0501-DQB1*0301, DRB1*1301-DQA1*0103-DQB1*0603 and DRB1*0403-DQA1*0301-DQB1*0302 were considered protective. The distribution of protective, high-risk, and other haplotypes in the (first two) affected siblings and unaffected parents from Canarian and non-Canarian Spanish families was compared (Chi-square test). No significant differences were found between the regions in distribution of the HLA haplotypes in the affected siblings or in the non-affected parents. The high incidence of childhood-onset type 1 diabetes in the Canarian population does not appear to be explained by a greater prevalence of high-risk class II HLA haplotypes in families with the disease. However, sample size limits the differences that can be detected

  5. [THE COMPARATIVE ANALYSIS OF RESULTS OF DETECTION OF CARCINOGENIC TYPES OF HUMAN PAPILLOMA VIRUS BY QUALITATIVE AND QUANTITATIVE TESTS].

    Science.gov (United States)

    Kuzmenko, E T; Labigina, A V; Leshenko, O Ya; Rusanov, D N; Kuzmenko, V V; Fedko, L P; Pak, I P

    2015-05-01

    The analysis of results of screening (n = 3208; sexually active citizen aged from 18 to 59 years) was carried out to detect oncogene types of human papilloma virus in using qualitative (1150 females and 720 males) and quantitative (polymerase chain reaction in real-time (843 females and 115 males) techniques. The human papilloma virus of high oncogene type was detected in 65% and 68.4% of females and in 48.6% and 53% of males correspondingly. Among 12 types of human papilloma virus the most frequently diagnosed was human papilloma virus 16 independently of gender of examined and technique of analysis. In females, under application of qualitative tests rate of human papilloma virus 16 made up to 18.3% (n = 280) and under application of quantitative tests Rte of human papilloma virus made up to 14.9% (n = 126; p ≤ 0.05). Under examination of males using qualitative tests rate of human papilloma virus 16 made up to 8.3% (n = 60) and under application of qualitative tests made up to 12.2% (n = 14; p ≥ 0.05). Under application of qualitative tests rate of detection on the rest ofoncogene types of human papilloma virus varied in females from 3.4% to 8.4% and in males from 1.8% to 5.9%. Under application of qualitative tests to females rate of human papilloma virus with high viral load made up to 68.4%, with medium viral load - 2.85% (n = 24) and with low viral load -0.24% (n = 2). Under application of quantitative tests in males rate of detection of types of human papilloma virus made up to 53% and at that in all high viral load was established. In females, the most of oncogene types of human papilloma virus (except for 31, 39, 59) are detected significantly more often than in males.

  6. Increased BMR in overweight and obese patients with type 2 diabetes may result from an increased fat-free mass.

    Science.gov (United States)

    Sun, Min-xian; Zhao, Shi; Mao, Hong; Wang, Zhong-jing; Zhang, Xu-yan; Yi, Lan

    2016-02-01

    The study aimed to determine the relationships between the basal metabolic rate (BMR) and body composition of overweight and obese Chinese adults with type 2 diabetes mellitus (DM). This cross-sectional clinical study enrolled 193 Chinese adults with type 2 DM who were overweight (24 kg/m(2)=BMI≤28 kg/m(2), n=99), or obese (BMI ≥28 kg/m(2), n=94). Ninety-seven adults with normal BMIs, including 50 DM patients and 47 healthy adults, were recruited as a control group. BMR was measured by indirect calorimetry; predicted BMR was calculated according to the Schofield equation; and the relationships between BMR, body composition, and biochemical results were determined by the Pearson correlation. The results showed that obese DM patients had significantly higher BMRs than both overweight patients (PBMR was significantly lower than the predicted BMR (PBMR in both DM patients (r=0.874, P<0.01) and in healthy controls (r=0.902, P<0.01). It was concluded that overweight and obese Chinese adults with type 2 DM had increased BMRs compared with normal-weight controls, which may result from the difference in fat-free mass.

  7. Global expression differences and tissue specific expression differences in rice evolution result in two contrasting types of differentially expressed genes

    KAUST Repository

    Horiuchi, Youko

    2015-12-23

    Background Since the development of transcriptome analysis systems, many expression evolution studies characterized evolutionary forces acting on gene expression, without explicit discrimination between global expression differences and tissue specific expression differences. However, different types of gene expression alteration should have different effects on an organism, the evolutionary forces that act on them might be different, and different types of genes might show different types of differential expression between species. To confirm this, we studied differentially expressed (DE) genes among closely related groups that have extensive gene expression atlases, and clarified characteristics of different types of DE genes including the identification of regulating loci for differential expression using expression quantitative loci (eQTL) analysis data. Results We detected differentially expressed (DE) genes between rice subspecies in five homologous tissues that were verified using japonica and indica transcriptome atlases in public databases. Using the transcriptome atlases, we classified DE genes into two types, global DE genes and changed-tissues DE genes. Global type DE genes were not expressed in any tissues in the atlas of one subspecies, however changed-tissues type DE genes were expressed in both subspecies with different tissue specificity. For the five tissues in the two japonica-indica combinations, 4.6 ± 0.8 and 5.9 ± 1.5 % of highly expressed genes were global and changed-tissues DE genes, respectively. Changed-tissues DE genes varied in number between tissues, increasing linearly with the abundance of tissue specifically expressed genes in the tissue. Molecular evolution of global DE genes was rapid, unlike that of changed-tissues DE genes. Based on gene ontology, global and changed-tissues DE genes were different, having no common GO terms. Expression differences of most global DE genes were regulated by cis-eQTLs. Expression

  8. Comparison of rosuvastatin and atorvastatin for lipid lowering in patients with type 2 diabetes mellitus: results from the URANUS study

    Directory of Open Access Journals (Sweden)

    Berne Christian

    2005-06-01

    Full Text Available Abstract Objective The Use of Rosuvastatin versus Atorvastatin iN type 2 diabetes mellitUS (URANUS study compared rosuvastatin with atorvastatin for the reduction of low-density lipoprotein cholesterol (LDL-C in patients with type 2 diabetes. Methods After a 6-week dietary run-in, patients aged ≥ 18 years with type 2 diabetes and LDL-C ≥ 3.3 mmol/L were randomised to double-blind treatment with rosuvastatin 10 mg (n = 232 or atorvastatin 10 mg (n = 233 for 4 weeks. Doses were then titrated up to a maximum of rosuvastatin 40 mg or atorvastatin 80 mg over 12 weeks to achieve the 1998 European LDL-C goal ( Results Rosuvastatin reduced LDL-C levels significantly more than atorvastatin during the fixed-dose and titration periods (p Conclusion At the start dose and following dose titration, rosuvastatin was significantly more effective than atorvastatin at reducing LDL-C and achieving European LDL-C goals in patients with type 2 diabetes.

  9. Do sediment type and test durations affect results of laboratory-based, accelerated testing studies of permeable pavement clogging?

    Science.gov (United States)

    Nichols, Peter W B; White, Richard; Lucke, Terry

    2015-04-01

    Previous studies have attempted to quantify the clogging processes of Permeable Interlocking Concrete Pavers (PICPs) using accelerated testing methods. However, the results have been variable. This study investigated the effects that three different sediment types (natural and silica), and different simulated rainfall intensities, and testing durations had on the observed clogging processes (and measured surface infiltration rates) of laboratory-based, accelerated PICP testing studies. Results showed that accelerated simulated laboratory testing results are highly dependent on the type, and size of sediment used in the experiments. For example, when using real stormwater sediment up to 1.18 mm in size, the results showed that neither testing duration, nor stormwater application rate had any significant effect on PICP clogging. However, the study clearly showed that shorter testing durations generally increased clogging and reduced the surface infiltration rates of the models when artificial silica sediment was used. Longer testing durations also generally increased clogging of the models when using fine sediment (<300 μm). Results from this study will help researchers and designers better anticipate when and why PICPs are susceptible to clogging, reduce maintenance and extend the useful life of these increasingly common stormwater best management practices. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Transient Silencing of a Type IV P-Type ATPase, Atp10c, Results in Decreased Glucose Uptake in C2C12 Myotubes

    Directory of Open Access Journals (Sweden)

    S. E. Hurst

    2012-01-01

    Full Text Available Atp10c is a strong candidate gene for diet-induced obesity and type 2 diabetes. To identify molecular and cellular targets of ATP10C, Atp10c expression was altered in vitro in C2C12 skeletal muscle myotubes by transient transfection with an Atp10c-specific siRNA. Glucose uptake assays revealed that insulin stimulation caused a significant 2.54-fold decrease in 2-deoxyglucose uptake in transfected cells coupled with a significant upregulation of native mitogen-activated protein kinases (MAPKs, p38, and p44/42. Additionally, glucose transporter-1 (GLUT1 was significantly upregulated; no changes in glucose transporter-4 (GLUT4 expression were observed. The involvement of MAPKs was confirmed using the specific inhibitor SB203580, which downregulated the expression of native and phosphorylated MAPK proteins in transfected cells without any changes in insulin-stimulated glucose uptake. Results indicate that Atp10c regulates glucose metabolism, at least in part via the MAPK pathway, and, thus, plays a significant role in the development of insulin resistance and type 2 diabetes.

  11. Homocysteine levels are associated with the results of {sup 123}I-metaiodobenzylguanidine myocardial scintigraphy in type 2 diabetic patients

    Energy Technology Data Exchange (ETDEWEB)

    Anan, Futoshi; Yonemochi, Hidetoshi; Nakagawa, Mikiko; Saikawa, Tetsunori [Oita University, Department of Cardiovascular Science, Faculty of Medicine, Hasama, Oita (Japan); Masaki, Takayuki; Takahashi, Naohiko; Yoshimatsu, Hironobu [Oita University, Department of Internal Medicine I, Oita (Japan); Eshima, Nobuoki [Oita University, Department of Biostatistics, School of Medicine, Oita (Japan)

    2007-01-15

    Elevated total plasma homocysteine (tHcy) levels and cardiovascular autonomic dysfunction are associated with a high mortality in type 2 diabetic patients. We tested the hypothesis that hyperhomocysteinemia is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients not receiving insulin treatment. The study group consisted of 17 type 2 diabetic patients with high tHcy levels (>15 mmol/l, age 58{+-}5 years, high tHcy group). The control group consisted of 23 age-matched type 2 diabetic patients with normal tHcy levels ({<=}15 mmol/l, age 58{+-}9 years, normal tHcy group). Cardiovascular autonomic function was assessed by baroreflex sensitivity, heart rate variability, plasma norepinephrine concentrations, and cardiac {sup 123}I-metaiodobenzylguanidine (MIBG) scintigraphy. Early and delayed {sup 123}I-MIBG myocardial uptake values were lower (p<0.005 and p<0.01, respectively) and the percent washout rate of {sup 123}I-MIBG was higher (p<0.001) in the high tHcy group than in the normal tHcy group. The fasting plasma insulin concentrations (p<0.0001) and the homeostasis model assessment (HOMA) index values (p<0.0001) were higher in the high tHcy group than in the normal tHcy group. Multiple regression analysis revealed that the level of tHcy was independently predicted by the HOMA index values and the myocardial uptake of {sup 123}I-MIBG at the delayed phase. Our results demonstrate that high levels of tHcy are associated with depressed cardiovascular autonomic function and insulin resistance in patients with type 2 diabetes mellitus. (orig.)

  12. Use of the LUS in sequence allele designations to facilitate probabilistic genotyping of NGS-based STR typing results.

    Science.gov (United States)

    Just, Rebecca S; Irwin, Jodi A

    2018-05-01

    Some of the expected advantages of next generation sequencing (NGS) for short tandem repeat (STR) typing include enhanced mixture detection and genotype resolution via sequence variation among non-homologous alleles of the same length. However, at the same time that NGS methods for forensic DNA typing have advanced in recent years, many caseworking laboratories have implemented or are transitioning to probabilistic genotyping to assist the interpretation of complex autosomal STR typing results. Current probabilistic software programs are designed for length-based data, and were not intended to accommodate sequence strings as the product input. Yet to leverage the benefits of NGS for enhanced genotyping and mixture deconvolution, the sequence variation among same-length products must be utilized in some form. Here, we propose use of the longest uninterrupted stretch (LUS) in allele designations as a simple method to represent sequence variation within the STR repeat regions and facilitate - in the nearterm - probabilistic interpretation of NGS-based typing results. An examination of published population data indicated that a reference LUS region is straightforward to define for most autosomal STR loci, and that using repeat unit plus LUS length as the allele designator can represent greater than 80% of the alleles detected by sequencing. A proof of concept study performed using a freely available probabilistic software demonstrated that the LUS length can be used in allele designations when a program does not require alleles to be integers, and that utilizing sequence information improves interpretation of both single-source and mixed contributor STR typing results as compared to using repeat unit information alone. The LUS concept for allele designation maintains the repeat-based allele nomenclature that will permit backward compatibility to extant STR databases, and the LUS lengths themselves will be concordant regardless of the NGS assay or analysis tools

  13. Type-specific HPV and Pap test results among low-income, underserved women: providing insights into management strategies.

    Science.gov (United States)

    Saraiya, Mona; Benard, Vicki B; Greek, April A; Steinau, Martin; Patel, Sonya; Massad, L Stewart; Sawaya, George F; Unger, Elizabeth R

    2014-10-01

    The primary cervical cancer screening strategy for women over age 30 is high-risk human papillomavirus (HPV) testing combined with Papanicolaou (Pap) testing (cotesting) every 5 years. This combination strategy is a preventive service that is required by the Affordable Care Act to be covered with no cost-sharing by most health insurance plans. The cotesting recommendation was made based entirely on prospective data from an insured population that may have a lower proportion of women with HPV positive and Pap negative results (ie, discordant results). The discordant group represents a very difficult group to manage. If the frequency of discordant results among underserved women is higher, health care providers may perceive the cotesting strategy to be a less favorable screening strategy than traditional Pap testing every 3 years. The Centers for Disease Control and Prevention's Cervical Cancer Study was conducted at 15 clinics in 6 federally qualified health centers across Illinois. Providers at these clinics were given the option of cotesting for routine cervical cancer screening. Type-specific HPV detection was performed on residual extracts using linear array. Pap test results were abnormal in 6.0% and HPV was positive in 7.2% of the underserved women screened in this study (mean age, 45.1 years). HPV prevalence decreased with age, from 10.3% among 30- to 39-year-olds to 4.5% among 50- to 60-year-olds. About 5% of the women had a combination of a positive HPV test and normal Pap test results; HPV 16/18 was identified in 14% of discordant women. The rate of discordant results among underserved women was similar to those reported throughout the US in a variety of populations. Typing for HPV 16/18 appears to assist in the management in a small proportion of women with discordant results. Published by Elsevier Inc.

  14. Evaluation of Magnetic Nanoparticle-Labeled Chondrocytes Cultivated on a Type II Collagen–Chitosan/Poly(Lactic-co-Glycolic Acid Biphasic Scaffold

    Directory of Open Access Journals (Sweden)

    Juin-Yih Su

    2017-01-01

    Full Text Available Chondral or osteochondral defects are still controversial problems in orthopedics. Here, chondrocytes labeled with magnetic nanoparticles were cultivated on a biphasic, type II collagen–chitosan/poly(lactic-co-glycolic acid scaffold in an attempt to develop cultures with trackable cells exhibiting growth, differentiation, and regeneration. Rabbit chondrocytes were labeled with magnetic nanoparticles and characterized by scanning electron microscopy (SEM, transmission electron (TEM microscopy, and gene and protein expression analyses. The experimental results showed that the magnetic nanoparticles did not affect the phenotype of chondrocytes after cell labeling, nor were protein and gene expression affected. The biphasic type II collagen–chitosan/poly(lactic-co-glycolic acid scaffold was characterized by SEM, and labeled chondrocytes showed a homogeneous distribution throughout the scaffold after cultivation onto the polymer. Cellular phenotype remained unaltered but with increased gene expression of type II collagen and aggrecan, as indicated by cell staining, indicating chondrogenesis. Decreased SRY-related high mobility group-box gene (Sox-9 levels of cultured chondrocytes indicated that differentiation was associated with osteogenesis. These results are encouraging for the development of techniques for trackable cartilage regeneration and osteochondral defect repair which may be applied in vivo and, eventually, in clinical trials.

  15. Ciliary Neurotrophic Factor (CNTF) for Macular Telangiectasia Type 2 (MacTel): Results from a phase I safety trial

    Science.gov (United States)

    Chew, Emily Y.; Clemons, Traci E.; Peto, Tunde; Sallo, Ferenc B.; Ingerman, Avner; Tao, Weng; Singerman, Lawrence; Schwartz, Steven D.; Peachey, Neal S.; Bird, Alan C.

    2015-01-01

    PURPOSE To evaluate the safety and tolerability of intraocular delivery of ciliary neurotrophic factor (CNTF) using an encapsulated cell implant for the treatment of macular telangiectasia type 2. DESIGN An open-labeled safety trial conducted in 2 centers enrolling 7 participants with macular telangiectasia type 2. METHODS The participant’s more severely affected eye (worse baseline visual acuity) received the high dose implant of CNTF. Patients were followed for a period of 36 months. The primary safety outcome was a change in the parameters of the electroretinogram (ERG). Secondary efficacy outcomes were changes in visual acuity, en face measurements of the optical coherence tomography of the disruption in the ellipsoid zone, and microperimetry when compared with baseline. RESULTS The ERG findings demonstrated a reduction in the amplitude of the scotopic b-wave in 4 participants 3 months after implantation (month 3). All parameters returned to baseline values by month 12 and remained so at month 36 with no clinical impact on dark adaptation. There was no change in visual acuity compared with baseline. The area of the defect as measured functionally by microperimetry and structurally by the en face OCT imaging of the ellipsoid zone loss appeared unchanged from baseline. CONCLUSIONS The intraocular delivery of CNTF in the encapsulated cell implant appeared to be safe and well tolerated in eyes with macular telangiectasia type 2. Further evaluation in a randomized controlled clinical trial is warranted to test for efficacy. PMID:25528956

  16. Regression of microalbuminuria in type 1 diabetic patients: results of a sequential intervention with improved metabolic control and ACE inhibitors.

    Science.gov (United States)

    Vilarrasa, N; Soler, J; Montanya, E

    2005-06-01

    The objective was to evaluate the effect of improved metabolic control and ACE inhibition used sequentially in the treatment of type 1 diabetic patients with microalbuminuria. We studied 44 consecutive type 1 diabetic patients with microalbuminuria not previously treated with ACE inhibitors. Improved metabolic control (optimisation period) was attempted for 6-12 months and patients with persistent microalbuminuria were subsequently treated with ACE inhibitors. Stepwise logistic regression analysis included the variables age, age at diabetes onset, duration of diabetes, HbA1c, initial albumin excretion rate (AER) and mean blood pressure as predictors of final AER. Thirty per cent of patients regressed to normoalbuminuria after the optimisation period, and 58% of them maintained normal AER 4.5+/-1.3 years later (3-7 years). Patients achieving normoalbuminuria had lower baseline AER (53+/-22 vs. 94+/-63 mg/24 h, p=0.012). The initial AER level was the only factor associated with final AER (r=0.58, p=0.021). Thirty patients with persistent microalbuminuria were treated with ACE inhibitors for two years, 35.5% of whom regressed to normal AER. Patients achieving normoalbuminuria after ACE inhibitor treatment had lower baseline AER (55+/-24 vs. 132+/-75 mg/24 h, p=0.03). The initial AER was the sole predictor of final AER (r=0.51, ptherapy resulted in long-term normalisation of AER in 47.4% of patients. The sequential implementation of improved metabolic control and ACE inhibitor therapy had a long-term beneficial effect in type 1 diabetic patients with microalbuminuria. We propose that type 1 diabetic patients with microalbuminuria could benefit from a period of metabolic improvement before the initiation of ACE inhibitor therapy.

  17. Result from systematic compilation of barrel bolt findings in S/KWU type PWRs in the context of computational analysis

    International Nuclear Information System (INIS)

    Kilian, R.; Devrient, B.; Koenig, G.; Stanislowski, M.; Widera, M.; Beusekom, R. van; Wermelinger, T.

    2015-01-01

    In 2005 intergranular stress corrosion cracking (IGSCC) of barrel bolts was observed in several S/KWU type PWRs. The bolts, known as star bolts, are made of SS type 316 Ti (German Material No. 1.4571 K) bars which are cold worked to adjust the required mechanical properties. This damage mechanism was so far less understood for PWR primary conditions. Therefore an extended joint research program was launched by AREVA GmbH and VGB e.V. to clarify the specific conditions which contributed to the observed findings on barrel bolts. A systematic analysis of the IGSCC affecting parameters as material, heats, environment and mechanical load was performed based on a plant data compilation from all six S/KWU PWRs with comparable core barrel design using barrel and baffle bolts made from type 316Ti. Using the outcome of this systematic data compilation additional computational fluid dynamics calculations in combination with radiolysis calculations were performed. The results showed that by a combination of reduced volume exchange by local flow conditions and radiolysis reactions forming oxidizing species as dissolved oxygen and/or hydrogen peroxide may locally affect the corrosion behavior of cold worked austenitic stainless steels. Therefore, small local volumes with oxidizing water chemistry conditions are assumed to lead to the IGSCC of cold worked type 316Ti. The comparison of the initial cold worked microstructure by TEM with the cold worked and in service irradiated microstructure (void formation, dislocation loop density, etc.) clearly reveals that neutron irradiation hardening in terms of IASCC (Irradiation-Assisted Stress Corrosion Cracking) is not the leading mechanism for these cases of barrel bolt cracking in the analyzed PWRs. (authors)

  18. A Mediterranean-type diet is associated with better metabolic profile in urban Polish adults: Results from the HAPIEE study

    Science.gov (United States)

    Grosso, Giuseppe; Stepaniak, Urszula; Micek, Agnieszka; Topor-Mądry, Roman; Stefler, Denes; Szafraniec, Krystyna; Bobak, Martin; Pająk, Andrzej

    2015-01-01

    Objective The aim of this study was to evaluate the relationship between adherence to a Mediterranean-type diet and metabolic syndrome (MetS) in the Polish arm of the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) cohort study. Materials/methods A cross-sectional survey including 8821 adults was conducted in Krakow, Poland. Food intake was evaluated through a validated food frequency questionnaire and adherence to the dietary pattern was assessed using a score specifically developed for non-Mediterranean countries (MedTypeDiet score). Linear and logistic regression models were performed to estimate beta and odds ratios (ORs) and 95% confidence intervals (CIs), respectively. Results Significant associations between the MedTypeDiet score and waist circumference (β = − 0.307 ± 0.239 cm), systolic blood pressure (β = − 0.440 ± 0.428 mmHg), and triglycerides (β = − 0.021 ± 0.016 mmol/L) were observed. After multivariable adjustment, individuals in the highest quartile of the score were less likely to have MetS, central obesity, high triglycerides, and hypertension. Increase of one standard deviation of the score was associated with 7% less odds of having MetS (OR 0.93, 95% CI: 0.88, 0.97). When analyzing the relation of single components of the MedTypeDiet score, wine, dairy products, and the total unsaturated:saturated fatty acids ratio were associated with MetS. Conclusions Adherence to a Mediterranean-like diet may decrease the risk of MetS also among non-Mediterranean populations. PMID:25752843

  19. The results of correction of endothelial dysfunction in type 2 diabetes mellitus in patients with diabetic retinopathy and associated hypertension

    Directory of Open Access Journals (Sweden)

    L. K. Moshetova

    2013-01-01

    Full Text Available Purpose:Studying the dynamics of clinical functional and morphological status of the retina against the metabolic and antiischemic therapy of retinopathy in type 2 diabetes associated with hypertension based on indicators in the tear fluid and serum nitric oxide metabolites.Methods: Following a standard ophthalmologic examination of 50 patients, among which are the two groups are similar in age andsex. The main group (n = 37 with Cd 2, DR and DR I and II hypertension II, III stage, the average age was 62,2±1,2 years, antihypertensive therapy — an ACE inhibitor Prestarium (5 mg. Patients of the group were divided into two subgroups: the first subgroup (n = 19who underwent parabulbarnom Mildronate (10 injections, the second subgroup (n = 18, which the drug was administered intranasally Semaks (20 days. The control group (n = 13 healthy (n = 6, and patients with type 2 diabetes without DR and GB (n = 7. Quantitative determination of the stable NO metabolites was determined in biochemical method samples of serum and lacrimal fluid.Results: After completing a course of therapy for patients of the first subgroup marked decrease in retinal thickness (p ≤ 0,05 in f.centralis, temporal lobe, the upper and lower bands parafovea and temporal area perifovea, while in the second group — in 9 areas of the macular area (p ≤ 0.05. It is also noted a significant increase in sensitivity to light in the macular area in patients of both subgroups (MAIA. On the background of the treatment observed reduction of NOx in the lacrimal fluid and serum of patients in both clinical groups. Thus, reduction of NOx in the lacrimal fluid was statistically significant in the subgroup of patients receiving anti-ischemic therapy semaks (p <0,05. In both clinical subgroups after treatment revealed correlation between systolic blood pressure and the level of NOx in the serum (r = 0,4; p <0,05.Conclusion: The positive effect (p <0,05 antioxidant (Mildronat and

  20. Host-Parasite Interactions in Individuals with Type 1 and 2 Diabetes Result in Higher Frequency ofAscaris lumbricoidesandGiardia lambliain Type 2 Diabetic Individuals.

    Science.gov (United States)

    Machado, Eleuza Rodrigues; Matos, Núbia Oliveira; Rezende, Sinione Morais; Carlos, Daniela; Silva, Thauana Cristina; Rodrigues, Leônia; Almeida, Maria Jarlene Rodrigues; de Oliveira, Maria Regina Fernandes; Muniz-Junqueira, Maria Imaculada; Gurgel-Gonçalves, Rodrigo

    2018-01-01

    Host-parasite interactions in diabetic patients might influence diabetes complications and intestinal parasitosis. The aim was to investigate the occurrence of enteroparasites in individuals with diabetes types 1 and 2. A descriptive study was designed to estimate frequencies of parasites and to compare them in individuals with diabetes types 1 and 2 from two Health Centers and one hospital in the Federal District of Brazil. Patients were allocated to the study by convenience. Three fecal samples of 156 diabetic individuals (120 type 1 and 36 type 2) were analyzed using two parasitological methods. Enteroparasites or commensals frequency in diabetics was 64%. Diabetics infected with up to six species of intestinal parasites or commensals were found. Frequencies of Ascaris lumbricoides and Giardia lamblia were higher in individuals with type 2 diabetes. The lower frequency of A. lumbricoides found in type 1 diabetes may be related to a strong Th2 response to parasites. Autoimmune response developed in type 1 diabetic individuals characterized by the production of Th1 cytokines could explain low frequency of G. lamblia . High frequency of parasites found in type 2 diabetes emphasizes the importance of periodic parasitological examinations in these individuals.

  1. Prevalence of comorbid depression is high in out-patients with Type 1 or Type 2 diabetes mellitus. Results from three out-patient clinics in the Netherlands

    NARCIS (Netherlands)

    Pouwer, F.; Geelhoed-Duijvestijn, P.H.L.M.; Tack, C.J.; Bazelmans, E.; Beekman, A.T.F.; Heine, R.J.; Snoek, F.J.

    2010-01-01

    Aims Depression is common in diabetes, but the scope of the problem and associated correlates are not well established in specialist diabetes care. We aimed to determine the prevalence of depression among adult outpatients with Type 1 (T1DM) or Type 2 diabetes (T2DM) using both self-report measures

  2. Prevalence of comorbid depression is high in out-patients with Type 1 or Type 2 diabetes mellitus. Results from three out-patient clinics in the Netherlands.

    NARCIS (Netherlands)

    Pouwer, F.; Geelhoed-Duijvestijn, P.H.; Tack, C.J.J.; Bazelmans, E.; Beekman, A.J.; Heine, R.J.; Snoek, F.J.

    2010-01-01

    AIMS: Depression is common in diabetes, but the scope of the problem and associated correlates are not well established in specialist diabetes care. We aimed to determine the prevalence of depression among adult outpatients with Type 1 (T1DM) or Type 2 diabetes (T2DM) using both self-report measures

  3. The amount and type of dairy product intake and incident type 2 diabetes: results from the EPIC-InterAct Study

    NARCIS (Netherlands)

    Sluijs, van der I.; Forouhi, N.G.; Beulens, J.W.; Schouw, van der Y.T.; Feskens, E.J.M.

    2012-01-01

    Background: Dairy product intake may be inversely associated with risk of type 2 diabetes, but the evidence is inconclusive for total dairy products and sparse for types of dairy products. Objective: The objective was to investigate the prospective association of total dairy products and different

  4. Depressive symptoms in youth with type 1 or type 2 diabetes: Results of the Pediatric Diabetes Consortium screening assessment of depression in diabetes study

    Science.gov (United States)

    To evaluate the frequency of depressive symptoms and the diagnosis and management of depression in youth with type 1 diabetes (T1D) and type 2 diabetes (T2D) enrolled in the Pediatric Diabetes Consortium T1D and T2D registries. The Children's Depression Inventory (CDI) 2 Self-Report (Short) version ...

  5. Host-Parasite Interactions in Individuals with Type 1 and 2 Diabetes Result in Higher Frequency of Ascaris lumbricoides and Giardia lamblia in Type 2 Diabetic Individuals

    Directory of Open Access Journals (Sweden)

    Eleuza Rodrigues Machado

    2018-01-01

    Full Text Available Host-parasite interactions in diabetic patients might influence diabetes complications and intestinal parasitosis. The aim was to investigate the occurrence of enteroparasites in individuals with diabetes types 1 and 2. A descriptive study was designed to estimate frequencies of parasites and to compare them in individuals with diabetes types 1 and 2 from two Health Centers and one hospital in the Federal District of Brazil. Patients were allocated to the study by convenience. Three fecal samples of 156 diabetic individuals (120 type 1 and 36 type 2 were analyzed using two parasitological methods. Enteroparasites or commensals frequency in diabetics was 64%. Diabetics infected with up to six species of intestinal parasites or commensals were found. Frequencies of Ascaris lumbricoides and Giardia lamblia were higher in individuals with type 2 diabetes. The lower frequency of A. lumbricoides found in type 1 diabetes may be related to a strong Th2 response to parasites. Autoimmune response developed in type 1 diabetic individuals characterized by the production of Th1 cytokines could explain low frequency of G. lamblia. High frequency of parasites found in type 2 diabetes emphasizes the importance of periodic parasitological examinations in these individuals.

  6. Types of treatment collaboration between conventional and alternative practitioners-results from a research project at a Danish MS hospital.

    Science.gov (United States)

    Skovgaard, Lasse; Haahr, Niels; Bjerre, Liv; Launsø, Laila

    2010-12-23

    More than 50% of People with Multiple Sclerosis (PwMS) in Denmark use alternative treatment. Most of them combine alternative and conventional treatment, but PwMS often find that they engage in parallel courses of treatment between which there is no dialogue, coordination or synergy. For this reason the Danish Multiple Sclerosis Society conducted a research project to develop and examine different models for collaboration between conventional and alternative treatment providers. The empirical material consisted of 10 individual interviews with practitioners, a group interview with practitioners, a group interview with professional staff at the Danish Multiple Sclerosis hospital that provided the organisational framework for the project, interviews with 59 patients and written responses from participating treatment providers in connection with 29 practitioner-researcher seminars held during the period 2004-2010. Collaboration between researchers and the treatment team resulted in the development and examination of several models which describe the strengths and weaknesses of various types of collaboration. The models show that the various types of collaboration place different requirements on the degree of 1) mutual acknowledgement and understanding among practitioners and 2) flexibility and resources in the organizational framework. The analyses also point to the fact that the degree of patient activity must be considered in relation to a given type of collaboration. The relationship between integration and pluralism can contribute to a fruitful discussion in regards to the value of treatment collaboration. In addition to the many positive perspectives that characterise integration of different treatment modalities the project points to the importance of not overlooking the opportunities, values and potential inherent in a pluralistic ideal in the form of patients' own active efforts and the dynamism that can arise when the patient becomes a co-informant, co

  7. Results of a bone splint technique for the treatment of lower limb deformities in children with type I osteogenesis imperfecta

    Directory of Open Access Journals (Sweden)

    Dasheng Lin

    2013-01-01

    Full Text Available Background: Children with osteogenesis imperfecta (OI can suffer from frequent fractures and limb deformities, resulting in impaired ambulation. Osteopenia and thin cortices complicate orthopedic treatment in this group. This study evaluates the clinical results of a bone splint technique for the treatment of lower limb deformities in children with type I OI. The technique consists of internal plating combined with cortical strut allograft fixation. Materials and Methods: We prospectively followed nine children (five boys, four girls with lower limb deformities due to type I OI, who had been treated with the bone splint technique (11 femurs, four tibias between 2003 and 2006. The fracture healing time, deformity improvement, ambulation ability and complications were recorded to evaluate treatment effects. Results: At the time of surgery the average age in our study was 7.7 years (range 5-12 years. The average length of followup was 69 months (range 60-84 months. All patients had good fracture healing with an average healing time of 14 weeks (range 12-16 weeks and none experienced further fractures, deformity, or nonunion. The fixation remained stable throughout the procedure in all cases, with no evidence of loosening or breakage of screws and the deformity and mobility significantly improved after surgery. Of the two children confined to bed before surgery, one was able to walk on crutches and the other needed a wheelchair. The other seven patients could walk without walking aids or support like crutches. Conclusions: These findings suggest that the bone splint technique provides good mechanical support and increases the bone mass. It is an effective treatment for children with OI and lower limb deformities.

  8. Results of the surgical correction of urinary stress incontinence according to the type of transobturator tape utilized

    Directory of Open Access Journals (Sweden)

    Bárbara Padilla-Fernández

    2013-09-01

    Full Text Available Objectives: To analyze the short and long term results of tapes of different materials used to treat stress urinary incontinence (SUI. A secondary objective was to evaluate the ability to adjust the tape after implantation. Materials and methods: Retrospective chart review of 355 patients with SUI operated between March 2003 and October 2011. Eight different types of transobturator tapes were used: Gynecare TVT-O®, Monarc®, SAFYRE®, Contasure KIM®, I-Stop®, DynaMesh®, Aris® Bandellete and Swing-band®. Results and complications were recorded. Results: The mean age at operation was 61 years. Correction of SUI was achieved in 87.88% of cases. The best results were obtained with Contasure KIM® (98.26 % continence. The tape was well tolerated and was elastic enough to be able to be adjusted 48-72 hours after implantation without deformation. Slings with macropores and over lock stiches on the superior and inferior borders presented the lower rates of postoperative urinary retention, pain, perior postoperative bleeding and urinary tract infections. Conclusions: Transobturator tension free tapes require a short operation time and have a low complication rate. The possibility of adjustment in the early postoperative period increases the success rate and reduces complications. Knotless meshes with macropores and over lock stiches appear to be better balanced, are quite resistant to stretching and deformation when readjusted after implantation and present a low infection rate.

  9. Efficacy of genital T cell responses to herpes simplex virus type 2 resulting from immunization of the nasal mucosa

    International Nuclear Information System (INIS)

    Milligan, Gregg N.; Dudley-McClain, Kristen L.; Chu Chinfun; Young, Christal G.

    2004-01-01

    Intravaginal (ivag) or intranasal (i.n.) immunization of C57BL/6J (B6) mice with a thymidine kinase-deficient strain (tk-) of herpes simplex virus type 2 (HSV-2) resulted in comparable protection of the genital epithelium and sensory ganglia against HSV-2 challenge. In contrast, protection of these sites was much reduced in i.n.-immunized compared to ivag-immunized B cell-deficient μMT mice. Fewer HSV-specific T cells were detected in the genital epithelium of i.n.-immunized compared to ivag-immunized μMT mice after HSV-2 challenge. Passive transfer of HSV-specific serum to immune μMT mice restored protection of these sites against HSV-2 challenge. These results suggest that protection of genital and neuronal sites may be conferred by i.n. immunization but may be more dependent on antibody-dependent mechanisms than the protection resulting from genital immunization. These results have implications for immunization strategies to elicit high levels of cell-mediated protection of the genital tract and sensory ganglia

  10. Analytic two-loop results for self-energy- and vertex-type diagrams with one non-zero mass

    International Nuclear Information System (INIS)

    Fleischer, J.; Kotikov, A.V.; Veretin, O.L.

    1999-01-01

    For a large class of two-loop self-energy- and vertex-type diagrams with only one non-zero mass (m) and the vertices also with only one non-zero external momentum squared (q 2 ) the first few expansion coefficients are calculated by the large mass expansion. This allows us to 'guess' the general structure of these coefficients and to verify them in terms of certain classes of 'basis elements', which are essentially harmonic sums. Since for this case with only one non-zero mass the large mass expansion and the Taylor series in terms of q 2 are identical, this approach yields analytic expressions of the Taylor coefficients, from which the diagram can be easily evaluated numerically in a large domain of the complex q 2 -plane by well known methods. It is also possible to sum the Taylor series and present the results in terms of polylogarithms

  11. Forensic typing of autosomal SNPs with a 29 SNP-multiplex--results of a collaborative EDNAP exercise.

    Science.gov (United States)

    Sanchez, J J; Børsting, C; Balogh, K; Berger, B; Bogus, M; Butler, J M; Carracedo, A; Court, D Syndercombe; Dixon, L A; Filipović, B; Fondevila, M; Gill, P; Harrison, C D; Hohoff, C; Huel, R; Ludes, B; Parson, W; Parsons, T J; Petkovski, E; Phillips, C; Schmitter, H; Schneider, P M; Vallone, P M; Morling, N

    2008-06-01

    We report the results of an inter-laboratory exercise on typing of autosomal single nucleotide polymorphisms (SNP) for forensic genetic investigations in crime cases. The European DNA Profiling Group (EDNAP), a working group under the International Society for Forensic Genetics (ISFG), organised the exercise. A total of 11 European and one US forensic genetic laboratories tested a subset of a 52 SNP-multiplex PCR kit developed by the SNPforID consortium. The 52 SNP-multiplex kit amplifies 52 DNA fragments with 52 autosomal SNP loci in one multiplex PCR. The 52 SNPs are detected in two separate single base extension (SBE) multiplex reactions with 29 and 23 SNPs, respectively, using SNaPshot kit, capillary electrophoresis and multicolour fluorescence detection. For practical reasons, only the 29 SBE multiplex reaction was carried out by the participating laboratories. A total of 11 bloodstains on FTA cards including a sample of poor quality and a negative control were sent to the laboratories together with the essential reagents for the initial multiplex PCR and the multiplex SBE reaction. The total SNP locus dropout rate was 2.8% and more than 50% of the dropouts were observed with the poor quality sample. The overall rate of discrepant SNP allele assignments was 2.0%. Two laboratories reported 60% of all the discrepancies. Two laboratories reported all 29 SNP alleles in all 10 positive samples correctly. The results of the collaborative exercise were surprisingly good and demonstrate that SNP typing with SBE, capillary electrophoresis and multicolour detection methods can be developed for forensic genetics.

  12. Types of treatment collaboration between conventional and alternative practitioners – results from a research project at a Danish MS hospital

    Directory of Open Access Journals (Sweden)

    Lasse Skovgaard

    2010-12-01

    Full Text Available Introduction: More than 50% of the People with Multiple Sclerosis (PwMS in Denmark use alternative treatment. Most of them combine alternative and conventional treatment, but PwMS often find that there is no dialogue, coordination or synergy between the parallel courses of treatment offered. For this reason the Danish Multiple Sclerosis Society conducted a research project to develop and examine different models for collaboration between conventional and alternative treatment providers. Materials and methods: Empirical material consist of individual interviews with practitioners, a group interview with practitioners, a group interview with professional staff at the Danish MS hospital that provided the organisational framework for the project, interviews with patients as well as written responses from participating treatment providers in connection with practitioner-researcher seminars held. Results: Collaboration between researchers and the treatment team resulted in the development examination of several models which describe the strengths and weaknesses of various types of collaboration. The models also show that the various types of collaboration place different requirements on the degree of 1 mutual acknowledgement and understanding among practitioners, 2 flexibility and resources in the organizational framework, and 3 patients' activities and own efforts, respectively.    Perspectives: The relationship between integration and pluralism can contribute to a fruitful discussion in regards to the value of treatment collaboration. In addition to the many positive perspectives the characterise integration of different treatment modalities the project points to the importance of not overlooking the opportunities, values and potential inherent in a pluralistic ideal in the form of patients' own active efforts and the dynamism that can arise when the patient becomes a co-informant, co-coordinator and/or co-integrator. 

  13. Listeria monocytogenes Circulating in Rabbit Meat Products and Slaughterhouses in Italy: Prevalence Data and Comparison Among Typing Results.

    Science.gov (United States)

    De Cesare, Alessandra; Parisi, Antonio; Mioni, Renzo; Comin, Damiano; Lucchi, Alex; Manfreda, Gerardo

    2017-03-01

    Rabbit meat has outstanding dietetic and nutritional properties. However, few data on microbiological hazards associated with rabbit productions are available. In this study, the presence of Listeria monocytogenes was determined in 430 rabbit carcasses, 256 rabbit meat cuts and products, and 599 environmental sponges collected from four Italian rabbit slaughterhouses over a period of 1 year. Prevalence of L. monocytogenes among the 1285 rabbit meat and environmental samples was 11%, with statistically significant differences between slaughterhouses. The highest prevalence (33.6%) was observed in rabbit meat cuts and products; the majority of positive environmental samples were collected from conveyor belts. Overall, 27.9% and 14.3% of rabbit cuts and carcasses, respectively, had L. monocytogenes counts higher than 1 colony-forming unit (CFU)/10 g. A selection of 123 isolates from positive samples was genotyped and serotyped to determine genetic profiles and diversity among L. monocytogenes isolates contaminating different slaughterhouses and classes of products investigated. Discriminatory power and concordance among the results obtained using multilocus variable-number tandem-repeat analysis (MLVA), multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), automated EcoRI ribotyping, and serotyping were assessed. The isolates selected for typing were classified into serotypes 1/2a (52.8%), 1/2c (32.5%), and 1/2b (14.6%). The majority of the isolates were classified as ST14 (34.1%), ST9 (35.5%), ST121 (17.9%), and ST224 (14.6%). The greatest discriminatory power was observed with the MLVA typing, followed by MLST, PFGE, and ribotyping. The best bidirectional concordance was achieved between PFGE and MLST. There was 100% correlation between both MLST and MLVA with serotype. Moreover, a high unidirectional correspondence was observed between MLVA and both MLST and PFGE, as well as between PFGE and both MLST and serotyping. The results of this

  14. Effects of two types of medical contrast media on routine chemistry results by three automated chemistry analyzers.

    Science.gov (United States)

    Park, Yu Jin; Rim, John Hoon; Yim, Jisook; Lee, Sang-Guk; Kim, Jeong-Ho

    2017-08-01

    The use of iodinated contrast media has grown in popularity in the past two decades, but relatively little attention has been paid to the possible interferential effects of contrast media on laboratory test results. Herein, we investigate medical contrast media interference with routine chemistry results obtained by three automated chemistry analyzers. Ten levels of pooled serum were used in the study. Two types of medical contrast media [Iopamiro (iopamidol) and Omnipaque (iohexol)] were evaluated. To evaluate the dose-dependent effects of the contrast media, iopamidol and iohexol were spiked separately into aliquots of serum for final concentrations of 1.8%, 3.6%, 5.5%, 7.3%, and 9.1%. The 28 analytes included in the routine chemistry panel were measured by using Hitachi 7600, AU5800, and Cobas c702 analyzers. We calculated the delta percentage difference (DPD) between the samples and the control, and examined dose-dependent trends. When the mean DPD values were compared with the reference cut-off criteria, the only uniformly interferential effect observed for all analyzers was in total protein with iopamidol. Two additional analytes that showed trends toward interferential effects only in few analyzers and exceeded the limits of the allowable error were the serum iron and the total CO 2 . The other combinations of analyzer and contrast showed no consistent dose-dependent propensity for change in any analyte level. Our study suggests that many of the analytes included in routine chemistry results, except total protein and serum iron, are not significantly affected by iopamidol and iohexol. These results suggest that it would be beneficial to apply a flexible medical evaluation process for patients requiring both laboratory tests and imaging studies, minimizing the need for strict regulations for sequential tests. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  15. The home-made retrievable ZQL-type vena caval filter: results of a prospective pilot study

    International Nuclear Information System (INIS)

    Xu Ke; Feng Bo; Su Hongying; Zhang Xitong; Zhou Yubin; Wang Ailin; Jiang Hong

    2003-01-01

    Objective: To evaluate the clinical value of the home-made retrievable ZQL-type vena cava filter for the prevention of pulmonary embolism. Methods: The filter was implanted via the right jugular vein or the healthy femoral vein in 24 cases of deep vein thrombosis (DVT) with/without pulmonary embolism (PE). At the same time, angiography of pulmonary artery was carried out. The abdominal X-ray plane graph was obtained on the third and seventh day after the operation. On the third, 6th, 12th and 18th month after operation, abdominal plane graphs and angiography of inferior vena cava and pulmonary artery were obtained. If the deep vein thrombosis was cleared out completely in 2 weeks, the filter was retrieved after the abdominal plane graph and angiography of the inferior vena cava and pulmonary artery were obtained. Otherwise, the filter was retained. The patients were asked to be followed up as will. All the radiology data of the cases were evaluated by two director physicians by blind way. Results: All the vena cava filters were implanted successfully in the proper position in the 24 cases (suprarenal inferior vena cava filter in 1 case and infrarenal inferior vena caval filter in 23 cases). Two filters were retrieved on the 7th and 9th day,respectively. The mean follow-up period was 6 months. There were no filter migration (>10 mm) and filter tilting (>10 degree). There were no filter fracture and no IVC wall penetration. There was no filter thrombosis except a filter catching a thrombus. There was no obstruction of inferior vena cava and pulmonary embolism. Conclusion: The implantation of the home-made retrievable ZQL-type vena cava filter is simple, the orientation is accurate, and the position of the filter can be regulated. It is a valuable option for clinical application because of its excellent stability and efficacy

  16. Granulocyte colony-stimulating factor in glycogen storage disease type 1b. Results of the European Study on Glycogen Storage Disease Type 1

    NARCIS (Netherlands)

    Visser, G.; Rake, J.P.; Labrune, P.; Leonard, J.V.; Moses, S.; Ullrich, K.; Wendel, U.; Groenier, K.H.; Smit, G.P.

    2002-01-01

    Patients with glycogen storage disease type 1b (GSD-1b) have neutropenia and neutrophil dysfunction that predispose to frequent infections and inflammatory bowel disease (IBD), for which granulocyte colony-stimulating factor (GCSF) is given. To investigate the use and the value of GCSF treatment in

  17. Polarimetric survey of main-belt asteroids. II. Results for 58 B- and C-type objects

    Science.gov (United States)

    Gil-Hutton, R.; Cañada-Assandri, M.

    2012-03-01

    Aims: We present results of a polarimetric survey of main-belt asteroids at Complejo Astronómico el Leoncito (CASLEO), San Juan, Argentina. The aims of this survey are to increase the database of asteroid polarimetry, to estimate diversity in polarimetric properties of asteroids that belong to different taxonomic classes, and to search for objects that exhibit anomalous polarimetric properties. Methods: The data were obtained with the Torino and CASPROF polarimeters at the 2.15m telescope. The Torino polarimeter is an instrument that allows simultaneous measurement of polarization in five different bands, and the CASPROF polarimeter is a two-hole aperture polarimeter with rapid modulation. Results: The survey began in 2003, and up to 2009 data on a sample of more than 170 asteroids were obtained. In this paper the results for 58 B- and C-type objects are presented, most of them polarimetrically observed for the first time. Using these data we find phase-polarization curves and polarimetric parameters for these taxonomic classes. Based on observations carried out at the Complejo Astronómico El Leoncito, operated under agreement between the Consejo Nacional de Investigaciones Científicas y Técnicas de la República Argentina and the National Universities of La Plata, Córdoba, and San Juan.Tables 1 and 2 are available in electronic form at CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/539/A115

  18. Polarimetric survey of main-belt asteroids. I. Results for fifty seven S-, L-, and K-type objects

    Science.gov (United States)

    Gil-Hutton, R.; Cañada-Assandri, M.

    2011-05-01

    Aims: We present the first results of a polarimetric survey of main-belt asteroids at Complejo Astronómico El Leoncito (Casleo), San Juan, Argentina. The aims of this survey are to increase the database of asteroid polarimetry, to estimate diversity in polarimetric properties of asteroids that belong to different taxonomic classes, and to search for objects that exhibit anomalous polarimetric properties, similar to those shown by the asteroid (234) Barbara. Methods: The data were obtained with the Torino and CASPROF polarimeters at the 2.15 m telescope. The Torino polarimeter is an instrument that allows the simultaneous measurement of polarization in five different bands, and the CASPROF polarimeter is a two-hole aperture polarimeter with rapid modulation. Results: The survey began in 2003, and up to 2009 data on a sample of more than 170 asteroids were obtained. In this paper the results of 57 S-, L-, and K-type objects are presented, most of them are being polarimetrically observed for the first time. Using these data we find phase-polarization curves and polarimetric parameters for these taxonomic classes. Furthermore, we also find two candidates, (397) Vienna and (458) Hercynia, that could have a phase-polarization curve with a large inversion angle. Based on observations carried out at the Complejo Astronómico El Leoncito, operated under agreement between the Consejo Nacional de Investigaciones Científicas y Técnicas de la República Argentina and the National Universities of La Plata, Córdoba, and San Juan.Tables 1 and 2 are only available in electronic form at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?j/A+A/529/A86

  19. Effects of lifestyle intervention in persons at risk for type 2 diabetes mellitus - results from a randomised, controlled trial

    Directory of Open Access Journals (Sweden)

    Nilsen Vegard

    2011-11-01

    Full Text Available Abstract Background Lifestyle change is probably the most important single action to prevent type 2 diabetes mellitus. The purpose of this study was to assess the effects of a low-intensity individual lifestyle intervention by a physician and compare this to the same physician intervention combined with an interdisciplinary, group-based approach in a real-life setting. Methods The "Finnish Diabetes Risk score" (FINDRISC was used by GPs to identify individuals at high risk. A randomised, controlled design and an 18 month follow-up was used to assess the effect of individual lifestyle counselling by a physician (individual physician group, (IG every six months, with emphasis on diet and exercise, and compare this to the same individual lifestyle counselling combined with a group-based interdisciplinary program (individual and interdisciplinary group, (IIG provided over 16 weeks. Primary outcomes were changes in lifestyle indicated by weight reduction ≥ 5%, improvement in exercise capacity as assessed by VO2 max and diet improvements according to the Smart Diet Score (SDS. Results 213 participants (104 in the IG and 109 in the IIG group, 50% women, with a mean age of 46 and mean body mass index 37, were included (inclusion rate > 91% of whom 182 returned at follow-up (drop-out rate 15%. There were no significant differences in changes in lifestyle behaviours between the two groups. At baseline 57% (IG and 53% (IIG of participants had poor aerobic capacity and after intervention 35% and 33%, respectively, improved their aerobic capacity at least one metabolic equivalent. Unhealthy diets according to SDS were common in both groups at baseline, 61% (IG and 60% (IIG, but uncommon at follow-up, 17% and 10%, respectively. At least 5% weight loss was achieved by 35% (IG and 28% (IIG. In the combined IG and IIG group, at least one primary outcome was achieved by 93% while all primary outcomes were achieved by 6%. Most successful was the 78% reduction in

  20. Identifying Barriers to Appropriate Use of Metabolic/Bariatric Surgery for Type 2 Diabetes Treatment:Policy Lab Results

    OpenAIRE

    Rubin, Jennifer K.; Hinrichs-Krapels, Saba; Hesketh, Rachel; Martin, Adam; Herman, William H.; Rubino, Francesco

    2016-01-01

    Despite increasing recognition of the efficacy, safety, and cost-effectiveness of bariatric/metabolic surgery in the treatment of type 2 diabetes, few patients who may be appropriate candidates and may benefit from this type of surgery avail themselves of this treatment option. To identify conceptual and practical barriers to appropriate use of surgical procedures, a Policy Lab was hosted at the 3rd World Congress on Interventional Therapies for Type 2 Diabetes on 29 September 2015. Twenty-si...

  1. Optimal construction and delivery of dual-functioning lentiviral vectors for type I collagen-suppressed chondrogenesis in synovium-derived mesenchymal stem cells.

    Science.gov (United States)

    Zhang, Feng; Yao, Yongchang; Zhou, Ruijie; Su, Kai; Citra, Fudiman; Wang, Dong-An

    2011-06-01

    This study aims to deliver both transforming growth factor β3 (TGF-β3) and shRNA targeting type I collagen (Col I) by optimal construction and application of various dual-functioning lentiviral vectors to induce Col I-suppressed chondrogenesis in synovium-derived mesenchymal stem cells (SMSCs). We constructed four lentiviral vectors (LV-1, LV-2, LV-3 and LV-4) with various arrangements of the two expression cassettes in different positions and orientations. Col I inhibition efficiency and chondrogenic markers were assessed with qPCR, ELISA and staining techniques. Among the four vectors, LV-1 has two distant and reversely oriented cassettes, LV-2 has two distant and same-oriented cassettes, LV-3 has two proximal and reversely oriented cassettes, and LV-4 has two proximal and same-oriented cassettes. Col I and chondrogenic markers, including type II collagen (Col II), aggrecan and glycosaminoglycan (GAG), were examined in SMSCs cultured in 3-D alginate hydrogel. All of the four vectors showed distinct effects in Col I level as well as diverse inductive efficiencies in upregulation of the cartilaginous markers. Based on real-time PCR results, LV-1 was optimal towards Col I-suppressed chondrogenesis. LV-1 vector is competent to promote Col I-suppressed chondrogenesis in SMSCs.

  2. Type D personality as a cardiovascular risk marker in the general population: results from the Gutenberg health study.

    Science.gov (United States)

    Beutel, M E; Wiltink, J; Till, Y; Wild, P S; Münzel, T; Ojeda, F M; Zeller, T; Schnabel, R B; Lackner, K; Blettner, M; Zwiener, I; Michal, M

    2012-01-01

    Type D personality is considered as an independent risk factor for morbidity and mortality in cardiovascular patients and a vulnerability factor for distress in the general population. Because representative community studies are rare, we sought to determine the prevalence of type D personality and its relationship with demographic characteristics, different features of mental disorders, cardiovascular risk factors, health behavior, endothelial function and cardiovascular biomarkers in the general population. The prevalence of type D personality and its correlates were analyzed cross-sectionally in a population-based sample of 5,000 Mid-Europeans aged 35-74 years from the Gutenberg Health Study. The prevalence of type D personality was 22.2% without remarkable differences in sex distribution. Type D subjects were characterized by lower socioeconomic status, lack of a partnership, increased depression, anxiety, depersonalization and health care utilization. Despite its strong association with mental disorders, type D personality emerged as psychometrically distinct. Although type D personality was independently associated with coronary heart disease (OR = 1.54, p = 0.044), no associations with traditional cardiovascular risk factors were found independently from depression or anxiety. Although type D personality is strongly associated with depression, anxiety, impaired mental and somatic health status, and increased health care utilization, the type D construct seems to comprise dysfunctional personality patterns not covered by depression and anxiety scales. Beyond these associations, the pathways of the cardiotoxic impact of type D personality remain to be elucidated. There is a need for prospective population studies on potential links between type D personality and cardiac disease. Copyright © 2012 S. Karger AG, Basel.

  3. [Assessments of long-term results of different types of sling procedures for stress urinary incontinence in women].

    Science.gov (United States)

    Loran, O B; Seregin, A V; Dovlatov, Z A

    2016-02-01

    To evaluate long-term results of surgery for stress urinary incontinence in women using different types of sling procedures. The study included 698 patients aged 42 to 68 years (median 54 years) with stress urinary incontinence. TVT was used in 167 (23.9%) cases, TVT-O Gynecare system in 359 (51.4%), TVT-O Monarch system in 105 (15.0%), and TVT Secur mini-sling system - in 67 (9.6%). Follow-up ranged from 12 to 108 months (median 55 months). Patients' status was assessed using UDI-6 and IIQ-7 questionnaires, an improvised treatment satisfaction questionnaire, voiding diary, cough test and 1-hour Pad-test. The effectiveness of the treatment, according to objective criteria was 92.2%, 93.3%, 91.4% and 92.5% after surgery with TVT, TVT-O Gynecare, TVT-O Monarch and TVT Secur, respectively, and according to subjective criteria - 90.4%, 91.1%, 89.5% and 91.0%. No differences in the effectiveness of techniques were found. The data obtained in long-term observations of a large sample of patients treated with a variety of techniques in a single center showed the effectiveness and safety of modern sling procedures for correcting urinary incontinence in women.

  4. Prognostic Impact of Different Histological Types on Gastric Adenocarcinoma: a Surveillance, Epidemiology, and End Results Database Analysis.

    Science.gov (United States)

    Liu, Kaitai; Wan, Juefeng; Bei, Yanping; Chen, Xue; Lu, Miaozhen

    2017-10-01

    The clinicopathological characteristics and prognosis of gastric mucinous adenocarcinoma (MAC) and signet ring cell carcinoma (SRC) are still controversial. We designed our study to evaluate the clinicopathologic features and prognosis of MAC, SRC and ordinary gastric adenocarcinoma (OGAC) by analyzing the Surveillance, Epidemiology, and End Results (SEER)-registered database. The 5-year overall survival (OS) of patients with SRC was significantly lower than that of patients with MAC (P = 0.001) and OGAC (P  0.05) and no significant difference between MAC and OGAC at stage IV (P = 0.110). Patients in SRC group had significantly worse survival than those in MAC and OGAC at stage IV (both P = 0.008), with 5-year OS of 3.3%, 5.8%, and 5.8%, respectively. However, the histological type was not found to be an independent prognostic factor of gastric cancer according to the multivariate analysis with Cox regression.

  5. Evaluation of fixed dose combination of glimepiride and metformin in patients with type 2 diabetes. Results of Russian observational study

    Directory of Open Access Journals (Sweden)

    Natalya Vladislavovna Zaytseva

    2015-04-01

    Full Text Available Aim.To investigate the efficacy and safety of combined glimepiride and metformin therapy in patients with type 2 diabetes mellitus (T2DM.Materials and methods.A multi-centre, open-label, prospective, observational study was conducted. A total of 1200 patients with T2DM inadequately controlled with metformin, glimepiride or combination of metformin + glimepiride were enrolled. Change in serum glycated haemoglobin (HbA1c, fasting plasma glucose (FPG, and postprandial blood glucose (PPG levels; weight; waist circumference and hypoglycemic episodes were evaluated.Results.Baseline HbA1c levels (8.24% ± 0.42% were significantly reduced after 12 weeks of treatment (7.48% ± 0.48% and at the end of the study(6.88% ± 0.56%. Target HbA1c levels (≤7% were achieved in 65.1% of patients at the final visit at 24 weeks. FPG and PPG levels decreased by 1.45 ± 1.14 mmol/l and 2.17 ± 1.27 mmol/l respectively (p < 0.001. No severe hypoglycemic events were reported. Body mass index reduced by 0.85 ± 1.28 kg/m2 (p < 0.001.Conclusion. Combined glimepiride and metformin therapy significantly improved long-term glycemic control in patients with T2DM during the period of 24 weeks without additional risk of hypoglycemic events or weight gain.

  6. 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.

    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

  7. Resource consumption and costs in Dutch patients with Type 2 diabetes mellitus. Results from 29 general practices

    NARCIS (Netherlands)

    Redekop, WK; Koopmanschap, MA; Rutten, GEHM; Wolffenbuttel, BHR; Stolk, RP; Niessen, LW

    Aims The aims of this study were to estimate the costs incurred by Dutch patients with Type 2 diabetes, examine which patient and/or treatment characteristics are associated with costs, and estimate the medical and non-medical costs of patients with Type 2 diabetes in The Netherlands. Methods

  8. Self-reported dietary intake of youth with recent onset of type 2 diabetes: Results from the TODAY study

    Science.gov (United States)

    Despite the widely recognized importance of diet in managing diabetes, few studies have documented usual dietary intake in young people with type 2 diabetes. The objective of our study were to assess dietary intake among a large, ethnically diverse cohort of young people with type 2 diabetes and com...

  9. Total hip arthroplasty for patients with Crowe type IV developmental dysplasia of the hip: Ten years results.

    Science.gov (United States)

    Zeng, Wei-Nan; Liu, Jun-Li; Wang, Fu-You; Zhang, Xin; Fan, Hua-Quan; Chen, Guang-Xing; Guo, Lin; Duan, Xiao-Jun; Zhou, Qiang; Yang, Liu

    2017-06-01

    The aim of this study was to determine the rate of union, functional results and complications in patients with Crowe IV developmental dysplasia of the hip (DDH) who underwent cementless total hip arthroplasty (THA) with S-ROM prostheses and subtrochanteric transverse shortening osteotomy. Forty-five patients (52 hips) operated between January 2005 and May 2008, with a mean age of 40.6 years at surgery were followed. The mean follow-up period was 9.8 years. Clinical outcomes, radiographic outcomes and complications were evaluated. Osteotomy union occurred in 52 of 52 femurs (100%). Mean Harris hip score improved from 33.7 ± 4.7 preoperatively to 81.2 ± 6.3, 90.8 ± 5.3 and 89.8 ± 7.1 at 1, 5 and 10 years postoperatively. Two patients had temporary sciatic nerve paralysis postoperatively, and 2 patients experienced early postoperative dislocation. Two patients complained about mild longer limb length than the non-operated limb at the last follow-up. Three hips showed osteolysis in Gruen zone 1, and 1 hip showed osteolysis in zone 1 and 7. No implants were revised, and no signs of component loosening and migration were observed at the last follow-up visit. S-ROM stem combined with transverse subtrochanteric shortening osteotomy in THA for patients with Crowe type IV DDH has good clinical results with small risk of complications. Copyright © 2017. Published by Elsevier Ltd.

  10. A Paleolithic-type diet results in iodine deficiency: a 2-year randomized trial in postmenopausal obese women.

    Science.gov (United States)

    Manousou, S; Stål, M; Larsson, C; Mellberg, C; Lindahl, B; Eggertsen, R; Hulthén, L; Olsson, T; Ryberg, M; Sandberg, S; Nyström, H F

    2018-01-01

    Different diets are used for weight loss. A Paleolithic-type diet (PD) has beneficial metabolic effects, but two of the largest iodine sources, table salt and dairy products, are excluded. The objectives of this study were to compare 24-h urinary iodine concentration (24-UIC) in subjects on PD with 24-UIC in subjects on a diet according to the Nordic Nutrition Recommendations (NNR) and to study if PD results in a higher risk of developing iodine deficiency (ID), than NNR diet. A 2-year prospective randomized trial in a tertiary referral center where healthy postmenopausal overweight or obese women were randomized to either PD (n=35) or NNR diet (n=35). Dietary iodine intake, 24-UIC, 24-h urinary iodine excretion (24-UIE), free thyroxin (FT4), free triiodothyronine (FT3) and thyrotropin (TSH) were measured at baseline, 6 and 24 months. Completeness of urine sampling was monitored by para-aminobenzoic acid and salt intake by urinary sodium. At baseline, median 24-UIC (71.0 μg/l) and 24-UIE (134.0 μg/d) were similar in the PD and NNR groups. After 6 months, 24-UIC had decreased to 36.0 μg/l (P=0.001) and 24-UIE to 77.0 μg/d (P=0.001) in the PD group; in the NNR group, levels were unaltered. FT4, TSH and FT3 were similar in both groups, except for FT3 at 6 months being lower in PD than in NNR group. A PD results in a higher risk of developing ID, than a diet according to the NNR. Therefore, we suggest iodine supplementation should be considered when on a PD.

  11. Canagliflozin and Heart Failure in Type 2 Diabetes Mellitus: Results From the CANVAS Program (Canagliflozin Cardiovascular Assessment Study).

    Science.gov (United States)

    Rådholm, Karin; Figtree, Gemma; Perkovic, Vlado; Solomon, Scott D; Mahaffey, Kenneth W; de Zeeuw, Dick; Fulcher, Greg; Barrett, Terrance D; Shaw, Wayne; Desai, Mehul; Matthews, David R; Neal, Bruce

    2018-03-11

    BACKGROUND : Canagliflozin is a sodium glucose cotransporter 2 inhibitor that reduces the risk of cardiovascular events. We report the effects on heart failure and cardiovascular death overall, in those with and without a baseline history of heart failure, and in other participant subgroups. METHODS : The CANVAS Program (Canagliflozin Cardiovascular Assessment Study) enrolled 10 142 participants with type 2 diabetes mellitus and high cardiovascular risk. Participants were randomly assigned to canagliflozin or placebo and followed for a mean of 188 weeks. The primary end point for these analyses was adjudicated cardiovascular death or hospitalized heart failure. RESULTS : Participants with a history of heart failure at baseline (14.4%) were more frequently women, white, and hypertensive and had a history of prior cardiovascular disease (all P failure was reduced in those treated with canagliflozin compared with placebo (16.3 versus 20.8 per 1000 patient-years; hazard ratio [HR], 0.78; 95% confidence interval [CI], 0.67-0.91), as was fatal or hospitalized heart failure (HR, 0.70; 95% CI, 0.55-0.89) and hospitalized heart failure alone (HR, 0.67; 95% CI, 0.52-0.87). The benefit on cardiovascular death or hospitalized heart failure may be greater in patients with a prior history of heart failure (HR, 0.61; 95% CI, 0.46-0.80) compared with those without heart failure at baseline (HR, 0.87; 95% CI, 0.72-1.06; P interaction =0.021). The effects of canagliflozin compared with placebo on other cardiovascular outcomes and key safety outcomes were similar in participants with and without heart failure at baseline (all interaction P values >0.130), except for a possibly reduced absolute rate of events attributable to osmotic diuresis among those with a prior history of heart failure ( P =0.03). CONCLUSIONS : In patients with type 2 diabetes mellitus and an elevated risk of cardiovascular disease, canagliflozin reduced the risk of cardiovascular death or hospitalized heart

  12. Experience of a Maastrich type II non heart beating donor program in a small city: preliminary results.

    Science.gov (United States)

    Miñambres, E; Suberviola, B; Guerra, C; Lavid, N; Lassalle, M; González-Castro, A; Ballesteros, M A

    2015-10-01

    To study the results of a non-controlled cardiac death (Maastricht type II) donor program in a city of 200,000 inhabitants. The study was initially focused on lung donation and was extended to kidney donation after 9 months. A prospective observational study was conducted between October 2012 and December 2013. The Intensive Care Unit of Marqués de Valdecilla University Hospital in Santander (Spain), and surrounding areas. Patients (< 55 years) who died of out-of-hospital cardiac arrest. All out-of-hospital cardiac arrests were treated with mechanical cardiac compression (LUCAS II). The diagnosis of death and organ preservation were performed in the ICU. A total of 14 calls were received, of which three were discarded. Of the 11 potential donors, 7 were effective donors with a median age of 39.5 years (range: 32-48). A total of 5 single lung transplants and four kidney transplants were performed. In addition, corneas and tissues were harvested. The non-valid donors were rejected mainly due to technical problems. There were no donation refusals on the part of the patient relatives. The lung transplant patient survival rate was 100% after one month and 80% after one year. One month after transplantation, the kidney recipients had a serum creatinine concentration of<2mg/dl. The interval from cardiac arrest to renal preservation was 80minutes (range: 71-89), and the interval from cardiac arrest to lung preservation was 84minutes (range: 77-94). A Maastricht type II donation program in a small city is viable for both abdominal and thoracic organs. The program was initially very cautious, but its potential is easily improvable by increasing donor and by equipping mobile ICU ambulances with mechanical cardiac compression systems. Full management of the donor in the ICU, avoiding the emergency department or operating rooms, reduces the warm ischemia time, thereby improving transplant outcomes. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  13. Efficacy and Biomarker Study of Bevacizumab for Hearing Loss Resulting From Neurofibromatosis Type 2–Associated Vestibular Schwannomas

    Science.gov (United States)

    Ye, Xiaobu; Duda, Dan G.; Halpin, Chris F.; Bergner, Amanda L.; Muzikansky, Alona; Merker, Vanessa L.; Gerstner, Elizabeth R.; Fayad, Laura M.; Ahlawat, Shivani; Jacobs, Michael A.; Jain, Rakesh K.; Zalewski, Christopher; Dombi, Eva; Widemann, Brigitte C.; Plotkin, Scott R.

    2016-01-01

    Purpose Neurofibromatosis type 2 (NF2) is a tumor predisposition syndrome characterized by bilateral vestibular schwannomas (VSs) resulting in deafness and brainstem compression. This study evaluated efficacy and biomarkers of bevacizumab activity for NF2-associated progressive and symptomatic VSs. Patients and Methods Bevacizumab 7.5 mg/kg was administered every 3 weeks for 46 weeks, followed by 24 weeks of surveillance after treatment with the drug. The primary end point was hearing response defined by word recognition score (WRS). Secondary end points included toxicity, tolerability, imaging response using volumetric magnetic resonance imaging analysis, durability of response, and imaging and blood biomarkers. Results Fourteen patients (estimated to yield > 90% power to detect an alternative response rate of 50% at alpha level of 0.05) with NF2, with a median age of 30 years (range, 14 to 79 years) and progressive hearing loss in the target ear (median baseline WRS, 60%; range 13% to 82%), were enrolled. The primary end point, confirmed hearing response (improvement maintained ≥ 3 months), occurred in five (36%) of 14 patients (95% CI, 13% to 65%; P < .001). Eight (57%) of 14 patients had transient hearing improvement above the 95% CI for WRS. No patients experienced hearing decline. Radiographic response was seen in six (43%) of 14 target VSs. Three grade 3 adverse events, hypertension (n = 2) and immune-mediated thrombocytopenic purpura (n = 1), were possibly related to bevacizumab. Bevacizumab treatment was associated with decreased free vascular endothelial growth factor (not bound to bevacizumab) and increased placental growth factor in plasma. Hearing responses were inversely associated with baseline plasma hepatocyte growth factor (P = .019). Imaging responses were associated with high baseline tumor vessel permeability and elevated blood levels of vascular endothelial growth factor D and stromal cell–derived factor 1α (P = .037 and .025

  14. Healthcare resource use, direct and indirect costs of hypoglycemia in type 1 and type 2 diabetes, and nationwide projections. Results of the HYPOS-1 study.

    Science.gov (United States)

    Giorda, C B; Rossi, M C; Ozzello, O; Gentile, S; Aglialoro, A; Chiambretti, A; Baccetti, F; Gentile, F M; Romeo, F; Lucisano, G; Nicolucci, A

    2017-03-01

    To obtain an accurate picture of the total costs of hypoglycemia, including the indirect costs and comparing the differences between type 1 (T1DM) and type 2 diabetes mellitus (T2DM). HYPOS-1 was a multicenter, retrospective cohort study which analyzed the data of 2229 consecutive patients seen at 18 diabetes clinics. Data on healthcare resource use and indirect costs by diabetes type were collected via a questionnaire. The domains of inpatient admission and hospital stay, work days lost, and third-party assistance were also explored. Resource utilization was reported as estimated incidence rates (IRs) of hypoglycemic episodes per 100 person-years and estimated costs as IRs per person-years. For every 100 patients with T1DM, 9 emergency room (ER) visits and 6 emergency medical service calls for hypoglycemia were required per year; for every 100 patients with T2DM, 3 ER visits and 1 inpatient admission were required, with over 3 nights spent in hospital. Hypoglycemia led to 58 work days per 100 person-years lost by the patient or a family member in T1DM versus 19 in T2DM. The costs in T1DM totaled €90.99 per person-year and €62.04 in T2DM. Direct and indirect costs making up the total differed by type of diabetes (60% indirect costs in T1DM versus 43% in T2DM). The total cost associated with hypoglycemia in Italy is estimated to be €107 million per year. Indirect costs meaningfully contribute to the total costs associated with hypoglycemia. As compared with T1DM, T2DM requires fewer ER visits and incurs lower indirect costs but more frequent hospital use. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  15. Early results of valve-sparing ascending aortic replacement in type A aortic dissection and aortic insufficiency

    Directory of Open Access Journals (Sweden)

    М. Л. Гордеев

    2016-08-01

    Full Text Available Aim: The study was designed to investigate predictors of effective valve-sparing ascending aortic replacement in patients with Stanford type A aortic dissection combined with aortic insufficiency and to analyze efficacy and safety of this kind of surgery.Methods: From January 2010 to December 2015, 49 patients with Stanford type A aortic dissection combined with aortic insufficiency underwent ascending aortic replacement. All patients were divided into 3 groups: valve-sparing procedures (group 1, n = 11, combined aortic valve and supracoronary ascending aortic replacement (group 2, n = 12, and Bentall procedure (group 3, n = 26. We assessed the initial status of patients, incidence of complications and efficacy of valve-sparing ascending aortic replacement.Results: The hospital mortality rate was 8.2% (4/49 patients. The amount of surgical correction correlated with the initial diameter of the aorta at the level of the sinuses of Valsalva. During the hospital period, none of patients from group 1 developed aortic insufficiency exceeding Grade 2 and the vast majority of patients had trivial aortic regurgitation. The parameters of cardiopulmonary bypass, cross-clamp time and circulatory arrest time did not correlate with the initial size of the ascending aorta and aortic valve blood flow impairment, neither did they influence significantly the incidence and severity of neurological complications. The baseline size of the ascending aorta and degree of aortic regurgitation did not impact the course of the early hospital period.Conclusions: Supracoronary ascending aortic replacement combined with aortic valve repair in ascending aortic dissection and aortic regurgitation is effective and safe. The initial size of the ascending aorta and aortic arch do not influence immediate results. The diameter of the aorta at the level of the sinuses of Valsalva and the condition of aortic valve leaflets could be considered as the limiting factors. Further long

  16. Evidence of an asymmetrical endophenotype in congenital fibrosis of extraocular muscles type 3 resulting from TUBB3 mutations.

    Science.gov (United States)

    Demer, Joseph L; Clark, Robert A; Tischfield, Max A; Engle, Elizabeth C

    2010-09-01

    Orbital magnetic resonance imaging (MRI) was used to investigate the structural basis of motility abnormalities in congenital fibrosis of the extraocular muscles type 3 (CFEOM3), a disorder resulting from missense mutations in TUBB3, which encodes neuron-specific beta-tubulin isotype III. Ophthalmic examinations in 13 volunteers from four CFEOM3 pedigrees and normal control subjects, were correlated with TUBB3 mutation and MRI findings that demonstrated extraocular muscle (EOM) size, location, contractility, and innervation. Volunteers included clinically affected and clinically unaffected carriers of R262C and D417N TUBB3 amino acid substitutions and one unaffected, mutation-negative family member. Subjects with CFEOM3 frequently had asymmetrical blepharoptosis, limited vertical duction, variable ophthalmoplegia, exotropia, and paradoxical abduction in infraduction. MRI demonstrated variable, asymmetrical levator palpebrae superioris and superior rectus EOM atrophy that correlated with blepharoptosis, deficient supraduction, and small orbital motor nerves. Additional EOMs exhibited variable hypoplasia that correlated with duction deficit, but the superior oblique muscle was spared. Ophthalmoplegia occurred only when the subarachnoid width of CN3 was muscle misinnervation by CN3. Optic nerve (ON) cross sections were subnormal, but rectus pulley locations were normal. CFEOM3 caused by TUBB3 R262C and D417N amino acid substitutions features abnormalities of EOM innervation and function that correlate with subarachnoid CN3 hypoplasia, occasional abducens nerve hypoplasia, and subclinical ON hypoplasia that can resemble CFEOM1. Clinical and MRI findings in CFEOM3 are more variable than those in CFEOM1 and are often asymmetrical. Apparent LR innervation by the inferior rectus motor nerve is an overlapping feature of Duane retraction syndrome and CFEOM1. These findings suggest that CFEOM3 is an asymmetrical, variably penetrant, congenital cranial dysinnervation disorder

  17. Association of Barrett's esophagus with type II Diabetes Mellitus: results from a large population-based case-control study.

    Science.gov (United States)

    Iyer, Prasad G; Borah, Bijan J; Heien, Herbert C; Das, Ananya; Cooper, Gregory S; Chak, Amitabh

    2013-09-01

    Central obesity could increase the risk for Barrett's esophagus (BE) and esophageal adenocarcinoma by mechanical and/or metabolic mechanisms, such as hyperinsulinemia. We performed an epidemiologic study to determine whether prior type 2 diabetes mellitus (DM2) is associated with BE. We performed a population-based case-control study using the General Practice Research Database, a UK primary care database that contains information on more than 8 million subjects, to identify cases of BE (using previously validated codes; n = 14,245) and matched controls without BE (by age, sex, enrollment date, duration of follow-up evaluation, and practice region by incidence density sampling; n = 70,361). We assessed the association of a prior diagnosis of DM2 with BE using conditional univariate and multivariable regression analysis. Confounders assessed included smoking, obesity measured by body mass index (BMI), and gastroesophageal reflux disease. BE cases were more likely than controls to have smoked (52.4% vs 49.9%), have a higher mean BMI (27.2 vs 26.9), and a higher prevalence of DM2 than controls (5.8% vs 5.3%). On multivariable analysis, DM2 was associated with a 49% increase in the risk of BE, independent of other known risk factors (odds ratio, 1.49; 95% confidence interval, 1.16-1.91). This association was stronger in women than men. Results remained stable with sensitivity analyses. In a large population-based case-control study, DM2 was a risk factor for BE, independent of obesity (as measured by BMI) and other risk factors (smoking and gastroesophageal reflux disease). These data suggest that metabolic pathways related to DM2 should be explored in BE pathogenesis and esophageal carcinogenesis. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

  18. A new type of climate network based on probabilistic graphical models: Results of boreal winter versus summer

    Science.gov (United States)

    Ebert-Uphoff, Imme; Deng, Yi

    2012-10-01

    In this paper we introduce a new type of climate network based on temporal probabilistic graphical models. This new method is able to distinguish between direct and indirect connections and thus can eliminate indirect connections in the network. Furthermore, while correlation-based climate networks focus on similarity between nodes, this new method provides an alternative viewpoint by focusing on information flow within the network over time. We build a prototype of this new network utilizing daily values of 500 mb geopotential height over the entire globe during the period 1948 to 2011. The basic network features are presented and compared between boreal winter and summer in terms of intra-location properties that measure local memory at a grid point and inter-location properties that quantify remote impact of a grid point. Results suggest that synoptic-scale, sub-weekly disturbances act as the main information carrier in this network and their intrinsic timescale limits the extent to which a grid point can influence its nearby locations. The frequent passage of these disturbances over storm track regions also uniquely determines the timescale of height fluctuations thus local memory at a grid point. The poleward retreat of synoptic-scale disturbances in boreal summer is largely responsible for a corresponding poleward shift of local maxima in local memory and remote impact, which is most evident in the North Pacific sector. For the NH as a whole, both local memory and remote impact strengthen from winter to summer leading to intensified information flow and more tightly-coupled network nodes during the latter period.

  19. A collaborative European exercise on mRNA-based body fluid/skin typing and interpretation of DNA and RNA results

    DEFF Research Database (Denmark)

    van den Berge, M; Carracedo, A; Gomes, I

    2014-01-01

    The European Forensic Genetics Network of Excellence (EUROFORGEN-NoE) undertook a collaborative project on mRNA-based body fluid/skin typing and the interpretation of the resulting RNA and DNA data. Although both body fluids and skin are composed of a variety of cell types with different functions...... of cell types was assessed. This scoring system builds on replicate RNA analyses and the ratio observed/possible peaks for each cell type [1]. The results of the exercise support the usefulness of this scoring system. When interpreting the data obtained from the analysis of the mock casework stains...

  20. Magnesium Intake, Quality of Carbohydrates, and Risk of Type 2 Diabetes: Results From Three U.S. Cohorts.

    Science.gov (United States)

    Hruby, Adela; Guasch-Ferré, Marta; Bhupathiraju, Shilpa N; Manson, JoAnn E; Willett, Walter C; McKeown, Nicola M; Hu, Frank B

    2017-12-01

    Magnesium intake is inversely associated with risk of type 2 diabetes in many observational studies, but few have assessed this association in the context of the carbohydrate quality of the diet. We hypothesized that higher magnesium intake is associated with lower risk of type 2 diabetes, especially in the context of a poor carbohydrate-quality diet characterized by low cereal fiber or high glycemic index (GI) or glycemic load (GL). In the Nurses' Health Study (NHS; 1984-2012, n = 69,176), NHS2 (1991-2013, n = 91,471), and the Health Professionals' Follow-Up Study (1986-2012, n = 42,096), dietary intake was assessed from food frequency questionnaires every 4 years. Type 2 diabetes was ascertained by biennial and supplementary questionnaires. We calculated multivariate hazard ratios (HRs) of magnesium intake and incident diabetes, adjusted for age, BMI, family history of diabetes, physical activity, smoking, hypertension, hypercholesterolemia, GL, energy intake, alcohol, cereal fiber, polyunsaturated fats, trans fatty acids, and processed meat, and we considered the joint associations of magnesium and carbohydrate quality on diabetes risk. We documented 17,130 incident cases of type 2 diabetes over 28 years of follow-up. In pooled analyses across the three cohorts, those with the highest magnesium intake had 15% lower risk of type 2 diabetes compared with those with the lowest intake (pooled multivariate HR in quintile 5 vs. 1: 0.85 [95% CI 0.80-0.91], P magnesium intake was more strongly associated with lower risk of type 2 diabetes among participants with high GI or low cereal fiber than among those with low GI or high cereal fiber (both P interaction magnesium intake is associated with lower risk of type 2 diabetes, especially in the context of lower carbohydrate-quality diets. © 2017 by the American Diabetes Association.

  1. Novel simple insulin delivery device reduces barriers to insulin therapy in type 2 diabetes: results from a pilot study.

    Science.gov (United States)

    Hermanns, Norbert; Lilly, Leslie C; Mader, Julia K; Aberer, Felix; Ribitsch, Anja; Kojzar, Harald; Warner, Jay; Pieber, Thomas R

    2015-05-01

    The PaQ® insulin delivery system is a simple-to-use patch-on device that provides preset basal rates and bolus insulin on demand. In addition to feasibility of use, safety, and efficacy (reported elsewhere), this study analyzed the impact of PaQ on patient-reported outcomes, including barriers to insulin treatment, diabetes-related distress, and attitudes toward insulin therapy in patients with type 2 diabetes on a stable multiple daily injection (MDI) regimen. This single-center, open-label, single-arm study comprised three 2-week periods: baseline (MDI), transition from MDI to PaQ, and PaQ treatment. Validated questionnaires were administered during the baseline and PaQ treatment periods: Barriers to Insulin Treatment questionnaire (BIT), Insulin Treatment Appraisal Scale (ITAS), and Problem Areas in Diabetes scale (PAID). Eighteen patients (age 59 ± 5 years, diabetes duration 15 ± 7 years, 21% female, HbA1c 7.7 ± 0.7%) completed the questionnaires. There was a strong, significant effect of PaQ use in mean BIT total scores (difference [D] = -5.4 ± 0.7.7, P = .01, effect size [d] = 0.70). Patients perceived less stigmatization by insulin injection (D = -2.2 ± 6.2, P = .18, d = 0.35), increased positive outcome (D = 1.9 ± 6.6, P = .17, d = 0.29), and less fear of injections (1.3 ± 4.8, P = .55, d = 0.28). Mean change in ITAS scores after PaQ device use showed a nonsignificant improvement of 1.71 ± 5.63 but moderate effect size (d = 0.30, P = .14). No increase in PAID scores was seen. The results and moderate to large effects sizes suggest that PaQ device use has beneficial and clinically relevant effects to overcoming barriers to and negative appraisal of insulin treatment, without increasing other diabetes-related distress. © 2015 Diabetes Technology Society.

  2. Status, results and usefulness of risk analyses for HTGR type reactors of different capacity accessory to planning

    International Nuclear Information System (INIS)

    Kroeger, W.; Mertens, J.

    1985-01-01

    As regards system-inherent risks, HTGR type reactors are evaluated with reference to the established light-water-moderated reactor types. Probabilistic HTGR risk analyses have shown modern HTGR systems to possess a balanced safety concept with a risk remaining distinctly below legally accepted values. Inversely, the development and optimization of the safety concepts have been (and are being) essentially co-determined by the probabilistic analyses, as it is technically sensible and economically necessary to render the specific safety-related HTGR properties eligible for licensing. (orig./HP) [de

  3. Effect of Human Serum and 2 Different Types of Platelet Concentrates on Human Meniscus Cell Migration, Proliferation, and Matrix Formation.

    Science.gov (United States)

    Freymann, Undine; Metzlaff, Sebastian; Krüger, Jan-Philipp; Hirsh, Glen; Endres, Michaela; Petersen, Wolf; Kaps, Christian

    2016-06-01

    To evaluate the effect of 10% human serum (HS), 5% platelet-rich plasma (PRP), and 5% autologous conditioned plasma (ACP) on migration, proliferation, and extracellular matrix (ECM) synthesis of human meniscus cells. Cell migration and proliferation on stimulation with HS, PRP, and ACP were assessed by chemotaxis assays and measurement of genomic DNA content. Meniscus cells were cultivated in pellets stimulated with 10% HS, 5% PRP, or 5% ACP. Meniscal ECM formation was evaluated by histochemical staining of collagen type I, type II, and proteoglycans and by analysis of fibrochondrocyte marker gene expression. Human meniscus cells were significantly attracted by all 3 blood-derived products (10% HS and 5% ACP: P = .0001, 5% PRP: P = .0002). Cell proliferation at day 9 was significantly increased on stimulation with 10% HS (P = .0001) and 5% PRP (P = .0002) compared with 5% ACP and controls. Meniscus cell pellet cultures showed the formation of a well-structured meniscal ECM with deposition of collagen type I, type II, and proteoglycans on stimulation with 10% HS, whereas 5% PRP or 5% ACP resulted in the formation of an inhomogeneous and more fibrous ECM. Stimulation with 10% HS and 5% ACP showed a significant induction of fibrochondrocyte marker genes such as aggrecan (HS: P = .0002, ACP: P = .0147), cartilage oligomeric matrix protein (HS: P = .0002, ACP: P = .0005), and biglycan (HS: P = .0002, ACP: P = .0003), whereas PRP showed no inducing effect. Among all tested blood-derived products, only stimulation with HS showed the formation of a meniscal ECM as well as positive cell proliferating and migrating effects in vitro. Regarding a potential biological repair of nonvascular meniscus lesions, our results may point toward the use of HS as a beneficial augment in regenerative meniscus repair approaches. Our findings may suggest that HS might be a beneficial augment for meniscus repair. Copyright © 2016 Arthroscopy Association of North America. Published

  4. Group cognitive behavioural therapy and weight regain after diet in type 2 diabetes: results from the randomised controlled POWER trial

    NARCIS (Netherlands)

    K.A.C. Berk (Kirsten); H. Buijks (Hanneke); A.J.M. Verhoeven (Adrie); Mulder, M.T. (Monique T.); B. Özcan (Behiye); van ’T Spijker, A. (Adriaan); R. Timman (Reinier); J.J. van Busschbach (Jan); E.J.G. Sijbrands (Eric)

    2018-01-01

    textabstractAims/hypothesis: Weight-loss programmes for adults with type 2 diabetes are less effective in the long term owing to regain of weight. Our aim was to determine the 2 year effectiveness of a cognitive behavioural group therapy (group-CBT) programme in weight maintenance after diet-induced

  5. Paraoxonase-1 Is Not Associated with Coronary Artery Calcification in Type 2 Diabetes: Results from the PREDICT Study

    Directory of Open Access Journals (Sweden)

    Bharti Mackness

    2012-01-01

    Full Text Available Objectives: To determine any association between serum paraoxonase-1 (PON1 activity, protein and coding region genetic polymorphisms and coronary artery calcification (CACS and to determine factors which modulate serum PON1 in type 2 diabetes (T2DM.

  6. L1CAM in Early-Stage Type I Endometrial Cancer: Results of a Large Multicenter Evaluation

    NARCIS (Netherlands)

    Zeimet, A.G.; Reimer, D.; Huszar, M.; Winterhoff, B.; Puistola, U.; Azim, S.A.; Muller-Holzner, E.; Ben-Arie, A.; Kempen, L.C.L.T. van; Petru, E.; Jahn, S.; Geels, Y.P.; Massuger, L.F.A.G.; Amant, F.; Polterauer, S.; Lappi-Blanco, E.; Bulten, J.; Meuter, A.; Tanouye, S.; Oppelt, P.; Stroh-Weigert, M.; Reinthaller, A.; Mariani, A.; Hackl, W.; Netzer, M.; Schirmer, U.; Vergote, I.; Altevogt, P.; Marth, C.; Fogel, M.

    2013-01-01

    BACKGROUND: Despite the excellent prognosis of Federation Internationale de Gynecologie et d'Obstetrique (FIGO) stage I, type I endometrial cancers, a substantial number of patients experience recurrence and die from this disease. We analyzed the value of immunohistochemical L1CAM determination to

  7. Increased alanine aminotransferase levels and associated characteristics among newly diagnosed type 2 diabetes patients: Results from the DD2 study

    DEFF Research Database (Denmark)

    Mor, Anil; Thomsen, Reimar W.; Rungby, Jørgen

    Objectives: Elevated levels of serum alanine aminotransferase (ALAT) have been linked with non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), insulin resistance and the metabolic syndrome in type 2 diabetes (T2D) patients. We examined ALAT levels in newly diagnosed T2D...

  8. Health Disparities by Type of Disability: Health Examination Results of Adults (18-64 Years with Disabilities in Shanghai, China.

    Directory of Open Access Journals (Sweden)

    Qi Kang

    Full Text Available There have been few studies on the disparities within the population with disabilities, especially in China. The aim of this study was to evaluate the differences in some health conditions among people with different types of disabilities in Shanghai.This study was conducted using data from the Shanghai Disabled Persons' Rehabilitation Comprehensive Information Platform. The records of 31,082 persons with disabilities who had undergone professional health examination were analyzed, and the prevalence and number of five diseases and five risk factors were examined. Logistic regression was used to explore disparities from two perspectives: 1 basic differences, unadjusted for other factors, and 2 differences after adjusting for key demographic covariates. A p-value < 0.05 was considered significant.Individuals with visual disability had a high rate of refractive error (60.0%, and averaged 1.75 diseases of interest, which was the highest value among all disability types. The mean number of risk factors we measured was greatest (1.96 in the population with mental disability. There were significant differences (p < 0.05 between the hearing and speech impairment group and the other groups with respect to most health outcomes, except chronic pharyngitis, hepatic cysts, and high blood pressure.Significant differences of selected health outcomes between groups with different types of disabilities remained after controlling for key demographic indicators. Further research is needed to explore the relationships between health conditions and disability types.

  9. Eagle Adventure: School-Based Type 2 Diabetes Prevention Program Results in Improved Outcomes Related to Food and Physical Activity

    Science.gov (United States)

    Stovall-Amos, Angelina; Parker, Stephany; Mata, Sara; Fox, Jill; Jackson, Teresa; Miracle, Sarah; Hermann, Janice

    2014-01-01

    The Eagle Adventure program was designed as a semester-long, SNAP-Ed program to address food and physical activity choices important for prevention of type 2 diabetes, obesity, and other chronic diseases. The program was developed for implementation in Grades 1-3. This article presents findings from two participating grade centers inclusive of…

  10. The use of mobile applications among adolescents with Type 1 diabetes : Results from Diabetes MILES Youth-Australia

    NARCIS (Netherlands)

    Trawley, S.; Browne, J.L.; Hagger, V.L.; Hendrieckx, C.; Holmes-Truscott, E.; Pouwer, F.; Skinner, T.C.; Speight, J.

    2016-01-01

    Background: The use of mobile applications (“apps”) for diabetes management is a rapidly developing area and has relevance to adolescents who tend to be early technology adopters. Apps may be useful for supporting self-management or connecting young people with type 1 diabetes (T1D) with their

  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

  12. Health Disparities by Type of Disability: Health Examination Results of Adults (18-64 Years) with Disabilities in Shanghai, China.

    Science.gov (United States)

    Kang, Qi; Chen, Gang; Lu, Jun; Yu, Huijiong

    2016-01-01

    There have been few studies on the disparities within the population with disabilities, especially in China. The aim of this study was to evaluate the differences in some health conditions among people with different types of disabilities in Shanghai. This study was conducted using data from the Shanghai Disabled Persons' Rehabilitation Comprehensive Information Platform. The records of 31,082 persons with disabilities who had undergone professional health examination were analyzed, and the prevalence and number of five diseases and five risk factors were examined. Logistic regression was used to explore disparities from two perspectives: 1) basic differences, unadjusted for other factors, and 2) differences after adjusting for key demographic covariates. A p-value disability had a high rate of refractive error (60.0%), and averaged 1.75 diseases of interest, which was the highest value among all disability types. The mean number of risk factors we measured was greatest (1.96) in the population with mental disability. There were significant differences (p types of disabilities remained after controlling for key demographic indicators. Further research is needed to explore the relationships between health conditions and disability types.

  13. Macrosomia despite good glycaemic control in Type I diabetic pregnancy; results of a nationwide study in The Netherlands

    NARCIS (Netherlands)

    Evers, I. M.; de Valk, H. W.; Mol, B. W. J.; ter Braak, E. W. M. T.; Visser, G. H. A.

    2002-01-01

    AIMS/HYPOTHESIS: To investigate the incidence of foetal macrosomia (i.e. birth weight >90th percentile) in a non-selected nationwide cohort of women with Type I (insulin-dependent) diabetes mellitus in The Netherlands and to identify risk indicators predictive for macrosomia. METHODS: We conducted a

  14. Abnormal levels of adipokines in adolescent offspring of women with type 1 diabetes - Results from the EPICOM study

    DEFF Research Database (Denmark)

    Lohse, Zuzana; Bytoft, Birgitte; Knorr, Sine

    2017-01-01

    AIMS/HYPOTHESIS: To investigate long-term consequences of diabetes during pregnancy, we determined adiponectin and leptin levels in adolescents born by women with type 1 diabetic (T1D) or non-diabetic mothers, and determined associations between adiponectin and leptin levels in adolescence and th...

  15. Identifying Barriers to Appropriate Use of Metabolic/Bariatric Surgery for Type 2 Diabetes Treatment: Policy Lab Results

    Science.gov (United States)

    Rubin, Jennifer K.; Hesketh, Rachel; Martin, Adam; Herman, William H.; Rubino, Francesco

    2016-01-01

    Despite increasing recognition of the efficacy, safety, and cost-effectiveness of bariatric/metabolic surgery in the treatment of type 2 diabetes, few patients who may be appropriate candidates and may benefit from this type of surgery avail themselves of this treatment option. To identify conceptual and practical barriers to appropriate use of surgical procedures, a Policy Lab was hosted at the 3rd World Congress on Interventional Therapies for Type 2 Diabetes on 29 September 2015. Twenty-six stakeholders participated in the Policy Lab, including academics, clinicians, policy-makers, industry leaders, and patient representatives. Participants were provided with a summary of available evidence about the cost-effectiveness of bariatric/metabolic surgery and the costs of increasing the use of bariatric/metabolic surgery, using U.K. and U.S. scenarios as examples of distinct health care systems. There was widespread agreement among this group of stakeholders that bariatric/metabolic surgery is a legitimate and cost-effective approach to the treatment of type 2 diabetes in obese patients. The following four building blocks were identified to facilitate policy changes: 1) communicating the scale of the costs and harms associated with rising prevalence of type 2 diabetes; 2) properly articulating the role of bariatric/metabolic surgery for certain population groups; 3) identifying new funding sources for bariatric/metabolic surgery; and 4) incorporating bariatric/metabolic surgery into the appropriate clinical pathways. Although more research is needed to identify specific clinical scenarios for the prioritization of bariatric/metabolic surgery, the case appears to be strong enough to engage relevant policy-makers and practitioners in a concerted discussion of how to better use metabolic surgical resources in conjunction with other interventions in good diabetes practice. PMID:27222554

  16. Plasma Cholesteryl Ester Fatty Acids do not Mediate the Association of Ethnicity with Type 2 Diabetes: Results From the HELIUS Study

    NARCIS (Netherlands)

    Muilwijk, Mirthe; Celis-Morales, Carlos; Nicolaou, Mary; Snijder, Marieke B.; Gill, Jason M. R.; van Valkengoed, Irene G. M.

    2018-01-01

    Scope: Ethnic minority groups have a higher risk of type 2 diabetes (T2D) than the host population. Our aim is to identify whether plasma cholesteryl ester fatty acids (CEFA) mediate the ethnic differences in type 2 diabetes. Methods and results: We included 202 Dutch, 206 South-Asian Surinamese,

  17. Test results of Salmonella typing by the NRLs-Salmonella in the Member States of the EU and the EnterNet Laboratories - Collaborative study VI on typing of Salmonella

    NARCIS (Netherlands)

    Korver H; Raes M; Maas HME; Ward LR; Wannet WJB; Henken AM; PHLS-Colindale/London; MGB; LIS

    2002-01-01

    Test results of Salmonella sero- and phage typing and antimicrobial susceptibility testing by the National Reference Laboratories for Salmonella in the Member States of the European Union and the EnterNet Laboratories: Collaborative study VI (2001) for Salmonella. The sixth collaborative typing

  18. Five-Year-Results of Laparoscopic Sleeve Gastrectomy with Duodenojejunal Bypass for Weight Loss and Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Seki, Yosuke; Kasama, Kazunori; Haruta, Hidenori; Watanabe, Atsushi; Yokoyama, Renzo; Porciuncula, Jose Paolo Cabreira; Umezawa, Akiko; Kurokawa, Yoshimochi

    2017-03-01

    Laparoscopic sleeve gastrectomy with duodenojejunal bypass (LSG-DJB) has been designated as a novel bariatric surgery procedure. This combination of sleeve gastrectomy and proximal intestinal bypass theoretically offers an effective and prolonged anti-diabetes effect. This is a follow-up of our institution's previous report on the short-term effects of LSG-DJB on type 2 diabetes mellitus (T2DM), which a 68.7 % remission (HbA1c surgery. The aforementioned result was comparable to the reported remission rates of laparoscopic Roux-en-Y gastric bypass. However, the durability of remission remains unknown. The objective of this study is to investigate the medium-term (up to 5 years) effects of LSG-DJB on weight loss and T2DM. In this analysis, consecutive 120 patients (female to male ratio = 61:59, mean age = 44.8 years) with T2DM who underwent LSG-DJB from April 2007 to November 2013 and were followed up beyond 1 year were included. The preoperative mean body weight and BMI were 105.7 kg and 38.5 kg/m 2 , respectively. The mean HbA1c and fasting blood glucose values were 8.9 % and 194 mg/dL, respectively. The mean duration of T2DM was 7.3 years. Fifty-five patients (46 %) were being treated with insulin prior to surgery. The follow-up rate was 97.5 % at 1 year, 73.3 % at 3 years, and 50.0 % at 5 years. The mean body weight was 74.9 kg at 1 year, 76.8 kg at 3 years, and 72.8 kg at 5 years (p < 0.001, compared to the baseline). The mean percent of total body weight loss (%TWL) was 28.9, 28.6, and 30.7 % at 1, 3, and 5 years, respectively. Remission of T2DM was achieved at 63.6, 55.3, and 63.6 % at 1, 3, and 5 years, respectively. Among those who achieved diabetes remission at 1 year, 10.8 % of them experienced recurrence during the subsequent follow-up period. Although recurrence of T2DM is observed in some patients over time, LSG-DJB is an effective procedure for achieving significant weight loss and improvement of glycemic control, and

  19. Housing type, location of residence and health status in Australian baby boomers: results from the Australian Baby Boomer (ABBA) Study.

    Science.gov (United States)

    Black, Deborah Ann; Wilson, Leigh Ann; O'Loughlin, Kate; Noone, Jack; Kendig, Hal; Butcher, Jennifer

    2015-03-01

    Baby Boomers are working and living longer than their pre-war counterparts, and are more likely to live in high density urban housing. This paper examines the relationship between housing type, working status and location of residence on health status in Baby Boomers. We investigated location of residence and housing type in 1009 participants of the Ageing Baby Boomers in Australia (ABBA) Study to identify any predictors of, or correlations between, these variables and health status. Current workers were less likely to report depression than retirees. We found a significantly higher rate of diabetes, obesity and hypertension in retirees than in current workers however rates of obesity, diabetes and hypertension were higher than predicted in current workers. The rates of chronic disease are higher than previous estimates and provide evidence to inform health promotion programs designed to increase physical activity and improve eating habits in baby boomers. © 2013 ACOTA.

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

    Science.gov (United States)

    Tak, Sanne R; Hendrieckx, Christel; Nefs, Giesje; Nyklíček, Ivan; Speight, Jane; Pouwer, François

    2015-04-01

    Although healthy food choices are important in the management of diabetes, making dietary adaptations is often challenging. Previous research has shown that people with type 2 diabetes are less likely to benefit from dietary advice if they tend to eat in response to emotions or external cues. Since 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 behaviours that were more restrained (β = 0.10) and less external (β = -0.11) and emotional (β = -0.20). The mindfulness subscale 'acting with awareness' was the strongest predictor of both external and emotional eating behaviour, whereas for emotional eating, 'describing' and 'being non-judgemental' were also predictive. These findings suggest that there is an association between dispositional mindfulness and eating behaviour in adults with type 1 or 2 diabetes. Since mindfulness interventions increase levels of dispositional mindfulness, future studies could examine if these interventions are also effective in helping people with diabetes to reduce emotional or external eating behaviour, and to improve the quality of their diet. Copyright © 2015 Elsevier Ltd

  1. Blood Culture Contamination and the Type of Microorganisms in True and False Positive Results in Patients Admitted at Avicenna Qazvin

    OpenAIRE

    E Sajadi; S Asefzade; M Asefzade; F Manuchehri

    2010-01-01

    Introduction: Diagnosis of infection based on blood culture alone is not a suitable method, but it is important to understand the clinical diagnosis for interpreting blood cultures. The goal of this study was to determine blood culture contamination and the type of microorganisms in false and real positive cases in patients admitted at Avicenna Hospital. Methods: This cross sectional study was done on all patients in the emergency and internal medicine departments from April, 2008 to October,...

  2. The volume and type of unhealthy bus shelter advertising around schools in Perth, Western Australia: Results from an explorative study.

    Science.gov (United States)

    Parnell, Ashleigh; Edmunds, Melinda; Pierce, Hannah; Stoneham, Melissa J

    2018-03-05

    Exposure to advertising for unhealthy food, alcohol and gambling has been shown to influence children and adolescents' behaviours and attitudes. This exploratory study aimed to assess the volume and type of unhealthy bus shelter advertisements near schools in five local government areas in Perth, Western Australia and to monitor whether the volume of unhealthy advertisements varied seasonally. The 29 local governments in the Perth metropolitan region were contacted seeking information regarding the locations of bus shelters featuring advertisements in their local government area. Five local governments provided sufficient information for an audit of the bus shelter advertisements in their area to be conducted. Every bus shelter within 500 m of a school was photographed and the type of advertisement recorded. The advertisements in the food, non-alcoholic beverage, alcohol, or gambling categories were then classified as being healthy, moderate, or unhealthy. This process was carried out in June, September, December 2016, and March 2017 to ascertain whether the type of advertisements displayed changed depending on the season. Of the 293 advertisements recorded over the four audits, 31% featured unhealthy products, 3% moderate, and advertisements were classified as being healthy. Seasonal variation in the volume of unhealthy advertisements was not identified. SO WHAT?: Western Australian school students are regularly exposed to unhealthy bus shelter advertisements. Stricter regulation of outdoor advertising is needed to ensure that young people are protected from the influence of unhealthy industries. © 2018 Australian Health Promotion Association.

  3. Use of complementary and alternative medicine by patients with chronic tension-type headache: results of a headache clinic survey.

    Science.gov (United States)

    Rossi, Paolo; Di Lorenzo, Giorgio; Faroni, Jessica; Malpezzi, Maria G; Cesarino, Francesco; Nappi, Giuseppe

    2006-04-01

    This study was undertaken to evaluate the rates, pattern, and presence of predictors of complementary and alternative medicine use in a clinical population of patients with chronic tension-type headache. The use of complementary and alternative medicine in the treatment of headaches is a growing phenomenon about which little is known. A total of 110 chronic tension-type headache patients attending a headache clinic participated in a physician-administered structured interview designed to gather information on complementary and alternative medicine use. Past use of complementary and alternative therapies was reported by 40% of the patients surveyed (22.7% in the previous year). Chronic tension-type headache patients prefer complementary and alternative practitioner-administered physical treatments to self-treatments, the most frequently used being chiropractic (21.9%), acupuncture (17.8%), and massage (17.8%). Only 41.1% of the patients perceived complementary and alternative therapies to be beneficial. The most common source of recommendation of complementary and alternative medicine was a friend or relative (41.1%). Most of the chronic tension-type headache patients used complementary and alternative treatment as a specific intervention for their headache (77.3%). Almost 60% of complementary and alternative medicine users had not informed their medical doctors of their use of complementary and alternative medicine. The most common reasons given for choosing to use a complementary or alternative therapy was the "potential improvement of headache" it offered (45.4%). The patients who had used more complementary and alternative treatments were found to be those recording a higher lifetime number of visits to conventional medical doctors, those with a comorbid psychiatric disorder, those enjoying a higher (household) income, and those who had never tried a preventive pharmacological treatment. Our findings suggest that headache-clinic chronic tension-type headache

  4. Long-Term Results of Cementless Total Hip Arthroplasty With Subtrochanteric Shortening Osteotomy in Crowe Type IV Developmental Dysplasia.

    Science.gov (United States)

    Wang, Duan; Li, Ling-Li; Wang, Hao-Yang; Pei, Fu-Xing; Zhou, Zong-Ke

    2017-04-01

    When surgeons reconstruct hips with a high dislocation related to severe developmental dysplasia of the hip (DDH) in total hip arthroplasty (THA), archiving long-term stable implant fixation and improving patient function and satisfaction remain challenging. The purpose of this study was to evaluate the 10-year outcomes of transverse subtrochanteric shortening osteotomy in cementless, modular THA in Crowe type IV-Hartofilakidis type III DDH. We reviewed 62 patients (76 hips) who underwent cementless THA with transverse subtrochanteric shortening osteotomy from 2002-2010. There were 49 women and 13 men with a mean age of 38.8 years, all of whom had Crowe type IV DDH. Mean follow-up period was 10 years. The acetabular cup was implanted in placement of the anatomical hip center in all hips. The mean Harris Hip Score significantly improved from 38.8 points to 86.1 points. Similarly, modified Merle d'Aubigne and Postel Hip Score, Hip dysfunction and Osteoarthritis Outcome Score, and SF-12 also significantly improved. The mean limb length discrepancy was reduced from 4.3 cm to 1.0 cm. At mean follow-up of 10 years, there were 3 cases of postoperative dislocation, 2 cases of transient nerve palsy, 1 case of nonunion, and 4 cases of intraoperative fracture. Revision surgery was performed in 2 patients due to isolated loosening of acetabular component and femoral stem, respectively. Our data demonstrated that the cementless, modular THA combined with transverse subtrochanteric shortening osteotomy was an effective and reliable technique with high rates of successful fixation of the implants and satisfactory clinical outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Glycemic Control and Urinary Tract Infections in Women with Type 1 Diabetes: Results from the DCCT/EDIC.

    Science.gov (United States)

    Lenherr, Sara M; Clemens, J Quentin; Braffett, Barbara H; Cleary, Patricia A; Dunn, Rodney L; Hotaling, James M; Jacobson, Alan M; Kim, Catherine; Herman, William; Brown, Jeanette S; Wessells, Hunter; Sarma, Aruna V

    2016-10-01

    We examined the relationship between glycemic control and urinary tract infections in women with type 1 diabetes mellitus. Women enrolled in the Epidemiology of Diabetes Interventions and Complications study, the observational followup of the Diabetes Control and Complications Trial, were surveyed to assess the rate of physician diagnosed urinary tract infections in the preceding 12 months. The relationship between glycated hemoglobin levels and number of urinary tract infections in the previous 12 months was assessed using a multivariable Poisson regression model. A total of 572 women were evaluated at year 17. Mean age was 50.7 ± 7.2 years, mean body mass index was 28.6 ± 5.9 kg/m(2), mean type 1 diabetes duration was 29.8 ± 5.0 years and mean glycated hemoglobin was 8.0% ± 0.9%. Of these women 86 (15.0%) reported at least 1 physician diagnosed urinary tract infection during the last 12 months. Higher glycated hemoglobin levels were significantly associated with number of urinary tract infections such that for every unit increase (1%) in recent glycated hemoglobin level, there was a 21% (p=0.02) increase in urinary tract infection frequency in the previous 12 months after adjusting for race, hysterectomy status, urinary incontinence, sexual activity in the last 12 months, peripheral and autonomic neuropathy, and nephropathy. The frequency of urinary tract infections increases with poor glycemic control in women with type 1 diabetes. This relationship is independent of other well described predictors of urinary tract infections and suggests that factors directly related to glycemic control may influence the risk of lower urinary tract infections. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  6. L1CAM in early-stage type I endometrial cancer: results of a large multicenter evaluation.

    Science.gov (United States)

    Zeimet, Alain G; Reimer, Daniel; Huszar, Monica; Winterhoff, Boris; Puistola, Ulla; Azim, Samira Abdel; Müller-Holzner, Elisabeth; Ben-Arie, Alon; van Kempen, Léon C; Petru, Edgar; Jahn, Stephan; Geels, Yvette P; Massuger, Leon F; Amant, Frédéric; Polterauer, Stephan; Lappi-Blanco, Elisa; Bulten, Johan; Meuter, Alexandra; Tanouye, Staci; Oppelt, Peter; Stroh-Weigert, Monika; Reinthaller, Alexander; Mariani, Andrea; Hackl, Werner; Netzer, Michael; Schirmer, Uwe; Vergote, Ignace; Altevogt, Peter; Marth, Christian; Fogel, Mina

    2013-08-07

    Despite the excellent prognosis of Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) stage I, type I endometrial cancers, a substantial number of patients experience recurrence and die from this disease. We analyzed the value of immunohistochemical L1CAM determination to predict clinical outcome. We conducted a retrospective multicenter cohort study to determine expression of L1CAM by immunohistochemistry in 1021 endometrial cancer specimens. The Kaplan-Meier method and Cox proportional hazard model were applied for survival and multivariable analyses. A machine-learning approach was used to validate variables for predicting recurrence and death. Of 1021 included cancers, 17.7% were rated L1CAM-positive. Of these L1CAM-positive cancers, 51.4% recurred during follow-up compared with 2.9% L1CAM-negative cancers. Patients bearing L1CAM-positive cancers had poorer disease-free and overall survival (two-sided Log-rank P relevance of these parameters was related strictly to L1CAM positivity. A classification and regression decision tree (CRT)identified L1CAM as the best variable for predicting recurrence (sensitivity = 0.74; specificity = 0.91) and death (sensitivity = 0.77; specificity = 0.89). To our knowledge, L1CAM has been shown to be the best-ever published prognostic factor in FIGO stage I, type I endometrial cancers and shows clear superiority over the standardly used multifactor risk score. L1CAM expression in type I cancers indicates the need for adjuvant treatment. This adhesion molecule might serve as a treatment target for the fully humanized anti-L1CAM antibody currently under development for clinical use.

  7. Conventional and advanced implant treatment in the type II diabetic patient: surgical protocol and long-term clinical results.

    Science.gov (United States)

    Tawil, Georges; Younan, Roland; Azar, Pierre; Sleilati, Ghassan

    2008-01-01

    To investigate the effect of type-2 diabetes on implant survival and complication rate. Prospective study enrolling type-2 diabetic patients suffering from edentulism, having a mean perioperative HbA1c level of 7.2%, and compliant with a maintenance program. All the patients underwent dental and periodontal examinations and had laboratory testing for HbA1c, fasting plasma glucose, blood lipids, and microalbuminuria. Nondiabetic patients matched for implant treatment indication served as controls. The influence of clinical diabetes-related factors and periodontal parameters (Plaque Index, bleeding on probing, probing depth) on implant survival were assessed via univariate then multivariate methods. Forty-five diabetic patients, followed for 1 to 12 years, mean age 64.7 years, received 255 implants: 143 following a classical protocol and 112 in cases of sinus floor elevation, immediate loading, and guided bone regeneration. Forty-five nondiabetic control patients received 244 implants: 142 following a classical protocol and 102 in cases of advanced surgery. Implant survival following conventional or advanced implant therapy was not statistically different between the well-controlled (HbA1c diabetic group was 97.2% (control 98.8%) and was not significantly different for age, gender, diabetes duration, smoking, or type of hypoglycemic therapy. The mean peri-implant bone loss was 0.41 +/- 0.58 mm (control, 0.49 +/- 0.64 mm). PI and BOP fairly correlated with postoperative complications. HbA1c was the only multivariate independent factor affecting the complication rate (P = .04). No statistically significant difference was found for patients (P = .81) or for implants (P = .66) for the advanced surgery cases or the conventional approach in diabetic patients compared to nondiabetic patients.

  8. Novel Simple Insulin Delivery Device Reduces Barriers to Insulin Therapy in Type 2 Diabetes: Results From a Pilot Study

    OpenAIRE

    Hermanns, Norbert; Lilly, Leslie C.; Mader, Julia K.; Aberer, Felix; Ribitsch, Anja; Kojzar, Harald; Warner, Jay; Pieber, Thomas R.

    2015-01-01

    Background: The PaQ® insulin delivery system is a simple-to-use patch-on device that provides preset basal rates and bolus insulin on demand. In addition to feasibility of use, safety, and efficacy (reported elsewhere), this study analyzed the impact of PaQ on patient-reported outcomes, including barriers to insulin treatment, diabetes-related distress, and attitudes toward insulin therapy in patients with type 2 diabetes on a stable multiple daily injection (MDI) regimen. Methods: This singl...

  9. Tobacco Use, Insulin Resistance, and Risk of Type 2 Diabetes: Results from the Multi-Ethnic Study of Atherosclerosis.

    Directory of Open Access Journals (Sweden)

    Rachel J Keith

    Full Text Available Tobacco use is associated with insulin resistance and incident diabetes. Given the racial/ethnic differences in smoking patterns and incident type 2 diabetes our objective was to evaluate the association between tobacco use and insulin resistance (IR as well as incident type 2 diabetes mellitus in a contemporary multiethnic cohort.We studied 5,931 Multi- Ethnic Study of Atherosclerosis (MESA participants who at baseline were free of type 2 diabetes (fasting glucose ≥7.0 mmol/l (126 mg/dl and/or use of insulin or oral hypoglycemic medications categorized by self-reported tobacco status and reclassified by urinary cotinine (available in 58% of participants as never, current or former tobacco users. The association between tobacco use, IR (fasting plasma glucose, insulin, and the homeostatic model assessment of insulin resistance (HOMA-IR and incident diabetes over 10 years was evaluated using multivariable linear regression and Cox proportional hazards models, respectively. Mean age of the participants was 62 (±10 years, 46% were male, 41% Caucasian, 12% Chinese, 26% African American and 21% Hispanic/Latino. IR biomarkers did not significantly differ between current, former, and never cigarette users (P >0.10 but showed limited unadjusted differences for users of cigar, pipe and smokeless tobacco (All P <0.05. Fully adjusted models showed no association between dose or intensity of tobacco exposure and any index of IR. When stratified into participants that quit smoking vs. those who continued smoking during the 10-year study there was no difference in serum glucose levels or frequency of diabetes. In fully adjusted models, there was no significant difference in diabetes risk between former or current cigarette smokers compared to never smokers [HR (95% CI 1.02 (0.77,1.37 and 0.81 (0.52,1.26 respectively].In a contemporary multi-ethnic cohort, there was no independent association between tobacco use and IR or incident type 2 diabetes. The role

  10. Amylase, Lipase, and Acute Pancreatitis in People With Type 2 Diabetes Treated With Liraglutide: Results From the LEADER Randomized Trial.

    Science.gov (United States)

    Steinberg, William M; Buse, John B; Ghorbani, Marie Louise Muus; Ørsted, David D; Nauck, Michael A

    2017-07-01

    To evaluate serum amylase and lipase levels and the rate of acute pancreatitis in patients with type 2 diabetes and high cardiovascular risk randomized to liraglutide or placebo and observed for 3.5-5.0 years. A total of 9,340 patients with type 2 diabetes were randomized to either liraglutide or placebo (median observation time 3.84 years). Fasting serum lipase and amylase were monitored. Acute pancreatitis was adjudicated in a blinded manner. Compared with the placebo group, liraglutide-treated patients had increases in serum lipase and amylase of 28.0% and 7.0%, respectively. Levels were increased at 6 months and then remained stable. During the study, 18 (0.4% [1.1 events/1,000 patient-years of observation] [PYO]) liraglutide-treated and 23 (0.5% [1.7 events/1,000 PYO]) placebo patients had acute pancreatitis confirmed by adjudication. Most acute pancreatitis cases occurred ≥12 months after randomization. Liraglutide-treated patients with prior history of pancreatitis ( n = 147) were not more likely to develop acute pancreatitis than similar patients in the placebo group ( n = 120). Elevations of amylase and lipase levels did not predict future risk of acute pancreatitis (positive predictive value pancreatitis among liraglutide-treated patients (regardless of previous history of pancreatitis) compared with the placebo group. Liraglutide was associated with increases in serum lipase and amylase, which were not predictive of an event of subsequent acute pancreatitis. © 2017 by the American Diabetes Association.

  11. Elemental abundance analysis of the early-type members of the open cluster M6: Preliminary results

    Science.gov (United States)

    Kılıçoǧlu, T.; Monier, R.; Fossati, L.

    2014-11-01

    Differences in chemical composition among main sequence stars within a given cluster are probably due to differences in their masses and other effects such as radiative diffusion, magnetic field, rotation, mixing mechanisms, mass loss, accretion and multiplicity. The early type main-sequence members of open clusters of different ages support studies of the competition between radiative diffusion and mixing mechanisms. We have analysed low- and high-resolution spectra covering the spectral range λ 4500-5840 Å of late B-, A- and F-type members of the open cluster M6 (age ˜100 Myr). The spectra were obtained with the FLAMES/GIRAFFE spectrograph mounted at UT2, the 8-m VLT telescope. The effective temperatures, surface gravities and microturbulent velocities of the stars were derived from both photometric and spectral methods. We have also performed a chemical abundance analysis using synthetic spectra. Abundances were determined for the elements C, O, Mg, Si, Ca, Sc, Ti, Cr, Mn, Fe, Ni, Y and Ba. The star-to-star variations in element abundances among the members of M6 are discussed.

  12. Loss of Col3a1, the gene for Ehlers-Danlos syndrome type IV, results in neocortical dyslamination.

    Directory of Open Access Journals (Sweden)

    Sung-Jin Jeong

    Full Text Available It has recently been discovered that Collagen III, the encoded protein of the type IV Ehlers-Danlos Syndrome (EDS gene, is one of the major constituents of the pial basement membrane (BM and serves as the ligand for GPR56. Mutations in GPR56 cause a severe human brain malformation called bilateral frontoparietal polymicrogyria, in which neurons transmigrate through the BM causing severe mental retardation and frequent seizures. To further characterize the brain phenotype of Col3a1 knockout mice, we performed a detailed histological analysis. We observed a cobblestone-like cortical malformation, with BM breakdown and marginal zone heterotopias in Col3a1⁻/⁻ mouse brains. Surprisingly, the pial BM appeared intact at early stages of development but starting as early as embryonic day (E 11.5, prominent BM defects were observed and accompanied by neuronal overmigration. Although collagen III is expressed in meningeal fibroblasts (MFs, Col3a1⁻/⁻ MFs present no obvious defects. Furthermore, the expression and posttranslational modification of α-dystroglycan was undisturbed in Col3a1⁻/⁻ mice. Based on the previous finding that mutations in COL3A1 cause type IV EDS, our study indicates a possible common pathological pathway linking connective tissue diseases and brain malformations.

  13. Recent results of exenatide use as adjunctive therapy in the treatment of patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Peggy Soule Odegard

    2009-07-01

    Full Text Available Peggy Soule Odegard1, Anthony DeSantis21School of Pharmacy, 2Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA, USA Abstract: Exenatide is a GLP-1 receptor agonist approved for use in type 2 diabetes mellitus. In clinical trials, significant reductions in serum glucose and weight were demonstrated for exenatide with primary glycemic effects of the twice daily formulation on prandial glucose control. In this paper, we review recent research with exenatide as adjunctive therapy in type 2 diabetes mellitus. In particular, studies demonstrate ongoing benefit on glycemic control and weight reduction with continued therapy up to 82 weeks duration and efficacy as adjunctive therapy for patients taking metformin, thiazolidinediones, and/or a sulfonylurea and as compared to sitagliptin and various insulin formulations. Compared to insulin, exenatide likely has greatest benefit for those patients who are overweight or who need improved prandial glucose control. The new long-acting release formulation of exenatide has demonstrated slightly improved efficacy compared to the twice daily formulation as well as a reduction in gastrointestinal side effects. Emerging research is further exploring novel benefits of exenatide as adjunctive DM therapy, effects on prandial glycemic control, markers of hepatic inflammation, alternative dosage forms including intra-nasal administration, and effects on beta cell function.Keywords: exenatide, diabetes, GLP-1

  14. Impact on outcome of different types of carotid stent: results from the European Registry of Carotid Artery Stenting.

    Science.gov (United States)

    Stabile, Eugenio; Giugliano, Giuseppe; Cremonesi, Alberto; Bosiers, Marc; Reimers, Bernhard; Setacci, Carlo; Cao, Piergiorgio; Schmidt, Andrej; Sievert, Horst; Peeters, Patrick; Nikas, Dimitrios; Sannino, Anna; de Donato, Gianmarco; Parlani, Giambattista; Castriota, Fausto; Hornung, Marius; Rubino, Paolo; Esposito, Giovanni; Tesorio, Tullio

    2016-06-12

    Conflicting data exist on the impact on outcome of the use of different stent types during carotid artery stenting (CAS). The aim of this study was to evaluate clinical outcomes according to different carotid stent design among the population of the European Registry of Carotid Artery Stenting (ERCAS). The present study was conducted in 1,604 patients who underwent neuroprotected CAS in ERCAS. All types of commercially available carotid stent were used. Open-cell design stents were classified according to free cell area into 7.5 mm2. A total of 713 closed-cell, 456 hybrid-cell, 238 7.5 mm2 open-cell stents were implanted. Overall, the 30-day stroke and death rate was 1.37%. At 30 days, 19 strokes occurred (1.18%): eight in the group of patients treated with a closed-cell (1.12%), two in those with a hybrid-cell (0.44%), three in those with a 7.5 mm2 open-cell stent (3.05%) (p=0.045). Data of the present study suggest that, in the setting of neuroprotected CAS performed in high-volume centres by properly trained operators, the use of an open-cell design stent with a free cell area >7.5 mm2 may be associated with an increased 30-day stroke risk.

  15. A far-from-CMC existence result for the constraint equations on manifolds with ends of cylindrical type

    International Nuclear Information System (INIS)

    Leach, Jeremy

    2014-01-01

    We extend the study of the vacuum Einstein constraint equations on manifolds with ends of cylindrical type initiated by Chruściel and Mazzeo (2012) and Chruściel et al (2012 Adv. Theor. Math. Phys. at press) by finding a class of solutions to the fully coupled system on such manifolds. We show that given a Yamabe positive metric g which is conformally asymptotically cylindrical on each end and a 2-tensor K such that (tr g K) 2 is bounded below away from zero and asymptotically constant, then we may find an initial data set ( g-bar , K-bar ) such that g-bar lies in the conformal class of g. (paper)

  16. Autosomal SNP typing of forensic samples with the GenPlex(TM) HID System: Results of a collaborative study

    DEFF Research Database (Denmark)

    Tomas, C.; Axler-DiPerte, G.; Budimlija, Z.M.

    2011-01-01

    The GenPlex(TM) HID System (Applied Biosystems - AB) offers typing of 48 of the 52 SNPforID SNPs and amelogenin. Previous studies have shown a high reproducibility of the GenPlex(TM) HID System using 250-500 pg DNA of good quality. An international exercise was performed by 14 laboratories (9...... in Europe and 5 in the US) in order to test the robustness and reliability of the GenPlex(TM) HID System on forensic samples. Three samples with partly degraded DNA and 10 samples with low amounts of DNA were analyzed in duplicates using various amounts of DNA. In order to compare the performance of the Gen...

  17. Effective elements of cognitive behaviour therapy for psychosis: results of a novel type of subgroup analysis based on principal stratification.

    Science.gov (United States)

    Dunn, G; Fowler, D; Rollinson, R; Freeman, D; Kuipers, E; Smith, B; Steel, C; Onwumere, J; Jolley, S; Garety, P; Bebbington, P

    2012-05-01

    Meta-analyses show that cognitive behaviour therapy for psychosis (CBT-P) improves distressing positive symptoms. However, it is a complex intervention involving a range of techniques. No previous study has assessed the delivery of the different elements of treatment and their effect on outcome. Our aim was to assess the differential effect of type of treatment delivered on the effectiveness of CBT-P, using novel statistical methodology. The Psychological Prevention of Relapse in Psychosis (PRP) trial was a multi-centre randomized controlled trial (RCT) that compared CBT-P with treatment as usual (TAU). Therapy was manualized, and detailed evaluations of therapy delivery and client engagement were made. Follow-up assessments were made at 12 and 24 months. In a planned analysis, we applied principal stratification (involving structural equation modelling with finite mixtures) to estimate intention-to-treat (ITT) effects for subgroups of participants, defined by qualitative and quantitative differences in receipt of therapy, while maintaining the constraints of randomization. Consistent delivery of full therapy, including specific cognitive and behavioural techniques, was associated with clinically and statistically significant increases in months in remission, and decreases in psychotic and affective symptoms. Delivery of partial therapy involving engagement and assessment was not effective. Our analyses suggest that CBT-P is of significant benefit on multiple outcomes to patients able to engage in the full range of therapy procedures. The novel statistical methods illustrated in this report have general application to the evaluation of heterogeneity in the effects of treatment.

  18. First Kepler results on compact pulsators - III. Subdwarf B stars with V1093 Her and hybrid (DW Lyn) type pulsations

    DEFF Research Database (Denmark)

    Reed, M.D.; Kawaler, Stephen D.; Østensen, Roy H.

    2010-01-01

    We present the discovery of non-radial pulsations in five hot subdwarf B (sdB) stars based on 27 d of nearly continuous time series photometry using the Kepler spacecraft. We find that every sdB star cooler than ≈27 500 K that Kepler has observed (seven so far) is a long-period pulsator of the V......1093 Her (PG 1716) class or a hybrid star with both short and long periods. The apparently non-binary long-period and hybrid pulsators are described here. The V1093 Her periods range from 1 to 4.5 h and are associated with g-mode pulsations. Three stars also exhibit short periods indicative of p......-modes with periods of 2-5 min and in addition, these stars exhibit periodicities between both classes from 15 to 45 min. We detect the coolest and longest-period V1093 Her-type pulsator to date, KIC010670103 (Teff≈ 20 900 K, Pmax≈ 4.5 h) as well as a suspected hybrid pulsator, KIC002697388, which is extremely cool...

  19. Incidence and risk factors for severe and symptomatic hypoglycemia in type 1 diabetes. Results of the HYPOS-1 study.

    Science.gov (United States)

    Giorda, Carlo B; Ozzello, Alessandro; Gentile, Sandro; Aglialoro, Alberto; Chiambretti, Anna; Baccetti, Fabio; Gentile, Francesco M; Lucisano, Giuseppe; Nicolucci, Antonio; Rossi, Maria Chiara

    2015-10-01

    Hypoglycemia is common in type 1 diabetes mellitus (T1DM). We aimed to update the incidence of severe and symptomatic hypoglycemia and investigate several correlated factors. In this multicenter, observational retrospective study, the data of 206 T1DM patients from a sample of 2,229 consecutive patients seen at 18 diabetes clinics were analyzed. Sociodemographic and clinical characteristics, severe hypoglycemia in the past 12 months, and symptomatic hypoglycemia in the past 4 weeks were recorded with a self-report questionnaire and a clinical form during a routine visit. Poisson multivariate models were applied. A minority of patients accounted for the majority of both severe and symptomatic episodes. The incidence rate (IR) of severe hypoglycemia was 0.49 (0.40-0.60) events/person-years. The incidence rate ratio (IRR) was higher in patients with previous severe hypoglycemia (3.71; 2.28-6.04), neuropathy (4.16; 2.14-8.05), long duration (>20 years, 2.96; 1.60-5.45), and on polypharmacy (1.24; 1.13-1.36), but it was lower when a complication was present. The IR of symptomatic hypoglycemia was 53.3 events/person-years, with an IRR significantly higher among women or patients with better education, or shorter duration or on pumps. The IRR was lower in patients with higher BMI or neuropathy or aged more than 50 years. Fewer than 20 % of T1DM patients are free from hypoglycemia, with one in six having experienced at least one severe episode in the last year. The distribution is uneven, with a tendency of episodes to cluster in some patients. Severe and symptomatic episodes have different correlates and reflect different conditions.

  20. Quality of care for patients with diabetes mellitus type 2 in 'model practices' in Slovenia - first results.

    Science.gov (United States)

    Petek, Davorina; Mlakar, Mitja

    2016-09-01

    A new organisation at the primary level, called model practices, introduces a 0.5 full-time equivalent nurse practitioner as a regular member of the team. Nurse practitioners are in charge of registers of chronic patients, and implement an active approach into medical care. Selected quality indicators define the quality of management. The majority of studies confirm the effectiveness of the extended team in the quality of care, which is similar or improved when compared to care performed by the physician alone. The aim of the study is to compare the quality of management of patients with diabetes mellitus type 2 before and after the introduction of model practices. A cohort retrospective study was based on medical records from three practices. Process quality indicators, such as regularity of HbA1c measurement, blood pressure measurement, foot exam, referral to eye exam, performance of yearly laboratory tests and HbA1c level before and after the introduction of model practices were compared. The final sample consisted of 132 patients, whose diabetes care was exclusively performed at the primary care level. The process of care has significantly improved after the delivery of model practices. The most outstanding is the increase of foot exam and HbA1c testing. We could not prove better glycaemic control (p>0.1). Nevertheless, the proposed benchmark for the suggested quality process and outcome indicators were mostly exceeded in this cohort. The introduction of a nurse into the team improves the process quality of care. Benchmarks for quality indicators are obtainable. Better outcomes of care need further confirmation.

  1. The association between dietary energy density and type 2 diabetes in Europe: results from the EPIC-InterAct Study.

    Directory of Open Access Journals (Sweden)

    Saskia W van den Berg

    Full Text Available Observational studies implicate higher dietary energy density (DED as a potential risk factor for weight gain and obesity. It has been hypothesized that DED may also be associated with risk of type 2 diabetes (T2D, but limited evidence exists. Therefore, we investigated the association between DED and risk of T2D in a large prospective study with heterogeneity of dietary intake.A case-cohort study was nested within the European Prospective Investigation into Cancer (EPIC study of 340,234 participants contributing 3.99 million person years of follow-up, identifying 12,403 incident diabetes cases and a random subcohort of 16,835 individuals from 8 European countries. DED was calculated as energy (kcal from foods (except beverages divided by the weight (gram of foods estimated from dietary questionnaires. Prentice-weighted Cox proportional hazard regression models were fitted by country. Risk estimates were pooled by random effects meta-analysis and heterogeneity was evaluated. Estimated mean (sd DED was 1.5 (0.3 kcal/g among cases and subcohort members, varying across countries (range 1.4-1.7 kcal/g. After adjustment for age, sex, smoking, physical activity, alcohol intake, energy intake from beverages and misreporting of dietary intake, no association was observed between DED and T2D (HR 1.02 (95% CI: 0.93-1.13, which was consistent across countries (I(2 = 2.9%.In this large European case-cohort study no association between DED of solid and semi-solid foods and risk of T2D was observed. However, despite the fact that there currently is no conclusive evidence for an association between DED and T2DM risk, choosing low energy dense foods should be promoted as they support current WHO recommendations to prevent chronic diseases.

  2. Combined effects of 19 common variations on type 2 diabetes in Chinese: results from two community-based studies.

    Directory of Open Access Journals (Sweden)

    Min Xu

    2010-11-01

    Full Text Available Many susceptible loci for type 2 diabetes mellitus (T2DM have recently been identified from Caucasians through genome wide association studies (GWAS. We aimed to determine the association of 11 known loci with T2DM and impaired glucose regulation (IGR, individually and in combination, in Chinese.Subjects were enrolled in: (1 a case-control study including 1825 subjects with T2DM, 1487 with IGR and 2200 with normal glucose regulation; and (2 a prospective cohort with 734 non-diabetic subjects at baseline. The latter was followed up for 3.5 years, in which 67 subjects developed T2DM. Nineteen single nucleotide polymorphisms (SNPs were selected to replicate in both studies. We found that CDKAL1 (rs7756992, SLC30A8 (rs13266634, rs2466293, CDKN2A/2B (rs10811661 and KCNQ1 (rs2237892 were associated with T2DM with odds ratio from 1.21 to 1.35. In the prospective study, the fourth quartile of risk scores based on the combined effects of the risk alleles had 3.05 folds (95% CI, 1.31-7.12 higher risk for incident T2DM as compared with the first quartile, after adjustment for age, gender, body mass index and diabetes family history. This combined effect was confirmed in the case-control study after the same adjustments. The addition of the risk scores to the model of clinical risk factors modestly improved discrimination for T2DM by 1.6% in the case-control study and 2.9% in the prospective study.Our study provided further evidence for these GWAS derived SNPs as the genetic susceptible loci for T2DM in Chinese and extended this association to IGR.

  3. Evaluating the diet of children at increased risk for type 1 diabetes: first results from the TEENDIAB study.

    Science.gov (United States)

    Weber, Katharina Susanne; Raab, Jennifer; Haupt, Florian; Aschemeier, Bärbel; Wosch, Anja; Ried, Christiane; Kordonouri, Olga; Ziegler, Anette-Gabriele; Winkler, Christiane

    2015-01-01

    The development of type 1 diabetes (T1D) is potentially influenced by nutrition. The aim of our study was to assess food and nutrient intakes of children at increased risk of T1D. Dietary intake of the last 4 weeks was assessed using a diet history interview. The daily nutrient and food intakes were compared with the German Dietary Reference Intakes, the Optimized Mixed Diet recommendations and those of a representative sample of children from the EsKiMo study. Children included in the analysis participated in the prospective TEENDIAB study. First-degree relatives of people with T1D (n 268), aged 8-12 years. The TEENDIAB children consumed 52·0 % of their total energy from carbohydrates, 32·6 % from fat and 14·3 % from protein. Compared with the reference values, their intake was lowest for folate at 61·3 % of the reference, for iodine at 58·1 % and for vitamin D at 8·9 %, and exceeded the reference for vitamin K about 5-fold, for Na about 3·5-fold and for protein about 1·5-fold. Their nutrient intakes were similar to those of a control cohort without increased T1D risk. The consumption of non-desirable food groups (meat products, sweets/snacks) was above the recommendations and the consumption of desirable food groups (fruits, vegetables, carbohydrate-rich foods) was below the recommendations. The TEENDIAB children had intakes considerably below the recommendations for vitamin D, iodine, folate and plant-based foods, and intakes above for vitamin K, Na, protein, meat products and sweets/snacks. They showed similar dietary patterns to non-risk children.

  4. Quality of life and satisfaction with treatment in subjects with type 2 diabetes: results in Spain of the PANORAMA study.

    Science.gov (United States)

    Depablos-Velasco, Pedro; Salguero-Chaves, Emilio; Mata-Poyo, Julio; Derivas-Otero, Beatriz; García-Sánchez, Ricardo; Viguera-Ester, Pablo

    2014-01-01

    Few studies are available on quality of life and treatment satisfaction of patients with type 2 diabetes mellitus (T2DM). Both of them were the primary objectives of the PANORAMA (NCT00916513) study. Metabolic control, treatment patterns, and management by healthcare professionals were also evaluated. This multicenter, cross-sectional, observational study randomly recruited>40 year-old patients with T2DM from Spanish healthcare centers. HbA1c was measured using the same technique in all patients, who also completed quality of life (EQ-5D and ADDQoL) and treatment satisfaction (DTSQ) questionnaires and the Hypoglycemia Fear Survey (HFS-II). Fifty-four investigators recruited 751 patients, 60.3% of whom had HbA1c levels <7%. Approximately 25% of patients on monotherapy had HbA1c values ≥ 7%, Patients with longer disease duration and more complex treatments, especially with insulin, showed the poorer control. Despite good overall treatment satisfaction (mean 29.3±6.1, 0 to 36-point scale), patients with a poorer metabolic control, previous hypoglycemia episodes, and more complex therapies had a worse QoL and a greater fear of suffering hypoglycemia. Despite advances in metabolic control, there are still areas to improve. Early addition of safe drugs to monotherapy would help achieve control objectives without increasing the risk of hypoglycemia, and delaying the start of insulin therapy. This would also improve QoL and treatment satisfaction. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  5. A new chemo-evolutionary population synthesis model for early-type galaxies; 2, Observations and Results

    NARCIS (Netherlands)

    Vazdekis, A.; Peletier, R. F.; Beckman, J. E.; Casuso, E.

    1997-01-01

    Submitted to: Astrophys. J. Suppl. Ser. Abstract: We present here the results of applying a new chemo-evolutionary stellar population model developed by ourselves in a previous paper (Vazdekis et al. 1996) to new high quality observational data of the nuclear regions of two representative elliptical

  6. A new chemo-evolutionary population synthesis model for early-type galaxies .2. Observations and results

    NARCIS (Netherlands)

    Vazdekis, A; Peletier, RF; Beckman, JE; Casuso, E

    We present the results of applying a new chemo-evolutionary stellar population model, developed in a previous paper, to new high-quality observational data of the nuclear regions of two representative elliptical galaxies and the bulge of the Sombrero galaxy. Here we fit in detail similar to 20

  7. Increased thyroxine sulfate levels in critically ill patients as a result of a decreased hepatic type I deiodinase activity

    NARCIS (Netherlands)

    R.P. Peeters (Robin); M.H.A. Kester (Monique); P.J. Wouters (Pieter); E. Kaptein (Ellen); H. van Toor (Hans); T.J. Visser (Theo); G. van den Berghe (Greet)

    2005-01-01

    textabstractIntroduction: Marked changes in peripheral thyroid hormone metabolism occur in critical illness, resulting in low serum T3 and high rT 3 levels. In this study, we investigated whether T4S levels are increased in patients who died after intensive care and whether T4S levels are correlated

  8. Prevalence of mental disorders among depressed coronary patients with and without Type D personality. Results of the multi-center SPIRR-CAD trial.

    Science.gov (United States)

    Lambertus, Frank; Herrmann-Lingen, Christoph; Fritzsche, Kurt; Hamacher, Stefanie; Hellmich, Martin; Jünger, Jana; Ladwig, Karl-Heinz; Michal, Matthias; Ronel, Joram; Schultz, Jobst-Hendrik; Vitinius, Frank; Weber, Cora; Albus, Christian

    Type D personality, as with formal mental disorders, is linked to increased mortality in coronary heart disease (CHD). Our aim was to determine the prevalence of mental disorders among depressed CHD patients with and without Type D personality. Depressive symptoms (HADS, HAM-D), Type D personality (DS-14) and mental disorders based on DSM-IV (SCID I and II) were assessed. Results were calculated by Kruskal-Wallis tests, Fisher's exact tests and logistic regression analyses. 570 CHD patients were included (age 59.2±9.5years; male 78.9%, HADS-D depression 10.4±2.5; HAM-D 11.3±6.6; Type D 60.1%). 84.8% of patients with Type D personality and 79.3% of non-Type D patients suffered from at least one mental disorder (p=0.092), while 41.8% of Type D positives and 27.8% of Type D negatives had at least two mental disorders (p=0.001). Patients with Type D personality significantly more often had social phobia [odds ratio (95% confidence interval): 3.79 (1.1 to 13.12); p=0.035], dysthymia [1.78 (1.12 to 2.84); p=0.015], compulsive [2.25 (1.04 to 4.86); p=0.038] or avoidant [8.95 (2.08 to 38.49); p=0.003] personality disorder. Type D personality among depressed CHD patients is associated with more complex and enduring mental disorders. This implies higher treatment demands. ISRCTN 76240576; NCT00705965. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  9. Humeral internal rotation osteotomy for the treatment of Erb-Duchenne-type obstetric palsy: clinical and radiographic results

    OpenAIRE

    Assunção, Jorge Henrique; Ferreira Neto, Arnaldo Amado; Benegas, Eduardo; Bolliger Neto, Raul; Prada, Flávia Santis; Malavolta, Eduardo Angeli; Gracitelli, Mauro Emilio Conforto; Camanho, Gilberto Luis

    2013-01-01

    OBJECTIVE: To evaluate the functional and radiographic results in patients undergoing shoulder anterior soft tissue stretching in association with open reduction and internal rotation osteotomy to centralize the humeral head as a treatment for Erb-Duchenne obstetric palsy sequelae. METHOD: A total of 35 patients underwent this surgical treatment, and the mean follow-up was 4.6 years. The Mallet scale was applied before and after the surgical procedure. A total of 20 patients underwent compute...

  10. Accuracy Rates of Sex Estimation by Forensic Anthropologists through Comparison with DNA Typing Results in Forensic Casework.

    Science.gov (United States)

    Thomas, Richard M; Parks, Connie L; Richard, Adam H

    2016-09-01

    A common task in forensic anthropology involves the estimation of the biological sex of a decedent by exploiting the sexual dimorphism between males and females. Estimation methods are often based on analysis of skeletal collections of known sex and most include a research-based accuracy rate. However, the accuracy rates of sex estimation methods in actual forensic casework have rarely been studied. This article uses sex determinations based on DNA results from 360 forensic cases to develop accuracy rates for sex estimations conducted by forensic anthropologists. The overall rate of correct sex estimation from these cases is 94.7% with increasing accuracy rates as more skeletal material is available for analysis and as the education level and certification of the examiner increases. Nine of 19 incorrect assessments resulted from cases in which one skeletal element was available, suggesting that the use of an "undetermined" result may be more appropriate for these cases. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  11. Humeral internal rotation osteotomy for the treatment of Erb-Duchenne-type obstetric palsy: clinical and radiographic results

    Science.gov (United States)

    Assunção, Jorge Henrique; Neto, Arnaldo Amado Ferreira; Benegas, Eduardo; Neto, Raul Bolliger; Prada, Flávia Santis; Malavolta, Eduardo Angeli; Gracitelli, Mauro Emilio Conforto; Camanho, Gilberto Luis

    2013-01-01

    OBJECTIVE: To evaluate the functional and radiographic results in patients undergoing shoulder anterior soft tissue stretching in association with open reduction and internal rotation osteotomy to centralize the humeral head as a treatment for Erb-Duchenne obstetric palsy sequelae. METHOD: A total of 35 patients underwent this surgical treatment, and the mean follow-up was 4.6 years. The Mallet scale was applied before and after the surgical procedure. A total of 20 patients underwent computed tomography to assess the glenoid version and humeral head subluxation. RESULTS: Functional improvement was achieved, as evidenced by an increase in the Mallet scale score from 12.14 to 16.46 (p<0.001). The correction of retroversion was achieved once the glenoid version ranged from -21.4 to -12 degrees (p<0.001). The humeral head subluxation improved from 6.5 to 35.2% (p<0.001). Patients older than 6 years of age did not achieve glenohumeral joint improvement with respect to dysplastic abnormalities. CONCLUSION: Internal rotation osteotomy in association with the stretching of anterior soft tissues of the shoulder in patients under the age of 7 years provided improvements in the function, retroversion, and subluxation of the glenohumeral joint. PMID:23917655

  12. High-power plasma dynamic systems of quasi-stationary type in IPP NSK KIPT: results and prospects

    International Nuclear Information System (INIS)

    Solyakov, D.G.

    2015-01-01

    This paper is devoted to brief review of main experimental results of investigations of high-power quasi-stationary plasma dynamic systems in the IPP NSC KIPT. In experiments were shown that to received accelerated plasma streams with high value of energy in quasi-stationary modes all conditions on the accelerating channel boundary should be controlled independently. As a results of optimizations of the modes of operation all QSPA active elements quasi-stationary plasma flow in the channel during 480 μs at discharge durations 550μs was obtained. The plasma streams velocity was close to theoretical limit for present experimental conditions. Plasma streams with maximum velocity up to 4.2 · 10 7 cm/s and total value of energy containment in the stream 0.4...0.6 MJ were received. The main properties of compression zone formation in the plasma streams generated by magneto-plasma compressor in quasi-stationary modes were investigated. In experiments were shown that initial conditions, namely residual pressure in the vacuum chamber made a big influence on the value of plasma density in compression zone. Compressive plasma streams with density (2...4)·10 18 cm -3 during 20...25μs at discharge duration 10μs were obtained. This value of plasma density is close to theoretical limit for present experimental conditions

  13. Humeral internal rotation osteotomy for the treatment of Erb-Duchenne-type obstetric palsy: clinical and radiographic results

    Directory of Open Access Journals (Sweden)

    Jorge Henrique Assunção

    2013-07-01

    Full Text Available OBJECTIVE: To evaluate the functional and radiographic results in patients undergoing shoulder anterior soft tissue stretching in association with open reduction and internal rotation osteotomy to centralize the humeral head as a treatment for Erb-Duchenne obstetric palsy sequelae. METHOD: A total of 35 patients underwent this surgical treatment, and the mean follow-up was 4.6 years. The Mallet scale was applied before and after the surgical procedure. A total of 20 patients underwent computed tomography to assess the glenoid version and humeral head subluxation. RESULTS: Functional improvement was achieved, as evidenced by an increase in the Mallet scale score from 12.14 to 16.46 (p<0.001. The correction of retroversion was achieved once the glenoid version ranged from -21.4 to -12 degrees (p<0.001. The humeral head subluxation improved from 6.5 to 35.2% (p<0.001. Patients older than 6 years of age did not achieve glenohumeral joint improvement with respect to dysplastic abnormalities. CONCLUSION: Internal rotation osteotomy in association with the stretching of anterior soft tissues of the shoulder in patients under the age of 7 years provided improvements in the function, retroversion, and subluxation of the glenohumeral joint.

  14. UK hazard assessment for a Laki-type volcanic eruption: modelling results for sulphur dioxide and sulphate aerosol

    Science.gov (United States)

    Witham, Claire; Vieno, Massimo; Schmidt, Anja; Aspinall, Willy; Braban, Christine; Hort, Matthew; Loughlin, Sue

    2015-04-01

    In response to the recent introduction of large gas-rich volcanic eruptions to the UK National Risk Register a modelling project has been conducted to improve our understanding of potential impacts to the UK from such an eruption on Iceland. A precautionary reasonable worst case eruption scenario based on the 1783-4 Laki eruption has been modelled 80 times using two different atmospheric chemistry and transport models (NAME and EMEP4UK) over 10 years of meteorology. The results provide information on the range of concentrations of sulphur dioxide gas (SO2), sulphate aerosol (SO4) and some halogen species that might be experienced in the UK during such an eruption and the likelihood of key thresholds being exceeded and over what durations. Data for the surface and for a range of key flight levels have been produced. In this presentation we will evaluate the ambient mass concentrations of SO2 and SO4 that could be experienced during and following such an eruption, as well as the likelihood of key health concentration thresholds being exceeded, and the maximum duration that levels could persist for. The prevailing meteorological conditions are the key influence on which parts of the North Atlantic and European region are affected at any time. The results demonstrate that the UK is unlikely to be affected by week after week of significantly elevated concentrations; rather there will a number of short (hours to days) pollution episodes where concentrations would be elevated above Moderate and High air quality index levels at the surface. This pattern fits with the generally changeable nature of the weather in the UK. Consecutive exceedance durations are longer for sulphate aerosol than SO2, and can be particularly lengthy in the low air quality index levels (1-2 weeks), which may be of relevance to health impact assessments. This work represents a detailed initial study but has not explored the full range of such an eruption. Nonetheless, the results from this project

  15. Applying plant functional types to construct biome maps from eastern North American pollen data: comparisons with model results

    Science.gov (United States)

    Williams, John W.; Summers, Robert L.; Webb, Thompson, III

    Global biome models like BIOME1 convert climate-model simulations of past climates into biome distributions and thus facilitate comparison of both climate and biome model results with biomes estimate from paleoecological data. We adapted a biomization method, recently developed for European pollen data, for use with pollen data in eastern North America and then compared its estimated biomes with those derived from applying BIOME1 to the climate simulations from the NCAR CCM1 (National Center for Atmospheric Research Community Climate Model, Version 1) for 6000 years ago (6 ka). We first tested the biomization method by seeing how well the biomes inferred from modern pollen data match observed biomes. We found that modifications to the method were necessary in part to account for physiological differences between North American and European taxa, and in part to cope with our choice of using just 23 major pollen taxa. Our modifications significantly improved the match between observed modern biomes and pollen-derived biomes, as measured by the kappa statistic. We tested our tuning of the biomization method by matching its inferred 6 ka biomes to biomes estimated from pollen data using the modern analog technique. The degree of agreement at 6 ka is close to that for today, showing that (1) the biomization method and modern analog technique, when applied to the same pollen data, produce consistent results, and (2) the modifications made to the biomization method are robust back to 6 ka. We then used the results of the biomization method to test the biome maps simulated by BIOME1, which derives biome distributions from observed climate values for today and from the climatic simulations of the CCM1 for 6 ka. Only a fair agreement is seen, and significant offsets exist in the placement of biomes by BIOME1. For today BIOME1 simulates the boundary between the temperate deciduous and cool mixed forests to be too far south and the steppe-forest boundary to be too far west

  16. INFLUENCE OF DIFFERENT TYPES OF NUTRITION ON PHYSICAL AND NEUROPSYCHICAL DEVELOPMENT OF INFANTS: RESULTS OF 12-MONTHS OBSERVATION

    Directory of Open Access Journals (Sweden)

    T. I. Legon’kova

    2011-01-01

    Full Text Available The basic ingredient of normal nutrition in infants is breast milk. If breast feeding is impossible the choice of artificial feeding formula should be made taking into account the qualities of formula which must be extremely close to that ones of breast milk. Objectives: to evaluate of state of health of infants having breast and artificial feeding. Methods: effectiveness and tolerance to adopted formula «Nutrilon Comfort» compared to standard milk formula and breast milk were analyzed. Dynamics of physical and neuro-psychical development of children was observed during 12 months. The cases of infectious diseases and tolerance to artificial feeding formulas were estimated. Results: prolonged observation of children from the group of adopted formula with immunomodulatory factors (long-chain polyunsaturated fatty acids and prebiotics showed its complex action (influence on physical, neuro-psychical development and infectious morbidity is similar to that one of breast feeding. Acute respiratory infections and atopic dermatitis in children having breast feeding and adopted formula developed rarely than in children from group of standard formula (p < 0.05. Conclusion: nutrition with «Nutrilon Comfort» formula in cases when breast feeding is impossible allows child’s development similar to children with breast feeding.

  17. EFFECTS OF COOPERATIVE LEARNING MODEL TYPE NUMBERED HEADS TOGETHER USING SIMULATION MEDIA PHET AND ACTIVITIES TOWARD STUDENT RESULTS

    Directory of Open Access Journals (Sweden)

    Fitri Mawaddah Lubis

    2015-12-01

    Full Text Available This study aimed to analyze the differences in learning outcomes of students taught by cooperative learning model NHT using simulation PhET and conventional learning, analyzing the differences in learning outcomes of students who have high activity and low activity, as well as the  interaction between learning model with the level of student activity in  influencing the outcome students learn physics. This research is a quasi experimental. The population in this study were students of class X SMK Tritech Informatika Medan. The tests were used to obtain the data is in the form of multiple choice. Test requirements have been carried out in the form of normality and homogeneity, which showed that the normal data and homogeneous. The data were analyzed using Anova analysis of two paths. The results showed that: The physics learning outcomes of students who use cooperative learning model NHT using PhET simulations media is better than students who use conventional learning models. The physics learning outcomes of students who have high learning activities is better than students who have Low learning activities. There is an interaction between cooperative learning model NHT PhET simulations using the media and the level of learning activity in influencing student learning outcomes. Average increase learning outcomes in the control class is greater than the experimental class.

  18. Thermal Response Testing Results of Different Types of Borehole Heat Exchangers: An Analysis and Comparison of Interpretation Methods

    Directory of Open Access Journals (Sweden)

    Angelo Zarrella

    2017-06-01

    Full Text Available The design phase of ground source heat pump systems is an extremely important one as many of the decisions made at that time can affect the system’s energy performance as well as installation and operating costs. The current study examined the interpretation of thermal response testing measurements used to evaluate the equivalent ground thermal conductivity and thus to design the system. All the measurements were taken at the same geological site located in Molinella, Bologna (Italy where a variety of borehole heat exchangers (BHEs had been installed and investigated within the project Cheap-GSHPs (Cheap and efficient application of reliable Ground Source Heat exchangers and Pumps of the European Union’s Horizon 2020 research and innovation program. The measurements were initially analyzed in accordance with the common interpretation based on the first-order approximation of the solution for the infinite line source model and then by utilizing the complete solutions of both the infinite line and cylinder source models. An inverse numerical approach based on a detailed model that considers the current geometry of the BHE and the axial heat transfer as well as the effect of weather on the ground surface was also used. Study findings revealed that the best result was generally obtained using the inverse numerical interpretation.

  19. Degree of Enhancement on Contrast Enhanced Spectral Mammography (CESM) and Lesion Type on Mammography (MG): Comparison Based on Histological Results.

    Science.gov (United States)

    Łuczyńska, Elżbieta; Niemiec, Joanna; Hendrick, Edward; Heinze, Sylwia; Jaszczyński, Janusz; Jakubowicz, Jerzy; Sas-Korczyńska, Beata; Rys, Janusz

    2016-10-21

    BACKGROUND Contrast enhanced spectral mammography (CESM) is a new method of breast cancer diagnosis in which an iodinated contrast agent is injected and dual-energy mammography is obtained in multiple views of the breasts. The aim of this study was to compare the degree of enhancement on CESM with lesion characteristics on mammography (MG) and lesion histology in women with suspicious breast lesions. MATERIAL AND METHODS The degree of enhancement on CESM (absent, weak, medium, or strong) was compared to lesion characteristics on MG (mass, mass with microcalcifications, or microcalcifications alone) and histology (infiltrating carcinoma, intraductal carcinoma, or benign) to compare sensitivity of the two modalities and to establish correlations that might improve diagnostic accuracy. RESULTS Among 225 lesions identified with CESM and MG, histological evaluation revealed 143 carcinomas (127 infiltrating, 16 intraductal) and 82 benign lesions. This is the largest cohort investigated with CESM to date. The sensitivity of CESM was higher than that of MG (100% and 90%, respectively, p=0.010). Medium or strong enhancement on CESM and the presence of a mass on MG was the most likely indictor of malignancy (55.1% p=0.002). Among benign lesions, 60% presented as enhancement on CESM (were false-positive), and most frequently as medium or weak enhancement, together with a mass on MG (53%, p=0.047). Unfortunately, the study did not find combinations of MG findings and CESM enhancement patterns that would be helpful in defining false-positive lesions. We observed systematic overestimation of maximum lesion diameter on CESM compared to histology (mean difference: 2.29 mm). CONCLUSIONS Strong or medium enhancement on CESM and mass or mass with microcalcifications on MG were strong indicators of malignant transformation. However, we found no combination of MG and CESM characteristics helpful in defining false-positive lesions.

  20. Open reduction and internal fixation of displaced intraarticular fractures of the calcaneus - influence of type of fracture and congruency of the subtalar joint upon functional result

    Directory of Open Access Journals (Sweden)

    Matej Andoljšek

    2005-11-01

    Full Text Available Background: More and more, open reduction and internal fixation (ORIF followed by early motion are advocated for displaced intraarticular fractures of the calcaneus. In prospective study the author asked, what are the results of ORIF with the calcaneal plate in intraarticular fractures of the calcaneus, and whether type of fracture and/or congruity in the subtalar joint influence these results.Methods: Forty-three intraarticular fractures of the calcaneus (30 Type II, 10 Type III and 3 Type IV according to Sanders classification were operated through extensile lateral approach. After reduction of the subtalar joint and restoration of the calcaneus shape, the fracture was fixed with the calcaneal plate. Mostly, surgery was delayed for a few days until soft tissues recuperate. Motion of the ankle and the subtalar joint was encouraged immediately, partial weight bearing after 6–8 weeks and full weight bearing after 3–4 month. After surgery, subtalar joint was found congruent in 33 (77% and non-congruent (within 2 mm in ten fractures.Results: Functional results of 36 fractures with a representative type distribution were evaluated 12 to 61 months postinjury. Functional results were satisfactory in 31 fractures (86% and not satisfactory in five (14%. All fractures with unsatisfactory results were comminutive (Type III or IV. Four fractures with congruent joint had unsatisfactory, and eight of nine fractures with uncongruent joint had satisfactory result. Statistically, functional results of the comminuted fractures were significantly worse. However, functional results of fractures with non-congruent joint were comparable to the results of fractures with congruent joint and analysis of variance showed that interaction of these two factors was not important.Conclusions: This prospective study confirms that ORIF enables satisfactory results in majority of displaced intraarticular fractures of the calcaneus. It also confirms that comminution in the

  1. Vitreoretinal surgery for proliferative diabetic retinopathy with two types of bandage contact lenses: clinical results and protection of corneal epithelium

    Directory of Open Access Journals (Sweden)

    Jia-Jia Chen

    2017-12-01

    Full Text Available AIM: To observe the effect of two kinds of bandage contact lenses on epithelial erosions and corneal thickness after vitreoretinal surgery for proliferative diabetic retinopathy(PDR. METHODS: In this prospective, nonrandomized, comparative clinical study, 69 eyes of 69 patients with PDR were divided into two groups. They underwent vitreoretinal surgery. Group A, 36 eyes of 36 cases, the bandage contact lens with diameter of 13.8mm were covered on corneal surface during surgery under noncontact wide-angle viewing systems. Group B, 33 eyes of 33 cases, the bandage contact lens with diameter of 14.0mm were covered on corneal surface during the same surgery. Visual acuity, intraocular pressure, slit-lamp examination, corneal fluorescein sodium staining, count of corneal endothelium cells, measure of corneal thickness before and after operation were assessed.RESULTS: Pre-operation, corneal fluorescein sodium staining positive rate was 42% in Group A and 42% in Group B(χ2=0.004, P=0.949. At 1d after surgery, the positive rate of was 47% in Group A and 45% in Group B(χ2=0.022, P=0.883. At 2d after surgery, the positive rate of was 44% in Group A and 45% in Group B(χ2=0.007, P=0.933. At 3d after surgery, the positive rate of was 44% in Group A and 42% in Group B(χ2=0.029, P=0.886. At 7d after surgery, the positive rate of was 42% in Group A and 39% in Group B(χ2=0.037, P=0.848. Count of corneal endothelium cells showed no significant difference between Group A and Group B(P>0.05. Count of corneal endothelium cells of Group A before surgery and at 7d after surgery were 2779.25±329.55 /mm2, 2777.14±331.17 /mm2, without significant difference(t=0.551, P=0.585; those of Group B were 2678.61±335.64/mm2, 2672.45±336.25 /mm2, without significant difference(t=1.774, P=0.086. Measure of corneal thickness was 519.25±23.42μm before surgery and 542.03±25.94μm after surgery in Group A(t=-6.854, Pt=-7.204, PCONCLUSION: Two kinds of bandage contact lenses

  2. [INCIDENCE OF CORONARY HEART DISEASE IN COMBINATION WITH TYPE 2 DIABETES MELLITUS ESTIMATED FROM RESULTS OF AN EPIDEMIOLOGICAL STUDY OF 20-59 YEAR OLD WOMEN].

    Science.gov (United States)

    Sultanova, S S; Kasumova, E N; Mamedova, R N

    2015-01-01

    We report evaluation of the incidence of coronary heart disease (CHD) in combination with type 2 diabetes mellitus (DM2) estimated from results of an epidemiological study of 20-59 year old women. CPD was shown to occur twice more frequently in association with DM2 especilly in the age groups of 30-39 and 50-59 years.

  3. The results of randomized controlled trial of low-dose radiation for wet-type age-related macular degeneration on a 1 year term basis

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-06-01

    Evaluation of low dose radiation therapy to the wet-type age-related macular degeneration (AMD) located at the fovea centralis. Patients were irradiated with 10 fractions of 2 Gy external beam or just observed. Between the treated (39) and untreated (31) cases, there was no significant difference in gender, age, initial visual acuity, or size of the neovascular membrane. With the follow-up of 12 months, the visual acuity was significantly well preserved and the size of the neovascular membrane was decreased. These results indicate that low dose irradiation is effective for the wet-type AMD of the stage we treated in the present study. (author)

  4. Perturbation of auxin homeostasis by overexpression of wild-type IAA15 results in impaired stem cell differentiation and gravitropism in roots.

    Science.gov (United States)

    Yan, Da-Wei; Wang, Jing; Yuan, Ting-Ting; Hong, Li-Wei; Gao, Xiang; Lu, Ying-Tang

    2013-01-01

    Aux/IAAs interact with auxin response factors (ARFs) to repress their transcriptional activity in the auxin signaling pathway. Previous studies have focused on gain-of-function mutations of domain II and little is known about whether the expression level of wild-type Aux/IAAs can modulate auxin homeostasis. Here we examined the perturbation of auxin homeostasis by ectopic expression of wild-type IAA15. Root gravitropism and stem cell differentiation were also analyzed. The transgenic lines were less sensitive to exogenous auxin and exhibited low-auxin phenotypes including failures in gravity response and defects in stem cell differentiation. Overexpression lines also showed an increase in auxin concentration and reduced polar auxin transport. These results demonstrate that an alteration in the expression of wild-type IAA15 can disrupt auxin homeostasis.

  5. Perturbation of auxin homeostasis by overexpression of wild-type IAA15 results in impaired stem cell differentiation and gravitropism in roots.

    Directory of Open Access Journals (Sweden)

    Da-Wei Yan

    Full Text Available Aux/IAAs interact with auxin response factors (ARFs to repress their transcriptional activity in the auxin signaling pathway. Previous studies have focused on gain-of-function mutations of domain II and little is known about whether the expression level of wild-type Aux/IAAs can modulate auxin homeostasis. Here we examined the perturbation of auxin homeostasis by ectopic expression of wild-type IAA15. Root gravitropism and stem cell differentiation were also analyzed. The transgenic lines were less sensitive to exogenous auxin and exhibited low-auxin phenotypes including failures in gravity response and defects in stem cell differentiation. Overexpression lines also showed an increase in auxin concentration and reduced polar auxin transport. These results demonstrate that an alteration in the expression of wild-type IAA15 can disrupt auxin homeostasis.

  6. The psychological profile of bariatric patients with and without type 2 diabetes: baseline results of the longitudinal GASMITO-PSYC study.

    Science.gov (United States)

    Wimmelmann, Cathrine L; Smith, Evelyn; Lund, Michael T; Hansen, Merethe; Dela, Flemming; Mortensen, Erik L

    2015-01-01

    Some bariatric patients are referred for surgery with a diagnosis of type 2 diabetes while others are referred without co-morbid diabetes, but psychological differences between patients with and without type 2 diabetes undergoing bariatric surgery have not yet been investigated. The objective of this study was to present the baseline results of the longitudinal GASMITO-PSYC study, and to evaluate the psychological differences between bariatric patients with and without type 2 diabetes. A total of 129 Roux-en- Y gastric bypass patients were recruited from the bariatric clinic at a hospital in the suburban Copenhagen area. Participants answered questionnaires concerning personality, mental symptoms, health-related quality of life (HRQOL), body image, lifestyle, and physical health including diabetes status on average 11 weeks before surgery. Questionnaires were either sent to the participant's home address or administered at the University of Copenhagen. Patients with type 2 diabetes scored higher on 'physical function' (P = .001), 'physical role' (P = .014), 'physical pain' (P = .021), and 'vitality' (P = .007) than nondiabetic patients after controlling for sex and age. The total study sample differed significantly from Danish test norms reporting higher neuroticism (P = .000), more mental symptoms (P = .000), lower HRQOL (P = .000), and less positive weight-related body image (P = .000). Patients with type 2 diabetes had better physical HRQOL than nondiabetic patients. This study highlights the importance of investigating whether these differences affect surgical outcomes. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  7. Psychological and personality factors in type 2 diabetes mellitus, presenting the rationale and exploratory results from The Maastricht Study, a population-based cohort study

    DEFF Research Database (Denmark)

    van Dooren, Fleur E P; Denollet, Johan; Verhey, Frans R J

    2016-01-01

    and education level. RESULTS: Individuals with type 2 diabetes had higher levels of depressive and anxiety symptoms, odds ratios (95 % CI) were 3.15 (1.49; 6.67), 1.73 (0.83-3.60), 1.50 (0.72-3.12), for PHQ-9 ≥ 10, current depressive disorder and GAD-7 ≥ 10, respectively. Type D personality, social inhibition...... and negative affectivity were more prevalent in type 2 diabetes, odds ratios were 1.95 (1.23-3.10), 1.35 (0.93-1.94) and 1.70 (1.14-2.51), respectively. Individuals with type 2 diabetes were less extraverted, less conscientious, less agreeable and less emotionally stable, and similar in openness to individuals......BACKGROUND: Strong longitudinal evidence exists that psychological distress is associated with a high morbidity and mortality risk in type 2 diabetes. Little is known about the biological and behavioral mechanisms that may explain this association. Moreover, the role of personality traits...

  8. G to A substitution in 5{prime} donor splice site of introns 18 and 48 of COL1A1 gene of type I collagen results in different splicing alternatives in osteogenesis imperfecta type I cell strains

    Energy Technology Data Exchange (ETDEWEB)

    Willing, M.; Deschenes, S. [Univ. of Iowa, Iowa City, IA (United States)

    1994-09-01

    We have identified a G to A substitution in the 5{prime} donor splice site of intron 18 of one COL1A1 allele in two unrelated families with osteogenesis imperfecta (OI) type I. A third OI type I family has a G to A substitution at the identical position in intron 48 of one COL1A1 allele. Both mutations abolish normal splicing and lead to reduced steady-state levels of mRNA from the mutant COL1A1 allele. The intron 18 mutation leads to both exon 18 skipping in the mRNA and to utilization of a single alternative splice site near the 3{prime} end of exon 18. The latter results in deletion of the last 8 nucleotides of exon 18 from the mRNA, a shift in the translational reading-frame, and the creation of a premature termination codon in exon 19. Of the potential alternative 5{prime} splice sites in exon 18 and intron 18, the one utilized has a surrounding nucleotide sequence which most closely resembles that of the natural splice site. Although a G to A mutation was detected at the identical position in intron 48 of one COL1A1 allele in another OI type I family, nine complex alternative splicing patterns were identified by sequence analysis of cDNA clones derived from fibroblast mRNA from this cell strain. All result in partial or complete skipping of exon 48, with in-frame deletions of portions of exons 47 and/or 49. The different patterns of RNA splicing were not explained by their sequence homology with naturally occuring 5{prime} splice sites, but rather by recombination between highly homologous exon sequences, suggesting that we may not have identified the major splicing alternative(s) in this cell strain. Both G to A mutations result in decreased production of type I collagen, the common biochemical correlate of OI type I.

  9. Risk of Immediate-Type Allergy to Local Anesthetics is Overestimated-Results from 5 Years of Provocation Testing in a Danish Allergy Clinic

    DEFF Research Database (Denmark)

    Kvisselgaard, Ask D; Mosbech, Holger F; Fransson, Sara

    2017-01-01

    : The main aim of this study was to investigate the incidence of immediate-type allergy to LAs in our regional allergy clinic over the 5-year period 2010 to 2014. METHODS: This was a retrospective single-center study of patients referred to a regional allergy clinic (excluding patients with perioperative......BACKGROUND: Local anesthetics (LAs) are used in many health care settings and exposure during a lifetime is almost inevitable. Immediate-type allergy to LAs is considered rare among allergy experts but is commonly suspected by health care workers from other specialties, and by patients. OBJECTIVE...... reactions) with suspected immediate allergy to LAs, who had undergone subcutaneous provocation with 1 or more LAs. Patients were identified in the hospital clinical coding system and clinical information about the reaction and investigation results was obtained from their medical records. RESULTS: A total...

  10. Associations of Circulating Lymphocyte Subpopulations with Type 2 Diabetes: Cross-Sectional Results from the Multi-Ethnic Study of Atherosclerosis (MESA.

    Directory of Open Access Journals (Sweden)

    Nels C Olson

    Full Text Available Distinct lymphocyte subpopulations have been implicated in the regulation of glucose homeostasis and obesity-associated inflammation in mouse models of insulin resistance. Information on the relationships of lymphocyte subpopulations with type 2 diabetes remain limited in human population-based cohort studies.Circulating levels of innate (γδ T, natural killer (NK and adaptive immune (CD4+ naive, CD4+ memory, Th1, and Th2 lymphocyte subpopulations were measured by flow cytometry in the peripheral blood of 929 free-living participants of the Multi-Ethnic Study of Atherosclerosis (MESA. Cross-sectional relationships of lymphocyte subpopulations with type 2 diabetes (n = 154 and fasting glucose and insulin concentrations were evaluated by generalized linear models.Each standard deviation (SD higher CD4+ memory cells was associated with a 21% higher odds of type 2 diabetes (95% CI: 1-47% and each SD higher naive cells was associated with a 22% lower odds (95% CI: 4-36% (adjusted for age, gender, race/ethnicity, and BMI. Among participants not using diabetes medication, higher memory and lower naive CD4+ cells were associated with higher fasting glucose concentrations (p<0.05, adjusted for age, sex, and race/ethnicity. There were no associations of γδ T, NK, Th1, or Th2 cells with type 2 diabetes, glucose, or insulin.A higher degree of chronic adaptive immune activation, reflected by higher memory and lower naive CD4+ cells, was positively associated with type 2 diabetes. These results are consistent with a role of chronic immune activation and exhaustion augmenting chronic inflammatory diseases, and support the importance of prospective studies evaluating adaptive immune activation and type 2 diabetes.

  11. Cell type-dependent induction of DNA damage by 1800 MHz radiofrequency electromagnetic fields does not result in significant cellular dysfunctions.

    Directory of Open Access Journals (Sweden)

    Shanshan Xu

    Full Text Available BACKGROUND: Although IARC clarifies radiofrequency electromagnetic fields (RF-EMF as possible human carcinogen, the debate on its health impact continues due to the inconsistent results. Genotoxic effect has been considered as a golden standard to determine if an environmental factor is a carcinogen, but the currently available data for RF-EMF remain controversial. As an environmental stimulus, the effect of RF-EMF on cellular DNA may be subtle. Therefore, more sensitive method and systematic research strategy are warranted to evaluate its genotoxicity. OBJECTIVES: To determine whether RF-EMF does induce DNA damage and if the effect is cell-type dependent by adopting a more sensitive method γH2AX foci formation; and to investigate the biological consequences if RF-EMF does increase γH2AX foci formation. METHODS: Six different types of cells were intermittently exposed to GSM 1800 MHz RF-EMF at a specific absorption rate of 3.0 W/kg for 1 h or 24 h, then subjected to immunostaining with anti-γH2AX antibody. The biological consequences in γH2AX-elevated cell type were further explored with comet and TUNEL assays, flow cytometry, and cell growth assay. RESULTS: Exposure to RF-EMF for 24 h significantly induced γH2AX foci formation in Chinese hamster lung cells and Human skin fibroblasts (HSFs, but not the other cells. However, RF-EMF-elevated γH2AX foci formation in HSF cells did not result in detectable DNA fragmentation, sustainable cell cycle arrest, cell proliferation or viability change. RF-EMF exposure slightly but not significantly increased the cellular ROS level. CONCLUSIONS: RF-EMF induces DNA damage in a cell type-dependent manner, but the elevated γH2AX foci formation in HSF cells does not result in significant cellular dysfunctions.

  12. Methicillin-resistant Staphylococcus aureus isolates with SCCmec type V and spa types t437 or t1081 associated to discordant susceptibility results between oxacillin and cefoxitin, Central Taiwan.

    Science.gov (United States)

    Ho, Cheng-Mao; Lin, Chien-Yu; Ho, Mao-Wang; Lin, Hsiao-Chuan; Chen, Chao-Jung; Lin, Lee-Chung; Lu, Jang-Jih

    2016-12-01

    Staphylococcus aureus isolates with discordant susceptibility results between oxacillin and cefoxitin obtained using automated microbiology systems are infrequently observed. From April 2013 to December 2014, 1956 methicillin-resistant S. aureus (MRSA) and 1761 methicillin-susceptible S. aureus isolates were obtained from different patients. Forty isolates (1.1% and 2% in case of S. aureus and MRSA, respectively) with discordant susceptibility results (oxacillin susceptible and cefoxitin resistant) and carrying mecA gene were obtained. Except 2 SCCmec type IV isolates, 38 MRSA isolates were all SCCmec type V (V T or non-V T ), which were further divided into V T (n=22) and non-V T (n=16). The most common spa type in V T and non-V T isolates were t437 (n=19) and t1081 (n=13), respectively. Only 55% of patients received effective antimicrobial agents; 2 mortalities were not attributable to MRSA infection. Using standard agar dilution, 17 MRSA isolates (0.46% and 0.87% in case of S. aureus and MRSA, respectively) had oxacillin MIC in the susceptible ranges (oxacillin-susceptible MRSA [OS-MRSA]); all carried SCCmec type V (V T , n=8; non-V T , n=9). The most common spa-MLST types of OS-MRSA in V T and non-V T were t437-ST59 (n=4) and t1081-ST45 (n=7), respectively. Concomitant testing by both cefoxitin- and oxacillin-based methods is a practical strategy for OS-MRSA detection in the clinical laboratories. Continuous monitoring of OS-MRSA isolates is necessary to elucidate their impact in clinical infectious diseases. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Supplementary Material for: Global expression differences and tissue specific expression differences in rice evolution result in two contrasting types of differentially expressed genes

    KAUST Repository

    Horiuchi, Youko

    2015-01-01

    Abstract Background Since the development of transcriptome analysis systems, many expression evolution studies characterized evolutionary forces acting on gene expression, without explicit discrimination between global expression differences and tissue specific expression differences. However, different types of gene expression alteration should have different effects on an organism, the evolutionary forces that act on them might be different, and different types of genes might show different types of differential expression between species. To confirm this, we studied differentially expressed (DE) genes among closely related groups that have extensive gene expression atlases, and clarified characteristics of different types of DE genes including the identification of regulating loci for differential expression using expression quantitative loci (eQTL) analysis data. Results We detected differentially expressed (DE) genes between rice subspecies in five homologous tissues that were verified using japonica and indica transcriptome atlases in public databases. Using the transcriptome atlases, we classified DE genes into two types, global DE genes and changed-tissues DE genes. Global type DE genes were not expressed in any tissues in the atlas of one subspecies, however changed-tissues type DE genes were expressed in both subspecies with different tissue specificity. For the five tissues in the two japonica-indica combinations, 4.6 ± 0.8 and 5.9 ± 1.5 % of highly expressed genes were global and changed-tissues DE genes, respectively. Changed-tissues DE genes varied in number between tissues, increasing linearly with the abundance of tissue specifically expressed genes in the tissue. Molecular evolution of global DE genes was rapid, unlike that of changed-tissues DE genes. Based on gene ontology, global and changed-tissues DE genes were different, having no common GO terms. Expression differences of most global DE genes were regulated by cis

  14. Abdominal visceral fat accumulation is associated with the results of 123I-metaiodobenzylguanidine myocardial scintigraphy in type 2 diabetic patients

    International Nuclear Information System (INIS)

    Anan, Futoshi; Masaki, Takayuki; Takahashi, Naohiko; Yoshimatsu, Hironobu; Yonemochi, Hidetoshi; Nakagawa, Mikiko; Saikawa, Tetsunori; Eshima, Nobuoki

    2007-01-01

    We tested the hypothesis that increased abdominal visceral accumulation (VFA) is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients not receiving insulin treatment. The fat distribution was evaluated by measuring the VFA by abdominal computed tomography at the umbilical level. The study group consisted of 24 type 2 diabetic patients with high VFA (≥100 cm 2 , age 60 ± 8 years, high VFA group). The control group consisted of 19 age-matched type 2 diabetic patients with normal VFA ( 2 , age 60 ± 7 years, normal VFA group). Cardiovascular autonomic function was assessed by baroreflex sensitivity, heart rate variability, plasma norepinephrine concentrations, and cardiac 123 I-metaiodobenzylguanidine (MIBG) scintigraphy. Early and delayed 123 I-MIBG myocardial uptake values were lower (p 123 I-MIBG was higher (p 123 I-MIBG during the delayed phase. Our results demonstrate that the level of VFA is associated with depressed cardiovascular autonomic function and insulin resistance in patients with type 2 diabetes mellitus. (orig.)

  15. The AD-type ectomycorrhizas, one of the most common morphotypes present in truffle fields, result from fungi belonging to the Trichophaea woolhopeia species complex.

    Science.gov (United States)

    Rubini, Andrea; Belfiori, Beatrice; Passeri, Valentina; Baciarelli Falini, Leonardo; Arcioni, Sergio; Riccioni, Claudia; Paolocci, Francesco

    2011-01-01

    Belowground ectomycorrhizal communities are often species rich. Characterization of the ectomycorrhizas (ECMs) underneath native truffle areas and/or cultivation sites is particularly relevant to identifying fungal species that might interfere with or promote truffle propagation and fruiting. Fungal identification at the genus/species level can now be achieved by combining detailed morphological and anatomical descriptions with molecular approaches. In a survey of the mycorrhizal biodiversity of Tuber melanosporum orchards and inoculated host plants in nurseries, we repeatedly sampled ECMs with morphological features resembling those of the ECMs widely known as the AD type. Despite the fact that the AD type is regarded as one of the most competitive fungal species towards Tuber spp., its taxonomical rank has yet to be resolved. By analyzing the 28S and internal transcribed spacer (ITS) rDNA regions, here, we show that AD-type ECMs result from host plant colonization by the pyronemataceous species Trichophaea woolhopeia. Further to this, the 28S and ITS phylogenetic trees built from the AD-type ECMs analyzed sustain the hypothesis that T. woolhopeia is a species complex.

  16. The results from trial operation of the ecological display for monitoring of drum-separator status at RBMK-type NPP

    International Nuclear Information System (INIS)

    Ivkin, A.S.; Anokhin, A.N.

    2013-01-01

    The paper describes procedure and results of ecological interface for monitoring of drum-separator at RBMK-type NPP. Trial operation has been carried out during four months at the full scope simulator of the leningrad NPP with participation of the licensed control room operators. The results from the trial operation demonstrate that ecological interface considerably increases efficiency of operator activity and essentially reduces protection activation rate caused by errors or untimely actions of operator compared to conventional human-machine interface [ru

  17. Results of zone II flexor tendon repair in children younger than age 6 years: botulinum toxin type A administration eased cooperation during the rehabilitation and improved outcome.

    Science.gov (United States)

    Tüzüner, Serdar; Balci, Nilüfer; Ozkaynak, Sibel

    2004-01-01

    The inability of young children with a zone II flexor tendon repair to cooperate in postoperative care and rehabilitation may represent a high risk for medical and surgical complications. To forestall that risk, botulinum toxin type A (2.5 U/kg, 7 U/kg) injection was used during surgery to induce forearm flexor muscle relaxation in seven children under 6 years old with zone 2 flexor tendon repairs. Patients received a controlled passive motion regimen after surgery. Results were evaluated on the basis of the acquisition of muscle tone and active finger movements, total range of motion of affected joints, postoperative grip strength, muscle atrophy, and phalangeal length. In this prospective clinical study, the mean follow-up was 18 months. All the children had good and excellent results based on the Strickland criteria. As for postoperative complications, one patient had bowstring and another had poor finger sensibility and first web space contracture that required Z-plasty. The selective use of botulinum toxin type A to weaken the targeted muscles generated a sufficient reduction in spontaneous activity of the fingers, permitting an improved rehabilitation program. Botulinum toxin type A administration could be an effective form of therapy, serving as an alternative or adjunct to conventional rehabilitation modalities in these children.

  18. Effects of substrate type and arsenic dosage level on arsenic behavior in grassland microcosms. Part I. Preliminary results on 74As transport

    International Nuclear Information System (INIS)

    Draggan, S.

    1977-01-01

    Microcosm design is an important factor in interpreting results obtained from studies of the environmental effects, mobility and persistence of contaminants. The behavior of pentavalent arsenic and a radioarsenic tracer was studied in three substrate types exposed to differing levels of stable As dosage. Soil cores excised intact from a natural grassland ecosystem were considered to most reliably represent the natural system under study since they retained the soil structure, and closely simulated the abiotic and biotic complexity, of the grassland ecosystem. The behavior of 74 As in the components of intact soil core microcosms differed appreciably from that observed for the other microcosm types where soil underwent manipulation. These differences were explained primarily on the basis of differences in soil structure

  19. Different clinical and biochemical phenotypes resulting from the same substitution at the same glycine residue in different chains of the type I collagen molecule

    Energy Technology Data Exchange (ETDEWEB)

    Paepe, A. De; Nuytinck, L. [Univ. of Gent, Brussels (Belgium); Spotila, L. [Jefferson Institute of Molecular Medicine, Philadelphia, PA (United States)] [and others

    1994-09-01

    Mutations in type I collagen produce osteogenesis imperfecta (OI; brittle bone disease), ranging in severity from lethal to very mild. This phenotypic variation is largely determined by the position and nature of the mutation. Because type I collagen consists of two {alpha}1 chains and one {alpha}2 chain, {alpha}1(I) mutations are generally regarded to have more serious consequences than {alpha}2(I) mutations. We have characterized a point mutation causing substitution of serine for glycine at position 661 of the {alpha}1(I) chain in a child with severe OI. This is precisely the same substitution that had been detected in the {alpha}2(I) chain in a woman with post-menopausal osteoporosis. She and two of her sons were heterozygous and the third son was homozygous as a result of uniparental disomy. Biochemical collagen profiles were studied in each of the patients and compared with a control. Medium and cell-layer collagens were overmodified in all patients. Overmodification was pronounced in the patient with the {alpha}1(I) mutation, but mild in the patients with the {alpha}2(I) mutation, being slightly less evident in the heterozygotes than in the homozygote. Thermal stability assays showed that the melting temperature of the mutant {alpha}1(I) chains was reduced by 3{degrees}C, whereas the melting curves in the patients with the {alpha}2(I) mutation were not significantly different from the control. These results show that the type of {alpha}-chain harboring the mutation influences the fundamental biochemical behavior of type I collagen molecules and strikingly emphasizes the predominant role of {alpha}1(I) chains compared with {alpha}2(I) in this respect.

  20. A novel ABO O allele caused by a large deletion covering two exons of the ABO gene identified in a Caucasian family showing discrepant ABO blood typing results.

    Science.gov (United States)

    Matzhold, Eva M; Drexler, Camilla; Wagner, Thomas

    2016-11-01

    The presence of ABO subgroup alleles and unusual O alleles often is associated with discrepant serologic findings in ABO blood group typing. In the ABO gene of a Caucasian female and her daughters who had aberrant ABO phenotypes, a novel ABO O allele characterized by a large deletion that included two exons was identified. ABO phenotypes were determined by standard agglutination tests and adsorption-elution studies. Allele-specific sequencing analyses of the ABO gene as well as messenger RNA transcripts were carried out. All three samples showed the same discrepant ABO blood typing results lacking A and B antigens, indicating Blood Group O, whereas anti-A1 and anti-A2 isoagglutinins were not detectable in reverse typing. Analyses of the ABO gene revealed a novel allele characterized by a deletion of 2169 base pairs, including sequences of Intron 1, Exon 2, Intron 2, Exon 3, and Intron 3. Exon 1 was directly joined to Exon 4 in the ABO transcript. Because the novel allele was associated with a well-described O allele, the absence of A-antigens in the inherited ABO subtype phenotype may be due to the identified mutation affecting the transmembrane-spanning domain of the encoded protein and impairing the transferase activity. © 2016 AABB.

  1. The Nainital-Cape Survey. II. Report for pulsation in five chemically peculiar A-type stars and presentation of 140 null results

    Science.gov (United States)

    Joshi, S.; Mary, D. L.; Martinez, P.; Kurtz, D. W.; Girish, V.; Seetha, S.; Sagar, R.; Ashoka, B. N.

    2006-08-01

    Aims.We search for photometric variability in chemically peculiar A type stars in the northern hemisphere. Methods: .High-speed photometric observations of Ap and Am star candidates have been carried out from ARIES (Manora Peak, Nainital) using a three-channel fast photometer attached to the ARIES 104-cm Sampurnanand telescope. Results: .This paper presents three new variables: HD 113878, HD 118660 and HD 207561. During the time span of the survey (1999 December to 2004 January) pulsations of the δ Sct type were also found for the two evolved Am stars HD 102480 and HD 98851, as reported in Joshi et al. (2002, 2003). Additionally, we present 140 null results of the survey for this time span. Conclusions: .The star HD 113878 pulsates with a period of 2.31 h, which is typical of δ Sct stars. HD 118660 exhibits multi-periodic variability with a prominent period of nearly 1 h. These periods need to be investigated and make HD 118660 a particularly interesting target for further observations. For HD 207561, a star classified as Am, a probable pulsation with a period of 6 min was found in the light curves obtained on two consecutive nights. Both HD 102480 and HD 98851 exhibit unusual alternating high and low amplitude maxima, with a period ratio of 2:1. The analysis of the null results confirms the photometric quality of the Nainital site.

  2. Intracellular Targeting of CEA Results in Th1-Type Antibody Responses Following Intradermal Genetic Vaccination by a Needle-Free Jet Injection Device

    Directory of Open Access Journals (Sweden)

    Susanne Johansson

    2007-01-01

    Full Text Available The route and method of immunization, as well as the cellular localization of the antigen, can influence the generation of an immune response. In general, intramuscular immunization results in Th1 responses, whereas intradermal delivery of DNA by gene gun immunization often results in more Th2 responses. Here we investigate how altering the cellular localization of the tumor antigen CEA (carcinoembryonic antigen affects the quality and amplitude of DNA vaccine-induced antibody responses in mice following intradermal delivery of DNA by a needle-free jet injection device (Biojector. CEA was expressed either in a membrane-bound form (wild-type CEA or in two truncated forms (CEA6 and CEA66 with cytoplasmic localization, where CEA66 was fused to a promiscuous T-helper epitope from tetanus toxin. Repeated intradermal immunization of BALB/c mice with DNA encoding wild-type CEA produced high antibody titers of a mixed IgG1/IgG2a ratio. In contrast, utilizing the DNA construct that resulted in intracellular targeting of CEA led to a reduced capacity to induce CEA-specific antibodies, but instead induced a Th1-biased immune response.

  3. Capillary blood islet autoantibody screening for identifying pre-type 1 diabetes in the general population: design and initial results of the Fr1da study.

    Science.gov (United States)

    Raab, Jennifer; Haupt, Florian; Scholz, Marlon; Matzke, Claudia; Warncke, Katharina; Lange, Karin; Assfalg, Robin; Weininger, Katharina; Wittich, Susanne; Löbner, Stephanie; Beyerlein, Andreas; Nennstiel-Ratzel, Uta; Lang, Martin; Laub, Otto; Dunstheimer, Desiree; Bonifacio, Ezio; Achenbach, Peter; Winkler, Christiane; Ziegler, Anette-G

    2016-05-18

    Type 1 diabetes can be diagnosed at an early presymptomatic stage by the detection of islet autoantibodies. The Fr1da study aims to assess whether early staging of type 1 diabetes (1) is feasible at a population-based level, (2) prevents severe metabolic decompensation observed at the clinical manifestation of type 1 diabetes and (3) reduces psychological distress through preventive teaching and care. Children aged 2-5 years in Bavaria, Germany, will be tested for the presence of multiple islet autoantibodies. Between February 2015 and December 2016, 100 000 children will be screened by primary care paediatricians. Islet autoantibodies are measured in capillary blood samples using a multiplex three-screen ELISA. Samples with ELISA results >97.5th centile are retested using reference radiobinding assays. A venous blood sample is also obtained to confirm the autoantibody status of children with at least two autoantibodies. Children with confirmed multiple islet autoantibodies are diagnosed with pre-type 1 diabetes. These children and their parents are invited to participate in an education and counselling programme at a local diabetes centre. Depression and anxiety, and burden of early diagnosis are also assessed. Of the 1027 Bavarian paediatricians, 39.3% are participating in the study. Overall, 26 760 children have been screened between February 2015 and November 2015. Capillary blood collection was sufficient in volume for islet autoantibody detection in 99.46% of the children. The remaining 0.54% had insufficient blood volume collected. Of the 26 760 capillary samples tested, 0.39% were positive for at least two islet autoantibodies. Staging for early type 1 diabetes within a public health setting appears to be feasible. The study may set new standards for the early diagnosis of type 1 diabetes and education. The study was approved by the ethics committee of Technische Universität München (Nr. 70/14). Published by the BMJ Publishing Group Limited. For

  4. DiAlert: a prevention program for overweight first degree relatives of type 2 diabetes patients: results of a pilot study to test feasibility and acceptability

    Directory of Open Access Journals (Sweden)

    Heideman Wieke H

    2012-09-01

    Full Text Available Abstract Background Prevalence of type 2 diabetes mellitus is increasing due to lifestyle changes, particularly affecting those genetically at risk. We developed DiAlert as a targeted group-based intervention aimed to promote intrinsic motivation and action planning for lifestyle changes and weight loss in first degree relatives of patients with type 2 diabetes mellitus. The main objective of the pilot of the DiAlert intervention was to assess fidelity, feasibility and acceptability prior to starting the randomized controlled trial. Methods Individuals with a family history of type 2 diabetes mellitus were self-identified and screened for eligibility. DiAlert consists of two group sessions. Feasibility, fidelity, acceptability and self-reported perceptions and behavioral determinants were evaluated in a pre-post study using questionnaires and observations. Determinants of behavior change were analyzed using paired-samples t tests and Wilcoxon signed rank tests. Results DiAlert was delivered to two groups of first degree relatives of patients with type 2 diabetes mellitus (N = 9 and N = 12. Feasibility and fidelity were confirmed. Overall, the DiAlert group sessions were positively evaluated (8.0 on a scale of 1 to 10 by participants. The intervention did not impact perceived susceptibility or worry about personal diabetes risk. Action planning with regard to changing diet and physical activity increased. Conclusions DiAlert proved feasible and was well-accepted by participants. Positive trends in action planning indicate increased likelihood of actual behavior change following DiAlert. Testing the effectiveness in a randomized controlled trial is imperative. Trial registration Netherlands National Trial Register (NTR: NTR2036

  5. Sex and age differences in the achievement of control targets in patients with type 2 diabetes: results from a population-based study in a South European region.

    Science.gov (United States)

    Cambra, K; Galbete, A; Forga, L; Lecea, O; Ariz, M J; Moreno-Iribas, C; Aizpuru, F; Ibañez, B

    2016-10-12

    We aimed to determine the degree to which control targets of glycaemia and cardiovascular risk factors were achieved among patients with type 2 diabetes and to investigate sex- and age-related differences in this population. This cross-sectional, population-based study was conducted in Spain. Glycated hemoglobin (HbA1c), blood pressure, LDL-c, HDL-c, triglycerides, BMI, and smoking history were obtained from electronic clinical primary care records (n = 32,638 cases). The proportions of patients who met control targets were determined according to sex and age groups. Comparisons between groups were conducted with t-tests for continuous variables, tests for trends in proportions for categorical and ordinal variables, and Pearson's chi-square tests and binary logistic regression models for categorical variables. The overall proportions of patients with type 2 diabetes who met the target objectives for HbA1c (<7 %, 53 mmol/mol), blood pressure (130/80 mmHg), and LDL-cholesterol (100 mg/dl) were 60, 40 and 41 %, respectively. Women were less likely than men to meet the control targets of HbA1c (59 vs 61 %), LDL (35 vs 45 %), and HDL (58 vs 78 %). Patients under 65 years of age presented poorer control than older age groups. Only a minority of patients with type 2 diabetes met the composite target objectives for glycemic control, blood pressure, and LDL. There are differential gaps in the control results of female patients and younger patients, which should prompt improvements in case management and care. There is room for further improvement in the cardiometabolic control of patients with type 2 diabetes.

  6. Abdominal visceral fat accumulation is associated with the results of {sup 123}I-metaiodobenzylguanidine myocardial scintigraphy in type 2 diabetic patients

    Energy Technology Data Exchange (ETDEWEB)

    Anan, Futoshi [Oita Red Cross Hospital, Department of Cardiology, Oita (Japan); Oita University, Department of Internal Medicine I, Oita (Japan); Masaki, Takayuki; Takahashi, Naohiko; Yoshimatsu, Hironobu [Oita University, Department of Internal Medicine I, Oita (Japan); Yonemochi, Hidetoshi; Nakagawa, Mikiko; Saikawa, Tetsunori [Oita University, Department of Cardiovascular Science, Oita (Japan); Eshima, Nobuoki [Oita University, Department of Biostatistics, School of Medicine, Oita (Japan)

    2007-08-15

    We tested the hypothesis that increased abdominal visceral accumulation (VFA) is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients not receiving insulin treatment. The fat distribution was evaluated by measuring the VFA by abdominal computed tomography at the umbilical level. The study group consisted of 24 type 2 diabetic patients with high VFA ({>=}100 cm{sup 2}, age 60 {+-} 8 years, high VFA group). The control group consisted of 19 age-matched type 2 diabetic patients with normal VFA (<100 cm{sup 2}, age 60 {+-} 7 years, normal VFA group). Cardiovascular autonomic function was assessed by baroreflex sensitivity, heart rate variability, plasma norepinephrine concentrations, and cardiac {sup 123}I-metaiodobenzylguanidine (MIBG) scintigraphy. Early and delayed {sup 123}I-MIBG myocardial uptake values were lower (p < 0.005 and p < 0.0001, respectively) and the percent washout rate of {sup 123}I-MIBG was higher (p < 0.0005) in the high VFA group than in the normal VFA group. The fasting plasma insulin concentrations (p < 0.005) and the homeostasis model assessment (HOMA) index values (p < 0.0005) were higher in the high VFA group than in normal VFA group. Multiple regression analysis revealed that the level of VFA was independently predicted by the HOMA index values and the myocardial uptake of {sup 123}I-MIBG during the delayed phase. Our results demonstrate that the level of VFA is associated with depressed cardiovascular autonomic function and insulin resistance in patients with type 2 diabetes mellitus. (orig.)

  7. Comparison of results of graft uptake using tragal cartilage perichondrium composite graft versus temporalis fascia in patients undergoing surgery for chronic otitis media - squamous type.

    Science.gov (United States)

    Khalilullah, S; Shah, Shankar P; Yadav, D; Shrivastav, R P; Bhattarai, H

    2016-08-02

    To assess, analyze and compare the results of graft uptake using Tragal Cartilage-Perichondrium Composite (TCPC) graft with Temporalis Fascia (TF) graft in patients who undergoing surgery for chronic otitis media - squamous type. Patients aged 13 years and above with diagnosis of chronic otitis media - squamous type undergoing modified radical mastoidectomy, either primary or revision surgery with grafting of tympanic membrane (TM) and patients undergoing excision of postero-superior retraction pocket (PSRP) were included in this study. Patients were divided in two groups: Group A-patients undergoing TCPC graft and Group B -patients undergoing TF graft. Graft uptake results were assessed between 8-12 weeks of surgery. In both Groups there were 30 patients each. In Group A successful graft uptake was seen in 27 patients (90 %) and failure of graft uptake was seen in 3 patients(10 %). In Group B successful graft uptake was seen in 28 patients (93.3 %) and failure in 2 patients (6.67 %).Out of the total 60 patients, 11 patients had PSRP. All 6 patients with PSRP in Group A had successful graft uptake and no retraction. Among the 5 patients with PSRP in Group B all patients had sucessful graft uptake, however, in 2 patients retraction of the tympanic membrane was seen similar to the preoperative findings. There was no statistical difference (p = 0.433) between the use of temporalis fascia or tragal cartilage perichondrium in patients undergoing surgery for chronic otitis media - squamous type.

  8. Compromised Lactobacillus helveticus starter activity in the presence of facultative heterofermentative Lactobacillus casei DPC6987 results in atypical eye formation in Swiss-type cheese.

    Science.gov (United States)

    O'Sullivan, Daniel J; McSweeney, Paul L H; Cotter, Paul D; Giblin, Linda; Sheehan, Jeremiah J

    2016-04-01

    Nonstarter lactic acid bacteria are commonly implicated in undesirable gas formation in several varieties, including Cheddar, Dutch-, and Swiss-type cheeses, primarily due to their ability to ferment a wide variety of substrates. This effect can be magnified due to factors that detrimentally affect the composition or activity of starter bacteria, resulting in the presence of greater than normal amounts of fermentable carbohydrates and citrate. The objective of this study was to determine the potential for a facultatively heterofermentative Lactobacillus (Lactobacillus casei DPC6987) isolated from a cheese plant environment to promote gas defects in the event of compromised starter activity. A Swiss-type cheese was manufactured, at pilot scale and in triplicate, containing a typical starter culture (Streptococcus thermophilus and Lactobacillus helveticus) together with propionic acid bacteria. Lactobacillus helveticus populations were omitted in certain vats to mimic starter failure. Lactobacillus casei DPC6987 was added to each experimental vat at 4 log cfu/g. Cheese compositional analysis and X-ray computed tomography revealed that the failure of starter bacteria, in this case L. helveticus, coupled with the presence of a faculatively heterofermentative Lactobacillus (L. casei) led to excessive eye formation during ripening. The availability of excess amounts of lactose, galactose, and citrate during the initial ripening stages likely provided the heterofermentative L. casei with sufficient substrates for gas formation. The accrual of these fermentable substrates was notable in cheeses lacking the L. helveticus starter population. The results of this study are commercially relevant, as they demonstrate the importance of viability of starter populations and the control of specific nonstarter lactic acid bacteria to ensure appropriate eye formation in Swiss-type cheese. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights

  9. Intravitreal delivery of AAV8 retinoschisin results in cell type-specific gene expression and retinal rescue in the Rs1-KO mouse

    Science.gov (United States)

    Park, TK; Wu, Z; Kjellstrom, S; Zeng, Y; Bush, RA; Sieving, PA; Colosi, P

    2009-01-01

    X-linked juvenile retinoschisis (XLRS) is a neurodevelopmental abnormality caused by retinoschisin gene mutations. XLRS is characterized by splitting through the retinal layers and impaired synaptic transmission of visual signals resulting in impaired acuity and a propensity to retinal detachment. Several groups have treated murine retinoschisis models successfully using adeno-associated virus (AAV) vectors. Owing to the fragile nature of XLRS retina, translating this therapy to the clinic may require an alternative to invasive subretinal vector administration. Here we show that all layers of the retinoschisin knockout (Rs1-KO) mouse retina can be transduced efficiently with AAV vectors administered by simple vitreous injection. Retinoschisin expression was restricted to the neuroretina using a new vector that uses a 3.5-kb human retinoschisin promoter and an AAV type 8 capsid. Intravitreal administration to Rs1-KO mice resulted in robust retinoschisin expression with a retinal distribution similar to that observed in wild-type retina, including the expression by the photoreceptors lying deep in the retina. No off-target expression was observed. Rs1-KO mice treated with this vector showed a decrease in the schisis cavities and had improved retinal signaling evaluated by recording the electroretinogram 11–15 weeks after the application. PMID:19458650

  10. Sexually transmitted Human Papillomavirus type variations resulting in high grade cervical dysplasia in North-East North Dakota and North-West Minnesota

    Directory of Open Access Journals (Sweden)

    Bianco Michelle

    2006-06-01

    Full Text Available Abstract Background A review of Pap smear diagnoses from a reference laboratory in Grand Forks, North Dakota over a 3-year period (07/00 to 10/03 revealed a two-fold higher rate of high grade squamous intraepithelial lesion in a community in northwest Minnesota (Roseau, 0.486% than in northeast North Dakota (Grand Forks, 0.249%, in spite of both having similar rates of low-grade squamous intraepithelial lesion (1.33% vs.1.30% respectively Objectives To identify the different types of HPV present in patient populations showing high-grade dysplasia in Grand Forks, ND and Roseau, MN. Study design Formaldehyde-fixed paraffin-embedded cervical tissue samples were analyzed using polymerase chain reaction (PCR to detect the presence of HPV type 16, 18 and 31. Results Our studies showed that 41 % of samples from Roseau were triply infected with HPV serotypes 16, 18 and 31 in comparison to 12 % from Grand Forks. Conclusion Due to the small sample size we were unable to prove the study to be statistically significant. However, our results suggest that the presence of HPV 16, 18 and 31 in triply infected samples may be the cause of the higher percentage of high-grade dysplasia in Roseau, MN when compared to Grand Forks, ND.

  11. Uncontrolled non-heartbeating donors (types i-ii) with normothermic recirculation vs. heartbeating donors: evaluation of functional results and survival.

    Science.gov (United States)

    Miranda-Utrera, N; Medina-Polo, J; Pamplona-Casamayor, M; Passas-Martínez, J B; Rodríguez-Antolín, A; de la Rosa Kehrmann, F; Duarte-Ojeda, J M; Tejido-Sánchez, A; Villacampa Aubá, F; Andrés Belmonte, A

    2015-09-01

    Non-heartbeating donors (NHBD) are an alternative to heartbeating donors (HBD). Our objective was to compare functional results and kidney survival from NHBDs and HBDs. A retrospective study comparing the results of 236 normothermically preserved kidneys from type i and ii type NHBDs with the results of 250 from HBDs that were transplanted in our center between 2005 and 2012. Homogeneity between groups was tested and we evaluated the presence of delayed graft function (DGF) associated with pretransplant variables of the donor and recipient. Both groups show homogeneity in pretransplant characteristics in terms of: age, HLA incompatibilities, and recipient hemodialysis time. Average follow-up time was 33 months (range 0-87) for NHBDs and 38 months (range 0-90) for HBDs. 5.5% of NHBDs showed primary non-function (PNF) vs. 4% of HBDs (P=.42) and 80.9% of DGF vs. 46.8% of HBDs (P<.001). At the end of the follow-up, there were no statistically significant differences in the survival of grafts (92.8% for NHBD vs. 93.6% for HBD, P=.71) and recipients (99.1% NHBD vs. 98.6% HBD, P=.28). Although the DGF percentage was greater for NHBDs, final creatinine as well as graft and recipient survival were similar for both groups. Therefore, in our experience, kidneys from NHBDs have similar results to those from HBDs and are an excellent source of organs for transplantation. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. The results of diagnostic and treatment of patients with diabetic retinopathy and age-related macular degeneration at a diabetes type 2.

    Directory of Open Access Journals (Sweden)

    I. V. Vorobyova

    2014-01-01

    Full Text Available Purpose: Explore the changing clinical and functional and morphological changes of the retina against application of angiogenesis inhibitor in patients with diabetes type 2 with comorbidity fundus: diabetic retinopathy (DR and agerelated macular degeneration (AMD.Patients and Methods. In the main study group included 22 patients (22 eyes with type 2 diabetes with combined fundus pathology DR and AMD. All patients before and after intravitreal injection of an angiogenesis inhibitor ranibizumab (Lucentis, Novartis was assessed visual acuity, macular thickness and macular morphology based on the results of OCT, the retinal sensitivity according to the data of microperimetry (MAIA. The control group study included 30 people (15 healthy and 15 with type 2 diabetes without DR.Results. When comparing the main group with the control group was revealed that visual acuity in the main group (0,27±0,05 was significantly lower than in the control group (0,8±0,01, p <0.05; retinal thickness was significantly higher in the control group, and the retinal sensitivity was significantly lower. On the background of intravitreal injection of ranibizumab all patients with DR and AMD had significantly increase in visual acuity on average by 37 % (from 0,27±0,05 before treatment to 0,37±0,05 after treatment, a significantly reduction of macular thickness in 9 out of 9 areas, including the fovea centralis, an average of 32.6 % and increase retinal sensitivity by 24 % (from 11,75±1,68 (dB to 14,58±1,68 (dB, (p <0.05. The correlations were found between visual acuity and retinal thickness, as well as between visual acuity and retinal sensitivity of the macula, before treatment r = –0,26, p <0.01 and r = 0,7 p <0.01, respectively, after treatment with r = –0,14, p <0.01 and r = 0,64, p <0.01, respectively. Conclusions. Intravitreal injection of angiogenesis inhibitor ranibizumab to patients with comorbidity fundus DR and AMD on a background of

  13. Resource use associated with type 2 diabetes in Asia, Latin America, the Middle East and Africa: results from the International Diabetes Management Practices Study (IDMPS).

    Science.gov (United States)

    Ringborg, A; Cropet, C; Jönsson, B; Gagliardino, J J; Ramachandran, A; Lindgren, P

    2009-07-01

    To estimate diabetes-related resource use and investigate its predictors among individuals with type 2 diabetes in 24 countries in Asia, Latin America, the Middle East and Africa. Cross-sectional observational data on diabetes-related resource use were collected from 15,016 individuals with type 2 diabetes within the second wave of International Diabetes Management Practices Study. Mean (SD) annual quantities were determined and predictors of diabetes-related hospitalisations, inpatient days, emergency room visits and absenteeism were investigated using negative binomial regression. Patients in Asia (n = 4678), Latin America (n = 6090) and the Middle East and Africa (n = 4248) made a mean (SD) of 3.4 (6.9), 5.4 (6.7) and 2.5 (4.4) General Practitioner visits per year. The mean (SD) number of inpatient days amounted to 3.8 (18.1), 2.2 (13.9) and 2.6 (13.5) per year. Results of the regression analysis showed the major influence of diabetes-related complications and inadequate glycaemic control on resource use. The expected annual rate of hospitalisation of patients with macrovascular complications compared with those without was 4.7 times greater in Asia [incidence rate ratio (IRR) = 4.7, 95% CI: 2.8-7.8, n = 2551], 5.4 times greater in Latin America (IRR = 5.4, 95% CI: 3.0-9.8, n = 3228) and 4.4 times greater in the Middle East and Africa (IRR = 4.4, 95% CI: 2.8-6.9, n = 2630). Micro- and macrovascular complications and inadequate glycaemic control are significant predictors of resource use in people with type 2 diabetes of developing countries. This knowledge confirms the health economic importance of early diagnosis of diabetes, education of patients and glycaemic control.

  14. Initiation of insulin pump therapy in children at diagnosis of type 1 diabetes resulted in improved long-term glycemic control.

    Science.gov (United States)

    Lang, Eunice G; King, Bruce R; Miller, Malcolm N; Dunn, Sandra V; Price, Darrell A; Foskett, Deborah C

    2017-02-01

    Insulin pump therapy (IPT) is increasingly used in children and young people with type 1 diabetes. There are limited studies evaluating the optimal time to start IPT. The aim of this study was to determine if early initiation of IPT in children with type 1 diabetes leads to improved glycaemic control and quality of life (QOL) compared with the later introduction of IPT. There were 38 subjects in the early pump group (EPG) (age 12.6 + 4.9 yr, 23 male) and 37 in the later pump group (LPG) (age 13.1 + 4.1 yr, 19 male). Hemoglobin A1c (HbA1c), rate of severe hypoglycemia, and diabetic ketoacidosis (DKA) were collected retrospectively over a 48-month period. Eligible subjects and/or their parents completed both a Paediatric and Paediatric Diabetes-specific Quality of Life Inventory. HbA1c measurements were lower in the EPG (6.8%; 51 mmol/mol) compared to the LPG (7.9%; 63 mmol/mol), across the 48 months of the study (p < 0.0001). There was no significant difference in the rate (per patient years) of severe hypoglycaemia (0.02; 0.07) p = 0.075 between the two groups. There were no episodes of DKA in either group. There was no significant difference in QOL between the groups with both having high satisfaction rates. Initiation of IPT at diagnosis of type 1 diabetes in children resulted in consistently lower HbA1c with no apparent change in hypoglycemia, DKA, or QOL. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Theoretical basal Ca II fluxes for late-type stars: results from magnetic wave models with time-dependent ionization and multi-level radiation treatments

    Science.gov (United States)

    Fawzy, Diaa E.; Stȩpień, K.

    2018-03-01

    In the current study we present ab initio numerical computations of the generation and propagation of longitudinal waves in magnetic flux tubes embedded in the atmospheres of late-type stars. The interaction between convective turbulence and the magnetic structure is computed and the obtained longitudinal wave energy flux is used in a self-consistent manner to excite the small-scale magnetic flux tubes. In the current study we reduce the number of assumptions made in our previous studies by considering the full magnetic wave energy fluxes and spectra as well as time-dependent ionization (TDI) of hydrogen, employing multi-level Ca II atomic models, and taking into account departures from local thermodynamic equilibrium. Our models employ the recently confirmed value of the mixing-length parameter α=1.8. Regions with strong magnetic fields (magnetic filling factors of up to 50%) are also considered in the current study. The computed Ca II emission fluxes show a strong dependence on the magnetic filling factors, and the effect of time-dependent ionization (TDI) turns out to be very important in the atmospheres of late-type stars heated by acoustic and magnetic waves. The emitted Ca II fluxes with TDI included into the model are decreased by factors that range from 1.4 to 5.5 for G0V and M0V stars, respectively, compared to models that do not consider TDI. The results of our computations are compared with observations. Excellent agreement between the observed and predicted basal flux is obtained. The predicted trend of Ca II emission flux with magnetic filling factor and stellar surface temperature also agrees well with the observations but the calculated maximum fluxes for stars of different spectral types are about two times lower than observations. Though the longitudinal MHD waves considered here are important for chromosphere heating in high activity stars, additional heating mechanism(s) are apparently present.

  16. The Influence of Type 1 Diabetes Mellitus on Pulmonary Function and Exercise Capacity - Results from the Study of Health in Pomerania (SHIP).

    Science.gov (United States)

    Stubbe, Beate; Schipf, Sabine; Schäper, Christoph; Felix, Stephan B; Steveling, Antje; Nauck, Matthias; Völzke, Henry; Wallaschofski, Henri; Friedrich, Nele; Ewert, Ralf; Ittermann, Till; Gläser, Sven

    2017-01-01

    Background: Diabetes mellitus Type 1 (T1DM) is associated with metabolic and microvascular diseases as part of a multi-organ and multi-systemic disorder. The dense network of capillary vessels in the lungs may change during the course of the development of microangiopathy. The connective tissue as well as alveoli may be subjected to non-enzymatic glycosylation of proteins which may in turn affect pulmonary function. Previous studies investigating lung function in patients with type 1 diabetes have only been performed on small numbers of patients. Our study is based on population data of the Study of Health in Pomerania (SHIP). Objective: To investigate the influence of metabolic control on pulmonary system function and to establish a decreased pulmonary system function as a late complication of T1DM in a population based setting. Methods: The study is a case matched study with multiple controls based on participants with T1DM (SHIP-DM-1, n=73) and non-diabetics (SHIP-1, n=292) from the population based study of Pomerania. Data on lung function and exercise performance stratified by age, sex, body mass index and smoking habits in participants with T1DM and without diabetes were matched. Results: Participants with T1DM showed a significantly lower total lung capacity, residual volume and forced vital capacity. The transfer factor for carbon monoxide, the maximum power output and oxygen uptake during exercise were significantly decreased in comparison to the general population without diabetes. Conclusion: The pattern of abnormal pulmonary function as observed in the present study with a reduction in lung volume parameters and reduced oxygen uptake in participants with T1DM suggests a restrictive type of lung disease caused by an intrinsic lung tissue derangement as well as pulmonary microangiopathy. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Risk of Immediate-Type Allergy to Local Anesthetics is Overestimated-Results from 5 Years of Provocation Testing in a Danish Allergy Clinic.

    Science.gov (United States)

    Kvisselgaard, Ask D; Mosbech, Holger F; Fransson, Sara; Garvey, Lene H

    2017-10-04

    Local anesthetics (LAs) are used in many health care settings and exposure during a lifetime is almost inevitable. Immediate-type allergy to LAs is considered rare among allergy experts but is commonly suspected by health care workers from other specialties, and by patients. The main aim of this study was to investigate the incidence of immediate-type allergy to LAs in our regional allergy clinic over the 5-year period 2010 to 2014. This was a retrospective single-center study of patients referred to a regional allergy clinic (excluding patients with perioperative reactions) with suspected immediate allergy to LAs, who had undergone subcutaneous provocation with 1 or more LAs. Patients were identified in the hospital clinical coding system and clinical information about the reaction and investigation results was obtained from their medical records. A total of 164 patients (123 women/41 men; median age, 56 years; range, 7-89 years) who had 189 provocations with LAs were included over the 5-year period 2010 to 2014. All 164 patients had negative subcutaneous provocations to all 189 tests with LAs (95% CI, 0%-1.83%). Another allergen was identified in 10% (n = 17) of the patients. None of the 164 patients with suspected immediate-type allergy to LAs reacted on provocation. Thus, no patients have been diagnosed with an immediate allergy to LAs in our regional allergy clinic in the 5-year period studied, and allergy to LAs must be considered very rare. Alternative mechanisms should be considered, but if symptoms are consistent with allergy, other potential allergens should be investigated. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  18. Experimental results of acetone hydrogenation on a heat exchanger type reactor for solar chemical heat pump; Solar chemical heat pump ni okeru acetone suisoka hanno netsu kaishu jikken

    Energy Technology Data Exchange (ETDEWEB)

    Takashima, T.; Doi, T.; Tanaka, T.; Ando, Y. [Electrotechnical Laboratory, Tsukuba (Japan); Miyahara, R.; Kamoshida, J. [Shibaura Institute of Technology, Tokyo (Japan)

    1996-10-27

    With the purpose of converting solar heat energy to industrial heat energy, an experiment of acetone hydrogenation was carried out using a heat exchanger type reactor that recovers heat generated by acetone hydrogenation, an exothermic reaction, and supplies it to an outside load. In the experiment, a pellet-like activated carbon-supported ruthenium catalyst was used for the acetone hydrogenation with hydrogen and acetone supplied to the catalyst layer at a space velocity of 400-1,200 or so. In the external pipe of the double-pipe type reactor, a heating medium oil was circulated in parallel with the flow of the reactant, with the heat of reaction recovered that was generated from the acetone hydrogenation. In this experiment, an 1wt%Ru/C catalyst and a 5wt%Ru/C catalyst were used so as to examine the effects of variation in the space velocity. As a result, from the viewpoint of recovering the heat of reaction, it was found desirable to increase the reaction speed by raising catalytic density and also to supply the reactant downstream inside the reaction pipe by increasing the space velocity. 1 ref., 6 figs., 1 tab.

  19. The impact of patient narratives on self-efficacy and self-care in Australians with type 2 diabetes: stage 1 results of a randomized trial.

    Science.gov (United States)

    Campbell, Tina; Dunt, D; Fitzgerald, J L; Gordon, I

    2015-09-01

    A randomized-controlled trial (RCT) was conducted from September 2009 to June 2011. National Diabetes Services Scheme registrants diagnosed with type 2 diabetes and aged 30-70 years were invited to participate in a 3-week intervention programme with follow-up at 4 weeks and 6 months. Data were collected using self-report questionnaires in the participant's homes. The intervention group received diabetes factsheets and a DVD comprising patient stories (narratives) of type 2 diabetes management. The control group (CG) received factsheets only. The RCT evaluated the impact of patient narratives on the study outcomes, self-efficacy and self-care, using the Aust/English Diabetes Management Self-efficacy Scale and the Summary Diabetes Self-care Activities measure. Participants were randomly assigned to the intervention or CG using block randomization. The study was not blinded. Six hundred and seventy people enrolled into the study with 335 allocated to each group. At 4 weeks, data were available for 598 participants. t-tests were used to analyse the results. The mean difference between the groups for self-efficacy was 7.2 units (P diabetes self-management programmes. ACTRN 12609000210279. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. The Provisional Extension To Induce Complete Attachment (PETTICOAT) technique to promote distal aortic remodelling in repair of acute DeBakey type I aortic dissection: preliminary results.

    Science.gov (United States)

    Hsu, Hung-Lung; Chen, Yin-Yin; Huang, Chun-Yang; Huang, Jih-Hsin; Chen, Jer-Shen

    2016-07-01

    To report our preliminary results of an aggressive technique, the Provisional Extension To Induce Complete Attachment (PETTICOAT), in repair of acute DeBakey type I aortic dissection. From April 2014 to November 2014, 18 patients with acute DeBakey type I aortic dissection were reviewed retrospectively. Nine patients underwent open repair combined with proximal stent grafting and distal bare stenting (PETTICOAT group). For comparison, another 9 patients underwent open repair combined with proximal stent grafting (NON-PETTICOAT group) were included. Open repair entailed ascending aorta plus total arch replacement under circulatory arrest, with variable aortic root work. Mortality and morbidity were recorded, and computed tomography was performed to evaluate the aortic remodelling at 6 months postoperatively. Preoperative parameters were similar. In the PETTICOAT group, one early mortality was noted. One complication of cardiac tamponade and sternal wound infection led to reopen surgeries. In the NON-PETTICOAT group, one case of transient ischaemic attack took place. Compared with the NON-PETTICOAT group, a significant increase in diameter of true lumen (median, 0.6 vs 0.1 mm, P University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  1. Predictors of adherence with self-care guidelines among persons with type 2 diabetes: results from a logistic regression tree analysis.

    Science.gov (United States)

    Yamashita, Takashi; Kart, Cary S; Noe, Douglas A

    2012-12-01

    Type 2 diabetes is known to contribute to health disparities in the U.S. and failure to adhere to recommended self-care behaviors is a contributing factor. Intervention programs face difficulties as a result of patient diversity and limited resources. With data from the 2005 Behavioral Risk Factor Surveillance System, this study employs a logistic regression tree algorithm to identify characteristics of sub-populations with type 2 diabetes according to their reported frequency of adherence to four recommended diabetes self-care behaviors including blood glucose monitoring, foot examination, eye examination and HbA1c testing. Using Andersen's health behavior model, need factors appear to dominate the definition of which sub-groups were at greatest risk for low as well as high adherence. Findings demonstrate the utility of easily interpreted tree diagrams to design specific culturally appropriate intervention programs targeting sub-populations of diabetes patients who need to improve their self-care behaviors. Limitations and contributions of the study are discussed.

  2. Impact of long-term air pollution exposure on metabolic control in children and adolescents with type 1 diabetes: results from the DPV registry.

    Science.gov (United States)

    Lanzinger, Stefanie; Rosenbauer, Joachim; Sugiri, Dorothea; Schikowski, Tamara; Treiber, Birgit; Klee, Daniela; Rathmann, Wolfgang; Holl, Reinhard W

    2018-02-24

    Studies on the association between air pollution and metabolic control in children and adolescents with type 1 diabetes are rare and findings are inconsistent. We examined the relationship between air pollution variables (particulate matter with an aerodynamic diameter air pollution exposure (annual and quinquennial means) data were linked to participants via the five-digit postcode areas of residency. Cross-sectional multivariable regression analysis was used to examine the association between air pollution and metabolic control. After comprehensive adjustment, an interquartile range increase in O 3 -AOT was associated with a lower HbA 1c (-3.7% [95% CI -4.4, -3.0]). The inverse association between O 3 -AOT and HbA 1c persisted after additional adjustment for degree of urbanisation or additional adjustment for PM 10 . Moreover, the inverse association remained stable in further sensitivity analyses. No significant associations between HbA 1c and PM 10 or NO 2 were found. No association was observed between any of the three air pollutants and insulin dose. The inverse association between O 3 -AOT and HbA 1c could not be explained by regional differences in diabetes treatment or by other differences between urban and rural areas. Furthermore, our results remained stable in sensitivity analyses. Further studies on the association between air pollution and HbA 1c in children and adolescents with type 1 diabetes are needed to confirm our observed association and to elucidate underlying mechanisms.

  3. Sexually transmitted Human Papillomavirus type variations resulting in high grade cervical dysplasia in North-East North Dakota and North-West Minnesota.

    Science.gov (United States)

    Balakrishnan, Lata; Clauson, Ryan; Weiland, Timothy; Bianco, Michelle; Milavetz, Barry

    2006-06-15

    A review of Pap smear diagnoses from a reference laboratory in Grand Forks, North Dakota over a 3-year period (07/00 to 10/03) revealed a two-fold higher rate of high grade squamous intraepithelial lesion in a community in northwest Minnesota (Roseau, 0.486%) than in northeast North Dakota (Grand Forks, 0.249%), in spite of both having similar rates of low-grade squamous intraepithelial lesion (1.33% vs.1.30% respectively) To identify the different types of HPV present in patient populations showing high-grade dysplasia in Grand Forks, ND and Roseau, MN. Formaldehyde-fixed paraffin-embedded cervical tissue samples were analyzed using polymerase chain reaction (PCR) to detect the presence of HPV type 16, 18 and 31. Our studies showed that 41% of samples from Roseau were triply infected with HPV serotypes 16, 18 and 31 in comparison to 12 % from Grand Forks. Due to the small sample size we were unable to prove the study to be statistically significant. However, our results suggest that the presence of HPV 16, 18 and 31 in triply infected samples may be the cause of the higher percentage of high-grade dysplasia in Roseau, MN when compared to Grand Forks, ND.

  4. Baseline results indicate poor glycemic control and delay in initiation and optimization of insulin therapy: results from the improving management practices and clinical outcomes in type 2 diabetes study

    Directory of Open Access Journals (Sweden)

    C R Anand Moses

    2012-01-01

    Full Text Available Introduction: Improving management practices and clinical outcomes in type 2 diabetes (IMPACT, was a prospective, open-label, 26- week, comparative, multi-center study to compare efficacy and safety of the Indian insulin guideline (IIG group versus routine clinical practice (RCP group in patients with type 2 diabetes. Materials and Methods: A total of 20,653 patients from 885 centers across India were enrolled and treated with premixed insulin therapy as per IIG or routine care. Results: Most of the participating centers (81.7% reported following a diabetes guideline in their practice routinely but only 20.4% targeted HbA1c 75% achieved an HbA1c <7%. Most of the physicians (39.8% also agreed that only 10-25% of the patients agree to start insulin therapy at the first counseling. Mean duration of diabetes before initiating insulin in patients using oral anti-diabetic drugs (OADs was 7 years, indicating a delay in initiating insulin therapy. The difference in mean daily dose of insulin at initiation vs. at 26 weeks was only 0.8 U (25.8 ± 11.3 at initiation compared to 26.6 ± 9.5, respectively, p = ns suggesting lack of treatment optimization. Weekly titration till achieving HbA1c <7% was done in 51.1% of the patients and only 8.9% performed self-titration. Conclusion: Baseline glycemic control in these patients was poor and reflects a delay in initiating insulin therapy. Data also reflect a lack of optimization of insulin doses.

  5. Changes in Cytokines and Aggrecan ARGS Neoepitope in Synovial Fluid and Serum and in C-Terminal Crosslinking Telopeptide of Type II Collagen and N-Terminal Crosslinking Telopeptide of Type I Collagen in Urine Over Five Years After Anterior Cruciate Ligament Rupture

    DEFF Research Database (Denmark)

    Struglics, André; Larsson, Staffan; Kumahashi, Nobuyuki

    2015-01-01

    acute anterior cruciate ligament (ACL) rupture. METHODS: Synovial fluid, serum, and urine were collected from 121 adults on 6 occasions over 5 years after acute ACL injury. Reference samples were obtained from subjects without knee injury. Concentrations of interleukin-6 (IL-6), IL-8, IL-10, interferon...

  6. Bone structure in two adult subjects with impaired minor spliceosome function resulting from RNU4ATAC mutations causing microcephalic osteodysplastic primordial dwarfism type 1 (MOPD1)

    DEFF Research Database (Denmark)

    Krøigård, Anne Bruun; Frost, Morten; Larsen, Martin Jakob

    2016-01-01

    Microcephalic osteodysplastic primordial dwarfism type 1 (MOPD1), or Taybi-Linder syndrome is characterized by distinctive skeletal dysplasia, severe intrauterine and postnatal growth retardation, microcephaly, dysmorphic features, and neurological malformations. It is an autosomal recessive...... disorder caused by homozygous or compound heterozygous mutations in the RNU4ATAC gene resulting in impaired function of the minor spliceosome.Here, we present the first report on bone morphology, bone density and bone microstructure in two adult MOPD1 patients and applied radiographs, dual energy X......, cortical thickness, total bone density, cortical bone density, trabecular bone density and trabecular bone volume per tissue volume (BV/TV) were all low. These findings may correlate to the short stature and low body weight of the MOPD1 patients. Our findings suggest that minor spliceosome malfunction may...

  7. Cost-effectiveness of intensified versus conventional multifactorial intervention in type 2 diabetes: results and projections from the Steno-2 study

    DEFF Research Database (Denmark)

    Gaede, Peter; Valentine, William J; Palmer, Andrew J

    2008-01-01

    and account Danish-specific costs to project life expectancy, quality-adjusted life expectancy (QALE), and lifetime direct medical costs expressed in year 2005 Euros. Clinical and cost outcomes were projected over patient lifetimes and discounted at 3% annually. Sensitivity analyses were performed. RESULTS...... gained. This is considered a conservative estimate because accounting prescription of generic drugs and capturing indirect costs would further favor intensified therapy. CONCLUSIONS: From a health care payer perspective in Denmark, intensive therapy was more cost-effective than conventional treatment......OBJECTIVE: To assess the cost-effectiveness of intensive versus conventional therapy for 8 years as applied in the Steno-2 study in patients with type 2 diabetes and microalbuminuria. RESEARCH DESIGN AND METHODS: A Markov model was developed to incorporate event and risk data from Steno-2...

  8. Symptoms of emotional, behavioral, and social difficulties in the Danish population of children and adolescents with type 1 diabetes – results of a national survey

    DEFF Research Database (Denmark)

    Kristensen, Lene Juel; Birkebæk, Niels; Mose, Anne

    2014-01-01

    OBJECTIVE: To assess the prevalence of psychological difficulties in Danish children and adolescents with type 1 diabetes using both child/adolescent and caregiver reports, and to investigate associations between these symptoms and metabolic control, adherence, and quality of life. RESEARCH DESIGN...... the prevalence observed in the norm sample--particularly with regard to older boys. Both BYI-Y and SDQ responses were significantly correlated with HbA1c, adherence, and quality of life. CONCLUSIONS: This study finds Danish children and adolescents with diabetes to report lower or comparable levels of emotional...... difficulties compared to norms, while caregiver reports are less positive. The results therefore support the value of a multi-informant approach to the assessment of symptoms of psychological difficulty in girls and boys with diabetes....

  9. A novel mechanism of V-type zinc inhibition of glutamate dehydrogenase results from disruption of subunit interactions necessary for efficient catalysis.

    Science.gov (United States)

    Bailey, Jaclyn; Powell, Lakeila; Sinanan, Leander; Neal, Jacob; Li, Ming; Smith, Thomas; Bell, Ellis

    2011-09-01

    Bovine glutamate dehydrogenase is potently inhibited by zinc and the major impact is on V(max) suggesting a V-type effect on catalysis or product release. Zinc inhibition decreases as glutamate concentrations decrease suggesting a role for subunit interactions. With the monocarboxylic amino acid norvaline, which gives no evidence of subunit interactions, zinc does not inhibit. Zinc significantly decreases the size of the pre-steady state burst in the reaction but does not affect NADPH binding in the enzyme-NADPH-glutamate complex that governs the steady state turnover, again suggesting that zinc disrupts subunit interactions required for catalytic competence. While differential scanning calorimetry suggests zinc binds and induces a slightly conformationally more rigid state of the protein, limited proteolysis indicates that regions in the vicinity of the antennae regions and the trimer-trimer interface become more flexible. The structures of glutamate dehydrogenase bound with zinc and europium show that zinc binds between the three dimers of subunits in the hexamer, a region shown to bind novel inhibitors that block catalytic turnover, which is consistent with the above findings. In contrast, europium binds to the base of the antenna region and appears to abrogate the inhibitory effect of zinc. Structures of various states of the enzyme have shown that both regions are heavily involved in the conformational changes associated with catalytic turnover. These results suggest that the V-type inhibition produced with glutamate as the substrate results from disruption of subunit interactions necessary for efficient catalysis rather than by a direct effect on the active site conformation. © 2011 The Authors Journal compilation © 2011 FEBS.

  10. A Novel Mechanism of V Type Zinc Inhibition of Glutamate Dehydrogenase Results from Disruption of Subunit Interactions Necessary for Efficient Catalysis

    Science.gov (United States)

    Bailey, Jaclyn; Powell, Lakeila; Sinanan, Leander; Neal, Jacob; Li, Ming; Smith, Thomas; Bell, Ellis

    2011-01-01

    SUMMARY Bovine Glutamate Dehydrogenase is potently inhibited by zinc and the major impact is on Vmax suggesting a V-type effect on catalysis or product release. Zinc inhibition decreases as glutamate concentrations decrease suggesting a role for subunit interactions. With the monocarboxylic amino acid, norvaline, which gives no evidence of subunit interactions zinc does not inhibit. Zinc significantly decreases the size of the pre-steady state burst in the reaction but does not affect NADPH binding in the Enzyme-NADPH-glutamate complex that governs the steady state turn-over again suggesting that zinc disrupts subunit interactions required for catalytic competence. While differential scanning calorimetry suggests zinc binds and induces a slightly conformationally more rigid state of the protein, limited proteolysis indicate regions in the vicinity of the antennae regions and the trimer-trimer interface become more flexible. The structures of GDH bound with zinc and europium show that zinc binds between the three dimers of subunits in the hexamer, a region shown to bind novel inhibitors that block catalytic turnover and is consistent with the above findings. In contrast, europium binds to the base of the antenna region and appears to abrogate the inhibitory effect of zinc. Structures of various states of the enzyme have shown that both regions are heavily involved in the conformational changes associated with catalytic turnover. These results suggest that the V-type inhibition produced with glutamate as the substrate results from disruption of subunit interactions necessary for efficient catalysis rather than by a direct effect on the active site conformation. PMID:21749647

  11. The association between patient-reported self-management behavior, intermediate clinical outcomes, and mortality in patients with type 2 diabetes: results from the KORA-A study.

    Science.gov (United States)

    Laxy, Michael; Mielck, Andreas; Hunger, Matthias; Schunk, Michaela; Meisinger, Christa; Rückert, Ina-Maria; Rathmann, Wolfgang; Holle, Rolf

    2014-06-01

    Little is known about the impact of diabetes self-management behavior (SMB) on long-term outcomes. We aimed to examine the association among patient-reported SMB, intermediate clinical outcomes, and mortality in patients with type 2 diabetes. Data were collected from 340 patients with type 2 diabetes of the KORA-A study (1997/1998) who were recruited from two previous population-based surveys (n = 161) and a myocardial infarction registry (n = 179) in southern Germany. Based on previous methodological work, a high level of SMB was defined as being compliant with at least four of six different self-care dimensions, comprising physical exercise, foot care, blood glucose self-monitoring, weight monitoring, having a diet plan, and keeping a diabetes diary. The vital status of the participants was observed until 2009. Multivariable linear, logistic, and Cox regression models were applied to assess the association with intermediate clinical outcomes at baseline and to predict mortality over the follow-up period, adjusted for sociodemographic, behavioral, and disease-related factors. In the cross-sectional perspective, a high level of SMB was weakly associated with a lower glycated hemoglobin A1c level (-0.44% [-4.8 mmol/mol] [95% CI -0.88 to 0.00]), but not with low-density lipoprotein cholesterol, systolic blood pressure, or the presence of microalbuminuria, peripheral arterial disease, or polyneuropathy. During a mean follow-up time of 11.6 years, 189 patients died. SMB was a preventive factor for all-cause (hazard ratio 0.61 [95% CI 0.40-0.91]) and cardiovascular mortality (0.65 [95% CI 0.41-1.03]). Although measuring SMB is difficult and the used operationalization might be limited, our results give some indication that a high level of SMB is associated with prolonged life expectancy in patients with type 2 diabetes and highlight the potential impact of the patients' active contribution on the long-term trajectory of the disease. We assume that the used proxy for SMB

  12. Flow visualization on a natural circulation inter-wrapper flow. Experimental and numerical results under a geometric condition of button type spacer pads

    Energy Technology Data Exchange (ETDEWEB)

    Yasuda, A.; Miyakoshi, H.; Hayashi, K.; Nishimura, M.; Kamide, H.; Hishida, K. [Japan Nuclear Cycle Development Inst., Oarai, Ibaraki (Japan). Oarai Engineering Center

    1999-04-01

    Investigations on the inter-wrapper flow (IWF) in a liquid metal cooled fast breeder reactor core have been carried out. The IWF is a natural circulation flow between wrapper tubes in the core barrel where cold fluid is coming from a direct heat exchanger (DHX) in the upper plenum. It was shown by the sodium experiment using 7-subassembly core model that the IWF can cool the subassemblies. To clarify thermal-hydraulic characteristics of the IWF in the core, the water experiment was performed using the flow visualization technique. The test rig for IWF (TRIF) has the core simulating the fuel subassemblies and radial reflectors. The subassemblies are constructed featuring transparent heater to enable both Joule heating and flow visualization. The transparent heater was made of glass with thin conductor film coating of tin oxide, and the glass heater was embedded on the wall of modeled wrapper tube made of acrylic plexiglass. In the present experiment, influences of peripheral geometric parameters such as flow holes of core formers on the thermal-hydraulic field were investigated with the button type spacer pads of the wrapper tube. Through the water tests, flow patterns of the IWF were revealed and velocity fields were quantitatively measured with a particle image velocimetry (PIV). Also, no substantial influence of peripheral geometry was found on the temperature field of the IWF, as far as the button type spacer pad was applied. Numerical simulation was applied to the experimental analysis of IWF by using multidimensional code with porous body model. The numerical results reproduced the flow patterns within TRIF and agreed well to experimental temperature distributions, showing capability of predicting IWF with porous body model. (author)

  13. The use of insulin declines as patients live farther from their source of care: results of a survey of adults with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Strauss Kaitlin

    2006-07-01

    Full Text Available Abstract Background Although most diabetic patients do not achieve good physiologic control, patients who live closer to their source of primary care tend to have better glycemic control than those who live farther away. We sought to assess the role of travel burden as a barrier to the use of insulin in adults with diabetes Methods 781 adults receiving primary care for type 2 diabetes were recruited from the Vermont Diabetes Information System. They completed postal surveys and were interviewed at home. Travel burden was estimated as the shortest possible driving distance from the patient's home to the site of primary care. Medication use, age, sex, race, marital status, education, health insurance, duration of diabetes, and frequency of care were self-reported. Body mass index was measured by a trained field interviewer. Glycemic control was measured by the glycosolated hemoglobin A1C assay. Results Driving distance was significantly associated with insulin use, controlling for the covariates and potential confounders. The odds ratio for using insulin associated with each kilometer of driving distance was 0.97 (95% confidence interval 0.95, 0.99; P = 0.01. The odds ratio for using insulin for those living within 10 km (compared to those with greater driving distances was 2.29 (1.35, 3.88; P = 0.02. Discussion Adults with type 2 diabetes who live farther from their source of primary care are significantly less likely to use insulin. This association is not due to confounding by age, sex, race, education, income, health insurance, body mass index, duration of diabetes, use of oral agents, glycemic control, or frequency of care, and may be responsible for the poorer physiologic control noted among patients with greater travel burdens.

  14. Heart failure outcomes with empagliflozin in patients with type 2 diabetes at high cardiovascular risk: results of the EMPA-REG OUTCOME® trial

    Science.gov (United States)

    Fitchett, David; Zinman, Bernard; Wanner, Christoph; Lachin, John M.; Hantel, Stefan; Salsali, Afshin; Johansen, Odd Erik; Woerle, Hans J.; Broedl, Uli C.; Inzucchi, Silvio E.

    2016-01-01

    Abstract Aims We previously reported that in the EMPA-REG OUTCOME® trial, empagliflozin added to standard of care reduced the risk of 3-point major adverse cardiovascular events, cardiovascular and all-cause death, and hospitalization for heart failure in patients with type 2 diabetes and high cardiovascular risk. We have now further investigated heart failure outcomes in all patients and in subgroups, including patients with or without baseline heart failure. Methods and results Patients were randomized to receive empagliflozin 10 mg, empagliflozin 25 mg, or placebo. Seven thousand and twenty patients were treated; 706 (10.1%) had heart failure at baseline. Heart failure hospitalization or cardiovascular death occurred in a significantly lower percentage of patients treated with empagliflozin [265/4687 patients (5.7%)] than with placebo [198/2333 patients (8.5%)] [hazard ratio, HR: 0.66 (95% confidence interval: 0.55–0.79); P heart failure hospitalization or cardiovascular death of 35 over 3 years. Consistent effects of empagliflozin were observed across subgroups defined by baseline characteristics, including patients with vs. without heart failure, and across categories of medications to treat diabetes and/or heart failure. Empagliflozin improved other heart failure outcomes, including hospitalization for or death from heart failure [2.8 vs. 4.5%; HR: 0.61 (0.47–0.79); P heart failure at baseline in both treatment groups, but were no more common with empagliflozin than with placebo. Conclusion In patients with type 2 diabetes and high cardiovascular risk, empagliflozin reduced heart failure hospitalization and cardiovascular death, with a consistent benefit in patients with and without baseline heart failure. PMID:26819227

  15. Results of LA-ICP-MS sulfide mapping from Algoma-type BIF gold systems with implications for the nature of mineralizing fluids, metal sources, and deposit models

    Science.gov (United States)

    Gourcerol, B.; Kontak, D. J.; Thurston, P. C.; Petrus, J. A.

    2018-01-01

    Quantitative laser ablation inductively coupled plasma-mass spectrometry (LA-ICP-MS) element distribution maps combined with traverse mode analyses have been acquired on various sulfides (pyrite, pyrrhotite, arsenopyrite) from three Canadian Algoma-type BIF-hosted gold deposits ( 4 Moz Au Meadowbank, ≥ 2.8 Moz Au Meliadine district, 6 Moz Au Musselwhite). These data, in conjunction with detailed petrographic and SEM-EDS observations, provide insight into the nature and relative timing of gold events, the presence and implication of trace element zoning regarding crystallization processes, and elemental associations that fingerprint gold events. Furthermore, the use of an innovative method of processing the LA-ICP-MS data in map and traverse modes, whereby the results are fragmented into time-slice data, to generate various binary plots (Ag versus Ni) provides a means to identify elemental associations (Te, Bi) not otherwise apparent. This integrated means of treating geochemical data, along with petrography, allows multiple gold events and remobilization processes to be recognized and their elemental associations determined. The main gold event in each of these deposits is characterized by the coupling of an As-Se-Te-Ag element association coincident with intense stratabound sulfide-replacement of the Fe-rich host rock. Additionally, the data indicate presence of a later remobilization event, which upgraded the Au tenor, as either non-refractory or refractory type, along fracture networks due to the ingress of subsequent base metal-bearing metamorphic fluids (mainly a Pb-Bi association). Furthermore, the data reveal a stratigraphic influence, as reflected in the elemental associations and the elemental enrichments observed and the nature of the sulfide phase hosting the gold mineralization (arsenopyrite versus pyrite).

  16. The results of pre-design studies on the development of a new design of gas turbine compressor package of GPA-C-16 type

    Science.gov (United States)

    Smirnov, A. V.; Chobenko, V. M.; Shcherbakov, O. M.; Ushakov, S. M.; Parafiynyk, V. P.; Sereda, R. M.

    2017-08-01

    The article summarizes the results of analysis of data concerning the operation of turbocompressor packages at compressor stations for the natural gas transmission system of Ukraine. The basic requirements for gas turbine compressor packages used for modernization and reconstruction of compressor stations are considered. Using a 16 MW gas turbine package GPA-C-16S/76-1,44M1 as an example, the results of pre-design studies and some technical solutions that improve the energy efficiency of gas turbine compressor packages and their reliability, as well as its environmental performance are given. In particular, the article deals with the matching of performance characteristics of a centrifugal compressor (hereinafter compressor) and gas turbine drive to reduce fuel gas consumption; as well as application of energy efficient technologies, in particular, exhaust gas heat recovery units and gas-oil heat exchangers in turbocompressor packages oil system; as well as reducing emissions of carbon monoxide into the atmosphere using a catalytic exhaust system. Described technical solutions can be used for development of other types of gas turbine compressor packages.

  17. Is Intergenerational Social Mobility Related to the Type and Amount of Physical Activity in Mid-Adulthood? Results from the 1946 British Birth Cohort Study

    Science.gov (United States)

    Silverwood, Richard J.; Pierce, Mary; Nitsch, Dorothea; Mishra, Gita D.; Kuh, Diana

    2012-01-01

    Purpose Greater levels of leisure-time or moderate-vigorous physical activity have consistently been found in those with greater socioeconomic position (SEP). Less is known about the effects of intergenerational social mobility. Methods We examined the influence of SEP and social mobility on mid-adulthood physical activity in the Medical Research Council National Survey of Health and Development. Two sub-domains of SEP were used: occupational class and educational attainment. Latent classes for walking, cycling, and leisure-time physical activity (LTPA) were used, plus sedentary behavior at age 36. Associations between types of physical activity and SEP were examined with the use of logistic or multinomial logistic regression. Results Being a manual worker oneself or having a father who was a manual worker was, relative to nonmanual work, associated with lower levels of sedentary behavior and greater walking activity, but also with lower LTPA. Compared with those who remained in a manual occupational class, upward occupational mobility was associated with more sedentary behavior, less walking, and increased LTPA. Associations with downward mobility were in the opposite directions. Similar results were obtained for educational attainment. Conclusions This study found clear evidence of social differences in physical activity. Persistently high SEP and upward social mobility were associated with greater levels of LTPA but also increased sedentary behavior and less walking. PMID:22534178

  18. The Contribution of Biogeographic Ancestry and Socioeconomic Status to Racial/Ethnic Disparities in Type 2 Diabetes: Results from the Boston Area Community Health (BACH) Survey

    Science.gov (United States)

    Piccolo, Rebecca S.; Pearce, Neil; Araujo, Andre B.; McKinlay, John B.

    2014-01-01

    Purpose Racial/ethnic disparities in the incidence of type 2 diabetes (T2DM) are well documented and many researchers have proposed that biogeographical ancestry (BGA) may play a role in these disparities. However, studies examining the role of BGA on T2DM have produced mixed results to date. Therefore, the objective of this research is to quantify the contribution of BGA to racial/ethnic disparities in T2DM incidence controlling for the mediating influences of socioeconomic factors. Methods We analyzed data from the Boston Area Community Health (BACH) Survey, a prospective cohort with approximately equal numbers of Black, Hispanic, and White participants. We used Ancestry Informative Markers to calculate the percentages of West African and Native American ancestry of participants. We used logistic regression with g-computation to analyze the contribution of BGA and socioeconomic factors to racial/ethnic disparities in T2DM incidence. Results We found that socioeconomic factors accounted for 44.7% of the total effect of T2DM attributed to Black race and 54.9% of the effect attributed to Hispanic ethnicity. We found that BGA had almost no direct association with T2DM and was almost entirely mediated by self-identified race/ethnicity and socioeconomic factors. Conclusions It is likely that non-genetic factors, specifically socioeconomic factors, account for much of the reported racial/ethnic disparities in T2DM incidence. PMID:25088753

  19. Comparison of 2 electronic cowside tests to detect subclinical ketosis in dairy cows and the influence of the temperature and type of blood sample on the test results.

    Science.gov (United States)

    Iwersen, M; Klein-Jöbstl, D; Pichler, M; Roland, L; Fidlschuster, B; Schwendenwein, I; Drillich, M

    2013-01-01

    The objective of this study was to determine the suitability of 2 electronic hand-held devices [FreeStyle Precision (FSP), Abbott GmbH & Co. KG, Wiesbaden, Germany and GlucoMen LX Plus (GLX), A. Menarini GmbH, Vienna, Austria] for measuring β-hydroxybutyrate (BHBA) in dairy cows. Three experiments were conducted to evaluate (1) the diagnostic performance of the devices, (2) the effect of the type of blood sample, and (3) the influence of the ambient temperature on the determined results. A total of 415 blood samples from lactating Holstein and Simmental cows were collected and analyzed with both devices (whole blood) and in a laboratory (serum). Correlation coefficients between whole-blood and serum BHBA concentrations were highly significant, with 94% for the FSP and 80% for the GLX device. Based on thresholds for subclinical ketosis of 1.2 and 1.4 mmol of BHBA/L, results obtained with the hand-held devices were evaluated by receiver operating characteristics analyses. This resulted in adjusted thresholds of 1.2 and 1.4 mmol/L for the FSP and 1.1 and 1.3 mmol/L for the GLX device. Applying these thresholds, sensitivities were 98 and 100% for the FSP and 80 and 86% for the GLX device, respectively. Corresponding specificities were 90 and 97% for the FSP and 87 and 96% for the GLX device, respectively. Additionally, concentrations of BHBA were tested with both devices in whole blood, EDTA-added whole blood, and in their resulting serum and plasma, collected from 65 animals. Determined BHBA concentrations were similar within each device for whole and EDTA-added blood, and in serum and plasma, but differed between whole blood and serum and between EDTA-added blood and plasma. Blood samples with low (0.4 mmol/L), medium (1.1 mmol/L), and high (1.6 mmol/L) BHBA concentrations were stored between +5 to +32°C and analyzed repeatedly at temperature levels differing by 4°C. Additionally, devices and test strips were stored at equal conditions and used for measurement

  20. Associations between stress and migraine and tension-type headache: results from a school-based study in adolescents from grammar schools in Germany.

    Science.gov (United States)

    Milde-Busch, Astrid; Blaschek, Astrid; Heinen, Florian; Borggräfe, Ingo; Koerte, Inga; Straube, Andreas; Schankin, Christoph; von Kries, Rüdiger

    2011-05-01

    Stress is considered the major contributor to migraine and tension-type headache in adolescents. Previous studies have focused on general stressors, whereas the aim of the present study was to investigate associations between individuals' stressful experiences and different types of headache. Adolescents from 10th and 11th grades of grammar schools filled in questionnaires. Stressful experiences were measured with the Trier Inventory of Chronic Stress. Type of headache was classified according to the International Classification of Headache Disorders. Linear regressions, adjusted for sex and grade, were calculated to estimate differences in stress scores that can be attributed to migraine, tension-type headache or miscellaneous headache. A total of 1260 questionnaires were analysed. Tension-type headache, migraine and co-existing migraine plus tension-type headache were found in 48.7%, 10.2% and 19.8% of the participants. In subjects with migraine or co-existing migraine plus tension-type headache, high increases in stress scores were found in all investigated dimensions, whereas much weaker and inconsistent associations were found in subjects with tension-type headache only. The characteristic of migraine is more associated with stressful experiences than this is the case for tension-type headache. This suggests that adolescent migraine patients might especially benefit from behavioural interventions regarding stress.

  1. A new psoralen-containing gel for topical PUVA therapy: development, and treatment results in patients with palmoplantar and plaque-type psoriasis, and hyperkeratotic eczema

    Energy Technology Data Exchange (ETDEWEB)

    De Rie, M.A.; Van Eendenburg, J.P.; Versnick, A.C.; Stolk, L.M.L.; Bos, J.D.; Westerhof, W. [Amsterdam Univ. (Netherlands). Academic Medical Center

    1995-06-01

    Topical photochemotherapy with psoralen and its derivatives 4,5`,8-trimethylpsoralen (TMP) and 8-methoxypsoralen (8-MOP), with UVA irradiation, was evaluated with regard to minimum phototoxic dose, concentration, timing of UVA irradiation and systemic and local side-effects, in healthy volunteers. Psoralen (0.005%) in aqueous gel was found to be superior to TMP and 8-MOP in aqueous gel. No hyperpigmentation was seen after topical PUVA treatment with psoralen in aqueous gel. Patients with plaque-type psoriasis (n=7), palmoplantar psoriasis (n=7) and hyperkeratotic eczema (n=2) were treated. Topical PUVA therapy was effective in most psoriasis patients, without the occurrence of local or systemic side-effects. Moreover, hyperkeratotic eczema patients who did not respond to conventional therapy showed partial remission. These results indicate that topical PUVA therapy with psoralen in aqueous gel is a useful therapeutic modality for treatment of psoriasis patients, and patients with recalcitrant dermatoses such as palmoplantar psoriasis and hyperkeratotic eczema. (author).

  2. The contribution of biogeographical ancestry and socioeconomic status to racial/ethnic disparities in type 2 diabetes mellitus: results from the Boston Area Community Health Survey.

    Science.gov (United States)

    Piccolo, Rebecca S; Pearce, Neil; Araujo, Andre B; McKinlay, John B

    2014-09-01

    Racial/ethnic disparities in the incidence of type 2 diabetes mellitus (T2DM) are well documented, and many researchers have proposed that biogeographical ancestry (BGA) may play a role in these disparities. However, studies examining the role of BGA on T2DM have produced mixed results to date. Therefore, the objective of this research was to quantify the contribution of BGA to racial/ethnic disparities in T2DM incidence controlling for the mediating influences of socioeconomic factors. We analyzed data from the Boston Area Community Health Survey, a prospective cohort with approximately equal numbers of black, Hispanic, and white participants. We used 63 ancestry-informative markers to calculate the percentages of participants with West African and Native American ancestry. We used logistic regression with G-computation to analyze the contribution of BGA and socioeconomic factors to racial/ethnic disparities in T2DM incidence. We found that socioeconomic factors accounted for 44.7% of the total effect of T2DM attributed to black race and 54.9% of the effect attributed to Hispanic ethnicity. We found that BGA had almost no direct association with T2DM and was almost entirely mediated by self-identified race/ethnicity and socioeconomic factors. It is likely that nongenetic factors, specifically socioeconomic factors, account for much of the reported racial/ethnic disparities in T2DM incidence. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. [Mid-Term to Long-Term Results of Revision Total Hip Arthroplasty Using the Oval-Shaped Acetabular Cup - TC Type].

    Science.gov (United States)

    Šťastný, E; Trč, T; Frýdl, J; Kopečný, Z; Philippou, T; Lisý, J

    2017-01-01

    INTRODUCTION The purpose of our paper is to evaluate the mid-term to long-term results and to confirm the basic criteria of a high-quality revision implant: safe bridging of bone defects, achievement of reliable primary fixation of revision acetabular cup, achievement of good secondary stability with documentable osteointegration of cup and demonstration of remodelling of transplanted bone tissue in the area of defects and in spaces between the implant ribs. MATERIAL AND METHODS Altogether 36 patients (38 cups) were evaluated who had undergone revision hip arthroplasty in the period from 2004 to 2010. The mean follow-up was 8.2 years (5.1-11.6 years after the reimplantation, more than 10 years in 16 patients who underwent surgery). The position and osseointegration of the implant were assessed by digital radiography, the remodelling of transplanted bone tissues in the area of defects and between the implant ribs by computed tomography with reducing artefacts around the metal implant (Aquilion 64 - Toshiba Medical Systems), and for the clinical outcomes the Harris Hip Score was used. RESULTS Preoperatively, the condition of the hip joint based on the Harris Hip Score was in 30 cases evaluated as poor, in 8 patients as satisfactory. At the time of final evaluation, 8 patients achieved excellent results, in 19 patients the condition of the joint was very good (in 2 patients bilaterally), in 6 patients it was considered satisfactory and in 3 patients poor. The mean value for HHS increased from 39.5 to 84.5. Based on the radiography evaluation, in 27 patients (in 2 patients bilaterally) the osseointegration of the revision cup was good, in 8 cases with a radiolucent line of 2-4 mm in width in DeLee zone III, in one case proximal migration of the cup occurred caused by deep infection. The informed consent form for pelvic CT was signed by 25 patients of our cohort. Remodelling of bone tissue in the space between the ribs of the implant was always detected, the presence of

  4. Differences in the Cardiometabolic Control in Type 2 Diabetes according to Gender and the Presence of Cardiovascular Disease: Results from the eControl Study

    Directory of Open Access Journals (Sweden)

    Josep Franch-Nadal

    2014-01-01

    Full Text Available The objective of this cross-sectional study was to assess differences in the control and treatment of modifiable cardiovascular risk factors (CVRF: HbA1c, blood pressure [BP], LDL-cholesterol, body mass index, and smoking habit according to gender and the presence of cardiovascular disease (CVD in patients with type 2 diabetes mellitus (T2DM in Catalonia, Spain. The study included available data from electronic medical records for a total of 286,791 patients. After controlling for sex, age, diabetes duration, and treatment received, both men and women with prior CVD had worse cardiometabolic control than patients without previous CVD; women with prior CVD had worse overall control of CVRFs than men except for smoking; and women without prior CVD were only better than men at controlling smoking and BP, with no significant differences in glycemic control. Finally, although the proportion of women treated with lipid-lowering medications was similar to (with prior CVD or even higher (without CVD than men, LDL-cholesterol levels were remarkably uncontrolled in both women with and women without CVD. The results stress the need to implement measures to better prevent and treat CVRF in the subgroup of diabetic women, specifically with more intensive statin treatment in those with CVD.

  5. The Association of Mindful Parenting with Glycemic Control and Quality of Life in Adolescents with Type 1 Diabetes: Results from Diabetes MILES-The Netherlands.

    Science.gov (United States)

    Serkel-Schrama, Inge J P; de Vries, Jolanda; Nieuwesteeg, Anke M; Pouwer, Frans; Nyklíček, Ivan; Speight, Jane; de Bruin, Esther I; Bögels, Susan M; Hartman, Esther E

    The objective of this study was to examine associations between the mindful parenting style of parents of adolescents (aged 12-18) with type 1 diabetes mellitus (T1DM), and the glycaemic control and quality of life (QoL) of the adolescents. Chronic health conditions, such as T1DM, that require demanding treatment regimens, can negatively impact adolescents' quality of life. Therefore, it is important to determine whether mindful parenting may have a positive impact in these adolescents. Age, sex and duration of T1DM were examined as potential moderators. Parents ( N  = 215) reported on their own mindful parenting style (IM-P-NL) and the adolescents' glycaemic control. Parents and the adolescents with T1DM ( N  = 129) both reported on adolescents' generic and diabetes-specific QoL (PedsQL™). The results showed that a more mindful parenting style was associated with more optimal hemoglobin A 1c (HbA 1c ) values for boys. For girls, a more mindful parenting style was associated with not having been hospitalized for ketoacidosis. For both boys and girls, a more mindful parenting style was associated with better generic and diabetes-specific proxy-reported QoL. In conclusion, mindful parenting style may be a factor in helping adolescents manage their T1DM. Mindful parenting intervention studies for parents of adolescents with T1DM are needed to examine the effects on adolescents' glycaemic control and their quality of life.

  6. A new psoralen-containing gel for topical PUVA therapy: development, and treatment results in patients with palmoplantar and plaque-type psoriasis, and hyperkeratotic eczema

    International Nuclear Information System (INIS)

    De Rie, M.A.; Van Eendenburg, J.P.; Versnick, A.C.; Stolk, L.M.L.; Bos, J.D.; Westerhof, W.

    1995-01-01

    Topical photochemotherapy with psoralen and its derivatives 4,5',8-trimethylpsoralen (TMP) and 8-methoxypsoralen (8-MOP), with UVA irradiation, was evaluated with regard to minimum phototoxic dose, concentration, timing of UVA irradiation and systemic and local side-effects, in healthy volunteers. Psoralen (0.005%) in aqueous gel was found to be superior to TMP and 8-MOP in aqueous gel. No hyperpigmentation was seen after topical PUVA treatment with psoralen in aqueous gel. Patients with plaque-type psoriasis (n=7), palmoplantar psoriasis (n=7) and hyperkeratotic eczema (n=2) were treated. Topical PUVA therapy was effective in most psoriasis patients, without the occurrence of local or systemic side-effects. Moreover, hyperkeratotic eczema patients who did not respond to conventional therapy showed partial remission. These results indicate that topical PUVA therapy with psoralen in aqueous gel is a useful therapeutic modality for treatment of psoriasis patients, and patients with recalcitrant dermatoses such as palmoplantar psoriasis and hyperkeratotic eczema. (author)

  7. Pharmaceutical counselling about different types of tablet-splitting methods based on the results of weighing tests and mechanical development of splitting devices.

    Science.gov (United States)

    Somogyi, O; Meskó, A; Csorba, L; Szabó, P; Zelkó, R

    2017-08-30

    The division of tablets and adequate methods of splitting them are a complex problem in all sectors of health care. Although tablet-splitting is often required, this procedure can be difficult for patients. Four tablets were investigated with different external features (shape, score-line, film-coat and size). The influencing effect of these features and the splitting methods was investigated according to the precision and "weight loss" of splitting techniques. All four types of tablets were halved by four methods: by hand, with a kitchen knife, with an original manufactured splitting device and with a modified tablet splitter based on a self-developed mechanical model. The mechanical parameters (harness and friability) of the products were measured during the study. The "weight loss" and precision of splitting methods were determined and compared by statistical analysis. On the basis of the results, the external features (geometry), the mechanical parameters of tablets and the mechanical structure of splitting devices can influence the "weight loss" and precision of tablet-splitting. Accordingly, a new decision-making scheme was developed for the selection of splitting methods. In addition, the skills of patients and the specialties of therapy should be considered so that pharmaceutical counselling can be more effective regarding tablet-splitting. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Incidence of type 2 diabetes in Mexico. Results of The Mexico City Diabetes Study after 18 years of follow-up.

    Directory of Open Access Journals (Sweden)

    Clicerio González-Villalpando

    2014-01-01

    Full Text Available Objective. To estimate the incidence of type 2 diabetes (T2D in Mexican population. Materials and methods. Population based prospective study. At baseline (1990, the population at risk (1939 non-diabetic adults 35-64 years was evaluated with oral glucose tolerance test. Subsequent similar evaluations were done (1994, 1998, 2008. American Diabetes Association diagnostic criteria were applied. Results. The period of observation was 27842 person-years, the cumulative incidence of T2D was 14.4 and 13.7 per 1000 person-years for men and women, respectively. Incidence was 15.8, 15.7 and 12.7 per 1 000 person-years for the second (1994, third (1998 and fourth (2008 follow-up phases, respectively. The mean age at diagnosis was 44 years for prevalent cases and 56 years for incident cases. Conclusions. This is the first estimate of long-term incidence of T2D in Mexican population. The incidence is among the highest reported worldwide. It remained with few changes throughout the study period.

  9. Polymorphisms in AHI1 are not associated with type 2 diabetes or related phenotypes in Danes: non-replication of a genome-wide association result

    DEFF Research Database (Denmark)

    Holmkvist, J; Anthonsen, S; Wegner, L

    2008-01-01

    AIMS/HYPOTHESIS: A genome-wide association study recently identified an association between common variants, rs1535435 and rs9494266, in the AHI1 gene and type 2 diabetes. The aim of the present study was to investigate the putative association between these polymorphisms and type 2 diabetes or t...

  10. A lifestyle intervention to reduce Type 2 diabetes risk in Dutch primary care: 2.5-year results of a randomized controlled trial

    NARCIS (Netherlands)

    Vermunt, P.W.; Milder, I.E.J.; Wielaard, F.; Vries, de J.H.M.; Baan, C.A.; Oers, van J.A.M.; Westert, G.P.

    2012-01-01

    Aims To determine the effectiveness of a 2.5-year lifestyle intervention for Type 2 diabetes prevention in Dutch general practice compared with usual care. Methods A randomized controlled trial of 925 individuals at high risk for Type 2 diabetes (FINDRISC-score = 13) in 14 general practices in the

  11. A lifestyle intervention to reduce Type 2 diabetes risk in Dutch primary care: 2.5-year results of a randomized controlled trial.

    NARCIS (Netherlands)

    Vermunt, P.W.; Milder, I.E.; Wielaard, F.; Vries, J.H. de; Baan, C.A.; Oers, J.A. van; Westert, G.P.

    2012-01-01

    Diabet. Med. 29, e223-e231 (2012) ABSTRACT: Aims To determine the effectiveness of a 2.5-year lifestyle intervention for Type 2 diabetes prevention in Dutch general practice compared with usual care. Methods A randomized controlled trial of 925 individuals at high risk for Type 2 diabetes

  12. Herpes simplex virus type 2 seropositivity among urban adults in Africa - Results from two cross-sectional surveys in Addis Ababa, Ethiopia

    NARCIS (Netherlands)

    Mihret, Wude; Rinke de Wit, Tobias F.; Petros, Beyene; Mekonnen, Yared; Tsegaye, Aster; Wolday, Dawit; Beyene, Asfaw; Aklilu, Mathias; Sanders, Eduard; Fontanet, Arnaud L.

    2002-01-01

    BACKGROUND: Although several surveys investigating the epidemiology of herpes simplex virus type 2 (HSV-2) infection using type-specific immunologic assays have been carried out in Africa, none has examined the risk factors for HSV-2 infection in a representative sample from an urban adult

  13. Basal insulin analogues in diabetic pregnancy: a literature review and baseline results of a randomised, controlled trial in type 1 diabetes

    DEFF Research Database (Denmark)

    Mathiesen, Elisabeth R; Damm, Peter; Jovanovic, Lois

    2011-01-01

    hagedorn insulin, both with insulin aspart, in women with type 1 diabetes planning a pregnancy (n = 306) or are already pregnant (n = 164). Inclusion criteria include type 1 diabetes > 12 months' duration; screening HbA1c ≤ 9.0% (women recruited prepregnancy), or pregnant with gestational age 8-12 weeks...

  14. Infection status outcome, machine learning method and virus type interact to affect the optimised prediction of hepatitis virus immunoassay results from routine pathology laboratory assays in unbalanced data

    Science.gov (United States)

    2013-01-01

    Background Advanced data mining techniques such as decision trees have been successfully used to predict a variety of outcomes in complex medical environments. Furthermore, previous research has shown that combining the results of a set of individually trained trees into an ensemble-based classifier can improve overall classification accuracy. This paper investigates the effect of data pre-processing, the use of ensembles constructed by bagging, and a simple majority vote to combine classification predictions from routine pathology laboratory data, particularly to overcome a large imbalance of negative Hepatitis B virus (HBV) and Hepatitis C virus (HCV) cases versus HBV or HCV immunoassay positive cases. These methods were illustrated using a never before analysed data set from ACT Pathology (Canberra, Australia) relating to HBV and HCV patients. Results It was easier to predict immunoassay positive cases than negative cases of HBV or HCV. While applying an ensemble-based approach rather than a single classifier had a small positive effect on the accuracy rate, this also varied depending on the virus under analysis. Finally, scaling data before prediction also has a small positive effect on the accuracy rate for this dataset. A graphical analysis of the distribution of accuracy rates across ensembles supports these findings. Conclusions Laboratories looking to include machine learning as part of their decision support processes need to be aware that the infection outcome, the machine learning method used and the virus type interact to affect the enhanced laboratory diagnosis of hepatitis virus infection, as determined by primary immunoassay data in concert with multiple routine pathology laboratory variables. This awareness will lead to the informed use of existing machine learning methods, thus improving the quality of laboratory diagnosis via informatics analyses. PMID:23800244

  15. Association of Barrett’s Esophagus With Type II Diabetes Mellitus: Results From a Large Population-based Case-Control Study

    Science.gov (United States)

    IYER, PRASAD G.; BORAH, BIJAN J.; HEIEN, HERBERT C.; DAS, ANANYA; COOPER, GREGORY S.; CHAK, AMITABH

    2013-01-01

    BACKGROUND & AIMS Central obesity could increase the risk for Barrett’s esophagus (BE) and esophageal adenocarcinoma by mechanical and/or metabolic mechanisms, such as hyperinsulinemia. We performed an epidemiologic study to determine whether prior type 2 diabetes mellitus (DM2) is associated with BE. METHODS We performed a population-based case-control study using the General Practice Research Database, a UK primary care database that contains information on more than 8 million subjects, to identify cases of BE (using previously validated codes; n = 14,245) and matched controls without BE (by age, sex, enrollment date, duration of follow-up evaluation, and practice region by incidence density sampling; n = 70,361). We assessed the association of a prior diagnosis of DM2 with BE using conditional univariate and multivariable regression analysis. Confounders assessed included smoking, obesity measured by body mass index (BMI), and gastroesophageal reflux disease. RESULTS BE cases were more likely than controls to have smoked (52.4% vs 49.9%), have a higher mean BMI (27.2 vs 26.9), and a higher prevalence of DM2 than controls (5.8% vs 5.3%). On multivariable analysis, DM2 was associated with a 49% increase in the risk of BE, independent of other known risk factors (odds ratio, 1.49; 95% confidence interval, 1.16–1.91). This association was stronger in women than men. Results remained stable with sensitivity analyses. CONCLUSIONS In a large population-based case-control study, DM2 was a risk factor for BE, independent of obesity (as measured by BMI) and other risk factors (smoking and gastroesophageal reflux disease). These data suggest that metabolic pathways related to DM2 should be explored in BE pathogenesis and esophageal carcinogenesis. PMID:23591277

  16. The effectiveness of German disease management programs (DMPs) in patients with type 2 diabetes mellitus and coronary heart disease: results from an observational longitudinal study.

    Science.gov (United States)

    Laxy, Michael; Stark, Renée; Meisinger, Christa; Kirchberger, Inge; Heier, Margit; von Scheidt, Wolfgang; Holle, Rolf

    2015-01-01

    Although the population-based German disease management programs (DMPs) for diabetes mellitus (DM) and coronary heart disease (CHD) are among the biggest worldwide, evidence on the effectiveness of these programs is still inconclusive or missing, particularly for high risk patients with comorbidities. The objective of this study was therefore to analyze the impact of DMPs on process and outcome parameters in patients with both, type 2 DM and CHD. Analyses are based on two postal surveys of patients from the KORA myocardial infarction registry (southern Germany) with type 2 DM and on two postal validation studies with patients' general physicians (2006, n = 312 and 2011, n = 212). The association between DMP enrollment (being enrolled in either DMP-DM or DMP-CHD) and guideline care (defined by several process indicators) at baseline (2006) and its development until follow-up (2011) was analyzed using logistic regression models accounting for the repeated measurements structure. The impact of DMP enrollment/guideline care on cumulated (quality-adjusted) life years ((QA)LYs) over a 4-year time horizon (2006-2010) was assessed using multiple linear regression methods. Logistic regression models were applied to analyze the association between DMP status and patient self-management at follow-up. Being enrolled in a DMP was associated with better guideline care at baseline [OR = 2.3 (95 % CI 1.27-4.03)], but not at follow-up [OR = 0.80 (95 % CI 0.40-1.58); p value for time-interaction management than patients not being enrolled into a DMP. The results of this study concerning the effectiveness of DMPs in patients with DM and CHD are mixed, but are weakly in favor of DMPs. However, we found a clear positive impact of guideline care on quality adjusted survival in this patient group. The development of the association between DMP enrollment and guideline care over the follow-up time indicates some external effects, which should be the subject of further

  17. Green leafy and cruciferous vegetable consumption and risk of type 2 diabetes: results from the Singapore Chinese Health Study and meta-analysis.

    Science.gov (United States)

    Chen, Guo-Chong; Koh, Woon-Puay; Yuan, Jian-Min; Qin, Li-Qiang; van Dam, Rob M

    2018-02-19

    Several previous prospective studies suggest that consumption of green leafy and cruciferous vegetables may lower the risk of type 2 diabetes (T2D). We investigated the association between consumption of different types of vegetables in relation to T2D risk in an Asian Population. We included 45 411 participants (age range: 45-74 years) of the Singapore Chinese Health Study (SCHS) free of diabetes, cancer or CVD at baseline (1993-1998). Dietary information was collected using a validated FFQ. Physician-diagnosed incident diabetes was reported at follow-up I (1999-2004) and II (2006-2010) interviews. Cox proportional hazards regression was used to estimate hazard ratio (HR) and 95 % CI of T2D risk. An updated meta-analysis was also conducted to summarise results for green leafy and cruciferous vegetables. During 494 741 person-years of follow-up, 5207 incident T2D occurred. After adjustment for potential confounders, neither total vegetables (top v. bottom quintile HR=1·08; 95 % CI 0·98, 1·18, P trend=0·66) nor specific vegetables including dark green leafy vegetables (HR=1·05; 95 % CI 0·96, 1·15, P trend=0·21) and cruciferous vegetables (HR=0·97; 95 % CI 0·88, 1·06, P trend=0·29) were substantially associated with risk of T2D. A meta-analysis (eleven studies with 754 729 participants and 58 297 cases) including the SCHS and all previous prospective studies suggested borderline significant inverse associations between green leafy (summary relative risk (RR)=0·91; 95 % CI 0·84, 1·00) and cruciferous vegetable consumption (RR=0·87; 95 % CI 0·76, 1·00) and T2D risk, with moderate-to-high heterogeneity. In conclusion, green leafy or cruciferous vegetable consumption was not substantially associated with risk of T2D in an Asian population. Meta-analysis of available cohort data indicated that evidence for a beneficial effect of green leafy or cruciferous vegetable consumption on T2D risk is not convincing.

  18. Exenatide once weekly versus insulin glargine for type 2 diabetes (DURATION-3): 3-year results of an open-label randomised trial.

    Science.gov (United States)

    Diamant, Michaela; Van Gaal, Luc; Guerci, Bruno; Stranks, Stephen; Han, Jenny; Malloy, Jaret; Boardman, Marilyn K; Trautmann, Michael E

    2014-06-01

    When patients with type 2 diabetes start their first injectable therapy, clinicians can choose between glucagon-like peptide-1 (GLP-1) receptor agonists and basal insulins. In DURATION-3, exenatide once weekly was compared with insulin glargine (henceforth, glargine) as first injectable therapy. Here, we report the results of the final 3-year follow-up. DURATION-3 was an open-label randomised trial done between May 13, 2008, and Jan 30, 2012. Patients with type 2 diabetes aged 18 years or older were enrolled at 72 sites worldwide. They were eligible when they had suboptimum glycaemic control (HbA1c 7.1-11.0% [54-97 mmol/mol]) despite maximum tolerated doses of metformin alone or with a sulfonylurea for at least 3 months, a stable bodyweight for at least 3 months, and a BMI of 25-45 kg/m(2) (23-45 kg/m(2) in South Korea and Taiwan). Patients were randomly assigned (1:1) by computer-generated random sequence with an interactive voice-response system (block size four, stratified by country and concomitant therapy) to once-weekly exenatide (2 mg subcutaneous injection) or once-daily glargine (titrated to target) to be given in addition to their existing oral glucose-lowering regimens. The primary efficacy measure at 3 years was change in HbA1c from baseline in patients given at least one dose of the assigned drug (ie, analyses by modified intention to treat). Patients, investigators, and data analysts were not masked to treatment assignment. This trial is registered with ClinicalTrials.gov, number NCT00641056. 456 patients underwent randomisation and received at least one dose of the assigned drug (233 given exenatide, 223 glargine). At 3 years, least-squares mean HbA1c change was -1.01% (SE 0.07) in the exenatide group versus -0.81% (0.07) in the glargine group (least-squares mean difference -0.20%, SE 0.10, 95% CI -0.39 to -0.02; p=0.03). Transient gastrointestinal adverse events characteristic of GLP-1 receptor agonists were more frequent with exenatide than

  19. [Functional results of type A botulinum toxin versus oral anti-inflammatory agents in the rehabilitation of painful shoulder syndrome caused by rotator cuff lesion].

    Science.gov (United States)

    Becerril, Bautista P; Negrete-Corona, J; Chávez-Hinojosa, E

    2014-01-01

    Rotator cuff conditions are characterized by unspecific signs, as well as anatomic alterations and symptoms. They have a multifactorial etiology and may include everything from tendinitis to massive, full thickness tears of the rotator cuff tendon that compromise the normal biomechanics of the involved shoulder. They usually occur in people over 40 years of age but lesions resulting from trauma may vary according to the mechanism of injury and are not directly related with the age at onset of symptoms. Vascular factors have been described as related with rotator cuff tendon damage in conditions affecting the microcirculation. However, recent studies have not proven that the tendon under direct observation shows hypovascularity. Type A botulinum toxin acts by blocking the release of acetylcholine in the neuromuscular plate; in the joints it releases capsular tension and reduces proinflammatory factors such as interleukin-1 (IL-1). There are only a few papers on its intraarticular benefit; in muscle and tendon groups it not only has a muscle relaxant effect, but several publications support its utility for pain management. It has been widely used in the rehabilitation of this group of patients at low doses. Material and methods: Prospective, investigational and longitudinal study involving the follow-up of 24 patients with a diagnosis of painful shoulder syndrome proven clinically and with imaging tests, and caused by rotator cuff lesions. The patients either did not meet the criteria for immediate surgical repair or had already undergone such a repair. Type A botulinum toxin was applied to 12 patients in the subacromial space around the rotator cuff conjoint tendon, as well as in the painful spots and in the muscle contracture in the shoulder. The total dose of Type A botulinum toxin was 200 IU. The control group, also composed of 12 patients, was given a COX-2 oral antiinflammatory agent for 6 weeks (Celecoxib, 100 mg BID). Both groups followed a pre

  20. Higher concentrations of osteoprotegerin in type 1 diabetic patients are related to retinopathy: Results from the Poznań Prospective Study.

    Science.gov (United States)

    Grzelka, Agata; Naskręt, Dariusz; Araszkiewicz, Aleksandra; Uruska, Aleksandra; Wegner, Małgorzata; Zozulińska-Ziółkiewicz, Dorota

    2017-12-01

    Osteoprotegerin (OPG) is an arterial calcification marker which has been associated with vascular damage. Elevated OPG concentrations associated with low-grade inflammatory processes are found in diabetic subjects. The aim of the study was to assess concentrations of OPG in relation to the presence of diabetic complications in patients with diabetes type 1 (DM 1) participating in the Poznań Prospective Study (PoProStu). The study included 74 patients with DM1 (48 men) with a median age of 39 years (interquartile range [IQR]: 34-43) and a median 15-year history (IQR: 14-16) of diabetes, who were participants in the PoProStu. Serum OPG concentration was measured using the ELISA method, and serum concentration of C-reactive protein was measured with a high sensitivity test (hsCRP). The visceral adipose index (VAI) was used to determine indirect markers of insulin resistance (IR). The prevalence of microangiopathic diabetes complications was assessed. Retinopathy was diagnosed in 28 patients (38%), diabetic kidney disease (DKD) in 28 (38%) patients, and neuropathy in 17 (23%) patients. The median OPG level was 43.8 (28.0-74.0) pg/mL. Patients with retinopathy had higher levels of OPG than those without retinopathy: 47.5 (35.0-88.0) vs 35.4 (24.7-69.4) pg/mL (p = 0.04). Positive correlations were observed between OPG concentration and hsCRP (Rs = 0.53; p < 0.001), HbA1c level (Rs = 0.36; p = 0.002), VAI (Rs = 0.23; p = 0.04) and waist circumference (Rs = 0.24; p = 0.04). Higher concentrations of osteoprotegerin in DM1 patients are related to the presence of retinopathy. The study results indicate that OPG might play a role in the pathogenesis of vascular complications in association with hyperglycemia and low-grade inflammatory processes.

  1. ONE ANTIGEN MISMATCHED RELATED VS. HLA-MATCHED UNRELATED DONOR HEMATOPOIETIC TRANSPLANTATION IN ADULTS WITH ACUTE LEUKEMIA: CIBMTR RESULTS IN THE ERA OF MOLECULAR HLA TYPING

    Science.gov (United States)

    Valcárcel, David; Sierra, Jorge; Wang, Tao; Kan, Fangyu; Gupta, Vikas; Hale, Gregory A.; Marks, David I.; McCarthy, Philip L; Oudshoorn, Machteld; Petersdorf, Effie W; Ringdén, Olle; Setterholm, Michelle; Spellman, Stephen R; Waller, Edmund K.; Gajewski, James L; Marino, Susana R.; Senitzer, David; Lee, Stephanie J.

    2012-01-01

    Purpose Approximately 13% of patients lacking an HLA-identical sibling have a 1-antigen-mismatched related donor (MMRD). Historically, outcomes using a 1-antigen MMRD were considered equivalent to a matched unrelated donor (UD). Recent improvements in unrelated donor (UD) stem cell transplantation (SCT) due to better molecular HLA-matching justifies investigating if UD should be preferred to MMRD in adult patients with acute leukemia. Patients and Methods The outcomes of MMRD (n=89) and HLA-A, B, C, DRB1 allele matched UD (n=700) SCT reported to the CIBMTR between 1995 and 2005 were compared. Patients were transplanted for acute myeloid leukemia (AML) or acute lymphoid leukemia (ALL) in first or second complete remission. Results Donor type was not associated with hematological recovery. Univariate and multivariate comparisons of MMRD vs. HLA-matched UD transplants showed no statistically significant differences in overall survival, disease free survival, transplant related mortality, relapse, and 100-day grade III–IV acute graft-versus-host disease (GVHD). MMRD SCT was associated with a lower rate of chronic GVHD at 1-year, 35% vs 47% p=0.03, which was confirmed in multivariate analysis (RR 0.58, 95% CI 0.39-0.85, p<0.01). Conclusion HLA-matched UD and MMRD SCT are associated with comparable survival. Since less chronic GVHD was observed in MMRD, this option when available remains the first choice in acute leukemia patients without an HLA-identical sibling in need of allogeneic transplantation. PMID:20674756

  2. Empagliflozin and Cardiovascular Outcomes in Asian Patients With Type 2 Diabetes and Established Cardiovascular Disease - Results From EMPA-REG OUTCOME®.

    Science.gov (United States)

    Kaku, Kohei; Lee, Jisoo; Mattheus, Michaela; Kaspers, Stefan; George, Jyothis; Woerle, Hans-Juergen

    2017-01-25

    In the EMPA-REG OUTCOME ® trial, empagliflozin added to standard of care reduced the risk of 3-point major adverse cardiovascular (CV) events (3-point MACE: composite of CV death, non-fatal myocardial infarction, or non-fatal stroke) by 14%, CV death by 38%, hospitalization for heart failure by 35%, and all-cause mortality by 32% in patients with type 2 diabetes (T2DM) and established CV disease. We investigated the effects of empagliflozin in patients of Asian race.Methods and Results:Patients were randomized to receive empagliflozin 10 mg, empagliflozin 25 mg, or placebo. Of 7,020 patients treated, 1,517 (21.6%) were of Asian race. The reduction in 3-point MACE in Asian patients was consistent with the overall population: 3-point MACE occurred in 79/1,006 patients (7.9%) in the pooled empagliflozin group vs. 58/511 patients (11.4%) in the placebo group (hazard ratio: 0.68 [95% confidence interval: 0.48-0.95], P-value for treatment by race interaction (Asian, White, Black/African-American): 0.0872). The effects of empagliflozin on the components of MACE, all-cause mortality, and heart failure outcomes in Asian patients were consistent with the overall population (P-values for interaction by race >0.05). The adverse event profile of empagliflozin in Asian patients was similar to the overall trial population. Reductions in the risk of CV outcomes and mortality with empagliflozin in Asian patients with T2DM and established CV disease were consistent with the overall trial population.

  3. Dietary strategies for patients with type 2 diabetes in the era of multi-approaches; review and results from the Dietary Intervention Randomized Controlled Trial (DIRECT).

    Science.gov (United States)

    Ben-Avraham, Sivan; Harman-Boehm, Ilana; Schwarzfuchs, Dan; Shai, Iris

    2009-12-01

    Dietary intervention is recognized as a key component in prevention and management of type 2 diabetes (T2DM) and the debate persists: which dietary strategy is most effective. In the Dietary Intervention Randomized Controlled Trial (DIRECT) 322 moderately obese participants were randomized for 2 years to one of three diet groups: low-fat, Mediterranean and low-carbohydrate. Differential effects were observed in the sub-group of patients with T2DM at 24 months: participants randomized to the Mediterranean diet, which had the highest intake of dietary fibers and unsaturated to saturated fat ratio, achieved greater significant improvements in fasting plasma glucose and insulin levels. Patients who were randomized to the low-carbohydrate diet, which had the minimal intake of carbohydrates, achieved a significant reduction of hemoglobin A1C. Although improvements were observed in all groups, the low-fat diet was likely to be less beneficial in terms of glycemic control and lipid metabolism. Interpretation of results from different studies on dietary strategies may be complex since there is often no consistency in diet compositions, calorie restriction, intensity of intervention, dietary assessment or extent of adherence in the trial. Nevertheless, it seems that low fat restricted calorie diets are effective for weight loss and are associated with some metabolic benefits; however, some recent trials have shown that low carbohydrate diets are as efficient in inducing weight loss and in some metabolic measures such as serum triglycerides and HDL-cholesterol may be even superior to low fat diets. When addressing the issue of diet quality rather than quantity applying the glycemic index may have some added benefits. Furthermore special features of the Mediterranean diet have apparent additional favorable effects for patients with T2DM. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  4. Effects of Long-Term Testosterone Therapy on Patients with “Diabesity”: Results of Observational Studies of Pooled Analyses in Obese Hypogonadal Men with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Ahmad Haider

    2014-01-01

    Full Text Available To investigate effects of long-term testosterone (T therapy in obese men with T deficiency (TD and type 2 diabetes mellitus (T2DM, data were collected from two observational, prospective, and cumulative registry studies of 561 men with TD receiving T therapy for up to 6 years. A subgroup of obese hypogonadal men with T2DM was analyzed. Weight, height, waist circumference (WC, fasting blood glucose (FBG, glycated haemoglobin (HbA1c blood pressure, lipid profile, C-reactive protein (CRP, and liver enzymes were measured. A total of 156 obese, diabetic men with T deficiency, aged 61.17 ± 6.18 years, fulfilled selection criteria. Subsequent to T therapy, WC decreased by 11.56 cm and weight declined by 17.49 kg (15.04%. Fasting glucose declined from 7.06 ± 1.74 to 5.59 ± 0.94 mmol/L (P<0.0001 for all. HbA1c decreased from 8.08 to 6.14%, with a mean change of 1.93%. Systolic and diastolic blood pressure, lipid profiles including total cholesterol: HDL ratio, CRP, and liver enzymes all improved (P<0.0001. Long-term T therapy for up to 6 years resulted in significant and sustained improvements in weight, T2DM, and other cardiometabolic risk factors in obese, diabetic men with TD and this therapy may play an important role in the management of obesity and diabetes (diabesity in men with T deficiency.

  5. Correlation between measures of hypoglycemia and glycemic improvement in sulfonylurea treated patients with type 2 diabetes in India: Results from the OBSTACLE hypoglycemia study

    Directory of Open Access Journals (Sweden)

    S Kalra

    2014-01-01

    Full Text Available Background: This study aimed to assess correlation between measures of hypoglycemia and glycemic control in patients with type 2 diabetes mellitus (T2DM treated with sulfonylureas. Materials and Methods: T2DM patients being initiated on a sulfonylurea (SU on background of a failing oral antihyperglycemic regimen were followed up for 12 weeks. (HbA1c was measured at baseline and end of follow-up. Hypoglycemia was assessed using Stanford Hypoglycemia Questionnaire at week 12. Results: Of the total 1069 patients enrolled, 950 were considered evaluable. A weak negative correlation was observed between end of follow-up HbA1c values and hypoglycemia score, using both linear regression analysis (correlation coefficient -0.12; P = 0.0002 and negative binomial regression (β slope -0.09; P = 0.0010. A similar correlation was also observed between change in HbA1c from baseline and hypoglycemia score (β slope -0.07; P = 0.0048. Mean HbA1c reduction was lowest (0.65 ± 2.27% in patients not reporting any hypoglycemia and highest (1.28 ± 2.40% in patients with hypoglycemia score greater than median of 2 (P = 0.0031. There was no correlation between hypoglycemia frequency and end of follow-up HbA1c values (P = 0.4111. Conclusion: With addition of SU on a background of a failing oral anti-hyperglycemic regimen, the extent of glycemic control correlates directly with measures of patient reported hypoglycemia.

  6. COMPARATIVE CONTROLLED STUDY OF ANTIHYPERTENSIVE EFFICACY AND SAFETY OF CARVEDILOL IN PATIENTS WITH HYPERTENSION AND OBESITY OR DIABETES 2 TYPE (BASED ON RESULTS OF MULTICENTER TRIAL ACCORD

    Directory of Open Access Journals (Sweden)

    Yu. V. Yu.V. Lukina

    2016-01-01

    Full Text Available Aim. To study efficacy and safety of beta-blocker with vasodilating properties carvedilol (Acridilole, Akrihin, Russia as a part of the combined therapy of patients with arterial hypertension (HT and diabetes mellitus 2 type (DM2 and/or obesity.Material and methods. 592 patients: 176 men (29,7% and 416 women (70,3% with HT were examined. 194 patients had D2 and 398 patients had obesity. Patients were randomized for carvedilol therapy (n=291 or control group (n=301. Carvedilol was prescribed additionally to current therapy in dose of 6,25 mg BID, in 2 weeks the dose was increased to 12,5 mg BID if it was necessary. Blood pressure (BP and heart rate, number of angina attacks were registered at visits. ECG, laboratory analysis (plasma lipide profile, serum glucose, glycolised haemoglobin, serum K+ and Na+, evaluation of depression and anxiety status (according to special questionnaires were performed on the first and the last visits.Results. 582 patients completed the study. 7 patients dropped out from carvedilol group and 3 patients - from control group. The levels of systolic BP (SBP and diastolic BP (DBP were decreased during study, more significantly in carvedilol group (р<0,0001. SBP decreased on 24,8 mm Hg in patients of carvedilol group and on 21,4 mm Hg in patients of control group. DBP decreased on 12,5 mm Hg and 11 mm Hg respectively. Angina attacks were registered less often in patients of carvedilol group (р=0,001. Serum glucose and lipid spectrum did not change in both groups. Depression level decreased in patients receiving carvedilol. 17 side effects were registered in carvedilol group and 15 - in control group (р=0,575Conclusion. High antihypertensive efficacy of carvedilol is confirmed in hypertensive patients with DM2 and/or obesity. Good tolerability and metabolic neutrality of carvedilol is also observed.

  7. COMPARATIVE CONTROLLED STUDY OF ANTIHYPERTENSIVE EFFICACY AND SAFETY OF CARVEDILOL IN PATIENTS WITH HYPERTENSION AND OBESITY OR DIABETES 2 TYPE (BASED ON RESULTS OF MULTICENTER TRIAL ACCORD

    Directory of Open Access Journals (Sweden)

    Yu. V. Yu.V. Lukina

    2009-01-01

    Full Text Available Aim. To study efficacy and safety of beta-blocker with vasodilating properties carvedilol (Acridilole, Akrihin, Russia as a part of the combined therapy of patients with arterial hypertension (HT and diabetes mellitus 2 type (DM2 and/or obesity.Material and methods. 592 patients: 176 men (29,7% and 416 women (70,3% with HT were examined. 194 patients had D2 and 398 patients had obesity. Patients were randomized for carvedilol therapy (n=291 or control group (n=301. Carvedilol was prescribed additionally to current therapy in dose of 6,25 mg BID, in 2 weeks the dose was increased to 12,5 mg BID if it was necessary. Blood pressure (BP and heart rate, number of angina attacks were registered at visits. ECG, laboratory analysis (plasma lipide profile, serum glucose, glycolised haemoglobin, serum K+ and Na+, evaluation of depression and anxiety status (according to special questionnaires were performed on the first and the last visits.Results. 582 patients completed the study. 7 patients dropped out from carvedilol group and 3 patients - from control group. The levels of systolic BP (SBP and diastolic BP (DBP were decreased during study, more significantly in carvedilol group (р<0,0001. SBP decreased on 24,8 mm Hg in patients of carvedilol group and on 21,4 mm Hg in patients of control group. DBP decreased on 12,5 mm Hg and 11 mm Hg respectively. Angina attacks were registered less often in patients of carvedilol group (р=0,001. Serum glucose and lipid spectrum did not change in both groups. Depression level decreased in patients receiving carvedilol. 17 side effects were registered in carvedilol group and 15 - in control group (р=0,575Conclusion. High antihypertensive efficacy of carvedilol is confirmed in hypertensive patients with DM2 and/or obesity. Good tolerability and metabolic neutrality of carvedilol is also observed.

  8. Complex carotid cavernous sinus fistulas Barrow type D: endovascular treatment via the ophthalmic vein, imaging control with standardized MRI, long-term results

    International Nuclear Information System (INIS)

    Struffert, T.; Grunwald, I.Q.; Reith, W.; Muecke, I.

    2007-01-01

    Purpose: Since feeding arteries from both the internal and external carotid artery are common, cavernous fistulas of Barrow type D are difficult to treat. Embolization using the transarterial approach is considered to be the standard therapy. However, it is often impossible to embolize feeders from the internal carotid artery. The transorbital approach after anterior orbitotomy through the ophthalmic vein is an alternative in this complex situation. The following reports our experience with three female patients who underwent transvenous embolization. Procedural success was documented using standardized MRI and clinical reevaluation. Materials and Methods: Three female patients between 57 and 78 years of age were diagnosed with carotid cavernous fistulas by conventional angiogram. All patients were suffering from exophthalmus and visual impairment. Two patients showed secondary glaucoma and diplopia. In one patient we performed a technically successful transarterial embolization using particles, but no relevant improvement of the patient's condition was seen. Transfemoral transvenous access via the sinus petrosus was not possible in any patient. All patients were then embolized via the ophthalmic vein using GDC detachable coils. All patients were clinically reevaluated by an ophthalmologist. Also a standardized MRI was performed for documentation. Follow-up was performed for the first patient for 32 months, for the second patient for 34 months and for the third patient for 50 months. Results: Transvenous embolization was technically successful in all three cases. Clinical symptoms disappeared rapidly. Postprocedural MRI showed a symmetric diameter of the ophthalmic vein. Venous congestion of the orbit caused by fatty tissue edema regressed completely. Contrast-enhanced magnetic resonance angiography showed normal arterial vessels without evidence of fistula. (orig.)

  9. Variations of insecticide residual bio-efficacy on different types of walls: results from a community-based trial in south Cameroon

    Directory of Open Access Journals (Sweden)

    Etang Josiane

    2011-11-01

    Full Text Available Abstract Background Determination of residual activity of insecticides is essential information for the selection of appropriate indoor spraying operation. The present study was undertaken to evaluate the residual effect of three candidate insecticide formulations on different indoor surfaces in order to guide future interventions, in the context of Cameroon and other African countries. Methods The study was conducted in the Ntougou neighbourhood in Yaoundé (capital city of Cameroon. Bendiocarb WP, lambda-cyhalothrin CS and deltamethrin WG were sprayed on the indoor wall surfaces of local cement, wood and mud houses. Their effects on the knockdown and mortality of the Kisumu susceptible strain of Anopheles gambiae s.s were assessed each month from March to September 2009, using the WHO plastic cones test. Knockdown and mortality rates were compared between different surfaces using Chi-square test. A Kaplan-Meir model was used to estimate the time of treatment failure. Results With bendiocarb WP, the knockdown rates were frequently above 98% during 13 weeks after spraying, except on mud walls where it significantly decreased at the 13th week (P th (83% and the 20th (88% weeks respectively (P 98%; while it varied between 60 and 100% on wood or mud surfaces. The survival estimates of bendiocarb WP treatments remaining effective in killing An. gambiae s.s. (mortality rate ≥ 80% was > 13 weeks on cement and wood surfaces and 13 weeks on mud surfaces. Those of lambda-cyhalothrin CS were > 26 weeks on wood surfaces, and 20 weeks on concrete and mud surfaces. By contrast, those of deltamethrin WG were 26 weeks on concrete, 20 weeks on mud surfaces and 15 weeks on wood surfaces. Conclusion Current data suggest variable durations of spray cycles for each product, according to the type of wall surfaces, highlighting the importance of testing candidate products in local context before using them in large scale.

  10. Suppression of the toll-like receptor 7-dependent type I interferon production pathway by autophagy resulting from enterovirus 71 and coxsackievirus A16 infections facilitates their replication.

    Science.gov (United States)

    Song, Jie; Hu, Yajie; Li, Jiaqi; Zheng, Huiwen; Wang, Jingjing; Guo, Lei; Shi, Haijng; Liu, Longding

    2018-01-01

    Toll-like receptors (TLRs) act as molecular sentinels, detecting invading viral pathogens and triggering host innate immune responses, including autophagy. However, many viruses have evolved a series of strategies to manipulate autophagy for their own benefit. Enterovirus 71 (EV71) and coxsackievirus A16 (CA16), as the primary agents causing hand, foot and mouth disease (HFMD), can induce autophagy leading to their replication. Therefore, the objective of this study was to investigate whether enhanced viral replication caused by autophagy in EV71 and CA16 infections was associated with a TLR-related signaling pathway. Our results demonstrate that complete autophagy and incomplete autophagy were observed in human bronchial epithelial (16HBE) cells infected with EV71 and CA16. Moreover, suppression of autophagy by the pharmacological modulator 3-MA significantly and clearly decreased the survival rates and viral replication of EV71 and CA16 in 16HBE cells. Inhibition of autophagy also enhanced the expression of molecules related to the TLR7-dependent type I interferon (IFN-I) production pathway, such as TLR7, MyD88, IRF7 and IFN-α/β. Finally, immunofluorescence staining demonstrated that TLR7 endosome marker M6PR levels were clearly reduced in EV71- and CA16-infected cells, while they were markedly elevated in infected cells treated with 3-MA. These findings suggest that increased EV71 and CA16 replication meditated by autophagy in 16HBE cells might promote degradation of the endosome, leading to suppression of the TLR7-mediated IFN-I signaling pathway.

  11. Preliminary Results of Relationship between Preoperative Walking Ability and Magnetic Resonance Imaging Morphology in Patients with Lumbar Canal Stenosis: Comparison between Trefoil and Triangle Types of Spinal Stenosis.

    Science.gov (United States)

    Azimi, Parisa; Yazdanian, Taravat; Benzel, Edward C

    2017-08-01

    Cross-sectional. To examine the relationship between magnetic resonance imaging (MRI) morphology stenosis grades and preoperative walking ability in patients with lumbar canal stenosis (LCS). No previous study has analyzed the correlation between MRI morphology stenosis grades and walking ability in patients with LCS. This prospective study included 98 consecutive patients with LCS who were candidates for surgery. Using features identified in T2-weighted axial magnetic, stenosis type was determined at the maximal stenosis level, and only trefoil and triangle stenosis grade types were considered because of sufficient sample size. Intraobserver and interobserver reliability were assessed by calculating weighted kappa coefficients. Symptom severity was evaluated via the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). Walking ability was assessed using the Self-Paced Walking Test (SPWT) and JOABPEQ subscales. Demographic characteristics, SPWT scores, and JOABPEQ scores were compared between patients with trefoil and triangle stenosis types. The mean patient age was 58.1 (standard deviation, 8.4) years. The kappa values of the MRI morphology stenosis grade types showed a perfect agreement between the stenosis grade types. The trefoil group (n=53) and triangle group (n=45) showed similar preoperative JOABPEQ subscale scores (e.g., low back pain, lumbar function, and mental health) and were not significantly different in age, BMI, duration of symptoms, or lumbar stenosis levels (all p >0.05); however, trefoil stenosis grade type was associated with a decreased walking ability according to the SPWT and JOABPEQ subscale scores. These findings suggest preoperative walking ability is more profoundly affected in patients with trefoil type stenosis than in those with triangle type stenosis.

  12. A Ta-rich low-P peraluminous granite: the Rechla cupola (Hoggar, Algeria) and associated pegmatites, the result of extreme fractionation of a A2-type magma.

    Science.gov (United States)

    Kesraoui, M.; Marignac, C.; Hamis, A.; Cuney, M.

    2012-04-01

    pronounced <0 Eu anomaly. Geochemical modelling shows that the main Rechla magma is likely the fractionated product of this already differentiated magma, mainly involving quartz and Kfs. The pegmatite rim is interpreted as the result of the sequential crystallization of a Rechla-type melt, with late individualisation of a Fe-rich magmatic-hydrothermal phase responsible for the quartz-zinnwaldite assemblage, leaving a strongly Be-enriched residual liquid (the fine-grained granite). As demonstrated by the Rechla occurrence, Ta concentration at levels similar to those in Beauvoir-type high-P peraluminous granites may be reached in the low-P low-Ta A2 suites, provided that extreme fractionation processes are established. Azzouni-Sekkal, A., Boissonnas, J. (1993). Une province magmatique de transition du calco-alcalin à l'alcalin : les granitoïdes pan-africains à structure annulaire de la chaîne pharusienne du Hoggar (Algérie). Bulletin Société Géologique France 164, 597-608. Linnen, R.L., Cuney, M. (2005). Granite-related rare-element deposits and experimental constraints on Ta-Nb-W-Sn-Zr-Hf mineralization. In: RL Linnen, IM Samson (eds), Rare-element geochemistry and mineral deposits, Geological Association of Canada (GAC) Short Course Notes 17, pp. 45-67.

  13. Enzyme Replacement Therapy and/or Hematopoietic Stem Cell Transplantation at diagnosis in patients with Mucopolysaccharidosis type I: results of a European consensus procedure

    LENUS (Irish Health Repository)

    de Ru, Minke H

    2011-08-10

    Abstract Background Mucopolysaccharidosis type I (MPS I) is a lysosomal storage disorder that results in the accumulation of glycosaminoglycans causing progressive multi-organ dysfunction. Its clinical spectrum is very broad and varies from the severe Hurler phenotype (MPS I-H) which is characterized by early and progressive central nervous system (CNS) involvement to the attenuated Scheie phenotype (MPS I-S) with no CNS involvement. Indication, optimal timing, safety and efficacy of the two available treatment options for MPS I, enzyme replacement therapy (ERT) and hematopoietic stem cell transplantation (HSCT), are subject to continuing debate. A European consensus procedure was organized to reach consensus about the use of these two treatment strategies. Methods A panel of specialists, including 8 specialists for metabolic disorders and 7 bone marrow transplant physicians, all with acknowledged expertise in MPS I, participated in a modified Delphi process to develop consensus-based statements on MPS I treatment. Fifteen MPS I case histories were used to initiate the discussion and to anchor decisions around either treatment mode. Before and at the meeting all experts gave their opinion on the cases (YES\\/NO transplantation) and reasons for their decisions were collected. A set of draft statements on MPS I treatment options composed by a planning committee were discussed and revised during the meeting until full consensus. Results Full consensus was reached on several important issues, including the following: 1) The preferred treatment for patients with MPS I-H diagnosed before age 2.5 yrs is HSCT; 2) In individual patients with an intermediate phenotype HSCT may be considered if there is a suitable donor. However, there are no data on efficacy of HSCT in patients with this phenotype; 3) All MPS I patients including those who have not been transplanted or whose graft has failed may benefit significantly from ERT; 4) ERT should be started at diagnosis and may be

  14. High-Dosage Ascorbic Acid Treatment in Charcot-Marie-Tooth Disease Type 1A: Results of a Randomized, Double-Masked, Controlled Trial

    Science.gov (United States)

    Lewis, Richard A.; McDermott, Michael P.; Herrmann, David N.; Hoke, Ahmet; Clawson, Lora L.; Siskind, Carly; Feely, Shawna M. E.; Miller, Lindsey J.; Barohn, Richard J.; Smith, Patricia; Luebbe, Elizabeth; Wu, Xingyao; Shy, Michael E.

    2013-01-01

    Importance No current medications improve neuropathy in subjects with Charcot-Marie-Tooth disease type 1A (CMT1A). Ascorbic acid (AA) treatment improved the neuropathy of a transgenic mouse model of CMT1A and is a potential therapy. A lower dosage (1.5 g/d) did not cause improvement in humans. It is unknown whether a higher dosage would prove more effective. Objective To determine whether 4-g/d AA improves the neuropathy of subjects with CMT1A. Design A futility design to determine whether AA was unable to reduce worsening on the CMT Neuropathy Score (CMTNS) by at least 50% over a 2-year period relative to a natural history control group. Setting Three referral centers with peripheral nerve clinics (Wayne State University, Johns Hopkins University, and University of Rochester). Participants One hundred seventy-four subjects with CMT1A were assessed for eligibility; 48 did not meet eligibility criteria and 16 declined to participate. The remaining 110 subjects, aged 13 to 70 years, were randomly assigned in a double-masked fashion with 4:1 allocation to oral AA (87 subjects) or matching placebo (23 subjects). Sixty-nine subjects from the treatment group and 16 from the placebo group completed the study. Two subjects from the treatment group and 1 from the placebo group withdrew because of adverse effects. Interventions Oral AA (4 g/d) or matching placebo. Main Outcomes and Measures Change from baseline to year 2 in the CMTNS, a validated composite impairment score for CMT. Results The mean 2-year change in the CMTNS was −0.21 for the AA group and −0.92 for the placebo group, both better than natural history (+1.33). This was well below 50% reduction of CMTNS worsening from natural history, so futility could not be declared (P > .99). Conclusions and Relevance Both treated patients and those receiving placebo performed better than natural history. It seems unlikely that our results support undertaking a larger trial of 4-g/d AA treatment in subjects with CMT1A

  15. Differences in morning-evening type and sleep duration between Black and White adults: Results from a propensity-matched UK Biobank sample.

    Science.gov (United States)

    Malone, Susan Kohl; Patterson, Freda; Lozano, Alicia; Hanlon, Alexandra

    2017-01-01

    Biological evidence suggests that ethno-racial differences in morning-evening type are possible, whereby Blacks may be more likely to be morning type compared to Whites. However, population-level evidence of ethno-racial difference in morning-evening type is limited. In an earlier study, we reported that morning type was more prevalent in Blacks compared to Whites in the United Kingdom (UK) Biobank cohort (N = 439 933). This study aimed to determine if these ethno-racial differences persisted after accounting for an even broader range of social, environmental and individual characteristics and employing an analytic approach that simulates randomization in observational data, propensity score modeling. Data from UK Biobank participants whose self-identified race/ethnicity was Black/Black British or White; who did not report daytime napping, shift work or night shift work; who provided full mental health information; and who were identified using propensity score matching were used (N = 2044). Each sample was strongly matched across all social, environmental and individual characteristics as indicated by absolute standardized mean differences morning, intermediate and evening type among Blacks (n = 1022) was compared with a matched sample of Whites (n = 1022) using multinomial logistic regression models. Blacks had a 62% greater odds of being morning type [odds ratio (OR) = 1.620, 95% confidence interval (CI): 1.336-1.964, p morning type and short nocturnal sleep in Blacks compared to Whites is not fully explained by a wide range of social and environmental factors. If sleep is an upstream determinant of health, these data suggest that ethno-racially targeted public health sleep intervention strategies are needed.

  16. Differences in morning–evening type and sleep duration between Black and White adults: Results from a propensity-matched UK Biobank sample

    Science.gov (United States)

    Malone, Susan Kohl; Patterson, Freda; Lozano, Alicia; Hanlon, Alexandra

    2017-01-01

    Biological evidence suggests that ethno-racial differences in morning–evening type are possible, whereby Blacks may be more likely to be morning type compared to Whites. However, population-level evidence of ethno-racial difference in morning–evening type is limited. In an earlier study, we reported that morning type was more prevalent in Blacks compared to Whites in the United Kingdom (UK) Biobank cohort (N = 439 933). This study aimed to determine if these ethno-racial differences persisted after accounting for an even broader range of social, environmental and individual characteristics and employing an analytic approach that simulates randomization in observational data, propensity score modeling. Data from UK Biobank participants whose self-identified race/ethnicity was Black/Black British or White; who did not report daytime napping, shift work or night shift work; who provided full mental health information; and who were identified using propensity score matching were used (N = 2044). Each sample was strongly matched across all social, environmental and individual characteristics as indicated by absolute standardized mean differences morning, intermediate and evening type among Blacks (n = 1022) was compared with a matched sample of Whites (n = 1022) using multinomial logistic regression models. Blacks had a 62% greater odds of being morning type [odds ratio (OR) = 1.620, 95% confidence interval (CI): 1.336–1.964, p morning type and short nocturnal sleep in Blacks compared to Whites is not fully explained by a wide range of social and environmental factors. If sleep is an upstream determinant of health, these data suggest that ethno-racially targeted public health sleep intervention strategies are needed. PMID:28488939

  17. Thermoluminescence emission spectrometry of glass display in mobile phones and resulting evaluation of the dosimetric properties of a specific type of display glass

    International Nuclear Information System (INIS)

    Discher, Michael; Woda, Clemens

    2014-01-01

    Glass displays of mobile phones are sensitive to ionizing radiation and can be used for retrospective dosimetry for the purpose of triage after a radiological accident or attack. In this study the two main types of glass display that are used in modern mobile phones were investigated using thermoluminescence (TL) emission spectrometry. A different TL spectrum was observed for the glass display of category A (lime-aluminosilicate glass) and category B (boron-silicate glass). Based on the spectral measurements an optimized detection window was chosen to re-evaluate the dosimetric properties (dose response, optical and long-term stability) of glass display category B. - Highlights: • Two display glass types show similar TL emission peaks but with strongly different relative intensities. • The intrinsic background TL signal peaks at similar wavelengths as the radiation induced signal. • Dosimetric properties of one display glass type were re-evaluated using an optimized detection window

  18. N-Terminal Pro-B-Type Natriuretic Peptide-Guided Therapy in Chronic Heart Failure Reduces Repeated Hospitalizations-Results From TIME-CHF.

    Science.gov (United States)

    Davarzani, Nasser; Sanders-van Wijk, Sandra; Karel, Joël; Maeder, Micha T; Leibundgut, Gregor; Gutmann, Marc; Pfisterer, Matthias E; Rickenbacher, Peter; Peeters, Ralf; Brunner-la Rocca, Hans-Peter

    2017-05-01

    Although heart failure (HF) patients are known to experience repeated hospitalizations, most studies evaluated only time to first event. N-Terminal B-type natriuretic peptide (NT-proBNP)-guided therapy has not convincingly been shown to improve HF-specific outcomes, and effects on recurrent all-cause hospitalization are uncertain. Therefore, we investigated the effect of NT-proBNP-guided therapy on recurrent events in HF with the use of a time-between-events approach in a hypothesis-generating analysis. The Trial of Intensified Versus Standard Medical Therapy in Elderly Patients With Congestive Heart Failure (TIME-CHF) randomized 499 HF patients, aged ≥60 years, left ventricular ejection fraction ≤45%, New York Heart Association functional class ≥I,I to NT-proBNP-guided versus symptom-guided therapy for 18 months, with further follow-up for 5.5 years. The effect of NT-proBNP-guided therapy on recurrent HF-related and all-cause hospitalizations and/or all-cause death was explored. One hundred four patients (49 NT-proBNP-guided, 55 symptom-guided) experienced 1 and 275 patients (133 NT-proBNP-guided, 142 symptom-guided) experienced ≥2 all-cause hospitalization events. Regarding HF hospitalization, 132 patients (57 NT-proBNP-guided, 75 symptom-guided) experienced 1 and 122 patients (57 NT-proBNP-guided, 65 symptom-guided) experienced ≥2 events. NT-proBNP-guided therapy was significant in preventing 2nd all-cause hospitalizations (hazard ratio [HR] 0.83; P = .01), in contrast to nonsignificant results in preventing 1st all-cause hospitalization events (HR 0.91; P = .35). This was not the case regarding HF hospitalization events (HR 0.85 [P = .14] vs HR 0.73 [P = .01]) The beneficial effect of NT-proBNP-guided therapy was seen only in patients aged <75 years, and not in those aged ≥75 years (interaction terms with P = .01 and P = .03 for all-cause hospitalization and HF hospitalization events, respectively). NT-proBNP-guided therapy

  19. Prevalence of Insulin Pump Therapy and Its Association with Measures of Glycemic Control: Results from the Canadian Study of Longevity in Type 1 Diabetes.

    Science.gov (United States)

    Boulet, Geneviève; Halpern, Elise M; Lovblom, Leif E; Weisman, Alanna; Bai, Johnny-Wei; Eldelekli, Devrim; Keenan, Hillary A; Brent, Michael H; Paul, Narinder; Bril, Vera; Cherney, David Z I; Perkins, Bruce A

    2016-05-01

    We aimed to determine cross-sectional insulin pump prevalence and factors associated with measures of glycemic control as a secondary analysis in a long-standing type 1 diabetes mellitus (T1DM) national cohort. Canadian participants with ≥50 years of T1DM (n = 305) were administered a comprehensive mail-based questionnaire including acquisition of contemporaneous laboratory results. Factors associated with pump use, glycosylated hemoglobin (HbA1c), and hypoglycemia were analyzed by regression. The 305 participants had a median age of 65 [interquartile range, 59, 71] years, median diabetes duration of 54 [51, 59] years, and mean HbA1c level of 7.5 ± 1.1%. Prevalence of pump use was 44% (133/305), with median duration of use 8 [4, 13] years. Compared with the non-pump subgroup, the pump subgroup had numerically lower but similar HbA1c levels (7.4 ± 0.9% vs. 7.6 ± 1.2%; P = 0.22) and reported greater numbers of minor hypoglycemia events (6.5 vs. 5.1 events/patient·month; P = 0.004) and fewer severe hypoglycemia events (0.5 vs. 1.3 events/patient·year; P = 0.02) in the past year. More frequent daily glucose tests and more frequent minor hypoglycemia events-but not pump therapy or its prescription parameters-were independently associated with lower HbA1c level in multivariable regression. However, use of insulin pump and habitual use of continuous glucose monitoring (≥1 week/month) were each independently associated with lower risk of severe hypoglycemia (risk ratio = 0.50 [P Insulin pump and continuous glucose monitoring technologies were associated with lower risk of severe hypoglycemia, while frequent daily glucose testing was associated with lower HbA1c level. These findings imply that basic self-management skill and technology play complementary roles in glycemic control among older adults with long-standing T1DM.

  20. Effects of meal preparation training on body weight, glycemia, and blood pressure: results of a phase 2 trial in type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Dasgupta Kaberi

    2012-10-01

    Full Text Available Abstract Background Modest reductions in weight and small increases in step- related activity (e.g., walking can improve glycemic and blood pressure control in type 2 diabetes mellitus (DM2. We examined changes in these parameters following training in time- efficient preparation of balanced, low- energy meals combined with pedometer- based step count monitoring. Methods Seventy- two adults with DM2 were enrolled in a 24- week program (i.e., 15 three- hour group sessions. They prepared meals under a chef’s supervision, and discussed eating behaviours/nutrition with a registered dietitian. They maintained a record of pedometer- assessed step counts. We evaluated changes from baseline to 24 weeks in terms of weight, step counts, hemoglobin A1c (HbA1c, glycemic control, blood pressure, and eating control ability (Weight Efficacy Lifestyle WEL Questionnaire. 53 participants (73.6% completed assessments. Results There were improvements in eating control (11.2 point WEL score change, 95% CI 4.7 to 17.8, step counts (mean change 869 steps/day, 95% CI 198 to 1,540, weight (mean change −2.2%; 95% CI −3.6 to −0.8, and HbA1c (mean change −0.3% HbA1c, 95% CI −0.6 to −0.1, as well as suggestion of systolic blood pressure reduction (mean change −3.5 mm Hg, 95% CI −7.8 to 0.9. Findings were not attributable to medication changes. In linear regression models (adjusted for age, sex, ethnicity, insulin use, season, a −2.5% weight change was associated with a −0.3% HbA1c change (95% CI −0.4 to −0.2 and a −3.5% systolic blood pressure change (95% CI −5.5 to −1.4. Conclusions In this ‘proof of concept’ study, persistence with the program led to improvements in eating and physical activity habits, glycemia reductions, and suggestion of blood pressure lowering effects. The strategy thus merits further study and development to expand the range of options for vascular risk reduction in DM2.

  1. A points-based algorithm for prognosticating clinical outcome of Chiari malformation Type I with syringomyelia: results from a predictive model analysis of 82 surgically managed adult patients.

    Science.gov (United States)

    Thakar, Sumit; Sivaraju, Laxminadh; Jacob, Kuruthukulangara S; Arun, Aditya Atal; Aryan, Saritha; Mohan, Dilip; Sai Kiran, Narayanam Anantha; Hegde, Alangar S

    2018-01-01

    OBJECTIVE Although various predictors of postoperative outcome have been previously identified in patients with Chiari malformation Type I (CMI) with syringomyelia, there is no known algorithm for predicting a multifactorial outcome measure in this widely studied disorder. Using one of the largest preoperative variable arrays used so far in CMI research, the authors attempted to generate a formula for predicting postoperative outcome. METHODS Data from the clinical records of 82 symptomatic adult patients with CMI and altered hindbrain CSF flow who were managed with foramen magnum decompression, C-1 laminectomy, and duraplasty over an 8-year period were collected and analyzed. Various preoperative clinical and radiological variables in the 57 patients who formed the study cohort were assessed in a bivariate analysis to determine their ability to predict clinical outcome (as measured on the Chicago Chiari Outcome Scale [CCOS]) and the resolution of syrinx at the last follow-up. The variables that were significant in the bivariate analysis were further analyzed in a multiple linear regression analysis. Different regression models were tested, and the model with the best prediction of CCOS was identified and internally validated in a subcohort of 25 patients. RESULTS There was no correlation between CCOS score and syrinx resolution (p = 0.24) at a mean ± SD follow-up of 40.29 ± 10.36 months. Multiple linear regression analysis revealed that the presence of gait instability, obex position, and the M-line-fourth ventricle vertex (FVV) distance correlated with CCOS score, while the presence of motor deficits was associated with poor syrinx resolution (p ≤ 0.05). The algorithm generated from the regression model demonstrated good diagnostic accuracy (area under curve 0.81), with a score of more than 128 points demonstrating 100% specificity for clinical improvement (CCOS score of 11 or greater). The model had excellent reliability (κ = 0.85) and was validated with

  2. Does chronic obstructive pulmonary disease with or without type 2 diabetes mellitus influence the risk of lung cancer? Result from a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Te-Chun Shen

    Full Text Available BACKGROUND: Previous studies have suggested that chronic obstructive pulmonary disease (COPD is an independent risk factor for lung cancer. There are some evidence that people with diabetes are at a risk of developing many forms of cancer, but inconclusive with regard to lung cancer. The aim of this study was to evaluate whether COPD with or without type 2 diabetes mellitus (T2DM influences the risk of developing lung cancer. METHODS: This is a retrospective cohort study consisting of 20,730 subjects newly diagnosed with COPD ("cases". Their data was collected from the National Health Insurance system of Taiwan from 1998 to 2010. Among these patients, 5,820 patients had T2DM and 14,910 patients did not have T2DM. The retrospective matched control group consisted of 20,729 subjects without either COPD or T2DM. The control group was matched with the cases for sex, age, and index year (the year that the patient was diagnosed with COPD. The subjects were followed until the end of 2011. RESULTS: The findings of our study showed that the risk of lung cancer was higher in the COPD group than in the non-COPD group, with adjusted hazard ratio (HR of 5.02 [95% confidence interval (CI = 4.23-5.94] among total case group, adjusted HR was 5.38 (95% CI = 4.52-6.40 in the cohort without T2DM and adjusted HR was 4.05 (95% CI = 3.26-5.03 in the cohort with T2DM. We observed a significantly protective effect from lung cancer (adjusted HR = 0.75, 95% CI = 0.63-0.90 of diabetic cohort than non-diabetic cohort among patients with COPD. CONCLUSION: Patients with COPD had a significantly higher risk of developing lung cancer than healthy people. However, there was a protective effect of T2DM for lung cancer among patients with COPD. Further investigation may be needed to corroborate the mechanism or bring up reliable reasons.

  3. [Prevalence of Disturbed Eating Behavior in Children and Adolescents with Type 1 Diabetes: Assessment and Comparison to Healthy Peers--Results of a Multicenter Questionnaire-based Study].

    Science.gov (United States)

    Hevelke, Linnea Kristiina; Albrecht, Carmen; Busse-Widmann, Petra; Kranz, Julia; Lange, Karin; Markowitz, Jessica T; Marshall, Louise F; Meurs, Stefanie; de Soye, Ilka H; Saßmann, Heike

    2016-03-01

    Published data on prevalence of disturbed eating behavior in youth with type 1 diabetes are heterogeneous. This study assesses the prevalence rate of disturbed eating behavior in a representative German sample of children and adolescents with type 1 diabetes. The prevalence rate is compared to the one published for a national sample of healthy peers. Furthermore prospects as well as limits of a generic screening tool used to identify disturbed eating behavior are compared to those of a diabetes specific screening tool. A total of 246 children and adolescents (age: 11-19 years) with type 1 diabetes, from 6 pediatric diabetes centers in Germany, completed the generic SCOFF questionnaire and the diabetes specific Diabetes Eating Problem Survey-Revised (DEPS-R) to assess their eating behavior. Prevalence data were compared to representative data from a nationwide survey in Germany (KiGGS-study). A total of 16.3% of the children and adolescents with type 1 diabetes scored above the SCOFF cut-off (≥ 2) (24.2% of the girls and 8.9% of the boys). The percentages in the healthy controls were 28.9% for girls and 15.2% for boys. Compared to this the prevalence of disturbed eating behavior was lower in the diabetes group (p=0.017 and peating behavior than their healthy peers. Particularly boys with type 1 diabetes practicing insulin-purging, are not reliably detected by a generic screening tool. As part of long-term care a diabetes specific screening tool should be used to identify adolescents with type 1 diabetes and disturbed eating behavior more reliably. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Effect of Cadmium Contaminants Against Absorption of Cadmium and the Results of 3 Types of Families Brassicaceae Vegetables on Peat Soil

    OpenAIRE

    Panthera Boy, Godefridus Delanova; Suswati, Denah; Susana, Rini

    2014-01-01

    Cadmium (Cd) is a heavy metal that is often the pollutants on agricultural land. This research aimed to study the absorption of cadmium (Cd) and yield of the three kinds family brassicaceae grown in peat media contaminated with cadmium (Cd). The method used in this research was Split Plot Design. As the main plot are 3 types of vegetables consist of 3 types of mustards: mustard greens, Chinese cabbage, and Chinese broccoli. Sub plot the dose cadmium treatment consisting of c0 (no contaminant)...

  5. Achieving ADA/ISPAD clinical guideline goals is associated with higher insulin sensitivity and cardiopulmonary fitness in adolescents with type 1 diabetes: Results from RESistance to InSulin in Type 1 ANd Type 2 diabetes (RESISTANT) and Effects of MEtformin on CardiovasculaR Function in AdoLescents with Type 1 Diabetes (EMERALD) Studies.

    Science.gov (United States)

    Bjornstad, Petter; Cree-Green, Melanie; Baumgartner, Amy; Coe, Gregory; Reyes, Yesenia Garcia; Schäfer, Michal; Pyle, Laura; Regensteiner, Judith G; Reusch, Jane Eb; Nadeau, Kristen J

    2018-05-01

    Most youth with type 1 diabetes do not meet the American Diabetes Association (ADA) and International Society for Pediatric and Adolescent Diabetes (ISPAD) targets for hemoglobin A1c (HbA1c), blood pressure (BP), lipids, and body mass index (BMI). We hypothesized that ISPAD/ADA goal achievement would be associated with better insulin sensitivity (IS) and cardiopulmonary fitness. IS was quantified as glucose infusion rate (GIR) from a hyperinsulinemic-euglycemic clamp in youth with type 1 diabetes from the RESistance to InSulin in Type 1 ANd Type 2 diabetes (RESISTANT) (n = 86) and Effects of MEtformin on CardiovasculaR Function in AdoLescents with Type 1 Diabetes (EMERALD) (n = 41) cohorts (n = 127; age 15.7 ± 2.2 years, 52% girls). Cardiopulmonary fitness was measured as peak oxygen consumption (VO 2 peak/kg) during upright (RESISTANT) or supine (EMERALD) cycle ergometry and were stratified by cycle type. Goal achievement was defined as HbA1c 35 mg/dL, triglycerides EMERALD participants for supine VO 2 peak. ADA/ISPAD goal achievement was associated with greater IS and cardiopulmonary fitness. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Clinical and functional results of laparoscopic intersphincteric resection for ultralow rectal cancer: is there a distinction between the three types of hand-sewn colo-anal anastomosis?

    Science.gov (United States)

    Zhang, Bin; Zhao, Ke; Liu, Quanlong; Yin, Shuhui; Zhuo, Guangzuan; Zhao, Yujuan; Zhu, Jun; Ding, Jianhua

    2017-04-01

    The purpose of this study is to compare the clinical and functional outcomes of three types of hand-sewn colo-anal anastomosis (CAA) after laparoscopic intersphincteric resection (Lap-ISR) for patients with ultralow rectal cancer. A total of 79 consecutive patients treated by Lap-ISR for low-lying rectal cancer in an academic medical center from June 2011 to February 2016. According to the distal tumor margin and individualized anal length, the patients underwent three types of hand-sewn CAA including partial-ISR, subtotal-ISR, and total-ISR. Of the 79 patients, 35.4% required partial-ISR, 43% adopted subtotal-ISR, and 21.5% underwent total-ISR. R0 resection was achieved in 78 patients (98.7%). In addition to distal resection margin, there were no significant differences in clinicopathological parameters and postoperative complications between the three groups. The type of hand-sewn CAA did not influence the 3-year disease-free survival (DFS) or local relapse-free survival (LFS). At 24-months follow-up, in spite of higher incontinence scores in total-ISR group, there were not statistically significant differences in functional outcomes including Wexner score or Kirwan grade between the groups. Nevertheless, patients with chronic anastomotic stricture showed worse anal function than those without the complication. The type of hand-sewn CAA after Lap-ISR may not influence oncological and functional outcomes, but chronic stricture deteriorates continence status.

  7. Negative appraisals of insulin therapy are common among adults with Type 2 diabetes using insulin : Results from Diabetes MILES - Australia cross-sectional survey

    NARCIS (Netherlands)

    Holmes-Truscott, E.; Skinner, T.C.; Pouwer, F.; Speight, J.

    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

  8. The venous thrombotic risk of oral contraceptives, effects of oestrogen dose and progestogen type: results of the MEGA case-control study

    NARCIS (Netherlands)

    van Hylckama Vlieg, A.; Helmerhorst, F.M.; Vandenbroucke, J.P.; Doggen, Catharina Jacoba Maria; Rosendaal, F.R.

    2009-01-01

    Objective To assess the thrombotic risk associated with oral contraceptive use with a focus on dose of oestrogen and type of progestogen of oral contraceptives available in the Netherlands. Design Population based case-control study. Setting Six participating anticoagulation clinics in the

  9. Gender differences and temporal variation in the incidence of type 1 diabetes : results of 8012 cases in the nationwide Diabetes Incidence Study in Sweden 1983-2002

    NARCIS (Netherlands)

    Ostman, J.; Lonnberg, G.; Arnqvist, H. J.; Blohme, G.; Bolinder, J.; Schnell, A. Ekbom; Eriksson, J. W.; Gudbjornsdottir, S.; Sundkvist, G.; Nystrom, L.

    Objectives. To establish the gender difference amongst newly diagnosed type 1 diabetic patients aged 15-34 years, considering age at diagnosis, temporal trend and seasonal variation at time of diagnosis. Study design. A population-based prospective study with a mean annual population at risk of 2.3

  10. Long-term outcome of Multiple Endocrine Neoplasia type 1 related manifestations : Results from the DutchMEN1 Study Group

    NARCIS (Netherlands)

    Pieterman, C.R.C.

    2018-01-01

    Multiple Endocrine Neoplasia type 1 (MEN1) is a rare syndrome caused by mutations in the MEN1 gene on chromosome 11. It is characterized by the occurrence of primary hyperparathyroidism (pHPT), duodenopancreatic neuroendocrine tumours (NET), pituitary tumours, adrenal adenomas and NET of the

  11. Diabetes mellitus type 2 and subsite-specific colorectal cancer risk in men and women: results from the Netherlands Cohort Study on diet and cancer

    NARCIS (Netherlands)

    Kort, S. de; Simons, C.C.; Brandt, P.A. van den; Goldbohm, R.A.; Arts, I.C.; Bruine, A.P.; Janssen-Heijnen, M.L.; Sanduleanu, S.; Masclee, A.A.; Weijenberg, M.P.

    2016-01-01

    Background: Type 2 diabetes mellitus (T2DM) is associated with an increased risk of colorectal cancer (CRC); however, studies differentiating between subsites of CRC are limited. We investigated how diabetes mellitus (DM) was associated with subsite-specific CRC risk in men and women. Methods: The

  12. Test results of Salmonella sero- and phage typing by the National Reference Laboratories and the EnterNet laboratories in the Member States of the European Union

    NARCIS (Netherlands)

    Raes M; Ward LR; Maas HME; Leeuwen WJ van; Henken AM; MGB; LIS; PHLS Laboratory of Enteric Pathogens

    2000-01-01

    The fourth collaborative study on serotyping and phage typing for Salmonella was organised by the Community Reference Laboratory in collaboration with the Public Health Laboratory Services. All the National Reference Laboratories for Salmonella and 12 EnterNet laboratories participated in the study.

  13. DiAlert: a prevention program for overweight first degree relatives of type 2 diabetes patients: results of a pilot study to test feasibility and acceptability

    NARCIS (Netherlands)

    Heideman, Wieke H.; de Wit, Maartje; Middelkoop, Barend J. C.; Nierkens, Vera; Stronks, Karien; Verhoeff, Arnoud P.; Snoek, Frank J.

    2012-01-01

    Background: Prevalence of type 2 diabetes mellitus is increasing due to lifestyle changes, particularly affecting those genetically at risk. We developed DiAlert as a targeted group-based intervention aimed to promote intrinsic motivation and action planning for lifestyle changes and weight loss in

  14. Agreement between self- and clinician-collected specimen results for detection and typing of high-risk human papillomavirus in specimens from women in Gugulethu, South Africa

    NARCIS (Netherlands)

    Jones, Heidi E.; Allan, Bruce R.; van de Wijgert, Janneke H. H. M.; Altini, Lydia; Taylor, Sylvia M.; de Kock, Alana; Coetzee, Nicol; Williamson, Anna-Lise

    2007-01-01

    We assessed the agreement in detection of high-risk human papillomavirus (HPV), as well as specific HPV types, between self- and clinician-obtained specimens for 450 women over 18 years of age attending a community health center in Gugulethu, South Africa. Both self-collected swabs and tampons had

  15. Amphetamine-type stimulant use among men who have sex with men (MSM) in Vietnam : Results from a socio-ecological, community-based study

    NARCIS (Netherlands)

    Vu, Nga Thi Thu; Holt, Martin; Phan, Huong Thi Thu; Le, Huong Thi; La, Lan Thi; Tran, Gioi Minh; Doan, Tung Thanh; Nguyen, Trang Nhu Nguyen; de Wit, John

    2016-01-01

    INTRODUCTION: Amphetamine-type-stimulants (ATS) use is associated with HIV-related sexual risk behaviours and is an emergent problem among men who have sex with men (MSM) in Vietnam. The purpose of this study is to describe ATS use patterns and understand the correlates of recent methamphetamine use

  16. The Association between Left Verticle Diastolic Dysfunction and Endothelial Dysfunction and the Result of Stress Myocardial SPECT in Asymptomatic Patients with Type 2 Diabetes

    Czech Academy of Sciences Publication Activity Database

    Charvát, J.; Michalová, K.; Chlumský, J.; Valenta, Zdeněk; Kvapil, M.

    2005-01-01

    Roč. 33, - (2005), s. 473-482 ISSN 0300-0605 Institutional research plan: CEZ:AV0Z10300504 Keywords : coronary heart disease * type 2 diabetes mellitus * left ventricular diastolic dysfunction * left ventricular hyperthropy * stress myocardial SPECT Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 0.653, year: 2005

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

    NARCIS (Netherlands)

    Tak, S.R.; Hendrieckx, C.; Nefs, G.M.; Nyklicek, I.; Speight, J.; Pouwer, F.

    2015-01-01

    Although healthy food choices are important in the management of diabetes, making dietary adaptations is often challenging. Previous research has shown that people with type 2 diabetes are less likely to benefit from dietary advice if they tend to eat in response to emotions or external cues. Since

  18. The association of mindful parenting with glycemic control and quality of life in adolescents with Type 1 Diabetes : Results from Diabetes MILES—The Netherlands

    NARCIS (Netherlands)

    Serkel-Schrama, I.J.P.; de Vries, J.; Nieuwesteeg, A.M.; Pouwer, F.; Nyklíček, I.; Speight, J.; de Bruin, E.I.; Bögels, S.M.; Hartman, E.E.

    2016-01-01

    The objective of this study was to examine associations between the mindful parenting style of parents of adolescents (aged 12–18) with type 1 diabetes mellitus (T1DM), and the glycaemic control and quality of life (QoL) of the adolescents. Chronic health conditions, such as T1DM, that require

  19. Contribution of change in glycosylated haemoglobin to insulin-associated weight gain: results of a longitudinal study in type 2 diabetic patients

    NARCIS (Netherlands)

    Jansen, H.J.; Hendriks, J.C.M.; Galan, B.E. de; Penders, G.; Tack, C.J.J.; Vervoort, G.M.M.

    2011-01-01

    To investigate the contribution of glycosylated haemoglobin change (HbA1c) on body weight in patients with type 2 diabetes after start of insulin therapy. We analysed 122 individual weight-profiles in relation to the change in HbA1c per se in these patients up to 36 months after the start of insulin

  20. Adiposity Impacts Intrarenal Hemodynamic Function in Adults With Long-standing Type 1 Diabetes With and Without Diabetic Nephropathy: Results From the Canadian Study of Longevity in Type 1 Diabetes.

    Science.gov (United States)

    Bjornstad, Petter; Lovshin, Julie A; Lytvyn, Yuliya; Boulet, Genevieve; Lovblom, Leif E; Alhuzaim, Omar N; Farooqi, Mohammed A; Lai, Vesta; Tse, Josephine; Cham, Leslie; Orszag, Andrej; Scarr, Daniel; Weisman, Alanna; Keenan, Hillary A; Brent, Michael H; Paul, Narinder; Bril, Vera; Perkins, Bruce A; Cherney, David Z I

    2018-04-01

    Central adiposity is considered to be an important cardiorenal risk factor in the general population and in type 1 diabetes. We sought to determine the relationship between central adiposity and intrarenal hemodynamic function in adults with long-standing type 1 diabetes with and without diabetic nephropathy (DN). Patients with type 1 diabetes ( n = 66, duration ≥50 years) and age-/sex-matched control subjects ( n = 73) were studied. The cohort was stratified into 44 DN Resistors (estimated glomerular filtration rate [eGFR] >60 mL/min/1.73 m 2 and inulin [GFR INULIN ], effective renal plasma flow for p -aminohippuric acid [ERPF PAH ]) was measured. Afferent arteriolar resistance, efferent arteriolar resistance, renal blood flow, renal vascular resistance [RVR], filtration fraction, and glomerular pressure were derived from the Gomez equations. Fat and lean mass were quantified by DXA. Whereas measures of adiposity did not associate with GFR INULIN or ERPF PAH in healthy control subjects, trunk fat mass inversely correlated with GFR INULIN ( r = -0.46, P INULIN values in DN and DN Resistors, but the relationships between central adiposity and ERPF PAH and RVR were attenuated and/or reversed in patients with DN compared with DN Resistors. The adiposity-intrarenal hemodynamic function relationship may be modified by the presence of type 1 diabetes and DN, requiring further study of the mechanisms by which adiposity influences renal hemodynamic function. © 2018 by the American Diabetes Association.

  1. Three-Dimensional Coculture of Meniscal Cells and Mesenchymal Stem Cells in Collagen Type I Hydrogel on a Small Intestinal Matrix-A Pilot Study Toward Equine Meniscus Tissue Engineering.

    Science.gov (United States)

    Kremer, Antje; Ribitsch, Iris; Reboredo, Jenny; Dürr, Julia; Egerbacher, Monika; Jenner, Florien; Walles, Heike

    2017-05-01

    Meniscal injuries are the most frequently encountered soft tissue injuries in the equine stifle joint. Due to the inherent limited repair potential of meniscal tissue, meniscal injuries do not only affect the meniscus itself but also lead to impaired joint homeostasis and secondary osteoarthritis. The presented study compares 3D coculture constructs of primary equine mesenchymal stem cells (MSC) and meniscus cells (MC) seeded on three different scaffolds-a cell-laden collagen type I hydrogel (Col I gel), a tissue-derived small intestinal matrix scaffold (SIS-muc) and a combination thereof-for their qualification to be applied for meniscus tissue engineering. To investigate cell attachment of primary MC and MSC on SIS-muc matrix SEM pictures were performed. For molecular analysis, lyophilized samples of coculture constructs with different cell ratios (100% MC, 100% MSC, and 50% MC and 50% MSC, 20% MC, and 80% MSC) were digested and analyzed for DNA and GAG content. Active matrix remodeling of 3D coculture models was indicated by matrix metalloproteinases detection. For comparison of tissue-engineered constructs with the histologic architecture of natural equine menisci, paired lateral and medial menisci of 15 horses representing different age groups were examined. A meniscus phenotype with promising similarity to native meniscus tissue in its GAG/DNA expression in addition to Col I, Col II, and Aggrecan production was achieved using a scaffold composed of Col I gel on SIS-muc combined with a coculture of MC and MSC. The results encourage further development of this scaffold-cell combination for meniscus tissue engineering.

  2. Designation of the European Working Group on Legionella Infection (EWGLI) amplified fragment length polymorphism types of Legionella pneumophila serogroup 1 and results of intercentre proficiency testing Using a standard protocol

    DEFF Research Database (Denmark)

    Fry, N K; Bangsborg, Jette Marie; Bergmans, A

    2002-01-01

    Infections (EWGLI) AFLP types, (ii). describes the EWGLI AFLP types identified for the 130 strains in the EWGLI culture collection, and (iii). reports the results of a newly introduced international programme of proficiency testing. Following preliminary analysis of 20 epidemiologically unrelated isolates...... (recorded as AFLP type 001-016 or untypeable) was determined by participants with reference to these 16 AFLP types, either visually or using gel analysis software where available, and reported to the coordinating centre. Nine of the 12 strains, including an epidemiologically related pair and two pairs...

  3. Off-Label Use of Phosphodiesterase Type 5 Inhibitor Erectile Dysfunction Medication to Enhance Sex Among Gay and Bisexual Men in Australia: Results From the FLUX Study.

    Science.gov (United States)

    Hammoud, Mohamed A; Jin, Fengyi; Lea, Toby; Maher, Lisa; Grierson, Jeffrey; Prestage, Garrett

    2017-06-01

    be representative of all GBMs in Australia. GBMs who used an oral EDM in the previous 6 months often used it for recreational purposes, but many of those who used it on a weekly basis also might have used it for therapeutic reasons. GBMs often use EDMs to enhance their sexual experiences often in the context of intensive sex partying (which can include risky sexual behavior). Hammoud MA, Jin F, Lea T, et al. Off-Label Use of Phosphodiesterase Type 5 Inhibitor Erectile Dysfunction Medication to Enhance Sex Among Gay and Bisexual Men in Australia: Results From the FLUX Study. J Sex Med 2017;14:774-784. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  4. RESULTS OF ADMINISTRATION OF COMBINED VACCINE AGAINST DIPHTHERIA, PERTUSSIS, TETANUS, POLIOMYELITIS AND HAEMOPHILIC INFECTION TYPE B IN CHILDREN WITH CONCOMITANT DISEASES

    Directory of Open Access Journals (Sweden)

    N. F. Snegova

    2011-01-01

    Full Text Available The article summarizes data on methods and opportunities of frequently ailing children rehabilitation. Authors mark a leading role of vaccination against pneumotropic infections. Questions of successful interaction between doctor and frequently ailing child’s parents are highlighted. The observation of 94 children 3 months — 3 years old (patients had different types of initial immune insuffiiency, neurological pathology, recurrent obstructive bronchitis, or were included in group of frequently ailing children vaccinated with Pentaxim was performed. 94% of children showed asymptomatic postvaccinal period. Fever up to 39°C occurred in 2.3% of patients. Local reactions (diameter was not over 3–5 cm developed in 1.7% of children. There was no any case of postvaccinal complication. Evaluation of vaccine’s reactogenity proves its safety and reasonability in immunization against pertussis, diphtheria, tetanus, poliomyelitis, Haemophilis influenzae type b in children of different health state including those with concomitant diseases.

  5. Gender differences in disordered eating behaviors and body dissatisfaction among adolescents with type 1 diabetes: Results from diabetes MILES youth-Australia.

    Science.gov (United States)

    Araia, Emanuala; Hendrieckx, Christel; Skinner, Timothy; Pouwer, Frans; Speight, Jane; King, Ross M

    2017-10-01

    To examine gender differences in disordered eating behaviors (DEB) and body dissatisfaction in adolescents with type 1 diabetes. While evidence shows that female youth with type 1 diabetes are more prone to DEB compared to their peers without diabetes, little is known about male adolescents. In a national online survey, adolescents (13-19 years) with type 1 diabetes for ≥1 year completed the Diabetes Eating Problem Survey-Revised (DEPS-R), and the Body Mass Index Silhouette Matching Test (BMI-SMT) and items on binge eating and insulin omission. About 477 adolescents (mean age 16 years; 62% females) completed the DEPS-R and 431 the BMI-SMT. The DEPS-R total score was higher for females than males, with scores for females increasing with age. BMI, HbA 1c , insulin omission, and binge-eating frequency were associated moderately with DEPS-R for both genders. On the BMI-SMT, 88% of females wanted to be thinner. Of the males, 76% reported body dissatisfaction; however, only 43% expressed a desire for thinness with the remainder desiring a larger body size. DEPS-R was positively associated with the discrepancy between perceived actual and ideal body size for both genders. A large proportion of adolescents with type 1 diabetes, particularly females reported engaging in DEB. Similarly, high rates of body dissatisfaction were reported, though ideal body shape preferences differed by gender. Given the high levels of self-reported DEB and gender-based patterns of body dissatisfaction, future research needs to examine the effectiveness of routine screening of DEB and consider implementation of stepped care approaches. © 2017 Wiley Periodicals, Inc.

  6. A serum biomarker reflecting collagen type I degradation (C1M) is an independent risk factor for acute myocardial infarction in postmenopausal women: results from the PERF study

    DEFF Research Database (Denmark)

    Bertelsen, D.M.; Nielsen, Signe Holm; Neergaard, J.S.

    2017-01-01

    Cardiovascular disease (CVD) is the leading cause of death in postmenopausal women, and symptoms of ischemic heart disease (IHD) and acute myocardial infarction (AMI) are often overlooked. With the loss of estrogen production collagen stability is affected with potential of an increased risk of u...... of unstable plaques in coronary vessels. Collagen type I, a major component of the cardiac extracellular matrix (ECM), is cleaved by matrix metalloproteinases (MMPs) and known to be active remodeled in CVD....

  7. Born-Mayer type molybdenum-helium and helium-helium interaction potentials, fitted to the results of the helium desorption experiments

    International Nuclear Information System (INIS)

    Heugten, W.F.W.M. van; Veen, A. van; Caspers, L.M.

    1979-01-01

    Classes of Born-Mayer type Mo-He and He-He potentials have been derived from helium desorption experiments. The classes are described by linear relations between the Born-Mayer parameters A and b. For computer simulations the Mo-He potential phisub(MoHe)(r)=exp (6.5-3.63 r) and the He-He potential phisub(HeHe)(r)=exp(5.3-5.51 r) are proposed. (Auth.)

  8. Sex Differences in the Effect of Type 2 Diabetes on Major Cardiovascular Diseases: Results from a Population-Based Study in Italy

    Science.gov (United States)

    Greci, Marina; Manicardi, Valeria

    2017-01-01

    The aim of the study is to assess sex difference in association between type 2 diabetes and incidence of major cardiovascular events, that is, myocardial infarction, stroke, and heart failure, using information retrieved by diabetes register. The inhabitants of Reggio Emilia (Italy) aged 30–84 were followed during 2012–2014. Incidence rate ratios and 95% confidence intervals were calculated using multivariate Poisson model. The age- and sex-specific event rates were graphed. Subjects with type 2 diabetes had an excess risk compared to their counterparts without diabetes for all the three major cardiovascular events. The excess risk is similar in women and men for stroke (1.8 times) and heart failure (2.7 times), while for myocardial infarction, the excess risk in women is greater than the one observed in men (IRR 2.58, 95% CI 2.22–3.00 and IRR 1.78, 95% CI 1.60–2.00, resp.; P of interaction < 0.0001). Women had always a lesser risk than men, but in case of myocardial infarction, the women with type 2 diabetes lost part of advantage gained by women free of diabetes (IRR 0.61, 95% CI 0.53–0.72 and IRR 0.36, 95% CI 0.33–0.39, resp.). In women with type 2 diabetes, the risk of major cardiovascular events is anticipated by 20–30 years, while in men it is by 15–20. PMID:28316624

  9. The association of mindful parenting with glycemic control and quality of life in adolescents with Type 1 Diabetes: Results from Diabetes MILES—The Netherlands

    OpenAIRE

    Serkel-Schrama, I.J.P.; de Vries, J.; Nieuwesteeg, A.M.; Pouwer, F.; Nyklíček, I.; Speight, J.; de Bruin, E.I.; Bögels, S.M.; Hartman, E.E.

    2016-01-01

    The objective of this study was to examine associations between the mindful parenting style of parents of adolescents (aged 12?18) with type 1 diabetes mellitus (T1DM), and the glycaemic control and quality of life (QoL) of the adolescents. Chronic health conditions, such as T1DM, that require demanding treatment regimens, can negatively impact adolescents? quality of life. Therefore, it is important to determine whether mindful parenting may have a positive impact in these adolescents. Age, ...

  10. Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial

    OpenAIRE

    Rushing, J.; Wing, R.; Wadden, T. A.; Knowler, W. C.; Lawlor, M.; Evans, M.; Killean, T.; Montez, M.; Espeland, M. A.; Zhang, P.

    2017-01-01

    Summary Objective The Action for Health in Diabetes (Look AHEAD) trial was a randomized controlled clinical trial to compare the effects of 10?years of intensive lifestyle intervention (ILI) with a control condition of diabetes support and education (DSE) on health outcomes in over 5,000 participants with type 2 diabetes. The ILI had significantly greater weight losses than DSE throughout the trial. The goal of this analysis is to describe the cost of delivering the intervention. Methods The ...

  11. RESULTS OF ADMINISTRATION OF COMBINED VACCINE AGAINST DIPHTHERIA, PERTUSSIS, TETANUS, POLIOMYELITIS AND HAEMOPHILIC INFECTION TYPE B IN CHILDREN WITH CONCOMITANT DISEASES

    OpenAIRE

    N. F. Snegova; L. V. Pushko; T. Yu. Illarionova; O. A. Salkina; Yu. V. Smirnova

    2011-01-01

    The article summarizes data on methods and opportunities of frequently ailing children rehabilitation. Authors mark a leading role of vaccination against pneumotropic infections. Questions of successful interaction between doctor and frequently ailing child’s parents are highlighted. The observation of 94 children 3 months — 3 years old (patients had different types of initial immune insuffiiency, neurological pathology, recurrent obstructive bronchitis, or were included in group of frequentl...

  12. Cementless Total Hip Arthroplasty With a High Hip Center for Hartofilakidis Type B Developmental Dysplasia of the Hip: Results of Midterm Follow-Up.

    Science.gov (United States)

    Chen, Min; Luo, Zheng-Liang; Wu, Ke-Rong; Zhang, Xiao-Qi; Ling, Xiao-Dong; Shang, Xi-Fu

    2016-05-01

    Acetabular reconstruction in adults with Hartofilakidis type B developmental dysplasia of the hip is a major technical challenge. The purpose of this retrospective study was to evaluate hip function and radiographic outcomes regarding high hip center at midterm follow-up. From January 1, 2007 to December 31, 2009, 37 patients who had Hartofilakidis type B developmental dysplasia of the hip underwent a primary total hip arthroplasty using a high hip center technique. Functional, radiographic, and survivorship outcomes were evaluated. Of the 37 patients, 31 patients (83.8%) were available for the mean follow-up of 6.1 years (range, 1.5-7.6 years). Thirty-one cementless cups were located at an average vertical distance of 38.1 ± 3.3 mm and at a mean horizontal distance of 35.5 ± 3.4 mm. The mean ratio of the height of the hip center was 2.4% (range, 2.0%-2.9%). The Harris Hip Scores were improved from 50.3 points (range, 38-63 points) preoperatively to 92.3 points (range, 85-100 points) at the final follow-up (P hip center technique in conjunction with a cementless acetabular component seems to be a valuable alternative to achieve satisfactory midterm outcomes for Hartofilakidis type B developmental dysplasia of the hip. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. The impact of level of education on vascular events and mortality in patients with type 2 diabetes mellitus: Results from the ADVANCE study.

    Science.gov (United States)

    Blomster, J I; Zoungas, S; Woodward, M; Neal, B; Harrap, S; Poulter, N; Marre, M; Williams, B; Chalmers, J; Hillis, G S

    2017-05-01

    The relationship between educational level and the risk of all-cause mortality is well established, whereas the association with vascular events in individuals with type 2 diabetes is not well described. Any association may reflect a link with common cardiovascular or lifestyle-based risk factors. The relationships between the highest level of educational attainment and major cardiovascular events, microvascular complications and all-cause mortality were explored in a cohort of 11,140 individuals with type 2 diabetes. Completion of formal education before the age of 16 was categorized as a low level of education. Regional differences between Asia, East Europe and Established Market Economies were also assessed. During a median of 5years of follow up, 1031 (9%) patients died, 1147 (10%) experienced a major cardiovascular event and 1136 (10%) a microvascular event. After adjustment for baseline characteristics and risk factors, individuals with lower education had an increased risk of cardiovascular events (hazard ratio (HR) 1.31, 95% CI 1.16-1.48, peducation was weakest in Established Market Economies and strongest in East Europe. A low level of education is associated with an increased risk of vascular events and death in patients with type 2 diabetes, independently of common lifestyle associated cardiovascular risk factors. The effect size varies between geographical regions. Copyright © 2017. Published by Elsevier B.V.

  14. Lactic Acidosis in Diabetic Population: Is Metformin Implicated? Results of a Matched Case-Control Study Performed on the Type 2 Diabetes Population of Grenoble Hospital University.

    Science.gov (United States)

    Lepelley, Marion; Giai, Joris; Yahiaoui, Nassima; Chanoine, Sébastien; Villier, Céline

    2016-01-01

    To evaluate the strength of association between lactic acidosis (LA) and well-recognized risk factors for LA, particularly the weight of metformin. This study is a matched case-control analysis concerning the type 2 diabetes population from Grenoble Hospital University. Cases of LA were defined biologically with pH 5 mmol/L. They were matched to 2 controls defined as type 2 diabetic inpatients who did not present a LA during the study period. We performed a conditional logistic regression. We included 302 cases and 604 controls; mean age was 69.5 years (SD 11.93). Intercurrent diseases were significantly associated with LA. Chronic medical conditions had a minor impact on LA incidence, except hepatocellular dysfunction. Metformin was significantly associated with a higher LA probability in case of acute kidney injury (AKI) (OR = 1.79; p value = 0.020) but not in patients without AKI. According to this study, metformin, compared to acute medical conditions, seemed not to be associated with LA in patients with type 2 diabetes; however in case of AKI, metformin may be associated with LA.

  15. Preliminary comparative assessment of PM10 hourly measurement results from new monitoring stations type using stochastic and exploratory methodology and models

    Science.gov (United States)

    Czechowski, Piotr Oskar; Owczarek, Tomasz; Badyda, Artur; Majewski, Grzegorz; Rogulski, Mariusz; Ogrodnik, Paweł

    2018-01-01

    The paper presents selected preliminary stage key issues proposed extended equivalence measurement results assessment for new portable devices - the comparability PM10 concentration results hourly series with reference station measurement results with statistical methods. In article presented new portable meters technical aspects. The emphasis was placed on the comparability the results using the stochastic and exploratory methods methodology concept. The concept is based on notice that results series simple comparability in the time domain is insufficient. The comparison of regularity should be done in three complementary fields of statistical modeling: time, frequency and space. The proposal is based on model's results of five annual series measurement results new mobile devices and WIOS (Provincial Environmental Protection Inspectorate) reference station located in Nowy Sacz city. The obtained results indicate both the comparison methodology completeness and the high correspondence obtained new measurements results devices with reference.

  16. [From research to medical advice: prescription of physical activity to 1,005 subjects with type 2 diabetes mellitus by 48 family doctors. Results].

    Science.gov (United States)

    Foglietta, Fosco; Buriani, Orazio; Casaroli, Claudio; De Togni, Aldo; Pasetti, Paolo; Conconi, Francesco

    2013-01-01

    to involve a group of general practitioners (GPs) in a programme for prescribing physical activity (PhA) for patients with type 2 diabetes; to document, for each patient, the amount of physical activity carried out and the modifications in biomedical variables and in the medical expenses possibly occurring after the PhA programme. 48 GPs joined the project. The beneficial effects of regular PhA on diabetes were presented to each patient enrolled. Walking daily for at least 15 minutes was suggested. A booklet with specific instructions and a step meter were given to each patient. Diet programmes were not modified. average daily PhA; values of Body Mass Index (BMI), waist circumference, systolic and diastolic blood pressure, blood glucose and HbA1c, blood cholesterol (total, LDL, HDL) and triglycerides determined before and at the end of the programme; pharmaceutical expenses attributed to the enrolled patients in 2008 (the year preceding the PhA programme) and in 2010 (the year of end of the PhA programme). of the 1,005 patients enrolled, 766 indicated their daily PhA. In all patients, and especially in those who presented values outside the norm in the variables considered at the start of the programme, improvements up to normalization were observed. A reduction in pharmaceutical expenses proportional to the PhA carried out was documented in the more active group of patients, who walked 1 km or more daily. the domiciliary PhA recommended by 48 GPs for 1,005 patients with type 2 diabetes enrolled in the programme was carried out by 766 subjects. The biomedical improvements and the reduction in pharmaceutical expenses, proportional to the PhA carried out, are in keeping with other reports in the literature. The major finding of this project is that GPs can effectively prescribe PhA to their patients who suffer form sport-sensitive diseases, such as type 2 diabetes.

  17. Increased skin autofluorescence of children and adolescents with type 1 diabetes despite a well-controlled HbA1c: results from a cohort study.

    Science.gov (United States)

    van der Heyden, Josine C; Birnie, Erwin; Mul, Dick; Bovenberg, Sarah; Veeze, Henk J; Aanstoot, Henk-Jan

    2016-09-09

    Early identification of children and adolescents with type 1 diabetes at high risk for development of complications is important, as early intervention may prevent further deterioration. Here we investigate the applicability of assessing skin advanced glycation end products (sAGEs) by skin autofluorescence (SAF) as a potential surrogate risk marker. This study included a cross-sectional analysis of SAF in 77 patients with type 1 diabetes mellitus and 118 healthy controls across age categories (11-12, 13-14, 15-16, and 17-19 years old). In patients, the impact of current and historical glycated hemoglobin (HbA1c) values, age, and duration of diabetes on SAF was studied in a retrospective cohort study and analyzed with multivariable analyses. SAF was significantly and similarly higher in patients when compared with controls across all age categories (P ≤0.009). For patients, age, duration of diabetes, and current and historical HbA1c were associated with SAF in univariate analysis. Multivariate analysis showed no association between HbA1c and SAF. A subgroup of patients with a HbA1c-within-target (≤7.5 %/59 mmol/mol) were observed to have high SAF. Children and adolescents with type 1 diabetes show higher SAF than controls. The presumed correlation of high HbA1c with high SAF does not exist in all patients. Thus, use of this non-invasive measure may provide a surrogate marker for diabetic complications, additional to HbA1c.

  18. A candidate type 2 diabetes polymorphism near the HHEX locus affects acute glucose-stimulated insulin release in European populations: results from the EUGENE2 study

    DEFF Research Database (Denmark)

    Staiger, Harald; Stancáková, Alena; Zilinskaite, Jone

    2008-01-01

    OBJECTIVE: In recent genome-wide association studies, two single nucleotide polymorphisms (SNPs) near the HHEX locus were shown to be more frequent in type 2 diabetic patients than in control subjects. Based on HHEX's function during embryonic development of the ventral pancreas in mice, we....... By contrast, the minor A-allele of HHEX SNP rs7923837 was significantly associated with higher IVGTT-derived first-phase insulin release before and after appropriate adjustment (P = 0.013 and P = 0.014, respectively). CONCLUSIONS: A common genetic variation in the 3'-flanking region of the HHEX locus, i...

  19. Plant-Based Dietary Patterns and Incidence of Type 2 Diabetes in US Men and Women: Results from Three Prospective Cohort Studies.

    OpenAIRE

    Ambika Satija; Shilpa N Bhupathiraju; Eric B Rimm; Donna Spiegelman; Stephanie E Chiuve; Lea Borgi; Walter C Willett; JoAnn E Manson; Qi Sun; Frank B Hu

    2016-01-01

    Background: Plant-based diets have been recommended to reduce the risk of type 2 diabetes (T2D). However, not all plant foods are necessarily beneficial. We examined the association of an overall plant-based diet and hypothesized healthful and unhealthful versions of a plant-based diet with T2D incidence in three prospective cohort studies in the US. Methods and Findings: We included 69,949 women from the Nurses’ Health Study (1984–2012), 90,239 women from the Nurses’ Health Study 2 (1991–201...

  20. Traveling-wave solutions of a modified Hodgkin-Huxley type neural model via Novel analytical results for nonlinear transmission lines with arbitrary I(V) characteristics

    OpenAIRE

    Valentino Anthony Simpao

    2000-01-01

    Herein an enhanced Hodgkin-Huxley (H-H) type model of neuron dynamics is solved analytically via formal methods. Our model is a variant of an earlier one by M.A. Mahrous and H.Y. Alkahby [1]. Their modified model is realized by a hyperbolic quasi-linear diffusion operator with time-delay parameters; this compared to the original H-H model with standard parabolic quasi-linear diffusion operator and no time-delay parameters. Besides these features, the present model also incorporates terms desc...

  1. Klebsiella Typing

    DEFF Research Database (Denmark)

    Hansen, D S; Skov, R; Benedí, J.V.

    2002-01-01

    unit (NICU) were K-typed by countercurrent immunoelectrophoresis (CCIE), O-typed by an inhibition enzyme-linked immunosorbent assay method, and typed by pulsed-field gel electrophoresis (PFGE) using the restriction enzyme XbaI. RESULTS: Typing data for the 104 bacteremia isolates were compared......OBJECTIVE: To compare pulsed-field gel electrophoresis (PFGE) typing and O:K-serotyping of Klebsiella in two different epidemiological settings. METHODS: One hundred and four bacteremia isolates without known epidemiological relation and 47 isolates from an outbreak in a neonatal intensive care...

  2. Adolescent Scoliosis 1A001: Radiographic Results of Selecting the Touched Vertebra as the Lowest Instrumented Vertebra in Lenke Type 1 (Main Thoracic) & Type 2 (Double Thoracic) Curves at a Minimum 5-year Follow-up

    OpenAIRE

    Lenke, Lawrence; Newton, Peter; Lehman, Ronald; Kelly, Michael; Clements, David; Errico, Thomas; Betz, Randall; Samdani, Amer; Blanke, Kathy; Oggiano, Leonardo; Sessa, Sergio; Rosa, Guido La; Guler, Umit Ozgur; Ozalay, Metin; Eyvazov, Kamil

    2017-01-01

    Introduction: A prior study showed the touched vertebra (TV), defined as the most cephalad thoracolumbar/lumbar vertebra “touched” by the center sacral vertical line (CSVL), as a potential landmark vertebra & recommended lowest instrumented vertebra (LIV) as well. We evaluated a large cohort of Lenke type 1 & 2 cases to determine if selecting the TV as the LIV will produce optimal positioning at a min. 5 yrs postoperative. Our hypothesis was that it would and that fusing short of the TV would...

  3. "Act on Threes" Paradigm for Treatment Intensification of Type 2 Diabetes in Managed Care: Results of a Randomized Controlled Study with an Educational Intervention Targeting Improved Glycemic Control.

    Science.gov (United States)

    Bieszk, Nella; Reynolds, Shannon L; Wei, Wenhui; Davis, Cralen; Kamble, Pravin; Uribe, Claudia

    2016-09-01

    Clinical inertia, which has been defined as the recognition of a problem with a patient's management but failing to act, is a concern in type 2 diabetes (T2D) because it places the patient at risk of diabetes-related complications. Despite managed care organizations making significant investment in this area, little is known about the impact of educational programs aimed at aligning patients and their physicians with diabetes guidelines and thus overcoming clinical inertia. To assess the impact of an educational intervention specifically designed to align patients and their physicians with 2012 American Diabetes Association (ADA) guidelines on glycated hemoglobin (A1c) testing frequency and insulin initiation. The "Act on Threes" educational intervention was a 12-month, randomized controlled prospective study that included Medicare Advantage patients aged 18-85 years with T2D, who received ≥ 3 oral antidiabetes drugs (OADs) and/or had A1c not at goal and/or had no recent A1c evaluation over 12 months, as identified through the analysis of administrative claims data (May 1, 2011-April 30, 2013) from the Humana database. Identified patients were randomized 3:1 to receive the Act on Threes educational intervention in conjunction with standard care (intervention group) or standard care alone (control group). For the educational intervention, patients and physicians were simultaneously mailed general and targeted information aimed at aligning them to 3 vital aspects of A1c control: timely measurement of A1c every 3 months; timely treatment intensification to meet A1c goals with treatment intensification every 3 months if A1c is not at goal; and insulin initiation when appropriate, including patients receiving ≥ 3 OADs with A1c not at goal. Control patients were only enrolled if the treating physician was not involved in the care of any patients in the intervention group. The primary outcome measures were A1c testing frequency based on the ADA standard for compliance

  4. Knowledge, attitudes and perceptions of people with type 2 diabetes as related to self-management practices: Results of a cross-sectional study conducted in Luzon, Philippines.

    Science.gov (United States)

    Ku, Grace Marie V; Kegels, Guy

    2015-06-01

    This study measured factors that could be associated with self-management practices of people with type 2 diabetes from two different health systems in the Philippines in terms of diabetes knowledge, attitudes, perceptions of support and self-efficacy, and obesity/adiposity. Knowledge, attitudes, perceptions, obesity/adiposity measures, adherence to medications, diabetes diet, and exercise and the number of diabetes consultations of people with type 2 diabetes utilizing services of two different health systems were collected. Analysis of variance was used to determine differences in knowledge, attitudes, perceptions, obesity/adiposity, and demographic characteristics according to: proper/under-utilization of services; adherence/non-adherence to medications, diet and exercise; high/low perceived self-efficacy; and the health systems. Logistic regression was done to identify any associations with obesity/adiposity, self-management practices, and perceived self-efficacy. There were 549 respondents. Differences in knowledge, attitudes, perceptions, and some demographic characteristics between the two health systems and between those with high/low self-efficacy perceptions were significant. Perceived self-efficacy was significantly associated with all four self-management practices. People consulting at the health service with a more supportive system had better perceived self-efficacy and self-care behavior. Higher knowledge, attitude, and perception scores were noted among those with better self-efficacy perceptions, which was associated with better self-care behavior. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  5. Response to desmopressin is influenced by the genotype and phenotype in type 1 von Willebrand disease (VWD): results from the European Study MCMDM-1VWD

    DEFF Research Database (Denmark)

    Castaman, G.; Lethagen, S.; Federici, A.B.

    2008-01-01

    %; and no response in 4%. Patients with some abnormality of VWF multimeric pattern had significantly lower basal FVIII:C and VWF, lower VWF:RCo/Ag ratio, and less complete responses to desmopressin than patients with a normal multimeric pattern (P=.002). Patients with mutations at codons 1130 and 1205 in the D'-D3......We have prospectively evaluated the biologic response to desmopressin in 77 patients with type 1 von Willebrand disease (VWD) enrolled within the Molecular and Clinical Markers for the Diagnosis and Management of type 1 VWD project. Complete response to desmopressin was defined as an increase...... of both ristocetin cofactor activity (VWF:RCo) and factor VIII coagulant activity (FVIII:C) to 50 IU/dL or higher and partial response as VWF:RCo or FVIII:C lower than 50 IU/dL after infusion, but at least 3-fold the basal level. Complete response was observed in 83% of patients; partial in 13...

  6. The venous thrombotic risk of oral contraceptives, effects of oestrogen dose and progestogen type: results of the MEGA case-control study

    Science.gov (United States)

    van Hylckama Vlieg, A; Helmerhorst, F M; Vandenbroucke, J P; Doggen, C J M

    2009-01-01

    Objective To assess the thrombotic risk associated with oral contraceptive use with a focus on dose of oestrogen and type of progestogen of oral contraceptives available in the Netherlands. Design Population based case-control study. Setting Six participating anticoagulation clinics in the Netherlands (Amersfoort, Amsterdam, The Hague, Leiden, Rotterdam, and Utrecht). Participants Premenopausal women gestodene (5.6, 3.7 to 8.4), 7.3-fold for desogestrel (7.3, 5.3 to 10.0), 6.8-fold for cyproterone acetate (6.8, 4.7 to 10.0), and 6.3-fold for drospirenone (6.3, 2.9 to 13.7). The risk of venous thrombosis was positively associated with oestrogen dose. We confirmed a high risk of venous thrombosis during the first months of oral contraceptive use irrespective of the type of oral contraceptives. Conclusions Currently available oral contraceptives still have a major impact on thrombosis occurrence and many women do not use the safest brands with regard to risk of venous thrombosis. PMID:19679614

  7. Plasma Cholesteryl Ester Fatty Acids do not Mediate the Association of Ethnicity with Type 2 Diabetes: Results From the HELIUS Study.

    Science.gov (United States)

    Muilwijk, Mirthe; Celis-Morales, Carlos; Nicolaou, Mary; Snijder, Marieke B; Gill, Jason M R; van Valkengoed, Irene G M

    2018-01-01

    Ethnic minority groups have a higher risk of type 2 diabetes (T2D) than the host population. Our aim is to identify whether plasma cholesteryl ester fatty acids (CEFA) mediate the ethnic differences in type 2 diabetes. We included 202 Dutch, 206 South-Asian Surinamese, 205 African Surinamese, 215 Turkish, and 213 Moroccan origin participants of the HELIUS study (Amsterdam, the Netherlands). Logistic regression is used to determine the associations between plasma CEFA and T2D. Mediation analysis is used to identify whether CEFA contributed to the association between ethnicity and T2D. We adjusted for ethnicity, age, sex, smoking, physical activity, and BMI. Associations between plasma CEFA and T2D were similar across all ethnic groups. Although differences in plasma CEFA across ethnic groups were observed, CEFA did not mediate the differences in T2D prevalence between ethnic groups. Although ethnic differences in plasma CEFA are found and CEFA are associated with T2D, CEFA does not contribute to the difference in T2D prevalence between ethnic groups. If confirmed, this implies that maintenance of the more beneficial CEFA profiles in the non-Dutch ethnic groups may be encouraged to prevent an even higher prevalence of T2D in these groups. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. Results of the ANCHOR prospective, multicenter registry of EndoAnchors for type Ia endoleaks and endograft migration in patients with challenging anatomy.

    Science.gov (United States)

    Jordan, William D; Mehta, Manish; Varnagy, David; Moore, William M; Arko, Frank R; Joye, James; Ouriel, Kenneth; de Vries, Jean-Paul

    2014-10-01

    Proximal attachment site complications continue to occur after endovascular repair of abdominal aortic aneurysms (EVAR), specifically type Ia endoleak and endograft migration. EndoAnchors (Aptus Endosystems, Sunnyvale, Calif) were designed to enhance endograft proximal fixation and sealing, and the current study was undertaken to evaluate the potential benefit of this treatment. During the 23-month period ending in December 2013, 319 subjects were enrolled at 43 sites in the United States and Europe. EndoAnchors were implanted in 242 patients (75.9%) at the time of an initial EVAR procedure (primary arm) and in 77 patients with an existing endograft and proximal aortic neck complications (revision arm). Technical success was defined as deployment of the desired number of EndoAnchors, adequate penetration of the vessel wall, and absence of EndoAnchor fracture. Procedural success was defined as technical success without a type Ia endoleak at completion angiography. Values are expressed as mean ± standard deviation and interquartile range. The 238 male (74.6%) and 81 female (25.4%) subjects had a mean age of 74.1 ± 8.2 years. Aneurysms averaged 58 ± 13 (51-63) mm in diameter at the time of EndoAnchor implantation (core laboratory measurements). The proximal aortic neck averaged 16 ± 13 (7-23) mm in length (42.7% <10 mm and 42.7% conical) and 27 ± 4 mm (25-30 mm) in diameter; infrarenal neck angulation was 24 ± 15 (13-34) degrees. The number of EndoAnchors deployed was 5.8 ± 2.1 (4-7). Technical success was achieved in 303 patients (95.0%) and procedural success in 279 patients (87.5%), 217 of 240 (89.7%) and 62 of 77 (80.5%) in the primary and revision arms, respectively. There were 29 residual type Ia endoleaks (9.1%) at the end of the procedure. During mean follow-up of 9.3 ± 4.7 months, 301 patients (94.4%) were free from secondary procedures. Among the 18 secondary procedures, eight were performed for residual type Ia endoleaks and the others

  9. Chronic migraine and chronic tension-type headache are associated with concomitant low back pain: results of the German Headache Consortium study.

    Science.gov (United States)

    Yoon, Min-Suk; Manack, Aubrey; Schramm, Sara; Fritsche, Guenther; Obermann, Mark; Diener, Hans-Christoph; Moebus, Susanne; Katsarava, Zaza

    2013-03-01

    The objective of this study was to evaluate the association between low and frequent low back pain and chronic migraine (CM) and chronic tension-type headache (CTTH) in a large, German population-based sample. Headaches were diagnosed according to International Classification of Headache Disorders-2 criteria and categorized according to frequency (episodic 1-14 days/month or chronic ≤15 days/month) and headache type (migraine or TTH). We defined frequent low back pain as self-reported low back pain on ≥15 days/month. We calculated odds ratios and 95% confidence intervals (CI) using logistic regression analyses, adjusting for sociodemographic covariates. There were 5605 respondents who reported headache in the previous year, of whom 255 (4.5%) had Chronic Headache. Migraine was diagnosed in 2933 respondents, of whom 182 (6.2%) had CM. TTH was diagnosed in 1253 respondents, of whom 50 (4.0%) had CTTH. Among 9944 respondents, 6030 reported low back pain, of whom 1267 (21.0%) reported frequent low back pain. In adjusted models, the odds of having frequent low back pain were between 2.1 (95% CI 1.7-2.6) and 2.7 (95% CI 2.3-3.2) times higher in all episodic headache subtypes when compared to No Headache. The odds of having frequent low back pain were between 13.7 (95% CI 7.4-25.3) and 18.3 (95% CI 11.9-28.0) times higher in all chronic headache subtypes when compared to No Headache. Low and frequent low back pain was associated with CM and CTTH. Multiple explanations may contribute to the association of headache and back pain, including the notion that the neurobiology of chronic headache, independent of primary headache type, not only involves the trigeminal pain pathway, but is also a part of abnormal general pain processing. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  10. Prevalence of elevated C-reactive protein among newly diagnosed type 2 diabetes patients in Denmark: Results from the population-based DD2 study

    DEFF Research Database (Denmark)

    Thomsen, Reimar W.; Mor, Anil; Rungby, Jørgen

    Objectives: Levels of high-sensitivity C-reactive protein (CRP) are increased in patients with prevalent type 2 diabetes (T2D) and may predict coronary heart disease. There is limited knowledge of CRP levels among newly diagnosed T2D patients in the population-based setting. We determined.......01), higher fasting blood glucose (7.26 vs. 6.82 mmol/L, ptreatment (7.7% vs. 5.0%, prevalence ratio 1.54 (95% CI: 0.96-2.13). Blood pressure, lipids, and current smoking were similar between groups. Patients with high...... the prevalence of elevated CRP in T2D patients included in the Danish DD2 study, and factors associated with such elevation. Methods: Measurements of CRP were performed in the first 1,036 T2D patients included in the DD2 project, a large nationwide prospective research project enrolling new T2D patients from...

  11. Aniracetam (Ro 13-5057) in the treatment of senile dementia of Alzheimer type (SDAT): results of a placebo controlled multicentre clinical study.

    Science.gov (United States)

    Senin, U; Abate, G; Fieschi, C; Gori, G; Guala, A; Marini, G; Villardita, C; Parnetti, L

    1991-12-01

    One hundred and nine elderly patients suffering from mild to moderate cognitive impairment fulfilling NINCDS-ADRDA criteria for probable dementia of the Alzheimer type were treated for 6 months with a new nootropic drug, aniracetam (Ro 13-5057) in a double-blind randomized study versus placebo. The two treatment groups were comparable at baseline for demographic and behaviourial parameters and symptomatology. Patients underwent clinical, behaviourial and psychometric evaluation every other month. The aniracetam group differed significantly from the placebo group by the end of the study and also showed a statistically significant improvement versus baseline in the psychobehavioural parameters, while in the placebo group a steady deterioration was observed. Tolerability to aniracetam was excellent.

  12. Impact of intensive lifestyle intervention on preference-based quality of life in type 2 diabetes: Results from the Look AHEAD trial.

    Science.gov (United States)

    Zhang, Ping; Hire, Don; Espeland, Mark A; Knowler, William C; Thomas, Sheikilya; Tsai, Adam G; Glick, Henry A

    2016-04-01

    To assess the effect of an intensive lifestyle intervention (ILI) compared with standard diabetes support and education (DSE) on preference-based health-related quality of life (HRQOL) in persons with overweight or obesity and type 2 diabetes. Look AHEAD was a multisite, randomized trial of 5,145 participants assigned to ILI or DSE. Four instruments were administered during the trial: Feeling Thermometer (FT), Health Utilities Index Mark 2 (HUI2), Health Utilities Index Mark 3 (HUI3), and Short Form 6D (SF-6D). Linear mixed effect models were used to estimate the mean difference in preference scores by treatment group for 9 years. The ILI had higher mean FT (0.019, 95% CI, 0.015-0.024, P < 0.001) and SF-6D (0.011, 95% CI, 0.006-0.014, P < 0.001) scores than the DSE. No significant group differences were observed for the HUI2 (0.004, 95% CI, -0.003 to 0.010, P = 0.23) and HUI3 (0.004, -0.004 to 0.012, P = 0.36). In year 1, the ILI had higher mean preference scores for all instruments. Thereafter, the increases remained significant only for FT and SF-6D, and the effects also become smaller. ILI aimed at reducing body weight among persons with overweight or obesity and type 2 diabetes improves preference-based HRQOL in the short term, but its long-term effect is unclear. © 2016 The Obesity Society.

  13. Skin autofluorescence is associated with carotid intima-media thickness, diabetic microangiopathy, and long-lasting metabolic control in type 1 diabetic patients. Results from Poznan Prospective Study.

    Science.gov (United States)

    Araszkiewicz, Aleksandra; Naskret, Dariusz; Zozulinska-Ziolkiewicz, Dorota; Pilacinski, Stanislaw; Uruska, Aleksandra; Grzelka, Agata; Wegner, Malgorzata; Wierusz-Wysocka, Bogna

    2015-03-01

    Our aim was to assess the association between skin autofluorescence (AF) related to advanced glycation end products (AGEs) accumulation and long-term metabolic control, microvascular complications and carotid intima-media thickness (IMT) in an observational cohort of type 1 diabetes (DM1). The analysis included 77 patients with DM1 (28 women and 49 men) aged 38 (IQR: 34-41), diabetes duration 15 (14-17), participating in Poznan Prospective Study (PoProStu). Skin AF was measured with AGE Reader (DiagnOptics). We found 50% of any microvascular complication; 37% of retinopathy, 37% of diabetic kidney disease and 22% of distal symmetrical neuropathy. Median carotid IMT was 0.57 (0.52-0.67) mm and skin AF 2.2 (IQR: 1.9-2.6). We found positive correlation between skin AF and patients' age (r=0.31, p=0.006), mean HbA1c from the observation time (r=0.35, p=0.001) and IMT (r=0.39, pmultivariate logistic regression presence of microvascular complications was independently associated with skin AF: for retinopathy (OR 3.49; 95% CI: 1.08-11.28, p=0.03), for diabetic kidney disease (OR 3.62; 95% CI: 1.16-11.28, p=0.02), for neuropathy (OR 5.01; 95% CI: 1.21-20.77, p=0.02) and for any microangiopathy (OR 3.13; 95% CI: 1.06-9.18, p=0.03). Skin AF is a reliable marker of past glycemic control of diabetes. Increased accumulation of AGEs is related to the presence of diabetic microangiopathy as well as subclinical macroangiopathy in patients with type 1. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Vaccinations in early life are not associated with development of islet autoimmunity in type 1 diabetes high-risk children: Results from prospective cohort data.

    Science.gov (United States)

    Beyerlein, Andreas; Strobl, Andreas N; Winkler, Christiane; Carpus, Michaela; Knopff, Annette; Donnachie, Ewan; Ankerst, Donna P; Ziegler, Anette-G

    2017-03-27

    Vaccinations in early childhood potentially stimulate the immune system and may thus be relevant for the pathogenesis of autoimmune diseases such as type 1 diabetes (T1D). We determined the association of vaccination burden with T1D-associated islet autoimmunity in children with high familial risk followed prospectively from birth. A total of 20,570 certified vaccination records from 1918 children were correlated with time to onset of T1D-associated islet autoimmunity using Cox regression, considering multiple time periods up until age two years and vaccination types, and adjusting for HLA genotype, sex, delivery mode, season of birth, preterm delivery and maternal T1D status. Additionally, prospective claims data of 295,420 subjects were used to validate associations for the tick-borne encephalitis (TBE) vaccination. Most vaccinations were not associated with a significantly increased hazard ratio (HR) for islet autoimmunity (e.g. HR [95% confidence interval]: 1.08 [0.96-1.21] per additional vaccination against measles, mumps and rubella at age 0-24months). TBE vaccinations within the first two years of life were nominally associated with a significantly increased autoimmunity risk (HR: 1.44 [1.06-1.96] per additional vaccination at age 0-24months), but this could not be confirmed with respect to outcome T1D in the validation cohort (HR: 1.02 [0.90-1.16]). We found no evidence that early vaccinations increase the risk of T1D-associated islet autoimmunity development. The potential association with early TBE vaccinations could not be confirmed in an independent cohort and appears to be a false positive finding. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. EFFECTS OF COOPERATIVE LEARNING MODEL TYPE STAD JUST-IN TIME BASED ON THE RESULTS OF LEARNING TEACHING PHYSICS COURSE IN PHYSICS SCHOOL IN PHYSICS PROGRAM FACULTY UNIMED

    Directory of Open Access Journals (Sweden)

    Teguh Febri Sudarma

    2013-06-01

    Full Text Available Research was aimed to determine: (1 Students’ learning outcomes that was taught with just in time teaching based STAD cooperative learning method and STAD cooperative learning method (2 Students’ outcomes on Physics subject that had high learning activity compared with low learning activity. The research sample was random by raffling four classes to get two classes. The first class taught with just in time teaching based STAD cooperative learning method, while the second class was taught with STAD cooperative learning method. The instrument used was conceptual understanding that had been validated with 7 essay questions. The average gain values of students learning results with just in time teaching based STAD cooperative learning method 0,47 higher than average gain values of students learning results with STAD cooperative learning method. The high learning activity and low learning activity gave different learning results. In this case the average gain values of students learning results with just in time teaching based STAD cooperative learning method 0,48 higher than average gain values of students learning results with STAD cooperative learning method. There was interaction between learning model and learning activity to the physics learning result test in students

  16. Gut hormone pharmacology of a novel GPR119 agonist (GSK1292263, metformin, and sitagliptin in type 2 diabetes mellitus: results from two randomized studies.

    Directory of Open Access Journals (Sweden)

    Derek J Nunez

    Full Text Available GPR119 receptor agonists improve glucose metabolism and alter gut hormone profiles in animal models and healthy subjects. We therefore investigated the pharmacology of GSK1292263 (GSK263, a selective GPR119 agonist, in two randomized, placebo-controlled studies that enrolled subjects with type 2 diabetes. Study 1 had drug-naive subjects or subjects who had stopped their diabetic medications, and Study 2 had subjects taking metformin. GSK263 was administered as single (25-800 mg; n = 45 or multiple doses (100-600 mg/day for 14 days; n = 96. Placebo and sitagliptin 100 mg/day were administered as comparators. In Study 1, sitagliptin was co-administered with GSK263 or placebo on Day 14 of dosing. Oral glucose and meal challenges were used to assess the effects on plasma glucose, insulin, C-peptide, glucagon, peptide tyrosine-tyrosine (PYY, glucagon-like peptide-1 (GLP-1 and glucose-dependent insulinotropic peptide (GIP. After 13 days of dosing, GSK263 significantly increased plasma total PYY levels by ∼ five-fold compared with placebo, reaching peak concentrations of ∼ 50 pM after each of the three standardized meals with the 300 mg BID dose. Co-dosing of GSK263 and metformin augmented peak concentrations to ∼ 100 pM at lunchtime. GSK263 had no effect on active or total GLP-1 or GIP, but co-dosing with metformin increased post-prandial total GLP-1, with little effect on active GLP-1. Sitagliptin increased active GLP-1, but caused a profound suppression of total PYY, GLP-1, and GIP when dosed alone or with GSK263. This suppression of peptides was reduced when sitagliptin was co-dosed with metformin. GSK263 had no significant effect on circulating glucose, insulin, C-peptide or glucagon levels. We conclude that GSK263 did not improve glucose control in type 2 diabetics, but it had profound effects on circulating PYY. The gut hormone effects of this GPR119 agonist were modulated when co-dosed with metformin and sitagliptin. Metformin may

  17. Tracing the Mass-Dependent Star Formation History of Late-Type Galaxies using X-ray Emission: Results from the CHANDRA Deep Fields

    Science.gov (United States)

    Lehmer, B.D; Brandt, W.N.; Schneider, D.P.; Steffen, A.T.; Alexander, D.M.; Bell, E.F.; Hornschemeier, A.E.; McIntosh, D.H.; Bauer, F.E.; Gilli, R.; hide

    2008-01-01

    We report on the X-ray evolution over the last approx.9 Gyr of cosmic history (i.e., since z = 1.4) of late-type galaxy populations in the Chandra Deep Field-North and Extended Chandra Deep Field-South (CDF-N and E-CDF-S. respectively; jointly CDFs) survey fields. Our late-type galaxy sample consists of 2568 galaxies. which were identified using rest-frame optical colors and HST morphologies. We utilized X-ray stacking analyses to investigate the X-ray emission from these galaxies, emphasizing the contributions from normal galaxies that are not dominated by active galactic nuclei (AGNs). Over this redshift range, we find significant increases (factors of approx. 5-10) in the X-ray-to-optical mean luminosity ratio (L(sub x)/L(sub B)) and the X-ray-to-stellar-mass mean ratio (L(sub x)/M(sub *)) for galaxy populations selected by L(sub B) and M(sub *), respectively. When analyzing galaxy samples selected via SFR, we find that the mean X-ray-to-SFR ratio (L(sub x)/SFR) is consistent with being constant over the entire redshift range for galaxies with SFR = 1-100 Solar Mass/yr, thus demonstrating that X-ray emission can be used as a robust indicator of star-formation activity out to z approx. 1.4. We find that the star-formation activity (as traced by X-ray luminosity) per unit stellar mass in a given redshift bin increases with decreasing stellar mass over the redshift range z = 0.2-1, which is consistent with previous studies of how star-formation activity depends on stellar mass. Finally, we extend our X-ray analyses to Lyman break galaxies at z approx. 3 and estimate that L(sub x)/L(sub B) at z approx. 3 is similar to its value at z = 1.4.

  18. Comparison of clinical and radiographic status around immediately loaded versus conventional loaded implants placed in patients with type 2 diabetes: 12- and 24-month follow-up results.

    Science.gov (United States)

    Al Amri, M D; Alfarraj Aldosari, A M; Al-Johany, S S; Al Baker, A M; Al Rifaiy, M Q; Al-Kheraif, A A

    2017-03-01

    There are no studies that have compared the clinical and radiographic status around immediately loaded (IL) and conventional loaded (CL) implants placed in patients with type 2 diabetes mellitus (T2DM). The aim was to compare the clinical and radiographic status around IL and CL implants placed in T2DM patients. One hundred and eight diabetic patients [55 with IL implants (Group 1) and 53 with CL implants (Group 2)] were included in this cross-sectional study. All implants were placed in healed sites in the maxillary and mandibular premolar and molar regions and supported single restorations. All patients underwent full mouth mechanical debridement biannually. Haemoglobin A1c (HbA1c) levels, clinical [bleeding on probing (BOP) and probing depth (PD) ≥ 4 mm] and radiographic [crestal bone loss (CBL)] peri-implant parameters were measured for both groups at 12- and 24-month follow-up. Group comparisons were performed using the Mann-Whitney U-test (P careful case selection, oral hygiene maintenance and glycaemic control is emphasised. © 2016 John Wiley & Sons Ltd.

  19. Intravitreal bevacizumab monotherapy for type-1 prethreshold, threshold, and aggressive posterior retinopathy of prematurity - 27 month follow-up results from Turkey.

    Science.gov (United States)

    Yetik, Huseyin; Gunay, Murat; Sirop, Sarkis; Salihoglu, Ziya

    2015-10-01

    To study the efficacy of intravitreal bevacizumab (IVB) injection as a single treatment for retinopathy of prematurity (ROP). This was a prospective interventional case series study performed in a clinical practice setting; a total of 122 patients including prethreshold (type 1) (n  = 79, 152 eyes, six unilateral), threshold (n = 12, 24 eyes), and aggressive posterior (APROP) (n = 31, 62 eyes); cases were included without any randomization or masking. A total of 253 IVB injections, 238 in the first session, 11 in the second session, and four in the third session were performed, and followed up for a mean of 89.155 ± 4.277 (range 82 to 105) weeks of postmenstrual age (PMA). Regression of ROP, maturation of the retina, and associated complications were evaluated. Total regression was achieved in 227/238 eyes (95.4 %) after the first dose injection. The remaining 11 received a second injection, after which an additional seven (234/238; 98.2 %) regressed; after the third injection, the remaining 4 (238/238; 100 %) regressed. Complete retinal vascular maturation was achieved without any significant complications in all of the cases. IVB injection as monotherapy seems to be a very effective treatment modality for ROP. Based on timely intervention, IVB as a single treatment modality can salvage almost all ROP cases before stage 4.

  20. Basal insulin initiation use and experience among people with type 2 diabetes mellitus with different patterns of persistence: results from a multi-national survey.

    Science.gov (United States)

    Perez-Nieves, Magaly; Ivanova, Jasmina I; Hadjiyianni, Irene; Zhao, Chen; Cao, Dachuang; Schmerold, Luke; Kalirai, Samaneh; King, Sarah; DeLozier, Amy M; Birnbaum, Howard G; Peyrot, Mark

    2017-10-01

    People with type 2 diabetes mellitus (T2DM) often interrupt basal insulin treatment soon after initiation. This study aimed to describe the experiences during and after basal insulin initiation among people with T2DM with different persistence patterns. Adults with T2DM from France, Germany, Spain, UK, US, Brazil, and Japan were identified from consumer panels for an online survey. Respondents who initiated basal insulin 3-24 months prior to survey date were categorized as continuers (no gaps of ≥7 days in insulin treatment); interrupters (first gap ≥7 days within 6 months of initiation and restarted insulin); and discontinuers (stopped insulin for ≥7 days within 6 months of initiation without restarting). Among 942 participants, continuers were older than interrupters and discontinuers (46, 37, and 38 years, respectively, p insulin initiation than interrupters and discontinuers, while interrupters had the most concerns. Continuers also reported fewer challenges during the first week of insulin use. Continuers were more likely to respond that insulin use had a positive impact on specific aspects of life than interrupters and discontinuers, for example on glycemic control (73.0%, 63.0%, and 61.8%, respectively; p insulin initiation there were significant differences in patient characteristics and experience during and after insulin initiation. Interrupters and discontinuers more frequently reported having concerns and challenges during the initiation process, negative impacts after initiation, and less improvement in glycemic control than continuers.

  1. Safety and effectiveness of insulin aspart in type 2 diabetic patients: results from the ASEAN cohort of the A₁chieve study.

    Science.gov (United States)

    Bebakar, Wan Mohamad Wan; Lim-Abrahan, Mary Anne; Jain, Ananá B; Seah, Darren; Soewondo, Pradana

    2013-04-01

    To examine the clinical safety and effectiveness of insulin aspart (IAsp) therapy in type 2 diabetes (T2D) patients from the ASEAN cohort of the international, 24-week, non-interventional A₁chieve study. T2D patients from Indonesia, Malaysia, Philippines and Singapore, who started IAsp therapy with or without oral glucose-lowering drugs, were included. The primary endpoint was the incidence of serious adverse drug reactions (SADRs), including major hypoglycaemic events. Secondary endpoints included hypoglycaemia, glycated haemoglobin A1c [HbA1c], fasting plasma glucose [FPG], postprandial plasma glucose [PPPG], systolic blood pressure [SBP], body weight and lipids. Quality of life (QoL) was assessed using the EQ-5D questionnaire. Overall, 312 T2D patients (222 insulin-naive and 90 insulin-experienced) with a mean ± SD age of 56.6 ± 11.2 years, BMI of 24.2 ± 3.9 kg/m(2) and diabetes duration of 7.0 ± 5.7 years were included. The mean daily IAsp dose was 0.51 ± 0.31 U/kg at baseline titrated up to 0.60 ± 0.29 U/kg at Week 24. No SADRs or major hypoglycaemic events were reported in the entire subgroup. The proportion of patients who reported overall hypoglycaemia decreased from baseline to Week 24 (7.1% vs. 0.3%, p ASEAN cohort. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Efficacy and safety of saxagliptin monotherapy or added to metformin in Chinese patients with type 2 diabetes mellitus: results from the 24-week, post-marketing SUNSHINE study.

    Science.gov (United States)

    Gu, Weiqiong; Liang, Li; Wang, Shengxiang; Wang, Yunzhi; Wu, Yanxiang; Tian, Jian; Yang, Gangyi; Piao, Chunli; Li, Yuzhong; Yin, Jianmei; Xin, Xiaoping; Tan, Xingrong; Ning, Guang; Wang, Weiqing

    2016-11-01

    The aim of the present study was to explore the efficacy and safety of saxagliptin in a large Chinese population with type 2 diabetes mellitus (T2DM). In all, 1423 T2DM patients from 92 research centers, either drug naïve or uncontrolled by metformin, were enrolled in this single-arm cohort study; patients were treated with saxagliptin 5 mg once daily for 24 weeks. The primary efficacy endpoint was the change from baseline in HbA1c at 24 weeks in the per-protocol analysis set. Secondary endpoints included the proportion of patients achieving HbA1c mass index, or treatment background. In elderly patients (≥65 years) and those with mild renal impairment (50 < CCr ≤ 80 mL/min), the incidence of AEs was similar to that of the entire study population. Saxagliptin significantly improved glycemic control and was well tolerated in Chinese T2DM patients, including the elderly and patients with mild renal impairment. © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  3. Effect of intensive lifestyle intervention on sexual dysfunction in women with type 2 diabetes: results from an ancillary Look AHEAD study.

    Science.gov (United States)

    Wing, Rena R; Bond, Dale S; Gendrano, Isaias Noel; Wadden, Thomas; Bahnson, Judy; Lewis, Cora E; Brancati, Frederick; Schneider, Stephen; Kitabchi, Abbas E; Van Dorsten, Brent; Rosen, Raymond C

    2013-10-01

    Sexual dysfunction is a prevalent problem in obese women with type 2 diabetes. This study examined the effects of intensive lifestyle intervention (ILI) in these women. Look AHEAD is a 16-center, randomized, controlled trial evaluating the health effects of ILI compared with a control group (diabetes support and education [DSE]). The Look AHEAD Sexual Function Ancillary study included 375 female participants at five Look AHEAD sites. Participants completed the Female Sexual Function Inventory (FSFI) and Beck Depression Inventory (BDI), and assessments of weight and cardiovascular risk factors at baseline and 1 year were made. At baseline, 50% of the 229 participants who reported being sexually active met criteria for female sexual dysfunction (FSD); only BDI score was related to FSD. One-year weight losses were greater in the ILI group than in the DSE group (7.6 vs. 0.45 kg; Pwomen with FSD at baseline, those in the ILI group (N=60) compared with those in the DSE group (N=53) were significantly more likely to remain sexually active (83 vs. 64%; P28 vs. 11%; Pwomen who did not have FSD at baseline. Participation in ILI appeared to have beneficial effects on sexual functioning among obese women with diabetes, particularly in those who had FSD at baseline.

  4. Physician-patient communication at diagnosis of type 2 diabetes and its links to patient outcomes: New results from the global IntroDia® study.

    Science.gov (United States)

    Polonsky, William H; Capehorn, Matthew; Belton, Anne; Down, Susan; Alzaid, Aus; Gamerman, Victoria; Nagel, Friedericke; Lee, Jisoo; Edelman, Steven

    2017-05-01

    To investigate patient experiences during the diagnosis of type 2 diabetes mellitus (T2DM), focusing on how physician-patient communication at diagnosis influences patients' psychosocial stress and subsequent self-management and outcomes. We surveyed adults with T2DM in 26 countries in a large cross-national study of physician-patient communication during early T2DM treatment (IntroDia®). The self-report questionnaire assessed retrospectively patient experiences during diagnosis conversations (focusing on 43 possible conversational elements, and communication quality) and potential effects on patient-reported outcomes. Data from 3628 people with T2DM who had been prescribed oral treatment at diagnosis were analysed. Exploratory factor analyses of the conversational elements yielded four coherent, meaningful factors: Encouraging (Cronbach's α=0.86); Collaborative (α=0.88); Recommending Other Resources (α=0.75); and Discouraging (α=0.72). Patient-perceived communication quality (PPCQ) at diagnosis was positively associated with Encouraging (β=+1.764, pcommunication at T2DM diagnosis may contribute to subsequent greater patient well-being and self-care, and may be enhanced by greater physician use of Collaborative and Encouraging conversation elements. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. The Added Value of Log File Analyses of the Use of a Personal Health Record for Patients With Type 2 Diabetes Mellitus: Preliminary Results.

    Science.gov (United States)

    Sieverink, Floor; Kelders, Saskia M; Braakman-Jansen, Louise M A; van Gemert-Pijnen, Julia E W C

    2014-03-01

    The electronic personal health record (PHR) is a promising technology for improving the quality of chronic disease management. Until now, evaluations of such systems have provided only little insight into why a particular outcome occurred. The aim of this study is to gain insight into the navigation process (what functionalities are used, and in what sequence) of e-Vita, a PHR for patients with type 2 diabetes mellitus (T2DM), to increase the efficiency of the system and improve the long-term adherence. Log data of the first visits in the first 6 weeks after the release of a renewed version of e-Vita were analyzed to identify the usage patterns that emerge when users explore a new application. After receiving the invitation, 28% of all registered users visited e-Vita. In total, 70 unique usage patterns could be identified. When users visited the education service first, 93% of all users ended their session. Most users visited either 1 or 5 or more services during their first session, but the distribution of the routes was diffuse. In conclusion, log file analyses can provide valuable prompts for improving the system design of a PHR. In this way, the match between the system and its users and the long-term adherence has the potential to increase. © 2014 Diabetes Technology Society.

  6. Alternative Mating Type Configurations (a/α versus a/a or α/α) of Candida albicans Result in Alternative Biofilms Regulated by Different Pathways

    Science.gov (United States)

    Srikantha, Thyagarajan; Huang, Guanghua; Garnaas, Adam M.; Soll, David R.

    2011-01-01

    Similar multicellular structures can evolve within the same organism that may have different evolutionary histories, be controlled by different regulatory pathways, and play similar but nonidentical roles. In the human fungal pathogen Candida albicans, a quite extraordinary example of this has occurred. Depending upon the configuration of the mating type locus (a/α versus a/a or α/α), C. albicans forms alternative biofilms that appear similar morphologically, but exhibit dramatically different characteristics and are regulated by distinctly different signal transduction pathways. Biofilms formed by a/α cells are impermeable to molecules in the size range of 300 Da to 140 kDa, are poorly penetrated by human polymorphonuclear leukocytes (PMNs), and are resistant to antifungals. In contrast, a/a or α/α biofilms are permeable to molecules in this size range, are readily penetrated by PMNs, and are susceptible to antifungals. By mutational analyses, a/α biofilms are demonstrated to be regulated by the Ras1/cAMP pathway that includes Ras1→Cdc35→cAMP(Pde2—|)→Tpk2(Tpk1)→Efg1→Tec1→Bcr1, and a/a biofilms by the MAP kinase pathway that includes Mfα→Ste2→ (Ste4, Ste18, Cag1)→Ste11→Hst7→Cek2(Cek1)→Tec1. These observations suggest the hypothesis that while the upstream portion of the newly evolved pathway regulating a/a and α/α cell biofilms was derived intact from the upstream portion of the conserved pheromone-regulated pathway for mating, the downstream portion was derived through modification of the downstream portion of the conserved pathway for a/α biofilm formation. C. albicans therefore forms two alternative biofilms depending upon mating configuration. PMID:21829325

  7. Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial.

    Science.gov (United States)

    Rushing, J; Wing, R; Wadden, T A; Knowler, W C; Lawlor, M; Evans, M; Killean, T; Montez, M; Espeland, M A; Zhang, P

    2017-03-01

    The Action for Health in Diabetes (Look AHEAD) trial was a randomized controlled clinical trial to compare the effects of 10 years of intensive lifestyle intervention (ILI) with a control condition of diabetes support and education (DSE) on health outcomes in over 5,000 participants with type 2 diabetes. The ILI had significantly greater weight losses than DSE throughout the trial. The goal of this analysis is to describe the cost of delivering the intervention. The ILI was designed to promote weight loss and increase physical activity. It involved a combination of group plus individual intervention sessions, with decreasing frequency of contact over the 10 years. The intervention incorporated a variety of strategies, including meal replacement products, to improve weight loss outcomes. The costs of intervention delivery were derived from staff surveys of effort and from records of intervention materials from the 16 US academic clinical trial sites. Costs were calculated from the payer perspective and presented in 2012 dollars. During the first year, when intervention delivery was most intensive, the annual cost of intervention delivery, averaged (standard deviation) across clinical sites, was $2,864.6 ($513.3) per ILI participant compared with $202.4 ($76.6) per DSE participant. As intervention intensity declined, costs decreased, such that from years 5 to 9 of the trial, the annual cost of intervention was $1,119.8 ($227.7) per ILI participant and $102.9 ($33.0) per DSE participant. Staffing accounted for the majority of costs throughout the trial, with meal replacements and materials to promote adherence accounting for smaller shares. The sustained weight losses produced by the Look AHEAD intervention were supported by intervention costs that were within the range of other weight loss programmes. Future work will include an evaluation of the cost-effectiveness of the ILI and will contain additional follow-up data.

  8. Role of Adipose Tissue Insulin Resistance in the Natural History of Type 2 Diabetes: Results From the San Antonio Metabolism Study.

    Science.gov (United States)

    Gastaldelli, Amalia; Gaggini, Melania; DeFronzo, Ralph A

    2017-04-01

    In the transition from normal glucose tolerance (NGT) to type 2 diabetes mellitus (T2DM), the role of β-cell dysfunction and peripheral insulin resistance (IR) is well established. However, the impact of dysfunctional adipose tissue has not been fully elucidated. The aim of this study was to evaluate the role of resistance to the antilipolytic effect of insulin (adipose tissue IR [Adipo-IR]) in a large group of subjects with NGT, impaired glucose tolerance (IGT), and T2DM. Three hundred two subjects with varying glucose tolerance received an oral glucose tolerance test (OGTT) and euglycemic insulin clamp. We evaluated Adipo-IR (fasting and mean OGTT plasma free fatty acid [FFA] × insulin concentrations), peripheral IR (1/[Matsuda index] and (M/I) -1 value), and β-cell function (calculated as the ratio of the increment in plasma insulin to glucose [OGTT/IR (ΔI/ΔG ÷ IR)]). Fasting Adipo-IR was increased twofold in obese subjects with NGT and IGT versus lean subjects with NGT (8.0 ± 1.1 and 9.2 ± 0.7 vs. 4.1 ± 0.3, respectively) and threefold in subjects with T2DM (11.9 ± 0.6; P < 0.001). Progressive decline in ΔI/ΔG ÷ IR was associated with a progressive impairment in FFA suppression during OGTT, whereas the rise in mean plasma glucose concentration only became manifest when subjects became overtly diabetic. The progressive decline in β-cell function that begins in individuals with NGT is associated with a progressive increase in FFA and fasting Adipo-IR. © 2017 by the American Diabetes Association.

  9. Results of a phase II pilot study of moderate dose radiotherapy for inoperable desmoid-type fibromatosis--an EORTC STBSG and ROG study (EORTC 62991-22998).

    Science.gov (United States)

    Keus, R B; Nout, R A; Blay, J-Y; de Jong, J M; Hennig, I; Saran, F; Hartmann, J T; Sunyach, M P; Gwyther, S J; Ouali, M; Kirkpatrick, A; Poortmans, P M; Hogendoorn, P C W; van der Graaf, W T A

    2013-10-01

    To determine the activity of radiotherapy in patients with inoperable desmoid-type fibromatosis (DF) a multicenter prospective phase II trial was carried out. Patients with inoperable progressive disease of primary, recurrent or incompletely resected lesions received a dose of 56 Gy in 28 fractions. Follow-up MRI studies were carried out every 3 months for 2 years and thereafter every 6 months. The primary end point was local control rate at 3 years, estimated by a nonparametric method for interval-censored survival data. Secondary end points were objective tumor response, acute and late toxic effect. Forty-four patients (27 F/17 M) were enrolled from 2001 to 2008. Median age was 39.5 years. Main tumor sites included trunk 15 (34.1%) and extremities 27 (61.3%). Median follow-up was 4.8 years. The 3-year local control rate was 81.5% (90% one-sided confidence interval 74% to 100%). Best overall response during the first 3 years was complete response (CR) 6 (13.6%), partial response (PR) 16 (36.4%), stable disease 18 (40.9%), progressive disease 3 (6.8%) and nonassessable 1 (2.3%). Five patients developed new lesions. After 3 years, the response further improved in three patients: (CR 2, PR 1). Acute grade 3 side-effects were limited to skin, mucosal membranes and pain. Late toxic effect consisted of mild edema in 10 patients. Moderate dose radiotherapy is an effective treatment of patients with DF. Response after radiation therapy is slow with continuing regression seen even after 3 years.

  10. Use of insulin pump therapy in children and adolescents with type 1 diabetes and its impact on metabolic control: comparison of results from three large, transatlantic paediatric registries.

    Science.gov (United States)

    Sherr, Jennifer L; Hermann, Julia M; Campbell, Fiona; Foster, Nicole C; Hofer, Sabine E; Allgrove, Jeremy; Maahs, David M; Kapellen, Thomas M; Holman, Naomi; Tamborlane, William V; Holl, Reinhard W; Beck, Roy W; Warner, Justin T

    2016-01-01

    While the use of insulin pumps in paediatrics has expanded dramatically, there is still considerable variability among countries in the use of pump technology. The present study sought to describe differences in metabolic control and pump use in young people with type 1 diabetes using data collected in three multicentre registries. Data for the years 2011 and 2012 from 54,410 children and adolescents were collected from the Prospective Diabetes Follow-up Registry (DPV; n = 26,198), T1D Exchange (T1DX; n = 13,755) and the National Paediatric Diabetes Audit (NPDA; n = 14,457). The modality of insulin delivery, based on age, sex and ethnic minority status, and the impact of pump use on HbA1c levels were compared. The overall mean HbA1c level was higher in the NPDA (8.9 ± 1.6% [74 ± 17.5 mmol/mol]) than in the DPV (8.0 ± 1.6% [64 ± 17.0 mmol/mol], p pump use was much lower in the NPDA (14%) than in the DPV (41%, p pump use was associated with a lower mean HbA1c (pump: 8.0 ± 1.2% [64 ± 13.3 mmol/mol] vs injection: 8.5 ± 1.7% [69 ± 18.7 mmol/mol], p pump (p pump less often compared with girls (p insulin pump therapy.

  11. Switching from biphasic human insulin to biphasic insulin aspart 30 in type 2 diabetes: results from the ASEAN subgroup of the A₁chieve study.

    Science.gov (United States)

    Hussein, Zanariah; Lim-Abrahan, Mary Anne; Jain, Anand B; Goh, Su Yen; Soewondo, Pradana

    2013-04-01

    To evaluate the safety and effectiveness of biphasic insulin aspart 30 (BIAsp 30) in ASEAN type 2 diabetes (T2D) patients switched from biphasic human insulin (BHI) in the non-interventional 24-week A₁chieve study. Indonesian, Malaysian, Filipino and Singaporean patients switched from BHI to BIAsp 30 at their physicians' discretion were included. The incidence of serious adverse drug reactions (SADRs), including major hypoglycaemia was the primary endpoint. Changes in hypoglycaemia, glycated haemoglobin A1c (HbA1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPPG), lipids, body weight and systolic blood pressure were also evaluated. Quality of life (QoL) was measured using the EQ-5D questionnaire. For the 465 patients included (mean ± SD age: 56 ± 10.3 years, diabetes duration: 9.7 ± 7.1 years, baseline HbA1c: 9.4 ± 1.8%), the mean pre-study BHI dose was 0.62 ± 0.28 IU/kg and 63.4% were dosing BHI twice daily (bid). The mean baseline BIAsp 30 dose was 0.65 ± 0.27 U/kg, titrated up to 0.71 ± 0.28 U/kg over 24 weeks, and most patients continued bid dosing. No SADRs or major hypoglycaemic episodes were reported. The proportion of patients reporting overall hypoglycaemia decreased significantly from 10.8% at baseline to 3.4% at Week 24 (p ASEAN subgroup poorly controlled on BHI. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  12. Safety and effectiveness of biphasic insulin aspart 30 in type 2 diabetes: results from the ASEAN cohort of the A₁chieve study.

    Science.gov (United States)

    Lim-Abrahan, Mary Anne; Jain, Anand B; Bebakar, Wan Mohamad Wan; Seah, Darren; Soewondo, Pradana

    2013-04-01

    To determine the safety and effectiveness of biphasic insulin aspart 30 (BIAsp 30) in the ASEAN cohort of the A₁chieve study. Type 2 diabetes patients from Indonesia, Malaysia, Philippines and Singapore prescribed BIAsp 30 therapy were included. The primary outcome was evaluation of serious adverse drug reactions including major hypoglycaemia over 24 weeks. Secondary outcomes were changes in hypoglycaemic events, serious adverse events (SAEs) and effectiveness parameters. This sub-analysis included 2798 patients (insulin-naive, 1903; insulin-experienced, 895) with mean age ± SD, 55.3 ± 10.8 years, BMI, 24.9 ± 4.6 kg/m(2) and diabetes duration, 7.5 ± 5.9 years. Baseline HbA1c in the entire cohort was poor (9.9%, 85 mmol/mol). A total of 15 SAEs were reported in 7 insulin-experienced patients (1 moderate event was related to BIAsp 30). Overall hypoglycaemia at Week 24 was 0.88 events/patient-year compared to 1.71 events/patient-year reported at baseline (change in proportion of patients affected, p < 0.0001). No major hypoglycaemia was reported at Week 24. BIAsp 30 significantly improved glucose control (HbA1c, fasting plasma glucose and postprandial plasma glucose, p < 0.001) at Week 24. The proportion of patients achieving HbA1c <7.0% at Week 24 was 35.3% compared to 3.5% at baseline. The lipid profile and systolic blood pressure also improved significantly (p < 0.001). Quality of life was positively impacted (mean change in visual analogue scores from EQ-5D = 10.6 ± 13.8 points, p < 0.001). BIAsp 30 was well-tolerated and improved glucose control while decreasing the risk of hypoglycaemia. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  13. Safety and effectiveness of insulin detemir in type 2 diabetes: results from the ASEAN cohort of the A₁chieve study.

    Science.gov (United States)

    Soewondo, Pradana; Mohamed, Mafauzy; Jain, Anand B; Sy, Rosa Allyn G; Khoo, Chin Meng

    2013-04-01

    To determine the safety and effectiveness of insulin detemir (IDet) in type 2 diabetes patients from the ASEAN cohort of the A1chieve study. Patients from Indonesia, Malaysia, Philippines and Singapore prescribed IDet at the discretion of their physicians were included. The primary outcome was the incidence of serious adverse drug reactions including major hypoglycaemia over 24 weeks. Secondary endpoints included changes in the frequency of hypoglycaemia, serious adverse events and effectiveness assessments. This sub-analysis included 1540 patients (insulin-naive, 1239; insulin-experienced, 301) with mean age ± SD 56.4 ± 10.9 years, BMI 25.4 ± 4.6 kg/m(2) and diabetes duration 6.9 ± 5.3 years. Insulin-naive patients received a baseline IDet dose of 0.24 ± 0.11 U/kg titrated up to 0.37 ± 0.21 U/kg by Week 24. The pre-study insulin dose in insulin-experienced patients was 0.41 ± 0.25 U/kg and baseline IDet dose was 0.31 ± 0.24 U/kg titrated up to 0.40 ± 0.20 U/kg by Week 24. Overall hypoglycaemia decreased from 1.73 to 0.46 events/patient-year from baseline to Week 24 (change in proportion of patients affected, p < 0.0001). At Week 24, 1 major hypoglycaemic event was reported in 1 insulin-experienced patient. IDet significantly improved glucose control (p < 0.001) at Week 24. The lipid profile and systolic blood pressure improved (p < 0.001) and body weight did not change significantly. Quality of life was positively impacted (p < 0.001). IDet was well-tolerated and improved glycaemic control without increasing the risk of hypoglycaemia or weight gain. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. The association of protein intake (amount and type) with ovarian antral follicle counts among infertile women: results from the EARTH prospective study cohort.

    Science.gov (United States)

    Souter, I; Chiu, Y-H; Batsis, M; Afeiche, M C; Williams, P L; Hauser, R; Chavarro, J E

    2017-09-01

    To evaluate the association between protein intake (amount and type) and antral follicle count (AFC). Prospective cohort. Academic fertility centre. Two hundred and sixty-five women undergoing fertility treatments at an academic fertility centre and participating in an ongoing study on environment and reproductive health. We measured AFC in ultrasonographic evaluation among women undergoing infertility treatments. Women completed a previously validated semi-quantitative food frequency questionnaire. We used Poisson regression to evaluate the relation between protein intake and AFC while adjusting for age, body mass index, race, smoking status, and total energy intake. Antral follicle count. Among 265 women (mean age: 35.0 ± 3.9 years, 85% Caucasian), total protein intake (% energy) was unrelated to AFC. When protein from different food sources was considered separately, we found a negative association between dairy protein intake and AFC. The mean AFC was 14.4% (3.9-23.7%) lower for women in the highest quintile of dairy protein intake than for women in the bottom quintile after adjusting for potential confounders (P-trend = 0.04). This association was stronger among women who had never smoked (P-trend = 0.002) but was not observed among previous smokers (P-trend = 0.36). There were no associations between protein intake from either non-dairy animal or vegetable sources and AFC. Higher dairy protein intake (≥5.24% of energy) was associated with lower antral follicle counts among women presenting for infertility treatment. These findings should be further investigated in prospective studies also designed to clarify the biology underlying the observed associations. Higher dairy protein intake was associated with lower antral follicle counts in an infertile population. © 2017 Royal College of Obstetricians and Gynaecologists.

  15. Phosphates of crandallite type (plumibogummite, goyazite, gorceixcite) results of amblygonite under weathering conditions from Coronel Murta's pegmatites (northeastern Miras Gerais) and your paleoecological meaning

    International Nuclear Information System (INIS)

    Neves, J.M.C.; Marciano, V.R.P.R.O.; Lena, J.C. de; Soares, A.C.P.

    1987-01-01

    This paper deals with crandallite type phosphates (plumbogummite, go yazite gorceixcite) originating from amblygonite under weathering conditions active in very recent times in the Coronel Murta are (northeastern Minas Gerais). Amblygonite, the crystallization of which too place about 500 Ma ago within the replacement bodies of pegmatites emplaced in mia-bearing quartzites from the Proterozoic Salinas Group, was the start ing material for the above mentione supergene minerals. The pegmatitic veins, emplaced in the quartzites according to wo perpendicular joint systems, underwent a strong weathering which produced the total kaolinization of the pegmatitic primary feldspars observed at the present time. During the supergene processes, the amblygonite, after acting as a geochemical fence for Ca, Sr, Ba, Pb etc., which provided conditions for the formation of the crandallitic minerals, was transformed into kaolinite. The stability fields these crandallitic minerals, comparared to those of kaolinite and amblygonite, show that they are easily formed under rather high pH values. As the environment becomes more acid and keeping in mind the very low cationic activities in groundwaters, al these phosphates become unstable and, under SiO 2 metasomatism, envolve to kaolinite. This is thermodynamically sound as revealed not only by the calculated stability diagrams but by the identified mineral assemblages as well. These mineral assemblages and their widespread regional scaterring seem to be induced not only by climatic and relief conditions but also by their position within the weathering profile. In the Coronel Murta area the most effective factors seem to have the very recent climatic and relief changes. (author) [pt

  16. Gender-specific association between night-work exposure and type-2 diabetes: results from longitudinal study of adult health, ELSA-Brasil.

    Science.gov (United States)

    Silva-Costa, Aline; Rotenberg, Lúcia; Nobre, Aline Araújo; Schmidt, Maria Inês; Chor, Dora; Griep, Rosane Härter

    2015-11-01

    Diabetes is a multifactorial disease of increasing prevalence. The literature suggests an impact of night work on metabolic components, though the relationship with diabetes is unclear. Our aim was to investigate gender-specific associations between night work and type-2 diabetes (DM2) or impaired glucose tolerance (IGT) using baseline data of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The cohort comprised 15 105 civil servants, aged 35-74 years. Baseline assessments (2008-2010) included clinical and laboratory measurements and interviews on sociodemographic, occupational, and health characteristics. In the baseline sample (N=14 427), 19.6% were classified as having DM2 and 20.5% as having IGT. Mean age was 52.1 (SD 9.1) years. A total of 2041 participants worked at night for 1-20 years and 687 for >20 years. Among women exposed to night work for >20 years compared with no night work after adjustments for potential confounders, including obesity, the odds ratios (OR) derived from multinomial logistic regression for DM2 and IGT were 1.42 [95% confidence interval (95% CI) 1.39-1.45] and 0.96 (95% CI 0.94-0.99), respectively. Among men exposed to night work for >20 years compared with no night work, the OR for DM2 and IGT were 1.06 (95% CI 1.04-1.08) and 0.99 (95% CI 0.98-1.01), respectively. The association between years of night work and diabetes is stronger among women than men. Longitudinal studies from ELSA-Brasil will be able to corroborate or refute these findings.

  17. Diabetes mellitus type 2 and subsite-specific colorectal cancer risk in men and women: results from the Netherlands Cohort Study on diet and cancer.

    Science.gov (United States)

    de Kort, Sander; Simons, C C J M; van den Brandt, Piet A; Goldbohm, R Alexandra Sandra; Arts, Ilja C W; de Bruine, Adriaan P; Janssen-Heijnen, Maryska L G; Sanduleanu, Silvia; Masclee, Ad A M; Weijenberg, Matty P

    2016-08-01

    Type 2 diabetes mellitus (T2DM) is associated with an increased risk of colorectal cancer (CRC); however, studies differentiating between subsites of CRC are limited. We investigated how diabetes mellitus (DM) was associated with subsite-specific CRC risk in men and women. The Netherlands Cohort Study on diet and cancer is a prospective study among 120 852 men and women aged 55-69 years old at baseline in 1986. Information on DM, anthropometric, dietary and lifestyle factors was self-reported at baseline. T2DM was defined as the diagnosis of DM after 30 years of age. Incident CRC cases were identified by record linkage with the Netherlands cancer registry and the Dutch pathology registry. After 17.3 years of follow-up, 1735 incident male CRC cases and 1321 female CRC cases were available for analyses. Subsite-specific hazard ratios (HRs) for CRC were estimated in case-cohort analyses using Cox regression. At baseline, 3.1% of subcohort members reported T2DM, of whom 80% were diagnosed after 50 years of age. Multivariable-adjusted models showed that the risk of proximal colon cancer was significantly increased in women with T2DM versus women without T2DM (HR=1.80, 95% confidence interval: 1.10-2.94). There was no association between T2DM and the risk of overall CRC, distal colon cancer and rectal cancer in women. In men, T2DM was not associated with overall CRC (HR=0.98, 95% confidence interval: 0.64-1.50), or with risk at any subsite. This prospective study showed an increased risk of proximal colon cancer in women with T2DM compared with non-T2DM women.

  18. Multiple endocrine neoplasia type 2 syndromes (MEN 2): results from the ItaMEN network analysis on the prevalence of different genotypes and phenotypes.

    Science.gov (United States)

    Romei, Cristina; Mariotti, Stefano; Fugazzola, Laura; Taccaliti, Augusto; Pacini, Furio; Opocher, Giuseppe; Mian, Caterina; Castellano, Maurizio; degli Uberti, Ettore; Ceccherini, Isabella; Cremonini, Nadia; Seregni, Ettore; Orlandi, Fabio; Ferolla, Piero; Puxeddu, Efisio; Giorgino, Francesco; Colao, Annamaria; Loli, Paola; Bondi, Fabio; Cosci, Barbara; Bottici, Valeria; Cappai, Antonello; Pinna, Giovanni; Persani, Luca; Verga, Uberta; Uberta, Verga; Boscaro, Marco; Castagna, Maria Grazia; Cappelli, Carlo; Zatelli, Maria Chiara; Faggiano, Antongiulio; Francia, Giuseppe; Brandi, Maria Luisa; Falchetti, Alberto; Pinchera, Aldo; Elisei, Rossella

    2010-08-01

    Multiple endocrine neoplasia type 2 (MEN 2) is a genetic disease characterized by medullary thyroid carcinoma (MTC) associated (MEN 2A and 2B) or not familial MTC (FMTC) with other endocrine neoplasia due to germline RET gene mutations. The prevalence of these rare genetic diseases and their corresponding RET mutations are unknown due to the small size of the study population. We collected data on germline RET mutations of 250 families with hereditary MTC followed in 20 different Italian centres. The most frequent RET amino acid substitution was Val804Met (19.6%) followed by Cys634Arg (13.6%). A total of 40 different germline RET mutations were present. Six families (2.4%) were negative for germline RET mutations. The comparison of the prevalence of RET germline mutations in the present study with those published by other European studies showed a higher prevalence of Val804Met and Ser891Ala mutations and a lower prevalence of Leu790Phe and Tyr791Phe (P<0.0001). A statistically significant higher prevalence of mutations affecting non-cysteine codons was also found (P<0.0001). Furthermore, the phenotype data collection showed an unexpected higher prevalence of FMTC (57.6%) with respect to other MEN 2 syndromes (34% MEN 2A and 6.8% of MEN 2B). In conclusion, we observed a statistically significant different pattern of RET mutations in Italian MEN 2 families with respect to other European studies and a higher prevalence of FMTC phenotype. The different ethnic origins of the patients and the particular attention given to analysing apparently sporadic MTC for RET germline mutations may explain these findings.

  19. Clinical status of a cohort of patients with type 1 diabetes diagnosed more than 2 decades before. Results of a specific clinical follow-up program.

    Science.gov (United States)

    Amor, Antonio J; Cabrer, Maria; Giménez, Marga; Vinagre, Irene; Ortega, Emilio; Conget, Ignacio

    2016-01-01

    The clinical course of type 1 diabetes mellitus (T1DM) has changed in recent decades. The aim of our study was to assess the long-term (> 20 years) clinical status of a patient cohort with T1DM under a specific treatment and follow-up program. A single center, observational, cross-sectional study was conducted of a patient cohort diagnosed with T1DM in the 1986-1994 period at our tertiary university hospital. Clinical characteristics, metabolic parameters, and occurrence of chronic complications and comorbidities after > 20 years of follow-up were collected. All subjects entered our specific program for patients with newly-diagnosed T1D and were followed up using the same clinical protocol. Data are shown as mean (standard deviation) or as number of patients and percentage. The appropriate test was used to compare quantitative and qualitative data. A P value diabetes unit at the time of the analysis. Of these patients, 24.8% were administered continuous subcutaneous insulin infusion (CSII). Mean HbA1c in the past 5 years and in the last year were7.8±0.9% and 7.7±1.1% respectively (7.3±1.5% in those given CSII). Smoking was reported by 19.6% of patients, while 15.7% had high blood pressure and 37.9% dyslipidemia. Diabetic retinopathy was diagnosed in 20.4%, and 11.3% of the total cohort had nephropathy. Only 1.3% of our patients had a history of CVD. Data collected from a cohort of patients with T1DM for more than 2 decades regularly followed up with a specific program in a tertiary university hospital suggest a remarkably low prevalence of diabetic complications. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. CBF tomograms with [/sup 99m/Tc-HM-PAO in patients with dementia (Alzheimer type and HIV) and Parkinson's disease--initial results

    International Nuclear Information System (INIS)

    Costa, D.C.; Ell, P.J.; Burns, A.; Philpot, M.; Levy, R.

    1988-01-01

    We present preliminary data on the utility of functional brain imaging with [99mTc]-d,l-HM-PAO and single photon emission computed tomography (SPECT) in the study of patients with dementia of the Alzheimer type (DAT), HIV-related dementia syndrome, and the on-off syndrome of Parkinson's disease. In comparison with a group of age-matched controls, the DAT patients revealed distinctive bilateral temporal and posterior parietal deficits, which correlate with detailed psychometric evaluation. Patients with amnesia as the main symptom (group A) showed bilateral mesial temporal lobe perfusion deficits (p less than 0.02). More severely affected patients (group B) with significant apraxia, aphasia, or agnosia exhibited patterns compatible with bilateral reduced perfusion in the posterior parietal cortex, as well as reduced perfusion to both temporal lobes, different from the patients of the control group (p less than 0.05). SPECT studies of HIV patients with no evidence of intracraneal space occupying pathology showed marked perfusion deficits. Patients with Parkinson's disease and the on-off syndrome studied during an on phase (under levodopa therapy) and on another occasion after withdrawal of levodopa (off) demonstrated a significant change in the uptake of [99mTc]-d,l-HM-PAO in the caudate nucleus (lower on off) and thalamus (higher on off). These findings justify the present interest in the functional evaluation of the brain of patients with dementia. [99mTc]-d,l-HM-PAO and regional cerebral blood flow (rCBF)/SPECT appear useful and highlight individual disorders of flow in a variety of neuropsychiatric conditions

  1. CBF tomograms with (/sup 99m/Tc-HM-PAO in patients with dementia (Alzheimer type and HIV) and Parkinson's disease--initial results

    Energy Technology Data Exchange (ETDEWEB)

    Costa, D.C.; Ell, P.J.; Burns, A.; Philpot, M.; Levy, R.

    1988-12-01

    We present preliminary data on the utility of functional brain imaging with (99mTc)-d,l-HM-PAO and single photon emission computed tomography (SPECT) in the study of patients with dementia of the Alzheimer type (DAT), HIV-related dementia syndrome, and the on-off syndrome of Parkinson's disease. In comparison with a group of age-matched controls, the DAT patients revealed distinctive bilateral temporal and posterior parietal deficits, which correlate with detailed psychometric evaluation. Patients with amnesia as the main symptom (group A) showed bilateral mesial temporal lobe perfusion deficits (p less than 0.02). More severely affected patients (group B) with significant apraxia, aphasia, or agnosia exhibited patterns compatible with bilateral reduced perfusion in the posterior parietal cortex, as well as reduced perfusion to both temporal lobes, different from the patients of the control group (p less than 0.05). SPECT studies of HIV patients with no evidence of intracraneal space occupying pathology showed marked perfusion deficits. Patients with Parkinson's disease and the on-off syndrome studied during an on phase (under levodopa therapy) and on another occasion after withdrawal of levodopa (off) demonstrated a significant change in the uptake of (99mTc)-d,l-HM-PAO in the caudate nucleus (lower on off) and thalamus (higher on off). These findings justify the present interest in the functional evaluation of the brain of patients with dementia. (99mTc)-d,l-HM-PAO and regional cerebral blood flow (rCBF)/SPECT appear useful and highlight individual disorders of flow in a variety of neuropsychiatric conditions.

  2. Flexible Carbon-Use Efficiency across Litter Types and during Decomposition Partly Compensates Nutrient Imbalances-Results from Analytical Stoichiometric Models.

    Science.gov (United States)

    Manzoni, Stefano

    2017-01-01

    Mathematical models involving explicit representations of microbial processes have been developed to infer microbial community properties from laboratory and field measurements. While this approach has been used to estimate the kinetic constants related to microbial activity, it has not been fully exploited for inference of stoichiometric traits, such as carbon-use efficiency (CUE). Here, a hierarchy of analytically-solvable mass-balance models of litter carbon (C) and nitrogen (N) dynamics is developed, to infer decomposer CUE from measured C and N contents during litter decomposition. The models are solved in the phase space-expressing litter remaining N as a function of remaining C-rather than in time, thus focusing on the stoichiometric relations during decomposition rather than the kinetics of degradation. This approach leads to explicit formulas that depend on CUE and other microbial properties, which can then be treated as model parameters and retrieved via nonlinear regression. CUE is either assumed time-invariant or as a function of the fraction of remaining litter C as a substitute for time. In all models, CUE tends to increase with increasing litter N availability across a range of litter types. When temporal trends in CUE are considered, CUE increases during decomposition of N-poor litter cohorts, in which decomposers are initially N-limited, but decreases in N-rich litter possibly due to C-limitation. These patterns of flexible CUE that partly compensate stoichiometric imbalances are robust to moderate shifts in decomposer C:N ratio and hold across wide climatic gradients.

  3. Flexible Carbon-Use Efficiency across Litter Types and during Decomposition Partly Compensates Nutrient Imbalances—Results from Analytical Stoichiometric Models

    Science.gov (United States)

    Manzoni, Stefano

    2017-01-01

    Mathematical models involving explicit representations of microbial processes have been developed to infer microbial community properties from laboratory and field measurements. While this approach has been used to estimate the kinetic constants related to microbial activity, it has not been fully exploited for inference of stoichiometric traits, such as carbon-use efficiency (CUE). Here, a hierarchy of analytically-solvable mass-balance models of litter carbon (C) and nitrogen (N) dynamics is developed, to infer decomposer CUE from measured C and N contents during litter decomposition. The models are solved in the phase space—expressing litter remaining N as a function of remaining C—rather than in time, thus focusing on the stoichiometric relations during decomposition rather than the kinetics of degradation. This approach leads to explicit formulas that depend on CUE and other microbial properties, which can then be treated as model parameters and retrieved via nonlinear regression. CUE is either assumed time-invariant or as a function of the fraction of remaining litter C as a substitute for time. In all models, CUE tends to increase with increasing litter N availability across a range of litter types. When temporal trends in CUE are considered, CUE increases during decomposition of N-poor litter cohorts, in which decomposers are initially N-limited, but decreases in N-rich litter possibly due to C-limitation. These patterns of flexible CUE that partly compensate stoichiometric imbalances are robust to moderate shifts in decomposer C:N ratio and hold across wide climatic gradients. PMID:28491054

  4. Flexible Carbon-Use Efficiency across Litter Types and during Decomposition Partly Compensates Nutrient Imbalances—Results from Analytical Stoichiometric Models

    Directory of Open Access Journals (Sweden)

    Stefano Manzoni

    2017-04-01

    Full Text Available Mathematical models involving explicit representations of microbial processes have been developed to infer microbial community properties from laboratory and field measurements. While this approach has been used to estimate the kinetic constants related to microbial activity, it has not been fully exploited for inference of stoichiometric traits, such as carbon-use efficiency (CUE. Here, a hierarchy of analytically-solvable mass-balance models of litter carbon (C and nitrogen (N dynamics is developed, to infer decomposer CUE from measured C and N contents during litter decomposition. The models are solved in the phase space—expressing litter remaining N as a function of remaining C—rather than in time, thus focusing on the stoichiometric relations during decomposition rather than the kinetics of degradation. This approach leads to explicit formulas that depend on CUE and other microbial properties, which can then be treated as model parameters and retrieved via nonlinear regression. CUE is either assumed time-invariant or as a function of the fraction of remaining litter C as a substitute for time. In all models, CUE tends to increase with increasing litter N availability across a range of litter types. When temporal trends in CUE are considered, CUE increases during decomposition of N-poor litter cohorts, in which decomposers are initially N-limited, but decreases in N-rich litter possibly due to C-limitation. These patterns of flexible CUE that partly compensate stoichiometric imbalances are robust to moderate shifts in decomposer C:N ratio and hold across wide climatic gradients.

  5. Influenza vaccination in people with type 2 diabetes, coverage, predictors of uptake, and perceptions. Result of the MADIABETES cohort a 7years follow up study.

    Science.gov (United States)

    Jiménez-Garcia, Rodrigo; Lopez-de-Andres, Ana; Hernandez-Barrera, Valentin; Gómez-Campelo, Paloma; San Andrés-Rebollo, Francisco J; de Burgos-Lunar, Carmen; Cárdenas-Valladolid, Juan; Abánades-Herranz, Juan Carlos; Salinero-Fort, Miguel Angel

    2017-01-03

    We aim to determine influenza vaccination uptake among people with diabetes included in the MADIABETES cohort study in order to identify predictors of uptake and to analyze reasons for adherence and non-adherence with vaccination. Using data from the MADIABETES Study we conducted a retrospective case record form based study without controls. We included outpatients with type 2 diabetes mellitus. Information was obtained from computerized clinical records and by telephone survey. The main dependent variables were influenza vaccination uptake in the year 2013 and the reason for receiving or refusing vaccination. Overall, 65.7% had received the influenza vaccine in 2013. The mean number of influenza vaccines received from 2007 to 2013 was 3.24 (SD1.15), although 19.23% had not received any influenza vaccine and 23.3% had been vaccinated against pneumococcus. The variables that increased the probability of being vaccinated were inclusion in the age-based recommendation (⩾60years), having a chronic respiratory disease, previous pneumococcal vaccination, higher number of visits to the general practitioner, higher number of influenza vaccines, and longer time since diabetes diagnosis. A higher mean glycated haemoglobin value in 2013 was associated with a reduced probability of vaccination. Most patients (90%) agreed to be vaccinated following their physician's advice because of their age or their chronic conditions. The most common reason for refusal among men was the belief that they were not at risk (41.6% vs. 29.79% in women); the most common reason for refusal among women was fear of adverse reactions (32.53% vs. 20.23% in men). The uptake of influenza vaccination among diabetic patients in the present study was below desirable levels. The main barrier to vaccination was lack of knowledge regarding the need for and risks and advantages of influenza vaccination. Healthcare professionals should educate and encourage influenza vaccination among people with diabetes

  6. Amphetamine-type stimulant use among men who have sex with men (MSM) in Vietnam: Results from a socio-ecological, community-based study.

    Science.gov (United States)

    Vu, Nga Thi Thu; Holt, Martin; Phan, Huong Thi Thu; Le, Huong Thi; La, Lan Thi; Tran, Gioi Minh; Doan, Tung Thanh; Nguyen, Trang Nhu Nguyen; de Wit, John

    2016-01-01

    Amphetamine-type-stimulants (ATS) use is associated with HIV-related sexual risk behaviours and is an emergent problem among men who have sex with men (MSM) in Vietnam. The purpose of this study is to describe ATS use patterns and understand the correlates of recent methamphetamine use from a socio-ecological perspective. From September through December, 2014, 622 MSM were recruited in Hanoi and Ho Chi Minh City, Vietnam. We collected information on demographic characteristics, HIV testing behaviours, use of ATS and other recreational drugs (ever and recently), sexual sensation seeking, depressive mood, experienced and internalized stigma related to homosexuality, social involvement with other MSM, and perceptions of ATS use in MSM networks. We performed descriptive statistics to describe ATS use patterns and multivariate logistic regression to establish independent correlates of recent methamphetamine use. Nearly one-third (30.4%) had ever used ATS, including 23.6% who had used methamphetamine, 4.3% who had used amphetamine ('speed') and 20.9% who had used ecstasy. 20.1% and 11.9% had ever used methamphetamine and ecstasy, respectively, during sex. Eighteen percent of methamphetamine users were classified as engaged in high-risk use. Recent methamphetamine use (in the last 3 months) was associated with participants perceiving more methamphetamine use in their MSM network, recent sex work, and higher sexual sensation seeking scores. ATS use is relatively prevalent among MSM sampled in Vietnam's main cities. Interventions to address methamphetamine are warranted for MSM in Vietnam. Methamphetamine treatments are needed for high-risk users. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. THE RESULTS OF USING OF INDICATORS OF THE HIGH-TEST CAST IRON OF TYPE ICH STRUCTURE IN CONDITIONS OF PRODUCT

    Directory of Open Access Journals (Sweden)

    A. L. Majorov

    2006-01-01

    Full Text Available The results of development of the indicator of highstrength pig-iron are submitted in the report. The indicator using allows to carry out the testing of the pig-iron structure in conditions of manufacture without additional preparation of the casting surface.

  8. Retrograde pyelonephritis and lumbar spondylitis as a result of Salmonella typhi in a type 2 diabetes patient with neurogenic bladder.

    Science.gov (United States)

    Fukuda, Tatsuya; Bouchi, Ryotaro; Minami, Isao; Ohara, Norihiko; Nakano, Yujiro; Nishitani, Rie; Murakami, Masanori; Takeuchi, Takato; Akihisa, Momoko; Fujita, Masamichi; Izumiyama, Hajime; Hashimoto, Koshi; Yoshimoto, Takanobu; Ogawa, Yoshihiro

    2016-05-01

    We present a case of a 62-year-old diabetic woman with acute pyelonephritis and spondylitis caused by Salmonella typhi. She was admitted to Tokyo Medical Dental University Hospital, Tokyo, Japan, because of unconsciousness and was diagnosed with sepsis by retrograde pyelonephritis as a result of Salmonella typhi. Antibiotics treatment was immediately started; however, she subsequently developed lumbar spondylitis, and long-term conservative treatment with antibiotics and a fixing device were required. This is the first report of a diabetic patient who developed retrograde urinary tract infection with Salmonella typhi, followed by sepsis and spondylitis. The infection could be a result of diabetic neuropathy, presenting neurogenic bladder and hydronephrosis. The patient was successfully treated with antibiotics and became asymptomatic with normal inflammatory marker levels, and no clinical sign of recurrence was observed in the kidney and spine at 4 months.

  9. Type of Autonomic Regulation and Risk of Cardiac Event in Athletes (Based on the Results of Dynamic Study of Heart Rate Variability and Dispersed ESG Mapping

    Directory of Open Access Journals (Sweden)

    T.G. Kirillova

    2012-06-01

    Full Text Available Dynamic study of heart rate variability and dispersed cardiac mapping of 11 students-athletes, aged 20-24, using apparatus Ekosan-2007 was conducted during 15 months. The results of the study help to imagine the individual image of autonomic regulation and its changes, opening up new possibilities to control body reserves in everyday life, during training and for early prediction of overtraining, stress and donozological states

  10. Lot-to-lot consistency, safety and immunogenicity of 3 lots of Haemophilus influenzae type b conjugate vaccine: results from a phase III randomized, multicenter study in infants.

    Science.gov (United States)

    Klein, Nicola P; Abu-Elyazeed, Remon; Cornish, Matthew; Leonardi, Michael L; Weiner, Leonard B; Silas, Peter E; Grogg, Stanley E; Varman, Meera; Frenck, Robert W; Cheuvart, Brigitte; Baine, Yaela; Miller, Jacqueline M; Leyssen, Maarten; Mesaros, Narcisa; Roy-Ghanta, Sumita

    2017-06-16

    Vaccination against Haemophilus influenzae type b (Hib) is included in routine pediatric immunization schedule in the United States. Previous vaccine shortages have created the need for additional options for Hib vaccination. This phase III, randomized, multi-centered study (NCT01000974) evaluated the safety and immunogenicity of a monovalent tetanus toxoid-conjugate Hib vaccine (Hib-TT) compared to a monovalent (Hib-TT control) and a combination Hib-TT vaccine. We hierarchically assessed lot-to-lot consistency of 3 Hib-TT lots and non-inferiority of Hib-TT to Hib-TT control. We co-administered routine pediatric vaccines with Hib-TT vaccines at 2, 4, 6months (primary vaccination) and 15-18months of age (booster vaccination). We recorded adverse events (AEs) for 4 (solicited) and 31days (unsolicited) post-vaccination and serious AEs (SAEs) throughout the study. Of 4009 enrolled children, 3086 completed booster phase. Lot-to-lot consistency was not demonstrated. The study met statistical criteria for non-inferiority of Hib-TT to Hib-TT control in terms of immune responses to Hib and co-administered vaccines' antigens, but not in terms of participants achieving post-primary vaccination anti-PRP levels ≥1µg/mL. Because of the hierarchical nature of the objectives, non-inferiority could not be established. In all groups, 92.5-96.7% and 99.6-100% of participants achieved anti-PRP levels ≥0.15µg/mL, while 78.3-89.8% and 97.9-99.1% had anti-PRP levels ≥1µg/mL, post-primary and post-booster vaccination, respectively. Immune responses to co-administered vaccines and reported incidence of AEs were comparable among groups. We recorded SAEs for 107/2963 (3.6%), 24/520 (4.6%), and 21/520 (4.0%) children post-primary vaccination, and 29/2337 (1.2%), 4/435 (0.9%), and 2/400 (0.5%) children post-booster vaccination with Hib-TT, Hib-TT control and combination Hib-TT vaccine, respectively; 6/5330 (0.1%) SAEs in the Hib-TT groups were considered vaccine-related. Hib

  11. The role of neighborhood characteristics in racial/ethnic disparities in type 2 diabetes: results from the Boston Area Community Health (BACH) Survey.

    Science.gov (United States)

    Piccolo, Rebecca S; Duncan, Dustin T; Pearce, Neil; McKinlay, John B

    2015-04-01

    Racial/ethnic disparities in the prevalence of type 2 diabetes mellitus (T2DM) are well documented and until recently, research has focused almost exclusively on individual-based determinants as potential contributors to these disparities (health behaviors, biological/genetic factors, and individual-level socio-demographics). Research on the role of neighborhood characteristics in relation to racial/ethnic disparities in T2DM is very limited. Therefore, the aim of this research is to identify and estimate the contribution of specific aspects of neighborhoods that may be associated with racial/ethnic disparities in T2DM. Data from the Boston Area Community Health III Survey (N = 2764) was used in this study, which is a community-based random-sample survey of adults in Boston, Massachusetts from three racial/ethnic groups (Black, Hispanic, and White). We applied two-level random intercepts logistic regression to assess the associations between race/ethnicity, neighborhood characteristics (census tract socioeconomic status, racial composition, property and violent crime, open space, geographic proximity to grocery stores, convenience stores, and fast food, and neighborhood disorder) and prevalent T2DM (fasting glucose > 125 mg/dL, HbA1c ≥ 6.5%, or self-report of a T2DM diagnosis). Black and Hispanic participants had 2.89 times and 1.48 times the odds of T2DM as White participants, respectively. Multilevel models indicated a significant between-neighborhood variance estimate of 0.943, providing evidence of neighborhood variation. Individual demographics (race/ethnicity, age and gender) explained 22.3% of the neighborhood variability in T2DM. The addition of neighborhood-level variables to the model had very little effect on the magnitude of the racial/ethnic disparities and on the between-neighborhood variability. For example, census tract poverty explained less than 1% and 6% of the excess odds of T2DM among Blacks and Hispanics and only 1.8% of the neighborhood

  12. Effects of meal preparation training on body weight, glycemia, and blood pressure: results of a phase 2 trial in type 2 diabetes.

    Science.gov (United States)

    Dasgupta, Kaberi; Hajna, Samantha; Joseph, Lawrence; Da Costa, Deborah; Christopoulos, Stavroula; Gougeon, Rejeanne

    2012-10-17

    Modest reductions in weight and small increases in step- related activity (e.g., walking) can improve glycemic and blood pressure control in type 2 diabetes mellitus (DM2). We examined changes in these parameters following training in time- efficient preparation of balanced, low- energy meals combined with pedometer- based step count monitoring. Seventy- two adults with DM2 were enrolled in a 24- week program (i.e., 15 three- hour group sessions). They prepared meals under a chef's supervision, and discussed eating behaviours/nutrition with a registered dietitian. They maintained a record of pedometer- assessed step counts. We evaluated changes from baseline to 24 weeks in terms of weight, step counts, hemoglobin A1c (HbA1c, glycemic control), blood pressure, and eating control ability (Weight Efficacy Lifestyle WEL Questionnaire). 53 participants (73.6%) completed assessments. There were improvements in eating control (11.2 point WEL score change, 95% CI 4.7 to 17.8), step counts (mean change 869 steps/day, 95% CI 198 to 1,540), weight (mean change -2.2%; 95% CI -3.6 to -0.8), and HbA1c (mean change -0.3% HbA1c, 95% CI -0.6 to -0.1), as well as suggestion of systolic blood pressure reduction (mean change -3.5 mm Hg, 95% CI -7.8 to 0.9). Findings were not attributable to medication changes. In linear regression models (adjusted for age, sex, ethnicity, insulin use, season), a -2.5% weight change was associated with a -0.3% HbA1c change (95% CI -0.4 to -0.2) and a -3.5% systolic blood pressure change (95% CI -5.5 to -1.4). In this 'proof of concept' study, persistence with the program led to improvements in eating and physical activity habits, glycemia reductions, and suggestion of blood pressure lowering effects. The strategy thus merits further study and development to expand the range of options for vascular risk reduction in DM2.

  13. Particulate matter and markers of glycemic control and insulin resistance in type 2 diabetic patients: result from Wellcome Trust Genetic study.

    Science.gov (United States)

    Khafaie, Morteza Abdullatif; Salvi, Sundeep Santosh; Ojha, Ajay; Khafaie, Behzad; Gore, Sharad Damodar; Yajnik, Chittaranjan Sakerlal

    2017-12-21

    There is growing evidence that air pollution is associated with increased risk of type 2 diabetes (T2DM). However, information related to whether particulate matter (PM) contributing to worsened metabolic control in T2DM patients is inconsistent. We examined the association of PM 10 exposure with glucose-function parameters in young-onset T2DM patients. We investigated the association between a year ambient concentration of PM 10 at residential places, using AERMOD dispersion model, with fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), 2 h post meal plasma glucose (2hPG), homeostasis model assessment of insulin resistance (HOMA-IR), β-cell function (HOMA-β) and disposition index (DI) in 1213 diabetic patients from the Wellcome Trust Genetic study at the Diabetes Unit, KEM Hospital Research Center, Pune, India. We used linear regression models and adjusted for a variety of individual and environmental confounding variables. Possible effect modification by age, gender, waist-to-hip ratio (WHR) and smoking status were investigated. Sensitivity analysis assessed the impact of relative humidity (RH) and temperature a day before examination and anti-diabetic and HHR medication (Hydralazine, Hydrochlorothiazide and Reserpine). We found that 1 SD increment in background concentration of PM 10 at residential places (43.83 µg/m 3 ) was significantly associated with 2.25 mmol/mol and 0.38 mmol/l increase in arithmetic means of HbA1c and 2hPG, respectively. A similar increase in PM 10 was also associated with 4.89% increase in geometric mean of HOMA-IR. The associations remained significant after adjustment to RH and temperature, and WHR and smoking enhanced the size of the effect. Our study suggests that long-term exposure to PM 10 is associated with higher glycaemia and insulin resistance. In context of our previous demonstration of association of SO 2 and NO x and plasma C-reactive protein, we suggest that air pollution could influence progression of

  14. Primary prevention of cardiovascular events with low-dose aspirin and vitamin E in type 2 diabetic patients: results of the Primary Prevention Project (PPP) trial.

    Science.gov (United States)

    Sacco, Michele; Pellegrini, Fabio; Roncaglioni, Maria C; Avanzini, Fausto; Tognoni, Gianni; Nicolucci, Antonio

    2003-12-01

    We investigated in general practice the efficacy of antiplatelets and antioxidants in primary prevention of cardiovascular events in people with type 2 diabetes. The Primary Prevention Project (PPP) is a randomized, open trial with a two-by-two factorial design aimed to investigate low-dose aspirin (100 mg/day) and vitamin E (300 mg/day) in the prevention of cardiovascular events in patients with one or more cardiovascular risk factors. The primary end point was a composite end point of cardiovascular death, stroke, or myocardial infarction. A total of 1,031 people with diabetes in the PPP, aged >/=50 years, without a previous cardiovascular event were enrolled by 316 general practitioners and 14 diabetes outpatient clinics. The PPP trial was prematurely stopped (after a median of 3.7 years) by the independent data safety and monitoring board because of a consistent benefit of aspirin compared with the control group in a population of 4,495 patients with one or more major cardiovascular risk factors. In diabetic patients, aspirin treatment was associated with a nonsignificant reduction in the main end point (relative risk [RR] = 0.90, 95% CI 0.50-1.62) and in total cardiovascular events (0.89, 0.62-1.26) and with a nonsignificant increase in cardiovascular deaths (1.23, 0.69-2.19). In nondiabetic subjects, RRs for the main end point, total cardiovascular events, and cardiovascular deaths were 0.59 (0.37-0.94), 0.69 (0.53-0.90), and 0.32 (0.14-0.72), respectively. No significant reduction in any of the end points considered could be found with vitamin E in either diabetic or nondiabetic subjects. Our data suggest a lower effect of primary prevention of cardiovascular disease (CVD) with low-dose aspirin in diabetic patients as opposed to subjects with other cardiovascular risk factors. If confirmed, these findings might indicate that the antiplatelet effects of aspirin in diabetic patients are overwhelmed by aspirin-insensitive mechanisms of platelet activation and

  15. Changing Patients' Treatment Preferences and Values with a Decision Aid for Type 2 Diabetes Mellitus: Results from the Treatment Arm of a Randomized Controlled Trial.

    Science.gov (United States)

    Bailey, Robert A; Shillington, Alicia C; Harshaw, Qing; Funnell, Martha M; VanWingen, Jeffrey; Col, Nananda

    2018-04-01

    Failure to intensify treatment for type 2 diabetes mellitus (T2DM) when indicated, or clinical inertia, is a major obstacle to achieving optimal glucose control. This study investigates the impact of a values-focused patient decision aid (PDA) for T2DM antihyperglycemic agent intensification on patient values related to domains important in decision-making and preferred treatments. Patients with poorly controlled T2DM who were taking a metformin-containing regimen were recruited through physicians to access a PDA presenting evidence-based information on T2DM and antihyperglycemic agent class options. Participants' preferences for treatment, decision-making, and the relative importance they placed on various values related to treatment options (e.g., dosing, weight gain, side effects) were assessed before and after interacting with the PDA. Changes from baseline were calculated (post-PDA minus pre-PDA difference) and assessed in univariate generalized linear models exploring associations with patients' personal values. Analyses included 114 diverse patients from 27 clinics across the US. The importance of avoiding injections, concern about hypoglycemia, and taking medications only once a day significantly decreased after interacting with the PDA [- 1.1 (p = 0.002), - 1.3 (p importance of taking medications that avoided weight gain increased [0.8 (p = 0.004)]. Prior to viewing the PDA, most patients (58.8%) had not begun thinking about the decision of adding a medication, and few (12.3%) indicated that they had already made a decision. Post-PDA, 46.5% could state a medication preference. The values-focused PDA for T2DM medication intensification prepared patients to make a shared decision with their clinician and changed patients' values regarding what was important in making that decision. Helping patients understand their options and underlying values can promote shared decision-making and may reduce clinical inertia delaying treatment intensification

  16. A Reassessment of the Marrubium Vulgare L. Herb’s Potential Role in Diabetes Mellitus Type 2: First Results Guide the Investigation toward New Horizons

    Science.gov (United States)

    Martín Esteban, Jorge; Rodríguez Villanueva, Laura

    2017-01-01

    Despite the wide variety of pharmacological activities described for the Marrubium vulgare L. herb, amazingly, only one clinical trial can be found in scientific literature. It was designed for the evaluation of its antidiabetic activity. Worse, the outcomes of this trial were contradictory to what previous in vivo mice assays had concluded. Therefore, should Marrubium vulgare be ruled out due to its lack of therapeutic potential in diabetes? The authors suggest a reevaluation of the clinical trial methodology to establish valid and final results. PMID:28930271

  17. A Reassessment of the Marrubium Vulgare L. Herb's Potential Role in Diabetes Mellitus Type 2: First Results Guide the Investigation toward New Horizons.

    Science.gov (United States)

    Rodríguez Villanueva, Javier; Martín Esteban, Jorge; Rodríguez Villanueva, Laura

    2017-08-02

    Despite the wide variety of pharmacological activities described for the Marrubium vulgare L. herb, amazingly, only one clinical trial can be found in scientific literature. It was designed for the evaluation of its antidiabetic activity. Worse, the outcomes of this trial were contradictory to what previous in vivo mice assays had concluded. Therefore, should Marrubium vulgare be ruled out due to its lack of therapeutic potential in diabetes? The authors suggest a reevaluation of the clinical trial methodology to establish valid and final results.

  18. A Reassessment of the Marrubium Vulgare L. Herb’s Potential Role in Diabetes Mellitus Type 2: First Results Guide the Investigation toward New Horizons

    Directory of Open Access Journals (Sweden)

    Javier Rodríguez Villanueva

    2017-08-01

    Full Text Available Despite the wide variety of pharmacological activities described for the Marrubium vulgare L. herb, amazingly, only one clinical trial can be found in scientific literature. It was designed for the evaluation of its antidiabetic activity. Worse, the outcomes of this trial were contradictory to what previous in vivo mice assays had concluded. Therefore, should Marrubium vulgare be ruled out due to its lack of therapeutic potential in diabetes? The authors suggest a reevaluation of the clinical trial methodology to establish valid and final results.

  19. The study of the container types used for transport and final disposal of the radioactive wastes resulting from decommissioning of nuclear facilities

    International Nuclear Information System (INIS)

    Postelnicu, C.

    1998-01-01

    The purpose of the present paper is to select from a variety of package forms and capacities some containers which will be used for transport and disposal of the radioactive wastes resulting from decommissioning of nuclear facilities into the National Repository for Radioactive Waste - Baita, Bihor county. Taken into account the possibilities of railway and / or road transport and waste disposal in our country, detailed container classification was given in order to use them for radioactive waste transport and final disposal from decommissioning of IFIN-HH Research Reactor. (author)

  20. Negative appraisals of insulin therapy are common among adults with Type 2 diabetes using insulin: Results from Diabetes MILES - Australia cross-sectional survey

    DEFF Research Database (Denmark)

    Holmes-Truscott, E.; Holmes-Truscott, E.; Skinner, T. C.

    2015-01-01

    -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...... negative insulin appraisals were significantly younger (Mean Diff. = 5 years, P diabetes-specific self-efficacy (P diabetes distress...... (all P diabetes using insulin, and are associated with lower general and diabetes-specific emotional well-being, reduced diabetes-specific self-efficacy and satisfaction with blood glucose. What...

  1. Clinical phenotype associations with various types of anti-dsDNA antibodies in patients with recent onset of rheumatic symptoms. Results from a multicentre observational study

    DEFF Research Database (Denmark)

    Compagno, Michele; Rekvig, Ole P; Bengtsson, Anders A

    2014-01-01

    was obtained in 547 patients. Anti-dsDNA antibodies were most frequently detected by ELISA. LRA showed that overall positivity of anti-dsDNA antibodies was associated with proteinuria and pleuritis. Alopecia was significantly associated only with CLIFT-positivity. Besides confirming the same findings, PCA...... showed that combined positivity of CLIFT and ELISA was also associated with lymphopenia. CONCLUSIONS: Our results show that different anti-dsDNA antibody specificities are associated with nephropathy, pleuritis, alopecia and lymphopenia, regardless of the diagnosis. It may challenge the importance...

  2. Plant-Based Dietary Patterns and Incidence of Type 2 Diabetes in US Men and Women: Results from Three Prospective Cohort Studies.

    Directory of Open Access Journals (Sweden)

    Ambika Satija

    2016-06-01

    Full Text Available Plant-based diets have been recommended to reduce the risk of type 2 diabetes (T2D. However, not all plant foods are necessarily beneficial. We examined the association of an overall plant-based diet and hypothesized healthful and unhealthful versions of a plant-based diet with T2D incidence in three prospective cohort studies in the US.We included 69,949 women from the Nurses' Health Study (1984-2012, 90,239 women from the Nurses' Health Study 2 (1991-2011, and 40,539 men from the Health Professionals Follow-Up Study (1986-2010, free of chronic diseases at baseline. Dietary data were collected every 2-4 y using a semi-quantitative food frequency questionnaire. Using these data, we created an overall plant-based diet index (PDI, where plant foods received positive scores, while animal foods (animal fats, dairy, eggs, fish/seafood, poultry/red meat, miscellaneous animal-based foods received reverse scores. We also created a healthful plant-based diet index (hPDI, where healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils, tea/coffee received positive scores, while less healthy plant foods (fruit juices, sweetened beverages, refined grains, potatoes, sweets/desserts and animal foods received reverse scores. Lastly, we created an unhealthful plant-based diet index (uPDI by assigning positive scores to less healthy plant foods and reverse scores to healthy plant foods and animal foods. We documented 16,162 incident T2D cases during 4,102,369 person-years of follow-up. In pooled multivariable-adjusted analysis, both PDI and hPDI were inversely associated with T2D (PDI: hazard ratio [HR] for extreme deciles 0.51, 95% CI 0.47-0.55, p trend < 0.001; hPDI: HR for extreme deciles 0.55, 95% CI 0.51-0.59, p trend < 0.001. The association of T2D with PDI was considerably attenuated when we additionally adjusted for body mass index (BMI categories (HR 0.80, 95% CI 0.74-0.87, p trend < 0.001, while that with hPDI remained

  3. [Prognostic factors in patients with non-ST-segment elevation acute coronary syndrome concurrent with type 2 diabetes mellitus (according to the results of the registry)].

    Science.gov (United States)

    Golikov, A P; Berns, S A; Stryuk, R I; Shmidt, E A; Golikova, A A; Barbarash, O L

    To investigate factors that influence annual prognosis in patients with non-ST-segment elevation acute coronary syndrome ((NSTEACS) concurrent with type 2 diabetes mellitus (DM2). The registry of patients with NSTEACS (non-ST-segment elevation myocardial infarction (NSTEMI), unstable angina) included 415 patients, of them 335 had no carbohydrate metabolic disorders, 80 had DM2. The follow-up period, during which the prognosis was evaluated in the patients, was one year after hospital discharge following the index NSTEACS event. Lipidogram readings and the serum levels of endothelin-1 (ET-1), sP-selectin, sE-selectin, and sPECAM were determined on day 10 after admission to hospital. All the patients underwent coronary angiography (CA), Doppler ultrasound of peripheral arteries during their hospital stay. The patients with DM2 versus those without diabetes proved to be significantly older and to have a higher body mass index; among them there were more women, they were noted to have more frequently hypertension and less frequently smoked. The presence of DM2 was associated with significantly increased intima-media thickness and higher GRACE scores (p=0.013) as compared to those in the patients with normal carbohydrate metabolism. There were significant differences in high-density lipoprotein levels that were lower, as well as in triglyceride levels and atherogenic index, which were higher in patients with DM2 than in those without this condition. In addition, there were significant differences in ET-1, sP-selectin, sE-selectin, and sPECAM levels that were significantly higher in the DM2 group. Moreover, the levels of ET-1 and sPECAM were above normal in both the DM and non-DM2 groups. Assessment of poor outcomes at one year of the observation established that cardiovascular mortality rates were significantly higher and coronary angiography was performed much less frequently in the DM2 group. The most significant prognostic factors associated with a poor prognosis

  4. Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the Chennai cohort of the A 1 chieve study

    Directory of Open Access Journals (Sweden)

    J S Kumar

    2013-01-01

    Full Text Available Background: The A 1 chieve, a multicentric (28 countries, 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726 in routine clinical care across four continents. Materials and Methods: Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from Chennai, India. Results: A total of 1334 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Patients had started on or were switched to biphasic insulin aspart (n = 983, insulin detemir (n = 205, insulin aspart (n = 42, basal insulin plus insulin aspart (n = 41 and other insulin combinations (n = 63. At baseline glycaemic control was poor for both insulin naïve (mean HbA 1 c: 9.4% and insulin users (mean HbA 1 c: 9.3% groups. After 24 weeks of treatment, both groups showed improvement in HbA 1 c (insulin naïve: −2.1%, insulin users: −1.9%. SADRs including major hypoglycaemic events or episodes did not occur in any of the study patients. Conclusion: Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia.

  5. Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the Haryana cohort of the A 1 chieve study

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2013-01-01

    Full Text Available Background: The A 1 chieve, a multicentric (28 countries, 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726 in routine clinical care across four continents. Materials and Methods: Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from Haryana, India. Results: A total of 345 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Patients had started on or were switched to biphasic insulin aspart (n = 236, insulin detemir (n = 66, insulin aspart (n = 28, basal insulin plus insulin aspart (n = 1 and other insulin combinations (n = 14. At baseline glycaemic control was poor for both insulin naïve (mean HbA 1 c: 10.7% and insulin user (mean HbA 1 c: 10.5% groups. After 24 weeks of treatment, both the groups showed improvement in HbA 1 c (insulin naïve: −3.9%, insulin users: −3.3%. SADRs including major hypoglycaemic events or episodes did not occur in any of the study patients. Conclusion: Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia.

  6. Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the Oman cohort of the A 1 chieve study

    Directory of Open Access Journals (Sweden)

    Mustafa Al Abousi

    2013-01-01

    Full Text Available Background: The A 1 chieve, a multicentric (28 countries, 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726 in routine clinical care across four continents. Materials and Methods: Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from Oman. Results: A total of 349 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Study patients had started on or were switched to biphasic insulin aspart (n = 121, insulin detemir (n = 171, insulin aspart (n = 2, basal insulin plus insulin aspart (n = 38 and other insulin combinations (n = 17. At baseline glycaemic control was poor for both insulin naïve (mean HbA 1 c: 9.2% and insulin user (mean HbA 1 c: 8.8% groups. After 24 weeks of treatment, both the groups showed improvement in HbA 1 c (insulin naïve: −2.1%, insulin users: −1.6%. SADRs including major hypoglycaemic events did not occur in the study patients. Conclusion: Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia and no weight gain.

  7. Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the Maharashtra cohort of the A 1 chieve study

    Directory of Open Access Journals (Sweden)

    Uday Phadke

    2013-01-01

    Full Text Available Background: The A 1 chieve, a multicentric (28 countries, 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726 in routine clinical care across four continents. Materials and Methods: Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from Maharashtra, India. Results: A total of 3069 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Patients had started on or were switched to biphasic insulin aspart (n = 2115, insulin detemir (n = 461, insulin aspart (n = 333, basal insulin plus insulin aspart (n = 92 and other insulin combinations (n = 61. At baseline glycaemic control was poor for both insulin naïve (mean HbA 1 c: 8.8 and insulin user (mean HbA 1 c: 9.1% groups. After 24 weeks of treatment, both the groups showed improvement in HbA 1 c (insulin naïve: −1.4%, insulin users: −1.4%. SADRs including major hypoglycaemic events or episodes did not occur in any of the study patients. Conclusion: Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia.

  8. Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the Kuwait cohort of the A 1 chieve study

    Directory of Open Access Journals (Sweden)

    Alaa Daban

    2013-01-01

    Full Text Available Background: The A 1 chieve, a multicentric (28 countries, 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726 in routine clinical care across four continents. Materials and Methods: Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from Kuwait. Results: A total of 1185 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Study patients had started on or were switched to biphasic insulin aspart (n = 472, insulin detemir (n = 472, insulin aspart (n = 4, basal insulin plus insulin aspart (n = 188 and other insulin combinations (n = 48. At baseline, glycaemic control was poor for both insulin naïve (mean HbA 1 c: 9.8% and insulin user (mean HbA 1 c: 9.4% groups. After 24 weeks of treatment, both the groups showed improvement in HbA 1 c (insulin naïve: −2.4%, insulin users: −1.7%. No major hypoglycaemic episodes were observed at 24 weeks. SADR was reported in 0.1% of insulin users. Conclusion: Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia.

  9. Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the Marrakech cohort of the A 1 chieve study

    Directory of Open Access Journals (Sweden)

    El Ansari Nawal

    2013-01-01

    Full Text Available Background: The A 1 chieve, a multicentric (28 countries, 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726 in routine clinical care across four continents. Materials and Methods: Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from Marrakech, Morocco. Results: A total of 196 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Study patients had started on or were switched to biphasic insulin aspart (n = 71, insulin detemir (n = 83, insulin aspart (n = 5, basal insulin plus insulin aspart (n = 14 and other insulin combinations (n = 23. At baseline glycaemic control was poor for both insulin naïve (mean HbA 1 c: 9.3% and insulin user (mean HbA 1 c: 9.3% groups. After 24 weeks of treatment, both the study groups showed improvement in HbA 1 c (insulin naïve: −2.3%, insulin users: −1.9%. SADR′s including major hypoglycaemic events did not occur in any of the study patients. Conclusion: Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia.

  10. Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the Casablanca cohort of the A 1 chieve study

    Directory of Open Access Journals (Sweden)

    Ahmed Farouqi

    2013-01-01

    Full Text Available Background: The A 1 chieve, a multicentric (28 countries, 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726 in routine clinical care across four continents. Materials and Methods: Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from Casablanca, Morocco. Results: A total of 495 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Study patients had started on or were switched to biphasic insulin aspart (n = 231, insulin detemir (n = 151, insulin aspart (n = 19, basal insulin plus insulin aspart (n = 53 and other insulin combinations (n = 41. At baseline glycaemic control was poor for both insulin naïve (mean HbA 1 c: 10.2% and insulin user (mean HbA 1 c: 9.4% groups. After 24 weeks of treatment, both groups showed improvement in HbA 1 c (insulin naïve: −2.3%, insulin users: −1.8%. Major hypoglycaemia was observed in the insulin naïve group after 24 weeks. SADRs were reported in 1.2% of insulin naïve and 2.1% of insulin user groups. Conclusion: Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia.

  11. Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the Kolkata cohort of the A 1 chieve study

    Directory of Open Access Journals (Sweden)

    Anirban Majumder

    2013-01-01

    Full Text Available Background: The A 1 chieve, a multicentric (28 countries, 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726 in routine clinical care across four continents. Materials and Methods: Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from Kolkata, India. Results: A total of 576 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Patients had started on or were switched to biphasic insulin aspart (n = 417, insulin detemir (n = 70, insulin aspart (n = 55, basal insulin plus insulin aspart (n = 19 and other insulin combinations (n = 15. At baseline, glycaemic control was poor for both insulin naïve (mean HbA 1 c: 8.3% and insulin user (mean HbA 1 c: 8.6% groups. After 24 weeks of treatment, both the groups showed improvement in HbA 1 c (insulin naïve: −1.3%, insulin users: −1.4%. SADRs including major hypoglycaemic events or episodes did not occur in any of the study patients. Conclusion: Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia.

  12. Reciprocal exchange of minor components of type 1 and F1C fimbriae results in hybrid organelles with changed receptor specificities

    DEFF Research Database (Denmark)

    Klemm, P; Christiansen, Gunna; Kreft, B

    1994-01-01

    recognition proteins present in the organelles as minor structural elements. The organization of the fim and foc gene clusters encoding these fimbriae, as well as the structures of the organelles, are very similar, although the actual sequence homology of the structural elements is not remarkable; notably...... to epithelial cells in the collecting ducts of the human kidney as well as to cells of various cell lines. This report addresses the question of fimbrial promiscuity. Our data indicate that minor fimbrial structural elements can be exchanged between the two fimbrial systems, resulting in hybrid organelles...... with changed receptor specificity. This is the first study on reciprocal exchange of structural components from two different fimbrial systems....

  13. Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the Rajasthan cohort of the A 1 chieve study

    Directory of Open Access Journals (Sweden)

    Akhil Joshi

    2013-01-01

    Full Text Available Background: The A 1 chieve, a multicentric (28 countries, 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726 in routine clinical care across four continents. Materials and Methods: Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from Rajasthan, India. Results: A total of 477 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Patients had started on or were switched to biphasic insulin aspart (n = 340, insulin detemir (n = 90, insulin aspart (n = 37, basal insulin plus insulin aspart (n = 7 and other insulin combinations (n = 2. At baseline glycaemic control was poor for both insulin naïve (mean HbA 1 c: 8.3% and insulin user (mean HbA 1 c: 8.4% groups. After 24 weeks of treatment, both the groups showed improvement in HbA 1 c (insulin naïve: −0.9%, insulin users: −1.2%. Major hypoglycaemic events decreased from 0.5 events/patient-year to 0.0 events/patient-year in insulin naïve group while no change from baseline (1.3 events/patients-year was observed for insulin users. SADRs were not reported in any of the study patients. Conclusion: Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia.

  14. A multiplex single nucleotide polymorphism typing assay for detecting mutations that result in decreased fluoroquinolone susceptibility in Salmonella enterica serovars Typhi and Paratyphi A.

    LENUS (Irish Health Repository)

    Song, Yajun

    2010-08-01

    OBJECTIVES: Decreased susceptibility to fluoroquinolones has become a major problem for the successful therapy of human infections caused by Salmonella enterica, especially the life-threatening typhoid and paratyphoid fevers. METHODS: By using Luminex xTAG beads, we developed a rapid, reliable and cost-effective multiplexed genotyping assay for simultaneously detecting 11 mutations in gyrA, gyrB and parE of S. enterica serovars Typhi and Paratyphi A that result in nalidixic acid resistance (Nal(R)) and\\/or decreased susceptibility to fluoroquinolones. RESULTS: This assay yielded unambiguous single nucleotide polymorphism calls on extracted DNA from 292 isolates of Salmonella Typhi (Nal(R) = 223 and Nal(S) = 69) and 106 isolates of Salmonella Paratyphi A (Nal(R) = 24 and Nal(S) = 82). All of the 247 Nal(R) Salmonella Typhi and Salmonella Paratyphi A isolates were found to harbour at least one of the target mutations, with GyrA Phe-83 as the most common one (143\\/223 for Salmonella Typhi and 18\\/24 for Salmonella Paratyphi A). We also identified three GyrB mutations in eight Nal(S) Salmonella Typhi isolates (six for GyrB Phe-464, one for GyrB Leu-465 and one for GyrB Asp-466), and mutations GyrB Phe-464 and GyrB Asp-466 seem to be related to the decreased ciprofloxacin susceptibility phenotype in Salmonella Typhi. This assay can also be used directly on boiled single colonies. CONCLUSIONS: The assay presented here would be useful for clinical and reference laboratories to rapidly screen quinolone-resistant isolates of Salmonella Typhi and Salmonella Paratyphi A, and decipher the underlying genetic changes for epidemiological purposes.

  15. Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the Mumbai cohort of the A1chieve study.

    Science.gov (United States)

    Talwalkar, P G; Gupta, Vishal; Kovil, Rajiv

    2013-11-01

    The A1chieve, a multicentric (28 countries), 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726) in routine clinical care across four continents. Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from Mumbai, India. A total of 2112 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Patients had started on or were switched to biphasic insulin aspart (n = 1561), insulin detemir (n = 313), insulin aspart (n = 144), basal insulin plus insulin aspart (n = 53) and other insulin combinations (n = 41). At baseline glycaemic control was poor for both insulin naïve (mean HbA1c: 8.7%) and insulin user (mean HbA1c: 9.2%) groups. After 24 weeks of treatment, both the groups showed improvement in HbA1c (insulin naïve: -1.4%, insulin users: -1.8%). SADRs including major hypoglycaemic events or episodes did not occur in any of the study patients. Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia.

  16. Type inference for correspondence types

    DEFF Research Database (Denmark)

    Hüttel, Hans; Gordon, Andy; Hansen, Rene Rydhof

    2009-01-01

    We present a correspondence type/effect system for authenticity in a π-calculus with polarized channels, dependent pair types and effect terms and show how one may, given a process P and an a priori type environment E, generate constraints that are formulae in the Alternating Least Fixed......-Point (ALFP) logic. We then show how a reasonable model of the generated constraints yields a type/effect assignment such that P becomes well-typed with respect to E if and only if this is possible. The formulae generated satisfy a finite model property; a system of constraints is satisfiable if and only...... if it has a finite model. As a consequence, we obtain the result that type/effect inference in our system is polynomial-time decidable....

  17. New and known type 2 diabetes as coronary heart disease equivalent: results from 7.6 year follow up in a middle east population

    Directory of Open Access Journals (Sweden)

    Sheikholeslami Farhad

    2010-12-01

    Full Text Available Abstract Background To investigate whether the known diabetes mellitus (KDM or newly diagnosed diabetes mellitus (NDM could be regarded as a coronary heart disease (CHD risk equivalent among a relatively young Middle East population with high prevalence of diabetes mellitus (DM. Methods A population based cohort study of 2267 men and 2931 women, aged ≥ 30 years. Prior CHD was defined as self-reported or ECG positive CHD at baseline, KDM as subjects using any kind of glucose-lowering medications and NDM according to fasting plasma glucose and 2-h postchallenge glycemia. Participants were categorized to six groups according to the presence of known or newly diagnosed DM and CHD at baseline (DM-/CHD-, DM-/CHD+, NDM+/CHD-, NDM+/CHD+, KDM+/CHD-, KDM+/CHD+ and Cox regression analysis were used to estimate the hazard ratio (HR of CHD events for these DM/CHD groups, given DM-/CHD-as the reference. Results During 7.6-year follow up, 358 CHD events occurred. After controlling traditional risk factors, HRs of CHD events for DM-/CHD+ group were 2.1 (95% CI: 1.4-3.1 and 5.2 (3.2-8.3 in men and women respectively. Corresponding HRs for NDM+/CHD-were 1.7 (1.1-2.7 and 3.1 (1.8-5.6 and for KDM+/CHD-were 1.7 (0.9-3.3 and 6.2 (3.6-10.6 in men and women respectively. The HRs for NDM+/CHD+ and KDM+/CHD+ groups (i.e. participants with history of both diabetes and CHD were 6.4 (3.2-12.9 and 8.0 (4.3-14.8 in women and 3.2 (1.9-5.6 and 4.2 (2.2-7.8 in men, respectively. The hazard of CHD events did not differ between KDM+/CHD-and DM-/CHD+ in both genders using paired homogeneity test, however the HR for NDM+/CHD-was marginally lower than the HR for DM-/CHD+ in women (p = 0.085. Conclusions KDM patients in both genders and NDM especially in men exhibited a CHD risk comparable to nondiabetics with a prior CHD, furthermore diabetic subjects with prior CHD had the worst prognosis, by far more harmful in women than men; reinforcing the urgent need for intensive care and

  18. The phenotypic features of osteogenesis imperfecta resulting from a mutation of the carboxyl-terminal pro alpha 1(I) propeptide that impairs the assembly of type I procollagen and formation of the extracellular matrix

    NARCIS (Netherlands)

    Cole, WG; Chow, CW; Bateman, JF; Sillence, DO

    1996-01-01

    The features of a baby with lethal perinatal osteogenesis imperfecta (OI-II), resulting from the substitution of tryptophan 94 by cysteine in the carboxyl-terminal propeptide of pro alpha 1(I) chains of type I procollagen, were studied. The limbs and torso were of normal length, shape, and

  19. No influence of BCR-ABL1 transcript types e13a2 and e14a2 on long-term survival: results in 1494 patients with chronic myeloid leukemia treated with imatinib.

    Science.gov (United States)

    Pfirrmann, Markus; Evtimova, Dobromira; Saussele, Susanne; Castagnetti, Fausto; Cervantes, Francisco; Janssen, Jeroen; Hoffmann, Verena S; Gugliotta, Gabriele; Hehlmann, Rüdiger; Hochhaus, Andreas; Hasford, Joerg; Baccarani, Michele

    2017-05-01

    The genomic break on the major breakpoint cluster region of chromosome 22 results in two BCR-ABL1 transcripts of different sizes, e14a2 and e13a2. Favorable survival probabilities of patients with chronic myeloid leukemia (CML) in combination with too small patient samples may yet have obstructed the observation of differences in overall survival of patients according to transcript type. To overcome potential power problems, overall survival (OS) probabilities and probabilities of CML-related death were analyzed in 1494 patients randomized to first-line imatinib treatment. OS probabilities and probabilities of dying of CML were compared using the log-rank or Gray test whichever was appropriate. Both tests were stratified for the EUTOS long-term survival score. Between the groups with a single transcript, neither OS probabilities (stratified log-rank test: p = 0.106) nor probabilities of CML-related death were significantly different (stratified Gray test: p = 0.256). Regarding OS, the Cox hazard ratio (HR) of transcript type e13a2 (n = 565) to type e14a2 (n = 738) was 1.332 (95% CI 0.940-1.887). Considering probabilities of leukemia-related death, the corresponding subdistribution HR resulted in 1.284 (95% CI 0.758-2.176). Outcome did not change if patients with both transcripts (n = 191) were added to the 738 with type e14a2 only. The prognostic association of transcript type and long-term survival outcome was weak and without clinical relevance. However, earlier reported differences in the rate and the depth of molecular response could be relevant for the chance of successfully discontinuing TKI treatment. The effect of transcript type on molecular relapse after discontinuation is unknown, yet.

  20. In-vitro-Studie zum Einfluss von Fibrin in Knorpelkonstrukten auf der Basis von PGA-Vliesstoffen

    DEFF Research Database (Denmark)

    Schmal, H; Mehlhorn, A T; Kurze, C

    2008-01-01

    and cultured using a serum-free technique. The cells were seeded on PGA-91 scaffolds with and without an additional fibrin component; the constructs were cultured for 2 weeks in vitro. Besides cell viability, DNA content, pH, aggrecan production, mRNA expression of aggrecan, and collagen types I and II were...... determined by real-time PCR. Furthermore, cartilage grafts were histologically analyzed. RESULTS: All constructs contained viable, metabolically active cells in the investigated time period. There was no cell proliferation within the graft, and the DNA content was decreased over time. The pH level constantly...

  1. Timing of blood transfusion and not ABO blood type is associated with survival in patients treated with radical cystectomy for nonmetastatic bladder cancer: Results from a single high-volume institution.

    Science.gov (United States)

    Moschini, Marco; Bianchi, Marco; Rossi, Martina Sofia; Dell׳Oglio, Paolo; Gandaglia, Giorgio; Fossati, Nicola; Mattei, Agostino; Damiano, Rocco; Shariat, Shahrokh F; Salonia, Andrea; Montorsi, Francesco; Briganti, Alberto; Colombo, Renzo; Gallina, Andrea

    2016-06-01

    Perioperative transfusions have been recently associated to poor outcomes as an indirect consequence of immune-hematological changes related to transfusion itself and blood type. We tested the role of blood transfusion on cancer-specific mortality (CSM) and overall mortality (OM), considering the effect of ABO system, Rh factor, and timing of transfusions. The study focused on 728 patients with bladder cancer treated with radical cystectomy at a single tertiary care referral center between January 1995 and August 2013 with complete ABO blood type information. Kaplan-Meier analysis was used to assess the effect of transfusions, stratified according to ABO type and Rh factor, on CSM and OM. The same endpoints were tested in Cox regression models, after adjusting for all available confounders. A total of 341 (46.8%), 277 (38.0%), 83 (11.4%), and 27 (3.7%) patients had blood type O, A, B and AB, respectively. Overall, 630 (86.5%) and 98 (13.5%) patients were Rh-and Rh+, respectively. At a median follow-up time of 65 months, 225 (30.9%) and 282 (38.7%) patients recorded CSM and OM, respectively. At univariable analyses, ABO blood type and Rh status were not associated to either CSM or OM (all P>0.2). Similar results were observed when ABO blood type and Rh factor were tested in multivariable models (all P>0.3). Conversely, Charlson score, preoperative hemoglobin, number of nodes removed, pathological T stage, and number of positive nodes were associated to both CSM and OM (all Pblood units in the postoperative period (P>0.05) was associated with an increase of CSM and OM. Although ABO type or Rh factor or both were associated with several adverse outcomes in many cancers, we were not able to confirm this association in bladder cancer. Based on our results, the effect of transfusion on survival is independent by ABO type but is associated to the timing of blood supply administration. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Helicobacter pylori from Peptic Ulcer Patients in Uganda Is Highly Resistant to Clarithromycin and Fluoroquinolones: Results of the GenoType HelicoDR Test Directly Applied on Stool

    Directory of Open Access Journals (Sweden)

    Denish Calmax Angol

    2017-01-01

    Full Text Available Background. Around 70–90% of peptic ulcer disease (PUD is due to Helicobacter pylori and requires treatment with antimicrobials to which these bacteria are susceptible. Common H. pylori diagnostic tests do not provide drug susceptibility data. Using the GenoType HelicoDR PCR test designed for gastric biopsies for simultaneous detection of H. pylori and its resistance to clarithromycin (CLA/fluoroquinolones (FLQ, we present evidence for stool as an optional test specimen and also provide data on prevalence of H. pylori resistance to CLA and FLQ in Uganda. Methods. Stool from 142 symptomatic PUD patients at three hospitals in Kampala was screened for H. pylori using a rapid antigen test. The GenoType HelicoDR test was run on all H. pylori antigen positives to determine PCR positivity and resistance to CLA/FLQ. Results. Thirty-one samples (22% were H. pylori antigen positive, and 21 (68% of these were H. pylori PCR positive. Six of the 21 (29% were resistant to CLA and eight to FLQ (42%, while two gave invalid FLQ resistance results. Conclusion. Stool is a possible specimen for the GenoType HelicoDR test for rapid detection of H. pylori and drug resistance. In Uganda, Helicobacter pylori is highly resistant to CLA and FLQ.

  3. Relevance of positive cardiovascular outcome trial results in clinical practice: perspectives from the Academy for Cardiovascular Risk, Outcomes and Safety Studies in Type 2 Diabetes (ACROSS T2D

    Directory of Open Access Journals (Sweden)

    Schernthaner G

    2017-12-01

    Full Text Available Guntram Schernthaner,1 Kamlesh Khunti,2 Chaim Lotan,3 Michel Burnier,4 Heinz Drexel,5 Martin Prázný61Department of Medicine I, Rudolfstiftung Hospital, Vienna, Austria; 2Diabetes Research Centre, Leicester General Hospital, Leicester, UK; 3Cardiovascular Division, Hadassah Medical Centre, Jerusalem, Israel; 4Division of Nephrology and Hypertension Consultation, University Hospital of Lausanne, Lausanne, Switzerland; 5Vorarlberg Institute for Vascular Investigation and Treatment, Feldkirch, Austria; 6Charles University, Prague, Czech RepublicAbstract: Type 2 diabetes (T2D imposes a substantial disease burden, predominantly from cardiovascular disease (CVD, which accounts for >50% of deaths in this population and leads to a 12-year reduction in the life expectancy of a 60-year-old male patient with T2D and CVD compared with the general population. The results from mandatory cardiovascular outcome trials (CVOTs are therefore of great interest in the field. The Academy for Cardiovascular Risk, Outcomes and Safety Studies in Type 2 Diabetes meeting program aims to bring together experts from several associated disciplines to provide fair and balanced resources for those involved in the management of patients with T2D. This publication represents the opinions of the faculty on the key learnings from the meeting held in Vienna in the spring of 2017. In particular, we detail how data from the EMPA-REG OUTCOME® [cardiovascular outcomes trial of empagliflozin] and Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER® (liraglutide CVOTs can be practically interpreted across clinical specialities. It is hoped that this translation of CVOT data will achieve a dual treatment paradigm for the management of both raised glucose levels and CV risk in patients with T2D. Keywords: type 2 diabetes, cardiovascular disease, CVOT, SGLT2 inhibitors, GLP-1 agonists, DPP-4 inhibitors

  4. Intermittent Vagal Nerve Block for Improvements in Obesity, Cardiovascular Risk Factors, and Glycemic Control in Patients with Type 2 Diabetes Mellitus: 2-Year Results of the VBLOC DM2 Study.

    Science.gov (United States)

    Shikora, Scott A; Toouli, James; Herrera, Miguel F; Kulseng, Bård; Brancatisano, Roy; Kow, Lilian; Pantoja, Juan P; Johnsen, Gjermund; Brancatisano, Anthony; Tweden, Katherine S; Knudson, Mark B; Billington, Charles J; Billingto, Charles J

    2016-05-01

    One-year results of the VBLOC DM2 study found that intermittent vagal blocking (VBLOC therapy) was safe among subjects with obesity and type 2 diabetes mellitus (T2DM) and led to significant weight loss and improvements in glycemic parameters and cardiovascular risk factors. Longer-term data are needed to determine whether the results are sustained. VBLOC DM2 is a prospective, observational study of 28 subjects with T2DM and body mass index (BMI) between 30 and 40 kg/m(2) to assess mid-term safety and weight loss and improvements in glycemic parameters, and other cardiovascular risk factors with VBLOC therapy. Continuous outcome variables are reported using mixed models. At 24 months, the mean percentage of excess weight loss was 22% (95% CI, 15 to 28, p obesity and glycemic control were largely sustained after 2 years of treatment with VBLOC therapy with a well-tolerated risk profile.

  5. Blood Types

    Science.gov (United States)

    ... Drive Home Types of Blood Donations Blood Types Blood Types Not all blood is alike. There are eight ... African descent. Learn More About Blood and Diversity Blood Types and Transfusion There are very specific ways in ...

  6. Adding pharmacists to primary care teams reduces predicted long-term risk of cardiovascular events in type 2 diabetic patients without established cardiovascular disease: results from a randomized trial.

    Science.gov (United States)

    Ladhani, N N; Majumdar, S R; Johnson, J A; Tsuyuki, R T; Lewanczuk, R Z; Spooner, R; Simpson, S H

    2012-11-01

    To determine the impact of adding pharmacists to primary care teams on predicted 10-year risk of cardiovascular events in patients with Type 2 diabetes without established cardiovascular disease. This was a pre-specified secondary analysis of randomized trial data. The main study found that, compared with usual care, addition of a pharmacist resulted in improvements in blood pressure, dyslipidaemia, and hyperglycaemia for primary care patients with Type 2 diabetes. In this sub-study, predicted 10-year risk of cardiovascular events at baseline and 1 year were calculated for patients free of cardiovascular disease at enrolment. The primary outcome was change in UK Prospective Diabetes Study (UKPDS) risk score; change in Framingham risk score was a secondary outcome. Baseline characteristics were similar between the 102 intervention patients and 93 control subjects: 59% women, median (interquartile range) age 57 (50-64) years, diabetes duration 3 (1-6.5) years, systolic blood pressure 128 (120-140) mmHg, total cholesterol 4.34 (3.75-5.04) mmol/l and HbA(1c) 54 mmol/mol (48-64 mmol/mol) [7.1% (6.5-8.0%)]. Median baseline UKPDS risk score was 10.2% (6.0-16.7%) for intervention patients and 9.5% (5.8-15.1%) for control subjects (P = 0.80). One-year post-randomization, the median absolute reduction in UKPDS risk score was 1.0% greater for intervention patients compared with control subjects (P = 0.032). Similar changes were seen with the Framingham risk score (median reduction 1.2% greater for intervention patients compared with control subjects, P = 0.048). The two risk scores were highly correlated (rho = 0.83; P risk of cardiovascular events for patients with Type 2 diabetes without established cardiovascular disease. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

  7. Number of years of participation in some, but not all, types of physical activity during adolescence predicts level of physical activity in adulthood: Results from a 13-year study.

    Science.gov (United States)

    Bélanger, Mathieu; Sabiston, Catherine M; Barnett, Tracie A; O'Loughlin, Erin; Ward, Stéphanie; Contreras, Gisèle; O'Loughlin, Jennifer

    2015-06-10

    Adolescent physical activity (PA) levels track into adulthood. However it is not known if type of PA participated in during adolescence is associated with PA levels later in life. We aimed to identify natural groupings of types of PA and to assess whether number of years participating in these different groupings during adolescence is related to PA level in early adulthood. 673 adolescents in Montreal, Canada, age 12-13 years at baseline (54% female), reported participation in 29 physical activities every 3 months over 5 years (1999-2005). They also reported their PA level at age 24 years (2011-12). PA groupings among the 29 physical activities were identified using factor analysis. The association between number of years participating in each grouping during adolescence and PA level at age 24 was estimated using linear regression within a general estimating equation framework. Three PA groupings were identified: "sports", "fitness and dance", and "running". There was a positive linear relationship between number of years participating in sports and running in adolescence and PA level at age 24 years (β (95% confidence interval) = 0.09 (0.04-0.15); 0.08 (0.01-0.15), respectively). There was no relationship between fitness and dance in adolescence and PA level at age 24. The association between PA participation in adolescence and PA levels in young adulthood may be specific to certain PA types and to consistency of participation during adolescence. Results suggest that efforts to establish the habit of participation in sports and running in adolescence may promote higher PA levels in adulthood.

  8. Improvement in Depressive Symptoms Is Associated with Reduced Oxidative Damage and Inflammatory Response in Type 2 Diabetic Patients with Subsyndromal Depression: The Results of a Randomized Controlled Trial Comparing Psychoeducation, Physical Exercise, and Enhanced Treatment as Usual

    Science.gov (United States)

    Vučić Lovrenčić, Marijana; Pibernik-Okan