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Sample records for cured hypoglycemia secondary

  1. Surgically cured hypoglycemia secondary to pleural solitary fibrous tumour: case report and update review on the Doege-Potter syndrome

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    Kalebi Ahmed Y

    2009-08-01

    Full Text Available Abstract The association of paraneoplastic hypoglycemia [Doege-Potter syndrome] and finger clubbing [Pierre-Marie-Bamberg syndrome] with pleural solitary fibrous tumour is rare. We present a previously unpublished but typical example of this rare occurrence together with a detailed updated literature review of previously published cases of pleural SFT discussing the histopathology of SFT; pathophysiology of the hypoglycemia and finger clubbing; treatment and outcome of pleural SFT. The patient, a 57-year-old African male was admitted at our hospital with recurrent episodes of hypoglycemia. He was found to have digital clubbing and decreased breath sounds in the right lower chest but no other significant clinical findings. His insulin level measured during an episode of hypoglycemia was undetectable. Chest radiograph and CT-scan revealed a lobulated mass in the right chest which was diagnosed to be SFT on histology. Surgical excision of the mass resulted in cure of the hypoglycemic episodes and rapid regression of the clubbing. Less than 65 cases of pleural SFT manifesting with hypoglycemia with or without finger-clubbing have been published in the English literature. The mean diameter of these tumours manifesting with hypoglycemia is 20 cm, 54% being benign while 42% were malignant. They predominantly present in the 6th-8th decade, average age of 64 years and a slight male preponderance at 58%. Complete surgical resection remains the most important predictor of clinical outcome in terms of recurrence and metastases, while providing instant cure for the hypoglycemia and rapid resolution of the finger clubbing.

  2. Hypoglycemia

    Science.gov (United States)

    ... hypoglycemia isn't a disease itself — it's an indicator of a health problem. Immediate treatment of hypoglycemia ... need to undergo an extended fast in a hospital setting. Or if your symptoms occur ... follow the diabetes management plan you and your doctor have developed. If ...

  3. "Big IGF-II"-induced hypoglycemia secondary to gastric adenocarcinoma.

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    Morbois-Trabut, L; Maillot, F; De Widerspach-Thor, A; Lamisse, F; Couet, C

    2004-06-01

    Non-islet cell tumor-related hypoglycemia is a rare phenomenon. We report the case of a 63 Year-old man admitted for hemiparesia and a capillary blood glucose of 20 mg/dL. The presence of an immature form of IGF-II that can mimic the effect of insulin, namely "big IGF-II", explained this patient's hypoglycaemia. A moderately differentiated adenocarcinoma of the cardia with metastatic extension to the stomach and the liver was demonstrated. Octreotide failed to control the hypoglycaemia, therefore prednisolone (2 mg/kg per day) and enteral feeding prevented new episodes of severe hypoglycaemia.

  4. Nonislet Cell Tumor Hypoglycemia

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    Johnson Thomas

    2013-01-01

    Full Text Available Nonislet cell tumor hypoglycemia (NICTH is a rare cause of hypoglycemia. It is characterized by increased glucose utilization by tissues mediated by a tumor resulting in hypoglycemia. NICTH is usually seen in large mesenchymal tumors including tumors involving the GI tract. Here we will discuss a case, its pathophysiology, and recent advances in the management of NICTH. Our patient was diagnosed with poorly differentiated squamous cell carcinoma of esophagus. He continued to be hypoglycemic even after starting continuous tube feeds and D5W. General workup for hypoglycemia was negative and insulin-like growth factor II (IGF II was in the normal range. Hypoglycemia secondary to “big” IGF II was considered, and patient was started on steroids. His hypoglycemia resolved within a day of treatment with steroids. Initially patient had hypoglycemia unawareness, which he regained after maintaining euglycemia for 48 hours.

  5. Reactive Hypoglycemia

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    ... from low blood sugar (hypoglycemia) that occurs while fasting. Signs and symptoms of reactive hypoglycemia may include ... and very important. It's also important to include physical activity in your daily routine. Your doctor can help ...

  6. Low Blood Glucose (Hypoglycemia)

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    ... Disease, & Other Dental Problems Diabetes & Sexual & Urologic Problems Low Blood Glucose (Hypoglycemia) What is hypoglycemia? Hypoglycemia, also called low blood glucose or low blood sugar, occurs when ...

  7. No hypoglycemia after subcutaneous administration of glucagon-like peptide-1 in lean type 2 diabetic patients and in patients with diabetes secondary to chronic pancreatitis

    DEFF Research Database (Denmark)

    Knop, Filip K; Vilsbøll, Tina; Larsen, Steen

    2003-01-01

    or subcutaneous administration of GLP-1 concomitant with intravenous glucose results in hypoglycemia in healthy subjects. Because GLP-1 is also effective in type 2 diabetic patients and is currently being evaluated as a therapeutic agent, it is important to investigate whether GLP-1 may cause hypoglycemia...... in such patients. We have previously shown that GLP-1 does not cause hypoglycemia in obese type 2 diabetic patients with insulin resistance amounting to 5.4 +/- 1.1 according to homeostasis model assessment (HOMA). In this study, we investigated diabetic patients with normal or close to normal insulin sensitivity....... RESEARCH DESIGN AND METHODS: Eight lean type 2 diabetic patients (group 1) aged 60 years (range 50-72) with BMI 23.1 kg/m(2) (20.3-25.5) and HbA(1c) 8.0% (6.9-11.4) and eight patients with type 2 diabetes secondary to chronic pancreatitis (group 2) aged 52 years (41-62) with BMI 21.9 kg/m(2) (17...

  8. Hypoglycemia Secondary to Sulfonylurea Ingestion in a Patient with End Stage Renal Disease: Results from a 72-Hour Fast

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    Alice Abraham

    2015-01-01

    Full Text Available Insulin, proinsulin, and C-peptide levels increase with sulfonylurea exposure but the acuity of increase has not been described in dialysis patients. We present a case of a dialysis patient who presented with hypoglycemia and was found to have accidental sulfonylurea ingestion. This is a 73-year-old man with ESRD on peritoneal dialysis, without history of diabetes, who presented with hypoglycemia. Past medical history includes multiple myeloma, congestive heart failure, and hypertension. At initial presentation, his blood glucose was 47 mg/dL, with concomitant elevations in the following: C-peptide 30.5 (nl: 0.8–3.5 ng/mL, insulin 76 (nl: 3–19 μIU/mL, and proinsulin 83.3 (nl: ≤8.0 pmol/L. During the 72-hour fast, which he completed without hypoglycemia, insulin declined to be within normal limits (to 12 μIU/mL; proinsulin (to 12.1 pmol/L and C-peptide (to 7.2 ng/mL levels decreased but remained elevated. The sulfonylurea screen ultimately returned positive for glipizide, clinching the diagnosis. This is the first reported case which characterizes the chronic elevation of proinsulin in a patient with ESRD, as well as its dramatic increase after a presumed solitary exposure to sulfonylurea. The 72-hour fast conducted gives insight into the clearance of insulin, proinsulin, and C-peptide after sulfonylurea ingestion in ESRD.

  9. Neuroendocrine responses to hypoglycemia.

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    Tesfaye, Nolawit; Seaquist, Elizabeth R

    2010-11-01

    The counterregulatory response to hypoglycemia is a complex and well-coordinated process. As blood glucose concentration declines, peripheral and central glucose sensors relay this information to central integrative centers to coordinate neuroendocrine, autonomic, and behavioral responses and avert the progression of hypoglycemia. Diabetes, both type 1 and type 2, can perturb these counterregulatory responses. Moreover, defective counterregulation in the setting of diabetes can progress to hypoglycemia unawareness. While the mechanisms that underlie the development of hypoglycemia unawareness are not completely known, possible causes include altered sensing of hypoglycemia by the brain and/or impaired coordination of responses to hypoglycemia. Further study is needed to better understand the intricacies of the counterregulatory response and the mechanisms contributing to the development of hypoglycemia unawareness.

  10. Severe hypoglycemia symptoms, antecedent behaviors, immediate consequences and association with glycemia medication usage: Secondary analysis of the ACCORD clinical trial data

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    Bonds Denise E

    2012-05-01

    Full Text Available Abstract Background Hypoglycemia is a common complication of diabetes treatment. This paper describes symptoms, predecessors, consequences and medications associated with the first episode of severe hypoglycemia among ACCORD participants with type 2 diabetes, and compares these between intensive (Int: goal A1C Methods Information about symptoms, antecedents, and consequences was collected at the time participants reported an episode of severe hypoglycemia. Data on medications prescribed during the clinical trial was used to determine the association of particular diabetes drug classes and severe hypoglycemia. Results The most frequently reported symptoms in both glycemia group were weakness/fatigue (Int 29%; Std 30% and sweating (Int 26%; Std 27%, followed by confusion/disorientation (Int 22%; Std 29% and shakiness (Int 21%; Std 19%. Approximately half of all events were preceded by a variation in food intake (Int 48%; Std 58%. The most common consequences were confusion (Int 37%; Std 34%, loss of consciousness (Int 25%; Std 25%, and hospitalization (Int 18%; Std 24%. The highest rates of hypoglycemia were found among those participants treated with insulin only (Int 6.09/100 person yrs; Std 2.64/100 person yrs while the lowest were among those prescribed oral agents only (Int 1.93/100 person yrs; Std 0.20/100 person yrs. Conclusions Severe hypoglycemia episodes were frequently preceded by a change in food intake, making many episodes potentially preventable. Symptoms of confusion/disorientation and loss of consciousness were frequently seen. The highest rates of hypoglycemia were seen with prescription of insulin, either alone or in combination with other medications. Clinical Trial Registration Number: NCT00000620

  11. Hypoglycemia in Diabetes Mellitus.

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    Freeland, Barbara

    2017-09-01

    Hypoglycemia is a serious acute complication of diabetes treatment. Recognizing the risk factors and taking steps to prevent low blood glucose should be a part of self-management education for all people taking glucose-lowering medications. It is important for home care clinicians to evaluate their patient's understanding of hypoglycemia and the appropriate treatment options.

  12. No hypoglycemia after subcutaneous administration of glucagon-like peptide-1 in lean type 2 diabetic patients and in patients with diabetes secondary to chronic pancreatitis

    DEFF Research Database (Denmark)

    Knop, Filip K; Vilsbøll, Tina; Larsen, Steen

    2003-01-01

    administration of GLP-1 concomitant with intravenous glucose results in hypoglycemia in healthy subjects. Because GLP-1 is also effective in type 2 diabetic patients and is currently being evaluated as a therapeutic agent, it is important to investigate whether GLP-1 may cause hypoglycemia in such patients. We...... have previously shown that GLP-1 does not cause hypoglycemia in obese type 2 diabetic patients with insulin resistance amounting to 5.4 +/- 1.1 according to homeostasis model assessment (HOMA). In this study, we investigated diabetic patients with normal or close to normal insulin sensitivity.......Glucagon-like peptide 1 (GLP-1) is a proglucagon derivative secreted primarily from the L-cells of the small intestinal mucosa in response to the ingestion of meals. GLP-1 stimulates insulin secretion and inhibits glucagon secretion. It has previously been shown that intravenous or subcutaneous...

  13. Comparative evaluation of secondary caries formation around light-cured fluoride-releasing restorative materials

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    N Sathyajith Naik

    2017-01-01

    Full Text Available Aim: The aim of this study was to compare and evaluate secondary caries formation around light-cured fluoride-releasing restorative materials. Methodology: Standard Class V cavities were prepared on the buccal and lingual surfaces of forty extracted healthy premolars. The teeth were randomly divided into four groups of ten teeth each and labeled as Group I, II, III, and IV and restored with one of the following materials, namely, Fuji II LC (Group I, Vitremer (Group II, F-2000 (Group III, and Z-100 (Group IV; Control. The teeth were thermocycled and immersed in jars containing an acid gel for caries-like lesion formation. After 15 weeks, the samples were removed, washed, and sectioned buccolingually through the restoration. The sections were then grounded to a thickness of 80–100 µm. After imbibition in water, the sections were mounted on slides and lesions were examined, measured, and photographed with Leica DMRB Research Microscope. The observation recorded was subjected to (a analysis of variance, (b Studentized range test (Newman–Keuls, (c Snedecor's F-test. Results: The depth of the outer lesion in teeth restored with Z-100 (Group IV; Control was significantly higher than the teeth restored with F-2000 (Group III, Vitremer (Group II, and Fuji II LC (Group I (P < 0.01. The depth of the outer lesion in teeth restored with F-2000 (Group III was also significantly higher than the teeth restored with Vitremer (Group II and Fuji II LC (Group I (P < 0.01. However, there was no significant difference in depth of the outer lesions among the teeth restored with Vitremer (Group II and Fuji II LC (Group I. No wall lesion (WL was evident in teeth restored with Vitremer (Group II and Fuji II LC (Group I. The WL length and body depth in teeth restored with Z-100 (Group IV; Control were significantly higher than the teeth restored with F-2000 (Group III (P < 0.01. Conclusion: It was concluded that Fuji II LC and Vitremer had a inhibitory effect on the

  14. Enhanced therapy for primary and secondary syphilis: a longitudinal retrospective analysis of cure rates and associated factors.

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    Tittes, Julia; Aichelburg, Maximilian C; Antoniewicz, Lukasz; Geusau, Alexandra

    2013-09-01

    For the treatment of early infectious syphilis, enhanced therapy with three dosages of benzathine penicillin G has been under consideration, particularly in the human immunodeficiency virus type 1 infected population (HIV-1). The serological outcome of 249 patients with primary and secondary syphilis treated with standard or enhanced therapy was analyzed retrospectively; 98% (139/142) achieved serological cure with a single dosage and 92% with enhanced therapy (P=0.033). In HIV-1 infected individuals, cure rates were 88% after a single dosage compared to 97% after three dosages (P=0.18). A fourfold decrease of Venereal Disease Research Laboratory (VDRL) titres was achieved within a median of 102 days after treatment initiation (SD=2; 95% CI=98-106). Patients aged over 40 years were 5.5 times (OR=5.52; 95% CI=1.43-21.32; P=0.013) and patients with low baseline VDRL titres (≤ 1:32) were 4 times (OR=4.25; 95% CI=1.21-14.87; P=0.024) more likely to experience serological failure.

  15. INFLUENCE OF MOLECULAR STRUCTURES OF SECONDARY AMINE TERMINATED POLY(ESTER-AMINE)S ON THE CURING PERFORMANCE WITH EPOXY RESIN

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Five secondary amine terminated poly(ester-amine)s (defined as PEA) with controlled molecular structures were synthesized through reacting excessive piperazine with phthalicdiglycol diacrylate (PDDA) and 1,1,1-trimethylolpropane triacrylate (TMPTA) at a constant secondary amine/acrylate group ratio of 1.5/1 and at different PDDA/TMPTA molar ratios.Both IR and 1H-NMR spectra indicated that all acrylate groups were consumed in the reaction, based on which the structural parameters were calculated from the 1H-NMR spectra. With decreasing PDDA/TMPTA ratio, the content of secondary amine, degree of branching, molecular weight, Tg and Td increased accordingly. These polymers were further used as both crosslinkers and flexibilizers for a linear epoxy resin E51 to form cured films under ambient condition, The gel content,relative hardness and Tg of the resulting films increased as PEA molecules changed from linear to highly branching structures. Due to the flexibility of PEA molecules, all the films possessed excellent mechanical performance.

  16. Factors associated with serological cure and the serofast state of HIV-negative patients with primary, secondary, latent, and tertiary syphilis.

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    Man-Li Tong

    Full Text Available BACKGROUND: Some syphilis patients remain in a serologically active state after the recommended therapy. We currently know too little about the characteristics of this serological response. METHODS: We conducted a cohort study using the clinical database from Zhongshan Hospital, Medical College of Xiamen. In total, 1,327 HIV-negative patients with primary, secondary, latent, and tertiary syphilis were enrolled. Bivariate and multivariate analyses were utilised to identify factors associated with a serological cure and serofast state in syphilis patients one year after therapy. Chi-square tests were used to determine the differences in the serological cure rate across different therapy time points. RESULTS: One year after the recommended therapy, 870 patients achieved a serological cure, and 457 patients (34.4% remained in the serofast state. The serological cure rate increased only within the first 6 months. The bivariate analysis indicated that male or younger patients had a higher likelihood of a serological cure than female or older patients. Having a baseline titre ≤ 1∶2 or ≥ 1∶64 was associated with an increased likelihood of a serological cure. The serological cure rate decreased for the different disease stages in the order of primary, secondary, latent, and tertiary syphilis. A distinction should be drawn between early and late syphilis. The multivariate analysis indicated that a serological cure was significantly associated with the disease phase, gender, age, and baseline rapid plasma reagin (RPR titre. CONCLUSIONS: The serofast state is common in clinical work. After one year of the recommended therapy, quite a few syphilis patients remained RPR positive. The primary endpoint of the study indicated that disease phase, gender, age and baseline RPR titre were crucial factors associated with a serological cure.

  17. Prevention Rather than Cure? Primary or Secondary Intervention for Dealing with Media Exposure to Terrorism

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    Slone, Michelle; Shoshani, Anat

    2010-01-01

    The authors examined the efficacy of primary versus secondary intervention in moderating state anxiety and state anger from media-based exposure to terrorism. Two hundred participants, allocated to a terrorism or nonterrorism media exposure and to antecedent or subsequent therapeutic or control intervention, were assessed for state anxiety and…

  18. Prevention Rather than Cure? Primary or Secondary Intervention for Dealing with Media Exposure to Terrorism

    Science.gov (United States)

    Slone, Michelle; Shoshani, Anat

    2010-01-01

    The authors examined the efficacy of primary versus secondary intervention in moderating state anxiety and state anger from media-based exposure to terrorism. Two hundred participants, allocated to a terrorism or nonterrorism media exposure and to antecedent or subsequent therapeutic or control intervention, were assessed for state anxiety and…

  19. Hypoglycemia in Emergency Department

    Institute of Scientific and Technical Information of China (English)

    Yu-Jang Su; Chia-Jung Liao

    2015-01-01

    Objective:To study the epidemiology, etiologies and prognostic factors of hypoglycemia. Methods:A retrospective chart review of hypoglycemic cases from December, 2009 to February, 2012 was conducted to gather the following patient data: age, gender, vital signs at triage, white blood cell count, serum glucose, C-reactive protein, glutamic oxaloacetic transaminase, creatinine, sodium, potassium, past history of liver cirrhosis, uremia, concomitant infection, concomitant cancer/malignancy, length of stay, lack of recent meal, status of acute renal failure and concomitant stroke. A total of 186 cases were enrolled in our study. We analyzed the data using commercial statistics software (SPSS for Windows, version 11.0, SPSS Inc., Chicago, IL). We used the Student's t-test andχ2 test for the statistical analyses, and significance was set at a P value less than 0.05. Results: Hypoglycemia is related to several co-morbidities. In total, 10.2%of the patients had liver cirrhosis and 7.0% had uremia. More than half (55.4%) were bacterial infection during hospitalization. Acute renal failure accounted for 26.3%of the hypoglycemic episodes. In addition to the etiology of infection, the lack of a recent meal accounted for 44.6%hypoglycemic episodes. A total of 2.2%of the cases resulted from an acute cerebrovascular accident. Approximately 8.6%were concomitant with malignancy. Conclusions: When hypoglycemic patients present in the emergency department, physicians should pay attention to the presence of infection, malignancy, liver diseases (liver cirrhosis and biliary tract infection), and acute renal failure.

  20. Refractory hypoglycemia in a patient with functional adrenal cortical carcinoma

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    Katia Regina Marchetti

    2016-11-01

    Full Text Available Adrenacarcinomas are rare, and hypoglycemic syndrome resulting from the secretion of insulin-like growth factor II (IGF-II by these tumors have been described infrequently. This study describes the case of a young woman with severe persistent hypoglycemia and a large adrenal tumor and discusses the physiopathological mechanisms involved in hypoglycemia. The case is described as a 21-year-old woman who presented with 8 months of general symptoms and, in the preceding 3 months, with episodes of mental confusion and visual blurring secondary to hypoglycemia. A functional assessment of the adrenal cortex revealed ACTH-independent hypercortisolism and hyperandrogenism. Hypoglycemia, hypoinsulinemia, low C-peptide and no ketones were also detected. An evaluation of the GH–IGF axis revealed GH blockade (0.03; reference: up to 4.4 ng/mL, greatly reduced IGF-I levels (9.0 ng/mL; reference: 180–780 ng/mL, slightly reduced IGF-II levels (197 ng/mL; reference: 267–616 ng/mL and an elevated IGF-II/IGF-I ratio (21.9; reference: ~3. CT scan revealed a large expansive mass in the right adrenal gland and pulmonary and liver metastases. During hospitalization, the patient experienced frequent difficult-to-control hypoglycemia and hypokalemia episodes. Octreotide was ineffective in controlling hypoglycemia. Due to unresectability, chemotherapy was tried, but after 3 months, the patient’s condition worsened and progressed to death. In conclusion, our patient presented with a functional adrenal cortical carcinoma, with hyperandrogenism associated with hypoinsulinemic hypoglycemia and blockage of the GH–IGF-I axis. Patient’s data suggested a diagnosis of hypoglycemia induced by an IGF-II or a large IGF-II-producing tumor (low levels of GH, greatly decreased IGF-I, slightly decreased IGF-II and an elevated IGF-II/IGF-I ratio.

  1. Plasma glucagon and glucose recovery after hypoglycemia

    DEFF Research Database (Denmark)

    Hilsted, J; Frandsen, Henrik Lund; Holst, Janett

    1991-01-01

    ) and of isolated alpha-adrenergic blockade on hormonal responses to hypoglycemia and on blood glucose recovery after hypoglycemia in healthy subjects. Neither of the pharmacological blockades had any significant effects on plasma glucagon responses to hypoglycemia nor had they any effect on the rate of blood...... glucose recovery after hypoglycemia. We conclude that the autonomic nervous system has no major influence on the glucagon response to hypoglycemia in healthy man. Changes in autonomic nervous activity are not essential for blood glucose recovery after hypoglycemia in healthy man....

  2. Individual and societal consequences of hypoglycemia

    DEFF Research Database (Denmark)

    Dømgaard, Mikala; Bagger, Malene; Rhee, Nicolai Alexander

    2015-01-01

    BACKGROUND: Hypoglycemia and fear of hypoglycemia threaten individuals' ability to work and drive. We studied the effect of hypoglycemia on the individual and society, with a focus on possible implications of new European union legislation on patients' continued ability to drive. METHODS: A cross...

  3. Norepinephrine kinetics during insulin-induced hypoglycemia

    DEFF Research Database (Denmark)

    Hilsted, J; Christensen, N J; Larsen, S

    1985-01-01

    Norepinephrine (NE) kinetics (plasma appearance rate, clearance, and forearm extraction) were measured during insulin-induced hypoglycemia in six healthy subjects. NE clearance did not change during hypoglycemia, indicating that the increase in plasma NE during hypoglycemia is due to an increased...

  4. Profound Hypoglycemia with Ecstasy Intoxication

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    Perliveh Carrera

    2015-01-01

    Full Text Available Background. 3,4-Methylenedioxymethamphetamine (MDMA or ecstasy is a synthetic drug that is commonly abused for its stimulant and euphoric effects. Adverse MDMA effects include hyperthermia, psychomotor agitation, hemodynamic compromise, renal failure, hyponatremia, and coma. However, endogenous hyperinsulinemia with severe persistent hypoglycemia has not been reported with MDMA use. Case Report. We report the case of a 29-year-old woman who remained severely hypoglycemic requiring continuous intravenous infusion of high-dose dextrose solutions for more than 24 hours after MDMA intoxication. Serum insulin and C-peptide levels confirmed marked endogenous hyperinsulinemia as the cause of the severe hypoglycemia. Why Should an Emergency Physician Be Aware of This? Immediate and frequent monitoring of blood glucose should be instituted in patients presenting with MDMA ingestion particularly if found to be initially hypoglycemic. Early recognition can help prevent the deleterious effects of untreated hypoglycemia that can add to the morbidity from MDMA use. Clinicians need to be aware of this side effect of MDMA so they can carefully monitor and treat it, especially in patients presenting with altered mental status.

  5. Postprandial Hypoglycemia: An Unusual Presentation for Insulinoma

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    Filiz Ekşi Haydardedeoğlu

    2016-03-01

    Full Text Available Insulinoma is the most common type of islet cell tumor of the pancreas and its incidence is estimated at four per one million persons per year. Although fasting hypoglycemia is the typical presentation, cases with postprandial hypoglycemia have rarely been reported. A 48-year-old woman was admitted to our department for evaluation of hypoglycemia. Laboratory data suggested a state of postprandial endogenous hyperinsulinemic hypoglycemia. Abdominal computed tomography revealed a mass lesion measuring 20 mm at the distal pancreas. A decision was made to perform an arterial calcium-stimulated venous sampling for excluding nesidioblastosis coexisting with a pancreatic incidental mass. After that the patient was referred to surgery. Pathological examination revealed a low-grade well-differentiated neuroendocrine tumor with regional lymph node metastasis. Herein, we report a case of malignant insulinoma presenting with postprandial hypoglycemia and discuss the differential diagnosis and possible mechanisms of postprandial hypoglycemia in insulinoma cases.

  6. Impact of hypoglycemia on daily life of type 2 diabetes patients in Ukraine

    Science.gov (United States)

    Mandrik, Olena; Severens, Johan L; Doroshenko, Olena; Pan’kiv, Vladymir; Kravchun, Nonna; Vlasenko, Maryna; Hulchiy, Mykola; Baljuk, Maryna; Komisarenko, Yuliia; Martsynik, Eugene; Sokolova, Liubov; Zalis’ka, Olga; Mankovsky, Boris

    2013-01-01

    This study evaluates the impact of hypoglycemia on the lives of Ukrainian patients with type 2 diabetes mellitus. The secondary objective was to explore patient–physician relationships and the attitudes of patients towards various informational resources on diabetes management. Three focus groups with 26 patients were conducted. Qualitative information was evaluated using content analysis. The results show that patients with type 2 diabetes mellitus in Ukraine are adapting to potential attacks of hypoglycemia; however, they still experience periodic manifestations of hypoglycemia that significantly affect their psychological well-being. This result is similar to observations made in other countries. Ukrainian patients >40 years old mainly receive information on disease management from endocrinologists, and rarely use internet resources on diabetes management. Information provision was especially important at the early stage of the disease, when patients lack information on hypoglycemia manifestations and could therefore fail to identify and manage it properly. PMID:23874102

  7. HYPOGLYCEMIA INDUCED BY ANTIDIABETIC SULFONYLUREAS.

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    Confederat, Luminiţa; Constantin, Sandra; Lupaşcu, Florentina; Pânzariu, Andreea; Hăncianu, Monica; Profire, Lenuţa

    2015-01-01

    Diabetes mellitus is a major health problem due to its increasing prevalence and life-threatening complications. Antidiabetic sulfonylureas represent the first-line drugs in type 2 diabetes even though the most common associated risk is pharmacologically-induced hypoglycemia. In the development of this side effect are involved several factors including the pharmacokinetic and pharmacodynamic profile of the drug, patient age and behavior, hepatic or renal dysfunctions, or other drugs associated with a high risk of interactions. If all these are controlled, the risk-benefit balance can be equal to other oral antidiabetic drugs.

  8. Hypoglycemia

    Science.gov (United States)

    ... No matter how careful parents and children are, kids with diabetes at some point will have episodes of low ... previous 1 • 2 • 3 • 4 For Teens For Kids For Parents MORE ON THIS TOPIC Diabetes Center Diabetes Control: Why It's Important Your Child's ...

  9. Update on strategies limiting iatrogenic hypoglycemia.

    Science.gov (United States)

    Bonaventura, Aldo; Montecucco, Fabrizio; Dallegri, Franco

    2015-09-01

    The prevalence of type 2 diabetes mellitus (T2DM) is increasing all over the world. Targeting good glycemic control is fundamental to avoid the complications of diabetes linked to hyperglycemia. This narrative review is based on material searched for and obtained via PubMed up to April 2015. The search terms we used were: 'hypoglycemia, diabetes, complications' in combination with 'iatrogenic, treatment, symptoms.' Serious complications might occur from an inappropriate treatment of hyperglycemia. The most frequent complication is iatrogenic hypoglycemia that is often associated with autonomic and neuroglycopenic symptoms. Furthermore, hypoglycemia causes acute cardiovascular effects, which may explain some of the typical symptoms: ischemia, QT prolongation, and arrhythmia. With regards to the latter, the night represents a dangerous period because of the major increase in arrhythmias and the prolonged period of hypoglycemia; indeed, sleep has been shown to blunt the sympatho-adrenal response to hypoglycemia. Two main strategies have been implemented to reduce these effects: monitoring blood glucose values and individualized HbA1c goals. Several drugs for the treatment of T2DM are currently available and different combinations have been recommended to achieve individualized glycemic targets, considering age, comorbidities, disease duration, and life expectancy. In conclusion, according to international guidelines, hypoglycemia-avoiding therapy must reach an individualized glycemic goal, which is the lowest HbA1c not causing severe hypoglycemia and preserving awareness of hypoglycemia. © 2015 The authors.

  10. Cerebral blood flow response to hypoglycemia is altered in patients with type 1 diabetes and impaired awareness of hypoglycemia.

    Science.gov (United States)

    Wiegers, Evita C; Becker, Kirsten M; Rooijackers, Hanne M; von Samson-Himmelstjerna, Federico C; Tack, Cees J; Heerschap, Arend; de Galan, Bastiaan E; van der Graaf, Marinette

    2017-06-01

    It is unclear whether cerebral blood flow responses to hypoglycemia are altered in people with type 1 diabetes and impaired awareness of hypoglycemia. The aim of this study was to investigate the effect of hypoglycemia on both global and regional cerebral blood flow in type 1 diabetes patients with impaired awareness of hypoglycemia, type 1 diabetes patients with normal awareness of hypoglycemia and healthy controls ( n = 7 per group). The subjects underwent a hyperinsulinemic euglycemic-hypoglycemic glucose clamp in a 3 T MR system. Global and regional changes in cerebral blood flow were determined by arterial spin labeling magnetic resonance imaging, at the end of both glycemic phases. Hypoglycemia generated typical symptoms in patients with type 1 diabetes and normal awareness of hypoglycemia and healthy controls, but not in patients with impaired awareness of hypoglycemia. Conversely, hypoglycemia increased global cerebral blood flow in patients with impaired awareness of hypoglycemia, which was not observed in the other two groups. Regionally, hypoglycemia caused a redistribution of cerebral blood flow towards the thalamus of both patients with normal awareness of hypoglycemia and healthy controls, consistent with activation of brain regions associated with the autonomic response to hypoglycemia. No such redistribution was found in the patients with impaired awareness of hypoglycemia. An increase in global cerebral blood flow may enhance nutrient supply to the brain, hence suppressing symptomatic awareness of hypoglycemia. Altogether these results suggest that changes in cerebral blood flow during hypoglycemia contribute to impaired awareness of hypoglycemia.

  11. Metabolic responses to hypoglycemia in juvenile diabetics

    DEFF Research Database (Denmark)

    Hilsted, J; Madsbad, S; Krarup, T;

    1980-01-01

    Glucagon and metabolic responses to insulin-induced hypoglycemia were studied in seven juvenile diabetics, age 31 +/- 2 years (mean and S.E.M.), duration of diabetes 17 +/- 3 years, with diabetic autonomic neuropathy (decreased beat-to-beat variation in heart rate during hyperventilation and...... in both patient groups. Metabolic responses to hypoglycemia were also similar in the two patient groups. In conclusion, diabetic autonomic neuropathy has no effect on glucagon and metabolic responses to hypoglycemia in juvenile, insulin-treated diabetics....

  12. Norfloxacin-induced hypoglycemia and urticaria

    National Research Council Canada - National Science Library

    Mishra, Ajay; Dave, Nikhil

    2012-01-01

    ...)-sensitive potassium channels in pancreatic β-cell membranes. This report highlights hypoglycemia with urticaria as an adverse drug reaction of norfloxacin in a middle aged non-diabetic patient...

  13. Economic Burden of Hypoglycemia in Patients with Type 2 Diabetes Mellitus from Korea.

    Directory of Open Access Journals (Sweden)

    Gyuri Kim

    Full Text Available Hypoglycemia is a very serious complication in patients with type 2 diabetes mellitus (T2DM and affects the economic burden of treatment. This study aims to create models of the cost of treating hypoglycemia in patients with T2DM based upon physician estimates of medical resource usage.Using a literature review and personal advice from endocrinologists and emergency physicians, we developed several models for managing patients with hypoglycemia. The final model was approved by the consulting experts. We also developed 3 unique surveys to allow endocrinologists, emergency room (ER physicians, and primary care physicians to evaluate the resource usage of patients with hypoglycemia. Medical costs were calculated by multiplying the estimated medical resource usage by the corresponding health insurance medical care costs reported in 2014.In total, 40 endocrinologists, 20 ER physicians, and 30 primary care physicians completed the survey. We identified 12 types of standard medical models for secondary or tertiary hospitals and 4 for primary care clinics based on the use of ER, general ward, or intensive care unit (ICU and patients' status of consciousness and self-respiration. Estimated medical costs per person per hypoglycemic event ranged from $17.28 to $1,857.09 for secondary and tertiary hospitals. These costs were higher for patients who were unconscious and for those requiring ICU admission.Hypoglycemia has a substantial impact on the medical costs and its prevention will result in economic benefits for T2DM patients and society.

  14. Impact of hypoglycemia on daily life of type 2 diabetes patients in Ukraine

    NARCIS (Netherlands)

    E.A. Mandrik (Olena); J.L. Severens (Hans); O. Doroshenko (Olena); V. Pan'kiv (Vladymir); N. Kravchun (Nonna); M. Vlasenko (Maryna); M. Hulchiy (Mykola); M. Baljuk (Maryna); Y. Komisarenko (Yuliia); E. Martsynik (Eugene); L. Sokolova (Liubov); O. Zalis'ka (Olga); B. Mankovsky (Boris)

    2013-01-01

    textabstractThis study evaluates the impact of hypoglycemia on the lives of Ukrainian patients with type 2 diabetes mellitus. The secondary objective was to explore patient-physician relationships and the attitudes of patients towards various informational resources on diabetes management. Three foc

  15. Hypoglycemia during moderate intensity exercise reduces counterregulatory responses to subsequent hypoglycemia.

    Science.gov (United States)

    Cade, W Todd; Khoury, Nadia; Nelson, Suzanne; Shackleford, Angela; Semenkovich, Katherine; Krauss, Melissa J; Arbeláez, Ana María

    2016-09-01

    Hypoglycemia, which occurs commonly during and following exercise in people with diabetes, is thought to be due to attenuated counterregulation in the setting of therapeutic insulin excess. To better understand the pathophysiology of counterregulation, we aimed to determine if dextrose administration to maintain euglycemia during moderate intensity exercise alters the attenuation of counterregulatory responses to subsequent hypoglycemia in healthy adults : Counterregulatory responses to hypoglycemia were assessed in 18 healthy adults after bed rest and following exercise with (n = 9) and without (n = 9) dextrose infusion. Responses were measured during a stepped euglycemic-hypoglycemic clamp 24 h after either bed rest or two 90-min bouts of exercise at 70% peak oxygen uptake : Hypoglycemia occurred during the second bout of exercise without dextrose infusion. Plasma glucagon and epinephrine responses to stepped hypoglycemia after antecedent exercise without dextrose infusion were significantly lower at the 45 mg/dL glycemic level compared to after bed rest. However, no attenuation of the counterregulatory responses to hypoglycemia was evident after antecedent exercise when dextrose was infused. This study suggests that the attenuation of the counterregulatory responses during hypoglycemia after exercise is likely due to the hypoglycemia that occurs during moderate prolonged exercise and not solely due to exercise or its intensity.

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

    DEFF Research Database (Denmark)

    Hendrieckx, Christel; Hagger, Virginia; Jenkins, Alicia

    2017-01-01

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

  17. Vascular Cures

    Science.gov (United States)

    ... is Possible EVERY DOLLAR SAVES LIVES. Donate Now Vascular Cures innovates patient-centered research, catalyzes breakthrough collaborations and empowers people in their vascular health journey. what is vascular disease PATIENTS see ...

  18. Hypoglycemia in type 2 diabetes: Standpoint of an experts′ committee (India hypoglycemia study group

    Directory of Open Access Journals (Sweden)

    Mohan Viswanathan

    2012-01-01

    Full Text Available The epidemic of type 2 diabetes and the recognition that achieving specific glycemic goals can substantially reduce morbidity have made the effective treatment of hyperglycemia a top priority. Despite compelling evidence that tight glycemic control is crucial for delaying disease progression, increased risk of hypoglycemia associated with such control underscore the complexity of diabetes management. In most cases, hypoglycemia results from an excess of insulin, either absolute or relative to the available glucose substrate and the factors perhaps exacerbating the risk are pharmacokinetic imperfections, behavioral, co-morbidities etc. Additionally, many patients remain undiagnosed, and many diagnosed patients are not treated appropriately. In this article, the challenges of hypoglycemia, confronting health care providers and their patients with diabetes, are discussed for making treatment decisions that will help minimize risk of hypoglycemia and eventually overcome formidable barriers to optimal diabetes management. Strategies to treat and minimize the frequency and severity of hypoglycemia without compromising on glycemic goals are also presented.

  19. Severe Hypoglycemia Accompanied with Thyroid Crisis

    Directory of Open Access Journals (Sweden)

    Yuki Nakatani

    2012-01-01

    Full Text Available We report a 32-year-old Japanese women with severe hypoglycemia accompanied with thyroid crisis. She complained of dyspnea, general fatigue, and leg edema. She was diagnosed with hyperthyroidism with congestive heart failure and liver dysfunction. Soon after admission, sudden cardiopulmonary arrest occurred. She was then transferred to the intensive care unit. Her serum glucose level was 7 mg/dl. Intravenous glucose, hydrocortisone, diuretics, and continuous hemodiafiltration (CHDF saved her. We considered that hypoglycemia occurred due to heart failure and liver dysfunction due to thyroid crisis.

  20. Cross-cultural variation in symptom perception of hypoglycemia

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2013-01-01

    Conclusion: Significant cross-cultural differences related to the symptomatology of hypoglycemia are noted. Indian diabetologists should be aware of the varying presentation of hypoglycemia based on language and ethnic background.

  1. Persistent Hypoglycemia in Patient with Hodgkin’s Disease

    OpenAIRE

    Harold Cinco Lim; Lubna Bashir Munshi; David Sharon

    2015-01-01

    Hypoglycemia is a rare complication of Hodgkin's disease. Several explanations have been postulated but the exact pathophysiology is not well understood. We are presenting a case of newly diagnosed Stage IV Hodgkin's disease that developed persistent and recurrent hypoglycemia despite giving glucagon, repeated 50% dextrose, and D5 and D10 continuous infusion. Hypoglycemia workup showed the C-peptide level to be low. Patient was suspected of having hypoglycemia related to lymphoma and was give...

  2. The economic impact of insulin-related hypoglycemia in Denmark

    DEFF Research Database (Denmark)

    Hoskins, Nicki; Tikkanen, Christian Klyver; Pedersen-Bjergaard, Ulrik

    2017-01-01

    AIMS: To estimate the direct cost of hypoglycemia in insulin-treated adults with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in Denmark. MATERIALS AND METHODS: The Local Impact of Hypoglycemia Tool (LIHT) was used to estimate the costs associated with insulin-related hypoglycemia. Average......, the costs associated with using a new insulin or introducing a patient education program could be offset with the cost saving from reducing hypoglycemia....

  3. Hypoglycemia-associated changes in the electroencephalogram in patients with type 1 diabetes and normal hypoglycemia awareness or unawareness

    DEFF Research Database (Denmark)

    Sejling, A. S.; Kjaer, T. W.; Pedersen-Bjergaard, U.;

    2015-01-01

    Hypoglycemia is associated with increased activity in the low-frequency bands in the electroencephalogram (EEG). We investigated whether hypoglycemia awareness and unawareness are associated with different hypoglycemia-associated EEG changes in patients with type 1 diabetes.Twenty-four patients...... participated in the study; 10 with normal hypoglycemia awareness and 14 with hypoglycemia unawareness. The patients were studied at normoglycemia (5-6 mmol/l), hypoglycemia (2.0-2.5 mmol/l) and during recovery (5-6 mmol/l) by hyperinsulinemic glucose clamp. During each one-hour period, EEG, cognitive function...... amplitude remained increased. Cognitive function declined equally during hypoglycemia in both groups and during recovery reaction time was still prolonged in a subset of tests. The aware group reported higher hypoglycemia symptom scores and had higher epinephrine and cortisol responses compared...

  4. Decreased rates of hypoglycemia following implementation of a comprehensive computerized insulin order set and titration algorithm in the inpatient setting.

    Science.gov (United States)

    Sinha Gregory, Naina; Seley, Jane Jeffrie; Gerber, Linda M; Tang, Chin; Brillon, David

    2016-12-01

    More than one-third of hospitalized patients have hyperglycemia. Despite evidence that improving glycemic control leads to better outcomes, achieving recognized targets remains a challenge. The objective of this study was to evaluate the implementation of a computerized insulin order set and titration algorithm on rates of hypoglycemia and overall inpatient glycemic control. A prospective observational study evaluating the impact of a glycemic order set and titration algorithm in an academic medical center in non-critical care medical and surgical inpatients. The initial intervention was hospital-wide implementation of a comprehensive insulin order set. The secondary intervention was initiation of an insulin titration algorithm in two pilot medicine inpatient units. Point of care testing blood glucose reports were analyzed. These reports included rates of hypoglycemia (BG 200 mg/dL in phase 1, BG > 180 mg/dL in phase 2). In the first phase of the study, implementation of the insulin order set was associated with decreased rates of hypoglycemia (1.92% vs 1.61%; p algorithm was associated with decreased rates of hypoglycemia (2.57% vs 1.82%; p = 0.039) and increased rates of hyperglycemia (31.76% vs 41.33%; p set and titration algorithm significantly decreased rates of hypoglycemia. This significant reduction in hypoglycemia was associated with increased rates of hyperglycemia. Hardwiring the algorithm into the electronic medical record may foster adoption.

  5. Rituximab induced hypoglycemia in non-Hodgkin's lymphoma

    Directory of Open Access Journals (Sweden)

    Lali V

    2006-12-01

    Full Text Available Abstract Background Hypoglycemia is a vary rare toxicity of rituximab. The exact mechanism of rituximab induced hypoglycemia is not clear. Case presentation A 50 year old female presented with a left tonsillar non Hodgkin's lymphoma and was started on R-CHOP chemotherapy. Twenty four hours after the first rituximab infusion, she developed hypoglycemia which was managed by IV glucose infusion. Conclusion Hypoglycemia following rituximab administration is rare. Possibilities of hypoglycemia should be kept in mind in patients developing symptoms like fatigue, restlessness, and sweating while on rituximab therapy.

  6. Prevention of hypoglycemia-induced neuronal death by minocycline.

    Science.gov (United States)

    Won, Seok Joon; Kim, Jin Hee; Yoo, Byung Hoon; Sohn, Min; Kauppinen, Tiina M; Park, Man-Seong; Kwon, Hyung-Joo; Liu, Jialing; Suh, Sang Won

    2012-09-22

    Diabetic patients who attempt strict management of blood glucose levels frequently experience hypoglycemia. Severe and prolonged hypoglycemia causes neuronal death and cognitive impairment. There is no effective tool for prevention of these unwanted clinical sequelae. Minocycline, a second-generation tetracycline derivative, has been recognized as an anti-inflammatory and neuroprotective agent in several animal models such as stroke and traumatic brain injury. In the present study, we tested whether minocycline also has protective effects on hypoglycemia-induced neuronal death and cognitive impairment. To test our hypothesis we used an animal model of insulin-induced acute hypoglycemia. Minocycline was injected intraperitoneally at 6 hours after hypoglycemia/glucose reperfusion and injected once per day for the following 1 week. Histological evaluation for neuronal death and microglial activation was performed from 1 day to 1 week after hypoglycemia. Cognitive evaluation was conducted 6 weeks after hypoglycemia. Microglial activation began to be evident in the hippocampal area at 1 day after hypoglycemia and persisted for 1 week. Minocycline injection significantly reduced hypoglycemia-induced microglial activation and myeloperoxidase (MPO) immunoreactivity. Neuronal death was significantly reduced by minocycline treatment when evaluated at 1 week after hypoglycemia. Hypoglycemia-induced cognitive impairment is also significantly prevented by the same minocycline regimen when subjects were evaluated at 6 weeks after hypoglycemia. Therefore, these results suggest that delayed treatment (6 hours post-insult) with minocycline protects against microglial activation, neuronal death and cognitive impairment caused by severe hypoglycemia. The present study suggests that minocycline has therapeutic potential to prevent hypoglycemia-induced brain injury in diabetic patients.

  7. Prevention of hypoglycemia-induced neuronal death by minocycline

    Directory of Open Access Journals (Sweden)

    Won Seok

    2012-09-01

    Full Text Available Abstract Diabetic patients who attempt strict management of blood glucose levels frequently experience hypoglycemia. Severe and prolonged hypoglycemia causes neuronal death and cognitive impairment. There is no effective tool for prevention of these unwanted clinical sequelae. Minocycline, a second-generation tetracycline derivative, has been recognized as an anti-inflammatory and neuroprotective agent in several animal models such as stroke and traumatic brain injury. In the present study, we tested whether minocycline also has protective effects on hypoglycemia-induced neuronal death and cognitive impairment. To test our hypothesis we used an animal model of insulin-induced acute hypoglycemia. Minocycline was injected intraperitoneally at 6 hours after hypoglycemia/glucose reperfusion and injected once per day for the following 1 week. Histological evaluation for neuronal death and microglial activation was performed from 1 day to 1 week after hypoglycemia. Cognitive evaluation was conducted 6 weeks after hypoglycemia. Microglial activation began to be evident in the hippocampal area at 1 day after hypoglycemia and persisted for 1 week. Minocycline injection significantly reduced hypoglycemia-induced microglial activation and myeloperoxidase (MPO immunoreactivity. Neuronal death was significantly reduced by minocycline treatment when evaluated at 1 week after hypoglycemia. Hypoglycemia-induced cognitive impairment is also significantly prevented by the same minocycline regimen when subjects were evaluated at 6 weeks after hypoglycemia. Therefore, these results suggest that delayed treatment (6 hours post-insult with minocycline protects against microglial activation, neuronal death and cognitive impairment caused by severe hypoglycemia. The present study suggests that minocycline has therapeutic potential to prevent hypoglycemia-induced brain injury in diabetic patients.

  8. [Diabetes mellitus induced by pentamidine, without previous episodes of hypoglycemia, in patients with AIDS].

    Science.gov (United States)

    Santos, I; del Arco, C; García-Polo, I; Noguerado, A; Caso, E; Gómez-Pan, A

    1990-12-01

    The onset of a pneumonia by P. carinii in AIDS patients have force scientist to look for others therapies against this parasite. It is more necessary when the first line treatment which is cotrimoxazol produced secondary effects or not therapeutic effects. Pentamidine which is an agent usually used to treat leishmaniasis and trypanosomiasis, but it is an alternative for P. carinii infection. The problems are the frequent and severe secondary effects when administered by continuous infusions and less when it is inhaled. Between those effects are the changes in carbohydrate metabolism which are 9% of them. It is frequent observe hypoglycemia during infusion following by hyperglycemia in 5% of the cases which convert the patients in diabetic insulinodependent. A case of a patient who developed diabetes mellitus insulinodependent, 10 days after the end of pentamidine treatment, without previous episodes of hypoglycemia, is presented. The medical literature is reviewed.

  9. Norfloxacin-induced hypoglycemia and urticaria

    Directory of Open Access Journals (Sweden)

    Ajay Mishra

    2012-01-01

    Full Text Available Fluoroquinolone-induced hypoglycemia is not a common adverse drug reaction. However, it has been reported with most of the available agents and appears to be more common in elderly patients with a history of type 2 diabetes who are receiving oral sulfonylureas. The exact mechanism of this effect is unknown but is postulated to be a result of blockage of Adenosine 5′-Triphosphate (ATP-sensitive potassium channels in pancreatic β-cell membranes. This report highlights hypoglycemia with urticaria as an adverse drug reaction of norfloxacin in a middle aged non-diabetic patient. Clinicians should be alert about the possibility of its potential adverse effect in patients who are receiving norfloxacin therapy.

  10. Increased Mortality of Patients With Diabetes Reporting Severe Hypoglycemia

    OpenAIRE

    McCoy, Rozalina G.; Van Houten, Holly K; Ziegenfuss, Jeanette Y; Nilay D. Shah; Wermers, Robert A; Smith, Steven A.

    2012-01-01

    OBJECTIVE Hypoglycemia is a cause of significant morbidity among patients with diabetes and may be associated with greater risk of death. We conducted a retrospective study to determine whether patient self-report of severe hypoglycemia is associated with increased mortality. RESEARCH DESIGN AND METHODS Adult patients (N = 1,020) seen in a specialty diabetes clinic between August 2005 and July 2006 were questioned about frequency of hypoglycemia during a preencounter interview; 7 were lost to...

  11. Hypoglycemia-associated electroencephalogram and electrocardiogram changes appear simultaneously

    DEFF Research Database (Denmark)

    Larsen, Anine Poulsen; Højlund, Kurt; Poulsen, Mikael Kjær;

    2013-01-01

    Tight glycemic control in type 1 diabetes mellitus (T1DM) may be accomplished only if severe hypoglycemia can be prevented. Biosensor alarms based on the body's reactions to hypoglycemia have been suggested. In the present study, we analyzed three lead electrocardiogram (ECG) and single-channel e......Tight glycemic control in type 1 diabetes mellitus (T1DM) may be accomplished only if severe hypoglycemia can be prevented. Biosensor alarms based on the body's reactions to hypoglycemia have been suggested. In the present study, we analyzed three lead electrocardiogram (ECG) and single...

  12. Hypoglycemia and hemostatic parameters in juvenile-onset diabetes

    DEFF Research Database (Denmark)

    Hilsted, J; Madsbad, S; Nielsen, J D;

    1980-01-01

    Hypoglycemia was induced by intravenous infusion of insulin in six juvenile-onset diabetic subjects. Hemostatic parameters were assessed before insulin infusion and 0, 1, and 2 h after discontinuation of insulin infusion. The onset of hypoglycemia coincided with an enhancement of ADP-induced plat......Hypoglycemia was induced by intravenous infusion of insulin in six juvenile-onset diabetic subjects. Hemostatic parameters were assessed before insulin infusion and 0, 1, and 2 h after discontinuation of insulin infusion. The onset of hypoglycemia coincided with an enhancement of ADP...... potentially lead to intravascular coagulation in juvenile-onset diabetic patients....

  13. Management of Refractory Noninsulinoma Pancreatogenous Hypoglycemia Syndrome with Gastric Bypass Reversal: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Bhavana B. Rao

    2015-01-01

    Full Text Available Background. Roux-en-Y gastric bypass (RYGB is a commonly performed, effective bariatric procedure; however, rarely, complications such as postprandial hypoglycemia due to noninsulinoma pancreatogenous hypoglycemia syndrome (NIPHS may ensue. Management of refractory NIPHS is challenging. We report a case that was successfully treated with RYGB reversal. Case Report. A 58-year-old male with history of RYGB nine months earlier for morbid obesity presented for evaluation of postprandial, hypoglycemic seizures. Testing for insulin level, insulin antibodies, oral hypoglycemic agents, pituitary axis hormone levels, and cortisol stimulation was unrevealing. Computed tomography (CT scan of the abdomen was unremarkable. A 72-hour fast was completed without hypoglycemia. Mixed meal testing demonstrated endogenous hyperinsulinemic hypoglycemia (EHH and selective arterial calcium stimulation testing (SACST was positive. Strict dietary modifications, maximal medical therapy, gastrostomy tube feeding, and stomal reduction failed to alleviate symptoms. Ultimately, he underwent laparoscopic reversal of RYGB. Now, 9 months after reversal, he has markedly reduced hypoglycemia burden. Discussion. Hyperfunctioning islets secondary to exaggerated incretin response and altered intestinal nutrient delivery are hypothesized to be causative in NIPHS. For refractory cases, there is increasing skepticism about the safety and efficacy of pancreatic resection. RYGB reversal may be successful.

  14. QT measurement and heart rate correction during hypoglycemia

    DEFF Research Database (Denmark)

    Christensen, Toke Folke; Randløv, Jette; Christensen, Leif Engmann;

    2010-01-01

    Introduction. Several studies show that hypoglycemia causes QT interval prolongation. The aim of this study was to investigate the effect of QT measurement methodology, heart rate correction, and insulin types during hypoglycemia. Methods. Ten adult subjects with type 1 diabetes had hypoglycemia...... induced by intravenous injection of two insulin types in a cross-over design. QT measurements were done using the slope-intersect (SI) and manual annotation (MA) methods. Heart rate correction was done using Bazett's (QTcB) and Fridericia's (QTcF) formulas. Results. The SI method showed significant...... a significant impact on the prolongation of QT during hypoglycemia. Heart rate correction may also influence the QT during hypoglycemia while the type of insulin is insignificant. Prolongation of QTc in this study did not reach pathologic values suggesting that QTc prolongation cannot fully explain the dead...

  15. Recurrent Hypoglycemia in a Hemodialysis Patient Related to Propoxyphene Treatment

    Directory of Open Access Journals (Sweden)

    Hui-Ting Lee

    2007-07-01

    Full Text Available There are various etiologies for hypoglycemia in patients with chronic renal failure, and its pathogenesis is complex. Concomitant use of medications is the most common cause. We report a rare case of an 82-year-old woman with type 2 diabetes mellitus in end-stage renal disease undergoing maintenance hemodialysis, who experienced recurrent symptomatic hypoglycemia during treatment with propoxyphene for pain relief. Hypoglycemia occurred simultaneously with elevated levels of serum immunoreactive insulin and C-peptide. After discontinuing propoxyphene, hypoglycemia mitigated and the level of insulin returned to normal range. Our case reminds us that propoxyphene-induced hypoglycemia should not be ignored, especially in hemodialysis patients with cold sweats, agitation and depressed consciousness.

  16. Hypoglycemia-Induced Changes in the Electroencephalogram: An Overview

    DEFF Research Database (Denmark)

    Blaabjerg, Lykke; Juhl, Claus Bogh

    2016-01-01

    Hypoglycemia is defined by an abnormally low blood glucose level. The condition develops when rates of glucose entry into the systematic circulation are reduced relative to the glucose uptake by the tissues. A cardinal manifestation of hypoglycemia arises from inadequate supply of glucose...... to the brain, where glucose is the primary metabolic fuel. The brain is one of the first organs to be affected by hypoglycemia. Shortage of glucose in the brain, or neuroglycopenia, results in a gradual loss of cognitive functions causing slower reaction time, blurred speech, loss of consciousness, seizures......, and ultimately death, as the hypoglycemia progresses. The electrical activity in the brain represents the metabolic state of the brain cells and can be measured by electroencephalography (EEG). An association between hypoglycemia and changes in the EEG has been demonstrated, although blood glucose levels alone...

  17. The unexpected truth about dates and hypoglycemia

    Directory of Open Access Journals (Sweden)

    Mohammed I Yasawy

    2016-01-01

    Full Text Available Background: Dates are a concentrated source of essential nutrients, vitamins, minerals, and carbohydrates (CHOs, which are necessary for the maintenance of optimum health. Most of the CHOs in dates come from sugars including glucose and fructose. Dates are commonly consumed in Saudi Arabia, particularly at the time of breaking the fast to provide instant energy and maintain blood sugar level. However, dates may cause hypoglycemia in a rare condition named as heredity fructose intolerance (HFI, and a few families have been to see us with a history of that nature. This is to report the preliminary results of an on-going study of a group of patients who get symptoms of hypoglycemia following the ingestion of dates and have suffered for years without an accurate diagnosis. Methodology: This report is based on three patients, from the same family, living in a date growing region of the Kingdom of Saudi Arabia (KSA. The patients had been to several medical centers without getting any definite answers or diagnosis until they were referred to the Gastroenterology Clinic of King Fahd Hospital of the University, Al-Khobar, KSA. The data were obtained by careful history and laboratory investigations, and a final diagnosis of HFI made on fructose intolerance test (FIT. Results: The patients reported that they had avoided eating dates because of various symptoms, such as bloating, nausea, and even hypoglycemia when larger amounts were consumed. Their other symptoms included sleepiness, sweating, and shivering. After full examinations and necessary laboratory tests based on the above symptoms, FIT was performed and the patients were diagnosed with HFI. They were referred to a dietitian who advised a fructose-free diet. They felt well and were free of symptoms. Conclusion: HFI may remain undiagnosed until adulthood and may lead to disastrous complications and even death. The diagnosis can only be suspected after a careful dietary history is taken supported by

  18. Optimal Composite Curing System

    Science.gov (United States)

    Handel, Paul; Guerin, Daniel

    The Optimal Composite Curing System (OCCS) is an intelligent control system which incorporates heat transfer and resin kinetic models coupled with expert knowledge. It controls the curing of epoxy impregnated composites, preventing part overheating while maintaining maximum cure heatup rate. This results in a significant reduction in total cure time over standard methods. The system uses a cure process model, operating in real-time, to determine optimal cure profiles for tool/part configurations of varying thermal characteristics. These profiles indicate the heating and cooling necessary to insure a complete cure of each part in the autoclave in the minimum amount of time. The system coordinates these profiles to determine an optimal cure profile for a batch of thermally variant parts. Using process specified rules for proper autoclave operation, OCCS automatically controls the cure process, implementing the prescribed cure while monitoring the operation of the autoclave equipment.

  19. Early feeding and neonatal hypoglycemia in infants of diabetic mothers

    Directory of Open Access Journals (Sweden)

    Leandro Cordero

    2013-12-01

    Full Text Available Objectives: To examine the effects of early formula feeding or breast-feeding on hypoglycemia in infants born to 303 A1-A2 and 88 Class B-RF diabetics. Methods: Infants with hypoglycemia (blood glucose < 40 mg/dL were breast-fed or formula-fed, and those with recurrences were given intravenous dextrose. Results: Of 293 infants admitted to the well-baby nursery, 87 (30% had hypoglycemia, corrected by early feeding in 75 (86%, while 12 (14% required intravenous dextrose. In all, 98 infants were admitted to the newborn intensive care unit for respiratory distress (40%, prematurity (33% or prevention of hypoglycemia (27%. Although all newborn intensive care unit patients received intravenous dextrose, 22 (22% had hypoglycemia. Of 109 hypoglycemia episodes, 89 (82% were single low occurrences. At discharge, 56% of well-baby nursery and 43% of newborn intensive care unit infants initiated breast-feeding. Conclusions: Hypoglycemia among infants of diabetic mothers can be corrected by early breast-feeding or formula feeding.

  20. Classification of hypoglycemia awareness in people with type 1 diabetes in clinical practice

    DEFF Research Database (Denmark)

    Høi-Hansen, Thomas; Pedersen-Bjergaard, Ulrik; Thorsteinsson, Birger

    2010-01-01

    No consensus exists on classification of hypoglycemia awareness. We compared three methods for assessment of hypoglycemia awareness in a clinical setting.......No consensus exists on classification of hypoglycemia awareness. We compared three methods for assessment of hypoglycemia awareness in a clinical setting....

  1. Insulinoma Causing Hypoglycemia in a Patient with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Wei-Yi Lei

    2007-05-01

    Full Text Available Insulinoma in a patient with pre-existing diabetes is extremely rare. A 74-year-old woman with type 2 diabetes mellitus who had been treated with a sulfonylurea for 6 years began experiencing frequent episodes of hypoglycemia. Endogenous hyperinsulinism was found 9 months after the sulfonylurea was discontinued, and transabdominal ultrasonography and magnetic resonance imaging identified a pancreatic tumor. Pathology examination of the resected tumor demonstrated an insulinoma. Postoperatively, the patient had no further episodes of hypoglycemia. Thereafter, she required insulin to control her hyperglycemia. Although hypoglycemic agents are the commonest cause of hypoglycemia in type 2 diabetes, insulinomas may occur in these patients. This possibility should be considered if the hypoglycemia persists despite dose adjustment or cessation of the drugs.

  2. Overestimation of hypoglycemia in infants with a high hematocrit

    NARCIS (Netherlands)

    Kemperman, Hans; van Solinge, Wouter W; de Vooght, Karen MK

    2016-01-01

    Background: In neonates, hypoglycemia is an emergency condition requiring urgent treatment. Therefore, rapid and reliable blood glucose measurements are necessary. However, this step has been proven difficult because of both analytical and preanalytical variables. In our children's hospital, we inci

  3. Doege-Potter syndrome presenting with hypoinsulinemic hypoglycemia in a patient with a malignant extrapleural solitary fibrous tumor: a case report

    Directory of Open Access Journals (Sweden)

    Schutt Robert C

    2013-01-01

    Full Text Available Abstract Introduction Doege-Potter syndrome is a paraneoplastic syndrome characterized by non-islet cell tumor hypoglycemia secondary to a solitary fibrous tumor. This tumor causes hypoglycemia by the secretion of a prohormone form of insulin-like growth factor II. We describe the diagnosis and management of Doege-Potter syndrome and the use of transarterial chemoembolization in a patient with a malignant extrapleural solitary fibrous tumor. Case presentation Our patient was a 64-year-old Caucasian woman who initially presented with urinary incontinence and was found to have a 14.5×9.0×9.0cm retroperitoneal solitary fibrous tumor compressing her bladder. Her tumor was surgically resected but recurred with multiple hepatic metastatic lesions. The hepatic metastases progressed despite systemic chemotherapy and treatment with doxorubicin transarterial chemoembolization. Her course was complicated by the development of recurrent fasting hypoglycemia, most likely secondary to Doege-Potter syndrome. Her hypoglycemia was managed with corticosteroid therapy and frequent scheduled nutrient intake overnight. Conclusions The rarity of hepatic solitary fibrous tumors and consequent lack of controlled trials make this report significant in that it describes the diagnostic approach to Doege-Potter syndrome, describes our experience with the use of doxorubicin transarterial chemoembolization, and presents management options for tumor-associated hypoglycemia in the case of extensive disease not amenable to surgical resection.

  4. Low ambient temperature and neuroendocrine response to hypoglycemia in men.

    Science.gov (United States)

    Jezová, D; Juránková, E; Kvetnanský, R; Kaciuba-Uscilko, H; Nazar, K; Vigas, M

    1995-12-01

    Nutritional factors, such as an excess or a deficiency of glucose, play an important role in neuroendocrine regulations. Hormonal and metabolic responses to hypoglycemia were examined in healthy non-obese volunteers under conditions of low ambient temperature. Hypoglycemia was induced by intravenous injection of insulin in two randomized trials performed at room temperature and at 4 degrees C. At room temperature, the typical neuroendocrine response to hypoglycemia was established. The increases of ACTH, beta-endorphin, growth hormone and cortisol in response to insulin hypoglycemia failed to be modified by low ambient temperature. Acute cold exposure significantly reduced epinephrine and totally inhibited prolactin response to insulin-induced hypoglycemia. In spite of significant changes in epinephrine response to hypoglycemia at low ambient temperature, no striking differences in plasma glucose levels compared to those measured at room temperature were observed. However, under conditions of low temperature the reestablishment of normoglycemia was delayed. No changes in free fatty acids were found under our experimental conditions. The presented data show that low ambient temperature exerts selective effects on some neuroendocrine and metabolic parameters.

  5. Metabolic and Neurologic Sequelae in a Patient with Long-Standing Anorexia Nervosa Who Presented with Septic Shock and Deep Hypoglycemia

    NARCIS (Netherlands)

    de Jager, Corine M.; Hoekstra, Miriam; Nijsten, Maarten W. N.; Lansink, Annemieke Oude; Ismael, Farouq

    2011-01-01

    Objective: To report the case of a 48-year female with chronic remitting anorexia nervosa who was found comatose at home and admitted to our hospital with a deep hypoglycemia (glucose level 0.6 mmol/L; 11 mg/dL) and septic shock secondary to a bilateral pneumonia. Method: Case report. Results: After

  6. Metabolic and Neurologic Sequelae in a Patient with Long-Standing Anorexia Nervosa Who Presented with Septic Shock and Deep Hypoglycemia

    NARCIS (Netherlands)

    de Jager, Corine M.; Hoekstra, Miriam; Nijsten, Maarten W. N.; Oude Lansink, Annemieke; Ismael, Farouq

    2011-01-01

    Objective: To report the case of a 48-year female with chronic remitting anorexia nervosa who was found comatose at home and admitted to our hospital with a deep hypoglycemia (glucose level 0.6 mmol/L; 11 mg/dL) and septic shock secondary to a bilateral pneumonia. Method: Case report. Results: After

  7. Recurrent hypoglycemia increases anxiety and amygdala norepinephrine release during subsequent hypoglycemia

    Directory of Open Access Journals (Sweden)

    Ewan eMcNay

    2015-11-01

    Full Text Available Recurrent hypoglycemia (RH is a common and debilitating side effect of therapy in patients with both type 1 and, increasingly, type 2 diabetes. Previous studies in rats have shown marked effects of RH on subsequent hippocampal behavioral, metabolic, and synaptic processes. In addition to impaired memory, patients experiencing RH report alterations in cognitive processes that include mood and anxiety, suggesting that RH may also affect amygdala function. We tested the impact of RH on amygdala function using an elevated plus-maze test of anxiety together with in vivo amygdala microdialysis for norepinephrine (NEp, a widely used marker of basolateral amygdala cognitive processes. In contrast to findings in the hippocampus and pre-frontal cortex, neither RH nor acute hypoglycemia alone significantly affected plus-maze performance or NEp release. However, animals tested when hypoglycemic who had previously experienced RH had elevated amygdala NEp during plus-maze testing, accompanied by increased anxiety (i.e. less time spent in the open arms of the plus-maze. The results show that RH has widespread effects on subsequent brain function, which vary by neural system.

  8. Severe hypoglycemia-induced lethal cardiac arrhythmias are mediated by sympathoadrenal activation.

    Science.gov (United States)

    Reno, Candace M; Daphna-Iken, Dorit; Chen, Y Stefanie; VanderWeele, Jennifer; Jethi, Krishan; Fisher, Simon J

    2013-10-01

    For people with insulin-treated diabetes, severe hypoglycemia can be lethal, though potential mechanisms involved are poorly understood. To investigate how severe hypoglycemia can be fatal, hyperinsulinemic, severe hypoglycemic (10-15 mg/dL) clamps were performed in Sprague-Dawley rats with simultaneous electrocardiogram monitoring. With goals of reducing hypoglycemia-induced mortality, the hypotheses tested were that: 1) antecedent glycemic control impacts mortality associated with severe hypoglycemia; 2) with limitation of hypokalemia, potassium supplementation could limit hypoglycemia-associated deaths; 3) with prevention of central neuroglycopenia, brain glucose infusion could prevent hypoglycemia-associated arrhythmias and deaths; and 4) with limitation of sympathoadrenal activation, adrenergic blockers could prevent hypoglycemia-induced arrhythmic deaths. Severe hypoglycemia-induced mortality was noted to be worsened by diabetes, but recurrent antecedent hypoglycemia markedly improved the ability to survive an episode of severe hypoglycemia. Potassium supplementation tended to reduce mortality. Severe hypoglycemia caused numerous cardiac arrhythmias including premature ventricular contractions, tachycardia, and high-degree heart block. Intracerebroventricular glucose infusion reduced severe hypoglycemia-induced arrhythmias and overall mortality. β-Adrenergic blockade markedly reduced cardiac arrhythmias and completely abrogated deaths due to severe hypoglycemia. Under conditions studied, sudden deaths caused by insulin-induced severe hypoglycemia were mediated by lethal cardiac arrhythmias triggered by brain neuroglycopenia and the marked sympathoadrenal response.

  9. Hypoglycemia associated with off-label sitagliptin use

    Directory of Open Access Journals (Sweden)

    Heather P Whitley

    2008-11-01

    Full Text Available Heather P Whitley1,2, Kristi Kelley11Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Auburn, AL, USA; 2Department of Community and Rural Medicine, University of Alabama School of Medicine, Tuscaloosa, AL, USAPurpose: To describe a case of hypoglycemia induced by off-label use of sitagliptin in an adult patient with type 2 diabetes.Case summary: Addition of sitagliptin to metformin, glimepiride, and NovoLog® 70/30 Mix induced hypoglycemia in a 55-year-old Caucasian female. Hypoglycemia improved, although still occurred periodically, following sulfonylurea discontinuation and a 28% insulin dose reduction. Hypoglycemic symptoms were absent during a 3-day dechallange but occurred again upon sitagliptin reinitiation.Discussion: Although the mechanism of action of sitagliptin does not predispose patients to hypoglycemic events, when combined with hypoglycemia-inducing medications, eg, sulfonylureas or insulin, and possibly meglitinides, the incidence likely increases.Conclusions: Caution should be used when combining sitagliptin with either sulfonylureas or insulin, and possibly meglitinides, for the treatment of type 2 diabetes as hypoglycemia may ensue. Hypoglycemia due to off-label combinations with insulin and sitagliptin may be prevented by reducing meal-time insulin doses. Prescribers and patients should vigilantly monitor for hypoglycemic events when using sitagliptin off-label with similar pharmacologic combinations such as meglitinides and other rapid-acting insulin products. Additionally, clinicians may encounter resistance from insurance companies to cover such off-label combinations.Keywords: diabetes, DPP-IV inhibitor, sitagliptin, hypoglycemia, drug-induced, off-label

  10. Severe hypoglycemia in users of sulfonylurea antidiabetic agents and antihyperlipidemics.

    Science.gov (United States)

    Leonard, C E; Bilker, W B; Brensinger, C M; Han, X; Flory, J H; Flockhart, D A; Gagne, J J; Cardillo, S; Hennessy, S

    2016-05-01

    Drug-drug interactions causing severe hypoglycemia due to antidiabetic drugs is a major clinical and public health problem. We assessed whether sulfonylurea use with a statin or fibrate was associated with severe hypoglycemia. We conducted cohort studies of users of glyburide, glipizide, and glimepiride plus a statin or fibrate within a Medicaid population. The outcome was a validated, diagnosis-based algorithm for severe hypoglycemia. Among 592,872 persons newly exposed to a sulfonylurea+antihyperlipidemic, the incidence of severe hypoglycemia was 5.8/100 person-years. Adjusted hazard ratios (HRs) for sulfonylurea+statins were consistent with no association. Most overall HRs for sulfonylurea+fibrate were elevated, with sulfonylurea-specific adjusted HRs as large as 1.50 (95% confidence interval (CI): 1.24-1.81) for glyburide+gemfibrozil, 1.37 (95% CI: 1.11-1.69) for glipizide+gemfibrozil, and 1.63 (95% CI: 1.29-2.06) for glimepiride+fenofibrate. Concomitant therapy with a sulfonylurea and fibrate is associated with an often delayed increased rate of severe hypoglycemia.

  11. Gastric Bypass Reduces Symptoms and Hormonal Responses in Hypoglycemia.

    Science.gov (United States)

    Abrahamsson, Niclas; Börjesson, Joey Lau; Sundbom, Magnus; Wiklund, Urban; Karlsson, F Anders; Eriksson, Jan W

    2016-09-01

    Gastric bypass (GBP) surgery, one of the most common bariatric procedures, induces weight loss and metabolic effects. The mechanisms are not fully understood, but reduced food intake and effects on gastrointestinal hormones are thought to contribute. We recently observed that GBP patients have lowered glucose levels and frequent asymptomatic hypoglycemic episodes. Here, we subjected patients before and after undergoing GBP surgery to hypoglycemia and examined symptoms and hormonal and autonomic nerve responses. Twelve obese patients without diabetes (8 women, mean age 43.1 years [SD 10.8] and BMI 40.6 kg/m(2) [SD 3.1]) were examined before and 23 weeks (range 19-25) after GBP surgery with hyperinsulinemic-hypoglycemic clamp (stepwise to plasma glucose 2.7 mmol/L). The mean change in Edinburgh Hypoglycemia Score during clamp was attenuated from 10.7 (6.4) before surgery to 5.2 (4.9) after surgery. There were also marked postsurgery reductions in levels of glucagon, cortisol, and catecholamine and the sympathetic nerve responses to hypoglycemia. In addition, growth hormone displayed a delayed response but to a higher peak level. Levels of glucagon-like peptide 1 and gastric inhibitory polypeptide rose during hypoglycemia but rose less postsurgery compared with presurgery. Thus, GBP surgery causes a resetting of glucose homeostasis, which reduces symptoms and neurohormonal responses to hypoglycemia. Further studies should address the underlying mechanisms as well as their impact on the overall metabolic effects of GBP surgery.

  12. Insight into hypoglycemia in pediatric type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Lehecka Kimberly E

    2012-06-01

    Full Text Available Abstract Hypoglycemia is a common complication of insulin treatment in type 1 diabetes mellitus and can occur in any patient with diabetes when glucose consumption exceeds supply. Many studies have been done to elucidate those factors that predict severe hypoglycemia: younger age, longer duration of diabetes, lower HgbA1c, higher insulin dose, lower Body Mass Index, male gender, Caucasian race, underinsurance or low socioeconomic status, and the presence of psychiatric disorders. Hypoglycemia can affect patients' relationships, occupation, and daily activities such as driving. However, one of the greatest impacts is patients' fear of severe hypoglycemic events, which is a limiting factor in the optimization of glycemic control. Therefore, the importance of clinicians’ ability to identify those patients at greatest risk for hypoglycemic events is two-fold: 1 Patients at greatest risk may be counseled as such and offered newer therapies and monitoring technologies to prevent hypoglycemic events. 2 Patients at lower risk may be reassured and encouraged to improve their glycemic control. Since the risk of long-term complications with poor blood glucose control outweighs the risks of hypoglycemia with good blood glucose control, patients should be encouraged to aim for glucose concentrations in the physiologic range pre- and post-prandially. Advancements in care, including multiple daily injection therapy with analog insulin, continuous subcutaneous insulin infusion, and continuous glucose monitoring, have each subsequently improved glycemic control and decreased the risk of severe hypoglycemia.

  13. Curing Behavior of Epoxy Asphalt

    Institute of Scientific and Technical Information of China (English)

    YU Jianying; CONG Peiliang; WU Shaopeng; CHENG Songbo

    2009-01-01

    The curing process of epoxy asphalt was analyzed by Fourier transform infrared (FT-IR)spectroscopy.Effect of curing temperature on viscosity of epoxy asphalt,and changes of mechanical properties with curing time were investigated.The evolution of concentration of epoxy band was followed as a function of the applied curing process.The experimental results indicate that the curing reaction rate of epoxy asphalt is invariable before 70 min at 120℃,and it decreases when curing time exceeds 70 min.The viscosity of epoxy asphalt increases slowly with curing time at initial curing stage.But it increases quickly after initial curing stage and the initial curing time decreases as the curing temperature increases.The tensile strength increases slowly at incipient curing stage and increases rapidly when curing time is form 20 min to 70 min.The elongation at break shows a decrease with curing time,but it exceeds 200%after cured.

  14. 继发性腰椎间隙感染合并肺脓肿的救治%The Cure of Secondary Cases Interspace of Lumbar Vertebrae Infection Complicated Pulmonary Abscess

    Institute of Scientific and Technical Information of China (English)

    张淼; 顾苏俊

    2009-01-01

    OBJECTIVE Research the therapeutic effectiveness of combination Imipenem and teicoplanin to treat septicemia due to interspace of lumbar vertebrae Infection complicated pulmonary abscess and the method of diagnosis, prevention and cure of Secondary interspace of lumbar vertebrae Injection. METHODS The successful cure case-report that severe postoperative interspace of lumbar vertebrae infection complicated blood-borne pulmonary abscess used small needle knife to treat Lumbar intervertebral disc protrusion (LIDP) were reviewed.RESULTS Unstandard asepsis technique and invasive operation long time operation, too mang damage of tissue in operation, patient weak, diabetes, glucocorticoid, lacking postoperative anti infection therapy etc. Lumbocrural pain were found aggravated, high fever, blood sedimentation increased, CRP heightened. CONCLUSIONS Strict asepsis,sufficient preoperotive preparation, Standard operation, less damage, can reduce interspace of lumbar vertebrae infection rate. Strict asepsis and less damage in the operation can reduce the incidence of intervertebral disc space infection.%目的 探讨亚胺培南/西司他丁与替考拉宁联合应用治疗腰椎间隙感染后败血症合并肺脓肿的疗效以及继发件腰椎间隙感染的发病特点、诊断及防治方法.方法 通过对1例小针刀治疗腰椎间盘突出后导致重度腰椎间隙感染合并血源性肺脓肿患者的成功救治进行同顾性总结分析.结果 无菌观念不严格、介入性操作不规范、手术时间长、术中组织损伤多、患者基础条件差、糖尿病、应用糖皮质激素、术后抗炎不足等因素有关;患者术后3 d腰腿痛加剧.高热,血沉增快,C-反应蛋白增高.结论 严格无菌观念,充分术前准备,术中操作规范减少损伤可减少腰椎间隙感染的发生.

  15. Brain injuries due to neonatal hypoglycemia: case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Bong; Song, Chang Joon; Chang, Mae Young; Youn, Hyae Won [College of Medicine, Chungram National Univ., Daejeon (Korea, Republic of)

    2003-10-01

    Although hypoglycemia may be common among neonates, brain injuries resulting from isolated neonatal hypoglycemia are rare. The condition may cause neurological symptoms such as stupor, jitteriness, and seizures, though in their absence, diagnosis delayed or difficult. Hypoglycemia was diagnosed in a three-day-old neonate after he visited the emergency department with loose stool, poor oral intake, and decreased activity, first experienced two days earlier. Two days after his visity, several episodes of seizure occurred. T2 and diffusion-weighted magnetic resonance (MR) scanning, performed at 11 days of age, revealed bilateral and symmetrical high signal intensity lesions in occipital, parietal, and temporal lobes. We report the MR findings of hypoglycemic encephalopathy in a neonate.

  16. Radiation curing of epoxies

    Science.gov (United States)

    Dickson, Lawrence W.; Singh, Ajit

    The literature on radiation polymerization of epoxy compounds has been reviewed to assess the potential use of radiation for curing these industrially important monomers. Chemical curing of epoxies may proceed by either cationic or anionic mechanisms depending on the nature of the curing agent, but most epoxies polymerize by cationic mechanisms under the influence of high-energy radiation. Radiation-induced cationic polymerization of epoxy compounds is inhibited by trace quantities of water because of proton transfer from the chain-propagating epoxy cation to water. Several different methods with potential for obtaining high molecular weight polymers by curing epoxies with high-energy radiation have been studied. Polymeric products with epoxy-like properties have been produced by radiation curing of epoxy oligomers with terminal acrylate groups and mixtures of epoxies with vinyl monomers. Both of these types of resin have good potential for industrial-scale curing by radiation treatment.

  17. The Curing Meter

    DEFF Research Database (Denmark)

    Jensen, Ole Mejlhede

    2006-01-01

    Curing technology concerns adjustment and control of temperature and moisture conditions in hardening structures and elements of concrete. The curing technology comprises e.g. measurement, adjustment and control of the moisture conditions during the early hardening phase of the concrete to achiev...... from concrete surfaces in the early hardening phase. The Concrete Curing Meter is designed for simple and reliable monitoring of water loss from a wet surface of fresh concrete. This new measuring technique has been tested with several prototypes of the Curing Meter....

  18. Hypoglycemia-Related Electroencephalogram Changes Assessed by Multiscale Entropy

    DEFF Research Database (Denmark)

    Fabris, C.; Sparacino, G.; Sejling, A. S.

    2014-01-01

    physiopathological conditions have never been assessed in hypoglycemia. The present study investigates if properties of the EEG signal measured by nonlinear entropy-based algorithms are altered in a significant manner when a state of hypoglycemia is entered. Subjects and Methods: EEG was acquired from 19 patients...... derivation in the two glycemic intervals was assessed using the multiscale entropy (MSE) approach, obtaining measures of sample entropy (SampEn) at various temporal scales. The comparison of how signal irregularity measured by SampEn varies as the temporal scale increases in the two glycemic states provides...

  19. Sleep disturbances in IDDM patients with nocturnal hypoglycemia

    DEFF Research Database (Denmark)

    Bendtson, I; Gade, J; Thomsen, C E

    1992-01-01

    a polygraphic sleep analysis system. The scoring was mainly based on the color density spectral array of the EEG. Blood glucose and growth hormone were measured serially. Asymptomatic, spontaneous nocturnal hypoglycemia occurred in 38% of the nights. Conventional sleep analysis showed a tendency toward......Eight insulin-dependent diabetic patients were studied to evaluate sleep patterns during normoglycemia and spontaneous and insulin-induced hypoglycemia. Two channels of electroencephalogram (EEG), electromyogram and actooculogram were recorded. The signals were analyzed off-line, using...

  20. GLP1 and glucagon co-secreting pancreatic neuroendocrine tumor presenting as hypoglycemia after gastric bypass

    DEFF Research Database (Denmark)

    Guimarães, Marta; Rodrigues, Pedro; Pereira, Sofia S;

    2015-01-01

    Post-prandial hypoglycemia is frequently found after bariatric surgery. Although rare, pancreatic neuroendocrine tumors (pNET), which occasionally are mixed hormone secreting, can lead to atypical clinical manifestations, including reactive hypoglycemia. Two years after gastric bypass surgery for...

  1. Hypoglycemia in pregnant women with type 1 diabetes: predictors and role of metabolic control

    DEFF Research Database (Denmark)

    Nielsen, Lene Ringholm; Pedersen-Bjergaard, Ulrik; Thorsteinsson, Birger;

    2008-01-01

    In pregnancy with type 1 diabetes, we evaluated occurrence of mild and severe hypoglycemia and analyzed the influence of strict metabolic control, nausea, vomiting, and other potential predictors of occurrence of severe hypoglycemia.......In pregnancy with type 1 diabetes, we evaluated occurrence of mild and severe hypoglycemia and analyzed the influence of strict metabolic control, nausea, vomiting, and other potential predictors of occurrence of severe hypoglycemia....

  2. Antecedent adrenaline attenuates the responsiveness to but not the release of counterregulatory hormones during subsequent hypoglycemia.

    NARCIS (Netherlands)

    Galan, B.E. de; Rietjens, S.J.; Tack, C.J.J.; Werf, S.P. van der; Sweep, C.G.J.; Lenders, J.W.M.; Smits, P.

    2003-01-01

    Hypoglycemia unawareness is thought to be the consequence of recurrent hypoglycemia, yet the underlying mechanism is still incompletely understood. The aim of the present study was to determine the role of antecedent elevated adrenaline in the pathogenesis of hypoglycemia unawareness. Sixteen health

  3. Hypothalamic-Pituitary-Adrenal Axis Programming after Recurrent Hypoglycemia during Development

    Directory of Open Access Journals (Sweden)

    Raghavendra Rao

    2015-08-01

    Full Text Available Permanent brain injury is a complication of recurrent hypoglycemia during development. Recurrent hypoglycemia also has adverse consequences on the neuroendocrine system. Hypoglycemia-associated autonomic failure, characterized by ineffective glucose counterregulation during hypoglycemia, is well described in children and adults on insulin therapy for diabetes mellitus. Whether recurrent hypoglycemia also has a programming effect on the hypothalamus-pituitary-adrenal cortex (HPA axis has not been well studied. Hypoglycemia is a potent stress that leads to increased glucocorticoid secretion in all age groups, including the perinatal period. Other conditions associated with exposure to excess glucocorticoid in the perinatal period have a programming effect on the HPA axis activity. Limited animal data suggest the possibility of similar programming effect after recurrent hypoglycemia in the postnatal period. The age at exposure to hypoglycemia likely determines the HPA axis response in adulthood. Recurrent hypoglycemia in the early postnatal period likely leads to a hyperresponsive HPA axis, whereas recurrent hypoglycemia in the late postnatal period lead to a hyporesponsive HPA axis in adulthood. The age-specific programming effects may determine the neuroendocrine response during hypoglycemia and other stressful events in individuals with history of recurrent hypoglycemia during development.

  4. The Curing Meter

    DEFF Research Database (Denmark)

    Jensen, Ole Mejlhede

    2006-01-01

    Curing technology concerns adjustment and control of temperature and moisture conditions in hardening structures and elements of concrete. The curing technology comprises e.g. measurement, adjustment and control of the moisture conditions during the early hardening phase of the concrete to achiev...... from concrete surfaces in the early hardening phase. The Concrete Curing Meter is designed for simple and reliable monitoring of water loss from a wet surface of fresh concrete. This new measuring technique has been tested with several prototypes of the Curing Meter.......Curing technology concerns adjustment and control of temperature and moisture conditions in hardening structures and elements of concrete. The curing technology comprises e.g. measurement, adjustment and control of the moisture conditions during the early hardening phase of the concrete to achieve...... an optimal development of properties in the hardening concrete – so-called "moisture curing". Proper moisture curing is vital to concrete but laborious to accomplish and difficult to control at the construction site with present methods. This paper concerns a new method for site measurement of evaporation...

  5. Postprandial hyperinsulinemic hypoglycemia after Roux-en-Y gastric bypass

    DEFF Research Database (Denmark)

    Øhrstrøm, Caroline Christfort; Worm, Dorte; Hansen, Dorte Lindqvist

    2017-01-01

    of developing hypoglycemia. Known risk factors are female sex, longer time since surgery, and lack of prior diabetes. Management of the hypoglycemic episodes is difficult, and only dietary modifications consisting of frequent and less carbohydrate-rich meals seem to be efficient. Medical treatments and surgical...

  6. A Rare Case of Noninsulinoma Pancreatogenous Hypoglycemia Syndrome

    Directory of Open Access Journals (Sweden)

    Jeffrey Nadelson

    2012-01-01

    Full Text Available As the obesity pandemic continues to worsen and medical interventions remain only moderately effective, bariatric surgery remains an important option for patients. In certain instances, patients who have undergone the procedure experience postprandial symptoms of neuroglycopenia caused by noninsulinoma pancreatogenous hypoglycemia syndrome (NIPHS. NIPHS is a recently described syndrome and is also very rare, and therapeutic approaches are still under debate. We report the case of a 51-year-old female who underwent Roux-en-Y gastric bypass and presented with episodic postprandial hypoglycemia 2 years after surgery. An insulinoma was absent from all abdominal imaging. Fasting C-peptide, insulin, and glucose were normal. Due to the possibility of NIPHS, clinical treatment was commenced with acarbose, leading to a significant reduction of hypoglycemic episodes. NIPHS occurs in approximately 0.5% to 7% of patients with hyperinsulinemic hypoglycemia. Sporadic hypoglycemia postgastric bypass is an important entity that should be understood by all surgeons and internists who are involved in postgastric bypass care.

  7. [Effect of cyclic somatostatin on ethanol-induced hypoglycemia].

    Science.gov (United States)

    Piccardo, M G; Marchetti, A M; Breda, E

    1979-06-30

    The authors examined the activity of the cyclic Somatostatin on Ethanol hypoglycemia. While the peptide is capable of increasing the plasma glucose levels of hypoglicemia starved rats, it does not increase the levels of plasma glucose in normal rats under the action of ethanol perfusion.

  8. [Electrophysiologic study of neonatal hypoglycemia prolonged by hyperinsulinism].

    Science.gov (United States)

    Parain, D; Samson-Dollfus, D

    1983-11-01

    A case of neonatal hyperinsulinism with hypoglycemia is reported. The EEGs were abnormal because of a lack of sleep modulation. The CT scan showed pathological occipital hypodensities. The flashes VER were abnormal at 1, 2 and 6 months of age, chiefly on the right occipital lead and showing a possible lesion of the right retrochiasmatic pathways.

  9. Comparison of oral glucose tolerance tests and mixed meals in patients with apparent idiopathic postabsorptive hypoglycemia: absence of hypoglycemia after meals.

    Science.gov (United States)

    Charles, M A; Hofeldt, F; Shackelford, A; Waldeck, N; Dodson, L E; Bunker, D; Coggins, J T; Eichner, H

    1981-06-01

    The relationship between symptoms of idiopathic postabsorptive hypoglycemia and glucose homeostasis was evaluated by giving oral glucose tolerance tests (OGTT) and mixed meals to 18 patients and 16 controls. Chemical hypoglycemia after OGTT occurred as often in patients referred because of possible hypoglycemia symptoms, 18 out of 80 (23%), as in controls, 4 out of 16 (25%). After glucose, patients showed both clinical and chemical hypoglycemia (mean +/- SE plasma glucose, 48 +/- 3 mg/dl), but insulin, glucagon, and growth hormone responses were similar to controls. After mixed meals, no chemical hypoglycemia occurred in patients (mean plasma glucose, 79 +/- 3 mg/dl), yet 14 out of 18 (78%) had symptoms and/or signs consistent with hypoglycemia. No abnormality of glucose homeostasis was observed after meals that could account for symptoms or signs experienced by patients with idiopathic postabsorptive hypoglycemia. Since factors other than hypoglycemia appear to be involved, the disorder should be termed the idiopathic postprandial syndrome to avoid the connotation of chemical hypoglycemia.

  10. C-CURE

    Data.gov (United States)

    US Agency for International Development — C-CURE system manages certain aspects of the access control system, including collecting employee and contractor names and photographs. The Office of Security uses...

  11. Curing of Concrete

    African Journals Online (AJOL)

    and pipes illustrate defects frequently caused by improper curing. Proper ... because in such pastes the layers of hydrated ... *3) When cement hydrates the solid products occupy a volume equal to the sum of volumes of anhydrous cement and.

  12. HEART FAILURE, DIABETES, BETA-BLOCKERS AND RISK OF HYPOGLYCEMIA

    Directory of Open Access Journals (Sweden)

    A. A. Aleksandrov

    2008-01-01

    Full Text Available Aim. To evaluate an influence of carvedilol on risk of hypoglycemia in patients with diabetes type 2 (D2 and chronic heart failure (CHF treated with angiotensin converting enzyme (ACE inhibitors.Material and methods. 13 patients (10 men, 3 women; aged 59,8±6,7 y.o. with D2 and CHF caused by ischemic heart disease were included in the study. Before inclusion all patients were treated with ACE inhibitors and various beta-blockers (atenolol, metoprolol, bisoprolol. These beta-blockers were changed for carvedilol. Heart ultrasonography, blood pressure control, glycemia monitoring, HbA1c level determination were performed before, during and after carvedilol therapy.Results. Carvedilol reduces frequency and duration of hypoglycaemia episodes. There were not episodes of severe hypoglycaemia during carvedilol therapy.Conclusion. Carvedilol reduces risk of hypoglycemia when it is used in combination with ACE inhiditors in diabetic patients with CHF.

  13. Insulinoma: A rare cause of hypoglycemia in a young female

    Directory of Open Access Journals (Sweden)

    Fnu Kelash

    2014-09-01

    Full Text Available Insulinoma is an exceedingly uncommon pancreatic islet cell neuroendocrine tumor. The estimated incidence is approximately four cases per million individuals per year and accounts for 60% of islets cell tumors. It causes glycopenic symptoms which includes headache, feeling irritable, confused, seizure or coma and leads to catecholamine excess which includes rapid heartbeat, sweating, palpitations and feelings of hunger. Early detection of the tumor prevents recurrent episodes of lethal hypoglycemia.

  14. Reducing the Risk of Hypoglycemia Associated With Intravenous Insulin

    Science.gov (United States)

    Sandler, Victoria; Misiasz, Meaghan R.; Jones, Jocelyn

    2014-01-01

    Computerized insulin infusion protocols have facilitated more effective blood glucose (BG) control in intensive care units (ICUs). This is particularly important in light of the risks associated with hypoglycemia. End stage renal disease (ESRD) increases the risk of insulin-induced hypoglycemia. We evaluated BG control in 210 patients in 2 medical ICUs and in 2 surgical ICUs who were treated with a computerized insulin infusion program (CIIP). Our CIIP was programmed for a BG target of 140-180 mg/dL for medical ICU patients or 120-160 mg/dL for surgical ICU patients. In addition, we focused on BG control in the 11% of our patients with ESRD. Mean BG was 147 ± 20 mg/dL for surgical ICU patients and 171 ± 26 mg/dL for medical ICU patients. Of both surgical and medical ICU patients, 17% had 1 or more BG 60-79 mg/dL, while 3% of surgical ICU and 8% of medical ICU patients had 1 or more BG < 60 mg/dL. Mean BG in ESRD patients was 147 ± 16 mg/dL similar to 152 ± 23 mg/dL in patients without ESRD. Of ESRD patients, 41% had 1 or more BG < 79 mg/dL as compared with 17.8% of non-ESRD patients (P < .01). A higher BG target for medical ICU patients as compared with surgical ICU patients yielded comparably low rates of moderate or severe hypoglycemia. However, hypoglycemia among ESRD patients was more common compared to non-ESRD patients, suggesting a need for a higher BG target specific to ESRD patients. PMID:25172875

  15. Maternal glycemic control and hypoglycemia in type 1 diabetic pregnancy

    DEFF Research Database (Denmark)

    Mathiesen, Elisabeth R; Kinsley, Brendan; Amiel, Stephanie A

    2007-01-01

    with HI. A1C was comparable with human insulin in second (IAsp-HI -0.04 [-0.18 to 0.11]) and third (-0.08 [-0.23 to 0.06]) trimesters. A total of 80% of subjects achieved an A1C ... in basal-bolus therapy with NPH insulin in pregnant women with type 1 diabetes and may potentially offer some benefits in terms of postprandial glucose control and preventing severe hypoglycemia....

  16. Generalized Anxiety Disorder and Hypoglycemia Symptoms Improved with Diet Modification

    OpenAIRE

    Monique Aucoin; Sukriti Bhardwaj

    2016-01-01

    Observational evidence suggests that a relationship may exist between high glycemic index diets and the development of anxiety and depression symptoms; however, as no interventional studies assessing this relationship in a psychiatric population have been completed, the possibility of a causal link is unclear. AB is a 15-year-old female who presented with concerns of generalized anxiety disorder and hypoglycemia symptoms. Her diet consisted primarily of refined carbohydrates. The addition of ...

  17. Glycogen Supercompensation in the Rat Brain After Acute Hypoglycemia is Independent of Glucose Levels During Recovery.

    Science.gov (United States)

    Duarte, João M N; Morgenthaler, Florence D; Gruetter, Rolf

    2017-01-12

    Patients with diabetes display a progressive decay in the physiological counter-regulatory response to hypoglycemia, resulting in hypoglycemia unawareness. The mechanism through which the brain adapts to hypoglycemia may involve brain glycogen. We tested the hypothesis that brain glycogen supercompensation following hypoglycemia depends on blood glucose levels during recovery. Conscious rats were submitted to hypoglycemia of 2 mmol/L for 90 min and allowed to recover at different glycemia, controlled by means of i.v. glucose infusion. Brain glycogen concentration was elevated above control levels after 24 h of recovery in the cortex, hippocampus and striatum. This glycogen supercompensation was independent of blood glucose levels in the post-hypoglycemia period. In the absence of a preceding hypoglycemia insult, brain glycogen concentrations were unaltered after 24 h under hyperglycemia. In the hypothalamus, which controls peripheral glucose homeostasis, glycogen levels were unaltered. Overall, we conclude that post-hypoglycemia glycogen supercompensation occurs in several brain areas and its magnitude is independent of plasma glucose levels. By supporting brain metabolism during recurrent hypoglycemia periods, glycogen may have a role in the development of hypoglycemia unawareness.

  18. Radiation curing in the eighties

    Energy Technology Data Exchange (ETDEWEB)

    Vrancken, A. (UCB, Drogenbos (Belgium). Chemical Specialities Div.)

    1984-05-01

    The subject is discussed under the headings: introduction; what is radiation curing; history; radiation curable resins (with properties of products); ultraviolet and electron beam curing; photoinitiation and the ultraviolet light curing process; electron beam curing (initiation; electron beam accelerators); end uses (graphic arts; wood finishing; paper upgrading; adhesives; metal finishing; electronic chemical; floor coatings).

  19. Medical image of the week: tumor-induced hypoglycemia

    Directory of Open Access Journals (Sweden)

    Parashar P

    2015-05-01

    Full Text Available No abstract available. Article truncated after 150 words. A 39 year-old man with a history of widely metastatic (brain, liver and lung nonseminomatous germ cell tumor was admitted to the hospital with severe abdominal pain and altered mental status. A CT of the abdomen and pelvis with IV contrast revealed a marked increase in the size of the liver metastases, portal vein tumor thrombus and changes of pseudocirrhosis. There were numerous large heterogeneously enhancing masses within the liver parenchyma with central necrosis (Figure 1. The patient had significant and sustained hypoglycemia, with the lowest glucose recorded of 30 mg/dl. He required multiple IV doses of 50% dextrose and an infusion of 10% dextrose to maintain a serum glucose level greater than 55 mg/dl. His mental status improved with treatment of the hypoglycemia. The patient decided to pursue a palliative approach to care and was discharged with home hospice services. Tumor-induced hypoglycemia (TIH is a paraneoplastic syndrome that is ...

  20. Starvation of cancer via induced ketogenesis and severe hypoglycemia.

    Science.gov (United States)

    Kapelner, Adam; Vorsanger, Matthew

    2015-03-01

    Neoplasms are highly dependent on glucose as their substrate for energy production and are generally not able to catabolize other fuel sources such as ketones and fatty acids. Thus, removing access to glucose has the potential to starve cancer cells and induce apoptosis. Unfortunately, other body tissues are also dependent on glucose for energy under normal conditions. However, in human starvation (or in the setting of diet-induced ketogenesis), the body "keto-adapts" and glucose requirements of most tissues drop to almost nil. Exceptions include the central nervous system (CNS) and various other tissues which have a small but obligatory requirement of glucose. Our hypothesized treatment takes keto-adaptation as a prerequisite. We then propose the induction of severe hypoglycemia by depressing gluconeogenesis while administering glucose to the brain. Although severe hypoglycemia normally produces adverse effects such as seizure and coma, it is relatively safe following keto-adaptation. We hypothesize that our therapeutic hypoglycemia treatment has potential to rapidly induce tumor cell necrosis.

  1. Masked hypoglycemia in the presence of icodextrin for peritoneal dialysis.

    Science.gov (United States)

    Khouli, Michael M

    2013-02-01

    Handheld glucose meters remain a rapid means of excluding hypoglycemia as a cause of altered mental status in the Emergency Department. However, emergency physicians must be alert for factors that can mask hypoglycemia at the bedside. An 80-year-old man with diabetes mellitus and end-stage renal disease on peritoneal dialysis presents with altered mental status, hypotension, and a bedside handheld glucose meter reading of 99mg/dL. His mental status failed to improve with treatment of hypotension and the patient was intubated for airway protection. Laboratory-measured serum glucose was 29mg/dL. His mental status improved after glucose administration. It was subsequently determined that the patient used icodextrin (Extraneal(®), Baxter Healthcare Corporation, Deerfield, IL) as his peritoneal dialysate. This is partly absorbed into serum and hydrolyzed to oligosaccharides that are falsely detected as glucose by many handheld glucose meters. The peritoneal dialysate icodextrin can produce falsely elevated bedside glucose meter values. As the prevalence of diabetic nephropathy and dialysis increases, emergency physicians must remain vigilant for such cases of unrecognized hypoglycemia. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. A Novel Algorithm in the Management of Hypoglycemia in Newborns

    Directory of Open Access Journals (Sweden)

    Swapna Naveen

    2014-01-01

    Full Text Available Study Objective. To evaluate the safety of a new protocol in comparison to the standard protocol for managing hypoglycemia in neonates. Methods. Open label RCT-pilot study. Neonates admitted to NICU with hypoglycemia and requiring intravenous fluids were included. Fifty-seven eligible neonates were randomly allocated to either intervention group (starting fluids with 10% dextrose and increments of 1.5% or standard protocol group (GIR of 6 mg/kg/min with increments of 2 mg/kg/min till control of hypoglycemia. Primary outcome of the study was to know proportion of infants with subsequent hypoglycemia and hyperglycemia after enrolment. Results. The initial GIR (6 ± 0 mg/kg/min versus 4.8 ± 1.4 mg/kg/min, P < 0.001, the mean maximum GIR (6.7 ± 1.6 mg/kg/min versus 5.6 ± 2 mg/kg/min, P = 0.03, the maximum concentration of glucose infused (13.8 ± 2.9% versus 10.9 ± 1.9%, P < 0.001, and the total amount of glucose infused were significantly lower in the intervention group. The mean maximum blood sugar was significantly higher (129 ± 57 mg/dL versus 87 ± 30 mg/dL, P = 0.001 and there was a trend towards high proportion of infants with Hyperglycemia in the standard protocol group (n = 10, 39% versus n = 5, 16%, P = 0.07. The median difference between the highest and the lowest recorded sugar for any infant was significantly higher in the standard protocol group (median 93 mg/dL, IQR 52 to 147 mg/dL versus median 50 mg/dL, IQR 38 to 62.5 mg/dL, P = 0.03. Conclusion. A new and novel algorithm in the management of hypoglycemia in neonates is as safe as the standard protocol and requires further testing before routine implementation.

  3. Postoperative sensitivity in Class V composite restorations: Comparing soft start vs. constant curing modes of LED

    OpenAIRE

    Fahad Umer; Frahan Raza Khan

    2011-01-01

    Background: One of the major disadvantages associated with using composites is polymerization shrinkage; stresses are generated at the margins, and if these stresses exceed the bond strength, microleakage occurs at the tooth restoration interface which causes ingress of cariogenic bacteria, post-operative sensitivity, and secondary caries. LED offers several curing modes: constant cure, ramped cure, and soft start cure. It is claimed that soft start polymerization mode produces less polymeriz...

  4. Dual cure photocatalyst systems

    Energy Technology Data Exchange (ETDEWEB)

    DeVoe, R.J.; Brown-Wensley, K.A.; Holmes, G.L.; Mathis, M.D.; McCormick, F.B.; Palazzotto, M.C.; Spurgeon, K.M. (Minnesota Mining and Mfg. Co., St. Paul, MN (USA). Corporate Research Labs.)

    1990-01-01

    A family of dual cure photocatalyst systems is being developed to be used in the solventless processing of organic coatings. The photocatalyst systems consist of organometallic compounds often in combination with other agents. Upon photolysis, the photocatalyst system generates a Lewis acid and a free radical. The Lewis acid can initiate the polymerization of epoxies or the addition of isocyanates and polyols to form polyurethanes while the free radical can initiate the polymerization of acrylates. The performance of the various photocatalyst systems will be compared on the basis of the physical properties of the cured compositions they produce. 17 figs.

  5. Automated detection of hypoglycemia-induced EEG changes recorded by subcutaneous electrodes in subjects with type 1 diabetes--the brain as a biosensor

    DEFF Research Database (Denmark)

    Juhl, Claus B.; Højlund, Kurt; Elsborg, Rasmus

    2010-01-01

    Hypoglycemia unawareness is a common condition associated with increased risk of severe hypoglycemia. We test the hypothesis that specific changes in the electroencephalogram (EEG) during hypoglycemia can be recorded by subcutaneous electrodes and processed by a general mathematical algorithm, an......, and that hypoglycemia associated EEG changes appear before the development of severe hypoglycemia....

  6. Avoiding hypoglycemia: a key to success for glucose-lowering therapy in type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Ahrén B

    2013-04-01

    Full Text Available Bo Ahrén Department of Clinical Sciences, Lund, Faculty of Medicine, Lund University, Lund, Sweden Abstract: Type 2 diabetes carries a risk for hypoglycemia, particularly in patients on an intensive glucose control plan as a glucose-lowering strategy, where hypoglycemia may be a limitation for the therapy and also a factor underlying clinical inertia. Glucose-lowering medications that increase circulating insulin in a glucose-independent manner, such as insulin and sulfonylurea therapy, are the most common cause of hypoglycemia. However, other factors such as a delayed or missed meal, physical exercise, or drug or alcohol consumption may also contribute. Specific risk factors for development of hypoglycemia are old age, long duration of diabetes, some concomitant medication, renal dysfunction, hypoglycemia unawareness, and cognitive dysfunction. Hypoglycemia is associated with acute short-term symptoms related to either counterregulation, such as tachycardia and sweating, or to neuroglycopenia, such as irritability, confusion, and in severe cases stupor, coma, and even death. However, there are also long-term consequences of hypoglycemia such as reduced working capacity, weight gain, loss of self-confidence with reduced quality of life, and increased risk for cardiovascular diseases. For both the patients, the health care system, and the society at large, hypoglycemia carries a high cost. Strategies to mitigate the risk of hypoglycemia include awareness of the condition; education of patients, relatives, and health-care providers; and selecting appropriate glucose-lowering medication that also judges the risk for hypoglycemia to prevent this complication. This article summarizes the current knowledge of hypoglycemia and its consequences with a special emphasis on its consequences for the choice of glucose-lowering therapy. Keywords: type 2 diabetes, hypoglycemia, treatment, sulfonylurea, incretin therapy, insulin

  7. Prolactin and growth hormone responses to hypoglycemia in patients with systemic sclerosis and psoriatic arthritis.

    Science.gov (United States)

    Rovensky, Jozef; Raffayova, Helena; Imrich, Richard; Radikova, Zofia; Penesova, Adela; Macho, Ladislav; Lukac, Jozef; Matucci-Cerinic, Marco; Vigas, Milan

    2006-06-01

    This study compared prolactin (PRL) and growth hormone (GH) responses to hypoglycemia in premenopausal females with systemic sclerosis (SSc) and psoriatic arthritis (PsA) with those in matched healthy controls. No differences were found in glucose and GH responses to hypoglycemia in both groups of patients compared to controls. SSc patients had lower PRL response (P < 0.05) to hypoglycemia compared to controls. PRL response tended to be lower also in PsA patients, however the difference did not reach level of statistical significance (P = 0.11). The present study showed decreased PRL response to hypoglycemia in premenopausal females with SSc.

  8. Risk of cardiac arrhythmias during hypoglycemia in patients with type 2 diabetes and cardiovascular risk.

    Science.gov (United States)

    Chow, Elaine; Bernjak, Alan; Williams, Scott; Fawdry, Robert A; Hibbert, Steve; Freeman, Jenny; Sheridan, Paul J; Heller, Simon R

    2014-05-01

    Recent trials of intensive glycemic control suggest a possible link between hypoglycemia and excess cardiovascular mortality in patients with type 2 diabetes. Hypoglycemia might cause arrhythmias through effects on cardiac repolarization and changes in cardiac autonomic activity. Our aim was to study the risk of arrhythmias during spontaneous hypoglycemia in type 2 diabetic patients with cardiovascular risk. Twenty-five insulin-treated patients with type 2 diabetes and a history of cardiovascular disease or two or more risk factors underwent simultaneous continuous interstitial glucose and ambulatory electrocardiogram monitoring. Frequency of arrhythmias, heart rate variability, and markers of cardiac repolarization were compared between hypoglycemia and euglycemia and between hyperglycemia and euglycemia matched for time of day. There were 134 h of recording at hypoglycemia, 65 h at hyperglycemia, and 1,258 h at euglycemia. Bradycardia and atrial and ventricular ectopic counts were significantly higher during nocturnal hypoglycemia compared with euglycemia. Arrhythmias were more frequent during nocturnal versus daytime hypoglycemia. Excessive compensatory vagal activation after the counterregulatory phase may account for bradycardia and associated arrhythmias. QT intervals, corrected for heart rate, >500 ms and abnormal T-wave morphology were observed during hypoglycemia in some participants. Hypoglycemia, frequently asymptomatic and prolonged, may increase the risk of arrhythmias in patients with type 2 diabetes and high cardiovascular risk. This is a plausible mechanism that could contribute to increased cardiovascular mortality during intensive glycemic therapy.

  9. Endocrine and metabolic emergencies in children: hypocalcemia, hypoglycemia, adrenal insufficiency, and metabolic acidosis including diabetic ketoacidosis

    National Research Council Canada - National Science Library

    Kim, Se Young

    2015-01-01

    .... Delayed diagnosis and treatment may lead to serious consequences of the pediatric patients, for example, cerebral dysfunction leading to coma or death of the patients with hypoglycemia, hypocalcemia...

  10. Curing the queue

    NARCIS (Netherlands)

    Zonderland, Maartje Elisabeth

    2012-01-01

    In this dissertation we study several problems related to the management of healthcare and the cure of disease. In each chapter a hospital capacity distribution problem is analyzed using techniques from operations research, also known as mathematical decision theory. The problems considered are insp

  11. 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.

  12. Regulation of serum potassium during insulin-induced hypoglycemia.

    Science.gov (United States)

    Petersen, K G; Schlüter, K J; Kerp, L

    1982-07-01

    Counterregulatory secretion of epinephrine occurs during severe insulin-induced hypoglycemia. Under these conditions (minimal plasma glucose 27.4 +/- 1 mg/dl) the decrease of serum potassium concentration (0.9 mVal/L) is mediated by two mechanisms: insulin-induced (0.48 mVal/L) and epinephrine-induced (0.42 mVal/L) cellular uptake of potassium. Epinephrine-induced serum potassium uptake appears to be more sensitive to beta-adrenoceptor blockade than glucose production. The intensification of insulin-induced hypokalemia by epinephrine is of clinical significance.

  13. Treatment and risk factor analysis of hypoglycemia in diabetic rhesus monkeys.

    Science.gov (United States)

    He, Sirong; Chen, Younan; Wei, Lingling; Jin, Xi; Zeng, Li; Ren, Yan; Zhang, Jie; Wang, Li; Li, Hongxia; Lu, Yanrong; Cheng, Jingqiu

    2011-02-01

    In order to anticipate and promptly treat hypoglycemia in diabetic monkeys treated with insulin or other glucose-lowering drugs, the relationships between the incidence and symptoms of hypoglycemia in these animals, and many factors involved in model development and sustainment were analyzed. Different procedures were performed on 22 monkeys for the induction of diabetes. The monkey models were evaluated by blood glucose, insulin, C-peptide levels and intravenous glucose tolerance tests. A glucose treatment program for the diabetic monkeys was administered and laboratory tests were regularly performed. A standard procedure of hypoglycemia treatment was established and the risk factors of hypoglycemia were analyzed by a logistic regression model. Furthermore, the relationships between the four methods of diabetes induction, renal function, glycemic control and hypoglycemia were studied using one-way analysis of variance and t-test. We found that the hypoglycemic conditions of diabetic monkeys were improved rapidly by our treatment. The statistical analysis suggested that the modeling methods, renal function and glycemic control were related to the incidence of hypoglycemia. In detail, the progress of diabetes, effects of glycemic control and, particularly, the severity of the hypoglycemia differed according to the induction strategy used. The models induced by partial pancreatectomy with low-dose streptozotocin were not prone to hypoglycemia and their glycemic controls were stable. However, the models induced by total pancreatectomy were more vulnerable to severe hypoglycemia and their glycemic controls were the most unstable. Moreover, the levels of blood creatinine and triglyceride increased after the development of diabetes, which was related to the occurrence of hypoglycemia. In conclusion, we suggested that total pancreatectomy and renal impairment are two important risk factors for hypoglycemia in diabetic monkeys. More attention should be paid to daily care

  14. Pyruvate administration reduces recurrent/moderate hypoglycemia-induced cortical neuron death in diabetic rats.

    Directory of Open Access Journals (Sweden)

    Bo Young Choi

    Full Text Available Recurrent/moderate (R/M hypoglycemia is common in type 1 diabetes patients. Moderate hypoglycemia is not life-threatening, but if experienced recurrently it may present several clinical complications. Activated PARP-1 consumes cytosolic NAD, and because NAD is required for glycolysis, hypoglycemia-induced PARP-1 activation may render cells unable to use glucose even when glucose availability is restored. Pyruvate, however, can be metabolized in the absence of cytosolic NAD. We therefore hypothesized that pyruvate may be able to improve the outcome in diabetic rats subjected to insulin-induced R/M hypoglycemia by terminating hypoglycemia with glucose plus pyruvate, as compared with delivering just glucose alone. In an effort to mimic juvenile type 1 diabetes the experiments were conducted in one-month-old young rats that were rendered diabetic by streptozotocin (STZ, 50mg/kg, i.p. injection. One week after STZ injection, rats were subjected to moderate hypoglycemia by insulin injection (10 U/kg, i.p. without anesthesia for five consecutive days. Pyruvate (500 mg/kg was given by intraperitoneal injection after each R/M hypoglycemia. Three hours after last R/M hypoglycemia, zinc accumulation was evaluated. Three days after R/M hypoglycemia, neuronal death, oxidative stress, microglial activation and GSH concentrations in the cerebral cortex were analyzed. Sparse neuronal death was observed in the cortex. Zinc accumulation, oxidative injury, microglial activation and GSH loss in the cortex after R/M hypoglycemia were all reduced by pyruvate injection. These findings suggest that when delivered alongside glucose, pyruvate may significantly improve the outcome after R/M hypoglycemia by circumventing a sustained impairment in neuronal glucose utilization resulting from PARP-1 activation.

  15. Hypothalamic S-nitrosylation contributes to the counter-regulatory response impairment following recurrent hypoglycemia.

    Directory of Open Access Journals (Sweden)

    Xavier Fioramonti

    Full Text Available AIMS: Hypoglycemia is a severe side effect of intensive insulin therapy. Recurrent hypoglycemia (RH impairs the counter-regulatory response (CRR which restores euglycemia. During hypoglycemia, ventromedial hypothalamus (VMH production of nitric oxide (NO and activation of its receptor soluble guanylyl cyclase (sGC are critical for the CRR. Hypoglycemia also increases brain reactive oxygen species (ROS production. NO production in the presence of ROS causes protein S-nitrosylation. S-nitrosylation of sGC impairs its function and induces desensitization to NO. We hypothesized that during hypoglycemia, the interaction between NO and ROS increases VMH sGC S-nitrosylation levels and impairs the CRR to subsequent episodes of hypoglycemia. VMH ROS production and S-nitrosylation were quantified following three consecutive daily episodes of insulin-hypoglycemia (RH model. The CRR was evaluated in rats in response to acute insulin-induced hypoglycemia or via hypoglycemic-hyperinsulinemic clamps. Pretreatment with the anti-oxidant N-acetyl-cysteine (NAC was used to prevent increased VMH S-nitrosylation. RESULTS: Acute insulin-hypoglycemia increased VMH ROS levels by 49±6.3%. RH increased VMH sGC S-nitrosylation. Increasing VMH S-nitrosylation with intracerebroventricular injection of the nitrosylating agent S-nitroso-L-cysteine (CSNO was associated with decreased glucagon secretion during hypoglycemic clamp. Finally, in RH rats pre-treated with NAC (0.5% in drinking water for 9 days hypoglycemia-induced VMH ROS production was prevented and glucagon and epinephrine production was not blunted in response to subsequent insulin-hypoglycemia. CONCLUSION: These data suggest that NAC may be clinically useful in preventing impaired CRR in patients undergoing intensive-insulin therapy.

  16. Hypocarnitinemic hypoglycemia and heart failure in an infant with a constant parenteral elementary nutrition during measles vaccination-related febrile illness.

    Science.gov (United States)

    Okanari, K; Takahashi, M; Maeda, T; Sato, K; Suenobu, S; Izumi, T

    2007-12-01

    A 1-year and 11-month-old female infant with bilateral lesions of the thalamus, basal ganglia, cerebellar and brainstem disease died from heart failure 9 days after being administered a measles vaccination. She had a high fever, hypocarnitinemic and non-ketotic hypoglycemia, serum levels of total carnitine 7.4 micromol/L, free carnitine 5.6 micromol/L, acylcarnitine 1.8 micromol/L and glucose 13 mg/dL. Due to feeding difficulty, the patient, however, had been administered parenteral elementary nutrition through a feeding tube since early infancy. The commercially available parenteral nutrition solutions do not contain carnitine. A secondary carnitine deficiency followed by non-ketotic hypoglycemia-related heart failure may readily develop even in a patient without valproic acid, during high fever.

  17. Hiccups: causes and cures.

    Science.gov (United States)

    Lewis, J H

    1985-12-01

    Hiccups result from a wide variety of conditions that act on the supraspinal hiccup center or that stimulate or disinhibit the limbs of its reflex arc. While scores of hiccup remedies have been reported over the centuries, no single "cure" stands out as being the most effective. Measures that stimulate the uvula or pharynx or disrupt diaphragmatic (respiratory) rhythm are simple to use and often help to speed the end of a bout of otherwise benign, self-limited hiccups. Such manueuvers may also terminate persistent hiccups. Drug therapy usually becomes necessary for more intractable hiccups; chlorpromazine and metoclopramide being two of the most widely employed agents for this purpose. Physical disruption of the phrenic nerve, hypnosis, and acupuncture are other modes of therapy that have been used in severe cases. Because so many reports of hiccup "cures" are based on anecdotal experience rather than controlled clinical studies, I review the available treatments to provide a rational approach for the management of hiccups.

  18. Episodic hypoglycemia with psi-hydroxy fatty acid excretion.

    Science.gov (United States)

    Colle, E; Mamer, O A; Montgomery, J A; Miller, J D

    1983-02-01

    We present case histories of two young children with episodes of hypoglycemia, elevation of SGOT, low insulin levels, increased urinary excretion of psi-hydroxy fatty acids (5-hydroxyhexanoic, 7-hydroxyoctanoic and 9-hydroxydecanoic), traces of the corresponding psi-ketoacids and elevations of urinary adipic, suberic, and sebacic acids. The ratio of psi-hydroxy fatty acids to 3-hydroxybutyric in the urine of these patients is higher than in patients of similar ages with similar illnesses. These acids persisted while the patients were well. Increased urinary psi-hydroxy fatty acids could be reproduced by a load of medium chain triglycerides without precipitating other clinical symptoms. Three children with hypoglycemia were found not to excrete measurable amounts of these unusual acids while ill. A medium chain triglyceride load in one of these children after recovery failed to elicit psi-hydroxy acid excretion. Small amounts of urinary 5-hydroxyhexanoic acid only were found in two patients with acute Reye's syndrome and in three of five severely ill children with starvation ketonuria. In this last group, no urinary psi-hydroxyacids could be detected after recovery. Normal children do not excrete measurable amounts (less than 1 mg/g creatinine) of these psi-hydroxyacids.

  19. Analyzing EEG signals under insulin-induced hypoglycemia in type 1 diabetes patients.

    Science.gov (United States)

    Nguyen, Lien B; Nguyen, Anh V; Ling, Sai Ho; Nguyen, Hung T

    2013-01-01

    Hypoglycemia is dangerous and considered as a limiting factor of the glycemic control therapy for patients with type 1 diabetes mellitus (T1DM). Nocturnal hypoglycemia is especially feared because early warning symptoms are unclear during sleep so an episode of hypoglycemia may lead to a fatal effect on patients. The main objective of this paper is to explore the correlation between hypoglycemia and electroencephalography (EEG) signals. To do this, the EEG of five T1DM adolescents from an overnight insulin-induced study is analyzed by spectral analysis to extract four different parameters. We aim to explore the response of these parameters during the clamp study which includes three main phases of normal, hypoglycemia and recovery. We also look at data at the blood glucose level (BGL) of 3.3-3.9 mmol/l to find a threshold to distinguish between non-hypoglycemia and hypoglycemia states. The results show that extracted EEG parameters are highly correlated with patients' conditions during the study. It is also shown that at the BGL of 3.3 mmol/l, responses to hypoglycemia in EEG signals start to significantly occur.

  20. Body position and the neuroendocrine response to insulin-induced hypoglycemia in healthy subjects.

    Science.gov (United States)

    Radikova, Z; Penesova, A; Jezova, D; Kvetnansky, R; Vigas, M; Macho, L; Koska, J

    2003-10-01

    Changes in body fluid distribution are known to influence neuroendocrine function. The aim of the present study was to test the hypothesis that changes in plasma volume affect the counterregulatory neuroendocrine response to hypoglycemia. The tests were performed in 12 subjects in two situations: 'head-up' (+60 degrees head-up tilt standing for 30 min and hypoglycemia in sitting position afterwards) and 'leg-up' (leg-up position for 30 min and hypoglycemia in leg-up position afterwards) in a random order. Insulin-induced hypoglycemia was adjusted to 2.7 mmol/l for 15 min by glucose infusion. Plasma volume was greater by 2.2% (p < 0.001) in leg-up and lower by 9.6% (p < 0.001) in head-up position compared to the basal value in sitting position. Head-up position was associated with increases in ACTH, aldosterone, norepinephrine levels and plasma renin activity (p < 0.01). Leg-up position resulted in decreases in plasma growth hormone and epinephrine concentrations (p < 0.05). Except epinephrine, the neuroendocrine response to hypoglycemia, if any, was mild. Hypoglycemia failed to activate ACTH release after head-up position. Body fluid redistribution did not modify hormonal changes during insulin hypoglycemia. In conclusion, we suggest that body position and accompanying plasma volume changes do not appear to affect neuroendocrine and counterregulatory responses to moderate, short duration hypoglycemia in healthy subjects.

  1. An unusual cause of hypoglycemia in a middle-aged female after bariatric surgery

    Directory of Open Access Journals (Sweden)

    Ranjan Pathak

    2014-04-01

    Full Text Available Non-insulinoma pancreatogenous hypoglycemia syndrome (NIPHS is a disorder characterized by postprandial hypoglycemia and islet cell hypertrophy. It is an uncommon complication of weight-loss surgery. However, with the rising incidence of gastric bypass surgeries, it is important to be able to recognize the clinical picture of NIPHS and not to incorrectly ascribe the symptoms to late dumping syndrome.

  2. Association between hypoglycemia and dementia in patients with type 2 diabetes.

    Science.gov (United States)

    Sheen, Yi-Jing; Sheu, Wayne H H

    2016-06-01

    In addition to increased risks of macrovascular and microvascular complications, patients with type 2 diabetes mellitus (T2DM) usually also are at increased risk for cognitive impairment and dementia. Hypoglycemia, a common consequence of diabetes treatment, is considered an independent risk factor for dementia in patients with T2DM. Hypoglycemia and dementia are clinically underestimated and are related to poor outcomes; thus, they may compromise the life expectancy of patients with T2DM. Epidemiological evidence of hypoglycemia-associated cognitive decline and dementia is highly varied. Acute, severe hypoglycemic episodes induce chronic subclinical brain damage, cognitive decline, and subsequent dementia. However, the effects of recurrent moderate hypoglycemia on cognitive decline and dementia remain largely uninvestigated. Poor glycemic control (including fluctuation of hemoglobin A1C [HbA1c] and glucose values) and the viscous circle of bidirectional associations between dementia and hypoglycemia may be clinically relevant. The possible pathophysiological hypotheses include post-hypoglycemic neuronal damage, inflammatory processes, coagulation defects, endothelial abnormalities, and synaptic dysfunction of hippocampal neurons during hypoglycemia episodes. This article reviews previous findings, provides insight into the detection of groups at high risk of hypoglycemia-associated dementia, and proposes specific strategies to minimize the potential burdens associated with hypoglycemia-related neurocognitive disorders in patients with T2DM.

  3. Hypoglycemia in pregnant women with type 1 diabetes - Predictors and role of metabolic control

    DEFF Research Database (Denmark)

    Nielsen, L.R.; Johansen, M.; Pedersen-Bjergaard, U.;

    2008-01-01

    OBJECTIVE- In pregnancy with type 1 diabetes, we evaluated occurrence of mild and severe hypoglycemia and analyzed the influence of strict metabolic control, nausea, Vomiting, and other potential predictors of occurrence of severe hypoglycemia. RESEARCH DESIGN AND METHODS- A prospective observati......OBJECTIVE- In pregnancy with type 1 diabetes, we evaluated occurrence of mild and severe hypoglycemia and analyzed the influence of strict metabolic control, nausea, Vomiting, and other potential predictors of occurrence of severe hypoglycemia. RESEARCH DESIGN AND METHODS- A prospective...... (managed by the patient) and severe (requiring assistance from others) hypoglycemia. RESULTS- Forty-nine (45%) women experienced 178 severe hypoglycemic events, corresponding to 5.3, 2.4, and 0.5 events/patient-year in the first, second, and third trimesters, respectively. The incidence of mild...... hypoglycemia. A1C, median SMPG, and fluctuations in SMPG decreased during pregnancy, with no differences between women with and without severe hypoglycemia. Logistic regression analysis identified history of severe hypoglycemia the year preceding pregnancy (odds ratio 3.3 [95% CI 1.2-9.2]) and impaired...

  4. Fear of hypoglycemia and its clinical significance: a case-control study

    Directory of Open Access Journals (Sweden)

    Elena Georgievna Starostina

    2013-11-01

    Full Text Available Aim. To assess the prevalence of fear of hypoglycemia, its clinical features and influence on diabetes compensation.Materials and Methods. A cross-sectional study was conducted with 200 sequentially enrolled participants with type 2 diabetes mellitus (T2DM; n=139 and type 1 diabetes mellitus (T1DM; n=61. Patients were screened for psychiatric disorders with appropriate inventory and examined by a psychiatrist. Subjects identified as those with fear of hypoglycemia (n=12 formed the study group, while control group was assembled of individuals without phobic signs, matched for gender, age, type and duration of diabetes and concomitant psychiatric disorders.Results. Prevalence of fear of hypoglycemia was estimated at 6%, being consistently higher in patients with T1DM (16.1% vs. T2DM (1%; p=0.0002. Fear of hypoglycemia was associated with higher median HbA1c (9.4% [8.6 ; 9.9] vs. 8.2% [6.8 ; 9.3], p<0.05. These findings are in agreement with considerably higher prevalence of proliferative retinopathy (33% observed in study group (0% in control group, p<0.05. Phobic patients with T1DM had higher occurrence of ketoacidosis (41.7% of subjects, 7 cases than control subjects (16.6% of subjects, 2 cases. Similar trend was observed for severe hypoglycemic events. There was no significant difference between the groups in sensitivity to hypoglycemia, cognitive functions, educational level or social status. Patients with fear of hypoglycemia tend to regard hypoglycemia as primary, highly hazardous challenge of diabetes mellitus and perceive its symptoms as «extremely unpleasant». However, in this study phobic patients maintained the same level of self-monitoring as their control counterparts and demonstrated comparable knowledge of the causes of hypoglycemia. None of the participants reported a habit of carrying carbohydrates for hypoglycemia management.Conclusion. Fear of hypoglycemia is highly prevalent among patients with T1DM and is often

  5. Treatment of severe diabetic hypoglycemia with glucagon: an underutilized therapeutic approach

    Directory of Open Access Journals (Sweden)

    Kedia N

    2011-09-01

    Full Text Available Nitil KediaColney Medical Centre, London Colney, Herts, UKAbstract: Tight glycemic control is important in reducing and delaying vascular complications in type 1 and 2 diabetes patients; however, the benefits achieved through strict metabolic control are counterbalanced by an increased risk of hypoglycemia. Glucagon is an effective therapy for treating severe hypoglycemia. Available as an emergency kit, glucagon is an essential tool for rapid response, but remains underappreciated and underused. This article reviews the role of glucagon in treating severe hypoglycemia and discusses the need for better education on glucagon for people with diabetes and their caregivers in order to alleviate fears of hypoglycemia and of administering glucagon in the event of an emergency.Keywords: severe hypoglycemia, glucagon, type 1 diabetes, type 2 diabetes

  6. Hypoglycemia-related electroencephalogram changes are independent of gender, age, duration of diabetes, and awareness status in type 1 diabetes

    DEFF Research Database (Denmark)

    Remvig, Line Sofie; Elsborg, Rasmus; Sejling, Anne-Sophie;

    2012-01-01

    subsequently stratified by age group (± 50 years), gender, duration of diabetes (± 20 years), and hypoglycemia awareness status (normal/impaired awareness of hypoglycemia). Results: An increase in the log amplitude of the delta, theta, and alpha band and a decrease in the alpha band centroid frequency......, and hypoglycemia awareness status. This indicates that it may be possible to establish a general algorithm for hypoglycemia detection based on EEG measures....

  7. [Severe hypoglycemia in children and adolescents suffering from type 1 diabetes mellitus].

    Science.gov (United States)

    Cosmescu, Adriana; Felea, Doina; Mătăsaru, Silvia

    2008-01-01

    Hypoglycemia is the main fear of diabetic children and their parents. Severe hypoglycemia and diabetes ketoacidosis are medical emergencies that concern a patient's life prognosis. To determine the rate of occurrence of severe hypoglycemia and identification of the latter's causes. The study was carried out on a group of 84 children and adolescents suffering from type 1 diabetes, whom were investigated to determine the rate of occurrence of severe hypoglycemia episodes in the last 12 months, to identify their risk factors and to try to establish a relation between the onset of hypoglycemia and certain parameters like age, duration of disease, insulin therapy, metabolic control. 23 of the 84 patients reported at least one severe hypoglycemia in the last 12 months. 47% of the cases of hypoglycemia were caused by the patient's failure to observe the meal timetable, which led to delays in the carbohydrates intake, 19% were due to a high physical effort and 14% by excessive insulin administration. Most of the patients with severe hypoglycemia, that is 20 if 23, were on a multiple insulin injection treatment. As concerns the blood sugar balance, the mean Hb A1c values were between 6.4% and 9.1%, the severe hypoglycemia episodes occurred both in patients with very good metabolic control and in those with poor blood sugar balance. Severe hypoglycemia occurred in 27.3% of the children and adolescents suffering from type 1 diabetes, the most frequent cause revealed by this study being the delay in the carbohydrates intake. The prevention of this acute metabolic complication by a continuous medical education of diabetic patients is essential.

  8. Association of Hypoglycemia With Subsequent Dementia in Older Patients With Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Mehta, Hemalkumar B; Mehta, Vinay; Goodwin, James S

    2017-08-01

    Studies have found conflicting evidence regarding the association of hypoglycemia with dementia. We evaluated an association of hypoglycemia with subsequent dementia in patients with type 2 diabetes. This retrospective longitudinal cohort study used the Clinical Practice Research Datalink, an electronic medical records data from the United Kingdom, from 2003 to 2012. We included patients aged >65 years diagnosed with type 2 diabetes, with no prior diagnosis of dementia. Dementia was defined using diagnosis codes from medical records. All patients were followed from the date of initial diabetes diagnosis. To account for competing risk of death, we used Fine and Gray's competing risk model to determine the association of hypoglycemia with dementia while adjusting for potential confounders. Hypoglycemia was modeled as a time-dependent covariate. Of 53,055 patients, 5.7% (n = 3,018) had at least one hypoglycemia episodes. The overall incidence rate of dementia was 12.7 per 1,000 person-years. In the fully adjusted model that controlled for all confounders, the occurrence of at least one hypoglycemia episode was associated with 27% higher odds of subsequent dementia (hazard ratio = 1.27; 95% confidence interval = 1.06-1.51). The risk increased with the number of hypoglycemia episodes: one episode (hazard ratio = 1.26; 95% confidence interval = 1.03-1.54); two or more episodes (hazard ratio = 1.50; 95% confidence interval = 1.09-2.08). Hypoglycemia is associated with a higher risk of dementia and may be responsible in part for the higher risk of dementia in patients with diabetes. Alternatively, hypoglycemia may be a marker for undiagnosed cognitive impairment, and we cannot rule out the possibility of reverse causation between hypoglycemia and dementia.

  9. The Clinical Characteristics and Risk Factors of Neonatal Hypoglycemia%新生儿低血糖症的临床特点及高危因素的分析

    Institute of Scientific and Technical Information of China (English)

    曹祎明

    2014-01-01

    目的:探讨新生儿低血糖症的临床特点、高危因素及防治效果。方法回顾性分析本院新生儿科收治的93例新生儿低血糖症的临床资料,分析其相关高危因素及治疗效果。结果新生儿低血糖症患儿的临床症状多不明显,且缺乏特异性,多见于早产儿、足月小于胎龄儿、新生儿窒息、糖尿病母亲婴儿、感染等高危儿。经有效治疗后93例均痊愈,有效率为100%。结论对有低血糖高危因素的新生儿应常规监测血糖,及时治疗,避免低血糖引起中枢神经系统损伤。%Objective To investigate the clinical features, risk factors and preventive effection of neonatal hypoglycemia. Methods A retrospective analysis of the clinical data of 93 cases of neonatal hypoglycemia in the neonatal ward were analyzed, analysis of the risk factors and treatment effect. Results The clinical symptoms of children with neonatal hypoglycemia is not obvious, and lack of specificity, more common in premature, small for gestational age, neonatal asphyxia, infants of diabetic mother and infection,etc. After effective treatment 93 cases were cured, 100%efficiency. Conclusion Newborns at high risk for hypoglycemia should be regularly monitored for the blood sugar, timely treatment, avoid hypoglycemia caused with central nervous system injury.

  10. EFFECTS OF ACUTE HYPOGLYCEMIA ON THE OREXIN SYSTEM IN RAT

    Institute of Scientific and Technical Information of China (English)

    Yu-yan Zhao; Lei Guo; Jian Du; Guo-liang Liu

    2005-01-01

    Objective To evaluate the effects of acute glucose level changes on expression of prepro-orexin, orexin 1 receptor (OX1R) and orexin 2 receptor (OX2R) mRNA in rat hypothalamus tissue and pancreatic islets cells.Methods Thirty adult male Wistar rats were randomly divided into three equal groups (n= 10). The acute hypoglycemia rat model was induced by a single subcutaneous injection of insulin. Twenty acute hypoglycemia rats were divided into group B and group C. Group B was allowed to eat freely, while group C was food-deprived. Control rats were injected the same volume of saline. The effect of glucose levels (2.8 mmol/L and 8.3 mmol/L) on pancreatic islet cell orexin system was detected in pancreas islet cell cultured in vitro. The expression of prepro-orexin and OXR mRNA was examined in rat hypothalamus tissue and pancreatic islets cell cultured in vitro using reverse transcription-polymerase chain reaction (RTPCR).Results Expression of orexin mRNA increased about 150% for the food-deprived hypoglycemia rats in comparison with control group (P < 0.01), whereas expression of OX1R mRNA decreased up to 30% (P < 0.01). However, expression of OX2R mRNA was unchanged in comparison with control group. In vitro, after incubation with 2.8 mmol/L glucose for 6hours, the expression of prepro-orexin mRNA increased 2 times in rat pancreas islet cells in comparison with 8.3 mmol/Lglucose group (P < 0.01). But the expression of OX1R mRNA was not sensitive to acute glucose fluctuation.Conclusions Orexin in rat hypothalamus is stimulated by decline in blood glucose and inhibited by signals related to feeding. Moreover, glucose plays a role in modulating the gene expression of prepro-orexin in rat pancreatic islet cells.

  11. Nationwide reduction in the frequency of severe hypoglycemia by half

    DEFF Research Database (Denmark)

    Fredheim, S.; Johansen, A.; Thorsen, S. U.

    2015-01-01

    -years. The incidence rate peaked with 16.0 per 100 person-years in 2008 reaching a nadir of 4.9 in 2011. Overall, insulin pump reduced the rate of SH with 27 % compared to any pen treatment (P = 0.003). When stratifying pen treatment, premixed insulin increased the rate of SH by 1.9-fold (P = 0.0015) and NPH increased...... the rate by 1.6-fold (P = 0.003) versus pump treatment, whereas long-acting insulin analogues were comparable with pump treatment (P = 0.1485). We found no association of SH with glycemic control (P > 0.05). Conclusions: A nationwide halving in rates of severe hypoglycemia was observed during the study...

  12. Modeling HIV Cure

    Science.gov (United States)

    Perelson, Alan; Conway, Jessica; Cao, Youfang

    A large effort is being made to find a means to cure HIV infection. I will present a dynamical model of post-treatment control (PTC) or ``functional cure'' of HIV-infection. Some patients treated with suppressive antiviral therapy have been taken off of therapy and then spontaneously control HIV infection such that the amount of virus in the circulation is maintained undetectable by clinical assays for years. The model explains PTC occurring in some patients by having a parameter regime in which the model exhibits bistability, with both a low and high steady state viral load being stable. The model makes a number of predictions about how to attain the low PTC steady state. Bistability in this model depends upon the immune response becoming exhausted when over stimulated. I will also present a generalization of the model in which immunotherapy can be used to reverse immune exhaustion and compare model predictions with experiments in SIV infected macaques given immunotherapy and then taken off of antiretroviral therapy. Lastly, if time permits, I will discuss one of the hurdles to true HIV eradication, latently infected cells, and present clinical trial data and a new model addressing pharmacological means of flushing out the latent reservoir. Supported by NIH Grants AI028433 and OD011095.

  13. Glycemic goals in diabetes: trade-off between glycemic control and iatrogenic hypoglycemia.

    Science.gov (United States)

    Cryer, Philip E

    2014-07-01

    The selection of a glycemic goal in a person with diabetes is a compromise between the documented upside of glycemic control-the partial prevention or delay of microvascular complications-and the documented downside of glycemic control-the recurrent morbidity and potential mortality of iatrogenic hypoglycemia. The latter is not an issue if glycemic control is accomplished with drugs that do not cause hypoglycemia or with substantial weight loss. However, hypoglycemia becomes an issue if glycemic control is accomplished with a sulfonylurea, a glinide, or insulin, particularly in the setting of absolute endogenous insulin deficiency with loss of the normal decrease in circulating insulin and increase in glucagon secretion and attenuation of the sympathoadrenal response as plasma glucose concentrations fall. Then the selection of a glycemic goal should be linked to the risk of hypoglycemia. A reasonable individualized glycemic goal is the lowest A1C that does not cause severe hypoglycemia and preserves awareness of hypoglycemia, preferably with little or no symptomatic or even asymptomatic hypoglycemia, at a given stage in the evolution of the individual's diabetes.

  14. Glucose counterregulation in diabetes secondary to chronic pancreatitis

    DEFF Research Database (Denmark)

    Larsen, S; Hilsted, J; Philipsen, E K

    1990-01-01

    Glucose counterregulation and hormonal responses after insulin-induced hypoglycemia were investigated in six patients with diabetes mellitus secondary to chronic pancreatitis, in seven with insulin-dependent (type I) diabetes mellitus, and in seven healthy subjects. Glucose counterregulation...... was identical in type I patients and in the patients with chronic pancreatitis, whereas both groups had impaired glucose recovery compared with the healthy subjects. The patients with chronic pancreatitis had no glucagon response to hypoglycemia, whereas epinephrine increased significantly. In an additional...... experiment, glucose recovery did not occur after hypoglycemia during concomitant beta-adrenoceptor blockade in these patients. In conclusion, glucose counterregulation is preserved but slightly impaired in patients with diabetes secondary to chronic pancreatitis, and the combination of total glucagon...

  15. NOCTURNAL HYPOGLYCEMIA--THE MAIN INDICATION FOR INSULIN PUMP THERAPY IN ADULTHOOD.

    Science.gov (United States)

    Baretić, Maja; Kraljević, Ivana; Renar, Ivana Pavlić

    2016-03-01

    The aim was to determine which adult type 1 diabetic patient receiving multiple daily injection therapy is the most appropriate candidate for insulin pump therapy, while taking into consideration limited insulin pump affordability in Croatia. A total of 145 type 1 diabetic patients (52% diagnosed in adult age) were monitored at the Department of Endocrinology, Clinical Department of Internal Medicine, Zagreb University Hospital Center from 2009 to 2014. Twenty-one patients started insulin pump therapy in adulthood (seven men and 14 women, median age 27). Five patients had chronic complications (retinopathy in two, polyneuropathy in one, and both nephropathy and retinopathy in two patients). The median HbA1c at the initiation of pump therapy was 6.95% versus 6.5% after 1 year of pump therapy. Patients were stratified according to indications for insulin pump therapy (frequent and/or severe hypoglycemia, specific lifestyle, having not reached glycemic goals despite adherence/labile diabetes, and preconception). Patients could meet more than one criterion. Initially, the occurrence of hypoglycemia was analyzed by 6-day continuous glucose monitoring, while re-evaluation was done after collecting history data at 1 year ± 3 months. Initially, all patients had a median of 5 hypoglycemias/6 days (30% nocturnal) versus 1 hypoglycemia/6 days (without nocturnal) after 1 year. The Wilcoxon signed-rank test yielded a statistically significant difference in hypoglycemic events, nocturnal hypoglycemia and HbA1c. Patients commencing insulin pump therapy due to hypoglycemia initially had median HbA1c of 6.7% with 7 hypoglycemia/6 days (50% nocturnal). After one year, median HbA1c was 6% with 1 hypoglycemia/6 days (without nocturnal). In conclusion, the main indication for insulin pump therapy in adults is the frequency of hypoglycemia, especially nocturnal ones.

  16. Leptin acts in the brain to influence hypoglycemic counterregulation: disparate effects of acute and recurrent hypoglycemia on glucagon release.

    Science.gov (United States)

    Reno, Candace M; Ding, Yuyan; Sherwin, Robert

    2015-12-15

    Leptin has been shown to diminish hyperglycemia via reduced glucagon secretion, although it can also enhance sympathoadrenal responses. However, whether leptin can also inhibit glucagon secretion during insulin-induced hypoglycemia or increase epinephrine during acute or recurrent hypoglycemia has not been examined. To test whether leptin acts in the brain to influence counterregulation, hyperinsulinemic hypoglycemic (∼45 mg/dl) clamps were performed on rats exposed to or not exposed to recurrent hypoglycemia (3 days, ∼40 mg/dl). Intracerebroventricular artificial cerebral spinal fluid or leptin was infused during the clamp. During acute hypoglycemia, leptin decreased glucagon responses by 51% but increased epinephrine and norepinephrine by 24 and 48%, respectively. After recurrent hypoglycemia, basal plasma leptin levels were undetectable. Subsequent brain leptin infusion during hypoglycemia paradoxically increased glucagon by 45% as well as epinephrine by 19%. In conclusion, leptin acts within the brain to diminish glucagon secretion during acute hypoglycemia but increases epinephrine, potentially limiting its detrimental effects during hypoglycemia. Exposure to recurrent hypoglycemia markedly suppresses plasma leptin, whereas exogenous brain leptin delivery enhances both glucagon and epinephrine release to subsequent hypoglycemia. These data suggest that recurrent hypoglycemia may diminish counterregulatory responses in part by reducing brain leptin action.

  17. Nonislet Cell Tumor Hypoglycemia in a Patient with Adrenal Cortical Carcinoma

    Directory of Open Access Journals (Sweden)

    Se Won Kim

    2016-01-01

    Full Text Available Nonislet cell tumor hypoglycemia (NICTH is a rare but serious paraneoplastic syndrome in which a tumor secretes incompletely processed precursors of insulin-like growth factor-II (IGF-II, causing hypoglycemia. Here, we report an exceptional case of NICTH caused by nonfunctioning adrenocortical carcinoma in a 39-year-old male with recurrent hypoglycemia. The patient’s serum IGF-II/IGF-I ratio had increased to 27.8. The serum level of the IGF-II/IGF-I ratio was normalized after removal of the tumor, and the hypoglycemic attacks no longer occurred after the operation.

  18. Octreotide-induced hepatitis in a child with persistent hyperinsulinemia hypoglycemia of infancy.

    Science.gov (United States)

    Ben-Ari, Josef; Greenberg, Meidad; Nemet, Dan; Edelstein, Evgeny; Eliakim, Alon

    2013-01-01

    Persistent hyperinsulinemic hypoglycemia of infancy (PHHI), the most common cause of persistent hypoglycemia in the neonatal period and infancy, is a genetic disorder characterized by abnormal regulation of insulin secretion. Octreotide, a somatostatin analog, is often used as a second-line treatment when diazoxide therapy fails to control hypoglycemia. We report herein a rare development of octreotide-induced hepatitis following prolonged treatment for PHHI in an infant. Octreotide-induced hepatitis may occur mostly when high doses are given, or when dosing is increased. This warrants routine examination of liver function. When hepatitis develops, prompt cessation of octreotide therapy will probably result in subsequent resolution.

  19. Hypoglycemia-Associated EEG Changes in Prepubertal Children With Type 1 Diabetes

    DEFF Research Database (Denmark)

    Hansen, Grith Lærkholm; Foli-Andersen, Pia; Fredheim, Siri

    2016-01-01

    BACKGROUND: The purpose of this study was to explore the possible difference in the electroencephalogram (EEG) pattern between euglycemia and hypoglycemia in children with type 1 diabetes (T1D) during daytime and during sleep. The aim is to develop a hypoglycemia alarm based on continuous EEG...... measurement and real-time signal processing. METHOD: Eight T1D patients aged 6-12 years were included. A hyperinsulinemic hypoglycemic clamp was performed to induce hypoglycemia both during daytime and during sleep. Continuous EEG monitoring was performed. For each patient, quantitative EEG (qEEG) measures...

  20. Influence of erythropoietin on cognitive performance during experimental hypoglycemia in patients with type 1 diabetes mellitus

    DEFF Research Database (Denmark)

    Kristensen, Peter Lommer; Pedersen-Bjergaard, Ulrik; Kjær, Troels Wesenberg

    2013-01-01

    The incidence of severe hypoglycemia in type 1 diabetes has not decreased over the past decades. New treatment modalities minimizing the risk of hypoglycemic episodes and attenuating hypoglycemic cognitive dysfunction are needed. We studied if treatment with the neuroprotective hormone erythropoi...... erythropoietin (EPO) enhances cognitive function during hypoglycemia.......The incidence of severe hypoglycemia in type 1 diabetes has not decreased over the past decades. New treatment modalities minimizing the risk of hypoglycemic episodes and attenuating hypoglycemic cognitive dysfunction are needed. We studied if treatment with the neuroprotective hormone...

  1. Vascular endothelial growth factor during hypoglycemia in patients with type 1 diabetes mellitus: relation to cognitive function and renin-angiotensin system activity

    DEFF Research Database (Denmark)

    Kristensen, Peter Lommer; Høi-Hansen, Thomas; Boomsma, Frans;

    2009-01-01

    hypoglycemia. High activity in the renin-angiotensin system (RAS) is associated with an increased risk of severe hypoglycemia in patients with type 1 diabetes mellitus. Renin-angiotensin system possibly exerts its mechanism in hypoglycemia via VEGF. We studied the impact of mild hypoglycemia on plasma VEGF...

  2. Impact of hypoglycemia on patients with type 2 diabetes mellitus and their quality of life, work productivity, and medication adherence

    Directory of Open Access Journals (Sweden)

    Lopez JMS

    2014-05-01

    Full Text Available Janice MS Lopez,1 Kathy Annunziata,2 Robert A Bailey,1 Marcia FT Rupnow,1 Donald E Morisky31Janssen Scientific Affairs, LLC, Raritan, NJ, 2Kantar Health, Princeton, NJ, 3University of California at Los Angeles Fielding School of Public Health, Los Angeles, CA, USABackground: The purpose of this study was to determine the characteristics of adults with type 2 diabetes mellitus (T2DM that correlate with greater risk of hypoglycemia and determine the impact of hypoglycemia on health-related quality of life, work productivity, and medication adherence from a patient perspective.Methods: Data from a large web-based survey were retrospectively analyzed. Adults with a diagnosis of T2DM taking antihyperglycemic agents were included in the analysis. Participants with knowledge of their hypoglycemic history were divided into three groups: those experiencing recent hypoglycemia (previous 3 months, those experiencing nonrecent hypoglycemia, and those never experiencing hypoglycemia.Results: Of the participants with T2DM taking antihyperglycemic agents who were knowledgeable of their hypoglycemia history, 55.7% had ever experienced hypoglycemia. Of those, 52.7% had recent hypoglycemia. Compared with those who never experienced hypoglycemia, those who experienced hypoglycemia tended to: be younger; be more aware of their glycated hemoglobin (HbA1c levels; have higher HbA1c levels; have a higher body mass index; have higher Charlson Comorbidity Index scores; be on insulin, sulfonylureas, and/or glucagon-like peptide-1 agonists; and be less adherent to their antihyperglycemic agents. Hypoglycemia interfered with social activities, caused more missed work (absenteeism, more impairment while at work (presenteeism, and decreased overall work productivity compared with patients who had never experienced hypoglycemia. Overall health-related quality of life, as determined by the Short Form-36 health questionnaire, was negatively impacted by hypoglycemia. Both

  3. Controversies in HIV cure research

    Directory of Open Access Journals (Sweden)

    Johnston Rowena

    2012-03-01

    Full Text Available Abstract Background Antiretroviral therapy significantly reduces HIV viral burden and prolongs life, but does not cure HIV infection. The major scientific barrier to a cure is thought to be the persistence of the virus in cellular and/or anatomical reservoirs. Discussion Most efforts to date, including pharmaco, immuno or gene therapy, have failed to cure patients, with the notable exception of a stem cell transplant recipient commonly known as the Berlin patient. This case has revived interest in the potential to cure HIV infection and has highlighted the need to resolve critical questions in the basic, pre-clinical and clinical research spheres as they pertain specifically to efforts to eradicate HIV from the body of an infected person (a sterilizing cure or at least render the need for lifelong antiretroviral therapy obsolete (functional cure. This paper describes ongoing debates in each of these research spheres as they were presented and discussed at a satellite session that took place at the 6th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Rome in July 2011. Summary The resolution of these debates may have important implications for the search for a cure, the most efficient ways to identify and test promising interventions, and ultimately the availability of such a cure to diverse groups of HIV patients around the world.

  4. Mixture proportioning for internal curing

    DEFF Research Database (Denmark)

    Bentz, Dale P.; Pietro, Lura; Roberts, John W.

    2005-01-01

    hydration and strength development, reduced autogenous shrinkage and cracking, reduced permeability, and increased durability. The impact of internal curing begins immediately with the initial hydration of the cement, with benefits that are observed at ages as early as two days. Internal curing...

  5. Reversible hyperinsulinemic hypoglycemia after gastric bypass: a consequence of altered nutrient delivery

    DEFF Research Database (Denmark)

    McLaughlin, Tracey; Peck, Marcia; Holst, Jens;

    2010-01-01

    Severe hypoglycemia after Roux-en-Y gastric bypass surgery (RYGB) is an increasingly recognized condition, characterized by neuroglycopenia and inappropriately elevated insulin concentrations that occur primarily in the postprandial state. Both pathophysiology and treatment of this disorder remai...

  6. Hypoglycemia-Associated EEG Changes in Prepubertal Children With Type 1 Diabetes

    DEFF Research Database (Denmark)

    Hansen, GL; Foli-Andersen, P; Fredheim, S

    2016-01-01

    BACKGROUND: The purpose of this study was to explore the possible difference in the electroencephalogram (EEG) pattern between euglycemia and hypoglycemia in children with type 1 diabetes (T1D) during daytime and during sleep. The aim is to develop a hypoglycemia alarm based on continuous EEG...... measurement and real-time signal processing. METHOD: Eight T1D patients aged 6-12 years were included. A hyperinsulinemic hypoglycemic clamp was performed to induce hypoglycemia both during daytime and during sleep. Continuous EEG monitoring was performed. For each patient, quantitative EEG (qEEG) measures...... were calculated. A within-patient analysis was conducted comparing hypoglycemia versus euglycemia changes in the qEEG. The nonparametric Wilcoxon signed rank test was performed. A real-time analyzing algorithm developed for adults was applied. RESULTS: The qEEG showed significant differences...

  7. Poor pregnancy outcome after octreotide treatment during pregnancy for familial hyperinsulinemic hypoglycemia

    DEFF Research Database (Denmark)

    Skajaa, Gitte O; Mathiesen, Elisabeth R; Iyore, Elisabeth

    2014-01-01

    growth. At birth the girl was small for gestational age. She was admitted to the neonatal special care unit due to low blood glucose and intravenous glucose and early feeding was initiated. One day old, her condition deteriorated with signs of an abdominal catastrophe indicating necrotizing enterocolitis...... successfully. One child carried the mutation and was small for gestational age at birth while the other child did not carry the mutation and had normal birth weight. CONCLUSION: In a woman with late familial hyperinsulinemic hypoglycemia octreotide was given during the first four pregnancies resulting in 2......BACKGROUND: Late familial hyperinsulinemic hypoglycemia is characterized by recurrent episodes of hypoglycemia and an inappropriate insulinemic response. Treatment with octreotide (somatostatin analogue) reduces the prevalence of clinical significant hypoglycemia and might be beneficial during...

  8. CURING EFFICIENCY OF DUAL-CURE RESIN CEMENT UNDER ZIRCONIA WITH TWO DIFFERENT LIGHT CURING UNITS

    Directory of Open Access Journals (Sweden)

    Pınar GÜLTEKİN

    2015-04-01

    Full Text Available Purpose: Adequate polymerization is a crucial factor in obtaining optimal physical properties and a satisfying clinical performance from composite resin materials. The aim of this study was to evaluate the polymerization efficiency of dual-cure resin cement cured with two different light curing units under zirconia structures having differing thicknesses. Materials and Methods: 4 zirconia discs framework in 4 mm diameter and in 0.5 mm, 1 mm and 1.5 mm thickness were prepared using computer-aided design system. One of the 0.5 mm-thick substructures was left as mono-layered whereas others were layered with feldspathic porcelain of same thickness and ceramic samples with 4 different thicknesses (0.5, 1, 1.5 and 2.0 mm were prepared. For each group (n=12 resin cement was light cured in polytetrafluoroethylene molds using Light Emitting Diode (LED or Quartz-Tungsten Halogen (QHT light curing units under each of 4 zirconia based discs (n=96. The values of depth of cure (in mm and the Vickers Hardness Number values (VHN were evaluated for each specimen. Results: The use of LED curing unit produced a greater depth of cure compared to QTH under ceramic discs with 0.5 and 1 mm thickness (p<0.05.At 100μm and 300 μm depth, the LED unit produced significantly greater VHN values compared to the QTH unit (p<0.05. At 500 μm depth, the difference between the VHN values of LED and QTH groups were not statistically significant. Conclusion: Light curing may not result in adequate resin cement polymerization under thick zirconia structures. LED light sources should be preferred over QTH for curing dual-cure resin cements, especially for those under thicker zirconia restorations.

  9. Does orthostatic stress influence the neuroendocrine response to subsequent hypoglycemia in humans?

    Science.gov (United States)

    Radikova, Z; Penesova, A; Koska, J; Kvetnansky, R; Jezova, D; Huckova, M; Vigas, M; Macho, L

    2004-06-01

    Neuroendocrine response to stress stimuli is influenced by previous stimuli of different nature. The aim of the study was to test whether antecedent orthostatic stress may affect the neuroendocrine response to subsequent hypoglycemia. A group of 12 (6 men, 6 women) nonobese, healthy volunteers aged 19 to 27 y (mean 24 +/- 0.8) participated in the study in two sessions: controlled insulin-induced hypoglycemia to 2.7 mmol/L for 15 min either with or without antecedent orthostatic stress (30 min of 60 degrees head-up tilt before insulin administration). Orthostatic stress caused a significant decrease in plasma volume (-9.6%; P < 0.001) and a significant increase in plasma renin activity, aldosterone, norepinephrine (P < 0.01), and adrenocorticotropic hormone (ACTH) concentrations (P < 0.05) in all subjects. Growth hormone response to hypoglycemia was diminished in women (P < 0.01). The epinephrine response to hypoglycemia was diminished in women in comparison to men (P < 0.001), but was unaffected by antecedent orthostatic stress. Hypoglycemia failed to induce the ACTH release after its elevation during orthostatic stress. ACTH response to moderate hypoglycemia without previous orthostatic stress was evident only in men in comparison to women (P < 0.05). We conclude that the epinephrine, growth hormone, and ACTH responses to hypoglycemia were diminished in women. Except ACTH, the neuroendocrine response to mild hypoglycemia was not affected by previous orthostatic stress in healthy subjects. In the case of ACTH, the first stress stimulus is consequential for the subsequent response of this hormone, probably due to short-loop negative feedback effects.

  10. Correlates and outcomes of worries about hypoglycemia in family members of adults with diabetes

    DEFF Research Database (Denmark)

    Nefs, Giesje; Pouwer, Francois; Holt, Richard I G

    2016-01-01

    OBJECTIVE: We examined (a) the demographic and clinical correlates of worries about hypoglycemia in adult family members of adults with diabetes, and (b) the association of these worries with measures of diabetes support. METHODS: The second multinational Diabetes Attitudes, Wishes and Needs (DAW...... member involvement in diabetes care. Similar results were found for worries about nocturnal events. CONCLUSION: Worries about hypoglycemia were common in family members and were associated with suboptimal diabetes support. This issue therefore deserves increased clinician attention....

  11. Partial blockade of nicotinic acetylcholine receptors improves the counterregulatory response to hypoglycemia in recurrently hypoglycemic rats.

    Science.gov (United States)

    LaGamma, Edmund F; Kirtok, Necla; Chan, Owen; Nankova, Bistra B

    2014-10-01

    Recurrent exposure to hypoglycemia can impair the normal counterregulatory hormonal responses that guard against hypoglycemia, leading to hypoglycemia unawareness. This pathological condition known as hypoglycemia-associated autonomic failure (HAAF) is the main adverse consequence that prevents individuals with type 1 diabetes mellitus from attaining the long-term health benefits of tight glycemic control. The underlying molecular mechanisms responsible for the progressive loss of the epinephrine response to subsequent bouts of hypoglycemia, a hallmark sign of HAAF, are largely unknown. Normally, hypoglycemia triggers both the release and biosynthesis of epinephrine through activation of nicotinic acetylcholine receptors (nAChR) on the adrenal glands. We hypothesize that excessive cholinergic stimulation may contribute to impaired counterregulation. Here, we tested whether administration of the nAChR partial agonist cytisine to reduce postganglionic synaptic activity can preserve the counterregulatory hormone responses in an animal model of HAAF. Compared with nicotine, cytisine has limited efficacy to activate nAChRs and stimulate epinephrine release and synthesis. We evaluated adrenal catecholamine production and secretion in nondiabetic rats subjected to two daily episodes of hypoglycemia for 3 days, followed by a hyperinsulinemic hypoglycemic clamp on day 4. Recurrent hypoglycemia decreased epinephrine responses, and this was associated with suppressed TH mRNA induction (a measure of adrenal catecholamine synthetic capacity). Treatment with cytisine improved glucagon responses as well as epinephrine release and production in recurrently hypoglycemic animals. These data suggest that pharmacological manipulation of ganglionic nAChRs may be promising as a translational adjunctive therapy to avoid HAAF in type 1 diabetes mellitus.

  12. Sexual Dimorphism in Glucose and Lipid Metabolism during Fasting, Hypoglycemia, and Exercise

    OpenAIRE

    Hedrington, Maka S.; Davis, Stephen N.

    2015-01-01

    Sexually dimorphic physiologic responses occur during fasting, hypoglycemia, and exercise. The areas covered in this mini review include studies that have used isotopic tracer methods and/or euglycemic clamp studies to investigate substrate metabolism during the above common physiologic stress. Women have greater reliance on lipid metabolism during fasting, hypoglycemia, and exercise while men exhibit preference of carbohydrate utilization. Plasma glucose concentrations were shown to be lower...

  13. The effect of light curing units, curing time, and veneering materials on resin cement microhardness

    Directory of Open Access Journals (Sweden)

    Nurcan Ozakar Ilday

    2013-06-01

    Conclusion: Light-curing units, curing time, and veneering materials are important factors for achieving adequate dual cure resin composite microhardness. High-intensity light and longer curing times resulted in the highest microhardness values.

  14. Reversible Adrenal Insufficiency in Three Patients With Post–Roux-en-Y Gastric Bypass Noninsulinoma Pancreatogenous Hypoglycemia Syndrome

    Directory of Open Access Journals (Sweden)

    Shelly Mathur MD

    2014-03-01

    Full Text Available Objective. Noninsulinoma pancreatogenous hypoglycemia syndrome (NIPHS is a disorder of endogenous hyperinsulinemia that is clinically distinguishable from insulinoma, with a greater preponderance after Roux-en-Y gastric bypass (RYBG. Hyperinsulinemic hypoglycemia can predispose to attenuation of counterregulatory hormone responses to hypoglycemia, and consequent suppression of the hypothalamic–pituitary–adrenal (HPA axis. This case series describes 3 individuals who were diagnosed with adrenal insufficiency (AI after undergoing RYGB, complicated by NIPHS. Methods. A retrospective chart review was performed for each individual. Chart review applied particular attention to the onset of hyperinsulinemic hypoglycemia following bariatric surgery and the dynamic testing leading to the diagnoses of NIPHS and AI. Results. In each case, reactive hypoglycemia ensued within months to years after RYGB. Cosyntropin stimulation testing confirmed the diagnosis of AI. Hydrocortisone therapy reduced the frequency and severity of hypoglycemia and was continued until successful medical and/or surgical management of hyperinsulinism occurred. Follow-up testing of the HPA axis demonstrated resolution of AI. In all cases, hydrocortisone therapy was finally discontinued without incident. Conclusion. We speculate that transient AI is a potential complication in patients who experience recurrent hyperinsulinemic hypoglycemia after RYGB. The putative mechanism for this observation may be attenuation of the HPA axis after prolonged exposure to severe, recurrent hypoglycemia. We conclude that biochemical screening for AI should be considered in individuals who develop post-RYGB hyperinsulinemic hypoglycemia. If AI is diagnosed, supportive treatment should be maintained until hyperinsulinemic hypoglycemia has been managed effectively.

  15. Octreotide therapy and restricted fetal growth: pregnancy in familial hyperinsulinemic hypoglycemia

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    Marianne Geilswijk

    2017-02-01

    Full Text Available Hypoglycemia during pregnancy can have serious health implications for both mother and fetus. Although not generally recommended in pregnancy, synthetic somatostatin analogues are used for the management of blood glucose levels in expectant hyperinsulinemic mothers. Recent reports suggest that octreotide treatment in pregnancy, as well as hypoglycemia in itself, may pose a risk of fetal growth restriction. During pregnancy, management of blood glucose levels in familial hyperinsulinemic hypoglycemia thus forms a medical dilemma. We report on pregnancy outcomes in a woman with symptomatic familial hyperinsulinemic hypoglycemia, type 3. During the patient’s first pregnancy with a viable fetus octreotide treatment was instituted in gestational age 23 weeks to prevent severe hypoglycemic incidences. Fetal growth velocity declined, and at 37 weeks of gestation, intrauterine growth retardation was evident. During the second pregnancy with a viable fetus, blood glucose levels were managed through dietary intervention alone. Thus, the patient was advised to take small but frequent meals high in fiber and low in carbohydrates. Throughout pregnancy, no incidences of severe hypoglycemia occurred and fetal growth velocity was normal. We conclude that octreotide treatment during pregnancy may pose a risk of fetal growth restriction and warrants careful consideration. In some cases of familial hyperinsulinemic hypoglycemia, blood glucose levels can be successfully managed through diet only, also during pregnancy.

  16. The Impact of Hypoglycemia on the Cardiovascular System: Physiology and Pathophysiology.

    Science.gov (United States)

    Yang, Shi-Wei; Park, Kyoung-Ha; Zhou, Yu-Jie

    2016-10-01

    Intensive glycemic control may increase cardiovascular (CV) risk and mortality due to hypoglycemia. The pathophysiology of glucose counter-regulation in patients with type 1 or type 2 diabetes for over 15 years is characterized by impairment of the defense mechanisms against hypoglycemia. Hypoglycemia causes pronounced physiological and pathophysiological effects on the CV system as consequences of autonomic system activation and counter regulatory hormones release. These effects provoke a series of hemodynamic changes that include an increase in heart rate and peripheral systolic blood pressure, a decrease in central blood pressure, reduced peripheral arterial resistance, and increased myocardial contractility and cardiac output. Cardiac electrophysiological changes including flattening or inversion of T waves, QT prolongation, and ST segment depression were observed in both insulin-induced and spontaneous hypoglycemia. Sympathoadrenal activation is the main cause of these changes through mechanisms that involve, but are not limited to, catecholamine-mediated hypokalemia. Hypoglycemia is also involved in platelet activation. There is growing concern about the long-term effects of hypoglycemia, especially as related to inflammation and atherogenesis.

  17. Towards an HIV cure

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    Steven Deeks

    2014-11-01

    Full Text Available Given the challenge of delivering complex, expensive and potentially harmful antiretroviral therapy (ART on a global level, there is intense interest in the development of short-term, well-tolerated regimens that allow individuals to interrupt therapy indefinitely without experiencing a rebound in viremia. This so-called “cure” or “remission” might be due to complete eradication of all replication-competent HIV during ART or durable host-mediated control of persistent virus in absence of ART. Recent heroic interventions such as hematopoietic stem cell transplant and very early initiation of antiretroviral therapy suggest that dramatic reductions in the reservoir size can be achieved, but that complete eradication will be difficult if not impossible to achieve. Most attempts to stimulate effective host-mediated control of HIV have failed. It is likely that for a true cure to be achieved, both approaches – reductions in the reservoir size and durable immune surveillance – will be needed, a state that is similar to that observed in “elite” controllers and post-treatment controllers. The implications for recent advances and setbacks in achieving HIV remission for future research priorities will be discussed.

  18. Clinical Features and Causes of Endogenous Hyperinsulinemic Hypoglycemia in Korea

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    Chang-Yun Woo

    2015-04-01

    Full Text Available BackgroundEndogenous hyperinsulinemic hypoglycemia (EHH is characterized by an inappropriately high plasma insulin level, despite a low plasma glucose level. Most of the EHH cases are caused by insulinoma, whereas nesidioblastosis and insulin autoimmune syndrome (IAS are relatively rare.MethodsTo evaluate the relative frequencies of various causes of EHH in Korea, we retrospectively analyzed 84 patients who were diagnosed with EHH from 1998 to 2012 in a university hospital.ResultsAmong the 84 EHH patients, 74 patients (88%, five (6%, and five (6% were diagnosed with insulinoma, nesidioblastosis or IAS, respectively. The most common clinical manifestation of EHH was neuroglycopenic symptoms. Symptom duration before diagnosis was 14.5 months (range, 1 to 120 months for insulinoma, 1.0 months (range, 6 days to 7 months for nesidioblastosis, and 2.0 months (range, 1 to 12 months for IAS. One patient, who was diagnosed with nesidioblastosis in 2006, underwent distal pancreatectomy but was later determined to be positive for insulin autoantibodies. Except for one patient who was diagnosed in 2007, the remaining three patients with nesidioblastosis demonstrated severe hyperinsulinemia (157 to 2,719 µIU/mL, which suggests that these patients might have had IAS, rather than nesidioblastosis.ConclusionThe results of this study suggest that the prevalence of IAS may be higher in Korea than previously thought. Therefore, measurement of insulin autoantibody levels is warranted for EHH patients, especially in patients with very high plasma insulin levels.

  19. Mechanisms of hypoglycemia unawareness and implicationsin diabetic patients

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Hypoglycemia unawareness (HU) is defined at the onsetof neuroglycopenia before the appearance of autonomicwarning symptoms. It is a major limitation to achievingtight diabetes and reduced quality of life. HU occursin approximately 40% of people with type 1 diabetes mellitus (T1DM) and with less frequency in T2DM.Though the aetiology of HU is multifactorial, possiblemechanisms include chronic exposure to low bloodglucose, antecedent hypoglycaemia, recurrent severehypoglycaemia and the failure of counter-regulatoryhormones. Clinically it manifests as the inability torecognise impeding hypoglycaemia by symptoms, butthe mechanisms and mediators remain largely unknown.Prevention and management of HU is complex, andcan only be achieved by a multifactorial interventionof clinical care and structured patient education bythe diabetes team. Less know regarding the impact ofmedications on the development or recognition of thiscondition in patients with diabetes. Several medicationsare thought to worsen or promote HU, whereas othersmay have an attenuating effect on the problem. Thisarticle reviews recent advances in how the brain sensesand responds to hypoglycaemia, novel mechanismsby which people with insulin-treated diabetes developHU and impaired counter-regulatory responses. Theconsequences that HU has on the person with diabetesand their family are also described. Finally, it examinesthe evidence for prevention and treatment of HU,and summarizes the effects of medications that mayinfluence it.

  20. Diabetes Management and Hypoglycemia in Safety Sensitive Jobs

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    See-Muah Lee

    2011-03-01

    Full Text Available The majority of people diagnosed with diabetes mellitus are in the working age group in developing countries. The interrelationship of diabetes and work, that is, diabetes affecting work and work affecting diabetes, becomes an important issue for these people. Therapeutic options for the diabetic worker have been developed, and currently include various insulins, insulin sensitizers and secretagogues, incretin mimetics and enhancers, and alpha glucosidase inhibitors. Hypoglycemia and hypoglycaemic unawareness are important and unwanted treatment side effects. The risk they pose with respect to cognitive impairment can have safety implications. The understanding of the therapeutic options in the management of diabetic workers, blood glucose awareness training, and self-monitoring blood glucose will help to mitigate this risk. Employment decisions must also take into account the extent to which the jobs performed by the worker are safety sensitive. A risk assessment matrix, based on the extent to which a job is considered safety sensitive and based on the severity of the hypoglycaemia, may assist in determining one's fitness to work. Support at the workplace, such as a provision of healthy food options and arrangements for affected workers will be helpful for such workers. Arrangements include permission to carry and consume emergency sugar, flexible meal times, self-monitoring blood glucose when required, storage/disposal facilities for medicine such as insulin and needles, time off for medical appointments, and structured self-help rogams.

  1. Towards a 'cure' for IBD.

    Science.gov (United States)

    Fiocchi, Claudio

    2012-01-01

    To discuss a cure for IBD, one should first define the concept 'a cure'. If it is intended as the general restoration of health, this is already possible, as many current therapies do a good job in inducing long periods of remission in Crohn's disease, and colectomy can technically cure ulcerative colitis. If it is more strictly defined as the complete and permanent elimination of the cause, predisposing and permissive factors, reinstatement of normal microbial ecology and restoration of mucosal immune homeostasis, then a cure for IBD is out of reach, at least for now. Regardless of the definition, major strides have been made in attempting to cure IBD by addressing the key components of its pathogenesis: the environment (exposome), the genetic makeup (genome), the gut microbiota (microbiome) and the immune system (immunome). However, the isolated modulation of each component is insufficient to provide a cure, and different requirements may be needed depending on the stage of the disease and each patient subset. To achieve a cure, one key approach is currently missing: the integration of knowledge from all the pathogenic components. We continue to learn more and more about each component using traditional 'canonical' systems, which allow the accumulation of data without taking into consideration the other components. We are still not studying the 'omes' of IBD, we should be using 'omics' technologies that can generate a more global vision of IBD pathogenesis on which to base novel, multiple pathway-integrated therapies. Copyright © 2012 S. Karger AG, Basel.

  2. Curing efficacy of light emitting diodes of dental curing units

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    Seyd Mostafa Mousavinasab

    2009-03-01

    Full Text Available Background and aims. The aim of the present study was to compare the efficacy of quartz tungsten halogen (QTH and light emitting diode (LED curing lights on polymerization of resin composite. Materials and Methods. A hybrid resin composite was used to prepare samples which were cured using two QTH and ten LED light curing sources. Twelve groups, each containing ten samples, were prepared using each light source. The cured depth of the resin was determined using ISO 4049 method and Vickers hardness values were determined at 1.0 mm intervals. Data was analyzed by ANOVA and Tukey test. Results. Data analysis demonstrated a significant difference between light sources for depth of cure. At 1.0 mm below the surface all the tested light sources and at 2.0-mm intervals all light sources except two (Optilux 501 and LEDemetron I and at 3.0-mm intervals only two light sources (PenCure and LEDemetron II could produce hardness values higher than 80% of superficial layer values. Conclusion. This study showed that a variety of LED light sources used in the present study are as effective as the high-intensity QTH lights in polymerization of resin composite.

  3. Analysis the cases of hypoglycemia and nursing strategy in diabetes mellitus of the old patients.%老年糖尿病患者低血糖原因分析及护理对策

    Institute of Scientific and Technical Information of China (English)

    林少虹; 钟艳芬; 谭少屏

    2011-01-01

    Objective:To assist the old age of the diabetes mellitus know the harm of the hypoglycemia and master the basic prevention and cure methods.Methods :58 cases of the old age of the diabetes mellitus whom produced hypoglycemia were adopted corresponding treatment and nurse way which can make the blood sugar rise. Results: The hypoglycemia main cause were drugs, diets, movement and complications. Conclusion: It can prevent effectively the old age of the diabetes mellitus,The patients should be strengthened health education and improve the patients of obedience , the nurse introduce the drugs precautions and live guidance and make the patients go on self- protection. So as to produce hypoglycemia and advance the patients life quality with nurse methods.%目的:探讨老年糖尿病患者出现低血糖反应的诱因,帮助老年糖尿病患者认识低血糖的危害性,掌握基本防治方法.方法:对出现低血糖反应的58例老年糖尿病患者的临床资料进行回顾性分析.结果:患者出现低血糖反应的原因主要由药物、饮食、运动及并发症引起.结论:应加强健康教育,提高患者的遵医行为,介绍药物的注意事项及生活指导,促使其进行自我保护,有效防治低血糖的发生,提高患者的生活质量.

  4. Assessing fear of hypoglycemia among adults with type 1 diabetes – psychometric properties of the Norwegian version of the Hypoglycemia Fear Survey II questionnaire

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    Marit Graue

    2013-06-01

    Full Text Available Background: Hypoglycemia is common in type 1 diabetes, but the overall frequency of both mild and severe hypoglycemia is difficult to estimate. The Hypoglycemia Fear Survey II (HFS-II is often used to assess the fear of hypoglycemia. Material and methods: The aim of this study was to assess the psychometric properties of the Norwegian version of the HFS-II for adults, including the behavior (HFS-B and worry (HFS-W subscales, among 235 adults in Norway with type 1 diabetes. We assessed associations between HFS-II scores and other rating scales and demographic and clinical variables. Results: The Norwegian version of HFS-II had an acceptable factor structure in relation to HFS-W, whereas the structure within HFS-B was more questionable. The expected relationships between HFS-II subscales and measures of related constructs administered concurrently demonstrated adequate convergent and discriminant validity. Internal consistency and test-retest reliability were satisfactory. Conclusion: Access to reliable and valid self-report instruments enables the early detection of psychosocial problems. HFS-W performs well, whereas HFS-B needs to be further examined and developed.

  5. Novel techniques for concrete curing

    DEFF Research Database (Denmark)

    Kovler, Konstantin; Jensen, Ole Mejlhede

    2005-01-01

    It is known that some high-strength/high-performance concretes (HSC/HPC) are prone to cracking at an early age unless special precautions are taken. The paper deals with the methods of curing as one of the main strategies to ensure good performance of concrete. Curing by both external (conventional......) and internal methods is reviewed and analyzed, among other methods of mitigating shrinkage and cracking of concrete. The focus is on the mitigation of autogenous shrinkage of low water to binder ratio (w/b) concrete by means of internal curing. The concepts of internal curing are based on using lightweight...... aggregate, superabsorbent polymers or water-soluble chemicals, which reduce water evaporation (so called "internal sealing"). These concepts have been intensively researched in the 90s, but still are not widespread among contractors and concrete suppliers. The differences between conventional methods...

  6. Hypoglycemia-related information seeking among informal caregivers of type 2 diabetes patients: Implications for health education

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    Doreen Reifegerste

    2016-06-01

    Conclusions: Our results indicate the importance of the hypoglycemia-related information seeking of caregivers in managing incidents of hypoglycemia. These findings suggest the need to consider caregivers' health knowledge when developing health education programs in diabetes care. More attention must be focused on providing interventions that motivate information seeking and improve the comprehension of information. Interventions should inform caregivers about hypoglycemia to enhance their knowledge.

  7. Hypoglycemia induced changes in cholinergic receptor expression in the cerebellum of diabetic rats

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    Anju TR

    2010-02-01

    Full Text Available Abstract Glucose homeostasis in humans is an important factor for the functioning of nervous system. Hypoglycemia and hyperglycemia is found to be associated with central and peripheral nerve system dysfunction. Changes in acetylcholine receptors have been implicated in the pathophysiology of many major diseases of the central nervous system (CNS. In the present study we showed the effects of insulin induced hypoglycemia and streptozotocin induced diabetes on the cerebellar cholinergic receptors, GLUT3 and muscle cholinergic activity. Results showed enhanced binding parameters and gene expression of Muscarinic M1, M3 receptor subtypes in cerebellum of diabetic (D and hypoglycemic group (D + IIH and C + IIH. α7nAchR gene expression showed a significant upregulation in diabetic group and showed further upregulated expression in both D + IIH and C + IIH group. AchE expression significantly upregulated in hypoglycemic and diabetic group. ChAT showed downregulation and GLUT3 expression showed a significant upregulation in D + IIH and C + IIH and diabetic group. AchE activity enhanced in the muscle of hypoglycemic and diabetic rats. Our studies demonstrated a functional disturbance in the neuronal glucose transporter GLUT3 in the cerebellum during insulin induced hypoglycemia in diabetic rats. Altered expression of muscarinic M1, M3 and α7nAchR and increased muscle AchE activity in hypoglycemic rats in cerebellum is suggested to cause cognitive and motor dysfunction. Hypoglycemia induced changes in ChAT and AchE gene expression is suggested to cause impaired acetycholine metabolism in the cerebellum. Cerebellar dysfunction is associated with seizure generation, motor deficits and memory impairment. The results shows that cerebellar cholinergic neurotransmission is impaired during hyperglycemia and hypoglycemia and the hypoglycemia is causing more prominent imbalance in cholinergic neurotransmission which is suggested to be a cause of cerebellar

  8. Somatotropic, lactotropic and adrenocortical responses to insulin-induced hypoglycemia in patients with rheumatoid arthritis.

    Science.gov (United States)

    Rovensky, Jozef; Bakosová, Jana; Koska, Juraj; Ksinantová, Lucia; Jezová, Daniela; Vigas, Milan

    2002-06-01

    Neuroendocrine mechanisms have been suggested to play an important role in the onset and progression of rheumatoid arthritis (RA). The aim of this study was to evaluate hypothalamic-pituitary functions in RA patients by measurement of hormone responses to insulin-induced hypoglycemia. Insulin-hypoglycemia (Actrapid HM 0.1 IU/kg, i.v. as a bolus) was induced in 17 male patients and in 11 age-, gender-, and weight-matched healthy subjects. Concentrations of growth hormone (GH), prolactin (PRL) and cortisol were analyzed in plasma. PRL release after thyreoliberin stimulation (TRH, 200 g, i.v.) was determined in 21 patients with active forms of RA and in 12 control subjects to evaluate pituitary lactotropic response. In RA patients, basal concentrations of glucose, GH, PRL, and cortisol were in the normal range and they were comparable to those in the control group. Stress of hypoglycemia induced significant elevation of GH, PRL, and cortisol concentrations in all groups. Cortisol responses to hypoglycemia were comparable in patients and in control subjects. GH release during hypoglycemia was increased (p < 0.05) and PRL response was attenuated (p < 0.05) in RA patients versus control subjects. After TRH administration, PRL response was the same in patients as in healthy subjects. In conclusion, the present study revealed an altered hypothalamic-pituitary function in patients with RA, namely, an enhanced somatotropic and reduced lactotropic activation in response to insulin-induced hypoglycemia. Basal hormone levels and cortisol release during hypoglycemia were similar to those in healthy subjects.

  9. Moderate recurrent hypoglycemia during early development leads to persistent changes in affective behavior in the rat.

    Science.gov (United States)

    Moore, Holly; Craft, Tara K S; Grimaldi, Lisa M; Babic, Bruna; Brunelli, Susan A; Vannucci, Susan J

    2010-07-01

    Recurrent hypoglycemia is a common problem among infants and children that is associated with several metabolic disorders and insulin-dependent diabetes mellitus. Although studies have reported a relationship between a history of juvenile hypoglycemia and psychological health problems, the direct effects of recurrent moderate hypoglycemia have not been fully determined. Thus, in this study, we used an animal model to examine the effects of recurrent hypoglycemia during the juvenile period on affective, social, and motor function (assessed under euglycemic conditions) across development. To model recurrent hypoglycemia, rats were administered 5 U/kg of insulin or saline twice per day from postnatal day (P)10 to P19. Body weight gain was retarded in insulin-treated rats during the treatment period, but recovered by the end of treatment. However, insulin-treated rats displayed increases in affective reactivity that emerged early during treatment and persisted after treatment into early adulthood. Specifically, insulin-treated pups showed increased maternal separation-induced vocalizations as infants, and an exaggerated acoustic startle reflex as juveniles and young adults. Moreover, young adult rats with a history of recurrent juvenile hypoglycemia exhibited increased fear-potentiated startle and increases in behavioral and hormonal responses to restraint stress. Some of these effects were sex-dependent. The changes in affective behavior in insulin-exposed pups were accompanied by decreases in adolescent social play behavior. These results provide evidence that recurrent, transient hypoglycemia during juvenile development can lead to increases in fear-related behavior and stress reactivity. Importantly, these phenotypes are not reversed with normalization of blood glucose and may persist into adulthood.

  10. Correlation of cure monitoring techniques

    Science.gov (United States)

    Chang, S. S.; Mopsik, F. I.; Hunston, D. L.

    Six different composite matrix or neat resin cure-monitoring methods are presently used to follow the cure process in a model epoxy system, and the results obtained are compared. Differential scanning calorimetry, viscosity monitoring, the ultrasonic shear wave propagation technique, dielectric spectrometry, and two different fluorescence intensity techniques are compared with a view to common traits and differences. Dielectric fluorescence and ultrasonic measurement techniques are noted to be applicable to on-line process monitoring.

  11. Curing units' ability to cure restorative composites and dual-cured composite cements under composite overlay.

    Science.gov (United States)

    Park, Sung-Ho; Kim, Su-Sun; Cho, Yong-Sik; Lee, Chang-Kyu; Noh, Byng-Duk

    2004-01-01

    This study compared the efficacy of using conventional low-power density QTH (LQTH) units, high-power density QTH (HQTH) units, argon (Ar) laser and Plasma arc curing (PAC) units for curing dual-cured resin cements and restorative resin composites under a pre-cured resin composite overlay. The microhardness of the two types of restorative resins (Z100 and Tetric Ceram) and a dual-cured resin cement (Variolink II) were measured after they were light cured for 60 seconds in a 2 mm Teflon mold. The recorded microhardness was determined to be the optimum microhard-ness (OM). Either one of the two types of restorative resins (Z100, Tetric Ceram) or the dual cured resin cement (Variolink II) were placed under a 1.5-mm thick and 8 mm diameter pre-cured Targis (Vivadent/Ivoclar AG, Schaan, Liechtenstein) overlay. The specimens that were prepared for each material were divided into four groups depending upon the curing units used (HQTH, PAC, Laser or LQTH) and were further subdi-vided into subgroups according to light curing time. The curing times used were 30, 60, 90 and 120 seconds for HQTH; 12, 24, 36 and 48 seconds for the PAC unit; 15, 30, 45 and 60 for the Laser and 60, 120 or 180 seconds for the LQTH unit. Fifteen specimens were assigned to each sub- group. The microhardness of the upper and and lower composite surfaces under the Targis overlay were measured using an Optidur Vickers hardness-measuring instrument (Göttfert Feinwerktechnik GmbH, Buchen, Germany). In each material, for each group, a three-way ANOVA with Tukey was used at the 0.05 level of significance to compare the microhardnesses of the upper and lower composite surfaces and the previously measured OM of the material. From the OM of each material, 80% OM was calculated and the time required for the microhardness of the upper and lower surface of the specimen to reach 100% and 80% of OM was determined. In Z100 and Tetric Ceram, when the composites were light cured for 120 seconds using the HQTH lamp

  12. Cold-Curing Structural Epoxy Resins: Analysis of the Curing Reaction as a Function of Curing Time and Thickness

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    Carola Esposito Corcione

    2014-09-01

    Full Text Available The curing reaction of a commercial cold-curing structural epoxy resin, specifically formulated for civil engineering applications, was analyzed by thermal analysis as a function of the curing time and the sample thickness. Original and remarkable results regarding the effects of curing time on the glass transition temperature and on the residual heat of reaction of the cold-cured epoxy were obtained. The influence of the sample thickness on the curing reaction of the cold-cured resin was also deeply investigated. A highly exothermal reaction, based on a self-activated frontal polymerization reaction, was supposed and verified trough a suitable temperature signal acquisition system, specifically realized for this measurement. This is one of the first studies carried out on the curing behavior of these peculiar cold-cured epoxy resins as a function of curing time and thickness.

  13. Cold-Curing Structural Epoxy Resins: Analysis of the Curing Reaction as a Function of Curing Time and Thickness.

    Science.gov (United States)

    Corcione, Carola Esposito; Freuli, Fabrizio; Frigione, Mariaenrica

    2014-09-22

    The curing reaction of a commercial cold-curing structural epoxy resin, specifically formulated for civil engineering applications, was analyzed by thermal analysis as a function of the curing time and the sample thickness. Original and remarkable results regarding the effects of curing time on the glass transition temperature and on the residual heat of reaction of the cold-cured epoxy were obtained. The influence of the sample thickness on the curing reaction of the cold-cured resin was also deeply investigated. A highly exothermal reaction, based on a self-activated frontal polymerization reaction, was supposed and verified trough a suitable temperature signal acquisition system, specifically realized for this measurement. This is one of the first studies carried out on the curing behavior of these peculiar cold-cured epoxy resins as a function of curing time and thickness.

  14. Effect of Hypoglycemia on Performances, Metabolites, and Hormones in Periparturient Dairy Cows

    Institute of Scientific and Technical Information of China (English)

    XIA Cheng; WANG Zhe; LI Yan-fei; NIU Shu-ling; XU Chuang; ZHANG Cai; ZHANG Hong-you

    2007-01-01

    In this research work, 24 multiparous holstein cows were used to evaluate the effect of hypoglycemia on periparturient metabolism and lactation performance. The cows were arranged into two groups of hypoglycemia (L) and normal plasma glucose (N) based on plasma glucose level. The same diets were fed ad libitum from 28 days before expected calving date to 28 days after calving. The parameters relative to energy balance, such as dry matter intake (DMI), body weight (BW), milk yield (MY), and concentrations of plasma glucose, nonesterified fatty acids (NEFA), β-hydroxybutyric acid (BHBA), insulin (INS), glucagons (GLN), leptin (LP), neuropeptide Y (NPY) in plasma were measured at regular intervals. Incidence of hypoglycemia was higher prepartum than that of postpartum (88% vs. 50%), and the recurrence of hypoglycemia was reversed (31% vs. 100%). Hypoglycemia did not affect feed intake before and after calving. With the increase of postpartum feed intake, incidence of hypoglycemia decreased rapidly, even disappeared at 28 days of postpartum. Hypoglycemia had no impact on prepartum BW, but BW in L group was lower than that of cows in N group at 1 day and 14 days of postpartum (P<0.05). Milk yield was not affected by hypoglycemia. Cows in L group had higher plasma NEFA concentration than cows in N group. It reached a peak (1442 μmol L-1 vs. 1052 μmol L-1) at day 1 of postpartum (P < 0.05). Plasma BHBA concentration of cows in L group was higher than that in N group, which reached a peak (2.01 mmol L-1 vs. 1.34 mmol L-1) at 14 days of postpartum (P<0.05). Plasma concentration of INS and GLN was unaffected by treatment, but postpartum plasma GLN concentration obviously increased, especially in L group. Plasma concentration of LP and NPY before calving was unaffected by treatment, but postpartum LP level in L group was slightly lower than that in N group, and NPY level in L group was significantly higher than that in N group (P<0.05). Overall, periparturient

  15. Sensor-Augmented Insulin Pumps and Hypoglycemia Prevention in Type 1 Diabetes.

    Science.gov (United States)

    Steineck, Isabelle; Ranjan, Ajenthen; Nørgaard, Kirsten; Schmidt, Signe

    2017-01-01

    Hypoglycemia can lead to seizures, unconsciousness, or death. Insulin pump treatment reduces the frequency of severe hypoglycemia compared with multiple daily injections treatment. The addition of a continuous glucose monitor, so-called sensor-augmented pump (SAP) treatment, has the potential to further limit the duration and severity of hypoglycemia as the system can detect and in some systems act on impending and prevailing low blood glucose levels. In this narrative review we summarize the available knowledge on SAPs with and without automated insulin suspension, in relation to hypoglycemia prevention. We present evidence from randomized trials, observational studies, and meta-analyses including nonpregnant individuals with type 1 diabetes mellitus. We also outline concerns regarding SAPs with and without automated insulin suspension. There is evidence that SAP treatment reduces episodes of moderate and severe hypoglycemia compared with multiple daily injections plus self-monitoring of blood glucose. There is some evidence that SAPs both with and without automated suspension reduces the frequency of severe hypoglycemic events compared with insulin pumps without continuous glucose monitoring.

  16. Dumping syndrome: an unusual cause of severe hyperinsulinemic hypoglycemia in neurologically impaired children with gastrostomy.

    Science.gov (United States)

    Bizzarri, C; Cervoni, M; Crea, F; Cutrera, R; Schiavino, A; Schiaffini, R; Cappa, M

    2011-02-01

    This paper describes severe hyperinsulinemic hypoglycemia during bolus enteral feeding in two neurologically impaired children. Both children were affected by dysphagia with swallowing difficulties; caloric intake was inadequate. For these reasons, percutaneous endoscopic gastrostomy had been positioned during the first months of life. In one patient due to persisting vomiting, after a few months, a gastrojejunal tube (PEG-J) was inserted. Hypoglycemia was revealed by routine blood tests, without evidence of specific symptoms. Continuous subcutaneous glucose monitoring showed wide glucose excursions, ranging from hypoglycemia to hyperglycemia. Extremely high levels of insulin were detected at the time of hypoglycemia. A diagnosis of dumping syndrome (DS) was suspected in both children. In the child with PEG, the tip of the gastrostomy catheter was found to be lying in the bulbus duodeni. Once this had been pulled back, hypoglycemic episodes disappeared. The child with PEG-J needed continuous enteral feeding to reach a normal glucose balance. DS is a relatively common complication in children with gastrostomy, but extremely irregular glucose levels, ranging from hypoglycemia to hyperglycemia, and increased insulin secretion had not been previously demonstrated. The incidence of DS is probably underestimated in children receiving enteral feeding for neurological impairment. In these patients intensive monitoring of blood glucose levels should be performed to calibrate meals. Repeated underestimated hypoglycemic episodes could worsen neurological damage and cause a deterioration in clinical conditions.

  17. Hyperinsulinemic Hypoglycemia after Bariatric Surgery: Diagnosis and Management Experience from a Spanish Multicenter Registry

    Directory of Open Access Journals (Sweden)

    Nuria Vilarrasa

    2016-02-01

    Full Text Available Background: Severe postprandial hypoglycemia after bariatric surgery is a rare but invalidating complication. Our aim was to describe the different tests performed for its diagnosis and their outcomes as well as the response to the prescribed pharmacological and surgical treatments. Methods: Multicenter, retrospective systematic review of cases with recurrent severe postprandial hypoglycemia. Results: Over 11 years of follow-up, 22 patients were identified. The test most used to provoke hypoglycemia was the oral glucose load test followed by the mixed meal test which was the least standardized test. With pharmacological treatment, 3 patients were symptom-free (with octreotide and in 12 patients hypoglycemic episodes were attenuated. Seven patients had persistent hypoglycemic episodes and underwent surgery. Partial pancreatectomy was performed in 3 patients who had positive selective arterial calcium stimulation, and nesidioblastosis was confirmed in 2 patients. Reconversion to normal anatomy was performed in 3 patients, and 1 patient underwent a resection of the ‘candy cane' roux limb, with resolution of hypoglycemia in all cases. Conclusions: There is high heterogeneity in the evaluation and treatment options for postoperative hypoglycemia. In patients that do not respond to pharmacological treatment, reconstruction of gastrojejunal continuity may be the safest and most successful procedure.

  18. Biological Characterization of Gene Response to Insulin-Induced Hypoglycemia in Mouse Retina.

    Directory of Open Access Journals (Sweden)

    Martine Emery

    Full Text Available Glucose is the most important metabolic substrate of the retina and maintenance of normoglycemia is an essential challenge for diabetic patients. Chronic, exaggerated, glycemic excursions could lead to cardiovascular diseases, nephropathy, neuropathy and retinopathy. We recently showed that hypoglycemia induced retinal cell death in mouse via caspase 3 activation and glutathione (GSH decrease. Ex vivo experiments in 661W photoreceptor cells confirmed the low-glucose induction of death via superoxide production and activation of caspase 3, which was concomitant with a decrease of GSH content. We evaluate herein retinal gene expression 4 h and 48 h after insulin-induced hypoglycemia. Microarray analysis demonstrated clusters of genes whose expression was modified by hypoglycemia and we discuss the potential implication of those genes in retinal cell death. In addition, we identify by gene set enrichment analysis, three important pathways, including lysosomal function, GSH metabolism and apoptotic pathways. Then we tested the effect of recurrent hypoglycemia (three successive 4h periods of hypoglycemia spaced by 48 h recovery on retinal cell death. Interestingly, exposure to multiple hypoglycemic events prevented GSH decrease and retinal cell death, or adapted the retina to external stress by restoring GSH level comparable to control situation. We hypothesize that scavenger GSH is a key compound in this apoptotic process, and maintaining "normal" GSH level, as well as a strict glycemic control, represents a therapeutic challenge in order to avoid side effects of diabetes, especially diabetic retinopathy.

  19. Brain Glycogen Decreases During Intense Exercise Without Hypoglycemia: The Possible Involvement of Serotonin.

    Science.gov (United States)

    Matsui, Takashi; Soya, Shingo; Kawanaka, Kentaro; Soya, Hideaki

    2015-07-01

    Brain glycogen stored in astrocytes, a source of lactate as a neuronal energy source, decreases during prolonged exercise with hypoglycemia. However, brain glycogen dynamics during exercise without hypoglycemia remain unknown. Since intense exercise increases brain noradrenaline and serotonin as known inducers for brain glycogenolysis, we hypothesized that brain glycogen decreases with intense exercise not accompanied by hypoglycemia. To test this hypothesis, we employed a well-established acute intense exercise model of swimming in rats. Rats swam for fourteen 20 s bouts with a weight equal to 8 % of their body mass and were sacrificed using high-power (10 kW) microwave irradiation to inactivate brain enzymes for accurate detection of brain glycogen and monoamines. Intense exercise did not alter blood glucose, but did increase blood lactate levels. Immediately after exercise, brain glycogen decreased and brain lactate increased in the hippocampus, cerebellum, cortex, and brainstem. Simultaneously, serotonin turnover in the hippocampus and brainstem mutually increased and were associated with decreased brain glycogen. Intense swimming exercise that does not induce hypoglycemia decreases brain glycogen associated with increased brain lactate, implying an importance of glycogen in brain energetics during intense exercise even without hypoglycemia. Activated serotonergic regulation is a possible underlying mechanism for intense exercise-induced glycogenolysis at least in the hippocampus and brainstem.

  20. Sexual dimorphism in glucose and lipid metabolism during fasting, hypoglycemia and exercise

    Directory of Open Access Journals (Sweden)

    Maka S Hedrington

    2015-04-01

    Full Text Available Sexually dimorphic physiologic responses occur during fasting, hypoglycemia and exercise. The areas covered in this mini review include studies that have used isotopic tracer methods and/or euglycemic clamp studies to investigate substrate metabolism during the above common physiologic stress. Women have greater reliance on lipid metabolism during fasting, hypoglycemia and exercise while men exhibit preference of carbohydrate utilization. Plasma glucose concentrations were shown to be lower, while free fatty acids (FFA and lipolysis higher in women compared to men after fasting. Hypoglycemia resulted in significantly reduced epinephrine, norepinephrine, glucagon, growth hormone, pancreatic polypeptide and hepatic glucose production responses in females as compared to males. Sexual dimorphism during exercise was demonstrated by higher glycerol and FFA responses in women compared to men and higher carbohydrate oxidation rate in men. Mechanisms that can increase lipolytic rates in women include higher total fat mass, enhanced lipolytic sensitivity to epinephrine and increased activation of β adrenergic receptors.

  1. INCIDENCE & CAUSES OF NEONATAL HYPOGLYCEMIA AFTER CESAREAN SECTION IN A RURAL SETUP OF WEST BENGAL

    Directory of Open Access Journals (Sweden)

    Rudradev

    2014-01-01

    Full Text Available Neonatal hypoglycaemia a major cause of morbidity and mortality may lead to permanent brain damage. This is more common in babies delivered by Caesar ean Section. AIMS: A clinico - statistical study was performed among newborns delivered by Caesarean Section for a period of 1 year to find out: 1. The incidence of neonatal hypoglycemia at 48 hrs of birth. 2. Risk factors of neonatal hypoglycemia in case of cesarean section. 3. Incidence of neonatal hypoglycemia in newborns of mothers with obstetrical risks (dribbling, PET, & prolonged labour. 4. Incidence of hypoglycemia among low birth weight babies. SETTINGS AND DESIGN: A cross - sectional observational study was conducted based on deliveries by Caesarean Section over a period of 1 year. METHODS AND MATERI AL: Screening was done by GOD - POD (Glucose Oxidase - Peroxidase method from new born blood (venous at 48 hrs of life. We considered neonatal hypoglycaemia as blood glucose concentration < 50 mg/dl. Gestational age was calculated from LMP (Last Menstrual Pe riod. Additionally low birth weight babies were also considered for the study. STATISTICAL ANALYSIS: The number of newborns suffering from hypoglycaemia in each of the above groups were determined from the blood test and their incidences were calculated with respect to the total number of newborns (221 selected for the study. RESULTS: The overall incidence of neonatal hypoglycemia at 48 hrs was 16.3%.Those suffering from both preterm and dribbling the incidence of neonatal hypoglycemia was 100%. Other ca ses with risk factors had high incidence rates. CONCLUSION: The study reveals the importance of the risk factors for neonatal hypoglycaemia. All high risk cases had high incidence of neonatal hypoglycaemia. We should always be vigilant about those to prev ent neonatal morbidity and mortality.

  2. Fear of hypoglycemia and its clinical significance: a case-control study

    OpenAIRE

    Elena Georgievna Starostina; Elena Nikolaevna Moshnyaga

    2013-01-01

    Aim. To assess the prevalence of fear of hypoglycemia, its clinical features and influence on diabetes compensation.Materials and Methods. A cross-sectional study was conducted with 200 sequentially enrolled participants with type 2 diabetes mellitus (T2DM; n=139) and type 1 diabetes mellitus (T1DM; n=61). Patients were screened for psychiatric disorders with appropriate inventory and examined by a psychiatrist. Subjects identified as those with fear of hypoglycemia (n=12) formed the study gr...

  3. Changes of cognition and regional cerebral activity during acute hypoglycemia in normal subjects

    DEFF Research Database (Denmark)

    Bie-Olsen, Lise G; Kjaer, Troels W; Pedersen-Bjergaard, Ulrik

    2009-01-01

    cerebral blood flow (rCBF) as a marker of cerebral activity. Hypoglycemia was induced by intravenous insulin infusion in 19 healthy men performing two different cognitive tasks of varying complexity. The hypoglycemic stimulus [plasma glucose 2.2 mmol/liter (0.4)] produced a significant hormonal...... counterregulatory response. During the low cognitive load, rCBF decreased in response to hypoglycemia in a large bilateral area in the posterior part of the temporal lobe, and rCBF increased bilaterally in the anterior cingulate gyrus, the right frontal gyrus, the fusiform gyrus, thalamus, and the left inferior...

  4. Huge solitary fibrous tumor of the pleura with hypoglycemia and hypokalemia: a case report.

    Science.gov (United States)

    Li, Zhi; Wang, Jun; Zhu, Quan; Li, Hai; Chen, Yijiang; Chen, Liang

    2014-01-01

    The occurrence of hypoglycemia with an intrathoracic tumor is referred to as Doege- Potter syndrome (DPS). However, the association between hypokalemia and DPS is rare. We report a case of a solitary fibrous tumor of the pleura with refractory hypoglycemia and hypokalemia. A 57-year-old male was admitted to our hospital for unconsciousness. His serum glucose and potassium levels were low. Radiological findings revealed a large tumor occupying the left hemithorax. Despite being treated with glucose and potassium replacement therapy, the patient still suffered from repetitive fasting hypoglycemic and hypokalemia episodes. After the tumor was completely resected, his serum levels of glucose and potassium returned to normal level.

  5. Hyperinsulinemic hypoglycemia due to adult nesidioblastosis in insulin-dependent diabetes

    Institute of Scientific and Technical Information of China (English)

    A Raffel; G Kl(o)ppel; WT Knoefel; M Anlauf; SB Hosch; M Krausch; T Henopp; J Bauersfeld; R Klofat; D Bach; CF Eisenberger

    2006-01-01

    In neonates, persistent hyperinsulinemic hypoglycemia(PHH) is associated with nesidioblastosis. In adults, PHH is usually caused by solitary benign insulinomas. We report on an adult patient who suffered from insulin-dependent diabetes mellitus, and subsequently developed PHH caused by diffuse nesidioblastosis. Mlutations of the MEN1 and Mody 2/3 genes were ruled out. Preoperative diagnostic procedures, the histopathological criteria and the surgical treatment options of adult nesidioblastosis are discussed. So far only one similar case of adult nesidioblastosis subsequent to diabetes mellitus Ⅱ has been reported in the literature. In case of conversion of diabetes into hyperinsulinemic hypoglycemia syndrome,nesidioblastosis in addition to insulinoma should be considered.

  6. Gcg-XTEN: an improved glucagon capable of preventing hypoglycemia without increasing baseline blood glucose.

    Directory of Open Access Journals (Sweden)

    Nathan C Geething

    Full Text Available OBJECTIVE: While the majority of current diabetes treatments focus on reducing blood glucose levels, hypoglycemia represents a significant risk associated with insulin treatment. Glucagon plays a major regulatory role in controlling hypoglycemia in vivo, but its short half-life and hyperglycemic effects prevent its therapeutic use for non-acute applications. The goal of this study was to identify a modified form of glucagon suitable for prophylactic treatment of hypoglycemia without increasing baseline blood glucose levels. METHODOLOGY/PRINCIPAL FINDINGS: Through application of the XTEN technology, we report the construction of a glucagon fusion protein with an extended exposure profile (Gcg-XTEN. The in vivo half-life of the construct was tuned to support nightly dosing through design and testing in cynomolgus monkeys. Efficacy of the construct was assessed in beagle dogs using an insulin challenge to induce hypoglycemia. Dose ranging of Gcg-XTEN in fasted beagle dogs demonstrated that the compound was biologically active with a pharmacodynamic profile consistent with the designed half-life. Prophylactic administration of 0.6 nmol/kg Gcg-XTEN to dogs conferred resistance to a hypoglycemic challenge at 6 hours post-dose without affecting baseline blood glucose levels. Consistent with the designed pharmacokinetic profile, hypoglycemia resistance was not observed at 12 hours post-dose. Importantly, the solubility and stability of the glucagon peptide were also significantly improved by fusion to XTEN. CONCLUSIONS/SIGNIFICANCE: The data show that Gcg-XTEN is effective in preventing hypoglycemia without the associated hyperglycemia expected for unmodified glucagon. While the plasma clearance of this Gcg-XTEN has been optimized for overnight dosing, specifically for the treatment of nocturnal hypoglycemia, constructs with significantly longer exposure profiles are feasible. Such constructs may have multiple applications such as allowing for more

  7. No response of pancreatic hormones to hypoglycemia in diabetic autonomic neuropathy

    DEFF Research Database (Denmark)

    Hilsted, J; Madsbad, S; Krarup, T

    1982-01-01

    The responses of pancreatic hormones (i.e. glucagon, pancreatic polypeptide, and somatostatin) to insulin-induced hypoglycemia were investigated in 18 insulin-dependent diabetics without residual beta-cell function and in 6 normal subjects. Nine of the diabetics had autonomic neuropathy, and 9 had...... no neuropathy. After hypoglycemia, no significant increase in any of the 3 pancreatic hormones was found in the diabetics with autonomic neuropathy, whereas significant increments were found in the diabetics without neuropathy and in the normal subjects. These results suggest that autonomic nervous activity...

  8. Hypoglycemia, S-ACE and ACE genotypes in a Danish nationwide population of children and adolescents with type 1 diabetes

    DEFF Research Database (Denmark)

    Johannesen, Jesper; Svensson, Jannet; Bergholdt, Regine

    2011-01-01

    OBJECTIVE: High S-ACE levels have been shown to predispose to increased risk of hypoglycemia, however; some inconsistency relates to the risk of the ACE genotype. We investigated the association between S-ACE level at diagnosis and ACE genotype to long-term risk of severe hypoglycemia in more than...

  9. Are Changes in Heart Rate Variability During Hypoglycemia Confounded by the Presence of Cardiovascular Autonomic Neuropathy in Patients with Diabetes?

    DEFF Research Database (Denmark)

    Cichosz, Simon Lebech; Frystyk, Jan; Tarnow, Lise

    2017-01-01

    remain on how cardiovascular autonomic neuropathy (CAN) influences these measurable changes. This study aims to examine if changes in HRV during hypoglycemia are confounded by the presence of CAN. METHODS: Twenty-one adults (hereof 13 men) with T1D prone to hypoglycemia were recruited and monitored...

  10. Hypoglycemia, S-ACE and ACE genotypes in a Danish nationwide population of children and adolescents with type 1 diabetes

    DEFF Research Database (Denmark)

    Johannesen, Jesper; Svensson, Jannet; Bergholdt, Regine

    2011-01-01

    High S-ACE levels have been shown to predispose to increased risk of hypoglycemia, however; some inconsistency relates to the risk of the ACE genotype. We investigated the association between S-ACE level at diagnosis and ACE genotype to long-term risk of severe hypoglycemia in more than 1000...

  11. Curing efficiency of various types of light-curing units.

    Science.gov (United States)

    Rahiotis, Chris; Kakaboura, Afrodite; Loukidis, Michalis; Vougiouklakis, George

    2004-02-01

    This study compared monomer conversion (DC), the per cent linear polymerization shrinkage (%LS), the wall-to-wall contraction pattern (per cent of peripheral opening, %DM, and maximal marginal gap, MG) and depth of cure (DOC), of a hybrid resin composite (Spectrum TPH) exposed to different types of light-curing units and exposure modes (Virtuoso-PAC, Elipar TriLight-QTH, and FreeLight-LED). The QTH and LED units were used in two curing modes: the exponential ramp and the continuous output modes. Monomer conversion was investigated by micro Multiple Internal Reflection (MIR)-Fourier-transform infrared (FTIR) spectroscopy and %LS was measured by the deflective disc method. The wall-to-wall contraction method used a cylindrical cavity model in extracted human teeth. The per cent debonded margins relative to the cavity periphery (%DM) and the width of maximum gap (MG) was evaluated. The DOC was determined using Vickers microhardness measurements (200 g load, 20 s) at the top surface (H0), at 2 mm (H2) and at 4 mm (H4) depths, and the results expressed as H2/H0 and H4/H0 ratios. Significantly lower %DC and %LS values were provided by PAC and LED units. No differences were found in %DM among the curing units and PAC exhibited the highest MG. No significant differences were noted among light-curing groups in terms of H2/H0 microhardness values. The QTH, operated in exponential mode, resulted in the highest H4/H0 value. The exponential mode of the QTH demonstrated superior performance for the total of the characteristics evaluated.

  12. Hypoglycemia-related electroencephalogram changes are independent of gender, age, duration of diabetes, and awareness status in type 1 diabetes

    DEFF Research Database (Denmark)

    Remvig, Line Sofie; Elsborg, Rasmus; Sejling, Anne-Sophie

    2012-01-01

    subsequently stratified by age group (± 50 years), gender, duration of diabetes (± 20 years), and hypoglycemia awareness status (normal/impaired awareness of hypoglycemia). Results: An increase in the log amplitude of the delta, theta, and alpha band and a decrease in the alpha band centroid frequency...... and the peak frequency of the unified theta-alpha band constituted the most significant hypoglycemia indicators (all p changes remained stable across all strata. Conclusions: Hypoglycemia-associated EEG changes remain stable across age group, gender, duration of diabetes......Introduction: Neuroglycopenia in type 1 diabetes mellitus (T1DM) results in reduced cognition, unconsciousness, seizures, and possible death. Characteristic changes in the electroencephalogram (EEG) can be detected even in the initial stages. This may constitute a basis for a hypoglycemia alarm...

  13. The effect of training on responses of beta-endorphin and other pituitary hormones to insulin-induced hypoglycemia

    DEFF Research Database (Denmark)

    Mikines, K J; Kjær, Michael; Hagen, C;

    1985-01-01

    We studied whether the previously reported intensified beta-endorphin response to exercise after training might result from a training-induced general increase in anterior pituitary secretory capacity. Identical hypoglycemia was induced by insulin infusion in 7 untrained (VO2max 49 +/- 4 ml X (kg X...... min)-1, mean and SE) and 8 physically trained (VO2max 65 +/- 4 ml X (kg X min)-1) subjects. In response to hypoglycemia, levels of beta-endorphin and prolactin immunoreactivity in serum increased similarly in trained (from 41 +/- 2 pg X ml-1 and 6 +/- 1 pg X ml-1 before hypoglycemia to 103 +/- 11 pg X...... to hypoglycemia neither in trained nor in untrained subjects. Finally, differences in beta-endorphin responses to exercise between trained and untrained subjects cannot be ascribed to differences in responsiveness to hypoglycemia....

  14. The Characteristic and Prevention of Hypoglycemia Reaction of Type 2 Diabetes Mellitus of the Elderly%老年2型糖尿病低血糖反应的特点与预防

    Institute of Scientific and Technical Information of China (English)

    王尚珍

    2011-01-01

    Objectives to deepen the know ledge about hypoglycemia reaction characteristic of type 2 diabetes mellitus of the elderly and investigate prevention counterm easures to it. Methods We had a retrospective analysis on clinical material of 69 hypoglycemia reaction patients of type 2 diabetes mellitus of the elderly, summarizing the reasons, characteristic and prevention counterm easures of it. Results The characteristics of hypoglycemia reaction patients of type 2 diabetes mellitus of the elderly are non-typical clinical symptom , long duration time of hypoglycemia and slow recovery , the incentive of it is related to non-regular diet habit. Iatrogenic factor is another importrant reason of it. Conclusions The article suggests that we should deepen the know ledge about the clinical charac teristic of hypoglycem ia of type 2 diabetes mellitus of the elderly, finding out and cure as soon as possible;mean while we should strengthen propaganda about blood glucose monitoring of these patients and their family members, broaden standard of glucose control and prevent the occurring of hypoglycemia.%目的提高对老年2型糖尿病发生低血糖反应特点的认识,并探讨预防措施.方法回顾性分析69例老年2型糖尿病低血糖反应患者的临床资料,总结其低血糖发生的原因、特点及预防措施.结果老年2型糖尿病低血糖反应具有临床症状不典型、低血糖持续时间长、恢复慢等特点,其诱因主要与饮食不规律有关,医源性因素也是另一重要原因.结论提高对老年2型糖尿病低血糖临床特点的认识,及早发现和治疗;加强对老年2型糖尿病患者及家属血糖监测宣教,放宽血糖控制标准,预防低血糖的发生.

  15. 2型糖尿病患者发生低血糖症58例临床分析%Clinical analysis of 58 cases of hypoglycemia in type 2 diabetic patients

    Institute of Scientific and Technical Information of China (English)

    李新杰; 石方方

    2013-01-01

    目的探讨2型糖尿病患者发生低血糖的临床表现、发病因素及预防对策。方法回顾性分析58例2型糖尿病患者低血糖症的临床资料。结果低血糖的原因为:44例因降糖药物使用不当占75.8%,8例为运动时间较长占13.8%,6例未按时进食或进食过少占10.4%;56例经积极治疗痊愈,2例因合并乳酸性酸中毒死亡。结论降糖药物使用不当,不正确的生活习惯是导致低血糖发生的常见原因;合理用药,个体化治疗,良好的生活习惯,增加糖尿病知识及定期监测血糖,能明显减少低血糖的发生。%Objective To study clinical manifestations, the risk factors and preventive measures of hypoglycemia in type 2 diabetic patients. Methods The clinical data of 58 patients with type 2 diabetes hypoglycemia were retrospectively analyzed. Rusults 44 cases of hypoglycemia due to inappropriate use of hypoglycemic drugs,accounted for 75.8%,longer exercise time accounted for 13.8%, late to eat or eat too less accounted for 10.4%; 56 cases of al were cured,Two cases of death due to lactic acidosis. Conclusion The common reasons leading to hypoglycemia were related with the improper use of hypoglycemic drugs and the incorrect habits. Rational use of medicines, individualized treatment,good habits,increased in diabetes knowledge,and regular monitoring of blood glucose can significantly reduce the incidence of hypoglycemia.

  16. What's Tramadol Got to Do with It? A Case Report of Rebound Hypoglycemia, a Reappraisal and Review of Potential Mechanisms.

    Science.gov (United States)

    Odonkor, Charles A; Chhatre, Akhil

    2016-01-01

    Tramadol has gained traction as an analgesic of choice among pain practicing physicians. However some concerns regarding a previously unlabeled adverse reaction - hypoglycemia - have cast it in a dim light. Prior reports have noted an associated risk of hospitalization for hypoglycemia after tramadol use, but whether tramadol is the main causal agent is poorly understood and the underlying mechanisms are not well delineated. We present a unique case of rebound hypoglycemia as a variation of the theme of tramadol's adverse effect profile in a patient with type 1 diabetes mellitus, and reappraise potential mechanisms underlying this underappreciated phenomenon. A 71-year-old woman presented with right buttock pain and right lateral leg discomfort of 9-month duration. Her physical exam suggested sacroiliac joint (SIJ) etiology, confirmed by magnetic resonance imaging (MRI). She was scheduled for an SIJ-diagnostic and therapeutic block and started on tramadol 50 mg 3 times daily on as needed basis. The patient subsequently developed severe hypoglycemia initially resistant to euglycemia restorative interventions with a rebound episode. Hypoglycemia resolved with oral ingestion of high levels of glucose and the patient was taken off tramadol. Fortunately, she did not require hospitalization. The clinical scenario described is a case of rebound hypoglycemia after tramadol use in a patient with type-1 diabetes naïve to opioid analgesics. The episodes of hypoglycemia aligned perfectly with the anticipated pharmacodynamic and pharmacokinetic properties of tramadol. The specificity and temporality of events after tramadol use in this patient fulfilled causality criteria. Tramadol may cause rebound hypoglycemia in patients via interference of the intrinsic euglycemia-restoration pathways and a blunted autonomic counter-regulatory response to antecedent hypoglycemia. Its use must be tempered by this underappreciated adverse effect profile.Key words: Tramadol, hypoglycemia

  17. The Impact of Nocturnal Hypoglycemia on Clinical and Cost-Related Issues in Patients With Type 1 and Type 2 Diabetes.

    Science.gov (United States)

    Edelman, Steven V; Blose, Jamie S

    2014-05-01

    This article provides an overview of the clinical and economic issues associated with hypoglycemia in patients with type 1 and type 2 diabetes mellitus. Current research regarding hypoglycemia is comprehensively reviewed, with special emphasis on nocturnal hypoglycemia, as almost 50% of all severe hypoglycemic episodes occur at nighttime during sleep. Current findings on the economic and human burden of hypoglycemia are presented. Poor diabetes self-management leads to an increased risk for hypoglycemia and the development of long-term complications associated with poor glycemic control. Hypoglycemia is also associated with increased health care costs and resources required to treat hypoglycemic events, as well as personal financial costs and loss of productivity at school or work. In addition, fear, anxiety, and worry about hypoglycemic episodes are shown to interfere with patients' quality of life. Nocturnal hypoglycemia can cause a number of immediate clinical consequences, including convulsions, coma, and even death. Repeated long-term exposure to nocturnal hypoglycemia can blunt counterregulatory mechanisms that maintain glucose levels, leading to reduced cognitive function, impaired awareness of hypoglycemia, and hypoglycemia-associated autonomic failure. Clinicians must be aware of the impact of hypoglycemia, particularly nocturnal hypoglycemia, so that they can prescribe appropriate glucose-lowering therapy and educate patients about the prevention and management of hypoglycemic events to reduce anxiety and improve quality of life. © 2014 The Author(s).

  18. Breather cloth for vacuum curing

    Science.gov (United States)

    Reed, M. W.

    1979-01-01

    Finely-woven nylon cloth that has been treated with Teflon improves vacuum adhesive bonding of coatings to substrates. Cloth is placed over coating; entire assembly, including substrate, coating, and cloth, is placed in plastic vacuum bag for curing. Cloth allows coating to "breathe" when bag is evacuated. Applications include bonding film coatings to solar concentrators and collectors.

  19. Prevalence and possible mechanisms of reactive hypoglycemia in polycystic ovary syndrome

    DEFF Research Database (Denmark)

    Mumm, Hanne; Altinok, Magda Lambaa; Henriksen, Jan Erik;

    2016-01-01

    STUDY QUESTION: What is the prevalence of reactive hypoglycemia (RH) in polycystic ovary syndrome (PCOS) versus age- and body mass index (BMI)-matched healthy controls. SUMMARY ANSWER: The prevalence of RH was increased in PCOS versus controls. WHAT IS KNOWN ALREADY: Previous studies suggested...

  20. Hyperinsulinemic hypoglycemia associated with insulin antibodies caused by exogenous insulin analog

    Directory of Open Access Journals (Sweden)

    Chih-Ting Su

    2016-11-01

    Full Text Available Insulin antibodies (IA associated with exogenous insulin administration seldom caused hypoglycemia and had different characteristics from insulin autoantibodies (IAA found in insulin autoimmune syndrome (IAS, which was first described by Dr Hirata in 1970. The characteristic of IAS is the presence of insulin-binding autoantibodies and related fasting or late postprandial hypoglycemia. Here, we report a patient with type 1 diabetes mellitus under insulin glargine and insulin aspart treatment who developed recurrent spontaneous post-absorptive hyperinsulinemic hypoglycemia with the cause probably being insulin antibodies induced by exogenous injected insulin. Examinations of serial sera disclosed a high titre of insulin antibodies (33%, normal <5%, high insulin concentration (111.9 IU/mL and undetectable C-peptide when hypoglycemia occurred. An oral glucose tolerance test revealed persistent high serum levels of total insulin and undetectable C-peptide. Image studies of the pancreas were unremarkable, which excluded the diagnosis of insulinoma. The patient does not take any of the medications containing sulfhydryl compounds, which had been reported to cause IAS. After administering oral prednisolone for 3 weeks, hypoglycemic episodes markedly improved, and he was discharged smoothly.

  1. Hypoglycemia-Induced Decrease of EEG Coherence in Patients with Type 1 Diabetes

    DEFF Research Database (Denmark)

    Rubega, Maria; Sparacino, Giovanni; Sejling, Anne-Sophie;

    2016-01-01

    , 28.5 ± 2.6 years; glycated hemoglobin, 8.0 ± 0.2%) who underwent a hyperinsulinemic-hypoglycemic clamp study. The information partial directed coherence (iPDC) function was computed through multivariate autoregressive models during eu- and hypoglycemia in the theta and alpha bands. RESULTS...

  2. Prevalence and predictors of severe hypoglycemia in Danish children and adolescents with diabetes

    DEFF Research Database (Denmark)

    Johansen, A; Kanijo, B; Fredheim, S

    2015-01-01

    OBJECTIVE: To investigate the prevalence of severe hypoglycemia in Danish children and adolescents with type 1 diabetes and to pinpoint predictors of this acute complication in children on modern treatment modalities. RESEARCH DESIGN AND METHODS: The study is based on data from DanDiabKids, a nat...

  3. Functional Imaging in Hyperinsulinemic Hypoglycemia after Gastric Bypass Surgery for Morbid Obesity

    NARCIS (Netherlands)

    de Heide, Loek J. M.; Glaudemans, Andor W. J. M.; Oomen, Peter H. N.; Apers, Jan A.; Totte, Eric R. E.; van Beek, Andre P.

    2012-01-01

    Context: Hyperinsulinemic hypoglycemia after Roux-en-Y gastric bypass (RYGB) has been increasingly reported. It is induced by beta-cell hyperplasia often referred to as nesidioblastosis. Positron emission tomography (PET) with [11C]-5-hydroxytryptophan (C-11-HTP) and 6-[18F]fluoro-3,4-dihydroxy-L-ph

  4. Histopathological nerve and skeletal muscle changes in rats subjected to persistent insulin-induced hypoglycemia

    DEFF Research Database (Denmark)

    Jensen, Vivi Flou Hjorth; Mølck, Anne-Marie; Heydenreich, Annette;

    2016-01-01

    -study-comparator and thereby reduce the number of animals used during development. Thus, the aims of the present study were i) to develop a preclinical animal model of persistent hypoglycemia in rats using human insulin infusion for four weeks and ii) to investigate histopathological changes in sciatic nerves and quadriceps...

  5. Adrenomedullary response to hypoglycemia in first-degree relatives of patients with rheumatoid arthritis.

    Science.gov (United States)

    Rovensky, J; Imrich, R; Penesova, A; Radikova, Z; Scipova, A; Vlcek, M; Vigas, M

    2008-12-01

    Our recent studies showed blunted adrenomedullary responses to insulin-induced hypoglycemia in premenopausal females with rheumatoid arthritis (RA) and systemic sclerosis, suggesting dysregulation of the adrenomedullary hormonal system (AMHS). Since no relationship has been found between degree of AMHS dysfunction and clinical or inflammatory parameters in those patients, we hypothesize the presence of an inherited perturbation of the AMHS. To test this hypothesis, we evaluated adrenomedullary responses to insulin-induced hypoglycemia (0.1 IU/kg) in premenopausal female subjects: 17 glucocorticoid-naïve RA patients, 15 healthy first-degree family members (FDR), and 18 age- and body mass index-matched healthy controls. Our results demonstrate that when compared to controls, RA patients had lower baseline epinephrine levels (P= 0.01) and lower area under response curve (AUC) levels of norepinephrine (P < 0.001) and epinephrine (P < 0.003). In contrast, FDR had lower (P= 0.001) AUC levels of norepinephrine compared to controls and higher (P= 0.033) AUC levels of epinephrine compared to RA patients. There were no significant differences in epinephrine response between FDR and controls. Although we found lower norepinephrine responses to hypoglycemia in FDR of RA patients, adrenomedullary responses to hypoglycemia does not appear to be altered to the degree found in RA patients.

  6. Leptin-inhibited PBN neurons enhance responses to hypoglycemia in negative energy balance.

    Science.gov (United States)

    Flak, Jonathan N; Patterson, Christa M; Garfield, Alastair S; D'Agostino, Giuseppe; Goforth, Paulette B; Sutton, Amy K; Malec, Paige A; Wong, Jenny-Marie T; Germani, Mark; Jones, Justin C; Rajala, Michael; Satin, Leslie; Rhodes, Christopher J; Olson, David P; Kennedy, Robert T; Heisler, Lora K; Myers, Martin G

    2014-12-01

    Hypoglycemia initiates the counter-regulatory response (CRR), in which the sympathetic nervous system, glucagon and glucocorticoids restore glucose to appropriate concentrations. During starvation, low leptin levels restrain energy utilization, enhancing long-term survival. To ensure short-term survival during hypoglycemia in fasted animals, the CRR must overcome this energy-sparing program and nutrient depletion. Here we identify in mice a previously unrecognized role for leptin and a population of leptin-regulated neurons that modulate the CRR to meet these challenges. Hypoglycemia activates neurons of the parabrachial nucleus (PBN) that coexpress leptin receptor (LepRb) and cholecystokinin (CCK) (PBN LepRb(CCK) neurons), which project to the ventromedial hypothalamic nucleus. Leptin inhibits these cells, and Cck(cre)-mediated ablation of LepRb enhances the CRR. Inhibition of PBN LepRb cells blunts the CRR, whereas their activation mimics the CRR in a CCK-dependent manner. PBN LepRb(CCK) neurons are a crucial component of the CRR system and may be a therapeutic target in hypoglycemia.

  7. Risk indicators predictive for severe hypoglycemia during the first trimester of type 1 diabetic pregnancy

    NARCIS (Netherlands)

    Evers, IM; van der Schoot, B; ter Braak, EWMT; Janssen, N; de Valk, HW; Visser, GHA

    2002-01-01

    OBJECTIVES- To investigate the frequency of severe hypoglycemia (SH) and hypoglycemic coma during the first trimester of type 1 diabetic pregnancy and in the 4 months before gestation and to identify risk indicators predicting first trimester SH in a nonselected nationwide cohort of pregnant women w

  8. Autoimmune Hypoglycemia in a Patient with Characterization of Insulin Receptor Autoantibodies

    Directory of Open Access Journals (Sweden)

    Suk Chon

    2011-02-01

    Full Text Available BackgroundType B insulin resistance syndrome is a manifestation of autoantibodies to the insulin receptor that results in severe hyperglycemia and acanthosis nigricans. However, the mechanisms by which these autoantibodies induce hypoglycemia are largely unknown. In this paper, we report the case of patient with type B insulin resistance syndrome who presented with frequent severe fasting hypoglycemia and acanthosis nigricans.MethodsTo evaluate the mechanism of hypoglycemia, we measured the inhibition of insulin binding to erythrocytes and IM9 lymphocytes in a sample of the patient's dialyzed serum before and after immunosuppressive therapy.ResultsIn the patient's pre-treatment serum IgG, the binding of 125I-insulin to erythrocytes was markedly inhibited in a dose-dependent manner until the cold insulin level reached 10-9 mol/L. We also observed dose-dependent inhibition of insulin binding to IM9 lymphocytes, which reached approximately 82% inhibition and persisted even when diluted 1:20. After treatment with glucocorticoids, insulin-erythrocyte binding activity returned to between 70% and 80% of normal, while the inhibition of insulin-lymphocyte binding was reduced by 17%.ConclusionWe treated a patient with type B insulin resistance syndrome showing recurrent fasting hypoglycemia with steroids and azathioprine. We characterized the patient's insulin receptor antibodies by measuring the inhibition of insulin binding.

  9. Persistent Hyperinsulinemic Hypoglycemia of Infancy: A Rare Case with Multiple Anomalies

    Directory of Open Access Journals (Sweden)

    Zohre Sadat Sangsefidi

    2015-09-01

    Conclusion: Infants with PHHI are at a high risk of severe neurological damage due to severe hypoglycemia, unless immediate and adequate medical interventions are carried out. Considering the co-occurrence of different congenital anomalies and PHHI in the present case, further assessment of concomitant congenital disorders is highly recommended in PHHI patients.

  10. Causative anti-diabetic drugs and the underlying clinicalfactors for hypoglycemia in patients with diabetes

    Institute of Scientific and Technical Information of China (English)

    Hidekatsu Yanai; Hiroki Adachi; Hisayuki Katsuyama; Sumie Moriyama; Hidetaka Hamasaki; Akahito Sako

    2015-01-01

    Recent clinical trials indicated that the intensiveglycemic control do not reduce cardiovascular diseasemortality among diabetic patients, challenging asignificance of the strict glycemic control in diabetesmanagement. Furthermore, retrospective analysis ofthe Action to Control Cardiovascular Risk in Diabetesstudy demonstrated a significant association betweenhypoglycemia and mortality. Here, we systematicallyreviewed the drug-induced hypoglycemia, and alsothe underlying clinical factors for hypoglycemiain patients with diabetes. The sulfonylurea use issignificantly associated with severe hypoglycemia inpatients with type 2 diabetes. The use of biguanide(approximately 45%-76%) and thiazolidinediones(approximately 15%-34%) are also highly associatedwith the development of severe hypoglycemia. Inpatients treated with insulin, the intensified insulintherapy is more frequently associated with severehypoglycemia than the conventional insulin therapy andcontinuous subcutaneous insulin infusion. Among theunderlying clinical factors for development of severehypoglycemia, low socioeconomic status, aging, longerduration of diabetes, high HbA1c and low body massindex, comorbidities are precipitating factors for severehypoglycemia. Poor cognitive and mental functions arealso associated with severe hypoglycemia.

  11. Re-evaluating "transitional neonatal hypoglycemia": mechanism and implications for management

    Science.gov (United States)

    A Committee of the Pediatric Endocrine Society was recently formed to develop guidelines for evaluation and management of hypoglycemia in neonates, infants, and children. To aid in formulating recommendations for neonates, in this review, we analyzed available data on the brief period of hypoglycemi...

  12. Acute Hypoglycemia Induces Painful Neuropathy and the Treatment of Coenzyme Q10

    Directory of Open Access Journals (Sweden)

    Yan Ping Zhang

    2016-01-01

    Full Text Available Diabetic neuropathic pain is reduced with tight glycemic control. However, strict control increases the risk of hypoglycemic episodes, which are themselves linked to painful neuropathy. This study explored the effects of hypoglycemia-related painful neuropathy. Pretreatment with coenzyme Q10 (CoQ10 was performed to explore the preventive effect of CoQ10 on hypoglycemia-related acute neuropathic pain. Two strains of mice were used and 1 unit/kg of insulin was given to induce hypoglycemia. Mechanical sensitivity of hindpaw withdrawal thresholds was measured using von Frey filaments. Blood glucose levels were clamped at normal levels by joint insulin and glucose injection to test whether insulin itself induced hypersensitivity. Results suggest that the increased mechanical sensitivity after insulin injection is related to decreased blood glucose levels. When blood glucose levels remained at a normal level by the linked administration of insulin and glucose, mice demonstrated no significant change in mechanical sensitivity. Pretreatment with CoQ10 prevented neuropathic pain and the expression of the stress factor c-Fos. These results support the concept that pain in the diabetic scenario can be the result of hypoglycemia and not insulin itself. Additionally, pretreatment with CoQ10 may be a potent preventive method for the development of neuropathic pain.

  13. Decrease of EEG Coherence during hypoglycemia in type 1 diabetic subjects

    DEFF Research Database (Denmark)

    Rubega, M.; Sparacino, G.; Sejling, A. S.

    2015-01-01

    . The aim of the present work is to assess if and how hypoglycemia affects EEG coherence in a subset of EEG channels acquired in a hospital setting where eye- and muscle activation-induced artifacts are virtually absent. In particular, EEG multichannel data, acquired in 19 T1D hospitalized subjects...

  14. Insights into the biochemical and genetic basis of glucokinase activation from naturally occurring hypoglycemia mutations.

    NARCIS (Netherlands)

    Gloyn, A.L.; Noordam, C.; Willemsen, M.A.A.P.; Ellard, S.; Lam, W.W.; Campbell, I.W.; Midgley, P.; Shiota, C.; Buettger, C.; Magnuson, M.A.; Matschinsky, F.M.; Hattersley, A.T.

    2003-01-01

    Glucokinase (GCK) is a key regulatory enzyme in the pancreatic beta-cell and catalyzes the rate-limiting step for beta-cell glucose metabolism. We report two novel GCK mutations (T65I and W99R) that have arisen de novo in two families with familial hypoglycemia. Insulin levels, although inappropriat

  15. Accuracy evaluation of a new real-time continuous glucose monitoring algorithm in hypoglycemia

    DEFF Research Database (Denmark)

    Mahmoudi, Zeinab; Jensen, Morten Hasselstrøm; Johansen, Mette Dencker;

    2014-01-01

    UNLABELLED: Abstract Background: The purpose of this study was to evaluate the performance of a new continuous glucose monitoring (CGM) calibration algorithm and to compare it with the Guardian(®) REAL-Time (RT) (Medtronic Diabetes, Northridge, CA) calibration algorithm in hypoglycemia. SUBJECTS...

  16. Susan G. Komen for the Cure

    Science.gov (United States)

    ... an Event Komen Race for the Cure Susan G. Komen 3 Day Find Local Events Fundraise Fundraise ... 2016 Search Events Friday, September 22, 2017 Susan G. Komen Italia Race for the Cure® - Bologna Bologna, ...

  17. Accelerated Cure Project for Multiple Sclerosis

    Science.gov (United States)

    ... main content Accelerating research toward a cure for multiple sclerosis Home Contact Us Search form Search Connect Volunteer ... is to accelerate efforts toward a cure for multiple sclerosis by rapidly advancing research that determines its causes ...

  18. Rapid Development of the Radiation Curing Sector

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Radiation curing is an advanced material surface treatment technology using ultraviolet (UV) radiation and electronic beams (EB). With the greater attention paid to environ mentel protection in recent years ,radiation curing has developed rapidly.

  19. GLP1 and glucagon co-secreting pancreatic neuroendocrine tumor presenting as hypoglycemia after gastric bypass

    Science.gov (United States)

    Guimarães, Marta; Rodrigues, Pedro; Pereira, Sofia S; Nora, Mário; Gonçalves, Gil; Albrechtsen, Nicolai Wewer; Hartmann, Bolette; Holst, Jens Juul

    2015-01-01

    Summary Post-prandial hypoglycemia is frequently found after bariatric surgery. Although rare, pancreatic neuroendocrine tumors (pNET), which occasionally are mixed hormone secreting, can lead to atypical clinical manifestations, including reactive hypoglycemia. Two years after gastric bypass surgery for the treatment of severe obesity, a 54-year-old female with previous type 2 diabetes, developed post-prandial sweating, fainting and hypoglycemic episodes, which eventually led to the finding by ultrasound of a 1.8-cm solid mass in the pancreatic head. The 72-h fast test and the plasma chromogranin A levels were normal but octreotide scintigraphy showed a single focus of abnormal radiotracer uptake at the site of the nodule. There were no other clinical signs of hormone secreting pNET and gastrointestinal hormone measurements were not performed. The patient underwent surgical enucleation with complete remission of the hypoglycemic episodes. Histopathology revealed a well-differentiated neuroendocrine carcinoma with low-grade malignancy with positive chromogranin A and glucagon immunostaining. An extract of the resected tumor contained a high concentration of glucagon (26.707 pmol/g tissue), in addition to traces of GLP1 (471 pmol/g), insulin (139 pmol/g) and somatostatin (23 pmol/g). This is the first report of a GLP1 and glucagon co-secreting pNET presenting as hypoglycemia after gastric bypass surgery. Although pNET are rare, they should be considered in the differential diagnosis of the clinical approach to the post-bariatric surgery hypoglycemia patient. Learning points pNETs can be multihormonal-secreting, leading to atypical clinical manifestations.Reactive hypoglycemic episodes are frequent after gastric bypass.pNETs should be considered in the differential diagnosis of hypoglycemia after bariatric surgery. PMID:26266036

  20. Dipyrone in association with atropine inhibits the effect on gastric emptying induced by hypoglycemia in rats

    Science.gov (United States)

    Collares, E.F.; Vinagre, A.M.; Collares-Buzato, C.B.

    2017-01-01

    Atropine (AT) and dipyrone (Dp) induce a delay of gastric emptying (GE) of liquids in rats by inhibiting muscarinic receptors and activating β2-adrenergic receptors, respectively. The objective of the present study was to determine the effects of pretreatment with AT and Dp, given alone or in combination, on the effect of hypoglycemia in the liquid GE in rats. Male Wistar adult rats (280-310 g) were pretreated intravenously with AT, Dp, AT plus Dp or their vehicle and then treated 30 min later with iv insulin or its vehicle (n=8-10 animals/group). Thirty min after treatment, GE was evaluated by determining, in awake rats, the percent gastric retention (%GR) of a saline meal labeled with phenol red administered by gavage. The results indicated that insulin induced hypoglycemia in a dose-dependent manner resulting in a significant reduction in %GR of liquid only at the highest dose tested (1 U/kg). Pretreatment with AT significantly increased %GR in the rats treated with 1 U/kg insulin. Surprisingly, after pretreatment with AT, the group treated with the lowest dose of insulin (0.25 U/kg) displayed significantly lower %GR compared to its control (vehicle-treated group), which was not seen in the non-pretreated animals. Pretreatment with Dp alone at the dose of 40 mg/kg induced an increase in %GR in both vehicle and 0.25 U/kg-treated rats. A higher dose of Dp alone (80 mg/kg) significantly reduced the effect of a marked hypoglycemia induced by 1 U/kg of insulin on GE while in combination with AT the effect was completely abolished. The results with AT suggest that moderate hypoglycemia may render the inhibitory mechanisms of GE ineffective while Dp alone and in combination with AT significantly overcame the effect of hypoglycemia on GE. PMID:28876363

  1. Dipyrone in association with atropine inhibits the effect on gastric emptying induced by hypoglycemia in rats

    Directory of Open Access Journals (Sweden)

    E.F. Collares

    2017-08-01

    Full Text Available Atropine (AT and dipyrone (Dp induce a delay of gastric emptying (GE of liquids in rats by inhibiting muscarinic receptors and activating β2-adrenergic receptors, respectively. The objective of the present study was to determine the effects of pretreatment with AT and Dp, given alone or in combination, on the effect of hypoglycemia in the liquid GE in rats. Male Wistar adult rats (280-310 g were pretreated intravenously with AT, Dp, AT plus Dp or their vehicle and then treated 30 min later with iv insulin or its vehicle (n=8-10 animals/group. Thirty min after treatment, GE was evaluated by determining, in awake rats, the percent gastric retention (%GR of a saline meal labeled with phenol red administered by gavage. The results indicated that insulin induced hypoglycemia in a dose-dependent manner resulting in a significant reduction in %GR of liquid only at the highest dose tested (1 U/kg. Pretreatment with AT significantly increased %GR in the rats treated with 1 U/kg insulin. Surprisingly, after pretreatment with AT, the group treated with the lowest dose of insulin (0.25 U/kg displayed significantly lower %GR compared to its control (vehicle-treated group, which was not seen in the non-pretreated animals. Pretreatment with Dp alone at the dose of 40 mg/kg induced an increase in %GR in both vehicle and 0.25 U/kg-treated rats. A higher dose of Dp alone (80 mg/kg significantly reduced the effect of a marked hypoglycemia induced by 1 U/kg of insulin on GE while in combination with AT the effect was completely abolished. The results with AT suggest that moderate hypoglycemia may render the inhibitory mechanisms of GE ineffective while Dp alone and in combination with AT significantly overcame the effect of hypoglycemia on GE.

  2. Hypoglycemic neuronal death and cognitive impairment are prevented by poly(ADP-ribose) polymerase inhibitors administered after hypoglycemia.

    Science.gov (United States)

    Suh, Sang Won; Aoyama, Koji; Chen, Yongmei; Garnier, Philippe; Matsumori, Yasuhiko; Gum, Elizabeth; Liu, Jialing; Swanson, Raymond A

    2003-11-19

    Severe hypoglycemia causes neuronal death and cognitive impairment. Evidence suggests that hypoglycemic neuronal death involves excitotoxicity and DNA damage. Poly(ADP-ribose) polymerase-1 (PARP-1) normally functions in DNA repair, but promotes cell death when extensively activated by DNA damage. Cortical neuron cultures were subjected to glucose deprivation to assess the role of PARP-1 in hypoglycemic neuronal death. PARP-1-/- neurons and wild-type, PARP-1+/+ neurons treated with the PARP inhibitor 3,4-dihydro-5-[4-(1-piperidinyl)butoxy]-1(2H)-isoquinolinone both showed increased resistance to glucose deprivation. A rat model of insulin-induced hypoglycemia was used to assess the therapeutic potential of PARP inhibitors after hypoglycemia. Rats subjected to severe hypoglycemia (30 min EEG isoelectricity) accumulated both nitrotyrosine and the PARP-1 product, poly(ADP-ribose), in vulnerable neurons. Treatment with PARP inhibitors immediately after hypoglycemia blocked production of poly(ADP-ribose) and reduced neuronal death by >80% in most brain regions examined. Increased neuronal survival was also achieved when PARP inhibitors were administered up to 2 hr after blood glucose correction. Behavioral and histological assessments performed 6 weeks after hypoglycemia confirmed a sustained salutary effect of PARP inhibition. These results suggest that PARP-1 activation is a major factor mediating hypoglycemic neuronal death and that PARP-1 inhibitors can rescue neurons that would otherwise die after severe hypoglycemia.

  3. Techniques for internal water curing of concrete

    DEFF Research Database (Denmark)

    Jensen, Ole Mejlhede; Pietro, Lura

    2003-01-01

    This paper gives an overview of different techniques for incorporation of internal curing water in concrete. Internal curing can be used to mitigate self-desiccation and self-desiccation shrinkage. Some concretes may need 50 kg/m3 of internal curing water for this purpose. The price of the internal...

  4. Freud's psychoanalysis: a moral cure.

    Science.gov (United States)

    Eriksson, Johan

    2014-08-01

    That psychoanalytical treatment in its classical Freudian sense is primarily a moral or ethical cure is not a very controversial claim. However, it is far from obvious how we are to understand precisely the moral character of psychoanalysis. It has frequently been proposed that this designation is valid because psychoanalysis strives neither to cure psychological symptoms pharmaceutically, nor to superficially modify the behaviour of the analysand, but to lead the analysand through an interpretive process during which he gradually gains knowledge of the unconscious motives that determine his behaviour, a process that might ideally liberate him to obtain, in relation to his inner desires, the status of a moral agent. There resides something appealing in these claims. But it is the author's belief that there is an even deeper moral dimension applying to psychoanalytical theory and praxis. Freudian psychoanalysis is a moral cure due to its way of thematizing psychological suffering as moral suffering. And this means that the moral subject - the being that can experience moral suffering - is not primarily something that the psychoanalytical treatment strives to realize, but rather the presupposition for the way in which psychoanalysis theorizes psychological problems as such. Copyright © 2014 Institute of Psychoanalysis.

  5. From HCV To HBV Cure.

    Science.gov (United States)

    Schinazi, Raymond F; Asselah, Tarik

    2017-01-01

    Approximately 170 million people are chronically infected with HCV and 350 million are chronically infected with HBV worldwide. It is estimated that more than one million patients die from complications related to chronic viral hepatitis, mainly HCC which is one of the most frequent cancers in many countries, especially Africa, the Middle East and Asia. HCV drug development has been impressive, and this revolution led to several direct-acting antiviral agents achieving an HCV cure after only 6-12 weeks. This progress could theorically lead to HCV global elimination making HCV and its consequences a rarity. HBV research and development programs can learn from the HCV experience, to achieve an HBV functional or sterilizing cure. This review will summarize key steps which have been realized for an HCV cure, and discuss the next steps to achieve for an HCV elimination. And also, how this HCV revolution has inspired scientists and clinicians to achieve the same for HBV.

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

    Science.gov (United States)

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

    2017-01-01

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

  7. Toward defining a cutoff score for elevated fear of hypoglycemia on the hypoglycemia fear survey worry subscale in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Hajós, Tibor R S; Polonsky, William H; Pouwer, Frans

    2014-01-01

    ), and distress about diabetes symptoms (Diabetes Symptom Checklist-Revised) were available from Dutch patients with type 2 diabetes who were treated with oral medication or insulin (n = 1,530). Four criteria were applied to define a threshold for clinically meaningful FoH: 1) modal score distribution (MD...... with history of severe hypoglycemia. The EI criterion was the strongest associated with suboptimal well-being. CONCLUSIONS Although no definite cutoff score has been determined, the EI criterion may be most indicative of clinically relevant FoH in this exploratory study. Further testing of the clinical...

  8. Current perspectives on neonatal hypoglycemia, its management, and cerebral injury risk

    Directory of Open Access Journals (Sweden)

    Chandran S

    2015-02-01

    Full Text Available Suresh Chandran,1–4 Victor Samuel Rajadurai,1–3 Abdul Alim Abdul Haium,1–3 Khalid Hussain5,6 1Department of Neonatology, KK Women’s and Children’s Hospital, Singapore; 2Duke-NUS Graduate School of Medicine, Singapore; 3Yong Loo Lin School of Medicine, National University of Singapore, Singapore; 4Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; 5Department of Paediatric Endocrinology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, 6The Institute of Child Health, University College London, London, UK Abstract: Glucose is an essential substrate for mammalian cells; in particular, the brain needs glucose continuously as a primary source of energy. Hypoglycemia is the most common biochemical finding in the neonatal period. However, despite the common occurrence, there is still controversy on the definition of hypoglycemia in the newborn period. This has led to the development of guidelines designed to identify infants “at-risk” and the implementation of an “operational threshold” for physicians to consider intervention. In healthy term infants, the optimal hormonal and metabolic adaptations during the immediate neonatal period ensure an adequate energy substrate for the vital organs, whereas the abnormal glucose homeostasis observed in preterm and growth-retarded infants is multifactorial in origin. For these high-risk infants, it is important to identify, screen, and prevent significant hypoglycemia. Detailed investigations are warranted in infants with severe and persistent hypoglycemia. Neonatal hypoglycemia is a major cause of brain injury. The speculated mechanisms of cellular injury include excitatory neurotoxins active at N-methyl-D-aspartate receptors, increased mitochondrial free radical generation with initiation of apoptosis and altered cerebral energetic characteristics. This hypoglycemic brain injury predominantly affects parieto-occipital regions causing

  9. Composite cure monitoring with Bragg grating sensors

    Science.gov (United States)

    Slattery, Kerry T.; Corona-Bittick, Kelli; Dorr, Donald J.

    1998-03-01

    Residual stress is induced in fiber composite materials during the cure process because the thermal expansion coefficient of the fiber is generally much lower than that of the polymer matrix. The two materials are 'locked' together at the cure temperature. Then, as they cool, the matrix attempts to contract more than the fiber leading to tension in the matrix and compression in the fiber. This can lead to the formation of microcracks parallel to the fibers in thick composite piles or yarns. The magnitude of residual stress can be reduced by modifying the cure cycle; however, optimizing the cure cycle requires a complete understanding of the state of cure throughout the composite. This is a complex problem -- especially in thick composites. Pilot studies have been performed placing Bragg gratin sensors in glass fabric preforms and monitoring the response of the grating during resin infusion and cure. The typical response shows the initial thermal expansion of the Bragg grating, a rapid contraction of the grating as the resin gels, slower contraction during cure, and thermal contraction at the composite thermal expansion coefficient during cool down. This data is then sued with micromechanical models of the fiber/matrix interaction during cure to establish material parameters for cure simulation. Once verified, these cure simulation methods will be used to optimize tooling design and cure cycles in composite components.

  10. Symptomatic Hypoglycemia Related to Inappropriately High IGF-II Serum Levels in a Patient with Desmoplastic Small Round Cell Tumor

    Directory of Open Access Journals (Sweden)

    Williams Fernandes Barra

    2010-01-01

    Full Text Available A 45-year old man was diagnosed with desmoplastic small round cell tumor (DSRCT with involvement of the peritoneum and pelvis. Disease progression was observed despite systemic chemotherapy. Six months after diagnosis, he developed severe hypoglycemia presented with seizures. He received intravenous glucose infusion and hydrocortisone with poor glycemic control, but with seizures resolution. The investigation excluded insulinoma, adrenal, liver and GH deficiencies. Laboratory showed slight rise of IGF-II and significant increase of the ratio IGF-II : IGF-I, which is pathognomonic of non-islet cell tumor hypoglycemia (NICTH. He received the diagnoses of NICTH related to IGF-II inappropriate production by DSRCT. Despite the attempt to control tumor mass and hypoglycemia, the patient died 9 months after diagnosis. NICTH related to inappropriate IGF-II secretion should be investigated in all cancer patients with refractory hypoglycemia whom insulinoma and other metabolic abnormalities were excluded from.

  11. Combining genetic algorithm and Levenberg-Marquardt algorithm in training neural network for hypoglycemia detection using EEG signals.

    Science.gov (United States)

    Nguyen, Lien B; Nguyen, Anh V; Ling, Sai Ho; Nguyen, Hung T

    2013-01-01

    Hypoglycemia is the most common but highly feared complication induced by the intensive insulin therapy in patients with type 1 diabetes mellitus (T1DM). Nocturnal hypoglycemia is dangerous because sleep obscures early symptoms and potentially leads to severe episodes which can cause seizure, coma, or even death. It is shown that the hypoglycemia onset induces early changes in electroencephalography (EEG) signals which can be detected non-invasively. In our research, EEG signals from five T1DM patients during an overnight clamp study were measured and analyzed. By applying a method of feature extraction using Fast Fourier Transform (FFT) and classification using neural networks, we establish that hypoglycemia can be detected efficiently using EEG signals from only two channels. This paper demonstrates that by implementing a training process of combining genetic algorithm and Levenberg-Marquardt algorithm, the classification results are improved markedly up to 75% sensitivity and 60% specificity on a separate testing set.

  12. Use of octreotide to treat prolonged sulfonylurea-induced hypoglycemia in a patient with chronic renal failure.

    Science.gov (United States)

    Nzerue, C M; Thomas, J; Volcy, J; Edeki, T

    2003-01-01

    A diabetic patient with chronic renal failure who developed recurrent and prolonged episodes of hypoglycemia associated with use of sulfonylurea agent is presented here. This patient was hospitalized with neuroglycopenic symptoms of hypoglycemia that persisted in spite of large doses of parenteral glucose replacement. On administration of somatostatin analogue octreotide, hypoglycemia resolved and, blood glucose levels were maintained even after cessation of parenteral glucose. The patient received 2 subcutaneous doses of octreotide 12 hours apart, and made a complete recovery. Our experience suggests that use of octerotide to treat refractory or prolonged sulfonylurea-included hypoglycemia in renal failure patients is safe and effective; large prospective studies would be needed to validate these findings.

  13. Recurrent hypoglycemia in a patient of neurofibromatosis type 1 and type 1 diabetes mellitus: Munchausen′s syndrome mimicking Insulinoma

    Directory of Open Access Journals (Sweden)

    Mubaraq Naqash

    2015-01-01

    Full Text Available A 35-year-old widow having neurofibromatosis type 1 (NF 1 and type 1 diabetes mellitus (DM was admitted for abdominal pain, vomiting and recent onset low blood sugars. During hospitalization, the patient developed recurrent episodes of hypoglycemia despite stopping insulin. A possibility of insulinoma was made due to the presence of abdominal pain, vomiting, hypoglycemia, and association of insulinoma with NF 1. However, surprisingly c-peptide was very low and plasma insulin levels were high. A detailed psychiatric evaluation of the patient revealed Munchausen′s syndrome as a cause of recurrent hypoglycemia. Unrecognized psychiatric illnesses in type 1 DM may lead to overzealous investigation. In conclusion, the clinical presentations of persons with factitious disorder are varied and impact every area of medicine, factitious causes should always be considered in unclarified recurrent hypoglycemia, especially in cases presented with dramatic but inconsistent medical history, and an unusual personal behavior.

  14. Low-Carbohydrate Diet Impairs the Effect of Glucagon in the Treatment of Insulin-Induced Mild Hypoglycemia

    DEFF Research Database (Denmark)

    Ranjan, Ajenthen; Schmidt, Signe; Damm-Frydenberg, Camilla

    2017-01-01

    OBJECTIVE: This study compared the ability of glucagon to restore plasma glucose (PG) after mild hypoglycemia in patients with type 1 diabetes on an isocaloric high-carbohydrate diet (HCD) versus a low-carbohydrate diet (LCD). RESEARCH DESIGN AND METHODS: Ten patients with insulin pump-treated type...... 1 diabetes randomly completed 1 week of the HCD (≥250 g/day) and 1 week of the LCD (≤50 g/day). After each week, mild hypoglycemia was induced by a subcutaneous insulin bolus in the fasting state. When PG reached 3.9 mmol/L, 100 µg glucagon was given subcutaneously, followed by 500 µg glucagon 2 h...... of insulin, glucagon, and triglycerides. CONCLUSIONS: The LCD reduces the treatment effect of glucagon on mild hypoglycemia. Carbohydrate intake should be considered when low-dose glucagon is used to correct hypoglycemia....

  15. Effect of diabetic education on the knowledge, attitude and practices of diabetic patients towards prevention of hypoglycemia

    Directory of Open Access Journals (Sweden)

    Garima Bhutani

    2015-01-01

    Full Text Available Aims: To assess the role of diabetic education in increasing awareness about hypoglycemia and decreasing hypoglycemic symptoms in diabetics. Materials and Methods: This is a longitudinal study involving the use of a structured questionnaire for obtaining baseline information related to knowledge, attitude and practices (KAP of diabetic patients regarding hypoglycemia. Then the patients were given diabetic education by the treating doctor regarding hypoglycemia, its symptoms and prevention; the effect of which was assessed by repeating the same questionnaire after a month. The occurrence of hypoglycemic symptoms was also compared before and after diabetic education. Results: There is a significant improvement in all parameters like KAP with diabetic education. The hypoglycemic episodes also decrease significantly. Conclusions: Proper diabetic education is seen to improve the knowledge and attitude of the diabetic patients toward hypoglycemia. This leads to improved practices of such patients and decrease hypoglycemic episodes in them.

  16. Fasting adaptation in idiopathic ketotic hypoglycemia: a mismatch between glucose production and demand.

    Science.gov (United States)

    Huidekoper, Hidde H; Duran, Marinus; Turkenburg, Marjolein; Ackermans, Mariëtte T; Sauerwein, Hans P; Wijburg, Frits A

    2008-08-01

    In order to study the pathophysiology of hypoglycemia in idiopathic ketotic hypoglycemia (KH), glucose kinetics during fasting in patients with KH were determined. A fasting test was performed in 12 children with previously documented KH. Besides determination of glucoregulatory hormones, plasma ketones, FFA and alanine, the rates of endogenous glucose production (EGP), glucose uptake, gluconeogenesis (GNG) and glycogenolysis (GGL) were quantified using the [6,6-(2)H(2)] glucose isotope dilution method and the deuterated water method. The five youngest subjects (age 2.5-3.9 years) became hypoglycemic (glucose supply of alanine. Our results support the hypothesis that KH represents the lower tail of the Gaussian distribution of fasting tolerance in children.

  17. Intentional hypoglycemia to control bingeing in a patient with type 1 diabetes and bulimia nervosa.

    Science.gov (United States)

    Moosavi, Mandana; Kreisman, Stuart; Hall, Lacresha

    2015-02-01

    Most cases of eating disorders associated with type 1 diabetes mellitus are categorized as diabulimia, a disorder of withholding insulin treatment to lose weight through sustained hyperglycemia. In this paper, we report a unique case of a patient with both type 1 diabetes and bulimia nervosa who has an atypical way of controlling her bingeing by keeping her blood sugars low. This pattern of intentionally sustained hypoglycemia has not been previously described in the literature to the best of our knowledge. Knowing various presentations of eating disorders in patients with type 1 diabetes can provide healthcare workers with enhanced ability in recognizing and educating at-risk patients, in the hope of preventing serious hypoglycemia or complications. Furthermore, a patient's awareness of complications associated with suboptimal control of diabetes, whether by overdosing or underdosing their insulin regimen, might lead to avoidance of disordered eating behaviours.

  18. Adaptive System Identification for Estimating Future Glucose Concentrations and Hypoglycemia Alarms.

    Science.gov (United States)

    Eren-Oruklu, Meriyan; Cinar, Ali; Rollins, Derrick K; Quinn, Lauretta

    2012-08-01

    Many patients with diabetes experience high variability in glucose concentrations that includes prolonged hyperglycemia or hypoglycemia. Models predicting a subject's future glucose concentrations can be used for preventing such conditions by providing early alarms. This paper presents a time-series model that captures dynamical changes in the glucose metabolism. Adaptive system identification is proposed to estimate model parameters which enable the adaptation of the model to inter-/intra-subject variation and glycemic disturbances. It consists of online parameter identification using the weighted recursive least squares method and a change detection strategy that monitors variation in model parameters. Univariate models developed from a subject's continuous glucose measurements are compared to multivariate models that are enhanced with continuous metabolic, physical activity and lifestyle information from a multi-sensor body monitor. A real life application for the proposed algorithm is demonstrated on early (30 min in advance) hypoglycemia detection.

  19. Profound hypoglycemia-ınduced by vaccinium corymbosum juice and laurocerasus fruit.

    Science.gov (United States)

    Aktan, Ahmet Hamdi; Ozcelik, Abdullah; Cure, Erkan; Cure, Medine Cumhur; Yuce, Suleyman

    2014-01-01

    An emergency intervention was performed in a 75-year-old male patient with hypoglycemic attack and blackout. Although he was diagnosed with prediabetes before 2 years, he did not take any anti-diabetic drug or follow dietary advice. He drank Vaccinium corymbosum L (VC) juice daily with a belief that it increases sexual potency. Before the development of hypoglycemia, the patient had consumed about 500 ml VC juice in addition to eating 200-300 gram of Laurocerasus officinalis (LO) fruit. The measured plasma glucose (PG) level during loss of consciousness was 30 mg/dl. The profound hypoglycemia may be an unexpected side effect of an interaction between the chemical compositions of the two plants, occurred as a result of LO fruit intake that may have a strong PG-lowering effect or related to excessive intake of VC juice. Both plants may be considered in the alternative treatment of diabetes.

  20. Theophylline enhances glucose recovery after hypoglycemia in healthy man and in type I diabetic patients

    DEFF Research Database (Denmark)

    Hvidberg, A; Rasmussen, M H; Christensen, N J;

    1994-01-01

    ). The incremental AUC for cAMP was larger with theophylline for diabetic patients (P = .01). For healthy subjects, cAMP was greater with theophylline 30 minutes after insulin (P = .03). In conclusion, glucose recovery after hypoglycemia is significantly increased when theophylline is administered in an asthma...... after insulin-induced hypoglycemia. Eleven healthy subjects and nine type I (insulin-dependent) diabetic patients each participated in two experiments in randomized order, receiving on both days an insulin bolus of 0.15 IU/kg soluble insulin. On one day, theophylline (intravenous [IV] bolus of 220 mg......) was larger with theophylline than with NaCl (P = .04 for diabetic patients and P = .003 for healthy subjects). During the most active phase of glucose counterregulation, the rate of increase of plasma glucose was larger with theophylline (P = .003 for diabetic patients and P = .03 for healthy subjects...

  1. Frequency and risk factors of severe hypoglycemia in insulin-treated type 2 diabetes

    DEFF Research Database (Denmark)

    Akram, Kamran; Pedersen-Bjergaard, Ulrik; Borch-Johnsen, Knut

    2006-01-01

    . Only few studies looked into the impact of risk factors on the rate of SH. Impaired hypoglycemia awareness, high age, long duration of diabetes and insulin therapy increased the risk, while no association was found with HbA1c and insulin dose. The present knowledge of SH in insulin-treated type 2......Intensive treatment regimens including early initiation of insulin treatment are important to prevent late complications in type 2 diabetes. The assumed risk of severe hypoglycemia (SH) is a major barrier to initiation of insulin treatment. To assess the relevance of this risk we evaluated...... the frequency of SH as reported in the literature. Using Medline and Embase search we identified 11 studies (5 retrospective and 6 prospective) including at least 50 patients with insulin-treated type 2 diabetes followed for at least 6 months in which frequency of SH was reported. The incidence of SH...

  2. Optimizing glycemic control and minimizing the risk of hypoglycemia in patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Stanley S Schwartz

    2013-05-01

    Full Text Available Diabetic microvascular and macrovascular complications arise from hyperglycemia, presenting an increasing healthcare burden as the diabetic population continues to grow. Clinical trial evidence indicates that antihyperglycemic medications are beneficial with regard to microvascular disease (retinopathy, renal impairment, and perhaps neuropathy; however, the benefit of aggressive use of these medications with regard to cardiovascular risk has been less clear in recent studies. These studies were confounded by the propensity of the antihyperglycemic medications involved to cause hypoglycemia, which itself presents cardiovascular risk. This article presents additional context for these seemingly discordant results and maintains that the achievement of glycemic targets is warranted in most patients and provides cardiovascular benefit, provided that hypoglycemia is avoided and the treatment regimen is tailored to the needs of the individual patient. A treatment approach that is driven by these principles and emphasizes diet and exercise, a combination of noninsulin antidiabetic agents, not including sulfonylureas and glinides, and judicious use of insulin is also presented.

  3. The Impact of Nocturnal Hypoglycemia on Sleep in Subjects With Type 2 Diabetes

    DEFF Research Database (Denmark)

    Jennum, Poul; Stender-Petersen, Kirstine; Rabøl, Rasmus

    2015-01-01

    OBJECTIVE: The aim of this trial was to investigate the impact of nocturnal hypoglycemia on sleep patterns (assessed by polysomnography) and counterregulatory hormones. RESEARCH DESIGN AND METHODS: In this single-blinded, crossover trial, 26 subjects with type 2 diabetes attended two experimental...... night visits (one normoglycemic and one hypoglycemic) in randomized order. Plasma glucose (PG) levels were controlled by hyperinsulinemic glucose clamping. On the hypoglycemic night, hypoglycemia was induced after reaching sleep stage N2 by turning off glucose infusion until the PG target of 2.......7-2.8 mmol/L was reached and maintained for 15 min. Thereafter, subjects were brought back to normoglycemia for the rest of the night. On the normoglycemic night, PG was maintained at 5.0-7.0 mmol/L throughout the night. RESULTS: During the first 4 h of sleep (0-4 h; after reaching sleep stage N2...

  4. The Oncological Emergency Case: Paraneoplastic Hypoglycemia in Metastatic Breast Cancer - Case Report and Brief Review of the Literature

    OpenAIRE

    Richters, Lisa; Ortmann, Monika; Faust, Michael; Kraemer, Stefan; Mallmann, Peter; Harbeck, Nadia; Rhiem, Kerstin

    2013-01-01

    Background: Paraneoplastic hypoglycemia is a rare syndrome amoungtumorous diseases. It is often associated with a paraneoplasticsecretion of ‘big’ insulin-like growth factor-II. Methods: We describethis syndrome in a 60-year-old patient with advanced breast cancer 8years after primary diagnosis. Results and Conclusion: This non-isletcell tumor-induced hypoglycemia may be the only evidence for anotherwise clinically occult disease progression. Fast diagnosis andappropriate acute and causal tre...

  5. Cure-A-Phobia感

    Institute of Scientific and Technical Information of China (English)

    黄乔

    2015-01-01

    爵士乐源于二十世纪的非洲黑人音乐,被公认为欧洲现代流行音乐的开端,随着二十一世纪多元化文化的不断呈现,爵士乐在我国也愈来愈受到关注.特别是在各艺术类院校,相关爵士乐教学及演出活动也越来越多.本文在此将对瑞典爵士乐队Cure-A-Phobia的一场音乐会略抒己见.

  6. Modeling cancer glycolysis under hypoglycemia, and the role played by the differential expression of glycolytic isoforms.

    Science.gov (United States)

    Marín-Hernández, Alvaro; López-Ramírez, Sayra Y; Del Mazo-Monsalvo, Isis; Gallardo-Pérez, Juan C; Rodríguez-Enríquez, Sara; Moreno-Sánchez, Rafael; Saavedra, Emma

    2014-08-01

    The effect of hypoglycemia on the contents of glycolytic proteins, activities of enzymes/transporters and flux of HeLa and MCF-7 tumor cells was experimentally analyzed and modeled in silico. After 24 h hypoglycemia (2.5 mm initial glucose), significant increases in the protein levels of glucose transporters 1 and 3 (GLUT 1 and 3) (3.4 and 2.1-fold, respectively) and hexokinase I (HKI) (2.3-fold) were observed compared to the hyperglycemic standard cell culture condition (25 mm initial glucose). However, these changes did not bring about a significant increase in the total activities (Vmax ) of GLUT and HK; instead, the affinity of these proteins for glucose increased, which may explain the twofold increased glycolytic flux under hypoglycemia. Thus, an increase in more catalytically efficient isoforms for two of the main controlling steps was sufficient to induce increased flux. Further, a previous kinetic model of tumor glycolysis was updated by including the ratios of GLUT and HK isoforms, modified pyruvate kinase kinetics and an oxidative phosphorylation reaction. The updated model was robust in terms of simulating most of the metabolite levels and fluxes of the cells exposed to various glycemic conditions. Model simulations indicated that the main controlling steps were glycogen degradation > HK > hexosephosphate isomerase under hyper- and normoglycemia, and GLUT > HK > glycogen degradation under hypoglycemia. These predictions were experimentally evaluated: the glycolytic flux of hypoglycemic cells was more sensitive to cytochalasin B (a GLUT inhibitor) than that of hyperglycemic cells. The results indicated that cancer glycolysis should be inhibited at multiple controlling sites, regardless of external glucose levels, to effectively block the pathway. The mathematical models described here have been submitted to the JWS Online Cellular Systems Modelling Database and can be accessed at http://jjj.mib.ac.uk/database/achcar/index.html. [Database section added 21

  7. Secular Trends in the Clinical Characteristics of Type 2 Diabetic Patients With Severe Hypoglycemia Between 2008 and 2013

    Science.gov (United States)

    Ito, Hiroyuki; Tsugami, Emiko; Ando, Shigenori; Imai, Ayano; Matsumoto, Suzuko; Omoto, Takashi; Shinozaki, Masahiro; Nishio, Shinya; Abe, Mariko; Antoku, Shinichi; Mifune, Mizuo; Togane, Michiko

    2016-01-01

    Background We investigated the trends in the clinical characteristics and prescriptions of type 2 diabetic patients with severe hypoglycemia because the prescription rate of antidiabetic agents has significantly changed recently. Methods A total of 193 patients with type 2 diabetes with severe hypoglycemia induced by antidiabetic agents between 2008 and 2013 were divided into three groups based on the period of visit: 2008 - 2009, 2010 - 2011 and 2012 - 2013. Results While the proportion of patients with severe hypoglycemia using insulin (from 55% to 74%), biguanides (from 6% to 20%), glinides, and dipeptidyl peptidase-4 inhibitors significantly increased, those using sulfonylureas (from 45% to 20%) significantly decreased. Errors of drug use significantly increased as a trigger of hypoglycemia in recent years. The number of antidiabetic agents (from 1.9 ± 0.6 to 2.3 ± 0.7), non-diabetic agents (from 2.3 ± 2.4 to 4.3 ± 3.3), and total drugs prescribed were significantly higher in recent years among patients receiving insulin therapy. Conclusions Polypharmacy especially in patients receiving insulin therapy and errors of drug use have increased in type 2 diabetic patients with severe hypoglycemia in recent years. Intensive education in the usage rule of drugs is considered to be important in order to prevent severe hypoglycemia. PMID:27635175

  8. Insulin in the Medical Management of Postprandial Hypoglycemia in a Patient with Type 2 Diabetes after Gastric Bypass Surgery

    Directory of Open Access Journals (Sweden)

    Jennifer Leung Schoenberger

    2012-01-01

    Full Text Available Objective. We evaluated a 47-year-old woman with a history of type 2 diabetes and severe obesity who developed postprandial hypoglycemia after undergoing Roux-en-Y gastric bypass surgery and losing 60% of her total body weight. We studied her insulin secretion and blood glucose dynamics and were able to tailor a therapeutic regimen involving insulin that eliminated episodes of hypoglycemia. Methods. We studied blood glucose levels during a prolonged fast, performed continuous glucose monitoring studies using a subcutaneous glucose sensor, and evaluated regional pancreatic insulin secretion using selective arterial calcium stimulation. Results. Continuous glucose monitoring revealed that the patient had early (1-2 hr postprandial hyperglycemia followed by late (3-4 hr postprandial hypoglycemia. Biochemical studies confirmed endogenous pancreatogenous insulin secretion as the cause of episodic hypoglycemia, but imaging studies and selective arterial calcium stimulation failed to localize an insulinoma. The patient was treated with preprandial doses of insulin aspart in order to attenuate the early postprandial hyperglycemia, and the late hypoglycemic episodes were avoided. Conclusion. We describe an interesting and novel nonsurgical approach to the prevention of postprandial hypoglycemia in a patient with noninsulinoma pancreatogenous hypoglycemia after gastric bypass.

  9. The relationship of glucokinase activator-induced hypoglycemia with arteriopathy, neuronal necrosis, and peripheral neuropathy in nonclinical studies.

    Science.gov (United States)

    Pettersen, John C; Litchfield, John; Neef, Natasha; Schmidt, Stephen P; Shirai, Norimitsu; Walters, Karen M; Enerson, Bradley E; Chatman, Linda A; Pfefferkorn, Jeffrey A

    2014-06-01

    Glucokinase activators (GKAs) are being developed for the treatment of type 2 diabetes. The toxicity of 4 GKAs (PF-04279405, PF-04651887, piragliatin, and PF-04937319) was assessed in mice, rats, dogs, and/or monkeys. GKAs were administered for 2 to 8 weeks. Standard endpoints, glucose, and insulin were assessed. All compounds produced varying degrees of hypoglycemia in all species. Brain neuronal necrosis and/or peripheral neuropathy were observed with most compounds. These findings are consistent with literature reports linking hypoglycemia with nervous system effects. Arteriopathy, mainly of cardiac vessels, was observed at a low frequency in monkey and/or dog. Arteriopathy occurred only at doses that produced severe and prolonged periods of repeated hypoglycemia. Since this lesion occurred in multiple studies with structurally distinct GKAs, these results suggested arteriopathy was related to GKA pharmacology. The morphological characteristics of the arteriopathy were consistent with that produced by experimental catecholamine administration. We hypothesize that the prolonged periods of hypoglycemia resulted in increased local and/or systemic concentrations of catecholamines via a counterregulatory and/or stress-related mechanism. Alternatively, prolonged hypoglycemia may have resulted in endothelial dysfunction leading to arteriopathy. This risk can be managed in human patients in clinical studies by careful glucose monitoring and intervention to avoid prolonged episodes of hypoglycemia.

  10. [Quality of life and hypoglycemia burden in patients with type 2 diabetes mellitus on basal-bolus insulin therapy].

    Science.gov (United States)

    Ionova, T I; Odin, V I; Nikitina, T P; Kurbatova, K A

    2014-01-01

    This paper presents the results of the observational program "Parameters of life quality, symptoms of hypoglycemia and treatment satisfaction in patients with type 2 diabetes mellitus on basal-bolus insulin therapy" (2012-2014). The analysis included 1000 patients. It showed that their quality of life was below that of the general population due to compromised physical, role physical, and role emotional functioning (p diabetes mellitus on basal-bolus insulin therapy. They are characterized by impaired physical, psychological, and social functioning compared with the patients without hypoglycemic episodes (p quality of life was much worse (ES = 0.22-0.51). The profile of hypoglycemic episodes differed in different forms of hypoglycemia. The spectrum of symptoms and problems related to hypoglycemia was broader in patients with severe and/or nocturnal hypoglycemia. Patients free from hypoglycemia were less afraid of it than those used to have hypoglycemic episodes (p quality of life and hypoglycemia-related symptoms in patients with type 2 diabetes mellitus on basal-bolus insulin therapy allows for comprehensive estimation of the effectiveness of therapy on an individual basis.

  11. Malignant phyllodes tumor of the breast presenting with hypoglycemia: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Pacioles T

    2014-12-01

    Full Text Available Toni Pacioles,1 Rahul Seth,2,3 Cesar Orellana,3 Ivy John,4 Veera Panuganty,3 Ruban Dhaliwal3,5 1Department of Hematology and Oncology, Edwards Comprehensive Cancer Center, Marshall University, Huntington, WV, USA; 2Division of Hematology and Oncology, 3Department of Medicine, 4Department of Pathology, 5Division of Endocrinology, SUNY Upstate Medical University, Syracuse, NY, USA Abstract: Phyllodes tumors are rare fibroepithelial neoplasms that account for less than 1% of all breast tumors and are typically found in middle-aged women. Phyllodes tumors that present with hypoglycemia are even rarer. No one morphologic finding is reliable in predicting the clinical behavior of this tumor. Surgery has been the primary mode of treatment to date. However, the extent of resection and the role of adjuvant radiotherapy or chemotherapy are still controversial. Here, we present a challenging case of malignant phyllodes tumor of the breast associated with hypoglycemia, and review the literature regarding clinical findings, pathologic risk factors for recurrence, and treatment recommendations. Keywords: breast cancer, fibroepithelial neoplasm, neuroendocrine tumor, adjuvant treatment, non-islet cell tumor-induced hypoglycemia

  12. Effect of simulated microgravity on endocrine response to insulin-induced hypoglycemia in physically fit men.

    Science.gov (United States)

    Ksinantova, L; Koska, J; Kvetnansky, R; Marko, M; Hamar, D; Vigas, M

    2002-03-01

    Adaptation to microgravity is associated with alteration in some endocrine functions. In the present longitudinal study, the counterregulatory hormonal response to insulin-induced hypoglycemia (ITT, 0.1 IU/kg short acting insulin i. v.) was evaluated under simulated microgravity conditions in 15 physically fit subjects. ITT was performed at the beginning of the investigation, and again after completion of 6 weeks of endurance training and after a subsequent period of 4 days of head-down bed rest at a backward tilt of 6 degrees from the horizontal. Endurance training showed a significant increase in maximal aerobic capacity in previously well-trained subjects (increase by 12 %), as well as on attenuation of counterregulatory response of epinephrine to hypoglycemia. After 4 days of bed rest, basal concentrations of plasma norepinephrine was diminished (p < 0.002) and plasma renin activity was enhanced (p < 0.02). After bed rest, decreased responses of the two catecholamines (norepinephrine, p < 0.001; epinephrine, p < 0.001), growth hormone (p < 0.001), and cortisol (p < 0.05) were observed. Response of plasma renin activity after bed rest was increased (p < 0.01). This longitudinal study indicated that 4 days of bed rest in endurance-trained subjects induced increased response of PRA to hypoglycemia and attenuation of other counterregulatory neuroendocrine responses.

  13. Ocular Myasthenia Gravis, Hashimoto’s Thyroiditis, Iron Deficiency Anemia, and Reactive Hypoglycemia

    Directory of Open Access Journals (Sweden)

    Füsun Mayda Domaç

    2009-06-01

    Full Text Available Myasthenia gravis (MG may occur in association with other organ- specific or nonspecific autoimmune diseases. In our study, we present a patient with ocular myasthenia, Hashimoto’s thyroiditis, and iron deficiency anemia who later developed reactive hypoglycemia. A 25-year-old woman with complaints of fluctuating extraocular muscle weakness, ptosis, and diplopia was examined. MG, type I (ocular MG, was confirmed by an elevated titer of anti-acetylcholine receptor antibodies in serum (7 nmol/l, normal <0.6 and positive edrophonium test. Nerve conduction studies, needle electromyography, repetitive stimulation tests, and mediasten MRI were normal. The coexistence of Hashimoto's thyroiditis was diagnosed by the presence of a diffuse thyroid enlargement, elevated titers of anti-thyroglobulin antibodies (211.8 IU/ml, normal 0-115, thyroid peroxidase antibodies (356.4 IU/ml, normal 0-34, thyroid stimulating hormone (8.21 uIU/ml, normal 0.27-4.2, and a decreased titer of free-T4 (1.03ng/dl normal 1.8-4.6. Diplopia and ptosis have regressed with 180 mg/day pyridostigmine bromide. On her follow-up period, 8 months later, reactive hypoglycemia has been diagnosed. The coexistence of myastenia gravis, Hashimoto’s thyroiditis and reactive hypoglycemia was not found in the literature. We should take into consideration the association and the importance of recognizing and treating these pathologies in myastenia gravis. Turk Jem 2009; 13: 31-3

  14. Profound neonatal hypoglycemia and lactic acidosis caused by pyridoxine-dependent epilepsy.

    Science.gov (United States)

    Mercimek-Mahmutoglu, Saadet; Horvath, Gabriella A; Coulter-Mackie, Marion; Nelson, Tanya; Waters, Paula J; Sargent, Michael; Struys, Eduard; Jakobs, Cornelis; Stockler-Ipsiroglu, Sylvia; Connolly, Mary B

    2012-05-01

    Pyridoxine-dependent epilepsy (PDE) was first described in 1954. The ALDH7A1 gene mutations resulting in α-aminoadipic semialdehyde dehydrogenase deficiency as a cause of PDE was identified only in 2005. Neonatal epileptic encephalopathy is the presenting feature in >50% of patients with classic PDE. We report the case of a 13-month-old girl with profound neonatal hypoglycemia (0.6 mmol/L; reference range >2.4), lactic acidosis (11 mmol/L; reference range pyridoxine. The diagnosis of α-aminoadipic semialdehyde dehydrogenase deficiency was confirmed based on the elevated urinary α-aminoadipic semialdehyde excretion, compound heterozygosity for a known splice mutation c.834G>A (p.Val278Val), and a novel putative pathogenic missense mutation c.1192G>C (p.Gly398Arg) in the ALDH7A1 gene. She has been seizure-free since 1.5 months of age on treatment with pyridoxine alone. She has motor delay and central hypotonia but normal language and social development at the age of 13 months. This case is the first description of a patient with PDE due to mutations in the ALDH7A1 gene who presented with profound neonatal hypoglycemia and lactic acidosis masquerading as a neonatal-onset gluconeogenesis defect. PDE should be included in the differential diagnosis of hypoglycemia and lactic acidosis in addition to medically refractory neonatal seizures.

  15. Long-Term Prediction of Severe Hypoglycemia in Type 1 Diabetes

    DEFF Research Database (Denmark)

    Henriksen, Marie Moth; Færch, Louise; Thorsteinsson, Birger

    2016-01-01

    BACKGROUND: Prediction of risk of severe hypoglycemia (SH) in patients with type 1 diabetes is important to prevent future episodes, but it is unknown if it is possible to predict the long-term risk of SH. The aim of the study is to assess if long-term prediction of SH is possible in type 1...... diabetes. METHODS: A follow-up study was performed with 98 patients with type 1 diabetes. At baseline and at follow-up, the patients filled in a questionnaire about diabetes history and complications, number of SH in the preceding year and state of awareness, and HbA1c and C-peptide levels were measured......-up. CONCLUSIONS: Long-term prediction of severe hypoglycemia in type 1 diabetes was not possible, although baseline hypoglycemia unawareness tended to remain a predictor for risk of SH at follow-up. Therefore, it is important repeatedly to assess the different risk factors of SH to determine the actual risk....

  16. ASRM test report: Autoclave cure process development

    Science.gov (United States)

    Nachbar, D. L.; Mitchell, Suzanne

    1992-01-01

    ASRM insulated segments will be autoclave cured following insulation pre-form installation and strip wind operations. Following competitive bidding, Aerojet ASRM Division (AAD) Purchase Order 100142 was awarded to American Fuel Cell and Coated Fabrics Company, Inc. (Amfuel), Magnolia, AR, for subcontracted insulation autoclave cure process development. Autoclave cure process development test requirements were included in Task 3 of TM05514, Manufacturing Process Development Specification for Integrated Insulation Characterization and Stripwind Process Development. The test objective was to establish autoclave cure process parameters for ASRM insulated segments. Six tasks were completed to: (1) evaluate cure parameters that control acceptable vulcanization of ASRM Kevlar-filled EPDM insulation material; (2) identify first and second order impact parameters on the autoclave cure process; and (3) evaluate insulation material flow-out characteristics to support pre-form configuration design.

  17. Handling and Curing Characteristics of Cut-Strip Tobacco. Part 2: Effect of Yellowing Time and Drying Potential

    Directory of Open Access Journals (Sweden)

    Johnson WH

    2014-12-01

    Full Text Available This paper presents Part 2 of a study on comparative handling and curing characteristics of cut-strip vs. whole leaf tobacco. Part 1 considered the effect of leaf size (cut-strip size vs. whole leaf, packing density and mode of leaf orientation on cured leaf chemistry and leaf quality; whereas, the present study considers further the effect of leaf form, two yellowing times and two drying potentials during yellowing. Results showed that leaf chemistry and quality were quite similar for cut-strip (15.2 × 22.9 cm and whole leaf. Insignificant differences were noted for cured leaf starch and sugars, although slightly lower levels of alkaloids (significant at the 0.01 level were observed for cut strip. Curing treatments significantly affected leaf chemistry. Increased yellowing time resulted in lower levels of starch and higher levels of sugar. Sugars were also higher for tobacco yellowed under the higher drying potential. The two forms of leaf responded similarly to different curing schedules (i.e. no interaction of leaf form with schedule. Also, government grade and price data were essentially unaffected by leaf form or curing schedule over the range of variables tested. Cured leaf starch was abnormally high on the average for both leaf forms. Interestingly, starch levels were lower when intact tobacco was bulk-cured in racks rather than box cured (6.35% vs. 9.02%. Since curing schedules were similar, air velocity in the two curing methods might be a factor. Also the cured leaf starch content was about 56% lower for tobacco produced at the Oxford Tobacco Research Station (in a secondary study than at the Central Crops Research Station. It is postulated that carbohydrate and nitrogen metabolism during growth and maturation might be affected by excess rainfall events and/or nitrogen availability, with subsequent effects on starch-to-sugar conversion during curing.

  18. Arrhythmogenic effects of hypoglycemia in children and adolescents with type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Dmitriy Nikitich Laptev

    2013-12-01

    Full Text Available Aim. To determine the effects of hypoglycemia on the duration of QT interval, heart rate variability (HRV and frequency of arrhythmic events, as well as to closer investigate the factors associated with the development of various heart rhythm disorders in children and adolescents with type 1 diabetes mellitus (T1DM.Materials and methods. The study included 150 children and adolescents with T1DM at the age of 6–18 years. All participants underwent Holter monitoring and continuous glucose monitoring (CGM for 24 hours. QTc and HRV parameters (SDNN, RMSSD, SVVR were calculated automatically. Data was averaged for 5’-interval and juxtaposed with CGM. Patients identified with hypoglycemic events (blood glucose <3.5 mmol/L during the day (7:00–23:00 and nighttime (23:00–7:00 were selected for further study. In these patients length of QTc and RR intervals, HRV parameters and arrhythmic events were analyzed and collated with CGM data.Results. We observed 39 episodes of nocturnal hypoglycaemia in 32 patients (21.3% and 89 episodes of daytime hypoglycaemia in 46 patients (30.7%. Marked prolongation of QTc (hypo- vs. normoglycemia, respectively: 431 vs. 420 ms; p<0.05 and reduced HRV (hypo- vs. normoglycemia, respectively: SDNN 68 and 90 ms; RMSSD 56 and 61 ms; p <0.05 occurred during episodes of nocturnal hypoglycemia. The same pattern was observed during the day (hypo- vs. normoglycemia, respectively: SDNN 58 and 63 ms; RMSSD 32 and 36 ms; p<0.05. Eleven subjects with nocturnal hypoglycemia demonstrated either ventricular or supraventricular premature complexes. Thirty of subjects with diurnal hypoglycemia also had either ventricular or supraventricular premature complexes. Hypoglycemic episodes vs. normoglycemia were characterized by an increase in ventricular and supraventricular ectopic beats, ST segment and T-wave amplitude depression. Various rhythm abnormalities were associated with cardiovascular autonomic and peripheral neuropathy

  19. Interfacial Properties of Electron Beam Cured Composites

    Energy Technology Data Exchange (ETDEWEB)

    Eberle, C.C.

    1999-12-30

    The objectives of the CRADA are to: Confirm that fiber-resin adhesion is responsible for the observed poor shear properties; Determine the mechanism(s) responsible for poor adhesion between carbon fibers and epoxy resins after e-beam curing; Develop and evaluate resin systems and fiber treatments to improve the properties of e-beam cured, carbon-fiber-reinforced composites; and Develop refined methods for processing e-beam cured, carbon-fiber-reinforced composites.

  20. Microwave Cure of Phenol-Formaldehyde Adhesive

    OpenAIRE

    高谷, 政広; 田平, 英敏; 岡本, 忠

    2006-01-01

    [Synopsis] Phenol-formaldehyde resin has been used as a versatile material for adhesives and coatings of a wide range of adherends because of its excellent performance in water- resistance, strength against abrasion, and so on. However, it has a drawback of slow rate of cure and relevant emission of formaldehyde gas after bonding. We studied the curing performance under irradiation of microwave for the purpose of looking for a way of accelerating the cure rate of phenol formaldehyde resin. Th...

  1. Electron Beam Curing of Advanced Composites

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The fundamental concept of electron beam method and the application in cure of composites are elaborated in this paper. The components of electron beam curing system are introduced. The mechanisms of interaction between electron beam and polymer matrix composites are presented. Recent studies reported including work of authors themselves on electron beam curing of composites are also discussed. Moreover, the authors believe that it is necessary to do the basic research about understanding how electron beam affects cured network and the mechanical/physical properties of the composites, for establishing a quantitative or semi-quantitative formulation.

  2. Curing efficiency of three light emitting diode units at different curing profiles

    Directory of Open Access Journals (Sweden)

    Priyanka Verma

    2016-01-01

    Conclusions: Reduction of exposure time to 6 s with high-intensity curing light seemed to be clinically acceptable and should be recommended. Curing of metal brackets with single exposure from buccal side showed lower shear bond strength values.

  3. Prevention is better than cure

    CERN Multimedia

    Anaïs Schaeffer

    2012-01-01

    Throughout the year, members of the Safety Inspections Services section of HSE Unit devote themselves to ensuring the safety of all infrastructure and equipment that represent a specific hazard within the Organization. They regularly comb through all CERN's infrastructure to forestall any accidents and their potential impact, true to the adage that prevention is better than cure.   This site has a few (!) slight safety problems... Spot the mistakes! (Details of the game below.) Ensuring that an HV electrical installation is properly earthed, that a system under pressure has no weak points, that an item of lifting equipment can be used without risk, that safety valves operate at the right pressure threshold as well as checking that a heavy object that could inflict injury if it fell is not stored on top of a cupboard: such are the types of inspections performed by the Safety Inspection Service (DGS-SEE-SIS). "These checks reassure those in charge of equipment and infrastruct...

  4. Hepatitis C, stigma and cure.

    Science.gov (United States)

    Marinho, Rui Tato; Barreira, David Pires

    2013-10-28

    The infection with hepatitis C virus (HCV) is one of the most important global chronic viral infections worldwide. It is estimated to affect around 3% of the world population, about 170-200 million people. Great part of the infections are asymptomatic, the patient can be a chronic carrier for decades without knowing it. The most severe consequences of the chronic infection are liver cirrhosis and hepatocellular carcinoma, which appears in 20%-40% of the patients, leading to hepatic failure and death. The HCV was discovered 25 years ago in 1989, is a RNA virus and classified by the World Health Organization as an oncogenic one. Hepatocellular carcinoma is one of the most important cancers, the fifth worldwide in terms of mortality. It has been increasing in the Ocidental world, mainly due to chronic hepatitis C. Hepatitis C is not only a liver disease and a cause of cirrhosis, but also a mental, psychological, familiar, and social disease. The stigma that the infected person sometimes carries is tremendous having multiple consequences. The main cause is lack of adequate information, even in the health professionals setting. But, besides the "drama" of being infected, health professionals, family, society and the infected patients, must be aware of the chance of real cure and total and definitive elimination of the virus. The treatment for hepatitis C has begun in the last 80's with a percentage of cure of 6%. Step by step the efficacy of the therapy for hepatitis C is rapidly increasing and nowadays with the very new medications, the so called Direct Antiviral Agents-DAAs of new generation, is around 80%-90%.

  5. Curing Mechanism of Condensed Polynuclear Aromatic Resin and Thermal Stability of Cured Resin

    Institute of Scientific and Technical Information of China (English)

    Li Shibin; Sun Qiqian; Wang Yuwei; Wu Mingbo; Zhang Zailong

    2015-01-01

    In order to improve the thermal stability of condensed polynuclear aromatic (COPNA) resin synthesized from vacuum residue, 1,4-benzenedimethanol was added to cure COPNA resin. The curing mechanism was investigated by pro-ton nuclear magnetic resonance spectrometry, solid carbon-13 nuclear magnetic resonance spectrometry and Fourier trans-form infrared spectroscopy. Microstructures of the uncured and the cured COPNA resins were studied by scanning electron microscopy and X-ray diffractometry. The thermal stability of COPNA resins before and after curing was tested by thermo-gravimetric analysis. The element composition of the cured COPNA resin heated at different temperatures was analyzed by an element analyzer. The results showed that the uncured COPNA resin reacted with the cross-linking agent during the cur-ing process, and the curing mechanism was conifrmed to be the electrophilic substitution reaction. Compared with the un-cured COPNA resin, the cured COPNA resin had a smooth surface, well-ordered and streamlined sheet structure with more crystalline solids, better molecular arrangement and orientation. The weight loss process of the uncured and cured COPNA resins was divided into three stages. Carbon residue of the cured COPNA resin was 41.65%at 600℃, which was much higher than 25.02%of the uncured COPNA resin, which indicated that the cured COPNA resin had higher thermal stability.

  6. Identification of the epoxy curing mechanism under isothermal conditions by thermal analysis and infrared spectroscopy

    Science.gov (United States)

    Yamasaki, Hideki; Morita, Shigeaki

    2014-07-01

    A curing reaction of bisphenol A diglycidyl ether epoxy resin with 4,4‧-diaminodicyclohexyl methane hardener was investigated by means of modulated differential scanning calorimetry (MDSC), thermal scanning rheometer (TSR), near-infrared (NIR) and mid-infrared (MIR) spectroscopy. The relation between change in the physical properties and molecular structures during the isothermal curing reaction were studied. MDSC and NIR results corroborated vitrification with the secondary to tertiary amine conversion; the process afforded a three-dimensional cross-linking structure. TSR estimation of the gelation point was corroborated with the NIR-determined maximum concentration of the generated secondary amine. Two-dimensional correlation spectroscopy confirmed that reaction between the primary amine and epoxy occurred more rapidly than any other functional group reaction. The ether groups were generated at the early stage of the curing reaction, and their formation occurred immediately with the generation of hydroxyl groups.

  7. [Can we cure autism? From outcome to intervention].

    Science.gov (United States)

    Alessandri, M; Thorp, D; Mundy, P; Tuchman, R F

    2005-01-15

    Outcome in autism is variable but with a significant trend toward a poor prognosis and despite reports that outcome in individuals with autism may be improving secondary to early intensive interventions there is still much to be learned about the natural history and the effects of intervention in autism spectrum disorders. While there may not be a known cure for autism, there are a number of viable treatment options available. The primary models of treatment are non pharmacological interventions that include intervention models such as applied behavior analysis and developmental and structured teaching. The role of pharmacological interventions is limited to treating specific symptoms that may be interfering with a child's ability to learn or function within a particular environment. The question of whether or not we can cure autism needs to be discussed in terms of the need to overcome the as of yet poorly understood fundamental disturbance in autism and the need to develop treatment protocols specifically targeting social deficits. At the present time, it is more appropriate to speak of our quest to understand autism than it is to speak of a cure.

  8. Dental resin cure monitoring by inherent fluorescence

    Science.gov (United States)

    Li, Qun; Zhou, Jack X.; Li, Qingxiong; Wang, Sean X.

    2008-02-01

    It is demonstrated that the inherent fluorescence of a dental composite resin can be utilized to monitor the curing status, i.e. degree of conversion of the resin. The method does not require any sample preparation and is potentially very fast for real time cure monitoring. The method is verified by Raman spectroscopy analysis.

  9. 7 CFR 29.6010 - Cured.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Cured. 29.6010 Section 29.6010 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... INSPECTION Standards Definitions § 29.6010 Cured. Tobacco dried of its sap by either natural or...

  10. Finding a cure for HIV: will it ever be achievable?

    Directory of Open Access Journals (Sweden)

    Lewin Sharon R

    2011-01-01

    Full Text Available Abstract Combination antiretroviral therapy (cART has led to a major reduction in HIV-related mortality and morbidity. However, HIV still cannot be cured. With the absence of an effective prophylactic or therapeutic vaccine, increasing numbers of infected people, emerging new toxicities secondary to cART and the need for life-long treatment, there is now a real urgency to find a cure for HIV. There are currently multiple barriers to curing HIV. The most significant barrier is the establishment of a latent or "silent" infection in resting CD4+ T cells. In latent HIV infection, the virus is able to integrate into the host cell genome, but does not proceed to active replication. As a consequence, antiviral agents, as well as the immune system, are unable to eliminate these long-lived, latently infected cells. Reactivation of latently infected resting CD4+ T cells can then re-establish infection once cART is stopped. Other significant barriers to cure include residual viral replication in patients receiving cART, even when the virus is not detectable by conventional assays. In addition, HIV can be sequestered in anatomical reservoirs, such as the brain, gastrointestinal tract and genitourinary tract. Achieving either a functional cure (long-term control of HIV in the absence of cART or a sterilizing cure (elimination of all HIV-infected cells remains a major challenge. Several studies have now demonstrated that treatment intensification appears to have little impact on latent reservoirs. Some potential and promising approaches that may reduce the latent reservoir include very early initiation of cART and the use of agents that could potentially reverse latent infection. Agents that reverse latent infection will promote viral production; however, simultaneous administration of cART will prevent subsequent rounds of viral replication. Such drugs as histone deacetylase inhibitors, currently used and licensed for the treatment of some cancers, or

  11. 9 CFR 319.103 - Cured beef tongue.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Cured beef tongue. 319.103 Section 319... Cured beef tongue. In preparing “Cured Beef Tongue,” the application of curing solution to the fresh beef tongue shall not result in an increase in the weight of the cured beef tongue of more than...

  12. Curing agent for polyepoxides and epoxy resins and composites cured therewith. [preventing carbon fiber release

    Science.gov (United States)

    Serafini, T. T.; Delvigs, P.; Vannucci, R. D. (Inventor)

    1981-01-01

    A curing for a polyepoxide is described which contains a divalent aryl radical such as phenylene a tetravalent aryl radical such as a tetravalent benzene radical. An epoxide is cured by admixture with the curing agent. The cured epoxy product retains the usual properties of cured epoxides and, in addition, has a higher char residue after burning, on the order of 45% by weight. The higher char residue is of value in preventing release to the atmosphere of carbon fibers from carbon fiber-epoxy resin composites in the event of burning of the composite.

  13. Nocturnal hypoglycemia identified by a continuous glucose monitoring system in patients with primary adrenal insufficiency (Addison's Disease).

    Science.gov (United States)

    Meyer, Gesine; Hackemann, Annika; Reusch, Juergen; Badenhoop, Klaus

    2012-05-01

    Hypoglycemia can be a symptom in patients with Addison's disease. The common regimen of replacement therapy with oral glucocorticoids results in unphysiological low cortisol levels in the early morning, the time of highest insulin sensitivity. Therefore patients with Addison's disease are at risk for unrecognized and potentially severe nocturnal hypoglycemia also because of a disturbed counterregulatory function. Use of a continuous glucose monitoring system (CGMS) could help to adjust hydrocortisone treatment and to avoid nocturnal hypoglycemia in these patients. Thirteen patients with Addison's disease were screened for hypoglycemia wearing a CGMS for 3-5 days. In one patient we identified a hypoglycemic episode at 3:45 a.m. with a blood glucose level of 46 mg/dL, clearly beneath the 95% tolerance interval of minimal glucose levels between 2 and 4 a.m. (53.84 mg/dL). After the hydrocortisone replacement scheme was changed, the minimum blood glucose level between 2 and 4 a.m. normalized to 87 mg/dL. Continuous glucose monitoring can detect nocturnal hypoglycemia in patients with primary adrenal insufficiency and hence prevent in these patients an impaired quality of life and even serious adverse effects.

  14. Severe Hypoglycemia Is a Serious Complication and Becoming an Economic Burden in Diabetes

    Directory of Open Access Journals (Sweden)

    Won Chul Ha

    2012-08-01

    Full Text Available BackgroundThe prevalence of hypoglycemia is increasing due to the growing incidence of diabetes and the latest strict guidelines for glycated hemoglobin (HbA1c levels under 7%. This study examined the clinical characteristics, causal factors, and medical costs of severely hypoglycemic patients in an emergency room (ER of Uijeongbu St. Mary's Hospital.MethodsThe study consisted of a retrospective analysis of the characteristics, risk factors, and medical costs of 320 severely hypoglycemic patients with diabetes who presented to an ER of Uijeongbu St. Mary's Hospital from January 1, 2006 to December 31, 2009.ResultsMost hypoglycemic patients (87.5%, 280/320 were over 60 years old with a mean age of 69.5±10.9 years and a mean HbA1c level of 6.95±1.46%. Mean serum glucose as noted in the ER was 37.9±34.5 mg/dL. Renal function was decreased, serum creatinine was 2.0±2.1 mg/dL and estimated glomerular filtration rate (eGFR was 48.0±33.6 mL/min/1.73 m2. In addition, hypoglycemic patients typically were taking sulfonylureas or insulin and a variety of other medications, and had a long history of diabetes.ConclusionSevere hypoglycemia is frequent in older diabetic patients, subjects with low HbA1c levels, and nephropathic patients. Therefore, personalized attention is warranted, especially in long-term diabetics with multiple comorbidities who may not have been properly educated or may need re-education for hypoglycemia.

  15. The GOAT-ghrelin system is not essential for hypoglycemia prevention during prolonged calorie restriction.

    Directory of Open Access Journals (Sweden)

    Chun-Xia Yi

    Full Text Available OBJECTIVE: Ghrelin acylation by ghrelin O-acyltransferase (GOAT has recently been reported to be essential for the prevention of hypoglycemia during prolonged negative energy balance. Using a unique set of four different genetic loss-of-function models for the GOAT/ghrelin/growth hormone secretagogue receptor (GHSR system, we thoroughly tested the hypothesis that lack-of-ghrelin activation or signaling would lead to hypoglycemia during caloric deprivation. METHODOLOGY: Male and female knockout (KO mice for GOAT, ghrelin, GHSR, or both ghrelin and GHSR (dKO were subjected to prolonged calorie restriction (40% of ad libitum chow intake. Body weight, fat mass, and glucose levels were recorded daily and compared to wildtype (WT controls. Forty-eight hour blood glucose profiles were generated for each individual mouse when 2% or less body fat mass was reached. Blood samples were obtained for analysis of circulating levels of acyl- and desacyl-ghrelin, IGF-1, and insulin. PRINCIPAL FINDINGS: Chronic calorie restriction progressively decreased body weight and body fat mass in all mice regardless of genotype. When fat mass was depleted to 2% or less of body weight for 2 consecutive days, random hypoglycemic events occurred in some mice across all genotypes. There was no increase in the incidence of hypoglycemia in any of the four loss-of-function models for ghrelin signaling including GOAT KO mice. Furthermore, no differences in insulin or IGF-1 levels were observed between genotypes. CONCLUSION: The endogenous GOAT-ghrelin-GHSR system is not essential for the maintenance of euglycemia during prolonged calorie restriction.

  16. A physiological increase in insulin suppresses gluconeogenic gene activation in fetal sheep with sustained hypoglycemia.

    Science.gov (United States)

    Thorn, Stephanie R; Sekar, Satya M; Lavezzi, Jinny R; O'Meara, Meghan C; Brown, Laura D; Hay, William W; Rozance, Paul J

    2012-10-15

    Reduced maternal glucose supply to the fetus and resulting fetal hypoglycemia and hypoinsulinemia activate fetal glucose production as a means to maintain cellular glucose uptake. However, this early activation of fetal glucose production may be accompanied by hepatic insulin resistance. We tested the capacity of a physiological increase in insulin to suppress fetal hepatic gluconeogenic gene activation following sustained hypoglycemia to determine whether hepatic insulin sensitivity is maintained. Control fetuses (CON), hypoglycemic fetuses induced by maternal insulin infusion for 8 wk (HG), and 8 wk HG fetuses that received an isoglycemic insulin infusion for the final 7 days (HG+INS) were studied. Glucose and insulin concentrations were 60% lower in HG compared with CON fetuses. Insulin was 50% higher in HG+INS compared with CON and four-fold higher compared with HG fetuses. Expression of the hepatic gluconeogenic genes, PCK1, G6PC, FBP1, GLUT2, and PGC1A was increased in the HG and reduced in the HG+INS liver. Expression of the insulin-regulated glycolytic and lipogenic genes, PFKL and FAS, was increased in the HG+INS liver. Total FOXO1 protein expression, a gluconeogenic activator, was 60% higher in the HG liver. Despite low glucose, insulin, and IGF1 concentrations, phosphorylation of AKT and ERK was higher in the HG liver. Thus, a physiological increase in fetal insulin is sufficient for suppression of gluconeogenic genes and activation of glycolytic and lipogenic genes in the HG fetal liver. These results demonstrate that fetuses exposed to sustained hypoglycemia have maintained hepatic insulin action in contrast to fetuses exposed to placental insufficiency.

  17. A 36-year-old man with vomiting, pain abdomen, significant weight loss, hyponatremia, and hypoglycemia.

    Science.gov (United States)

    Mutreja, Deepti; Sivasami, Kartik; Tewari, Vanmalini; Nandi, Bhaskar; Nair, G Lakhsmi; Patil, Sunita D

    2015-01-01

    Diagnosis of Strongyloides stercoralis hyperinfection can be a challenge. The key to a timely diagnosis is to have a high index of suspicion. We present a rare case of a 36-year-old human immunodeficiency virus negative male patient, who was on multidrug therapy for lepromatous leprosy and was treated for type 2 lepra reactions with steroids in the past. The patient presented with vomiting and pain abdomen, persistent hyponatremia, and terminal hypoglycemia. He had features of malnutrition and had a rapid downhill course following admission. A diagnosis of S. stercoralis hyperinfection with sepsis and multiorgan failure, adrenal hemorrhage, and syndrome of inappropriate antidiuretic hormone secretion was established on a postmortem examination.

  18. Exercise Strategies for Hypoglycemia Prevention in Individuals With Type 1 Diabetes

    OpenAIRE

    Yardley, Jane E.; Ronald J Sigal

    2015-01-01

    IN BRIEF Fear of hypoglycemia is one of the main barriers to physical activity for individuals with type 1 diabetes. Recent studies indicate that anaerobic forms of exercise (i.e., resistance exercise/weight lifting, sprints, and high-intensity intervals) can attenuate exercise-related declines in blood glucose both during and after exercise in young, healthy adults with type 1 diabetes. These responses might vary based on age, sex, and fitness level and in the general safety of relying on th...

  19. Diminished epinephrine response to hypoglycemia despite enlarged adrenal medulla in trained rats

    DEFF Research Database (Denmark)

    Stallknecht, B; Kjaer, M; Mikines, K J

    1990-01-01

    )]. Cold stress or sham swim training did not increase adrenal weight or volume of adrenal medulla (P greater than 0.05). To stimulate adrenal medulla secretion, rats had an insulin-induced hypoglycemia. Insulin dose needed to suppress plasma glucose below 4.0 mM was four times greater in sedentary....../day or served as controls being either sedentary freely eating (C), food restricted (FR), sham swim trained (ST), or cold stressed (CS). Adrenal glands were weighted and cross sectioned for light microscopic determination of size of the adrenal medulla. Endurance-trained compared with control rats had heavier...

  20. Threshold-based insulin-pump interruption for reduction of hypoglycemia.

    Science.gov (United States)

    Bergenstal, Richard M; Klonoff, David C; Garg, Satish K; Bode, Bruce W; Meredith, Melissa; Slover, Robert H; Ahmann, Andrew J; Welsh, John B; Lee, Scott W; Kaufman, Francine R

    2013-07-18

    The threshold-suspend feature of sensor-augmented insulin pumps is designed to minimize the risk of hypoglycemia by interrupting insulin delivery at a preset sensor glucose value. We evaluated sensor-augmented insulin-pump therapy with and without the threshold-suspend feature in patients with nocturnal hypoglycemia. We randomly assigned patients with type 1 diabetes and documented nocturnal hypoglycemia to receive sensor-augmented insulin-pump therapy with or without the threshold-suspend feature for 3 months. The primary safety outcome was the change in the glycated hemoglobin level. The primary efficacy outcome was the area under the curve (AUC) for nocturnal hypoglycemic events. Two-hour threshold-suspend events were analyzed with respect to subsequent sensor glucose values. A total of 247 patients were randomly assigned to receive sensor-augmented insulin-pump therapy with the threshold-suspend feature (threshold-suspend group, 121 patients) or standard sensor-augmented insulin-pump therapy (control group, 126 patients). The changes in glycated hemoglobin values were similar in the two groups. The mean AUC for nocturnal hypoglycemic events was 37.5% lower in the threshold-suspend group than in the control group (980 ± 1200 mg per deciliter [54.4 ± 66.6 mmol per liter] × minutes vs. 1568 ± 1995 mg per deciliter [87.0 ± 110.7 mmol per liter] × minutes, Ppump was stopped for 2 hours, the mean sensor glucose value was 92.6 ± 40.7 mg per deciliter (5.1 ± 2.3 mmol per liter). Four patients (all in the control group) had a severe hypoglycemic event; no patients had diabetic ketoacidosis. This study showed that over a 3-month period the use of sensor-augmented insulin-pump therapy with the threshold-suspend feature reduced nocturnal hypoglycemia, without increasing glycated hemoglobin values. (Funded by Medtronic MiniMed; ASPIRE ClinicalTrials.gov number, NCT01497938.).

  1. Chronic estradiol and progesterone treatment in conscious dogs: effects on insulin sensitivity and response to hypoglycemia

    OpenAIRE

    Batista, Marcia R.; Smith, Marta S.; Snead, Wanda L.; Connolly, Cynthia C.; Lacy, D. Brooks; Moore, Mary Courtney

    2005-01-01

    We evaluated the effect of chronic (3 wk) subcutaneous treatment with progesterone and estradiol (PE; producing serum levels observed in the 3rd trimester of pregnancy) or placebo (C) on hepatic and whole body insulin sensitivity and response to hypoglycemia in conscious, overnight-fasted nonpregnant female dogs, using tracer and arteriovenous difference techniques. Insulin was infused peripherally for 3 h at 1.8 mU·kg−1·min−1. Glucose was allowed to fall to 3 mM (Hypo) or maintained at 6 mM ...

  2. Curing efficiency of modern LED units.

    Science.gov (United States)

    Rencz, Adam; Hickel, Reinhard; Ilie, Nicoleta

    2012-02-01

    Recent reports claim that modern light-emitting diode (LED) curing units improve curing efficiency by increasing the units' irradiance. In this context also, short polymerisation times up to 5 s are proposed. The aim of this study was to examine whether there are differences in the curing efficiency of modern LED curing units by assessing their effect on two different composite materials and by varying the irradiation time. A nano- and a micro-hybrid resin-based composite (RBC) were polymerised for 5, 10 and 20 s with three commercial and a Prototype LED unit (Elipar™ S10). Cylindrical specimens (6 mm in depth, 4 mm in diameter) were prepared in three increments, each 2-mm thick, and were consecutively cured. Degree of cure was measured for 20 min in real time at the bottom of the samples, starting with the photoinitiation. The micro-mechanical properties (modulus of elasticity, E and Vickers hardness, HV) were measured as a function of depth, in 100-μm steps, on the above described samples stored in distilled water for 24 h at 37°C. Data were analysed with multivariate ANOVA followed by Tukey's test, t test and partial eta-squared statistics. In descending order of the strength of their effect, the type of RBC, depth, polymerisation time and curing unit were significant factors affecting the micro-mechanical parameters (p surface, a minimum of 20 s of irradiation is necessary for an adequate polymerisation 2 mm beyond the surface.

  3. Hypoglycemia-activated GLUT2 neurons of the nucleus tractus solitarius stimulate vagal activity and glucagon secretion.

    Science.gov (United States)

    Lamy, Christophe M; Sanno, Hitomi; Labouèbe, Gwenaël; Picard, Alexandre; Magnan, Christophe; Chatton, Jean-Yves; Thorens, Bernard

    2014-03-04

    Glucose-sensing neurons in the brainstem participate in the regulation of energy homeostasis but have been poorly characterized because of the lack of specific markers to identify them. Here we show that GLUT2-expressing neurons of the nucleus of the tractus solitarius form a distinct population of hypoglycemia-activated neurons. Their response to low glucose is mediated by reduced intracellular glucose metabolism, increased AMP-activated protein kinase activity, and closure of leak K(+) channels. These are GABAergic neurons that send projections to the vagal motor nucleus. Light-induced stimulation of channelrhodospin-expressing GLUT2 neurons in vivo led to increased parasympathetic nerve firing and glucagon secretion. Thus GLUT2 neurons of the nucleus tractus solitarius link hypoglycemia detection to counterregulatory response. These results may help identify the cause of hypoglycemia-associated autonomic failure, a major threat in the insulin treatment of diabetes.

  4. Genetic variation and activity of the renin-angiotensin system and severe hypoglycemia in type 1 diabetes

    DEFF Research Database (Denmark)

    Pedersen-Bjergaard, Ulrik; Dhamrait, Sukhbir S.; Sethi, Amar A

    2008-01-01

    BACKGROUND: The deletion-allele of the angiotensin-converting enzyme (ACE) gene and elevated ACE activity are associated with increased risk of severe hypoglycemia in type 1 diabetes. We explored whether genetic and phenotypic variations in other components of the renin-angiotensin system...... are similarly associated. METHODS: Episodes of severe hypoglycemia were recorded in 171 consecutive type 1 diabetic outpatients during a 1-year follow-up. Participants were characterized at baseline by gene polymorphisms in angiotensinogen, ACE, angiotensin-II receptor types 1 (AT1R) and 2 (AT2R), and by plasma...... angiotensinogen concentration and serum ACE activity. RESULTS: Three risk factors for severe hypoglycemia were identified: plasma angiotensinogen concentration in the upper quartile (relative rate [RR] vs. lower quartile 3.1, 95% confidence interval [CI,] 1.4-6.8), serum ACE activity in the upper quartile (RR vs...

  5. Relative hypoglycemia of rectal insulin suppositories containing deoxycholic acid, sodium taurocholate, polycarbophil, and their combinations in diabetic rabbits.

    Science.gov (United States)

    Hosny, E A

    1999-06-01

    In this study, insulin suppositories containing 50 U insulin incorporated with 50 mg of deoxycholic acid, sodium taurocholate, or both were placed in the rectum of alloxan-induced hyperglycemic rabbits. A large decrease in plasma glucose concentrations was observed, and the relative hypoglycemias were calculated to be 38.0%, 34.9%, and 44.4%, respectively, compared with insulin subcutaneous (s.c.) injection (40 U). Insulin suppositories containing 50 mg polycarbophil alone or mixed with 50 mg deoxycholic acid produced relative hypoglycemia of 43.1% and 42.2%, respectively. The most pronounced effect was observed with the addition of polycarbophil to the suppository formulation containing a combination of deoxycholic acid and sodium taurocholate, which produced a 56% relative hypoglycemia compared with subcutaneous injection. These suppository formulations could be very promising alternatives to the current insulin injections, being roughly half as efficacious as subcutaneous injection.

  6. Elderly patients with diabetes 86 patients hypoglycemia of research%老年糖尿病患者86例低血糖的研究

    Institute of Scientific and Technical Information of China (English)

    戚晓栋; 李蓓

    2011-01-01

    目的 研究86例老年糖尿病患者低血糖的原因及健康教育的干预效果.方法 将我院2009年住院的86例老年糖尿病低血糖患者作为研究对象,分析低血糖的临床表现、危害、防治、原因及干预效果.结果 老年糖尿病患者低血糖的原因是不合理使用降糖药物(38.4%)、不合理使用胰岛素(24.4%)、摄入食物不足(16.3%)、发热感染(11.6%)、运动过量(5.8%)、空腹饮酒(3.5%).经过积极的健康教育和临床治疗,治愈率为100%,其中24.2%患者出现夜间低血糖症状.健康教育后患者的血糖(空腹血糖、餐后2 h血糖、糖化血红蛋白)均在正常范围,与干预前相比差异有统计学意义,P<0.001;自我血糖控制良好(合理饮食、血糖监测、合理运动)的患者数显著多于干预前,P<0.001.结论 老年糖尿病患者低血糖比例较高,加强对患者低血糖预防和治疗的健康教育,对预防低血糖的发生、减轻低血糖的危害有重要意义.%Objective To study the reasons and results of health educations for low blood sugar of 86 cases of elderly patients with diabetes. Methods Take 86 cases of elderly patients with diabetes and low blood sugar who hospitalized in 2009 as research subjects. Analyze the clinical manifestations of hypoglycemia,harm,prevention,causes and intervention.Results The reasons of elderly patients with diabetes and low blood sugar are unreasonably using hypoglycemic agents(38. 4%),unreasonably using insulin(24.4%),inadequate food intake (16.3%),fever,infection (11.6%),excessive movement (5.8% ),fasting alcohol (3.5%). After a positive health education and clinical treatment, the cure rate was 100%, of which 24.2% patients with nocturnal hypoglycemia. After health education, patients' blood glucose (fasting glucose, postprandial 2 h blood glucose, glycosylated hemoglobin)were within normal range,compared with before intervention significantly,P<0.0 01;Self blood glucose control

  7. One-step microwave foaming and curing

    Science.gov (United States)

    Gagliani, J.; Lee, R.; Sorathia, U. A. K.; Wilcoxson, A. L.

    1981-01-01

    Process that combines microwave foaming and curing of polyimide precursors in single step produces fire-resistant foam slabs of much larger volume than has previously been possible. By adding selected conductive fillers to powder precursors and by using high-power microwave oven, foam slabs with dimensions in excess of 61 by 61 by 7.6 cm are made. Typical foaming and curing and curing time is 35 minutes in microwave oven with additional 1 to 2 hour postcure in conventional oven.

  8. A Comparative Study of Blood Glucose Measurements Using Glucometer Readings and the Standard Method in the Diagnosis of Neonatal Hypoglycemia

    Directory of Open Access Journals (Sweden)

    Mohammad Torkaman

    2016-03-01

    Full Text Available Background: Hypoglycemia is one of the most common neonatal disorders, associated with severe complications. There has been a great deal of controversy regarding the definition and screening of hypoglycemia. Therefore, in this study, we aimed to determine a cut-off value for blood glucose level in glucometer readings. Methods: This cross-sectional study was conducted on 238 newborns at risk of hypoglycemia, admitted to Baqiyatallah Hospital of Tehran, Iran in 2012; the subjects were selected via simple sampling. After obtaining informed consents from the newborns’ parents, 1 cc blood samples were sent to the laboratory for measuring the blood glucose level. Moreover, venous blood samples, as well as heel-stick blood samples, were obtained for glucometer measurements. Blood glucose measurements were used to determine the cut-off value by the receiver operating characteristic (ROC curve and make comparisons with the diagnostic criteria for hypoglycemia in the literature. Results: A total of 238 infants with the mean weight of 2869±821.9 g were enrolled in this study. The mean (±SD blood glucose levels were 65.1±22.9, 82.9±24.7, and 84.4±24.8 mg/dl, based on the standard laboratory method, glucometer reading of venous blood samples, and glucometer reading of heel-stick capillary blood samples, respectively. The optimal cut-off point for hypoglycemia was determined as 65 mg/dl, using glucometer-based assessment of heel-stick blood samples. Conclusion: The significant difference in blood glucose levels measured by the laboratory method and outpatient glucometer readings highlights the importance of a cut-off value for rapid assessment and control of blood glucose and timely detection of hypoglycemia. In fact, the cut-off value introduced in the present study could facilitate such measurements.

  9. Acceleration of curing of resin composite at the bottom surface using slow-start curing methods.

    Science.gov (United States)

    Yoshikawa, Takako; Morigami, Makoto; Sadr, Alireza; Tagami, Junji

    2013-01-01

    The aim of this study was to evaluate the effect of two slow-start curing methods on acceleration of the curing of resin composite specimens at the bottom surface. The light-cured resin composite was polymerized using one of three curing techniques: (1) 600 mW/cm(2) for 60 s, (2) 270 mW/cm(2) for 10 s+0-s interval+600 mW/cm(2) for 50 s, and (3) 270 mW/cm(2) for 10 s+5-s interval+600 mW/cm(2) for 50 s. After light curing, Knoop hardness number was measured at the top and bottom surfaces of the resin specimens. The slow-start curing method with the 5-s interval caused greater acceleration of curing of the resin composite at the bottom surface of the specimens than the slow-start curing method with the 0-s interval. The light-cured resin composite, which had increased contrast ratios during polymerization, showed acceleration of curing at the bottom surface.

  10. Diabetic Hypoglycemia

    Science.gov (United States)

    ... prescription at most pharmacies) A serving of glucose gel (read the label for amount) If you have ... the activity. Eat a meal or snack with alcohol, if you choose to drink. Drinking alcohol on ...

  11. Insulin absorption and subcutaneous blood flow in normal subjects during insulin-induced hypoglycemia

    Energy Technology Data Exchange (ETDEWEB)

    Fernqvist-Forbes, E.; Linde, B.; Gunnarsson, R.

    1988-09-01

    We studied the effects of insulin-induced hypoglycemia on the absorption of 10 U /sup 125/I-labeled soluble human insulin injected sc in the thigh in 10 normal subjects. The disappearance of /sup 125/I from the injection site was followed by external gamma-counting. Subcutaneous blood flow (ATBF) was measured concomitantly with the 133Xe washout technique. The plasma glucose nadir (mean, 2.0 +/- 0.1 (+/- SE) mmol/L) occurred at 33 +/- 3 min and resulted in maximal arterial plasma epinephrine concentrations of approximately 6 nmol/L. From 30 min before to 60 min after the glucose nadir the (/sup 125/I)insulin absorption rate was depressed compared to that during normoglycemia. The first order disappearance rate constants were reduced by approximately 50% (P less than 0.01) during the first 30-min interval after the glucose nadir. During the same period ATBF increased by 100% (P less than 0.05). The results suggest that in normal subjects the absorption of soluble insulin from a sc depot is depressed in connection with hypoglycemia, despite considerably elevated ATBF.

  12. Neonatal hypoglycemia: A wide range of electroclinical manifestations and seizure outcomes.

    Science.gov (United States)

    Arhan, Ebru; Öztürk, Zeynep; Serdaroğlu, Ayşe; Aydın, Kürşad; Hirfanoğlu, Tuğba; Akbaş, Yılmaz

    2017-09-01

    We examined the various types of epilepsy in children with neonatal hypoglycemia in order to define electroclinical and prognostic features of these patients. We retrospectively reviewed the medical records of patients with a history of symptomatic neonatal hypoglycaemia who have been followed at Gazi University Hospital Pediatric Neurology Department between 2006 and 2015. Patients with perinatal asphyxia were excluded. Details of each patient's perinatal history, neurological outcome, epilepsy details, seizure outcome and EEG and brain MRI findings were reviewed. Fourty five patients (range 6 mo-15 y) with a history of symptomatic neonatal hypoglycaemia were included the study. Epilepsy developed in 36 patients and 23 of them had intractable epilepsy. All patients had occipital brain injury. We observed that most of the patients, either manifesting focal or generalized seizures, further develop intractable epilepsy. This finding establishes neonatal hypoglycemia as a possible cause to be considered in any case of intractable epilepsy. Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  13. Carcinoid syndrome, acromegaly, and hypoglycemia due to an insulin-secreting neuroendocrine tumor of the liver.

    Science.gov (United States)

    Furrer, J; Hättenschwiler, A; Komminoth, P; Pfammatter, T; Wiesli, P

    2001-05-01

    We report a patient with a hepatic neuroendocrine tumor showing an extraordinary change of the tumor's humoral manifestations from a clinically documented extrapituitary acromegaly and a typical carcinoid syndrome toward a hyperinsulinemic hypoglycemia syndrome. At the primary manifestation of the tumor, an increased serum level of insulin-like growth factor I due to overproduction of GHRH and an increased urinary excretion of 5-hydroxyindoleacetic acid were found. The clinical manifestation of the GHRH excess was an arthralgia, which resolved completely after operative tumor debulking and normalization of insulin-like growth factor I and GHRH serum levels. The secretion of serotonin from the tumor resulted in a typical carcinoid syndrome including right-sided valvular heart disease. On the later course of the disease, the humoral manifestations of the tumor were supplemented by the secretion of insulin, leading to recurrent severe hyperinsulinemic hypoglycemia. The hepatic origin of hyperinsulinism was demonstrated by selective arterial calcium stimulation. Moreover, tumor cells revealed insulin and C-peptide immunoreactivity in the immunohistochemical analysis. The patient died 8 yr after the initial diagnosis of the tumor, and a carefully performed autopsy procedure confirmed the absence of any extrahepatic tumor manifestation.

  14. Hypoglycemia Prevention and User Acceptance of an Insulin Pump System with Predictive Low Glucose Management

    DEFF Research Database (Denmark)

    Choudhary, Pratik; Olsen, Birthe S; Conget, Ignacio

    2016-01-01

    , and evaluated user acceptance via questionnaires. RESULTS: There were 2,322 suspend before low events (2.1 per subject-day). The mean (± SD) duration of pump suspension events was 56.4 ± 9.6 min, and the mean subsequent sensor glucose (SG) nadir was 71.8 ± 5.2 mg/dL. SG values following 1,930 (83......BACKGROUND: The MiniMed 640G sensor-augmented insulin pump system (Medtronic, Inc., Northridge, CA) can automatically suspend insulin delivery in advance of predicted hypoglycemia and restart it upon recovery. The aims of this analysis were to determine the rate at which predicted hypoglycemia...... was avoided with this strategy, as well as to assess user acceptance of the system and its insulin management features. SUBJECTS AND METHODS: Forty subjects with type 1 diabetes used the system for 4 weeks. We retrospectively evaluated performance of the system, using downloaded pump and sensor data...

  15. [Mineral water as a cure].

    Science.gov (United States)

    Nocco, Priska Binz

    2008-01-01

    The treatment of diseases with mineral spring water belongs to the oldest medical therapies. The "remedy" mineral water is therefore of importance also within the pharmacy. The present pharmacy historical work examines the impact of the use of mineral waters, as well as of their dried components, as therapeutic agents in the 19th and early 20th centuries, i.e. from approx. 1810 to 1930, as well as the contributions given by pharmacists in the development and analysis of mineral water springs. Beside these aspects, the aim here is also to describe the role played by pharmacists in the production of artificial mineral water as well as in the sale and wholesale of natural and artificial mineral water. In the first part of this work the situation in Switzerland and its surrounding countries, such as Germany, France, Italy and Austria, is discussed. The second part contains a case-study of the particular situation in the Canton Tessin. It is known from the scientific literature published at that time that information on mineral water was frequently reported. Starting from the beginning of the 19th century the number of such publications increased tremendously. The major part of them were publications in scientific journals or contributions to medical and pharmaceutical manuals and reference books. In particular the spa-related literature, such as spa-guides, was of growing interest to a broad public. The inclusion of monographs into the Swiss, the Cantonal as well the foreign pharmacopoeias granted a legal frame for the mineral waters and their dried components. These works are of major importance from a pharmacy historical standpoint and represent a unique proof of historical evidence of the old medicinal drug heritage. The most frequently used therapies based on mineral waters were drinking and bath cures. Several diseases, particularly those of a chronic character, were treated with mineral waters. The positive influence of these cures on the recovery of the patients

  16. Oral antidiabetic treatment in type-2 diabetes in the elderly: balancing the need for glucose control and the risk of hypoglycemia

    Directory of Open Access Journals (Sweden)

    Bramlage Peter

    2012-10-01

    Full Text Available Abstract Background We aimed at identifying variables predicting hypoglycemia in elderly type 2 diabetic patients and the relation to HbA1c values achieved. Design Prospective, observational registry in 3810 patients in primary care. Comparison of patients in different age tertiles: with an age Results Elderly patients had a later diabetes diagnosis, a longer diabetes duration, better glucose control and more frequent co-morbid disease conditions. Overall 10.7% of patients experienced any severity hypoglycemia within the last 12 months prior to inclusion. Higher rates of hypoglycemia were observed in the elderly than in the young after adjusting for differences in HbA1c, fasting and post-prandial blood glucose (OR 1.68; 95%CI 1.16-2.45. This was particularly true for hypoglycemic episodes without specific symptoms (OR 1.74; 95%CI 1.05-2.89. In a multivariate model stroke / transitory ischemic attack, the presence of heart failure, clinically relevant depression, sulfonylurea use and blood glucose self-measurement were associated with hypoglycemic events. Conclusion Elderly patients are at an increased risk of hypoglycemia even at comparable glycemic control. Therefore identified variables associated with hypoglycemia in the elderly such as heart failure, clinically relevant depression, the use of sulfonylurea help to optimize the balance between glucose control and low levels of hypoglycemia. Asymptomatic hypoglycemia should not be disregarded as irrelevant but considered as a sign of possible hypoglycemia associated autonomic failure.

  17. Kinetic studies of chemical shrinkage and residual stress formation in thermoset epoxy adhesives under confined curing conditions

    Science.gov (United States)

    Schumann, M.; Geiß, P. L.

    2015-05-01

    Faultless processing of thermoset polymers in demanding applications requires a profound mastering of the curing kinetics considering both the physico-chemical changes in the transition from the liquid to the solid state and the consolidation of the polymers network in the diffusion controlled curing regime past the gel point. Especially in adhesive joints shrinkage stress occurring at an early state of the curing process under confined conditions is likely to cause defects due to local debonding and thus reduce their strength and durability1. Rheometry is considered the method of choice to investigate the change of elastic and viscous properties in the progress of curing. Drawbacks however relate to experimental challenges in accessing the full range of kinetic parameters of thermoset resins with low initial viscosity from the very beginning of the curing reaction to the post-cure consolidation of the polymer due to the formation of secondary chemical bonds. Therefore the scope of this study was to interrelate rheological data with results from in-situ measurements of the shrinkage stress formation in adhesive joints and with the change of refractive index in the progress of curing. This combination of different methods has shown to be valuable in gaining advanced insight into the kinetics of the curing reaction. The experimental results are based on a multi component thermoset epoxy-amine adhesive.

  18. Effects of feeding high protein or conventional canola meal on dry cured and conventionally cured bacon.

    Science.gov (United States)

    Little, K L; Bohrer, B M; Stein, H H; Boler, D D

    2015-05-01

    Objectives were to compare belly, bacon processing, bacon slice, and sensory characteristics from pigs fed high protein canola meal (CM-HP) or conventional canola meal (CM-CV). Soybean meal was replaced with 0 (control), 33, 66, or 100% of both types of canola meal. Left side bellies from 70 carcasses were randomly assigned to conventional or dry cure treatment and matching right side bellies were assigned the opposite treatment. Secondary objectives were to test the existence of bilateral symmetry on fresh belly characteristics and fatty acid profiles of right and left side bellies originating from the same carcass. Bellies from pigs fed CM-HP were slightly lighter and thinner than bellies from pigs fed CM-CV, yet bacon processing, bacon slice, and sensory characteristics were unaffected by dietary treatment and did not differ from the control. Furthermore, testing the existence of bilateral symmetry on fresh belly characteristics revealed that bellies originating from the right side of the carcasses were slightly (P≤0.05) wider, thicker, heavier and firmer than bellies from the left side of the carcass.

  19. Light-cured resin for post patterns.

    Science.gov (United States)

    Waldmeier, M D; Grasso, J E

    1992-09-01

    A method of using light-cured acrylic resin as an alternative to the use of chemically-cured acrylic resins with elastomeric impressions for direct post patterns is presented. The GC Unifast LC acrylic resin is a powder/liquid type resin cured by exposure to visible light. The polymerization process has four stages before final curing: slurry, stringy, dough-like (plastic), and rubber-like (elastic). Advantages over current direct and indirect procedures include ease of manipulation of the material and no change in laboratory handling procedures. While in the dough-like state, the material can be contoured. In the rubber-like state, it is flexible to disengage from minor undercut areas.

  20. Fast Curing of Composite Wood Products

    Energy Technology Data Exchange (ETDEWEB)

    Dr. Arthur J. Ragauskas

    2006-04-26

    The overall objective of this program is to develop low temperature curing technologies for UF and PF resins. This will be accomplished by: • Identifying the rate limiting UF and PF curing reactions for current market resins; • Developing new catalysts to accelerate curing reactions at reduced press temperatures and times. In summary, these new curing technologies will improve the strength properties of the composite wood products and minimize the detrimental effects of wood extractives on the final product while significantly reducing energy costs for wood composites. This study is related to the accelerated curing of resins for wood composites such as medium density fiberboard (MDF), particle board (PB) and oriented strandboard (OSB). The latter is frequently manufactured with a phenol-formaldehyde resin whereas ureaformaldehyde (UF) resins are usually used in for the former two grades of composite wood products. One of the reasons that hinder wider use of these resins in the manufacturing of wood composites is the slow curing speed as well as inferior bondability of UF resin. The fast curing of UP and PF resins has been identified as an attractive process development that would allow wood to be bonded at higher moisture contents and at lower press temperatures that currently employed. Several differing additives have been developed to enhance cure rates of PF resins including the use of organic esters, lactones and organic carbonates. A model compound study by Conner, Lorenz and Hirth (2002) employed 2- and 4-hydroxymethylphenol with organic esters to examine the chemical basis for the reported enhanced reactivity. Their studies suggested that the enhance curing in the presence of esters could be due to enhanced quinone methide formation or enhanced intermolecular SN2 reactions. In either case the esters do not function as true catalysts as they are consumed in the reaction and were not found to be incorporated in the polymerized resin product. An

  1. Effect of cure cycle on curing process and hardness for epoxy resin

    Directory of Open Access Journals (Sweden)

    2009-09-01

    Full Text Available A 3-dimensional finite element model is developed to simulate and analyze the temperature and degree of cure field of epoxy casting part during cure process. The present model based on general finite element software ABAQUS is verified by literature example and experimental data. The numerical results show good agreement with literature example and measured data, and are even more accurate than the simulation of literature. After modeling successfully, the influence of temperature cure cycle ramps have on the temperature and degree of cure gradient is investigated. Moreover, the effect of non-uniform temperature and degree of cure field within epoxy casting part on hardness is demonstrated. The present model provides an accurate and novel method that allows further insight into the process of cure for epoxy resin.

  2. EVALUATION OF DIELECTRIC CURING MONITORING INVESTIGATING LIGHT-CURING DENTAL FILLING COMPOSITES

    Directory of Open Access Journals (Sweden)

    Johannes Steinhaus

    2011-05-01

    Full Text Available The aim of this study is the evaluation of a dielectric analysis (DEA method monitoring the curing behaviour of a light curing dental filling material in real-time. The evaluation is to extract the influence of light intensity on the photo-curing process of dental composite filling materials. The intensity change is obtained by measuring the curing process at different sample depth. It could be shown that increasing sample thickness, and therefore exponentially decreasing light intensity, causes a proportional decrease in the initial curing rate. Nevertheless, the results give rise to the assumption that lower illumination intensities over a long period cause higher overall conversion, and thus better mechanical properties. This would allow for predictions of the impact of different curing-rates on the final mechanical properties.

  3. High Power UV LED Industrial Curing Systems

    Energy Technology Data Exchange (ETDEWEB)

    Karlicek, Robert, F., Jr; Sargent, Robert

    2012-05-14

    UV curing is a green technology that is largely underutilized because UV radiation sources like Hg Lamps are unreliable and difficult to use. High Power UV LEDs are now efficient enough to replace Hg Lamps, and offer significantly improved performance relative to Hg Lamps. In this study, a modular, scalable high power UV LED curing system was designed and tested, performing well in industrial coating evaluations. In order to achieve mechanical form factors similar to commercial Hg Lamp systems, a new patent pending design was employed enabling high irradiance at long working distances. While high power UV LEDs are currently only available at longer UVA wavelengths, rapid progress on UVC LEDs and the development of new formulations designed specifically for use with UV LED sources will converge to drive more rapid adoption of UV curing technology. An assessment of the environmental impact of replacing Hg Lamp systems with UV LED systems was performed. Since UV curing is used in only a small portion of the industrial printing, painting and coating markets, the ease of use of UV LED systems should increase the use of UV curing technology. Even a small penetration of the significant number of industrial applications still using oven curing and drying will lead to significant reductions in energy consumption and reductions in the emission of green house gases and solvent emissions.

  4. Comparative study on compressive strength of Self cured SCC and Normally cured SCC

    Directory of Open Access Journals (Sweden)

    Ms. Akanksha A. Patil

    2014-11-01

    Full Text Available Curing is the process of maintaining proper moisture content particularly within 28 days to promote optimum cement hydration immediately after placement. Self-compacting concrete is made up of admixture i.e. superplasticizer. In recent years, self-compacting concrete (SCC has gained wide use for placement in congested reinforced concrete structures with difficult casting conditions. Also various curing methods are adopted in the construction industry especially for vertical structures, inaccessible areas s.a. high rise buildings, water scarce areas etc. In such structures conventional curing is not practically possible in most of the cases. But we need efficient curing which improves the strength and durability of concrete. In the present work, comparison of compressive strength of normally cured SCC and SCC cured with self curing material i.e. wax based, white pigmented, membrane forming concrete curing compound has been done. This study is investigating that weather the use of self curing compound is economical or not in remote areas of water without compromising with the compressive strength of concrete.

  5. Cure fraction estimation from the mixture cure models for grouped survival data.

    Science.gov (United States)

    Yu, Binbing; Tiwari, Ram C; Cronin, Kathleen A; Feuer, Eric J

    2004-06-15

    Mixture cure models are usually used to model failure time data with long-term survivors. These models have been applied to grouped survival data. The models provide simultaneous estimates of the proportion of the patients cured from disease and the distribution of the survival times for uncured patients (latency distribution). However, a crucial issue with mixture cure models is the identifiability of the cure fraction and parameters of kernel distribution. Cure fraction estimates can be quite sensitive to the choice of latency distributions and length of follow-up time. In this paper, sensitivity of parameter estimates under semi-parametric model and several most commonly used parametric models, namely lognormal, loglogistic, Weibull and generalized Gamma distributions, is explored. The cure fraction estimates from the model with generalized Gamma distribution is found to be quite robust. A simulation study was carried out to examine the effect of follow-up time and latency distribution specification on cure fraction estimation. The cure models with generalized Gamma latency distribution are applied to the population-based survival data for several cancer sites from the Surveillance, Epidemiology and End Results (SEER) Program. Several cautions on the general use of cure model are advised.

  6. Glucokinase mutation–a rare cause of recurrent hypoglycemia in adults: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Oluremi N. Ajala

    2016-10-01

    Full Text Available Background: Hypoglycemia occurs frequently in patients both in the inpatient and outpatient settings. While most hypoglycemia unrelated to diabetes treatment results from excessive endogenous insulin action, rare cases involve functional and congenital mutations in glycolytic enzymes of insulin regulation. Case: A 21-year-old obese woman presented to the emergency department with complaints of repeated episodes of lethargy, syncope, dizziness, and sweating. She was referred from an outside facility on suspicion of insulinoma, with severe hypoglycemia unresponsive to repeated dextrose infusions. Her plasma glucose was 20 mg/dl at presentation, 44 mg/dl on arrival at our facility, and remained low in spite of multiple dextrose infusions. The patient had been treated for persistent hyperinsulinemic hypoglycemia of infancy at our neonatal facility and 4 years ago was diagnosed as having an activating glucokinase (GCK mutation. She was then treated with octreotide and diazoxide with improvement in symptoms and blood glucose levels. Conclusion: Improved diagnostication and management of uncommon genetic mutations as typified in this patient with an activating mutation of the GCK gene has expanded the spectrum of disease in adult medicine. This calls for improved patient information dissemination across different levels and aspects of the health care delivery system to ensure cost-effective and timely health care.

  7. A novel syndrome of autosomal-dominant hyperinsulinemic hypoglycemia linked to a mutation in the human insulin receptor gene

    DEFF Research Database (Denmark)

    Højlund, Kurt; Hansen, Torben; Lajer, Maria

    2004-01-01

    a missense mutation (Arg1174Gln) in the tyrosine kinase domain of the insulin receptor gene that cosegregated with the disease phenotype (logarithm of odds [LOD] score 3.21). In conclusion, we report a novel syndrome of autosomal-dominant hyperinsulinemic hypoglycemia. The findings demonstrate...

  8. Association between regional cerebral blood flow during hypoglycemia and genetic and phenotypic traits of the renin-angiotensin system

    DEFF Research Database (Denmark)

    Bie-Olsen, Lise Grimmeshave; Pedersen-Bjergaard, Ulrik; Kjaer, Troels Wesenberg;

    2009-01-01

    The risk of severe hypoglycemia in patients with type I diabetes and high basal activity in the renin-angiotensin system (RAS) is significantly higher than in patients with low basal RAS activity. In healthy men, we tested the hypothesis that differences in spontaneous RAS activity are associated...

  9. Food Insecurity is Associated with Hypoglycemia and Poor Diabetes Self-Management in a Low-Income Sample with Diabetes

    Science.gov (United States)

    Seligman, Hilary K.; Davis, Terry C.; Schillinger, Dean; Wolf, Michael S.

    2010-01-01

    More than 14% of the American population is food insecure, or at risk of going hungry because of an inability to afford food. Food-insecure (FI) adults often reduce food intake or substitute inexpensive, energy-dense carbohydrates for healthier foods. We hypothesized these behaviors would predispose FI adults with diabetes to impaired diabetes self-management and hypoglycemia. We therefore assessed whether food insecurity was associated with multiple indicators of diabetes self-management (self-efficacy, medication- and glucose-monitoring adherence, hypoglycemia, or glycemic control) among 40 low-income adults with diabetes. Mean self-efficacy score was lower among FI than food-secure (FS) participants (34.4 vs. 41.2, p=.02). Food-insecure participants reported poorer adherence to blood glucose monitoring (RR=3.5, p=.008) and more hypoglycemia-related emergency department visits (RR=2.2, p=.007). Mean hemoglobin A1c was 9.2% among FI and 7.7% among FS participants (p=.08). Food insecurity is a barrier to diabetes self-management and a risk factor for clinically significant hypoglycemia. PMID:21099074

  10. Genetic variation and activity of the renin-angiotensin system and severe hypoglycemia in type 1 diabetes

    DEFF Research Database (Denmark)

    Pedersen-Bjergaard, U.; Dhamrait, S.S.; Sethi, A.A.;

    2008-01-01

    BACKGROUND: The deletion-allele of the angiotensin-converting enzyme (ACE) gene and elevated ACE activity are associated with increased risk of severe hypoglycemia in type 1 diabetes. We explored whether genetic and phenotypic variations in other components of the renin-angiotensin system...

  11. NT-pro-BNP during hypoglycemia and hypoxemia in normal subjects: Impact of renin-angiotensin system activity

    NARCIS (Netherlands)

    R. Due-Andersen (Rikke); U. Pedersen-Bjergaard (Ullrik); T. Høi-Hansen (Thomas); N.V. Olsen; C. Kistorp; J. Faber (Joerg); F. Boomsma (Frans); B. Thorsteinsson (Birger)

    2008-01-01

    textabstractBrain-derived natriuretic peptide (BNP) is a cardioprotective peptide released, together with the inactive NH2-terminal part of its prohormone (NT-pro-BNP), in response to different kinds of myocardial stress. Hypoglycemia and hypoxemia are conditions that threaten cellular function and

  12. Acarbose reduces the risk of pre-lunch hypoglycemia in elderly people with diabetes eating rice porridge for breakfast.

    Science.gov (United States)

    Hsieh, Ching Jung

    2010-09-01

    To decrease the risk of postprandial hyperglycemia and late hypoglycemia in elderly people with diabetes who eat rice porridge for breakfast, we administered 50mg acarbose to 30 elderly people with type 2 diabetes. The results demonstrated that acarbose could prevent the fluctuations in post-breakfast blood glucose levels.

  13. Rapid-onset hypoglycemia suppresses Fos expression in discrete parts of the ventromedial nucleus of the hypothalamus.

    Science.gov (United States)

    Foster, Nicholas N; Azam, Sana; Watts, Alan G

    2016-06-01

    The consensus view of the ventromedial nucleus of the hypothalamus (VMH) is that it is a key node in the rodent brain network controlling sympathoadrenal counterregulatory responses to hypoglycemia. To identify the location of hypoglycemia-responsive neurons in the VMH, we performed a high spatial resolution Fos analysis in the VMH of rats made hypoglycemic with intraperitoneal injections of insulin. We examined Fos expression in the four constituent parts of VMH throughout its rostrocaudal extent and determined their relationship to blood glucose concentrations. Hypoglycemia significantly decreased Fos expression only in the dorsomedial and central parts of the VMH, but not its anterior or ventrolateral parts. Moreover, the number of Fos-expressing neurons was significantly and positively correlated in the two responsive regions with terminal blood glucose concentrations. We also measured Fos responses in the paraventricular nucleus of the hypothalamus (PVH) and in several levels of the periaqueductal gray (PAG), which receives strong projections from the VMH. We found the expected and highly significant increase in Fos in the neuroendocrine PVH, which was negatively correlated to terminal blood glucose concentrations, but no significant differences were seen in any part of the PAG. Our results show that there are distinct populations of VMH neurons whose Fos expression is suppressed by hypoglycemia, and their numbers correlate with blood glucose. These findings support a clear division of glycemic control functions within the different parts of the VMH.

  14. Voglibose administration before the evening meal improves nocturnal hypoglycemia in insulin-dependent diabetic patients with intensive insulin therapy.

    Science.gov (United States)

    Taira, M; Takasu, N; Komiya, I; Taira, T; Tanaka, H

    2000-04-01

    Nocturnal hypoglycemia is one of the serious complications of intensive insulin therapy in patients with insulin-dependent diabetes mellitus (IDDM; type 1 DM). We assessed the effect of voglibose (alpha-glucosidase inhibitor) administration before the evening meal on nocturnal hypoglycemia in IDDM patients with intensive insulin therapy. Ten IDDM patients received 0.3 mg voglibose just before the evening meal for 5 days. The diet and insulin regimen were not changed throughout the study. Nocturnal plasma glucose levels (10 PM, 3 AM, and 7 AM) were studied in these patients before and during voglibose administration. Blood glucose levels were measured at 3 AM before and during voglibose treatment. The mean plasma glucose level at 3 AM was 3.4+/-0.4 mmol/L before voglibose treatment and 7.3+/-1.0 mmol/L during treatment. Plasma glucose at 3 AM was elevated in 9 of 10 patients with voglibose. The decrease in plasma glucose from 10 PM to 3 AM was 6.5+/-0.8 mmol/L before voglibose administration but 3.2+/-0.9 mmol/L during treatment (P hypoglycemia rate was 52% (17 of 33 nights) before voglibose administration but only 9.1% (3 of 33 nights) during treatment. We conclude that voglibose administration before the evening meal improves nocturnal hypoglycemia in IDDM patients with intensive insulin therapy.

  15. Disease burden evaluation of fall-related events in the elderly due to hypoglycemia and other diabetic complications: a clinical review

    Directory of Open Access Journals (Sweden)

    Malabu UH

    2014-08-01

    Full Text Available Usman H Malabu,1 Venkat N Vangaveti,1 Richard Lee Kennedy2 1School of Medicine and Dentistry, James Cook University, QLD, Australia; 2Department of Medicine, Deakin University, VIC, Australia Abstract: A hypoglycemia-induced fall is common in older persons with diabetes. The etiology of falls in this population is usually multifactorial, and includes microvascular and macrovascular complications and age-related comorbidities, with hypoglycemia being one of the major precipitating causes. In this review, we systematically searched the literature that was available up to March 31, 2014 from MEDLINE/PubMed, Embase, and Google Scholar using the following terms: hypoglycemia; insulin; diabetic complications; and falls in elderly. Hypoglycemia, defined as blood glucose <4.0 mmol/L (70 mg/dL requiring external assistance, occurs in one-third of elderly diabetics on glucose-lowering therapies. It represents a major barrier to the treatment of diabetes, particularly in the elderly population. Patients who experience hypoglycemia are at a high risk for adverse outcomes, including falls leading to bone fracture, seizures, cognitive dysfunction, and prolonged hospital stays. An increase in mortality has been observed in patients who experience any one of these events. Paradoxically, rational insulin therapy, dosed according to a patient's clinical status and the results of home blood glucose monitoring, so as to achieve and maintain recommended glycemic goals, can be an effective method for the prevention of hypoglycemia and falls in the elderly. Contingencies, such as clinician-directed hypoglycemia treatment protocols that guide the immediate treatment of hypoglycemia, help to limit both the duration and severity of the event. Older diabetic patients with or without underlying renal insufficiency or other severe illnesses represent groups that are at high risk for hypoglycemia-induced falls and, therefore, require lower insulin dosages. In this review

  16. On the diagnosis of hypoglycemia in car drivers--including a review of the literature.

    Science.gov (United States)

    Kernbach-Wighton, G; Sprung, R; Püschel, K

    2001-01-01

    Hypoglycemia may reach forensic relevance concerning the psychophysical ability of running a car and with respect to a possible imputability. Our retrospective study included anamnesis and clinical symptoms observed in drivers with impaired performance to point out correlations between biochemical parameters and the actual course of the disease and its sequelae on roadworthiness. Clinical-biochemical estimations were performed on glucose, lactic acid and ethanol including a toxicological screening. It is proposed to utilize the estimation of glucose and lactic acid (the so-called combined value) in blood samples taken on behalf of the police as an important hint to the actual state of glucose metabolism. The anamnesis and the symptomatology may complete the biochemical analyses.

  17. Abnormal Nocturnal Behavior due to Hypoglycemia in a Patient with Type 2 Diabetes.

    Science.gov (United States)

    Yang, Kwang Ik; Kim, Hyung Ki; Baek, Jeehun; Kim, Doh-Eui; Park, Hyung Kook

    2016-04-15

    Abnormal nocturnal behavior can have many causes, including primary sleep disorder, nocturnal seizures, and underlying medical or neurological disorders. A 79-year-old woman with type 2 diabetes was admitted for evaluation of abnormal nocturnal behavior. Every night at around 04:30 she was observed displaying abnormal behavior including leg shaking, fumbling with bedclothes, crawling around the room with her eyes closed, and non-responsiveness to verbal communication. Polysomnography with 20-channel electroencephalography (EEG) was performed. EEG showed that the posterior dominant rhythm was slower than that observed in the initial EEG, with diffuse theta and delta activities intermixed, and no epileptiform activity. The serum glucose level was 35 mg/dL at that time, and both the EEG findings and clinical symptoms were resolved after an intravenous injection of 50 mL of 50% glucose. These results indicate that nocturnal hypoglycemia should be considered as one of the possible etiologies in patients presenting with abnormal nocturnal behavior.

  18. A 36-year-old man with vomiting, pain abdomen, significant weight loss, hyponatremia, and hypoglycemia

    Directory of Open Access Journals (Sweden)

    Deepti Mutreja

    2015-01-01

    Full Text Available Diagnosis of Strongyloides stercoralis hyperinfection can be a challenge. The key to a timely diagnosis is to have a high index of suspicion. We present a rare case of a 36-year-old human immunodeficiency virus negative male patient, who was on multidrug therapy for lepromatous leprosy and was treated for type 2 lepra reactions with steroids in the past. The patient presented with vomiting and pain abdomen, persistent hyponatremia, and terminal hypoglycemia. He had features of malnutrition and had a rapid downhill course following admission. A diagnosis of S. stercoralis hyperinfection with sepsis and multiorgan failure, adrenal hemorrhage, and syndrome of inappropriate antidiuretic hormone secretion was established on a postmortem examination.

  19. Metastatic extrapleural malignant solitary fibrous tumor presenting with hypoglycemia (Doege–Potter syndrome

    Directory of Open Access Journals (Sweden)

    Andrew J. Degnan, MD, MPhil

    2017-03-01

    Full Text Available We report a rare case of metastatic malignant solitary fibrous tumor (SFT that presented with hypoglycemia because of insulin growth factor-2 production. Initial workup included computed tomography imaging that revealed a large, partially necrotic liver mass, a hypervascular pancreatic head lesion, and 2 renal lesions. Following hepatic resection, pancreatic head resection and nephrectomy, all these lesions demonstrated pathological findings that were consistent with SFT. The patient also had a history of an intracranial mass that had been previously resected and treated with gamma knife therapy at an outside institution, which was found to also be SFT. Six months after initial pancreatic head resection, the patient developed a new lesion involving the pancreatic tail that was found to represent recurrent metastatic SFT. This case emphasizes the highly aggressive nature of extrapleural SFT, while rare, and the role of imaging in follow-up for disease recurrence.

  20. Continuous subcutaneous infusion of glucagon by portable pump in non beta cell tumor hypoglycemia.

    Science.gov (United States)

    Houlbert, D; Altman, J J; Lageron, A; Capeau, J; Dahan, R; Friedberg, G; Wassef, M; Poffenbarger, P L; Segrestaa, J M

    1985-04-01

    Subcutaneous infusion of glucagon by portable pump appears to give very effective symptomatic relief from non beta cell tumor hypoglycemia when surgery, radiotherapy and chemotherapy are impossible or ineffective. This mode of glucagon administration was proposed in a patient who had severe nocturnal hypoglycemic attacks. The aim of the study was to specify the modes of utilization and to test the efficiency and the tolerance of this treatment. Glucagon was infused at 400 micrograms/h during every 12 hour night. Because of the hepatic action of glucagon it is very important to use this treatment with an adequate diet and to stop the infusion during the day to reconstitute the glycogen overload. This mode of glucagon administration was very effective in over 6 months of use and well tolerated.

  1. [Glycogen storage disease type IX presenting as abdominal distention, hepatomegaly and hypoglycemia during infancy].

    Science.gov (United States)

    Soler Palacín, P; Tomasa Wörner, N; Sánchez de Toledo Sancho, J; Yeste Fernández, D; Gussinyé Canadell, M; Carrascosa Lezcano, A

    2004-11-01

    Glycogen storage diseases are a rare group of disorders in daily pediatric practice but must be taken into account when a patient presents with poor physical growth, hepatomegaly, hypoglycemia, hypotonia and/or other metabolic disturbances. Early diagnosis allows treatment that might improve the patient's outcome to be started or, at the very least, genetic counseling to be given to the parents. We present a 10-month-old boy who presented with growth retardation, abdominal distention and hepatomegaly and who was finally diagnosed with glycogenosis type IX. Definitive diagnosis was obtained by demonstrating the enzyme defect (phosphorylase beta-kinase) in affected tissues. Enteral nutrition was started using a diurnal high-carbohydrate diet with frequent feedings and nocturnal nasogastric continuous feeding, achieving optimal growth parameters and clinical response.

  2. Hyperinsulinemic hypoglycemia due to diffuse nesidioblastosis in adults: A case report

    Institute of Scientific and Technical Information of China (English)

    Ran Hong; Dong-Youl Choi; Sung-Chul Lim

    2008-01-01

    Persistent hyperinsulinemic hypoglycemia is caused most commonly by an insulinoma in adults or by nesidioblastosis in neonates. In adults, nesidioblastosis is a rare disorder characterized by diffuse or disseminated proliferation of islet cells. We recently encountered a case of nesidioblastosis in an adult. A 71-year-old man was admitted due to intermittent general weakness, abdominal pain, and mild dyspnea. The patient underwent a subtotal gastrectomy for a gastric adenocarcinoma two years ago. After 5 d of admission, the patient showed symptoms of cold sweating, chilling, and hypotension 30 rain after eating. Thereafter,he frequently showed similar symptoms accounting for hypoglycemia regardless of food consumption. Laboratory findings revealed a low fasting blood glucose level (25 mg/dL), and a high insulin level (47 μIU/mL). Selective intra-arterial calcium stimulation with hepatic venous sampling (ASVS) was performed to localize a mass and revealed an increased insulin level about four-fold that of the normal fasting level at 60 s in the splenic artery, which suggested the presence of an insulinoma in the tail of pancreas. A distal pancreatectomy was performed. Neither intraoperative exploration nor a frozen biopsy specimen detected any mass-forming lesion. On the histological examination, many of the islets were enlarged and irregularly shaped in all specimens, the arrangement of which was a Iobulated islet pattern. Cytologically, a considerable subpopulation of endocrine cells showed enlarged and hyperchromatic nuclei. By immunohistochemistry, the cells were identified as β-cells. These clinical, radiological, microscopic and immuno-histochemical findings are consistent with diffuse nesidioblastosis in adults.

  3. Efficacy of an Overnight Predictive Low-Glucose Suspend System in Relation to Hypoglycemia Risk Factors in Youth and Adults With Type 1 Diabetes.

    Science.gov (United States)

    Calhoun, Peter M; Buckingham, Bruce A; Maahs, David M; Hramiak, Irene; Wilson, Darrell M; Aye, Tandy; Clinton, Paula; Chase, Peter; Messer, Laurel; Kollman, Craig; Beck, Roy W; Lum, John

    2016-11-01

    We developed a system to suspend insulin pump delivery overnight when the glucose trend predicts hypoglycemia. This predictive low-glucose suspend (PLGS) system substantially reduces nocturnal hypoglycemia without an increase in morning ketosis. Evaluation of hypoglycemia risk factors that could potentially influence the efficacy of the system remains critical for understanding possible problems with the system and identifying patients that may have the greatest benefit when using the system. The at-home randomized trial consisted of 127 study participants with hemoglobin A1c (A1C) of ≤8.5% (mmol/mol) for patients aged 4-14 years and ≤8.0% for patient aged 15-45 years. Factors assessed included age, gender, A1C, diabetes duration, daily percentage basal insulin, total daily dose of insulin (units/kg-day), bedtime BG, bedtime snack, insulin on board, continuous glucose monitor (CGM) rate of change (ROC), day of the week, time system activated, daytime exercise intensity, and daytime CGM-measured hypoglycemia. The PLGS system was effective in preventing hypoglycemia for each factor subgroup. There was no evidence that the PLGS system was more or less effective in preventing hypoglycemia in any one subgroup compared with the other subgroups based on that factor. In addition, the effect of the system on overnight hyperglycemia did not differ in subgroups. The PLGS system tested in this study effectively reduced hypoglycemia without a meaningful increase in hyperglycemia across a variety of factors. © 2016 Diabetes Technology Society.

  4. HEAT-RESISTANT COMPOSITES CURED BY ELECTRON BEAM

    Institute of Scientific and Technical Information of China (English)

    Jian-wen Bao; Yang Li; Xiang-bao Chen; Feng-mei Li

    2001-01-01

    Electron beam (EB) curing of composites has many advantages. Heat-resistant EB-curing composites could substitute polyimide composites used in aeronautical engines. In this paper, the effects of catalyst and dose on the cured resin were investigated. The heat-resistance of the resin cured by EB was evaluated by dynamic mechanical analysis (DMA). The experimental results show that the mechanical properties of the composites cured by EB could meet the specifications of aeronautical engines at 250°C.

  5. Assessment of Curing Efficiency and Effect of Moist Curing on Performance of Fly Ash Concrete

    Institute of Scientific and Technical Information of China (English)

    LI Meili; QIAN Jueshi; WANG Lixia; XU Shanshan; JIA Xingwen; FAN Yunyan

    2011-01-01

    This study was conducted to evaluate the sensitivity of compressive strength,water permeability and electrical resistance of near-surface layer concrete with different fly ash contents to curing conditions. It is shown that the sensitivity to curing condition and fly ash content descends in the following order: difference between internal and surface resistivity (ρ)at 28 days, water permeability and compressive strength; both of longer duration of moist curing and use of fly ash in concrete enhanced the water penetration resistance. It is indicated that the resistivity difference p at 28 days can reflect accurately the curing history of fly ash concrete regardless of mix proportions; and use of fly ash in concrete requires longer moist curing duration.

  6. Hypoglycemia and Medical Expenses in Patients with Type 2 Diabetes Mellitus: An Analysis Based on the Korea National Diabetes Program Cohort

    Science.gov (United States)

    Chon, Suk; Ahn, Kyu Jeung; Kim, Sung Hoon; Baik, Sei Hyun; Park, Yong Soo; Nam, Moon Suk; Lee, Kwan Woo; Woo, Jeong-Taek; Kim, Young Seol

    2016-01-01

    Background and Aims Hypoglycemia is one of the most important adverse events in individuals with type 2 diabetes mellitus (T2DM). However, hypoglycemia-related events are usually overlooked and have been documented less in clinical practice. Materials and Methods We evaluated the incidence, clinical characteristics, and medical expenses of hypoglycemia related events in T2DM patients based on the Korea National Diabetes Program (KNDP), which is the largest multi-center, prospective cohort in Korea (n = 4,350). For accurate outcomes, the KNDP data were merged with claims data from the Health Insurance Review and Assessment Service (HIRA) of Korea. Results During a median follow-up period of 3.23 years (95% CI: 3.14, 3.19), 88 subjects (2.02%) were newly diagnosed with hypoglycemia, and the incidence of hypoglycemia was 6.44 cases per 1,000 person-years (PY). Individuals with hypoglycemia were significantly older (59.7±10.7 vs. 53.3±10.4 years, p < 0.001), had more hospital visits (121.94±126.88 days/PY, p < 0.001), had a longer hospital stays (16.13±29.21 days/PY, p < 0.001), and incurred greater medical costs ($2,447.56±4,056.38 vs. $1,336.37±3,403.39 /PY, p < 0.001) than subjects without hypoglycemia. Conclusion Hypoglycemia-related events were infrequently identified among the medical records of T2DM subjects. However, they were associated significantly with poor clinical outcomes, and thus, hypoglycemia could have a substantial burden on the Korean national healthcare system. PMID:26890789

  7. Hypoglycemia and Medical Expenses in Patients with Type 2 Diabetes Mellitus: An Analysis Based on the Korea National Diabetes Program Cohort.

    Directory of Open Access Journals (Sweden)

    Sang Youl Rhee

    Full Text Available Hypoglycemia is one of the most important adverse events in individuals with type 2 diabetes mellitus (T2DM. However, hypoglycemia-related events are usually overlooked and have been documented less in clinical practice.We evaluated the incidence, clinical characteristics, and medical expenses of hypoglycemia related events in T2DM patients based on the Korea National Diabetes Program (KNDP, which is the largest multi-center, prospective cohort in Korea (n = 4,350. For accurate outcomes, the KNDP data were merged with claims data from the Health Insurance Review and Assessment Service (HIRA of Korea.During a median follow-up period of 3.23 years (95% CI: 3.14, 3.19, 88 subjects (2.02% were newly diagnosed with hypoglycemia, and the incidence of hypoglycemia was 6.44 cases per 1,000 person-years (PY. Individuals with hypoglycemia were significantly older (59.7±10.7 vs. 53.3±10.4 years, p < 0.001, had more hospital visits (121.94±126.88 days/PY, p < 0.001, had a longer hospital stays (16.13±29.21 days/PY, p < 0.001, and incurred greater medical costs ($2,447.56±4,056.38 vs. $1,336.37±3,403.39 /PY, p < 0.001 than subjects without hypoglycemia.Hypoglycemia-related events were infrequently identified among the medical records of T2DM subjects. However, they were associated significantly with poor clinical outcomes, and thus, hypoglycemia could have a substantial burden on the Korean national healthcare system.

  8. Correlates and outcomes of worries about hypoglycemia in family members of adults with diabetes: The second Diabetes Attitudes, Wishes and Needs (DAWN2) study.

    Science.gov (United States)

    Nefs, Giesje; Pouwer, François; Holt, Richard I G; Skovlund, Søren; Hermanns, Norbert; Nicolucci, Antonio; Peyrot, Mark

    2016-10-01

    We examined (a) the demographic and clinical correlates of worries about hypoglycemia in adult family members of adults with diabetes, and (b) the association of these worries with measures of diabetes support. The second multinational Diabetes Attitudes, Wishes and Needs (DAWN2) study cross-sectionally surveyed 2057 family members from 17 countries. Participants completed questions about demographics, diabetes, and psychosocial functioning, including worry about overall and nocturnal hypoglycemia. Analyses included hierarchical ordinal and linear regression. Eighty-five percent of family members (n=1661) were at least occasionally very worried about the risk of hypoglycemic events overall. Correlates of worries about hypoglycemia included female gender, higher age and lower education in the family member, younger age of the person with diabetes and this person being a parent or another adult (versus spouse or partner), insulin or non-insulin injectable treatment, severe or non-severe hypoglycemia in the past 12months, and family member recognition of hypoglycemia. Elevated worries about hypoglycemia had a significant independent association with increased odds of diabetes-related family arguments and family member frustration in providing helpful support (OR range 1.60-3.72). High levels of worries about hypoglycemia were associated with increased odds of attending diabetes-related health-care visits. Worries about hypoglycemia were not associated with family member involvement in diabetes care. Similar results were found for worries about nocturnal events. Worries about hypoglycemia were common in family members and were associated with suboptimal diabetes support. This issue therefore deserves increased clinician attention. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Curing kinetics and morphology of a nanovesicular epoxy/stearyl-block-poly(ethylene oxide) surfactant system.

    Science.gov (United States)

    Bogaerts, K; Lavrenova, A; Spoelstra, A B; Boyard, N; Goderis, B

    2015-08-21

    Brittle epoxy based thermosets can be made tougher by introducing structural inhomogeneities at the micro- or nanoscale. In that respect, nano vesicles and worm-like micelles from self-assembling blockcopolymers have been shown to be very effective. This paper describes the curing kinetics and morphology of an epoxy composed of diglycidyl ether of bisphenol A (DGEBA) and 4,4'-methylenedianiline (MDA), modified by 20% of the surfactant stearyl-block-poly(ethylene oxide). Time resolved, synchrotron small-angle X-ray scattering demonstrates that at any time during the epoxy curing process, the surfactant predominantly adopts a bilayer vesicular nano-morphology. Transmission electron microscopy on fully cured systems reveals the coexistence of spherical and worm-like micelles. Differential scanning calorimetry experiments prove that the presence of surfactant reduces the epoxy curing rate but that ultimately full curing is accomplished. The material glass transition temperature falls below that of the pure resin due to plasticization. It is suggested that favorable secondary interactions between the PEO segments and the epoxy resin are responsible for the observed phenomena.

  10. THE MECHANISM OF CURE REACTION OF 4,4'-DIAMINODIPHENYL METHANE WITH TETRAGLYCIDYL 4,4'-DIAMINODIPHENYL METHANE EPOXY

    Institute of Scientific and Technical Information of China (English)

    WANG Wei; WU Xuanzheng; QI Zongneng

    1992-01-01

    The cure reaction of tetraglycidyl 4,4'-diaminodiphenyl methane (TGDDM) epoxy resin with 4,4'-diaminodiphenyl methane (DDM) has been studied by using DSC. nstead of one exothermic peak, two exothermic peaks, indicative of a complex reaction mechanism, are shown in the DSC curve of TGDDM-DDM mixtures in nonisothermal cure experiments when the content of DDM is lower than stoichiometric ratio. The result of the kinetic analysis of the cure reaction shows that the activation energy of the lower temperature exotherm peak is about 56 kJ/mol and that of the higher temperature exotherm peak is about 136 kJ/mol. The lower temperature cure reaction peak can be attributed to the primary amine-epoxide and secondary amine-epoxide reactions, and the higher temperature cure reaction peak can be attributed to the epoxide-hydroxy reaction under catalysis of tertiary amine in the TGDDM epoxy resin. Because the network density of the cured epoxy resin is determined by these two reactions, the content of DDM has little effect on the glass transition temperature of cured epoxy resin.

  11. Curing mechanism of flexible aqueous polymeric coatings.

    Science.gov (United States)

    Irfan, Muhammad; Ahmed, Abid Riaz; Dashevskiy, Andriy; Kolter, Karl; Bodmeier, Roland

    2017-02-25

    The objective of this study was to explain curing phenomena for pellets coated with a flexible polymeric coating based on poly(vinyl acetate) (Kollicoat(®) SR 30D) with regard to the effect of starter cores, thickness of drug layer, adhesion of coating to drug-layered-cores as well as coating properties. In addition, appropriate approaches to eliminate the curing effect were identified. Sugar or MCC cores were layered with the model drugs carbamazepine, theophylline, propranolol HCl, tramadol HCl and metoprolol HCl using HPMC (5 or 25% w/w, based on drug) as a binder. Drug-layered pellets were coated with Kollicoat(®) SR 30D in a fluidized bed coater using TEC (10% w/w) as plasticizer and talc (35-100% w/w) as anti-tacking agent. Drug release, pellet properties (morphology, water uptake-weight loss and osmolality) and adhesion of the coating to the drug layer were investigated as a function of curing at 60 °C or 60 °C/75% RH for 24 h. The film formation of the aqueous dispersion of Kollicoat(®) SR 30D was complete, and therefore, a strong curing effect (decrease in drug release) at elevated temperature and humidity (60 °C/75% RH) could not be explained by the well-known hydroplasticization and the further gradual coalescence of the colloidal polymer particles. According to the provided mechanistic explanation, the observed curing effect was associated with 1) high flexibility of coating, 2) adhesion between coating and drug layer, 3) water retaining properties of the drug layer, and 4) osmotically active cores. Unwanted curing effects could be minimized/eliminated by the addition of talc or/and pore-forming water soluble polymers in the coating, increasing binder amount or applying an intermediate coating, by increasing the thickness of drug layer or using non-osmotic cores. A new insight into curing phenomena mainly associated with the adhesion between drug layer and coating was provided. Appropriate approaches to avoid unwanted curing effect were identified.

  12. Prevent and cure disuse bone loss

    Science.gov (United States)

    Jee, Webster S. S.

    1994-01-01

    Anabolic agents like parathyroid hormone and postagladin E-like substances were studied in dogs and rats to determine their effectiveness in the prevention and cure of bone loss due to immobilization. It was determined that postagladin E2 administration prevented immobilization while at the same time it added extra bone in a dose responsive manner. Although bone mass returns, poor trabecular architecture remains after normal ambulation recovery from immobilization. Disuse related bone loss and poor trabecular architecture were cured by post-immobilization postagladin E2 treatment.

  13. Curing kinetics of visible light curing dental resin composites investigated by dielectric analysis (DEA).

    Science.gov (United States)

    Steinhaus, Johannes; Hausnerova, Berenika; Haenel, Thomas; Großgarten, Mandy; Möginger, Bernhard

    2014-03-01

    During the curing process of light curing dental composites the mobility of molecules and molecule segments is reduced leading to a significant increase of the viscosity as well as the ion viscosity. Thus, the kinetics of the curing behavior of 6 different composites was derived from dielectric analysis (DEA) using especially redesigned flat sensors with interdigit comb electrodes allowing for irradiation at the top side and measuring the ion viscosity at the bottom side. As the ion viscosities of dental composites change 1-3 orders of magnitude during the curing process, DEA provides a sensitive approach to evaluate their curing behavior, especially in the phase of undisturbed chain growth. In order to determine quantitative kinetic parameters a kinetic model is presented and examined for the evaluation of the ion viscosity curves. From the obtained results it is seen that DEA might be employed in the investigation of the primary curing process, the quality assurance of ingredients as well as the control of processing stability of the light curing dental composites. Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  14. Strength of Geopolymer Cement Curing at Ambient Temperature by Non-Oven Curing Approaches: An Overview

    Science.gov (United States)

    Wattanachai, Pitiwat; Suwan, Teewara

    2017-06-01

    At the present day, a concept of environmentally friendly construction materials has been intensively studying to reduce the amount of releasing greenhouse gases. Geopolymer is one of the cementitious binders which can be produced by utilising pozzolanic wastes (e.g. fly ash or furnace slag) and also receiving much more attention as a low-CO2 emission material. However, to achieve excellent mechanical properties, heat curing process is needed to apply to geopolymer cement in a range of temperature around 40 to 90°C. To consume less oven-curing energy and be more convenience in practical work, the study on geopolymer curing at ambient temperature (around 20 to 25°C) is therefore widely investigated. In this paper, a core review of factors and approaches for non-oven curing geopolymer has been summarised. The performance, in term of strength, of each non-oven curing method, is also presented and analysed. The main aim of this review paper is to gather the latest study of ambient temperature curing geopolymer and to enlarge a feasibility of non-oven curing geopolymer development. Also, to extend the directions of research work, some approaches or techniques can be combined or applied to the specific properties for in-field applications and embankment stabilization by using soil-cement column.

  15. Severe hypoglycemia in a juvenile diabetic rat model: presence and severity of seizures are associated with mortality.

    Directory of Open Access Journals (Sweden)

    Margaret Maheandiran

    Full Text Available It is well accepted that insulin-induced hypoglycemia can result in seizures. However, the effects of the seizures, as well as possible treatment strategies, have yet to be elucidated, particularly in juvenile or insulin-dependent diabetes mellitus (IDDM. Here we establish a model of diabetes in young rats, to examine the consequences of severe hypoglycemia in this age group; particularly seizures and mortality. Diabetes was induced in post-weaned 22-day-old Sprague-Dawley rats by streptozotocin (STZ administered intraperitoneally (IP. Insulin IP (15 U/kg, in rats fasted (14-16 hours, induced hypoglycemia, defined as <3.5 mM blood glucose (BG, in 68% of diabetic (STZ and 86% of control rats (CON. Seizures occurred in 86% of STZ and all CON rats that reached hypoglycemic levels with mortality only occurring post-seizure. The fasting BG levels were significantly higher in STZ (12.4 ± 1.3 mM than in CON rodents (6.3 ± 0.3 mM, resulting in earlier onset of hypoglycemia and seizures in the CON group. However, the BG at seizure onset was statistically similar between STZ (1.8 ± 0.2 mM and CON animals (1.6 ± 0.1 mM as well as between those that survived (S+S and those that died (S+M post-seizure. Despite this, the S+M group underwent a significantly greater number of seizure events than the S+S group. 25% glucose administered at seizure onset and repeated with recurrent seizures was not sufficient to mitigate these continued convulsions. Combining glucose with diazepam and phenytoin significantly decreased post-treatment seizures, but not mortality. Intracranial electroencephalograms (EEGs were recorded in 10 CON and 9 STZ animals. Predictive EEG changes were not observed in these animals that underwent seizures. Fluorojade staining revealed damaged cells in non-seizing STZ animals and in STZ and CON animals post-seizure. In summary, this model of hypoglycemia and seizures in juvenile diabetic rats provides a paradigm for further study of

  16. Light-Cured Self-Etch Adhesives Undergo Hydroxyapatite-Triggered Self-Cure.

    Science.gov (United States)

    Liu, Y; Bai, X; Liu, Y W; Wang, Y

    2016-03-01

    Light cure is a popular mode of curing for dental adhesives. However, it suffers from inadequate light delivery when the restoration site is less accessible, in which case a self-cure mechanism is desirable to salvage any compromised polymerization. We previously reported a novel self-cure system mediated by ethyl 4-(dimethylamino)-benzoate (4E) and hydroxyapatite (HAp). The present work aims to investigate if such self-cure phenomenon takes place in adhesives that underwent prior inadequate light cure and to elucidate if HAp released from the dental etching process is sufficient to trigger it. Model self-etch adhesives were formulated with various components, including bis[2-methacryloyloxy)ethyl]-phosphate (2MP) as acidic monomer and trimethylbenzoyl-diphenylphosphine oxide (TPO) as photoinitiator. In vitro evolution of degree of conversion (DC) of HAp-incorporated adhesives was monitored by infrared spectroscopy during light irradiation and dark storage. Selected adhesives were allowed to etch and extract HAp from enamel, light-cured in situ, and stored in the dark, after which Raman line mapping was used to obtain spatially resolved DC across the enamel-resin interface. Results showed that TPO+4E adhesives reached DC similar to TPO-only counterparts upon completion of light irradiation but underwent another round of initiation that boosted DC to ~100% regardless of HAp level or prior light exposure. When applied to enamel, TPO-only adhesives had ~80% DC in resin, which gradually descended to ~50% in enamel, whereas TPO+4E adhesives consistently scored ~80% DC across the enamel-resin interface. These observations suggest that polymerization of adhesives that underwent insufficient light cure is salvaged by the novel self-cure mechanism, and such salvaging effect can be triggered by HAp released from dental substrate during the etching process.

  17. Mechanical characterization and modeling of curing thermosets

    NARCIS (Netherlands)

    Van 't Hof, C.

    2006-01-01

    Chemical shrinkage and simultaneous build-up of mechanical properties in curing thermosets leads to the build-up of residual stresses and strains. Depending on the constraints these may cause interface failure, dimensional inaccuracy or failure in the thermoset or its surrounding structure. The pre

  18. Creep measurements on curing epoxy systems

    DEFF Research Database (Denmark)

    Kammer, Charlotte; Szabo, Peter

    1998-01-01

    The chemical curing of a stoichiometric mixture of the diglycidyl ether of bisphenol A and a 1,3-bis-(aminomethyl)-cyclohexane is studied.Creep experiments are combined with measurements in a Differential Scanning Calorimeter (DSC) to determine the change in bulk viscosity due to network formation....

  19. Internal water curing with Liapor aggregates

    DEFF Research Database (Denmark)

    Lura, Pietro

    2005-01-01

    Internal water curing is a very efficient way to counteract self-desiccation and autogenous shrinkage in high performance concrete, thereby reducing the likelihood of early-age cracking. This paper deals with early-age volume changes and moisture transport in lightweight aggregate concrete realiz...

  20. Creep measurements on curing epoxy systems

    DEFF Research Database (Denmark)

    Kammer, Charlotte; Szabo, Peter

    1998-01-01

    The chemical curing of a stoichiometric mixture of the diglycidyl ether of bisphenol A and a 1,3-bis-(aminomethyl)-cyclohexane is studied.Creep experiments are combined with measurements in a Differential Scanning Calorimeter (DSC) to determine the change in bulk viscosity due to network formation....

  1. Talking Cure Models: A Framework of Analysis

    Science.gov (United States)

    Marx, Christopher; Benecke, Cord; Gumz, Antje

    2017-01-01

    Psychotherapy is commonly described as a “talking cure,” a treatment method that operates through linguistic action and interaction. The operative specifics of therapeutic language use, however, are insufficiently understood, mainly due to a multitude of disparate approaches that advance different notions of what “talking” means and what “cure” implies in the respective context. Accordingly, a clarification of the basic theoretical structure of “talking cure models,” i.e., models that describe therapeutic processes with a focus on language use, is a desideratum of language-oriented psychotherapy research. Against this background the present paper suggests a theoretical framework of analysis which distinguishes four basic components of “talking cure models”: (1) a foundational theory (which suggests how linguistic activity can affect and transform human experience), (2) an experiential problem state (which defines the problem or pathology of the patient), (3) a curative linguistic activity (which defines linguistic activities that are supposed to effectuate a curative transformation of the experiential problem state), and (4) a change mechanism (which defines the processes and effects involved in such transformations). The purpose of the framework is to establish a terminological foundation that allows for systematically reconstructing basic properties and operative mechanisms of “talking cure models.” To demonstrate the applicability and utility of the framework, five distinct “talking cure models” which spell out the details of curative “talking” processes in terms of (1) catharsis, (2) symbolization, (3) narrative, (4) metaphor, and (5) neurocognitive inhibition are introduced and discussed in terms of the framework components. In summary, we hope that our framework will prove useful for the objective of clarifying the theoretical underpinnings of language-oriented psychotherapy research and help to establish a more comprehensive

  2. Severe Hypoglycemia due to Isolated ACTH Deficiency in Children: A New Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Michael Y. Torchinsky

    2011-01-01

    Full Text Available Isolated ACTH deficiency causes life-threatening severe hypoglycemia. A 7-year-old girl with hypoglycemia due to this rare disorder is described. Our patient had undetectable plasma ACTH repeatedly and cortisol 0 mcg/dl before and after ACTH 1-24 stimulation. There was no evidence of other pituitary hormone deficiency. Glucocorticoid replacement therapy resulted in resolution of all symptoms and normalization of blood glucose. Previously published data on isolated ACTH deficiency in children is summarized. Review of the literature showed that the prevalence of this condition could be underestimated in the neonatal period and in Prader-Willi syndrome. Isolated ACTH deficiency occurs in older children as well as in neonates.

  3. A Case of Inoperable Malignant Insulinoma with Resistant Hypoglycemia Who Experienced the Most Significant Clinical Improvement with Everolimus

    Directory of Open Access Journals (Sweden)

    Emre Bozkirli

    2013-01-01

    Full Text Available Metastatic insulinomas may sometimes present with recurrent life-threatening hypoglycemia episodes. Such patients usually fail to respond to various therapeutic agents which causes constant dextrose infusion requirement. Herein, we present a resistant case of inoperable malignant insulinoma who was treated with many therapeutic agents and interventions including somatostatin analogues, Yttrium-90 radioembolization, everolimus, radiotherapy, and chemoembolization. Close blood sugar monitorization during these therapies showed the most favourable response with everolimus. Everolimus treatment resulted in rapid improvement of hypoglycemia episodes, letting us discontinue dextrose infusion and discharge the patient. However, experience with everolimus in such patients is still limited, and more precise data can be obtained with the increasing use of this agent for neuroendocrine tumours.

  4. A case of autoimmune hypoglycemia outside Japan: Rare, but in the era of expanding drug-list, important to suspect

    Directory of Open Access Journals (Sweden)

    Krishan Gopal

    2013-01-01

    Full Text Available We are hereby reporting a case of a 72-year-old Indian man, who, in the absence of a detectable tumor, presented with symptomatic hypoglycemia in the postabsorptive state (3-5 h after meal. His serum levels of insulin and C-peptide were very high. He was not taking any hypoglycemic drug. Hypoglycemic episodes completely subsided after withdrawal of pentoprazole and incorporation of small frequent meals in the dietary plan. Six months after the initial presentation, the subject became free of hypoglycemic episodes. Although insulin autoimmune syndrome (IAS is the third leading cause of spontaneous hypoglycemia in Japan, it is extremely uncommon in the Western Countries. Till 2009, more than 200 cases from Japan and as many as 58 cases outside Asia have been reported. To the best of our knowledge, this is the first case of IAS reported from India.

  5. Ischemia‐reperfusion injury and hypoglycemia risk in insulin‐treated T1DM rats following different modalities of regular exercise

    OpenAIRE

    Matthew W. McDonald; Hall, Katharine E.; Jiang, Mao; Noble, Earl G.; Melling, C.W. James

    2014-01-01

    Abstract While regular exercise is known to improve cardiovascular function, individuals with type 1 diabetes mellitus (T1DM) have an increased risk for exercise‐induced hypoglycemia. Clinical data suggest that higher intensities of acute exercise may alleviate the onset of hypoglycemia; however, the cardiovascular benefit from these forms of exercise in patients with T1DM has yet to be established. The purpose of this study was to investigate the cardiovascular benefit of different regular e...

  6. Disease burden evaluation of fall-related events in the elderly due to hypoglycemia and other diabetic complications: a clinical review

    OpenAIRE

    Malabu UH; Vangaveti VN; Kennedy RL

    2014-01-01

    Usman H Malabu,1 Venkat N Vangaveti,1 Richard Lee Kennedy2 1School of Medicine and Dentistry, James Cook University, QLD, Australia; 2Department of Medicine, Deakin University, VIC, Australia Abstract: A hypoglycemia-induced fall is common in older persons with diabetes. The etiology of falls in this population is usually multifactorial, and includes microvascular and macrovascular complications and age-related comorbidities, with hypoglycemia being one of the major precipitating causes. In ...

  7. COMPARISON OF THE E44 EPOXY RESINS IN DIFFERENT CONTENTS OF CURING AGENT BY MICROWAVE AND THERMAL CURING METHODS

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    This paper discusses the fundamental principle of microwave heating, and based on the advantages of microwave heating, use maleic anhydride as curing agent.The technology of microwave curing E44 epoxy resins is investigated,the mechanical properties of cured epoxy resin samples in different contents of curing agent by microwave and thermal curing methods are measured respectively, and then some experimental results for which are obtained.At last, this paper analyses why microwave curing can improve mechanical property of epoxy resin.

  8. Complex III deficiency due to an in-frame MT-CYB deletion presenting as ketotic hypoglycemia and lactic acidosis

    Directory of Open Access Journals (Sweden)

    Mari Mori

    2015-09-01

    Full Text Available Complex III deficiency due to a MT-CYB mutation has been reported in patients with myopathy. Here, we describe a 15-year-old boy who presented with metabolic acidosis, ketotic hypoglycemia and carnitine deficiency. Electron transport chain analysis and mitochondrial DNA sequencing on muscle tissue lead to the eventual diagnosis of complex III deficiency. This case demonstrates the critical role of muscle biopsies in a myopathy work-up, and the clinical efficacy of supplement therapy.

  9. Intensive Individualized Reinforcement Education Is Important for the Prevention of Hypoglycemia in Patients with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Yun-Mi Yong

    2015-04-01

    Full Text Available BackgroundWe investigated whether an intensive individualized reinforcement education program could influence the prevention of hypoglycemic events in patients with type 2 diabetes.MethodsFrom March 2013 to September 2013, patients aged 35 to 75 years with type 2 diabetes who had not previously participated in diabetes education, and treated with insulin or a sulfonylurea-containing regimen were included in the study. After structured group education, the patients assigned to the intensive individualized education group (IT were requested to visit for reinforcement. All subjects in the IT were encouraged to self-manage dose adjustments. Participants in both groups (control group [CG, group education only; n=22] and IT [n=24] attended follow-up visits at 2, 8, 12, and 24 weeks. At each visit, all patients were asked whether they had experienced hypoglycemia.ResultsThe total study population consisted of 20 men (43.5%; mean age and diabetic duration of 55.9±11.0 and 5.1±7.3 years, respectively. At 24 weeks, there were no significant differences in hemoglobin A1c values between the CG and IT. The total number of hypoglycemic events per patient was 5.26±6.5 in the CG and 2.58±2.3 times in the IT (P=0.004. Adherence to lifestyle modification including frequency of exercise, self-monitoring of blood glucose, or dietary habit was not significantly different between the groups. However, adherence to hypoglycemia management, especially the dose adjustment of medication, was significantly higher in the IT compared with the CG.ConclusionCompared with the structured group education, additional IT resulted in additional benefits in terms of avoidance of hypoglycemia and treating hypoglycemia in patients with type 2 diabetes.

  10. Discordance between growth hormone (GH) responses after GH-releasing hormone and insulin hypoglycemia in myotonic dystrophy.

    Science.gov (United States)

    Okimura, Y; Chihara, K; Kita, T; Kashio, Y; Sato, M; Kitajima, N; Abe, H; Takahashi, K; Fujita, T

    1988-11-01

    Plasma GH responses to human GHRH, arginine, L-dopa, and insulin-induced hypoglycemia were determined in seven myotonic dystrophy (MD) patients. An iv bolus injection of GHRH-(1-44)-NH2 (1 microgram/kg BW) only slightly increased plasma GH concentrations in MD patients. The mean peak plasma GH level after GHRH injection [4.2 +/- 0.8 (+/- SE) micrograms/L] was significantly lower than that in 10 age-matched normal subjects (26.7 +/- 4.3 micrograms/L) or that in 6 patients with progressive muscular dystrophy (22.8 +/- 6.6 micrograms/L) whose nutritional status was similar to that of the MD patients. Even with a larger dose of GHRH (3 micrograms/kg BW), the plasma GH rises were minimal in the MD patients (mean peak, 5.9 +/- 1.8 micrograms/L). The plasma GH responses to a 30-min iv infusion of arginine (0.5 g/kg BW) and oral ingestion of L-dopa (0.5 g) were attenuated to a similar extent, whereas insulin-induced hypoglycemia caused a significant increase in plasma GH in all seven MD patients [mean peak, 17.4 +/- 4.1 (+/- SE) microgram/L]. The plasma TSH responses to TRH and plasma insulin-like growth factor I levels were similar in the MD patients and normal subjects. These findings suggest that 1) the impaired GH release after GHRH, arginine, and L-dopa administration in MD patients is not due to somatotroph deficiency, since the GH response to hypoglycemia is well preserved; and 2) insulin-induced hypoglycemia may stimulate GH release at least in part via inhibition of somatostatin release.

  11. Coordinated changes in hepatic amino acid metabolism and endocrine signals support hepatic glucose production during fetal hypoglycemia.

    Science.gov (United States)

    Houin, Satya S; Rozance, Paul J; Brown, Laura D; Hay, William W; Wilkening, Randall B; Thorn, Stephanie R

    2015-02-15

    Reduced fetal glucose supply, induced experimentally or as a result of placental insufficiency, produces an early activation of fetal glucose production. The mechanisms and substrates used to fuel this increased glucose production rate remain unknown. We hypothesized that in response to hypoglycemia, induced experimentally with maternal insulin infusion, the fetal liver would increase uptake of lactate and amino acids (AA), which would combine with hormonal signals to support hepatic glucose production. To test this hypothesis, metabolic studies were done in six late gestation fetal sheep to measure hepatic glucose and substrate flux before (basal) and after [days (d)1 and 4] the start of hypoglycemia. Maternal and fetal glucose concentrations decreased by 50% on d1 and d4 (P < 0.05). The liver transitioned from net glucose uptake (basal, 5.1 ± 1.5 μmol/min) to output by d4 (2.8 ± 1.4 μmol/min; P < 0.05 vs. basal). The [U-¹³C]glucose tracer molar percent excess ratio across the liver decreased over the same period (basal: 0.98 ± 0.01, vs. d4: 0.89 ± 0.01, P < 0.05). Total hepatic AA uptake, but not lactate or pyruvate uptake, increased by threefold on d1 (P < 0.05) and remained elevated throughout the study. This AA uptake was driven largely by decreased glutamate output and increased glycine uptake. Fetal plasma concentrations of insulin were 50% lower, while cortisol and glucagon concentrations increased 56 and 86% during hypoglycemia (P < 0.05 for basal vs. d4). Thus increased hepatic AA uptake, rather than pyruvate or lactate uptake, and decreased fetal plasma insulin and increased cortisol and glucagon concentrations occur simultaneously with increased fetal hepatic glucose output in response to fetal hypoglycemia.

  12. Influence of erythropoietin on cognitive performance during experimental hypoglycemia in patients with type 1 diabetes mellitus: a randomized cross-over trial.

    Directory of Open Access Journals (Sweden)

    Peter Lommer Kristensen

    Full Text Available INTRODUCTION: The incidence of severe hypoglycemia in type 1 diabetes has not decreased over the past decades. New treatment modalities minimizing the risk of hypoglycemic episodes and attenuating hypoglycemic cognitive dysfunction are needed. We studied if treatment with the neuroprotective hormone erythropoietin (EPO enhances cognitive function during hypoglycemia. MATERIALS AND METHODS: Eleven patients with type 1 diabetes, hypoglycemia unawareness and recurrent severe hypoglycemia completed the study. In a double-blind, randomized, balanced, cross-over study using clamped hypoglycemia they were treated with 40,000 IU of EPO or placebo administered intravenously six days before the two experiments. Cognitive function (primary endpoint, hypoglycemic symptoms, and counter-regulatory hormonal response were recorded. RESULTS: Compared with placebo, EPO treatment was associated with a significant reduction in errors in the most complex reaction time task (-4.7 (-8.1 to -1.3, p = 0.01 and a less reaction time prolongation (-66 (-117 to -16 msec, p = 0.02. EPO treatment did not change performance in other measures of cognition. Hypoglycemic symptoms, EEG-changes, and counter-regulatory hormone concentrations did not differ between EPO and placebo treatment. CONCLUSION: In patients with type 1 diabetes and hypoglycemia unawareness, treatment with EPO is associated with a beneficial effect on cognitive function in a complex reaction time task assessing sustained attention/working memory. Hypoglycemic symptoms and hormonal responses were not changed by EPO treatment. TRIAL REGISTRATION: ClinicalTrials.gov NCT00615368.

  13. Hypoglycemia After Initiation of Basal Insulin in Patients with Type 2 Diabetes in the United States: Implications for Treatment Discontinuation and Healthcare Costs and Utilization.

    Science.gov (United States)

    Dalal, Mehul R; Kazemi, Mahmood; Ye, Fen; Xie, Lin

    2017-08-04

    Hypoglycemia and fear of hypoglycemia may contribute to basal insulin discontinuation, poor glycemic control, and increased healthcare burden in patients with type 2 diabetes (T2D). This study aimed to determine the impact of hypoglycemia soon after basal insulin initiation on treatment discontinuation and economic outcomes in patients with T2D. Hypoglycemic events within 6 months of basal insulin initiation were identified using retrospective cohort data from patients with T2D, at least 18 years of age, initiated on basal insulin therapy in the Clinformatics™ Data Mart for Multiplan claims database from January 1, 2008, through August 31, 2012. Data were adjusted for baseline characteristics. Discontinuation was established for patients with 12-month follow-up data, while discontinuation risk was assessed in the extended analysis (6- to 24-month follow-up) by Cox regression analysis. Healthcare use and costs were determined. Of 55,608 patients, 4.5% experienced hypoglycemia within 6 months of basal insulin initiation. Patients with hypoglycemia were more likely to discontinue basal insulin within 12 months of initiation (79.0% vs. 74.2%; P cause ($30,719 vs. $19,079; P < 0.001) healthcare costs. US patients with T2D who experienced hypoglycemia within 6 months of basal insulin initiation were more likely to discontinue treatment, accompanied by a greater healthcare burden. Sanofi US, Inc.

  14. Analysis of Arrhythmia Caused by Diabetic Hypoglycemia%糖尿病低血糖诱发室性心律失常14例分析

    Institute of Scientific and Technical Information of China (English)

    陈聪

    2013-01-01

    目的::探讨糖尿病低血糖诱发室性心律失常作用机制及应对方法。方法:回顾性分析40例糖尿病低血糖病例在治疗前后的心律变化。结果:糖尿病低血糖有诱发室性心律失常作用。结论:糖尿病低血糖病例伴有室性心律失常时,应疑及由低血糖诱发可能性,同时糖尿病低血糖诱发的室性心律失常,只要抢救及时,大多数具有可逆性,并且预后良好。%Objective:To investigate the relationship between diabetic hypoglycemia and arrhythmia and the dealing methods.Method:Retrospectively studied 40 cases of diabetes hypoglycemia and the process before and after treatment.Result:Diabetic hypoglycemia could cause arrhythmia.Conclusion:If hypoglycemia arises with arrhythmia,it is possible that arrhythmia is caused by Hypoglycemia.Meanwhile many cases with arrhythmia caused by diabetic hypoglycemia may be reversible if saved in time.

  15. Bond strength of a light-cured and two auto-cured glass ionomer liners.

    Science.gov (United States)

    Holtan, J R; Nystrom, G P; Olin, P S; Rudney, J; Douglas, W H

    1990-10-01

    Ninety-nine extracted human molar teeth were used in this study comparing the shear bond strengths on dentine of one light-cured and two auto-cured polyalkenoate (glass ionomer) cements. Bond strength can be influenced by differences in tooth structure. A balanced-incomplete block design (Hull and Nie, 1981) was used to reduce variation attributable to such differences. Cements were applied to paired dentine surfaces in combinations such that 66 tooth sides were treated with each material. A light-cured dentinal adhesive and composite resin restorative material were then placed and shear bond strength testing was conducted exactly 24 h after the completion of each specimen. Mean forces (MPa) for the three materials were compared using an appropriate analysis of variance model (balanced-incomplete-blocks) The shear bond strengths (MPa) of the light-cured liner (Espe, Seefeld/Oberbay, FRG) was 4.71 +/- 1.16. Vitrabond showed the greatest variance of all three materials tested, however this material's average bond strength was greater than the maximum achieved for the other materials. Student-Newman-Keuls comparison of means showed that all cements differed significantly from each other (alpha = 0.05). It is concluded that the light-cured glass ionomer liner exhibited significantly better shear bond strength performance than the two auto-cured glass ionomers tested.

  16. Thermal and Cure Kinetics of Epoxy Molding Compounds Cured with Thermal Latency Accelerators

    Directory of Open Access Journals (Sweden)

    Chean-Cheng Su

    2013-01-01

    Full Text Available The cure kinetics and mechanisms of a biphenyl type epoxy molding compounds (EMCs with thermal latency organophosphine accelerators were studied using differential scanning calorimetry (DSC. Although the use of triphenylphosphine-1,4-benzoquinone (TPP-BQ and triphenylphosphine (TPP catalysts in biphenyl type EMCs exhibited autocatalytic mechanisms, thermal latency was higher in the TPP-BQ catalyst in EMCs than in the TPP catalyst in EMCs. Analyses of thermal characteristics indicated that TPP-BQ is inactive at low temperatures. At high temperatures, however, TPP-BQ increases the curing rate of EMC in dynamic and isothermal curing experiments. The reaction of EMCs with the TPP-BQ latent catalyst also had a higher temperature sensitivity compared to the reaction of EMCs with TPP catalyst. In resin transfer molding, EMCs containing the TPP-BQ thermal latency accelerator are least active at a low temperature. Consequently, EMCs have a low melt viscosity before gelation, and the resins and filler are evenly mixed in the kneading process. Additionally, flowability is increased before the EMCs form a network structure in the molding process. The proposed kinetic model adequately describes curing behavior in EMCs cured with two different organophosphine catalysts up to the rubber state in the progress of curing.

  17. Self-monitoring of blood glucose is associated with problem-solving skills in hyperglycemia and hypoglycemia.

    Science.gov (United States)

    Wang, Jing; Zgibor, Janice; Matthews, Judith T; Charron-Prochownik, Denise; Sereika, Susan M; Siminerio, Linda

    2012-01-01

    The purpose of this study was to examine the association between self-monitoring of blood glucose (SMBG) and problem-solving skills in response to detected hyperglycemia and hypoglycemia among patients with type 2 diabetes. Data were obtained from the American Association of Diabetes Educators Outcome System, implemented in 8 diabetes self-management education programs in western Pennsylvania. SMBG was measured by asking patients how often they checked, missed checking, or checked blood glucose later than planned. Problem-solving skill was measured by asking how often they modified their behaviors after detecting high or low blood glucose. Most patients checked their blood glucose at least once per day. However, when blood glucose was high or low, many of them reported doing nothing, and only some of them resolved the problem. There were significant associations between self-monitoring of blood glucose and problem-solving skills for hyperglycemia and hypoglycemia, after controlling for age, gender, ethnicity, education, and time since diagnosis. Patients reported poor problem-solving skills when detecting hyperglycemia and hypoglycemia via SMBG. Patients need to learn problem-solving skills along with SMBG training to achieve glycemic control.

  18. Recurrent Hypoglycemia in a Patient with Hodgkin’s Lymphoma: A Case Report with Review of Literature

    Directory of Open Access Journals (Sweden)

    Rawal Gautam

    2016-09-01

    Full Text Available A rare complication associated with the Hodgkin’s lymphoma is the occurrence of persistent or recurrent hypoglycemia. Although few cases have been reported in the literature, describing its pathophysiology to be multifactorial, it is difficult to determine the exact cause. We present the case of a 26 year old patient diagnosed with Hodgkin’s lymphoma who developed recurrent episodes of hypoglycemia and also discuss the various causes for its pathogenesis. In this case the serum insulin and C-peptide levels were found to be low, suggesting the presence of insulin like growth factors (IGF secreted by the cancer cells. Also, we performed a18F-2-fluoro-2-deoxy-d-glucose positron emission tomography that showed a massive tumor load. The published reports in literature have similary suggested the presence of IGF or auto-antibodies secreted by the tumor cells and also the Warburg effect in patients with high tumor load. Further research is required to clearly diagnose and define the exact etiopathogenesis of the hypoglycemia occurring in a patient with Hodgkin’s lymphoma.

  19. Potentiation of Insulin-Mediated Glucose Lowering without Elevated Hypoglycemia Risk by a Small Molecule Insulin Receptor Modulator

    Science.gov (United States)

    Wu, Margaret; Dai, Ge; Yao, Jun; Hoyt, Scott; Wang, Liangsu; Mu, James

    2015-01-01

    Insulin resistance is the key feature of type 2 diabetes and is manifested as attenuated insulin receptor (IR) signaling in response to same levels of insulin binding. Several small molecule IR activators have been identified and reported to exhibit insulin sensitization properties. One of these molecules, TLK19781 (Cmpd1), was investigated to examine its IR sensitizing action in vivo. Our data demonstrate that Cmpd1, at doses that produced minimal efficacy in the absence of insulin, potentiated insulin action during an OGTT in non-diabetic mice and enhanced insulin-mediated glucose lowering in diabetic mice. Interestingly, different from insulin alone, Cmpd1 combined with insulin showed enhanced efficacy and duration of action without increased hypoglycemia. To explore the mechanism underlying the apparent glucose dependent efficacy, tissue insulin signaling was compared in healthy and diabetic mice. Cmpd1 enhanced insulin’s effects on IR phosphorylation in both healthy and diabetic mice. In contrast, the compound potentiated insulin’s effects on Akt phosphorylation in diabetic but not in non-diabetic mice. These differential effects on signaling corresponding to glucose levels could be part of the mechanism for reduced hypoglycemia risk. The in vivo efficacy of Cmpd1 is specific and dependent on IR expression. Results from these studies support the idea of targeting IR for insulin sensitization, which carries low hypoglycemia risk by standalone treatment and could improve the effectiveness of insulin therapies. PMID:25799496

  20. Development and validation of an LC-MS/MS sulfonylurea assay for hypoglycemia cases in the emergency department.

    Science.gov (United States)

    Yang, He S; Wu, Alan H B; Johnson-Davis, Kamisha L; Lynch, Kara L

    2016-02-15

    Sulfonylureas are antidiabetic agents widely prescribed for the treatment of type-II diabetes. Detection of the presence of sulfonylureas in cases of unexplained hypoglycemia rules out other underlying pathophysiological conditions. The goal of this study was to develop and validate a qualitative liquid chromatography tandem mass spectrometry (LC-MS/MS) assay for the rapid identification of sulfonylureas in serum. An LC-MS/MS assay was developed using an Agilent HPLC with an AB Sciex 3200 LC-MS/MS operating in ESI positive mode. Linearity, LOD, precision, matrix effect, recovery, carry-over and stability of the final method were evaluated for method validation. Concordance with another clinically validated LC-MS/MS method was evaluated using remnant samples from patients prescribed a sulfonylurea. The assay performed well with all validation data meeting pre-determined criteria. The method comparison study showed a correlation coefficient of 0.99 for glipizide, the most common sulfonylurea, despite both methods being validated as qualitative methods. To date the validated assay has been utilized in 19 cases of unexplained hypoglycemia presenting to the emergency department, in which 5 were sulfonylurea positive. We have developed a rapid and sensitive LC-MS/MS sulfonylurea assay, and utilized this assay to assist in the differential diagnosis of unexplained hypoglycemia. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Responsiveness of glycogen breakdown to cyclic AMP in perfused liver from rats with insulin-induced hypoglycemia

    Directory of Open Access Journals (Sweden)

    M. Vardanega-Peicher

    2003-01-01

    Full Text Available The responsiveness of glycogen breakdown to cAMP was investigated in isolated perfused liver from male Wistar fed rats (200-220 g with insulin-induced hypoglycemia. The activation of glycogenolysis by 3 µM cAMP was decreased (P<0.05 in livers from rats with hypoglycemia induced by the administration of insulin or during the direct infusion of insulin into the isolated liver. The direct effect of insulin on glycogen catabolism promoted by 3 µM cAMP occurred as early as 3 min after starting insulin infusion. In contrast, the cAMP agonists resistant to phosphodiesterases, 8Br-cAMP and 6MB-cAMP, used at the same concentration as cAMP, i.e., 3 µM, did not modify the effect of insulin. The data suggest that the decreased hepatic responsiveness of glycogen breakdown during insulin-induced hypoglycemia is a direct effect of insulin decreasing the intracellular levels of cAMP.

  2. Incidence of extreme hyperglycemia and hypoglycemia in hospitalized patients during the month of July in teaching hospitals

    Directory of Open Access Journals (Sweden)

    Mansur Shomali

    2012-07-01

    Full Text Available Introduction: Blood glucose control has been found to be an important component in the care of hospitalized patients. Maintaining blood glucose within a target range using insulin intensively is a challenging task for physicians and requires skill and experience. We hypothesized that there may be more hyper- and hypoglycemia in July in teaching hospitals when new resident physicians begin their training. Methods: We reviewed point-of-care blood glucose data from hospitalized patients at four community teaching hospitals for 2010. We defined severe hypoglycemia as blood glucose < 41 mg/dL and severe hyperglycemia as blood glucose > 399 mg/dL. Occurrence of hyper- and hypoglycemic events was assessed overall at the particular hospital globally and based on individual nursing units. Monthly occurrence rates were compared against the annual mean for that unit. Results: The occurrence of hyper- and hypoglycemic events in July 2010 did not differ from the mean annual percentage of events at the applicable hospital. However, when the data were analyzed by the nursing unit, these extreme glucose events were significantly more common in 4 of the 11 units studied. Three of those four units were resident teaching units. Conclusions: These data suggest that there is some potential for increased risk of extreme hyper- and hypoglycemia at teaching hospitals in July, when new residents begin training.

  3. Effect of curing on clinical retention. A 7-year evaluation

    DEFF Research Database (Denmark)

    van Dijken, Jan WV; Pallesen, Ulla

    Objective: To evaluate in a prospective evaluation the retention of Class V compomer and hybrid resin composite restorations placed with a 1-step self etch system and cured with continuous, soft-start and pulse-delay curing. Methods: 139 Class V restorations were placed and cured at random in 60...... subjects with a compomer (Dyract AP;68) or resin composite (Tetric Ceram:67) and cured for 40s with continuous, soft-start and pulse-delay modes. The restorations were evaluated with slightly modified USPHS criteria yearly during 7 years. Results: Of 135 restorations evaluated at 7 years, 29 were lost, 17...... compomer (25%) and 12 Tetric Ceram (18%). The cumulative loss rates for the compomer and resin composite restorations cured with the three curing modes were. continuous cure: 26.1%/18.2%, soft-start: 22.7%/19.0%, pulse delay: 26.1%/16.7%. No statistical difference were seen between the curing modes...

  4. INTRODUCTION Curing is holding fruits at temperatures and ...

    African Journals Online (AJOL)

    One of the. EFFECT OF CURING ON THE SHELF LIFE OF AMBERSWEET ORANGES ... Alternaria citri. Incidence was lowest in fruits cured in the shade to 7% weight loss. .... Period of Storage (Weeks)/ Incidence of Decay (%). (% Wt. loss). 1.

  5. Drinking Peroxide as 'Natural' Cure Leads to Dangerous Blood Clots

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_163513.html Drinking Peroxide as 'Natural' Cure Leads to Dangerous Blood Clots ... 9, 2017 (HealthDay News) -- Ingesting high-concentration hydrogen peroxide as a "natural cure" or cleansing agent may ...

  6. [Dimensional accuracy of microwave-cured denture base resin].

    Science.gov (United States)

    Uchida, K; Okamoto, F; Ogata, K; Sato, T

    1989-02-01

    Recently, microwave-cured denture base resin was developed, and the resin solved the problem of internal porosity which had been generated by curing the conventional denture base resins with microwave irradiation. In this study, the dimensional accuracy of microwave-cured denture base resin was compared with that of other denture base resins, such as pour-type resin, heat-cured resin and heat-shock resin. From the experiment, the following results were obtained. 1. Dimensional accuracy of microwave-cured denture base resin was better than that of heat-cured resin and heat-shock resin, and was similar to that of pour-type resin. 2. Dimensional accuracy of microwave-cured denture base resin by slow cooling method and rapid cooling method was almost the same. Those findings suggest that microwave-cured denture base resin is valuable in clinic.

  7. Determinant of flexible Parametric Estimation of Mixture Cure ...

    African Journals Online (AJOL)

    PROF. OLIVER OSUAGWA

    2015-12-01

    Dec 1, 2015 ... Gastric Cancer data from 76 patients received adjuvant CRT and 125 receiving ... Keywords: Cure Fraction Model, Gastric Cancer, flexible Model, AIC, Mean time to cure. 1.0 Introduction ..... finish cancer registry. Int J Cancer ...

  8. Glucose turnover and hormonal changes during insulin-induced hypoglycemia in trained humans

    DEFF Research Database (Denmark)

    Kjær, Michael; Mikines, K J; Christensen, N J

    1984-01-01

    Eight athletes (T), studied the third morning after the last exercise session, and seven sedentary males (C) (maximal O2 consumption 65 +/- 4 vs. 49 +/- 4 (SE) ml X kg-1 X min-1, for T and C men, respectively) had insulin infused until plasma glucose, at an insulin level of 1,600 pmol X l-1, was ...... of heart rate, free fatty acid, and glycerol was faster. Responses of norepinephrine, cortisol, C-peptide, and lactate were similar in the two groups. Training radically changes hormonal responses but not glucose kinetics in insulin hypoglycemia.......Eight athletes (T), studied the third morning after the last exercise session, and seven sedentary males (C) (maximal O2 consumption 65 +/- 4 vs. 49 +/- 4 (SE) ml X kg-1 X min-1, for T and C men, respectively) had insulin infused until plasma glucose, at an insulin level of 1,600 pmol X l-1, was 1.......9 mmol X l-1. Glucose turnover was determined by primed constant rate infusion of 3-[3H]glucose. Basal C-peptide (0.46 +/- 0.04 vs. 0.73 +/- 0.06 pmol X ml-1) and glucagon (4 +/- 0.4 vs. 10 +/- 2 pmol X l-1) were lower (P less than 0.05) and epinephrine higher (0.30 +/- 0.06 vs. 0.09 +/- 0.03 nmol X l-1...

  9. Protection of hippocampal slices against hypoxia/hypoglycemia injury by a Gynostemma pentaphyllum extract.

    Science.gov (United States)

    Schild, L; Roth, A; Keilhoff, G; Gardemann, A; Brödemann, R

    2009-08-01

    In transverse hippcampus slices a short period of hypoxia/hypoglycemia induced by perfusion with O(2)/glucose-free medium caused early loss and incomplete restoration of evoked field potentials to only 50% in the CA(1) region. We report about a study investigating the effect of an ethanolic Gynostemma pentaphyllum extract in this system. When given with reperfusion the extract completely protected the cells of the slices from functional injury. The extract also protected at the subcellular level isolated mitochondria which had been subjected to hypoxia/reoxygenation in combination with elevated extramitochondrial Ca(2+) concentration from functional injury. In isolated mitochondria the extract protected from Ca(2+)-induced opening of the mitochondrial permeability transition pore and reduced lipid peroxidation. Our data demonstrate that the ethanolic extract of Gynostemma pentaphyllum has a high potential to protect from ischemia/reperfusion injury. It should be beneficial as prophylactic nutrition supplement and during revascularization of arterial blood vessels from stroke and other ischemic events such as coronary occlusion.

  10. Antepartum findings and obstetric aspects in pregnancies followed by neonatal persistent hyperinsulinemic hypoglycemia.

    Science.gov (United States)

    Parviainen, Anna-Maria; Puolakka, Jukka; Kirkinen, Pertti

    2002-04-01

    In this study we report antepartum and obstetric findings in cases of persistent hyperinsulinemic hypoglycemia of infancy (PHHI). The study is retrospective and covers the years 1983 to 1994, when there were 9 infants treated for PHHI in the region of the University Hospital of Kuopio. One of the mothers had gestational diabetes mellitus and one had insulin-dependent diabetes mellitus (IDDM). There were signs of fetal distress in cardiotocography (CTG) in 3 of 9 cases prenatally and in 3 of 9 cases intrapartum (33%). There were 5 premature deliveries (56%) and 5 cesarean sections (56%) in this series. Five neonates (56%) were macrosomic and one delivery was complicated by shoulder dystocia. Three neonates (33%) had a 1-minute Apgar score of <6, but there were no cases at 5 minutes. In cases of fetal macrosomia without a maternal diabetic problem amniocentesis may be carried out after 34 weeks of gestation to assay amniotic fluid insulin, C-peptide and erythropoietin to reveal rare cases of PHHI where there may be problems of fetal hypoxemia similar to those in diabetic pregnancies.

  11. Depression in Chinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence.

    Science.gov (United States)

    Zhang, Yuying; Ting, Rose Zw; Yang, Wenying; Jia, Weiping; Li, Wenhui; Ji, Linong; Guo, Xiaohui; Kong, Alice Ps; Wing, Yun-Kwok; Luk, Andrea Oy; Sartorius, Norman; Morisky, Donald E; Oldenburg, Brian; Weng, Jianping; Chan, Juliana Cn

    2015-11-01

    We hypothesize that depression in type 2 diabetes might be associated with poor glycemic control, in part due to suboptimal self-care. We tested this hypothesis by examining the associations of depression with clinical and laboratory findings in a multicenter survey of Chinese type 2 diabetic patients. 2538 patients aged 18-75 years attending hospital-based clinics in four cities in China underwent detailed clinical-psychological-behavioral assessment during a 12-month period between 2011 and 2012. Depression was diagnosed if Patient Health Questionnaire-9 (PHQ-9) score ≥10. Diabetes self-care and medication adherence were assessed using the Summary of Diabetes Self-care Activities and the 4-item Morisky medication adherence scale respectively. In this cross-sectional study (mean age: 56.4 ± 10.5[SD] years, 53% men), 6.1% (n = 155) had depression. After controlling for study sites, patients with depression had higher HbA(1c) (7.9 ± 2.0 vs. 7.7 ± 2.0%, P = 0.008) and were less likely to achieve HbA(1c) goal of diabetes was closely associated with hyperglycemia and hypoglycemia, which might be partly mediated through poor treatment adherence. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  12. Electron Beam Curing of Polymer Matrix Composites - CRADA Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Janke, C. J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Howell, Dave [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Norris, Robert E. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    1997-05-01

    The major cost driver in manufacturing polymer matrix composite (PMC) parts and structures, and one of the elements having the greatest effect on their quality and performance, is the standard thermal cure process. Thermal curing of PMCs requires long cure times and high energy consumption, creates residual thermal stresses in the part, produces volatile toxic by-products, and requires expensive tooling that is tolerant of the high cure temperatures.

  13. Techniques and materials for internal water curing of concrete

    DEFF Research Database (Denmark)

    Jensen, Ole Mejlhede; Lura, Pietro

    2006-01-01

    This paper gives an overview of different techniques for incorporation of internal curing water in concrete. Internal water curing can be used to mitigate self-desiccation and selfdesiccation shrinkage. Some concretes may need 50 kg/m3 of internal curing water for this purpose. The price of the i...

  14. 7 CFR 29.6002 - Air-cured.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Air-cured. 29.6002 Section 29.6002 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... INSPECTION Standards Definitions § 29.6002 Air-cured. Tobacco cured under natural atmospheric...

  15. 7 CFR 30.12 - Fire-cure.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Fire-cure. 30.12 Section 30.12 Agriculture Regulations... AND STANDARDS Classification of Leaf Tobacco Covering Classes, Types and Groups of Grades § 30.12 Fire-cure. To cure tobacco under artificial atmospheric conditions by the use of open fires, the smoke and...

  16. Curing Reaction Model of Epoxy Asphalt Binder

    Institute of Scientific and Technical Information of China (English)

    QIAN Zhendong; CHEN Leilei; WANG Yaqi; SHEN Jialin

    2012-01-01

    In order to understand the strength developing law of the epoxy asphalt mixture,a curing reaction model of the epoxy asphalt binder was proposed based upon the thermokinetic analysis.Given some assumptions,the model was developed by applying the Kissinger law as well as Arrhenius equation,and the differential scanning calorimetry was performed for estimating the model parameters.To monitor the strength development of the epoxy asphalt mixture,a strength test program was employed and then results were compared to those produced from the proposed model.The comparative evaluation shows that a good consistency exists between the outputs from test program and the proposed model,indicating that the proposed model can be used effectively for simulating the curing reaction process for the epoxy asphalt binder and predicting the strength development for the epoxy asphalt mixture.

  17. Contactless optoelectronic technique for monitoring epoxy cure.

    Science.gov (United States)

    Cusano, A; Buonocore, V; Breglio, G; Calabrò, A; Giordano, M; Cutolo, A; Nicolais, L

    2000-03-01

    We describe a novel noninvasive optical technique to monitor the refractive-index variation in an epoxy-based resin that is due to the polymerization process. This kind of resin is widely used in polymer matrix composites. It is well known that the process of fabricating a thermoset-based composite involves mass and heat transfer coupled with irreversible chemical reactions that induce physical changes. To improve the quality and the reliability of these materials, monitoring the cure and optimization of the manufacturing process are of key importance. We discuss the basic operating principles of an optical system based on angle deflection measurements and present typical cure-monitoring results obtained from optical characterization. The method provides a flexible, high-sensitivity, material-independent, low-cost, noninvasive tool for monitoring real-time refractive-index variation.

  18. Cure of HCV related liver disease.

    Science.gov (United States)

    Shiffman, Mitchell L; Benhamou, Yves

    2015-01-01

    Chronic hepatitis C virus (HCV) causes chronic liver injury and can lead to cirrhosis and hepatocellular carcinoma (HCC). HCV can also interact with the immune system to cause several HCV related disorders including essential mixed cryoglobulinemia, vasculitis, dermatitis, glomerulonephritis and lymphoma. A strong association between HCV and diabetes mellitus also exists. These extrahepatic features may lead to increased fatigue and a reduced quality of life. It is now possible to cure most patients with chronic HCV using oral antiviral therapy. Many of these HCV-related disorders and symptoms can be cured when HCV is eradicated. However, some patients may have irreversible injury to extrahepatic sites, cirrhosis that cannot resolve, an increased risk for HCC, persistent fatigue and a reduced quality of life, despite achieving sustained virological response.

  19. Alternative cancer cures: "unproven" or "disproven"?

    Science.gov (United States)

    Vickers, Andrew

    2004-01-01

    Oncology has always coexisted with therapies offered outside of conventional cancer treatment centers and based on theories not found in biomedicine. These alternative cancer cures have often been described as "unproven," suggesting that appropriate clinical trials have not been conducted and that the therapeutic value of the treatment is unknown. Contrary to much popular and scientific writing, many alternative cancer treatments have been investigated in good quality clinical trials, and they have been shown to be ineffective. In this article, clinical trial data on a number of alternative cancer cures including Livingston-Wheeler, Di Bella Multitherapy, antineoplastons, vitamin C, hydrazine sulfate, Laetrile, and psychotherapy are reviewed. The label "unproven" is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been "disproven."

  20. Aloe vera as cure for lichen planus.

    Science.gov (United States)

    Patil, Bharati A; Bhaskar, Hebbar Pragati; Pol, Jyoti S; Sodhi, Amandeep; Madhu, Asha V

    2013-01-01

    Oral lichen planus is a difficult condition to treat because of its chronic nature. Various treatment modalities have resulted in partial regression of symptoms but not a complete cure. Aloe vera, a product with minimal adverse effects, can be tried to treat this disorder. A 38-year-old male patient diagnosed with lichen planus of the skin and the oral mucosa was suffering from severe pain and a burning sensation intraorally and pruritus of the skin lesions. Considering the extensive involvement, an herbal alternative was considered. The patient was prescribed aloe vera juice and gel application for two months. At the nine-month follow-up, the patient was symptom-free and totally cured of the intraoral and skin lesions.

  1. Light-Curing Adhesive Repair Tapes

    Science.gov (United States)

    Allred, Ronald; Haight, Andrea Hoyt

    2009-01-01

    Adhesive tapes, the adhesive resins of which can be cured (and thereby rigidized) by exposure to ultraviolet and/or visible light, are being developed as repair patch materials. The tapes, including their resin components, consist entirely of solid, low-outgassing, nonhazardous or minimally hazardous materials. They can be used in air or in vacuum and can be cured rapidly, even at temperatures as low as -20 C. Although these tapes were originally intended for use in repairing structures in outer space, they can also be used on Earth for quickly repairing a wide variety of structures. They can be expected to be especially useful in situations in which it is necessary to rigidize tapes after wrapping them around or pressing them onto the parts to be repaired.

  2. Fast curing ethylene vinyl acetate films with dual curing agent towards application as encapsulation materials for photovoltaic modules

    Directory of Open Access Journals (Sweden)

    W-H. Ruan

    2014-02-01

    Full Text Available To speed up curing of ethylene vinyl acetate (EVA films as encapsulation materials for photovoltaic modules, a dual curing agent of benzoyl peroxide (BPO and butylperoxy 2-ethylhexyl carbonate (TBEC was introduced in this work. The experimental results indicated that for the weight ratio of BPO/TBEC of 0.6/2.4, over 80% gel content of EVA was yielded after curing at 130°C for 12 min. Compared with the case of single curing agent, the present one obviously operated at much lower temperature with faster rate. By carefully studying the influence of curing agent proportion and curing conditions on gel content of EVA films, as well as rheology and curing kinetics, the mechanism involved was analyzed and verified. The results are believed to be useful for developing new curing system of EVA encapsulation films with improved processability.

  3. Coating and curing apparatus and methods

    Energy Technology Data Exchange (ETDEWEB)

    Brophy, Brenor L.; Gonsalves, Peter R.; Maghsoodi, Sina; Colson, Thomas E.; Yang, Yu S.; Abrams, Ze' ev R.

    2016-04-19

    Disclosed is a coating apparatus including flow coating and roll-coating that may be used for uniform sol-gel coating of substrates such as glass, solar panels, windows or part of an electronic display. Also disclosed are methods for substrate preparation, flow coating and roll coating. Lastly, systems and methods for curing sol-gel coatings deposited onto the surface of glass substrates using high temperature air-knives, infrared emitters and direct heat applicators are disclosed.

  4. Photothermal Monitoring Of Curing Of Polymers

    Science.gov (United States)

    Rooney, Michael

    1993-01-01

    Time-resolved infrared radiometry (TRIR) adapted to monitoring curing of some polymers in production. Proposal part of continuing effort to perfect production of hydroxy-terminated polybutadiene for use in liners of solid-fuel rocket motors. Applicable to monitoring changing states of many other materials in process. TRIR, non-contact technique implemented with remotely situated equipment and better suited to use in production.

  5. Using Sex to Cure the Genome.

    Directory of Open Access Journals (Sweden)

    Eduardo P C Rocha

    2016-03-01

    Full Text Available The diversification of prokaryotes is accelerated by their ability to acquire DNA from other genomes. However, the underlying processes also facilitate genome infection by costly mobile genetic elements. The discovery that cells can uptake DNA by natural transformation was instrumental to the birth of molecular biology nearly a century ago. Surprisingly, a new study shows that this mechanism could efficiently cure the genome of mobile elements acquired through previous sexual exchanges.

  6. Sage Gene Expression Profiles Characterizing Cure

    Science.gov (United States)

    2006-10-01

    therapies to improve breast cancer cure frequency. Down Regulation of VEGF in MTCL Cells. RNA interference has been a powerful genetic tool to study...Science 296, 550 (2002). 100. D. A. Rubinson et al., Nat Genet 33, 401 (2003). 101. E. Devroe, P. A. Silver, BMC Biotechnol 2 (2002). 102. J. P...double- plotted along the estrous cycle. Double plotting of rhythmic patterns is a standard chronobiological technique that allows visualization of

  7. Cure Behavior and Thermal Properties of Diepoxidized Cardanol Resin Cured by Electron Beam Process

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Donghwan; Cheon, Jinsil [Kumoh National Institute of Technology, Gumi (Korea, Republic of)

    2013-07-01

    Thermal curing of epoxy resin requires high temperature, time-consuming process and the volatilization of hardener. It has known that electron beam curing of epoxy resin is a fast process and occurs at low or room temperature that help reduce residual mechanical stresses in thermosetting polymers. Diepoxidized cardanol (DEC) can be synthesized by an enzymatic method from cashew nut shell liquid (CNSL), that constitutes nearly one-third of the total nut weight. A large amount of CNSL can be formed as a byproduct of the mechanical processes used to render the cashew kerneledible and its total production approaches one million tons annually, which can be bio-degradable and replace the industrial thermosetting plastics. It is expected that DEC may be cured as in an epoxy resin, which was constituted on two epoxide group and long alkyl chain, and two-types of onium salts (cationic initiator) were used as a photo-initiator. The experimental variables of this study are type and concentration of photo-initiators and electron beam dosage. In this study, the effects of initiator type and concentration on the cure behavior and the thermal properties of DEC resin processed by using electron beam technology were studied using FT-IR, TGA, TMA, DSC, and DMA. Figure 1 is the FT-IR results, showing the change of chemical structure of pure DEC and electron beam cured DEC. The characteristic absorption peak of epoxide group appeared at 850cm{sup -1}. The shape and the height were reduced when the sample was irradiated with electron beam. From this result, the epoxide groups is DEC were opened by electron beam and cured. After then, electron beam cured DEC was investigated the effect of forming 3-dimensional network.

  8. An investigation on the effect of light cure and self cure composite resins on bonding strength of light cure glass ionomer to dentin (In-vitro

    Directory of Open Access Journals (Sweden)

    Pahlavan A

    2004-02-01

    Full Text Available Composite reins have recently become popular for posterior teeth restorations. Gap"nformation and subsequent microleakage are of the complications resulting from such restorations. One of the"ntechniques to overcome polymerization shrinkage of composite resins is sandwich technique (application of"nglass ionomer as a base beneath the composite resin. Since polymerization patterns in two types of composite"nresins (light cure and self cure differ from each other, various effects on the bond strength between glass"nionomer and dentin are expected."nPurpose: The aim of this in vitro study was to evaluate the effects of self- cure and light- cure composite"nresins in sandwich technique on the bond strength of light cure glass ionomer and dentin."nMaterials and Methods: 40 extracted human premolars were selected and divided into four groups:"nGroup 1: Light cure glass ionomer of 1mm thickness was placed on dentin."nGroup 2: 1mm thickness of light cure glass ionomer plus a mass of self cure composite resin of 2mm"nthickness were placed."nGroup 3: 1mm thickness of light cure glass ionomer plus light cure composite resin as two separate 1mm layer"nwere placed."nGroup 4: 1mm thickness of light cure glass ionomer with 37% phosphoric acid etching followed by two"nseparate layers of light cure composite resin of 1 mm thickness were placed."nSEM was used to determine gap size ai Gl- dentin and Gi- composite interlaces. The findings were analyzed"nby ANOVA and t-student tests."nResults: Groups 1 and 2 showed no gap at Gl-dentm interface and also cracks were not observed in all these"nspecimens. In group 3, there was gap between light cure GI and light cure composite resin and cracks were"nseen in GI, too. Group 4 showed gap at both interfaces and more cracks were seen in GI. Groups I and 2"nshowed the least gap formation and group 4 showed the most. Statistically significant difference was found"nbetween groups 3, 4 and group 1 (control, 2."nConclusion: Base

  9. Hepatopathy in an adult, secondary to congenital untreated panhypopituitarism and ectopic posterior pituitary gland

    Directory of Open Access Journals (Sweden)

    Miguel A Valle-Murillo

    2012-01-01

    Full Text Available We report a rare case of an adult with advanced liver failure in the setting of an untreated congenital panhypopituitarism. A 32-years-old man presented with a newly onset seizure episode secondary to hypoglycemia. In the initial exploration, we found eunuchoid habitus, absence of secondary sexual characteristics, ascites, and hepatic encephalopathy. Hormonal evaluation confirmed the absence of anterior hypophyseal hormones and the liver function tests showed derangement of liver function. Magnetic Resonance Imaging (MRI showed hypoplastic adenohypophysis and ectopic posterior pituitary gland. In the approach to liver disease, no cause was identified, besides the untreated panhypopituitarism.

  10. Accurate Cure Modeling for Isothermal Processing of Fast Curing Epoxy Resins

    Directory of Open Access Journals (Sweden)

    Alexander Bernath

    2016-11-01

    Full Text Available In this work a holistic approach for the characterization and mathematical modeling of the reaction kinetics of a fast epoxy resin is shown. Major composite manufacturing processes like resin transfer molding involve isothermal curing at temperatures far below the ultimate glass transition temperature. Hence, premature vitrification occurs during curing and consequently has to be taken into account by the kinetic model. In order to show the benefit of using a complex kinetic model, the Kamal-Malkin kinetic model is compared to the Grindling kinetic model in terms of prediction quality for isothermal processing. From the selected models, only the Grindling kinetic is capable of taking into account vitrification. Non-isothermal, isothermal and combined differential scanning calorimetry (DSC measurements are conducted and processed for subsequent use for model parametrization. In order to demonstrate which DSC measurements are vital for proper cure modeling, both models are fitted to varying sets of measurements. Special attention is given to the evaluation of isothermal DSC measurements which are subject to deviations arising from unrecorded cross-linking prior to the beginning of the measurement as well as from physical aging effects. It is found that isothermal measurements are vital for accurate modeling of isothermal cure and cannot be neglected. Accurate cure predictions are achieved using the Grindling kinetic model.

  11. Post-cure depth of cure of bulk fill dental resin-composites.

    Science.gov (United States)

    Alrahlah, A; Silikas, N; Watts, D C

    2014-02-01

    To determine the post-cure depth of cure of bulk fill resin composites through using Vickers hardness profiles (VHN). Five bulk fill composite materials were examined: Tetric EvoCeram(®) Bulk Fill, X-tra base, Venus(®) Bulk Fill, Filtek™ Bulk Fill, SonicFill™. Three specimens of each material type were prepared in stainless steel molds which contained a slot of dimensions (15 mm × 4 mm × 2 mm), and a top plate. The molds were irradiated from one end. All specimens were stored at 37°C for 24h, before measurement. The Vickers hardness was measured as a function of depth of material, at 0.3mm intervals. Data were analysed by one-way ANOVA using Tukey post hoc tests (α=0.05). The maximum VHN ranged from 37.8 to 77.4, whilst the VHN at 80% of max.VHN ranged from 30.4 to 61.9. The depth corresponding to 80% of max.VHN, ranged from 4.14 to 5.03 mm. One-way ANOVA showed statistically significant differences between materials for all parameters tested. SonicFill exhibited the highest VHN (presin composites can be cured to an acceptable post-cure depth, according to the manufacturers' claims. SonicFill and Tetric EvoCeram Bulk Fill had the greatest depth of cure among the composites examined. Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  12. Cure mechanisms in materials for use in esthetic dentistry.

    Science.gov (United States)

    Kwon, Tae-Yub; Bagheri, Rafat; Kim, Young K; Kim, Kyo-Han; Burrow, Michael F

    2012-02-01

    The current paper reviews the curing mechanisms found in resin-based materials used in dentistry. Historical aspects of dental products and the associated curing mechanisms are reviewed. In comparison with common industrial procedures, curing methods employed for dental materials are relatively limited because of the need to polymerize quickly in the oral cavity at an ambient temperature. Heat-cure and self-cure dental resins utilize benzoyl peroxide initiator alone with a tertiary amine co-initiator. At present, most dental restorative composites use a camphorquinone-amine complex initiation, visible light-cure, one-component systems, although alternative photoinitiators have been researched and developed. A multiple curing mode in a dual-cure material is a complex combination of various initiation systems. The use of aryl sulfinic acid sodium salt to overcome adverse chemical interactions between simplified adhesives and self- or dual-cure composites is based on another self-cure polymerization mechanism, sulfinic acid-initiated polymerization, proposed by Hagger in 1948. The sodium salt of aryl sulfinic acid reacts with an acidic monomer in simplified adhesives, and is believed to produce radicals. Clinically, it is important to try to optimize the degree of conversion of resin-based materials using proper manipulation and adequate light-curing techniques to ensure the best outcome for materials used to restore teeth.

  13. Rubber curing chemistry governing the orientation of layered silicate

    Directory of Open Access Journals (Sweden)

    2007-11-01

    Full Text Available The effect of curing systems on the orientation and the dispersion of the layered silicates in acrylonitrile butadiene rubber nanocomposite is reported. Significant differences in X-ray diffraction pattern between peroxide curing and sulfur curing was observed. Intense X-ray scattering values in the XRD experiments from peroxide cured vulcanizates indicate an orientation of the layers in a preferred direction as evinced by transmission electron micrographs. However, sulfur cured vulcanizates show no preferential orientation of the silicate particles. Nevertheless, a closer inspection of transmission electron microscopy (TEM images of peroxide and sulfur cured samples shows exfoliated silicate layers in the acrylonitrile butadiene rubber (NBR matrix. It was revealed in the prevailing study that the use of an excess amount of stearic acid in the formulation of the sulfur curing package leads to almost exfoliated type X-ray scattering pattern.

  14. Paradoxical increase in liver ketogenesis during long-term insulin-induced hypoglycemia in diabetic rats.

    Science.gov (United States)

    Schiavon, Fabiana P M; Gazola, Vilma A F G; Furlan, Maria M D P; Barrena, Helenton C; Bazotte, Roberto B

    2011-02-01

    It is well established that insulin inhibits liver ketogenesis. However, during insulin-induced hypoglycemia (IIH) the release of counterregulatory hormones could overcome the insulin effect on ketogenesis. To clarify this question the ketogenic activity in livers from alloxan-diabetic rats submitted to long-term IIH was investigated. Moreover, liver glycogenolysis, gluconeogensis, ureagenesis and the production of L-lactate were measured, and its correlation with blood levels of ketone bodies (KB), L-lactate, glucose, urea and ammonia was investigated. For this purpose, overnight fasted alloxan-diabetic rats (DBT group) were compared with control non-diabetic rats (NDBT group). Long-term IIH was obtained with an intraperitoneal injection of Detemir insulin (1 U/kg), and KB, glucose, L-lactate, ammonia and urea were evaluated at 0, 2, 4, 6, 8 or 10 h after insulin injection. Because IIH was well established two hours after insulin injection this time was used for liver perfusion experiments. The administration of Detemir insulin decreased (P < 0.05) blood KB and glucose levels, but there was an increase in the blood L-lactate levels and a rebound increase in blood KB during the glucose recovery phase of IIH. In agreement with these results, the capacity to produce KB from octanoate was increased in the livers of DBT rats. Moreover, the elevated blood L-lactate levels in DBT rats could be attributed to the higher (P < 0.05) glycogenolysis when part of glucose from glycogenolysis enters glycolysis, producing L-lactate. In contrast, except glycerol, gluconeogenesis was negligible in the livers of DBT rats. Therefore, during long-term IIH the higher liver ketogenic capacity of DBT rats increased the risk of hyperketonemia. In addition, in spite of the fact that the insulin injection decreased blood KB, there was a risk of worsening lactic acidosis.

  15. Gut microbiome response to short-term dietary interventions in reactive hypoglycemia subjects.

    Science.gov (United States)

    Quercia, Sara; Turroni, Silvia; Fiori, Jessica; Soverini, Matteo; Rampelli, Simone; Biagi, Elena; Castagnetti, Andrea; Consolandi, Clarissa; Severgnini, Marco; Pianesi, Mario; Fallucca, Francesco; Pozzilli, Paolo; Brigidi, Patrizia; Candela, Marco

    2017-08-14

    Reactive hypoglycemia (RH) is a metabolic disorder that provokes severe hypoglycemic episodes after meal. Over recent years, the gut microbiota (GM) has been recognized as potential target for the control of metabolic diseases, and the possibility to correct GM dysbioses through diet, favoring the recovery of metabolic homeostasis, has been considered. We investigate the impact of two short-term (3-day) nutritional interventions, based on the macrobiotic Ma-Pi 2 diet and a control Mediterranean diet, on the structure and functionality of the GM in 12 patients affected by RH. The GM composition was characterized by next-generation sequencing of the V3-V4 region of the 16S rRNA gene, and the ecosystem functionality was addressed by measuring the faecal concentration of short-chain fatty acids (SCFAs). In order to measure the short-term physiological GM fluctuation, the microbiome of 7 healthy people was characterized before and after 3 days of constant diet. While no convergence of the GM compositional profiles was observed, a significant increase in SCFA faecal levels was induced only in the Ma-Pi 2 diet group, suggesting the potential of this diet to support a short-term functional convergence of the GM, regardless of the individual compositional layout. The Ma-Pi 2 diet, with its high fiber load, was effective in increasing the production of SCFAs by the GM. Since these metabolites are known for their ability to counterbalance the metabolic deregulation in persons with glucose impairment disorders, their increased bioavailability could be of some relevance in RH. This article is protected by copyright. All rights reserved.

  16. Decreased levels of Fibroblast Growth Factor 21 are correlated with improved hypoglycemia in patients with insulinoma

    Science.gov (United States)

    Li, Xu; Yu, Haoyong; Yin, Jun; Li, Lianxi; Zhou, Jian; Li, Ming; Li, Qing; Chen, Haibing; Liu, Fang; Bao, Yuqian; Han, Junfeng; Jia, Weiping

    2017-01-01

    Fibroblast growth factor-21 (FGF-21) improves insulin sensitivity and lipid metabolism in obese or diabetic animal models and has been proposed as a potential therapeutic agent for treating T2DM, obesity, and their related complications. However, little is known about the changes of FGF21 levels in response to endogenous hyperinsulinemic hypoglycemia. To explore its relationship with parameters of glucose metabolism in patients with insulinoma, eleven subjects with pathological insulinoma and twenty-two healthy subjects were recruited for this study. Interestingly, we found that the serum FGF21 levels increased significantly in patients with insulinoma at baseline compared with the control group (381.36 ± 107.12 vs. 62.59 ± 10.48 pg/mL; P = 0.001). Furthermore, FGF21 was positively correlated with insulin (r = 0.80, P = 0.003) and proinsulin (r = 0.72, P = 0.012) in subjects with insulinoma. Multiple stepwise regression analysis showed that FGF21 was independently associated with insulin (β = 0.80, P = 0.003). In addition, FGF21 decreased significantly after surgery, and its change was still correlated positively with the changes in insulin (r = 0.61, P = 0.048) and proinsulin (r = 0.84, P = 0.001). These findings suggested that the serum FGF21 levels could be involved in a complex adaptive response to insulin secretion and glucose metabolism in humans. PMID:28225059

  17. Hypoglycemia, polycythemia and hyponatremia in a newborn exposed to nebivolol during pregnancy

    Directory of Open Access Journals (Sweden)

    Maria Giuseppa Sullo

    2015-01-01

    Full Text Available Nebivolol is a third-generation beta blocker that exerts selective antagonistic activity on β1 receptors. It has vasodilating properties that result from direct stimulation of endothelial nitric oxide synthase. Nebivolol is indicated for the treatment of hypertension and heart failure, and is generally well tolerated. In this article, we report a case of an infant who was admitted to the Pediatrics and Neonatology Unit of the Moscati Hospital (Aversa, Italy about 24 hours after birth. The reason for hospitalization was persistent severe hypoglycemia (blood glucose = 30 mg/dL and jaundice (total bilirubin = 12.5 mg/dL, indirect bilirubin 11.75 mg/dL. He was born by spontaneous delivery after a normal term pregnancy. Birth weight was 3040 g and the Apgar score was 6-9. The mother reported taking nebivolol 5 mg/day for unspecified tachycardia in the last 4 months of pregnancy. Clinical and instrumental investigations carried out during hospitalization did not reveal any congenital or perinatal abnormalities. After treatment for metabolic and electrolyte imbalance, he was discharged on the 10 th day of hospitalization, in good clinical condition and with normalization of clinical and laboratory parameters. Currently, there are no specific studies on nebivolol tolerability during pregnancy. Our data suggest that the risk profile of nebivolol during pregnancy is the same as that of other β-blockers. Therefore, further studies are required to determine the safety of β-blockers during pregnancy and the risks to the unborn child.

  18. Hipoglicemia por nesidioblastose: uma complicação rara da cirurgia bariátrica? Nesidioblastosis hypoglycemia: is it a rare complication of bariatric surgery?

    Directory of Open Access Journals (Sweden)

    Daniele Gehlen Klaus

    2007-12-01

    mórbidos com diabetes do tipo II, porém em alguns casos raros esse fenômeno benéfico gera malefícios, ou seja, a nesidioblastose, que deve ser corrigida pela ressecção parcial do pâncreas, sob pena de ameaçar a vida desses pacientes.BACKGROUND: Bariatric surgery has shown to be the most effective method in diabetes mellitus (DM type II resolution, reaching up to 80% of cure. However, some studies have shown the development of a hyperinsulinemic hypoglycemia state in certain morbidly obese patients after bariatric surgery, so called nesidioblastosis corresponding to pathological disseminated proliferation of pancreatic beta-cells. The purpose of this study is to review bibliographical data on nesidioblastosis after bariatric surgery, researching scientific articles published since 2000 over the subject. METHODS: A literature review was made over scientific articles published since 2000. Researching data based on PubMed (www.pubmed.gov, crossing the following headings: nesidioblastosis, hyperinsulinism, hypoglycemia and bariatric surgery complications. LITERATURE REVIEW: Fourteen publications related to the subject were reviewed. Among them, Cummings defends alterations in the functional activity of the intestinal tract after bariatric surgery promoting stimulation and excessive growth of pancreatic beta-cells and greater activity of pancreatic hormones, suggesting a possible cause for nesidioblastosis. Corroborating in order to elucidate the cause for this disease, authors suggest that the rapid intestinal transit after gastric bypass surgery elevates the serum level of glucagon-like peptide 1, thereby stimulating hyperinsulinemic hypoglycemia in these patients. Similarly, other authors defend the idea that the weight lost after bariatric surgery decrease intensively insulin-resistance due to hypertrophy and hyperfunctional state of pancreatic beta-cells, which is very common in obesity, promoting the development of nesidioblastosis. CONCLUSION

  19. CURING OF POLYMERIC COMPOSITES USING MICROWAVE RESIN TRANSFER MOULDING (RTM

    Directory of Open Access Journals (Sweden)

    R. YUSOFF

    2007-08-01

    Full Text Available The main objective of this work is to compare the difference between microwave heating and conventional thermal heating in fabricating carbon/epoxy composites. Two types of epoxy resin systems were used as matrices, LY5052-HY5052 and DGEBA-HY917-DY073. All composite samples were fabricated using resin transfer moulding (RTM technique. The curing of the LY5052-HY5052-carbon and the DGEBA-HY917-DY073-carbon composite systems, were carried out at 100 °C and 120 °C, respectively. Microwave heating showed better temperature control than conventional heating, however, the heating rate of the microwave cured samples were slower than the conventionally cured samples. This was attributed to the lower power (250 W used when heating with microwaves compared to 2000 W used in conventional heating. Study of thermal characteristics as curing progressed showed that the polymerisation reaction occurred at a faster rate during microwave curing than in conventional curing for both the DGEBA and the LY/HY5052 carbon composite systems. The actual cure cycle was reduced from 60 minutes to 40 minutes when using microwaves for curing DGEBA-carbon composites. As for LY/HY5052-carbon composites, the actual cure cycle was reduced from 3 hours to 40 minutes. Both conventional and microwave heating yielded similar glass transition temperatures (120 °C for DGEBA systems and 130 °C for LY/HY5052 systems. Microwave cured composites had higher void contents than conventionally cured composites (2.2-2.8% and 1.8-2.4% for DGEBA and LY/HY5052 microwave cured composites, respectively, compared to 0.2-0.4% for both DGEBA and LY/HY5052 thermally cured composites. C-scan traces showed that all composites, regardless of methods of curing, had minimal defects.

  20. Cure shrinkage effects in epoxy and polycyanate matrix composites

    Energy Technology Data Exchange (ETDEWEB)

    Spellman, G.P.

    1995-12-22

    A relatively new advanced composite matrix, polycyanate ester, was evaluated for cure shrinkage. The chemical cure shrinkage of composites is difficult to model but a number of clever experimental techniques are available to the investigator. In this work the method of curing a prepreg layup on top of a previously cured laminate of identical ply composition is utilized. The polymeric matrices used in advanced composites have been primarily epoxies and therefore a common system of this type, Fiberite 3501-6, was used as a base case material. Three polycyanate matrix systems were selected for the study. These are: Fiberite 954-2A, YLA RS-3, and Bryte Technology BTCy-1. The first three of these systems were unidirectional prepreg with carbon fiber reinforcement. The Bryte Technology material was reinforced with E-glass fabric. The technique used to evaluate cure shrinkage results in distortion of the flatness of an otherwise symmetric laminate. The first laminate is cured in a conventional fashion. An identical layup is cured on this first laminate. During the second cure all constituents are exposed to the same thermal cycles. However, only the new portion of the laminate will experience volumetric changes associate with matrix cure. The additional strain of cure shrinkage results in an unsymmetric distribution of residual stresses and an associated warpage of the laminate. The baseline material, Fiberite 3501-6, exhibited cure shrinkage that was in accordance with expectations. Cure strains were {minus}4.5E-04. The YLA RS-3 material had cure strains somewhat lower at {minus}3.2E-04. The Fiberite 954-2A cure strain was {minus}1.5E-04 that is 70% lower than the baseline material. The glass fabric material with the Bryte BTCy-1 matrix did not result in meaningful results because the processing methods were not fully compatible with the material.

  1. CURING KINETICS AND PROPERTIES OF ACRYLIC RESIN CURED WITH AZIRIDINE CROSSLINKER

    Institute of Scientific and Technical Information of China (English)

    Fei Xie; Zong-hui Liu; De-qing Wei

    2002-01-01

    A kind of aziridine crosslinkers was synthesized and used to crosslink acrylate copolymers. The crosslinking properties and curing kinetics of the resin were studied. It was found that with the increase of the content of crosslinker in the emulsion, the mechanical properties and solvent resistance of the resin will be apparently improved, but its glass transition temperature (Tg) is very low. The lowest amount of crosslinker used in the acrylic resin emulsion is 0.25%. Curing kinetics studied by DSC show that this curing reaction occurs readily because the apparent activation energy of the reaction is low(65.1 KJ/mol). These results demonstrate that the aziridine crosslinker is indeed a low temperature crosslinking agent and can be used at room temperature.

  2. Experimental Study on the Curing Effect of Dredged Sediments with Three Types of Curing Agents

    Directory of Open Access Journals (Sweden)

    Yan Lei-Ming

    2016-01-01

    Full Text Available Sediment solidification technology is widely used to dispose dredged sediment, three types of curing agents were used in this study to solidified the dredged sediment from shallows in Nantong with three types of curing agents: JY, ZL and FJ. The results showed that the optimal additive amounts of these three curing agents were 140g JY, 16g ZL, 2.0g FJ per 1000g of the dredged sediment respectively, their 28d USC were up to 2.48 MPa, 2.96 MPa and 3.00 MPa. JY has obvious early strength effect, which of FJ is not that obvious, but the later-stage strength of sediment solidified by FJ are relatively higher.

  3. Curing Study of Epoxy/clay Nanocomposite by a New Aromatic Diamine Functional Curing Agent

    Directory of Open Access Journals (Sweden)

    Seyed Mahdi Saadati

    2013-12-01

    Full Text Available The curing behavior of an epoxy/clay nanocomposite system composed of diglycidyl ether of bisphenol A (DGEBA epoxy resin with a new aromatic diamine curing agent and organically modified clay was investigated. Epoxy/clay nanocomposite samples were prepared by mixing DGEBA, different percentages of nanoclay (1, 3, 5, 7, and 9% and 4-(4-(2,6-diphenylpyridin-4-ylphenoxybenzene-1,3-diamine (DAP. The optimum ratio of the epoxy/clay nanocomposite system (3% was investigated by total enthalpy of the curing reaction from differential scanning calorimetry (DSC thermograms. The kinetic parameters such as activation energy, pre-exponential factor, and rate constant were obtained from DSC data.

  4. 复合树脂的不同固化方法对抗压强度影响%Effect of composite resins with different curing methods on compressive strength

    Institute of Scientific and Technical Information of China (English)

    徐晓; 崔智骁

    2001-01-01

    目的 探讨不同固化方法处理后对复合树脂抗压强度的影响。方法 采用光固化、光固化+光固化、光固化+热固化,3种不同固化方法处理3M和贺利氏复合树脂,在万能验试机上测试抗压强度。结果 2次处理的复合树脂抗压强度均比1次处理的复合树脂有较大提高,范围在51.8%~91.6%之间。不同的2次固化方法相比,统计学无显著差异。结论 复合树脂经2次固化方法处理,其抗压强度高于1次光固化方法的处理。%Objective To investigate the effect of composite resins dealedwith different curing methods on compressive strength. Methods The compressive strength change were determined by dealing with 3M composite resins and Herues composite resins by light cured, light cured + light cured and light cured + heat cured. Results The compressive strength with secondary cure was significantly higher than that of control groups (light cured only),a range from 51.8%~91.6% (P<0.05) , but there were no statistical difference between two secondary cure groups. Conclusion The compressive strength of secondary cured composite resins is higher than that of light cured only.

  5. Improving a self-curing dental resin by eliminating oxygen, hydroquinone and water from its curing process.

    Science.gov (United States)

    Keh, En-Sheng; Hayakawa, Iwao; Takahashi, Hidekazu; Watanabe, Akihiko; Iwasaki, Yasuhiko; Akiyoshi, Kazunari; Nakabayashi, Nobuo

    2002-12-01

    Self-curing dental resins are always manipulated in the presence of curing inhibitory factors such as oxygen, hydroquinone, water and another contaminants such as saliva and blood. The purpose of this study was to elucidate the effects of eliminating these curing inhibitory factors on resin properties. Several clinically relevant characteristics of an experimental resin cured in the absence of inhibitory factors (purified group) were determined and compared with the resin cured conventionally (control group). The purified group showed a significantly shorter induction period and higher reaction exotherm. It also showed significantly higher tensile strength and lower strain to failure. With regard to the amount of residual monomer, fracture toughness and fatigue strength the improvements were not significant. These findings suggest that the polymerization outcomes and mechanical properties of the purified group resin can be improved in general. Dental clinicians should pay attention to the storage and curing environments while manipulating the self-curing resin.

  6. Impact of symptomatic hypoglycemia on medication adherence, patient satisfaction with treatment, and glycemic control in patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Walz L

    2014-04-01

    Full Text Available Lotta Walz,1,3 Billie Pettersson,2,3 Ulf Rosenqvist,4 Anna Deleskog,3,5 Gunilla Journath,6 Per Wändell7 1Department of Oncology-Pathology, Karolinska Institutet, Stockholm, 2Center for Medical Technology Assessment, Linköping University, Linköping, 3Merck Sharp and Dohme (Sweden AB, Sollentuna, 4Department of Internal Medicine, Motala Hospital, Motala, 5Department of Molecular Medicine and Surgery, 6Department of Medicine, Karolinska Institutet, Stockholm, 7Department of Neurobiology, Care Sciences and Society, Centre for Family Medicine, Karolinska Institutet, Huddinge, Sweden Background: The purpose of this study was to evaluate the impact of symptomatic hypoglycemia on medication adherence, satisfaction with treatment, and glycemic control in patients with type 2 diabetes based on the treatment goals stated in the Swedish national guidelines. Methods: This cross-sectional, multicenter study was carried out between January and August 2009 in 430 consecutive primary health care patients on stable doses of metformin and sulfonylureas for at least 6 months. The patients completed questionnaires covering their experiences of low blood glucose and adherence, as well as barriers to and satisfaction with drug treatment (using the Treatment Satisfaction Questionnaire for Medication. Physicians collected the data from medical records. Results: Patients who experienced moderate or worse symptoms of hypoglycemia reported poorer adherence to medication (46% versus 67%; P<0.01 and were more likely to perceive barriers such as “bothered by medication side effects” (36% versus 14%; P<0.001 compared with patients with no or mild symptoms. Patients with moderate or worse symptoms of hypoglycemia were less satisfied with their treatment than those with no or mild symptoms as determined by the Treatment Satisfaction Questionnaire for Medication-Global satisfaction (67.0 versus 71.2; P<0.05. Overall, achievement of target glycated hemoglobin

  7. The cure for employee malaise--motivation.

    Science.gov (United States)

    Dawson, K M; Dawson, S N

    1991-01-01

    Although working conditions, hours, pay, and advancement opportunities are better now than in the 1950s--the "golden age" of American business--today's workers are significantly less satisfied. Why? The authors believe the cause of this malaise is lack of motivation. This article examines several techniques to cure employee malaise and discusses the long-term benefits of these techniques, which include empowerment, recognition, career development, the Pygmalion effect, incentives, and rewards. By making a commitment to these motivational techniques, managers will boost the morale and enthusiasm of their employees and their organization. This motivational process is not quick and easy; developing your employees is an ongoing process.

  8. Cure behavior of epoxy polymers used in microelectronics

    Science.gov (United States)

    Taweeplengsangsuke, Jantrawan

    2000-10-01

    Underfill resins are used to reduce solder fatigue in flip-chip assemblies. Both underfilling and curing processes are critical to achieve reliable finished products. This study included two main themes; the development of processing diagrams for commercial underfill resins and the fundamental understanding of cure kinetics and evolution of cure stresses in model epoxies. A variety of techniques have been used to characterize the fundamental phenomena involved in the processing of underfill resins. The flow behavior, cure kinetics, cure stresses, outgassing phenomena and void formation of underfill resins were studied. Processing diagrams for underfill resins were developed by mapping fundamental phenomena involved to provide a guideline for underfilling and curing steps. With these processing diagrams one should be able to design his underfilling and curing process with scientific approach. Two commercial underfill resins, which were evaluated as part of a SEMATECH program, where shown to possess significantly different processing characteristics. However, the appropriate explanation could not be made without knowing the proprietary chemistry of the systems. Therefore, model epoxies were formulated. Three different systems were investigated; amine, imidazole, and anhydride curing agent systems. With the known chemistry, the reaction kinetics and developed cure stress can be explained more clearly. Vitrification, which severely retards the rate of reaction, was found in amine (N-aminoethylpiperazine) and anhydride (Hexahydro-4-methylphthalic anhydride) cured systems when the cure temperatures were lower than the glass transition temperature (T g) of fully cured samples; however, imidazole(2-ethyl-4-methyl-imidazole) did not show vitrification when it was cured at 20 degrees below the T g of fully cured sample due to the large exotherms. Interestingly for imidazole system, the higher cure temperature exhibited a lower Tg. This could possibly be explained by the

  9. Impact of screening and monitoring of capillary blood glucose in the detection of hyperglycemia and hypoglycemia in non-critical inpatients

    Directory of Open Access Journals (Sweden)

    Rogerio Silicani Ribeiro

    2011-03-01

    Full Text Available Objective: To evaluate the impact of screening hyper and hypoglycemia measured by capillary glycemia and standard monitorization of  hyperglycemic patients hospitalized in regular care units of Hospital Israelita Albert Einstein. Methods: The capillary glycemia was  measured by the Precision PCx (Abbott glucosimeter, using the PrecisionWeb (Abbott software. The detection of hyper and hypoglycemia during the months of May/June were compared to those of March/April in 2009 and to the frequency of the diagnosis of diabetes in 2007. Rresults: There was an increase in the glycemia screening from 27.7 to 77.5% of hospitalized patients (p < 0.001, of hyperglycemia detection (from 9.3 to 12.2%; p < 0.001 and of hypoglycemia (from 1.5 to 3.3%; p < 0.001 during  the months of May/June  2009. According to this action 14 patients for each additional case of hyperglycemia and 26 cases for each case of hypoglycemia were identified. The detection of hyperglycemia was significantly higher (p < 0.001 than the frequency of registered diagnosis related do diabetes in the year of 2007. Cconclusions: the adoption of an institutional program of glycemia monitorization improves the detection of hyper and hypoglycemia and glycemia control in hospitalized patients in regular care units.

  10. Repetitive hypoglycemia increases circulating adrenaline level with resultant worsening of intimal thickening after vascular injury in male Goto-Kakizaki rat carotid artery.

    Science.gov (United States)

    Yasunari, Eisuke; Mita, Tomoya; Osonoi, Yusuke; Azuma, Kosuke; Goto, Hiromasa; Ohmura, Chie; Kanazawa, Akio; Kawamori, Ryuzo; Fujitani, Yoshio; Watada, Hirotaka

    2014-06-01

    Hypoglycemia associated with diabetes management is a potential risk for cardiovascular diseases. However, the effect of hypoglycemic episodes including a surge of sympathetic activity on the progression of neointima formation after vascular injury remains largely unknown. In this study, insulin was injected intraperitoneally into nonobese diabetic Goto-Kakizaki (GK) rats, once every 3 days for 4 weeks after balloon injury of carotid artery to induce hypoglycemia. Then, we evaluated balloon injury-induced neointima formation. Insulin treatment enhanced neointima formation and increased the number of proliferating cell nuclear antigen (PCNA)-positive cells in the carotid artery. Injection of glucose with insulin prevented hypoglycemia and abrogated intimal thickening. Also, bunazosin, an α1 adrenergic receptor antagonist, prevented intimal thickening and accumulation of PCNA-positive cells induced by insulin treatment despite the presence of concomitant hypoglycemia and high adrenaline levels. Incubation of cultured smooth muscle cells with adrenaline resulted in a significant increase in their proliferation and G0/G1 to S phase progression, which was associated with activation of extracellular signal-regulated kinase, enhanced expression of cell cycle regulatory molecules such as cyclin D1, and cyclin E, and phosphorylation of retinoblastoma protein. These adrenaline-induced effects were abrogated by bunazosin. Our data indicated that increased adrenaline induced by repetitive hypoglycemia promotes intimal thickening and smooth muscle cell proliferation after endothelial denudation in GK rats.

  11. [Secondary dyslipidemias].

    Science.gov (United States)

    Vargová, V; Pytliak, M; Mechírová, V

    2012-03-01

    Dyslipidemias rank among the most important preventabile factors of atherogenesis and its progression. This topic is increasingly being discussed as e.g. more than 50% of Slovak population die on atherosclerotic complications. According to etiology we distinguish primary dyslipidemias with strictly genetic background and secondary ones with origin in other disease or pathological state. Secondary dyslipidemias accompany various diseases, from common (endocrinopathies, renal diseases etc) to rare ones (thesaurismosis etc.) and represents one of symptoms of these diseases. Apart from particular clinical follow up of diagnosed dysipidemias, basic screening and secondary causes as well as treatment due to updated guidelines is recuired. In this review we present the most frequent dyslipidemias of clinical practice.

  12. Mechanical modeling of stress generation during cure of encapsulating resins

    Energy Technology Data Exchange (ETDEWEB)

    Lagasse, R.R.; Chambers, R.S.; Guess, T.R. (Sandia National Labs., Albuquerque, NM (USA)); Plazek, D.J.; Bero, C. (Pittsburgh Univ., PA (USA). Dept. of Materials Science and Engineering)

    1991-01-01

    We have developed a numerical model for calculating stresses generated during cure of shrinking encapsulating resins. Mechanical modeling of polymer encapsulated electronic devices usually focuses on stress generated during cooling after cure. The stress developed during cure, due to shrinkage of the encapsulant, is normally neglected. That assumption is valid if both the shear and bulk moduli of the encapsulant at the cure temperature are negligible with respect to the moduli at lower temperatures. Our measurements on a model epoxy encapsulant show that the shear modulus during cure, varying from 0 to 6 MPa, is at least 100 times smaller than that at ambient temperature. In contrast, the bulk modulus at the cure temperature is only 2.5 times smaller. Since the bulk modulus during cure cannot be neglected, significant stress can be produced if volume shrinkage is constrained by a stiff mold or embedded elements. In fact, mechanical failure of encapsulating materials during cure has been evident in some of our experiments. Using measurements of shear and bulk moduli plus volume shrinkage as inputs to a finite element model, we have successfully predicted the shrinkage strains and stresses developed during cure of a model epoxy resin inside a cylindrical tube. Consideration of cure shrinkage stress has led to a process modification that appears to reduce mechanical failures in a real encapsulated device. 6 refs., 6 figs.

  13. Nursing Observation on Diabetes Complicated With Hypoglycemia%糖尿病合并低血糖护理观察

    Institute of Scientific and Technical Information of China (English)

    黄珊珊

    2016-01-01

    目的:探讨糖尿病合并低血糖患者的护理过程,观察护理效果。方法选取本院2014年9月~2016年4月收治的120例糖尿病和低血糖患者,分析其临床资料,采取有针对性的护理措施。结果全部患者在经过精心护理后,临床症状均有所缓解,并未发生并发症,无死亡病例。结论糖尿病合并低血糖患者应密切关注自身血糖状况,相关护理人员应对患者予以宣教,监测患者血糖,降低副反应,效果明显。%Objective To investigate the nursing process of patients with diabetes melitus complicated with hypoglycemia and observe the nursing effect.Methods In our hospital,120 cases of diabetes and hypoglycemia patients from September 2014 to April 2016 were selected. To analyze the clinical data and take pertinent nursing measures.ResultsAl patients after careful nursing,clinical symptoms had been aleviated,no complications,no death cases. ConclusionDiabetic patients with hypoglycemia should pay close attention to their own blood sugar. Related nursing staff given propaganda and education to the patients,monitoring the patient blood sugar,reduce the side effects,the effect is obvious.

  14. Severe hypoglycemia in peritoneal dialysis patients due to overestimation of blood glucose by the point-of-care glucometer

    Directory of Open Access Journals (Sweden)

    Hasan M Al-Dorzi

    2011-01-01

    Full Text Available Although overestimation of blood glucose (BG by certain glucometers in peritoneal dialysis (PD patients has been reported, awareness of this problem by healthcare providers of multiple disciplines and different specialties is probably insufficient. This is a case series of four patients who had severe symptomatic hypoglycemia and normal BG by point-of-care glucometer at a tertiary care center from December 2007 to September 2008. We report four insulin-treated diabetic patients (age = 58.2 ± 16.2 years, 3 men and 1 woman on PD, who had acute decrease in level of consciousness in the emergency department (n = 1 and the hospital ward (n = 3. While they had their symptoms, they all had normal BG measured by the Accuchek glucometer (7.1 ± 3.3 mmol/L; nonetheless, simultaneous or near-simultaneous laboratory-measured BG levels were very low (2.0 ± 1.3 mmol/L. The mean difference in BG was 5.8 mmol/L (12 simultaneous or near-simultaneous measurements. Three patients had icodextrin-based PD in the night before symptomatic hypoglycemia. The first two patients, whose treatment for hypoglycemia was delayed, remained comatose and died later. The latter two patients were promptly treated with intravenous dextrose and did not have any neurologic sequelae. One of them died later from multiple organ failure. Over-estimation of BG in peritoneal dialysis patients by certain point-of-care glucometers is a serious problem and can be fatal. Increased awareness of this problem for all healthcare providers and use of appropriate glucometers are required.

  15. Critical parameters for electron beam curing of cationic epoxies and property comparison of electron beam cured cationic epoxies versus thermal cured resins and composites

    Energy Technology Data Exchange (ETDEWEB)

    Janke, C.J.; Norris, R.E.; Yarborough, K. [Oak Ridge National Lab., TN (United States). Oak Ridge Centers for Manufacturing Technology; Havens, S.J. [Oak Ridge Inst. for Science and Education, TN (United States); Lopata, V.J. [Atomic Energy of Canada Ltd., Pinawa, Manitoba (Canada). Whiteshell Labs.

    1997-01-16

    Electron beam curing of composites is a nonthermal, nonautoclave curing process offering the following advantages compared to conventional thermal curing: substantially reduced manufacturing costs and curing times; improvements in part quality and performance; reduced environmental and health concerns; and improvements in material handling. In 1994 a Cooperative Research and Development Agreement (CRADA), sponsored by the Department of Energy Defense Programs and 10 industrial partners, was established to advance electron beam curing of composites. The CRADA has successfully developed hundreds of new toughened and untoughened resins, offering unlimited formulation and processing flexibility. Several patent applications have been filed for this work. Composites made from these easily processable, low shrinkage material match the performance of thermal cured composites and exhibit: low void contents comparable to autoclave cured composites (less than 1%); superb low water absorption values in the same range as cyanate esters (less than 1%); glass transition temperatures rivaling those of polyimides (greater than 390 C); mechanical properties comparable to high performance, autoclave cured composites; and excellent property retention after cryogenic and thermal cycling. These materials have been used to manufacture many composite parts using various fabrication processes including hand lay-up, tow placement, filament winding, resin transfer molding and vacuum assisted resin transfer molding.

  16. Effect of oral contraceptives and/or metformin on GLP-1 secretion and reactive hypoglycemia in PCOS

    DEFF Research Database (Denmark)

    Glintborg, Dorte; Mumm, Hanne; Holst, Jens Juul

    2017-01-01

    CONTEXT: Insulin resistance in polycystic ovary syndrome (PCOS) may increase the risk of reactive hypoglycaemia (RH) and decrease glucagon-like peptide-1 (GLP-1) secretion. The possible effects of treatment with oral contraceptives (OCP) and/or metformin on GLP-1 secretion and risk of RH in PCOS...... significantly lower in obese vs. lean patients and were inversely associated with BMI. CONCLUSIONS: AUC GLP-1 levels were unchanged during treatment. Increased risk of hypoglycemia during metformin +OCP could be associated with increased insulin secretion....

  17. Influence of curing protocol on selected properties of light-curing polymers

    DEFF Research Database (Denmark)

    Dewaele, Magali; Asmussen, Erik; Peutzfeldt, Anne;

    2009-01-01

    The purpose of this study was to investigate the effect of light-curing protocol on degree of conversion (DC), volume contraction (C), elastic modulus (E), and glass transition temperature (T(g)) as measured on a model polymer. It was a further aim to correlate the measured values with each other....

  18. Heavy metal content in flue cured and air cured tobaccos from main production areas in Serbia

    Directory of Open Access Journals (Sweden)

    Radojičić Vesna

    2004-01-01

    Full Text Available The aim of this work was to examine the influence of growing conditions on heavy metal content in virginia (flue cured and burley (air cured tobacco type. Moreover, some of these metals could appear in the tobacco cigarette smoke. This fact may cause negative consequences for cigarette consumers. Examinations were carried out in five various production areas, for each tobacco type, during two years, 1998 and 1999; those were extreme years for production.Considering the results, it can be concluded: The most important factor for heavy metal content in tobacco leaves are weather conditions especially the amount of rainfall, since there is a direct correlation between the rainfall and size of roots, a dominant vegetation organ. It is inevitable that the metals content in flue cured and air cured tobaccos grown at different experimental lots, is still below the legally prescribed values. Tobacco leaves from Šabac production area have a little higher metal content than tobacco grown in other production areas, because a larger amount of copper was found. The metal content in plants can increase because of its absorption from soil, atmosphere, or mineral fertilizers and pesticides, and, what is very important, the content of metals can be high due to the vicinity of large industrial centers.

  19. Hypoglycemia in noncritically ill patients receiving total parenteral nutrition: a multicenter study. (Study group on the problem of hyperglycemia in parenteral nutrition; Nutrition area of the Spanish Society of Endocrinology and Nutrition).

    Science.gov (United States)

    Olveira, Gabriel; Tapia, María José; Ocón, Julia; Cabrejas-Gómez, Carmen; Ballesteros-Pomar, María D; Vidal-Casariego, Alfonso; Arraiza-Irigoyen, Carmen; Olivares, Josefina; Conde-García, Maria Carmen; García-Manzanares, Álvaro; Botella-Romero, Francisco; Quílez-Toboso, Rosa P; Matía, Pilar; Rubio, Miguel Ángel; Chicharro, Luisa; Burgos, Rosa; Pujante, Pedro; Ferrer, Mercedes; Zugasti, Ana; Petrina, Estrella; Manjón, Laura; Diéguez, Marta; Carrera, Ma José; Vila-Bundo, Anna; Urgelés, Juan Ramón; Aragón-Valera, Carmen; Sánchez-Vilar, Olga; Bretón, Irene; García-Peris, Pilar; Muñoz-Garach, Araceli; Márquez, Efren; Del Olmo, Dolores; Pereira, José Luis; Tous, María C

    2015-01-01

    Hypoglycemia is a common problem among hospitalized patients. Treatment of hyperglycemia with insulin is potentially associated with an increased risk for hypoglycemia. The aim of this study was to determine the prevalence and predictors of hypoglycemia (capillary blood glucose <70 mg/dL) in hospitalized patients receiving total parenteral nutrition (TPN). This prospective multicenter study involved 19 Spanish hospitals. Noncritically ill adults who were prescribed TPN were included, thus enabling us to collect data on capillary blood glucose and insulin dosage. The study included 605 patients of whom 6.8% (n = 41) had at least one capillary blood glucose <70 mg/dL and 2.6% (n = 16) had symptomatic hypoglycemia. The total number of hypoglycemic episodes per 100 d of TPN was 0.82. In univariate analysis, hypoglycemia was significantly associated with the presence of diabetes, a lower body mass index (BMI), and treatment with intravenous (IV) insulin. Patients with hypoglycemia also had a significantly longer hospital length of stay, PN duration, higher blood glucose variability, and a higher insulin dose. Multiple logistic regression analysis showed that a lower BMI, high blood glucose variability, and TPN duration were risk factors for hypoglycemia. Use of IV insulin and blood glucose variability were predictors of symptomatic hypoglycemia. The occurrence of hypoglycemia in noncritically ill patients receiving PN is low. A lower BMI and a greater blood glucose variability and TPN duration are factors associated with the risk for hypoglycemia. IV insulin and glucose variability were predictors of symptomatic hypoglycemia. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. CURE: Clean use of reactor energy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1990-05-01

    This paper presents the results of a joint Westinghouse Hanford Company (Westinghouse Hanford)-Pacific Northwest Laboratory (PNL) study that considered the feasibility of treating radioactive waste before disposal to reduce the inventory of long-lived radionuclides, making the waste more suitable for geologic disposal. The treatment considered here is one in which waste would be chemically separated so that long-lived radionuclides can be treated using specific processes appropriate for the nuclide. The technical feasibility of enhancing repository performance by this type of treatment is considered in this report. A joint Westinghouse Hanford-PNL study group developed a concept called the Clean Use of Reactor Energy (CURE), and evaluated the potential of current technology to reduce the long-lived radionuclide content in waste from the nuclear power industry. The CURE process consists of three components: chemical separation of elements that have significant quantities of long-lived radioisotopes in the waste, exposure in a neutron flux to transmute the radioisotopes to stable nuclides, and packaging of radionuclides that cannot be transmuted easily for storage or geologic disposal. 76 refs., 32 figs., 24 tabs.

  1. Radiation curing of carbon fibre composites

    Science.gov (United States)

    Spadaro, G.; Alessi, S.; Dispenza, C.; Sabatino, M. A.; Pitarresi, G.; Tumino, D.; Przbytniak, G.

    2014-01-01

    Epoxy/carbon fibre reinforced composites were produced by means of e-beam irradiation through a pulsed 10 MeV electron beam accelerator. The matrix consisted of a difunctional epoxy monomer (DGEBA) and an initiator of cationic polymerisation, while the reinforcement was a unidirectional high modulus carbon fibre fabric. Dynamic mechanical thermal analysis was carried out in order to determine the cross-linking degree. The analysis pointed out a nonuniformity in the cross-linking degree of the e-beam cured panels, with the formation of clusters at low Tg (glass transition temperature) and clusters at high Tg. An out-of-mould post irradiation thermal treatment on e-beam cured samples provides a higher uniformity in the network although some slight degradation effects. Mode I delamination fracture toughness and Interlaminar Shear Strength (ISS) were also investigated by means of Double Cantilever Beam (DCB) and Short Beam Shear tests, respectively. Results from this mechanical characterisation allowed to correlate fracture toughness of the bulk matrix resin, cross-linking density and fibre/matrix interaction to the delamination fracture behaviour of the fibre reinforced material.

  2. Out-of-Autoclave Cure Composites

    Science.gov (United States)

    Hayes, Brian S.

    2015-01-01

    As the size of aerospace composite parts exceeds that of even the largest autoclaves, the development of new out-of-autoclave processes and materials is necessary to ensure quality and performance. Many out-of-autoclave prepreg systems can produce high-quality composites initially; however, due to long layup times, the resin advancement commonly causes high void content and variations in fiber volume. Applied Poleramic, Inc. (API), developed an aerospace-grade benzoxazine matrix composite prepreg material that offers more than a year out-time at ambient conditions and provides exceptionally low void content when out-of-autoclave cured. When compared with aerospace epoxy prepreg systems, API's innovation offers significant improvements in terms of out-time at ambient temperature and the corresponding tack retention. The carbon fiber composites developed with the optimized matrix technology have significantly better mechanical performance in terms of hot-wet retention and compression when compared with aerospace epoxy matrices. These composites also offer an excellent overall balance of properties. This matrix system imparts very low cure shrinkage, low coefficient of thermal expansion, and low density when compared with most aerospace epoxy prepreg materials.

  3. Secondary dyslipidaemia

    African Journals Online (AJOL)

    Repro

    (e.g. metabolic syndrome, syndrome X), play a dominant role in ... change in the lipogram, the aggressive ... After dealing with the secondary cause, a risk assessment must be made by taking all .... caloric restriction for weight loss and low fat ...

  4. In situ cure monitoring of advanced fiber reinforced composites

    Science.gov (United States)

    Powell, Graham R.; Crosby, Peter A.; Fernando, Gerard F.; France, Chris M.; Spooncer, Ronald C.; Waters, David N.

    1995-04-01

    This paper describes a comparative study of in-situ cure monitoring and cure modelling by three methods: (a) evanescent wave spectroscopy, (b) refractive index change, (c) near- infrared spectroscopy. Optical fibers were embedded into aerospace epoxy resins during the manufacturing process of the composite. The cure characteristics were then tracked in real- time during the processing of the material via evanescent wave interaction. This technique is based upon monitoring of characteristic infrared absorption bands of the resin system to find the concentration of the epoxy and amine hardener as a function of cure time. Hence this technique is suitable for on-line process monitoring and optimization. Results obtained from the optical fiber sensors were used to model the curing behavior of the resin system. The results were compared with near-infrared spectroscopy and differential scanning calorimetry experiments carried out under similar conditions. The feasibility of utilizing refractive index changes to monitor the extent of cure has also been demonstrated.

  5. Photoacoustic monitoring of inhomogeneous curing processes in polystyrene emulsions

    Energy Technology Data Exchange (ETDEWEB)

    Vargas-Luna, M.; Gutierrez-Juarez, G.; Rodriguez-Vizcaino, J.M.; Varela-Nsjera, J.B.; Rodriguez-Palencia, J.M.; Bernal-Alvarado, J.; Sosa, M. [Instituto de Fisica, Universidad de Guanajuato, Leon, Guanajuato (Mexico); Alvarado-Gil, J.J. [Centro de Investigacion y de Estudios Avanzados del IPN, Unidad Merida, Antigua Carretera a Progreso, Merida, Yucatan (Mexico)

    2002-07-07

    The time evolution of the inhomogeneous curing process of polystyrene emulsions is studied using a variant of the conventional photoacoustic (PA) technique. The thermal effusivity, as a function of time, is determined in order to monitor the sintering process of a styrene emulsion in different steps of the manufacturing procedure. PA measurements of thermal effusivity show a sigmoidal growth as a function of time during the curing process. The parameterization of these curves permits the determination of the characteristic curing time and velocity of the process. A decreasing of the curing time and an increasing curing velocity for the final steps of the manufacturing process are observed. The feasibility of our approach and its potentiality for the characterization of other curing process are discussed. (author)

  6. Hypoglycemia induced by levofloxacin%左氧氟沙星致低血糖

    Institute of Scientific and Technical Information of China (English)

    周璇; 卢敏

    2014-01-01

    A 57-year-old woman with postoperative infection of rectal melanoma received an Ⅳ infusion of levofloxacin 0.2 g/100 ml twice daily.She developed weakness,hyperhidrosis,and palpitation 20 minutes after Ⅳ infusion.Laboratory examination showed that blood glucose was 2.7 mmol/L.Levofloxacin was discontinued immediately.She was given an Ⅳ infusion of 10% glucose 500 ml and candy.Her symptoms were mitigated.She was given an Ⅳ infusion of levofloxacin injection on the next day.The symptoms mentioned above recurred 10 minutes later.Laboratory examination showed blood glucose was 2.8 mmol/L.Levofloxacin was discontinued immediately and the symptomatic treatment was given again.Her hypoglycemia symptoms relieved.After switching to other antibiotics,her infection was under control and the hypoglycemic reaction did not occur again.%1例57岁女性患者因直肠黑色素瘤切除术后感染,给予左氧氟沙星注射液0.2 g/100 ml静脉滴注,2次/d,用药约20 min时患者出现乏力、盗汗、心悸等症状,急查血糖,为2.7 mmol/L.立即停用左氧氟沙星,静脉滴注10%葡萄糖500 ml,同时进食糖果,上述症状缓解.次日,再次静脉滴注左氧氟沙星约10 min后上述症状复现,即时血糖2.8 mmol/L.再次停用左氧氟沙星并给予对症治疗,症状缓解.改用其他抗生素治疗,患者感染得到控制,未再出现低血糖反应.

  7. Potentiation of Hormonal Responses to Hemorrhage and Fasting, but not Hypoglycemia in Conscious Adrenalectomized Rats

    Science.gov (United States)

    Darlington, Daniel N.; Keil, Lanny C.; Dallman, Mary F.

    1989-01-01

    Bilateral adrenalectomy (ADRX) in rats removes the source of two major stress-responsive hormones, corticosterone and epinephrine. To test how ADRX rats with-stand stress, we performed the following experiments in adult male rats provided with indwelling femoral arterial and venous cannulae and either ADRX or sham-adrenalectomized (Sham) 3 days later and given 0.5% NaCl to drink. Five to 6 days after adrenal surgery the rats were studied after either a 15 ml/kg.5 min hemorrhage or after an overnight fast followed by insulin-induced hypoglycemia. In fed unstressed ADRX rats, basal mean arterial blood pressure was slightly decreased; heart rate was increased; blood volume, vasopressin, and oxytocin concentrations were not different from sham values; and renin and norepinephrine were significantly elevated. The recovery of arterial pressure after hemorrhage in the ADRX rats was similar to that in the sham group over a 5-h period; however, the responses of vasopressin and oxytocin were significantly greater, and those of renin and norepinephrine were markedly potentiated in the ADRX group. Heart rate recovered faster in the ADRX group and was elevated, compared to the sham value, for most of the 5-h period. Restitution of blood volume was attenuated in the ADRX group, although the restitution of plasma protein was not different between the groups. A significant difference in the change in plasma osmolality between groups after hemorrhage may account for the attenuated restitution of blood volume. After an overnight fast, which reduced blood volume in both groups of rats, the plasma renin concentration rose still further in ADRX rats; the differences in other measured variables observed between fed ADRX and sham groups remained the same. The insulin-induced 50% decrease in glucose caused minor effects on arterial blood pressure and heart rate and occasioned responses in renin and norepinephrine of similar magnitudes in the two groups. We conclude that in the absence of

  8. Glucose administration inhibits the hepatic activation of gluconeogenesis promoted by insulin-induced hypoglycemia

    Directory of Open Access Journals (Sweden)

    Sharize Betoni Galende

    2009-08-01

    Full Text Available The activation of hepatic gluconeogenesis in male Wistar adult 6 h fasted rats during insulin-induced hypoglycemia (IIH was previously demonstrated. In this study, the effects of intraperitoneal (ip glucose (100 mg/kg on the activation of liver gluconeogenesis during IIH was investigated. Thus, 6 h fasted rats that received ip regular insulin (1 U/kg and 30 min later ip saline (Control group or glucose (Experimental group were compared. All the experiments were executed 60 min after insulin injection. The glycemia of Control and Experimental groups were not different (P > 0.05. To investigate gluconeogenesis, liver perfusion experiments were performed. The results demonstrated that excepting glycerol, livers from rats which received ip glucose showed lower (P Em estudo recente empregando ratos Wistar com 6 h de privação alimentar demonstramos que ocorre ativação da neoglicogênese hepática durante a hipoglicemia induzida por insulina (HII. Neste estudo, os efeitos da administração intraperitoneal (ip de glicose (100 mg/kg sobre a ativação da neoglicogênese hepática durante a HII foi investigada. Assim, ratos com 6 h de privação alimentar que receberam insulina regular ip (1 U/kg e 30 min depois salina (Grupo Controle ou glicose ip (Grupo Experimental foram comparados. Os experimentos foram executados 60 min após a injeção de insulina. A glicemia dos grupos Controle e Experimental não foi diferente (P > 0.05. Para investigar a neoglicogênese, realizouse experimentos de perfusão de fígado. Os resultados demonstraram, exceto para o glicerol, que fígados de ratos que receberam glicose ip (Grupo Experimental, apresentaram menor taxa (P < 0.05 de neoglicogênese a partir de L-alanina, Lglutamina, L-lactato ou L-alanina + L-glutamina + L-lactato + glicerol. Portanto, a ausência de recuperação da glicemia após administração de glicose foi mediada por inibição da neoglicogênese hepática.

  9. Conditional Tissue-Specific Foxa2 Ablation in Mouse Pancreas Causes Hyperinsulinemic Hypoglycemia: RETRACTED.

    Science.gov (United States)

    Wu, Zengbin; Fei, Aihua; Liu, Yingbin; Pan, Shuming

    , inappropriate hyperinsulinemia, and hypoglycemia in mice. Our conditional tissue-specific Foxa2 ablation mouse model will be useful in elucidating regulation of normal and abnormal α- and β-cell differentiation and pinpointing novel targets for diabetes control.

  10. PEPCK-C reexpression in the liver counters neonatal hypoglycemia in Pck1 (del/del) mice, unmasking role in non-gluconeogenic tissues.

    Science.gov (United States)

    Semakova, Jana; Hyroššová, Petra; Méndez-Lucas, Andrés; Cutz, Ernest; Bermudez, Jordi; Burgess, Shawn; Alcántara, Soledad; Perales, José C

    2017-02-01

    Whole body cytosolic phosphoenolpyruvate carboxykinase knockout (PEPCK-C KO) mice die early after birth with profound hypoglycemia therefore masking the role of PEPCK-C in adult, non-gluconeogenic tissues where it is expressed. To investigate whether PEPCK-C deletion in the liver was critically responsible for the hypoglycemic phenotype, we reexpress this enzyme in the liver of PEPCK-C KO pups by early postnatal administration of PEPCK-C-expressing adenovirus. This maneuver was sufficient to partially rescue hypoglycemia and allow the pups to survive and identifies the liver as a critical organ, and hypoglycemia as the critical pathomechanism, leading to early postnatal death in the whole-body PEPCK-C knockout mice. Pathology assessment of survivors also suggest a possible role for PEPCK-C in lung maturation and muscle metabolism.

  11. Short-term cost-effectiveness of insulin detemir and insulin aspart in people with type 1 diabetes who are prone to recurrent severe hypoglycemia

    DEFF Research Database (Denmark)

    Pedersen-Bjergaard, Ulrik; Kristensen, Peter Lommer; Nørgaard, Kirsten

    2016-01-01

    -years (QALYs) gained. Sensitivity analyses were conducted to test the robustness of the analysis. The main outcome measure was the incremental cost-effectiveness ratio (ICER). RESULTS: The insulin analogue regimen was associated with greater total costs compared with the human insulin regimen (20,418 DKK [1972......OBJECTIVE: Based on the data of the HypoAna trial (ClinicalTrials.gov NCT00346996), a short-term cost-effectiveness analysis was conducted comparing an all insulin analogue regimen with an all human insulin regimen in people with type 1 diabetes who are prone to recurrent severe hypoglycemia....... METHODS: Clinical data from the HypoAna trial and Danish cost data related to the treatment of severe hypoglycemia were used to populate a 1-year cost-effectiveness analysis. Hypoglycemia quality-of-life data were based on previously published utility values, used to calculate the quality-adjusted life...

  12. Sage Gene Expression Profiles Characterizing Cure

    Science.gov (United States)

    2005-10-01

    Controversies in Management, 1994. 2. Daland EM. Untreated carcinoma of the breast. Surg Gynaecol Obstet 1927, 44, 264–271. 3. Paget S. The distribution of secondary growths in cancer of the breast . Lancet

  13. Process Formulations And Curing Conditions That Affect Saltstone Properties

    Energy Technology Data Exchange (ETDEWEB)

    Reigel, M. M.; Pickenheim, B. R.; Daniel, W. E.

    2012-09-28

    The first objective of this study was to analyze saltstone fresh properties to determine the feasibility of reducing the formulation water to premix (w/p) ratio while varying the amount of extra water and admixtures used during processing at the Saltstone Production Facility (SPF). The second part of this study was to provide information for understanding the impact of curing conditions (cure temperature, relative humidity (RH)) and processing formulation on the performance properties of cured saltstone.

  14. The curing process of layered silicate/epoxy nanocomposites

    OpenAIRE

    Nieminen, Ilkka

    2009-01-01

    The industrial methods of processing polymeric thermoset matrix nanocomposites require a good knowledge of the matrix curing process. The dispersion of nanoparticles in the matrix effects the curing process due to the interaction between nanoparticles and the matrix at the atomic level, especially when the nanoparticles have been treated with a surfactant agent ( alquilammonium) that is in competition with the reactive groups of the hardener. This thesis investigates the curing process o...

  15. CYP2C9*2 allele increases risk for hypoglycemia in POR*1/*1 type 2 diabetic patients treated with sulfonylureas.

    Science.gov (United States)

    Ragia, G; Tavridou, A; Elens, L; Van Schaik, R H N; Manolopoulos, V G

    2014-01-01

    It is previously shown that carriers of the defective allele CYP2C9*3 that leads to impaired sulfonylurea metabolism are at increased sulfonylurea-induced hypoglycemia risk due to diminished drug metabolism, whereas no effect of CYP2C9*2 allele was found. Recently, a polymorphism in P450 oxidoreductase (POR) gene, assigned as POR*28 allele, was associated with increased CYP2C9 activity. The aim of this study was to assess i) the effect of POR*28 allele on sulfonylurea-induced hypoglycemia risk and ii) the association of CYP2C9*2 allele with hypoglycemia risk in non-carriers of POR*28 allele. The study group consisted of 176 patients with diagnosed type 2 diabetes mellitus (T2DM) treated with sulfonylureas, of whom 92 patients had experienced at least one drug-associated hypoglycemic event (cases), while 84 had never experienced a hypoglycemic event (controls). POR*28 allele was detected by use of real-time TaqMan PCR. POR*28 allele was not associated with sulfonyl-urea-induced hypoglycemia. In POR*1/*1 patients, CYP2C9*1/*2 genotype was more common in cases than in controls (32.7 vs. 14.3%, p=0.041). In a model adjusted for age, BMI, duration of T2DM and renal function, and POR*1/*1 entered as a selection variable, CYP2C9*2 allele increased the hypoglycemia risk in response to sulfonylurea (odds ratio: 3.218, p=0.031). In conclusion, our results suggest that POR*28 allele is masking the association of CYP2C9*2 allele with sulfonyl-urea-induced hypoglycemia. Therefore, POR*28 allele is an important source of CYP2C9 activity variability and combined with CYP2C9 gene poly-morphisms may explain individual variability in the effect of sulfonylureas.

  16. Curing Methods and Their Effects on The Strength of Concrete

    OpenAIRE

    Nuruddeen Usman; Muhammad Nura Isa

    2015-01-01

    There are a lot of arguments on which method of curing concrete gives good strength. These different opinions results into this study, which aim at investigating the effects of different curing methods on the strength of concrete. Laboratory test was employed for this study. Normal concretes were prepared using specified mix ratio of 1:2:4 and 1:3:6. The cubes tested for compressive strength at 3, 7, 21, and 28 days of curing respectively using four curing methods namely immersion...

  17. Optical fibre grating refractometers for resin cure monitoring

    Science.gov (United States)

    Buggy, S. J.; Chehura, E.; James, S. W.; Tatam, R. P.

    2007-06-01

    The use of fibre grating refractometers as a means of monitoring the cure of a UV-cured epoxy resin is presented. The wavelength shift of the attenuation bands of a long period grating and the spectral response of a tilted fibre Bragg grating sensor were measured simultaneously during the cure of the resin and compared with measurements made using a fibre optic Fresnel-based refractometer. The results showed a good correlation (6 × 10-3 rius) and illustrate the potential of the techniques for non-invasive composite material cure monitoring.

  18. Avoidable iatrogenic hypoglycemia in patients on peritoneal dialysis: the risks of nonspecific glucose monitoring devices and drug-device interaction.

    Science.gov (United States)

    Firanek, Catherine A; Jacob, Dalia T; Sloand, James A

    2014-12-01

    Health care professionals (HCPs) depend upon "point-of-care" (POC) glucometers to provide appropriate treatment in emergency and hospital environments. Most devices located in these settings use nonspecific test strip methodology (NSTSM), which is unable to distinguish glucose from nonglucose sugars, including maltose. This flaw can result in erroneous administration of insulin and harm to patients. Icodextrin is a colloidal osmotic agent used in peritoneal dialysis (PD) solutions to augment ultrafiltration and waste removal. The main metabolite of icodextrin is maltose. Three representative case reports of inappropriate medical action related to in-hospital use of NSTSM monitoring in PD patients using icodextrin are provided to emphasize importance of this interaction and HCP awareness. PD patients using icodextrin before hospitalization exhibited marked discrepancy between blood glucose (BG) measurements obtained from POC-NSTSM glucometers and those obtained by glucose-specific methods in clinical chemistry laboratories leading to inappropriate administration of insulin by HCPs and symptomatic hypoglycemia in all patients. None of the patients received icodextrin during hospitalization. Non-nephrology HCPs are unaware that POC glucometers are nonglucose specific and do not possess comprehensive knowledge of drug metabolism, particularly for uncommonly seen agents. The case reports highlight the absolute need for use of glucose-specific assays in BG determinations for patients using icodextrin within 2 weeks of hospitalization. To avoid future devastating consequences including severe hypoglycemia, coma, or death related to the drug-device interaction described, hospital protocols should require that all PD patients' BGs are measured in central chemistry laboratories.

  19. NT-pro-BNP during hypoglycemia and hypoxemia in normal subjects: impact of renin-angiotensin system activity

    DEFF Research Database (Denmark)

    Due-Andersen, R; Pedersen-Bjergaard, U; Høi-Hansen, T;

    2008-01-01

    Brain-derived natriuretic peptide (BNP) is a cardioprotective peptide released, together with the inactive NH2-terminal part of its prohormone (NT-pro-BNP), in response to different kinds of myocardial stress. Hypoglycemia and hypoxemia are conditions that threaten cellular function and hence...... potentially stimulate BNP release. BNP interacts with the renin-angiotensin system (RAS). The aim of this study was, therefore, to explore if basal RAS activity has an impact on NT-pro-BNP concentrations during myocardial stress induced by hypoglycemia and hypoxemia. From a cohort of 303 healthy young men, 10...... (mean nadir Po-2 5.8 +/- 0.5 kPa), and 3) normoglycemic normoxia (control). NT-pro-BNP was measured at baseline, during the stimuli, and in the recovery phase. Hypoxemia was associated with a 9% increase in NT-pro-BNP from 2.2 +/- 1.5 pmol/l at baseline to 2.4 +/- 1.5 pmol/l during hypoxemia (P

  20. Continuous Subcutaneous Insulin Infusion in Children: A Pilot Study Validating a Protocol to Avoid Hypoglycemia at Initiation

    Directory of Open Access Journals (Sweden)

    Patricia Olivier

    2017-04-01

    Full Text Available BackgroundThe occurrence of hypoglycemia and hyperglycemia during the first days after transition to continuous subcutaneous insulin infusion (CSII in patients with type 1 diabetes has not been systematically studied in children. The aim of this prospective study was to demonstrate that the protocol applied in our diabetes clinic is safe at CSII initiation in children.MethodsWe assessed 22 pediatric patients with type 1 diabetes, using continuous glucose monitoring (CGM before and after CSII initiation (±3 days.ResultsAfter CSII initiation, there was no difference in the rates of hypoglycemic events expressed as relative rates (RRs per person-reading (RR = 0.85, p = 0.52, 95% CI 0.52–1.39, as well as in the number of prolonged hypoglycemic events (>1 h per day (RR = 1.12, p = 0.56, 95% CI 0.75–1.68. We observed only a trend toward prolonged episodes of hyperglycemia after pump initiation (RR = 1.52, p = 0.06, 95% CI 0.97–2.35.ConclusionOur study is the first to assess, through CGM and in a prospective way, the impact of a CSII initiation protocol on glycemic values. Our protocol provides a safe model to avoid hypoglycemia at CSII initiation in children.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT01840358.

  1. Hyperinsulinemic hypoglycemia in Beckwith-Wiedemann syndrome due to defects in the function of pancreatic beta-cell adenosine triphosphate-sensitive potassium channels

    DEFF Research Database (Denmark)

    Hussain, K; Cosgrove, K E; Shepherd, R M

    2005-01-01

    Beckwith-Wiedemann syndrome (BWS) is a congenital overgrowth syndrome that is clinically and genetically heterogeneous. Hyperinsulinemic hypoglycemia occurs in about 50% of children with BWS and, in the majority of infants, it resolves spontaneously. However, in a small group of patients the hypo......Beckwith-Wiedemann syndrome (BWS) is a congenital overgrowth syndrome that is clinically and genetically heterogeneous. Hyperinsulinemic hypoglycemia occurs in about 50% of children with BWS and, in the majority of infants, it resolves spontaneously. However, in a small group of patients...

  2. Carnitine deficiency with hyperbilirubinemia, generalized skeletal muscle weakness and reactive hypoglycemia in a patient on long-term total parenteral nutrition: treatment with intravenous L-carnitine.

    Science.gov (United States)

    Worthley, L I; Fishlock, R C; Snoswell, A M

    1983-01-01

    Low levels of plasma carnitine and reduced urinary carnitine excretion with persistently elevated plasma bilirubin levels, reactive hypoglycemia and generalized skeletal muscle weakness are described in a patient requiring long-term total parenteral nutrition (TPN). Intravenous administration of L-carnitine at 400 mg/day for 7 days and subsequently a maintenance dose of 60 mg/day corrected the plasma carnitine deficiency and reactive hypoglycemia and was associated with a return to normal plasma bilirubin levels and a restoration of skeletal muscle strength.

  3. Link between Hypoglycemia and Cardiac Arrhythmias: An Answer to Why Tight Glycemic Control May Increase Mortality in ...

    Science.gov (United States)

    ... Disease (Nephropathy) Gastroparesis Mental Health Step On Up Treatment & Care Blood Glucose Testing Medication Doctors, Nurses & More ... us get closer to curing diabetes and better treatments for those living with diabetes. Other Ways to ...

  4. Brane polarization is no cure for tachyons

    CERN Document Server

    Bena, Iosif

    2015-01-01

    Anti-M2 and anti-D3 branes placed in regions with charges dissolved in fluxes have a tachyon in their near-horizon region, which causes these branes to repel each other. If the branes are on the Coulomb branch this tachyon gives rise to a runaway behavior, but when the branes are polarized into five-branes this tachyon only appears to lower the energy of the polarized branes, without affecting its stability. We analyze brane polarization in the presence of a brane-brane-repelling tachyon and show that when the branes are polarized along the direction of the tachyon the polarized shell is unstable. This implies that tachyons cannot be cured by brane polarization and indicates that, at least in a certain regime of parameters, anti-D3 branes polarized into NS5 branes at the bottom of the Klebanov-Strassler solution have an instability.

  5. Ambient Cured Alkali Activated Flyash Masonry Units

    Science.gov (United States)

    Venugopal, K.; Radhakrishna; Sasalatti, Vinod M.

    2016-09-01

    Geopolymers belong to a category of non-conventional and non-Portland cement based cementitious binders which are produced using industrial by products like fly ash and ground granulated blast furnace slag (GGBFS). This paper reports on the development of geopolymer mortars for production of masonry units. The geopolymer mortars were prepared by mixing various by products with manufactured sand and a liquid mixture of sodium silicate and sodium hydroxide solutions. After curing at ambient conditions, the masonry units were tested for strength properties such as water absorption, initial rate of absorption, compression, shear- bond, and stress-strain behaviour etc. It was observed that the flexural strength of the blocks is more than 2 MPa and shear bond strength is more than 0.4MPa. It was found that the properties of geopolymer blocks were superior to the traditional masonry units. Hence they can be recommended for structural masonry.

  6. Helicobacter pylori: Basic Mechanisms to Clinical Cure

    Directory of Open Access Journals (Sweden)

    ABR Thomson

    1995-01-01

    Full Text Available Since its rediscovery 10 years ago, Helicobacter pylori has reshaped our thinking about the course of peptic ulcer disease. Our approach to the patient with a duodenal ulcer has become one of attempting eradication therapy at the time of first diagnosis, in the hope of curing the ulcer disease. Gastric and duodenal ulceration are only two of the manifestations of this chronic antral infection; other complications of H pylori include gastritis, gastric cancer and possible maltomas. Therapy of H pylori infection is complicated and involves dual therapy with an antibiotic plus a protein pump inhibitor, such as omeprazole 20 mg bid plus amoxicillin 1 g bid for two weeks, triple or quadruple therapy with bismuth, two antibiotics and an H2-receptor antagonist. Vaccination against H pylori is on the far horizon.

  7. Curing of epoxy matrix composite in stratosphere

    Science.gov (United States)

    Kondyurin, Alexey; Kondyurina, Irina; Bilek, Marcela

    Large structures for habitats, greenhouses, space bases, space factories are needed for next stage of space exploitation. A new approach enabling large-size constructions in space relies on the use of the polymerization technology of fiber-filled composites with a curable polymer matrix applied in the free space environment. The polymerisation process is proposed for the material exposed to high vacuum, dramatic temperature changes, space plasma, sun irradiation and atomic oxygen (in low Earth orbit), micrometeorite fluence, electric charging and microgravitation. The stratospheric flight experiments are directed to an investigation of the curing polymer matrix under the stratospheric conditions on. The unique combination of low atmospheric pressure, high intensity UV radiation including short wavelength UV and diurnal temperature variations associated with solar irradiation strongly influences the chemical processes in polymeric materials. The first flight experiment with uncured composites was a part of the NASA scientific balloon flight program realised at the NASA stratospheric balloon station in Alice Springs, Australia. A flight cassette installed on payload was lifted with a “zero-pressure” stratospheric balloon filled with Helium. Columbia Scientific Balloon Facility (CSBF) provided the launch, flight telemetry and landing of the balloon and payload. A cassette of uncured composite materials with an epoxy resin matrix was exposed 3 days in the stratosphere (40 km altitude). The second flight experiment was realised in South Australia in 2012, when the cassette was exposed in 27 km altitude. An analysis of the chemical structure of the composites showed, that the space irradiations are responsible for crosslinking of the uncured polymers exposed in the stratosphere. The first prepreg in the world was cured successfully in stratosphere. The investigations were supported by Alexander von Humboldt Foundation, NASA and RFBR (12-08-00970) grants.

  8. Stratospheric experiments on curing of composite materials

    Science.gov (United States)

    Chudinov, Viacheslav; Kondyurin, Alexey; Svistkov, Alexander L.; Efremov, Denis; Demin, Anton; Terpugov, Viktor; Rusakov, Sergey

    2016-07-01

    Future space exploration requires a large light-weight structure for habitats, greenhouses, space bases, space factories and other constructions. A new approach enabling large-size constructions in space relies on the use of the technology of polymerization of fiber-filled composites with a curable polymer matrix applied in the free space environment on Erath orbit. In orbit, the material is exposed to high vacuum, dramatic temperature changes, plasma of free space due to cosmic rays, sun irradiation and atomic oxygen (in low Earth orbit), micrometeorite fluence, electric charging and microgravitation. The development of appropriate polymer matrix composites requires an understanding of the chemical processes of polymer matrix curing under the specific free space conditions to be encountered. The goal of the stratospheric flight experiment is an investigation of the effect of the stratospheric conditions on the uncured polymer matrix of the composite material. The unique combination of low residual pressure, high intensity UV radiation including short-wave UV component, cosmic rays and other aspects associated with solar irradiation strongly influences the chemical processes in polymeric materials. We have done the stratospheric flight experiments with uncured composites (prepreg). A balloon with payload equipped with heater, temperature/pressure/irradiation sensors, microprocessor, carrying the samples of uncured prepreg has been launched to stratosphere of 25-30 km altitude. After the flight, the samples have been tested with FTIR, gel-fraction, tensile test and DMA. The effect of cosmic radiation has been observed. The composite was successfully cured during the stratospheric flight. The study was supported by RFBR grants 12-08-00970 and 14-08-96011.

  9. Cure Kinetics of DGEBA with Hyperbranched Poly(3-hydroxyphenyl) Phosphate as Curing Agent Studied by Non-isothermal DSC

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    The cure kinetics of diglycidyl ether of bisphenol A(DGEBA) with hyperbranched poly(3-hydroxyphenyl) phosphate(HHPP) as the curing agent was investigated by means of non-isothermal differential scanning calorimetry(DSC) at various heating rates. The results were compared with the corresponding results by using 1,3-dihydroxybenzene(DHB) as a model compound. The results show that HHPP can enhance the cure reaction of DGEBA, resulting in the decrease of the peak temperature of the curing curve as well as the decrease of the activation energy because of the flexible -P-O- groups in the backbone of HHPP. However, both the activation energy of the cured polymer and the peak temperature of the curing curve are increased with DHB as a curing agent. The cure kinetics of the DGEBA/HHPP system was calculated by using the isoconversional method given by Málek. It was found that the two-parameter autocatalytic model(esták-Berggren equation) is the most adequate one to describe the cure kinetics of the studied system at various heating rates. The obtained non-isothermal DSC curves from the experimental data show the results being accordant with those theoretically calculated.

  10. The effect of curing time and curing method on microleakge of conservative adhesive resin restorations: an in vitro study

    Directory of Open Access Journals (Sweden)

    Alireza Heidari

    2012-01-01

    Full Text Available Background and Aims: Using the conservative adhesive resin restoration (CAR in uncooperative children lead to numerous problems because of being time consuming. The purpose of this study was to compare the microleakage of conservative adhesive resin restoration under separate curing and co-curing.Materials and Methods: In this experimental study, 120 intact premolar teeth were collected and 120 vertical grooves were prepared on them. Then the teeth were divided into four groups: group 1, separated curing of bonding agent, flowable composite and sealant; group 2, co-curing of all materials for 60 seconds; group 3,co-curing of all materials for 40 seconds and group 4, co-curing of all materials for 20 seconds. Then the specimens were thermocycled and immersed in basic fuchsin solution. The teeth were sectioned horizontally and dye penetration was evaluated with stereomicroscope. Date were analyzed using one-way ANOVA and Scheffe test.Results: Mean value of dye penetration in groups 1, 2, 3, and 4 was 1.53±0.6, 2.06±0.6, 2.5±0.7 and 3.53±0.6, respectively. There was a statistically significant difference between group 1 and the other groups (P=0.0001.Conclusion: Considering the problems caused by microleakage in conservative resin adhesive restorations, co-curing method should not be used. In the case of using co-curing method, 60 second curing time is suggested for sufficient polymerization.

  11. Influence of curing tip distance on resin composite Knoop hardness number, using three different light curing units.

    Science.gov (United States)

    Caldas, Danilo Biazzetto de Menezes; de Almeida, Janaina Bertoncelo; Correr-Sobrinho, Lourenço; Sinhoreti, Mário Alexandre Coelho; Consani, Simonides

    2003-01-01

    This in vitro study evaluated the influence of curing tip distance on the Knoop Hardness Number (KHN) of a resin composite when using three different light curing units: (1) a halogen light (XL 1500 curing unit-3M), (2) a "softstart-polymerization" (Elipar Trilight curing in an exponential mode-ESPE) and (3) a PAC (Apolo 95E curing unit-DMD). The resin composite, Filtek Z250 (3M), was cured by these curing units at three light-tip distances from the resin composite: 0 mm, 6 mm and 12 mm. The resin composite specimens were flattened to their middle portion and submitted to 18 KHN measurements perspecimen. The results showed that for the Elipar Trilight unit, the hardness of the resin composite decreased as the light tip distance increased. The XL 1500 unit presented a significant decrease in hardness as the depth of cure of the resin composite increased. Apolo 95E caused a decrease in the resin composite hardness values when the depth of cure and light tip distance increased.

  12. Micromechanical properties of veneer luting resins after curing through ceramics.

    Science.gov (United States)

    Oztürk, Elif; Hickel, Reinhard; Bolay, Sükran; Ilie, Nicoleta

    2012-02-01

    The aim of this study was to assess the performance of light-cured luting resin after curing under the ceramic restoration in comparison to dual-cured luting resin, by evaluating the micromechanical properties. Two hundred seventy thin luting composite films of ca. 170 μm in thickness were prepared by using two light-cured luting resins (Variolink Veneer, Ivoclar Vivadent; RelyX Veneer, 3M ESPE) and a dual-cured luting resin (Variolink II, Ivoclar Vivadent). The composites were cured by using a LED-unit (Bluephase®, Ivoclar Vivadent) with three different curing times (10, 20, and 30 s) under two ceramics (IPS e.max Press, Ivoclar Vivadent; IPS Empress® CAD, Ivoclar Vivadent) of different thicknesses (0, 0.75, and 2 mm). Forty-five groups were included, each containing six thin films. The samples were stored after curing for 24 h at 37°C by maintaining moisture conditions with distilled water. Micromechanical properties of the composites were measured with an automatic microhardness indenter (Fisherscope H100C, Germany). For each sample, ten indentations were made, thus totalizing 60 measurements per group. Micromechanical properties of the luting resins were statistically analyzed (SPSS 17.0). Significant differences were observed between the micromechanical properties of the luting resins (p mechanical properties compared to the light-cured luting resins. The effect of luting resin type on the micromechanical properties of the luting resins was higher than the effect of curing time, ceramic type and ceramic thickness respectively (*The values of reference without ceramics for 30 s curing time).

  13. Aminophenoxycyclotriphosphazene cured epoxy resins and the composites, laminates, adhesives and structures thereof

    Science.gov (United States)

    Kumar, Devendra (Inventor); Fohlen, George M. (Inventor); Parker, John A. (Inventor)

    1977-01-01

    Aminophenoxy cyclotriphosphazenes such as hexakis (4-aminophenoxy) cyclotriphosphazene and tris (4-aminophenoxy)-tris phenoxy cyclotriphosphazene are used as curing agents for epoxy resins. These 1,2-epoxy resins are selected from di- or polyepoxide containing organic moieties of the formula (CH2-CHO-CH2) m-W-R-W- (CH2CH-CH2O)m where R is diphenyl dimethylmethane, diphenylmethane; W is a nitrogen or oxygen atom; and m is 1 when W is oxygen and 2 when W is nitrogen. The resins are cured thermally in stages at between about 110 to 135 C for between about 1 and 10 min, then at between about 175 to 185 C for between 0.5 to 10 hr and post cured at between about 215 and 235 C for between 0.1 and 2 hr. These resins are useful for making fire resistant elevated temperature stable composites, laminates, molded parts, and adhesives and structures, usually for aircraft secondary structures and for spacecraft construction.

  14. Examination of a Standardized Test for Evaluating the Degree of Cure of EVA Encapsulation (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Miller, D.; Wohlgemuth, J.; Gu, X.; Haldeman, S.; Hidalgo, M.; Malguth, E.; Reid, C.; Shioda, T.; Schulze, S.; Wang, Z.

    2013-11-01

    The curing of cross-linkable encapsulation is a critical consideration for photovoltaic (PV) modules manufactured using a lamination process. Concerns related to ethylene-co-vinyl acetate (EVA) include the quality (e.g., expiration and uniformity) of the films or completion (duration) of the cross-linking of the EVA within a laminator. Because these issues are important to both EVA and module manufacturers, an international standard has recently been proposed by the Encapsulation Task-Group within the Working Group 2 (WG2) of the International Electrotechnical Commission (IEC) Technical Committee 82 (TC82) for the quantification of the degree of cure for EVA encapsulation. The present draft of the standard calls for the use of differential scanning calorimetry (DSC) as the rapid, enabling secondary (test) method. Both the residual enthalpy- and melt/freeze-DSC methods are identified. The DSC methods are calibrated against the gel content test, the primary (reference) method. Aspects of other established methods, including indentation and rotor cure metering, were considered by the group. Key details of the test procedure will be described.

  15. Hardening of a dual-cure resin cement using QTH and LED curing units

    OpenAIRE

    Santos,Maria Jacinta Moraes Coelho; Passos, Sheila Pestana; Encarnação, Monalisa Olga Lessa da; Santos Junior,Gildo Coelho; Bottino, Marco Antonio [UNESP

    2010-01-01

    p. 110-115 OBJECTIVE: This study evaluated the surface hardness of a resin cement (RelyX ARC) photoactivated through indirect composite resin (Cristobal) disks of different thicknesses using either a light-emitting diode (LED) or quartz tungsten halogen (QTH) light source. MATERIAL AND METHODS: Eighteen resin cement specimens were prepared and divided into 6 groups according to the type of curing unit and the thickness of resin disks interposed between the cement surface and light sourc...

  16. Hardening of a dual-cure resin cement using QTH and LED curing units

    Directory of Open Access Journals (Sweden)

    Maria Jacinta Moraes Coelho Santos

    2010-04-01

    Full Text Available OBJECTIVE: This study evaluated the surface hardness of a resin cement (RelyX ARC photoactivated through indirect composite resin (Cristobal disks of different thicknesses using either a light-emitting diode (LED or quartz tungsten halogen (QTH light source. MATERIAL AND METHODS: Eighteen resin cement specimens were prepared and divided into 6 groups according to the type of curing unit and the thickness of resin disks interposed between the cement surface and light source. Three indentations (50 g for 15 s were performed on the top and bottom surface of each specimen and a mean Vickers hardness number (VHN was calculated for each specimen. The data were analyzed using two-way ANOVA and Tukey-Kramer test was used for post-hoc pairwise comparisons. RESULTS: Increased indirect resin disk thickness resulted in decreased mean VHN values. Mean VHN values for the top surfaces of the resin cement specimens ranged from 23.2 to 46.1 (QTH and 32.3 to 41.7 (LED. The LED curing light source produced higher hardness values compared to the QTH light source for 2- and 3-mm-thick indirect resin disks. The differences were clinically, but not statistically significant. Increased indirect resin disk thickness also resulted in decreased mean VHN values for the bottom surfaces of the resin cement: 5.8 to 19.1 (QTH and 7.5 to 32.0 (LED. For the bottom surfaces, a statistically significant interaction was also found between the type of curing light source and the indirect resin disk thickness. CONCLUSION: Mean surface hardness values of resin cement specimens decreased with the increase of indirect resin disk thickness. The LED curing light source generally produced higher surface hardness values.

  17. Cure Behaviors of epoxy resin initiated by methylanilinium slats as latent cationic curing agent.

    Energy Technology Data Exchange (ETDEWEB)

    Park, S.J.; Kim, T.J.; Lee, C.J.; Lee, J.R. [Korea Research Institute of Chemical Technology, Taejeon (Korea); Park, J.K.; Shin, J.H. [Seoul National University, Seoul (Korea)

    2001-03-01

    The effect of novel N-crotyl-N, N-dimethyl-4-methylanilinium hexafluoroantimonate (CMH) curing agent as a thermal latent initiator on thermal behaviors, rheological properties, and thermal stability of diglycidylether of bisphenol A (DGEBA) epoxy cationic system was investigated. From DSC measurements of DGEBA/CMH system, it was shown that this system exhibits an excellent thermal latent characteristic at a given temperature. The conversion and conversion rate of DGEBA/CMH system increased with increasing the concentration of initiator, due to high activity of CMH. Rheological properties of the system were investigated under isothermal condition using a rheometer. The gelation time was obtained from the analysis of storage modulus (G'), loss modulus (G''), and damping factor (tan {delta}). As a result, the reduction of gelation time was affected by high curing temperature and concentration of CMH, resulting in high degree of network formation in cationic polymerization, due to difference of activity. The thermal stability of the cured epoxy resin was discussed in terms of the activation energy for decomposition and thermal factors determined from TGA measurements. (author). 29 refs., 3 tabs., 10 figs.

  18. ACID RESISTANCE OF FLYASH BASED GEOPOLYMER MORTAR UNDER AMBIENT CURING AND HEAT CURING

    Directory of Open Access Journals (Sweden)

    V.Sreevidya

    2012-02-01

    Full Text Available An Experimental study was conducted to assess the Acid resistance of flyash based geopolymer mortar specimens of size 50x50x50mm with a ratio of flyash to sand as 1:3.The ratio between solution(Sodiumhydroxide and Sodium silicate solution to flyash were 0.376,0.386,0.396 and 0.416. After casting the specimens were subjected to both ambient curing and heat curing. In heat curing the specimens were kept continuously at 60oC for 24 hrs. Durability of specimens was assessed by immersing them in 5% of sulfuric acid and 5%hydrochloric acid for a period of 14 weeks. Evaluation of its resistance in terms of change in weight, compressive strength and visual appearance at regular intervals was carried out. After exposure in the acid solutions for 14 weeks, the samples showed very low weight loss. Results obtained from the present study indicate that Geopolymers are highly resistance to sulfuric acid and hydrochloric acid.

  19. Curing mechanism of alkaline phenolic resin with organic ester

    Institute of Scientific and Technical Information of China (English)

    Huang Renhe; Wang Yanmin; Zhang Baoping

    2014-01-01

    To study the curing mechanism of alkaline phenolic resin with organic ester, three esters were chosen to react with three systems - alkaline phenolic resin, potassium hydroxide aqueous solution containing phenol, and potassium hydroxide aqueous solution. The variations of pH, heat release and gel pH during the reactions were monitored and measured. Infrared spectroscopy (IR) and thermal gravity analysis (TG) techniques were used to characterize the curing reaction. It was found that organic ester is only partial y hydrolyzed and resin can be cured through organic ester hydrolysis process as wel as the reaction with redundant organic ester. The sequential curing mechanism of alkaline phenolic resin cured by organic ester was identified as fol ows: a portion of organic ester is firstly hydrolyzed owing to the effect of the strong alkaline; the gel is then formed after the pH decreases to about 10.8-10.88, meanwhile, the redundant organic ester (i.e. non-hydrolysis ester) starts the curing reaction with the resin. It has also been found that the curing rate depends on the hydrolysis velocity of organic ester. The faster the hydrolysis speed of the ester, the faster the curing rate of the resin.

  20. Shortest exposure time possible with LED curing lights

    NARCIS (Netherlands)

    Busemann, I.; Lipke, C.; Schattenberg, A.V.M.B.; Willershausen, B.; Ernst, C.P.

    2011-01-01

    PURPOSE: To investigate the shortest exposure time of different light emitting diode (LED)-curing devices for different resin composites in a clinically relevant laboratory model. METHODS: Nine LED curing devices (Bluephase, Bluephase 16i, Bluephase G2, Bluephase 20i/Ivoclar Vivadent, DEMI/sds Kerr,

  1. Improved method facilitates debulking and curing of phenolic impregnated asbestos

    Science.gov (United States)

    Gaines, P.

    1966-01-01

    Workpieces covered with phenolic impregnated asbestos tape and then wrapped with a specified thickness of nylon yarn under pressure, are debulked and cured in a standard oven. This method of debulking and curing is used in the fabrication of ablative chambers for the Gemini and Apollo attitude control engines.

  2. Shortest exposure time possible with LED curing lights

    NARCIS (Netherlands)

    Busemann, I.; Lipke, C.; Schattenberg, A.V.M.B.; Willershausen, B.; Ernst, C.P.

    2011-01-01

    PURPOSE: To investigate the shortest exposure time of different light emitting diode (LED)-curing devices for different resin composites in a clinically relevant laboratory model. METHODS: Nine LED curing devices (Bluephase, Bluephase 16i, Bluephase G2, Bluephase 20i/Ivoclar Vivadent, DEMI/sds Kerr,

  3. Isothermal epoxy-cure monitoring using nonlinear ultrasonics

    NARCIS (Netherlands)

    Koissin, V.; Demcenko, A.; Korneev, V.A.

    2014-01-01

    Isothermal curing of LY 1564SP resin in an aluminium-adhesive-aluminium laminate is investigated, using a nonlinear ultrasonic immersion technique, to prove its applicability for this type of dynamic material transformation. For verification and comparison, epoxy-cure kinetics and rheological behavi

  4. Secondary caries formation in vitro around glass ionomer-lined amalgam and composite restorations.

    Science.gov (United States)

    Dionysopoulos, P; Kotsanos, N; Papadogianis, Y

    1996-08-01

    The aim of this in vitro secondary caries study was to examine the glass-ionomer liner's effect on wall-lesion inhibition when a conventional and a light-cured glass ionomer liner was placed under amalgam and composite resin restorations. Class V preparations in extracted upper premolars were used and ten restorations were used for each of the following groups: (i) two layers of copal varnish and amalgam; (ii) conventional glass-ionomer and amalgam; (iii) light-cured glass-ionomer and amalgam; (iv) bonding agent and light-cured composite resin; (v) conventional glass-ionomer, bonding agent and light-cured composite resin; (vi) light-cured glass-ionomer, extended 0.3 mm short of the enamel margin bonding agent and light-cured composite resin; and (vii) light-cured glass-ionomer, extended 1 mm short of the enamel margin, bonding agent and light-cured composite resin. The teeth were thermocycled and artificial caries were created using an acid-gel. The results of this study showed that artificial recurrent caries can be reduced significantly (P amalgam restorations. The results also showed that when the light-cured glass-ionomer liner was placed 0.3 mm from the cavosurface margin under composite resin restoration, the artificial recurrent caries reduced significantly (P < 0.05).

  5. Development of various curing effect of nominal strength Geopolymer concrete

    Directory of Open Access Journals (Sweden)

    S. Kumaravel

    2014-04-01

    Full Text Available Geopolymer concrete is an innovative method and is produced by complete elimination of ordinary Portland cement byproduced in fly ash. This study on different condition of curing in geopolymer concrete suitable for curing at ambient and heat-cured condition of temperature will widen its application to concrete structures. Low lime fly ash is used as the base material, which is reacted by alkaline solution and additional use of ground granulated blast furnace slag. Workability of fresh concrete and compressive strength of geopolymer concrete was investigated. The curing effect of geopolymer concrete is steam, hot air and ambient cubes specimens are tested in different days. Results are compared for various curing and strength of concrete.

  6. STUDY ON THE POST-CURE KINETICS OF EPOXY RESIN IRRADIATED BY AN ELECTRON BEAM

    Institute of Scientific and Technical Information of China (English)

    Jian-wen Bao; Ye Li; Xiang-yu Zhong; Xiang-bao Chen; Feng-mei Li

    2004-01-01

    The post-cure kinetics of electron beam (EB) curing of epoxy resin initiated by diaryiodinium was investigated.The post-cure reaction fits first order reaction kinetics. The reaction rate constant increases with increasing treatment temperature of post-cure. The reaction rate of post-cure is much lower than the rate of its reaction on electron beam treatment.

  7. Improved Glycemic Control Without Hypoglycemia in Elderly Diabetic Patients Using the Ubiquitous Healthcare Service, a New Medical Information System

    Science.gov (United States)

    Lim, Soo; Kang, Seon Mee; Shin, Hayley; Lee, Hak Jong; Won Yoon, Ji; Yu, Sung Hoon; Kim, So-Youn; Yoo, Soo Young; Jung, Hye Seung; Park, Kyong Soo; Ryu, Jun Oh; Jang, Hak C.

    2011-01-01

    OBJECTIVE To improve quality and efficiency of care for elderly patients with type 2 diabetes, we introduced elderly-friendly strategies to the clinical decision support system (CDSS)-based ubiquitous healthcare (u-healthcare) service, which is an individualized health management system using advanced medical information technology. RESEARCH DESIGN AND METHODS We conducted a 6-month randomized, controlled clinical trial involving 144 patients aged >60 years. Participants were randomly assigned to receive routine care (control, n = 48), to the self-monitored blood glucose (SMBG, n = 47) group, or to the u-healthcare group (n = 49). The primary end point was the proportion of patients achieving A1C <7% without hypoglycemia at 6 months. U-healthcare system refers to an individualized medical service in which medical instructions are given through the patient’s mobile phone. Patients receive a glucometer with a public switched telephone network-connected cradle that automatically transfers test results to a hospital-based server. Once the data are transferred to the server, an automated system, the CDSS rule engine, generates and sends patient-specific messages by mobile phone. RESULTS After 6 months of follow-up, the mean A1C level was significantly decreased from 7.8 ± 1.3% to 7.4 ± 1.0% (P < 0.001) in the u-healthcare group and from 7.9 ± 1.0% to 7.7 ± 1.0% (P = 0.020) in the SMBG group, compared with 7.9 ± 0.8% to 7.8 ± 1.0% (P = 0.274) in the control group. The proportion of patients with A1C <7% without hypoglycemia was 30.6% in the u-healthcare group, 23.4% in the SMBG group (23.4%), and 14.0% in the control group (P < 0.05). CONCLUSIONS The CDSS-based u-healthcare service achieved better glycemic control with less hypoglycemia than SMBG and routine care and may provide effective and safe diabetes management in the elderly diabetic patients. PMID:21270188

  8. Intracerebral hypoglycemia and its clinical relevance as a prognostic indicator in severe traumatic brain injury: A cerebral microdialysis study from India

    Directory of Open Access Journals (Sweden)

    Deepak K Gupta

    2016-01-01

    Conclusions: After decompressive craniectomy in severe TBI, there was a poor correlation between the plasma and CMD glucose concentration. A higher degree of variation was seen in the correlations for individual patients. Neither the mean blood glucose values nor the mean cerebral glucose values predicted the outcome at 3 months. The good outcome group had fewer episodes of both hyperglycemia and hypoglycemia.

  9. The Influence of New European Union Driver’s License Legislation on Reporting of Severe Hypoglycemia by Patients With Type 1 Diabetes

    DEFF Research Database (Denmark)

    Pedersen-Bjergaard, Ulrik; Færch, Louise; Allingbjerg, Marie-Louise

    2015-01-01

    OBJECTIVE: We test the hypotheses that the implementation in Denmark of new, stricter European Union (EU) legislation on driver's licensing, with the purpose to improve traffic safety in January 2012, has reduced the self-reported rate of severe hypoglycemia in a routine clinical setting and that...

  10. Prevention and Treatment of Diabetic Hypoglycemia and Hypoglycemic Co-ma%糖尿病低血糖和低血糖昏迷的临床防治

    Institute of Scientific and Technical Information of China (English)

    王玉芹

    2015-01-01

    Pre-hospital emergency physician should clearly hypoglycemia and hypoglycemia in diabetic coma etiology and pathogenesis, clinical manifestations, diagnosis and differential diagnosis. We should adhere to the diet therapy and exercise therapy, based on the rational use of hypoglycemic drugs, prevention of hypoglycemia and hypoglycemic coma occurred. Once hypoglycemia and hypoglycemic coma, patient reference light sugary drinks or food to relieve severe it should be sup-plemented by intravenous glucose concentration reasonable solution, actively symptomatic treatment of other complications and promote early recovery of patients.%院前急救医生应明确糖尿病低血糖和低血糖昏迷的病因和发病机制、临床表现及其诊断和鉴别诊断,应在坚持饮食治疗和运动治疗的基础上,合理应用降糖药物,预防低血糖和低血糖昏迷的发生。一旦出现低血糖和低血糖昏迷,轻者患者引用含糖饮料或食物即可缓解,重症者应经静脉补充合理浓度的葡萄糖溶液,积极对症治疗其他并发症,促使患者早日康复。

  11. Quantitative analysis of the concentrations of IGFs and several IGF-binding proteins in a large fibrous abdominal tumor and the circulation of a patient with hypoglycemia

    NARCIS (Netherlands)

    van Doorn, Jaap; van de Hoef, Wouter; Dullaart, Robin P. F.

    2015-01-01

    The syndrome of nonislet cell tumor induced hypoglycemia (NICTH) represent extreme cases of excessive expression and production of incompletely processed high-molecular-mass pro-IGF-II forms (big IGF-II) by an often large tumor. Tumor-derived big IGF-II is responsible for enhanced insulin-like

  12. Role of alpha 1- and alpha 2-adrenergic receptors in the growth hormone and prolactin response to insulin-induced hypoglycemia in man.

    Science.gov (United States)

    Tatár, P; Vigas, M

    1984-09-01

    The effects of intravenous infusion of the nonselective alpha-adrenergic antagonist phentolamine or of the selective alpha 2-adrenergic antagonist yohimbine on growth hormone (GH), prolactin (PRL) and cortisol secretion during insulin-induced hypoglycemia were studied in 11 healthy young men. The GH response was blunted following each antagonist used, PRL secretion was higher after yohimbine and diminished after phentolamine when compared to controls. The plasma cortisol response was not influenced by either compound. In another series of experiments no effect of an oral administration of prazosin, a selective alpha 1-adrenergic antagonist, on the secretion of GH, PRL and cortisol was found in any of 7 subjects. Prazosin inhibited blood pressure increase during hypoglycemia and induced slight drowsiness and fatigue in the subjects. It is concluded that in man alpha-adrenergic stimulation of GH secretion during hypoglycemia is transmitted via alpha 2-receptors, PRL secretion is mediated via alpha 1-receptors, whereas inhibition of PRL release is mediated via alpha 2-receptors. In this experiment no effect of alpha 1- or alpha 2-blockade on cortisol response to hypoglycemia was seen.

  13. Evaluation of the Counter-regulatory Responses to Hypoglycemia in Patients with Type 1 Diabetes during Opiate Receptor Blockade with Naltrexone

    DEFF Research Database (Denmark)

    Naik, Sarita; Belfort-DeAguiar, Renata; Sejling, Anne-Sophie

    2016-01-01

    with a high risk for hypoglycemia. MATERIALS AND METHODS: We performed a randomized, placebo-controlled, double-blinded, cross-over study in which 9 intensively treated subjects with T1DM underwent a 2-step euglycemic-hypoglycemic-hyperinsulinemic clamp on two separate occasions. Twelve hours and 1 hour...

  14. No Islet Cell Hyperfunction, but Altered Gut-Islet Regulation and Postprandial Hypoglycemia in Glucose-Tolerant Patients 3 Years After Gastric Bypass Surgery

    DEFF Research Database (Denmark)

    Dirksen, Carsten; Eiken, Aleksander; Bojsen-Møller, Kirstine N

    2016-01-01

    Postprandial hyperinsulinemia characterizes Roux-en-Y gastric bypass (RYGB) and sometimes leads to reactive hypoglycemia. We prospectively evaluated changes in beta cell function in seven RYGB-operated patients with a median follow-up of 2.9 years with hyperglycemic clamps and oral glucose tolera...

  15. Quantitative analysis of the concentrations of IGFs and several IGF-binding proteins in a large fibrous abdominal tumor and the circulation of a patient with hypoglycemia

    NARCIS (Netherlands)

    van Doorn, Jaap; van de Hoef, Wouter; Dullaart, Robin P. F.

    2015-01-01

    The syndrome of nonislet cell tumor induced hypoglycemia (NICTH) represent extreme cases of excessive expression and production of incompletely processed high-molecular-mass pro-IGF-II forms (big IGF-II) by an often large tumor. Tumor-derived big IGF-II is responsible for enhanced insulin-like effec

  16. Correlates and outcomes of worries about hypoglycemia in family members of adults with diabetes : The second Diabetes Attitudes, Wishes and Needs (DAWN2) study

    NARCIS (Netherlands)

    Nefs, G.M.; Pouwer, F.; Holt, R.I.; Skovlund, S.; Hermanns, N.; Nicolucci, A.; Peyrot, M.

    2016-01-01

    Objective We examined (a) the demographic and clinical correlates of worries about hypoglycemia in adult family members of adults with diabetes, and (b) the association of these worries with measures of diabetes support. Methods The second multinational Diabetes Attitudes, Wishes and Needs (DAWN2)

  17. Residual β-Cell Function 3 to 6 Years After Onset of Type 1 Diabetes Reduces Risk of Severe Hypoglycemia in Children and Adolescents

    DEFF Research Database (Denmark)

    Sorensen, Jesper Sand; Johannesen, Jesper; Pociot, Flemming

    2013-01-01

    boys) 4.8-18.9 years of age with type 1 diabetes for 3-6 years were included. RBF was assessed by testing meal-stimulated C-peptide concentrations. Information regarding severe hypoglycemia within the past year, current HbA(1c), and daily insulin requirements was retrieved from the medical records...

  18. Influence of Colistin Dose on Global Cure in Patients with Bacteremia Due to Carbapenem-Resistant Gram-Negative Bacilli.

    Science.gov (United States)

    Gibson, Gabrielle A; Bauer, Seth R; Neuner, Elizabeth A; Bass, Stephanie N; Lam, Simon W

    2015-11-02

    The increasing prevalence of multidrug-resistant (MDR) nosocomial infections accounts for increased morbidity and mortality of such infections. Infections with MDR Gram-negative isolates are frequently treated with colistin. Based on recent pharmacokinetic studies, current colistin dosing regimens may result in a prolonged time to therapeutic concentrations, leading to suboptimal and delayed effective treatment. In addition, studies have demonstrated an association between an increased colistin dose and improved clinical outcomes. However, the specific dose at which these outcomes are observed is unknown and warrants further investigation. This retrospective study utilized classification and regression tree (CART) analysis to determine the dose of colistin most predictive of global cure at day 7 of therapy. Patients were assigned to high- and low-dose cohorts based on the CART-established breakpoint. The secondary outcomes included microbiologic outcomes, clinical cure, global cure, lengths of intensive care unit (ICU) and hospital stays, and 7- and 28-day mortalities. Additionally, safety outcomes focused on the incidence of nephrotoxicity associated with high-dose colistin therapy. The CART-established breakpoint for high-dose colistin was determined to be >4.4 mg/kg of body weight/day, based on ideal body weight. This study evaluated 127 patients; 45 (35%) received high-dose colistin, and 82 (65%) received low-dose colistin. High-dose colistin was associated with day 7 global cure (40% versus 19.5%; P = 0.013) in bivariate and multivariate analyses (odds ratio [OR] = 3.40; 95% confidence interval [CI], 1.37 to 8.45; P = 0.008). High-dose colistin therapy was also associated with day 7 clinical cure, microbiologic success, and mortality but not with the development of acute kidney injury. We concluded that high-dose colistin (>4.4 mg/kg/day) is independently associated with day 7 global cure. Copyright © 2015, American Society for Microbiology. All Rights

  19. Ketogenesis evaluation in perfused liver of diabetic rats submitted to short-term insulin-induced hypoglycemia.

    Science.gov (United States)

    Barrena, Helenton Cristhian; Gazola, Vilma Aparecida Ferreira Godoi; Furlan, Maria Montserrat Diaz Pedrosa; Garcia, Rosângela Fernandes; de Souza, Helenir Medri; Bazotte, Roberto Barbosa

    2009-08-01

    Ketogenesis, inferred by the production of acetoacetate plus ss-hydroxybutyrate, in isolated perfused livers from 24-h fasted diabetic rats submitted to short-term insulin-induced hypoglycemia (IIH) was investigated. For this purpose, alloxan-diabetic rats that received intraperitoneal regular insulin (IIH group) or saline (COG group) injection were compared. An additional group of diabetic rats which received oral glucose (gavage) (100 mg kg(-1)) 15 min after insulin administration (IIH + glucose group) was included. The studies were performed 30 min after insulin (1.0 U kg(-1)) or saline injection. The ketogenesis before octanoate infusion was diminished (p ketogenesis, livers from diabetic rats submitted to short-term IIH which received insulin or insulin plus glucose showed maintained capacity to produce acetoacetate and ss-hydroxybutyrate from octanoate.

  20. 新生儿低血糖症20例临床分析%Clinical analysis of 20 cases with neonatal hypoglycemia

    Institute of Scientific and Technical Information of China (English)

    李春枝; 卫海燕; 古建平; 陈永兴; 刘晓景

    2013-01-01

    目的对导致患者发生低血糖症状的原因进行分析和探讨。方法我院2012年3月~2013年3月,共收治了新生儿低血糖患者20例。对这些患者进行常规的血糖监测。结果患者出现低血糖症状与胎龄、体重有一定的关系;导致患者产生低血糖的因素有感染、出血症、窒息、母亲患糖尿病、硬肿症、开奶延迟、喂养困难、先天性心脏病。结论对有低血糖症状的新生儿要进行严密的监测,对存在的高危因素进行及时的纠正,避免对患者的中枢神经造成损伤,使得患者出现神经系统的后遗症。%Objective To explore and analyze the cause of hypoglycemia symptoms. Methods From March 2012 to March 2013 in our hospital,a total of 20 neonates with hypoglycemia were monitored by conventional blood sugar. Results Neonates with symptoms of hypoglycemia was somewhat related to gestational age and weight; leading to hypoglycemia factors included: infection,hemorrhagic, asphyxia,mothers with diabetes mellitus, scleredema;open milk delay,feeding difficulty;congenital heart disease. Conclusion We should conduct rigorous monitoring the neonates with hypoglycemia,and timely correct the high risk factors existed,in order to avoid damage to the central nervous system of patients,that cause central nervous system sequelae.

  1. Cure kinetics and chemorheology of EPDM/graphene oxide nanocomposites

    Energy Technology Data Exchange (ETDEWEB)

    Allahbakhsh, Ahmad [Department of Polymer Engineering, Islamic Azad University, South Tehran Branch, 17776-13651 Tehran (Iran, Islamic Republic of); Mazinani, Saeedeh, E-mail: s.mazinani@aut.ac.ir [Amirkabir Nanotechnology Research Institute (ANTRI), Amirkabir University of Technology, Tehran (Iran, Islamic Republic of); Kalaee, Mohammad Reza [Department of Polymer Engineering, Islamic Azad University, South Tehran Branch, 17776-13651 Tehran (Iran, Islamic Republic of); Sharif, Farhad [Department of Polymer Engineering and Color Technology, Amirkabir University of Technology, Tehran (Iran, Islamic Republic of)

    2013-07-10

    Graphical abstract: - Highlights: • Graphene oxide content and dispersion as effective parameters on cure kinetics. • Graphene oxide as an effective controlling factor of crosslink density. • Interaction of graphene oxide with curing system (ZnO) during curing process. - Abstract: In this study, the effect of graphene oxide on cure behavior of ethylene–propylene–diene rubber (EPDM) nanocomposite is studied. In this regard, the cure kinetics of nanocomposite is studied employing different empirical methods. The required activation energy of nth-order cure process shows about 160 kJ/mol increments upon 5 phr graphene oxide loading compared to 1 phr graphene oxide loading. However, the required activation energy is significantly reduced followed by incorporation of graphene oxide in nanocomposites compared to neat EPDM sample. Furthermore, the effect of graphene oxide on structural properties of nanocomposites during the cure process is studied using X-ray diffraction, scanning electron microscopy and Fourier transform infrared spectrometry techniques. As the results show, graphene oxide interestingly affects the structure of zinc oxide during the vulcanization process. This behavior could be probably related to high tendency of zinc oxide to react with oxidized surface of graphene oxide.

  2. Development of a resin curing model for UV nanoimprint.

    Science.gov (United States)

    Lee, Jin Woo; Cho, Dong-Woo

    2005-10-01

    UV nanoimprint lithography uses UV light as an energy source. It is performed at room temperature and low pressure, and has its own merits as compared to thermal nanoimprint. In this paper, a measurement system was developed to measure the degree of resin curing in UV nanoimprint to improve our understanding of the resin solidification phenomenon. A curing model was then established based on the measurement results. The measurement system measured the degree of cure in real time and was composed of a Fourier transform infrared spectroscopy system, a UV light source, and an optical guide. Also, new UV-curable resins that had low viscosity values were developed for the UV nanoimprint process, and imprint tests using these resins were performed successfully. The curing model considered the UV irradiation time, power, and curing temperature, which are important parameters in the UV nanoimprint process. The degree of cure had an exponential relation to UV irradiation time, power, and temperature; thus, the curing model was expressed as an exponential function of the UV irradiation time, power, and temperature. The developed model was verified for various UV-curable resins.

  3. Composite depth of cure using four polymerization techniques

    Directory of Open Access Journals (Sweden)

    Ericson Janolio de Camargo

    2009-10-01

    Full Text Available The light-curing technique is relevant to reduce the degree of polymerization shrinkage, improving clinical and esthetic success of composite resin restorations. OBJECTIVE: To evaluate in vitro the effect of four light-curing techniques on depth of cure of a composite resin. MATERIAL AND METHODS: Ten specimens of a composite resin were made in cylindrical cavities prepared in PVC plates (3.0 X 7.0 mm for each light-curing technique. Four photoactivation methods were investigated: stepped, ramped, pulse-delay and traditional. Specimens were longitudinally sectioned and polished for microhardness measurements (kg/mm², which were made at 0.1, 1.0, 2.0 and 4.0 mm from the irradiated surface. Data were subjected to ANOVA and Tukey's test. RESULTS: The effect of factors studied (curing method and distance from the surface and the interaction of these factors was statistically significant (p<0.05. The traditional method of cure provided higher microhardness values (69.6 ± 2.5 than the stepped (63.5 ± 3.1 and pulsed (63.9 ± 3.2 methods at all depths evaluated, but it did not differ from the ramped method (66.7± 4.4 at 0.1 and 1.0 mm of depth. CONCLUSION: All techniques employed provided satisfactory cure of the composite resin up to the depth of 2.0 mm from the irradiated surface.

  4. A 'cure' for Down syndrome: what do parents want?

    Science.gov (United States)

    Inglis, A; Lohn, Z; Austin, J C; Hippman, C

    2014-10-01

    Recent advancements in molecular genetics raise the possibility that therapeutics or a 'cure' for Down syndrome (DS) may become available. However, there are no data regarding how parents of children with DS perceive the possibility of mitigating specific manifestations such as the intellectual disability (ID) associated with DS, or curing the condition entirely. To explore these issues, we distributed a questionnaire to members of the Lower Mainland Down Syndrome Society in British Columbia, Canada. Questionnaires were completed by 101 parents (response rate=41%). A majority (61%) viewed the possibility of reversing ID in DS positively, but only 41% said that they would 'cure' their child of DS if it were possible. Twenty-seven percent of respondents said they would not 'cure' their child, and 32% were unsure if they would 'cure' their child. The most commonly cited motivation for opting for a 'cure' was to increase their child's independence. However, parental attitudes' towards a 'cure' for DS were complex, affected by ethical issues, perceived societal values, and pragmatic factors such as the age of the individual and long-term care-giving burden. These findings could be used by healthcare professionals supporting families who include a member with DS and to direct future research.

  5. Electron Beam Cured Epoxy Resin Composites for High Temperature Applications

    Science.gov (United States)

    Janke, Christopher J.; Dorsey, George F.; Havens, Stephen J.; Lopata, Vincent J.; Meador, Michael A.

    1997-01-01

    Electron beam curing of Polymer Matrix Composites (PMC's) is a nonthermal, nonautoclave curing process that has been demonstrated to be a cost effective and advantageous alternative to conventional thermal curing. Advantages of electron beam curing include: reduced manufacturing costs; significantly reduced curing times; improvements in part quality and performance; reduced environmental and health concerns; and improvement in material handling. In 1994 a Cooperative Research and Development Agreement (CRADA), sponsored by the Department of Energy Defense Programs and 10 industrial partners, was established to advance the electron beam curing of PMC technology. Over the last several years a significant amount of effort within the CRADA has been devoted to the development and optimization of resin systems and PMCs that match the performance of thermal cured composites. This highly successful materials development effort has resulted in a board family of high performance, electron beam curable cationic epoxy resin systems possessing a wide range of excellent processing and property profiles. Hundreds of resin systems, both toughened and untoughened, offering unlimited formulation and processing flexibility have been developed and evaluated in the CRADA program.

  6. Variation of Resin Properties Through the Thickness of Cured Samples

    Science.gov (United States)

    1984-01-01

    It is the purpose of this work to gain knowledge of the glassy materials used as matrices in composites and to study the homogeneity resulting from the curing process. An attempt is made to link the glass transition quantitatively with the presence of a given material. Expoxy resins containing various amounts of hardener (TGDDM/DDS system) were cured in a muffle furnace at 473 K for seven hours. The glass transition temperature, T sub g versus weight minus percent of hardener in the epoxy resin were measured. A limit was rapidly reached in T sub g at only two percent hardener. Thus, the glass transition of the fully cured epoxy-amine matrix seems not much different from the epoxide-epoxide cure. The T sub g versus cure-time for the epoxide-epoxide reaction was also studied. My 720 was cured by itself in an oil bath at 473 K for different lengths of time. The T sub g was found to increase exponentially with the cure time, and a maximum T sub g of about 450 K was reached after eleven hours. The reaction was found to be inhibited by running the sample under argon.

  7. Development of Geopolymer Concrete with Different Curing Conditions

    Directory of Open Access Journals (Sweden)

    M.F. Nuruddin Nuruddin

    2011-02-01

    Full Text Available Environmental issues resulted from cement production have become a major concern today. To develop a sustainable future it is encouraged to limit the use of this construction material that can affect the environment. Cement replacement material was proposed to partially replace cement portion in concrete. Geopolymer is a part of inorganic polymer material that has similar bonding function like cement in concrete. It consists of alkaline solutions and geological source material. Alkaline liquids used in this research are 8 M sodium hydroxide (NaOH solution and sodium silicate (Na2SiO3 solutions, while source materials are fly ash and microwave incinerated rice husk ash (MIRHA. Three different curing regimes, namely hot gunny curing, ambient curing, and external exposure curing, were applied to obtain suitable method that was suitable with cast in situ application. Geopolymer concrete samples were tested on their compressive strength and microstructure properties. It was found that external exposure curing had the highest compressive strength compared to other two curing methods. Scanning electron microscopy analysis also showed better improvement in interfacial transition zone for concrete sample with external exposure curing.

  8. Can Fasting Glucose Levels or Post-Breakfast Glucose Fluctuations Predict the Occurrence of Nocturnal Asymptomatic Hypoglycemia in Type 1 Diabetic Patients Receiving Basal-Bolus Insulin Therapy with Long-Acting Insulin?

    Science.gov (United States)

    Mitsuishi, Sumie; Nishimura, Rimei; Ando, Kiyotaka; Tsujino, Daisuke; Utsunomiya, Kazunori

    2015-01-01

    To investigate whether the occurrence of nocturnal asymptomatic hypoglycemia may be predicted based on fasting glucose levels and post-breakfast glucose fluctuations. The study subjects comprised type 1 diabetic patients who underwent CGM assessments and received basal-bolus insulin therapy with long-acting insulin. The subjects were evaluated for I) fasting glucose levels and II) the range of post-breakfast glucose elevation (from fasting glucose levels to postprandial 1- and 2-hour glucose levels). The patients were divided into those with asymptomatic hypoglycemia during nighttime and those without for comparison. Optimal cut-off values were also determined for relevant parameters that could predict nighttime hypoglycemia by using ROC analysis. 64 patients (mean HbA1c 8.7 ± 1.8%) were available for analysis. Nocturnal asymptomatic hypoglycemia occurred in 23 patients (35.9%). Fasting glucose levels (I) were significantly lower in those with hypoglycemia than those without (118 ± 35 mg/dL vs. 179 ± 65 mg/dL; P fasting glucose level 54 mg/dL (0.65/0.61/0.71, P = 0.006), 2-h postprandial elevation > 78 mg/dL (0.65/0.73/0.71, P = 0.005). Nocturnal asymptomatic hypoglycemia was associated with increases in post-breakfast glucose levels in type 1 diabetes. Study findings also suggest that fasting glucose levels and the range of post-breakfast glucose elevation could help predict the occurrence of nocturnal asymptomatic hypoglycemia.

  9. Changes on degree of conversion of dual-cure luting light-cured with blue LED

    Science.gov (United States)

    Bandéca, M. C.; El-Mowafy, O.; Saade, E. G.; Rastelli, A. N. S.; Bagnato, V. S.; Porto-Neto, S. T.

    2009-05-01

    The indirect adhesive procedures constitute recently a substantial portion of contemporary esthetic restorative treatments. The resin cements have been used to bond tooth substrate and restorative materials. Due to recently introduction of the self-bonding resin luting cement based on a new monomer, filler and initiation technology has become important to study the degree of conversion of these new materials. In the present work the polymerization reaction and the filler content of dual-cured dental resin cements were studied by means of infra-red spectroscopy (FT-IR) and thermogravimetry (TG). Twenty specimens were made in a metallic mold (8 mm diameter × 1 mm thick) from each of 2 cements, Panavia® F2.0 (Kuraray) and RelyX™ Unicem Applicap (3M/ESPE). Each specimen was cured with blue LED with power density of 500 mW/cm2 for 30 s. Immediately after curing, 24 and 48 h, and 7 days DC was determined. For each time interval 5 specimens were pulverized, pressed with KBr and analyzed with FT-IR. The TG measurements were performed in Netzsch TG 209 under oxygen atmosphere and heating rate of 10°C/min from 25 to 700°C. A two-way ANOVA showed DC (%) mean values statistically significance differences between two cements ( p 0.05). The Relx-Y™ Unicem mean values were significantly higher than Panavia® F 2.0. The degree of conversion means values increasing with the storage time and the filler content showed similar for both resin cements.

  10. Clinical Analysis Of Neonatal Hypoglycemia%新生儿低血糖临床分析

    Institute of Scientific and Technical Information of China (English)

    林春繁

    2009-01-01

    目的 探讨新生儿低血糖症发生的病因与防治措施.方法 对2008年住院的480例新生儿于入院时进行足跟微量血糖常规检查.结果 查出低血糖121例,其中早产儿低出生体质量儿小于胎龄儿32例(26.4%),围产期窒息儿24例(19.8%),糖尿病母亲巨大儿14例(11.5%),感染败血症19例(15.7%),喂养困难22例(18.2%).早产儿低出生体质量儿小于胎龄儿、围产期窒息儿、糖尿病母亲巨大儿、感染败血症、喂养困难等易引起低血糖,是低血糖的常见病因.结论对存在早产、低出生体重、巨大、窒息、感染、喂养困难等有低血糖危险因素的新生儿,均应常规监测血糖,尽早诊治,早哺乳、早喂糖水、补液、防治新生儿糖代谢紊乱,避免低血糖引起脑损伤.%Objective The neonatal of the study hypoglyceia cause of disease of the occurrence and prevention and cure measure. Methods To 2008 hospitalization of 480 case new born carry on heel little blood sugar normal regulations check while hospitalize. Results Look up low blood sugar 121 case,among them pre-mature infant low birth weight son's being small be 32 case(26.4% )at the foetus age son,round to produce a period asphyxiation son 24 case(19.8%) ,the mother of diabetes huge son be 14 case(11.5%) ,infection septi-cemia 19 case(15.7%) ,feed to keep difficulty 22 case(18.2%). Premature infant low birth weight the son be small at the foetus age son and round to produce a period asphyxiation son, diabetes of mother huge son, infection septicemia ,feed to keep difficulty etc. easy cause low blood sugar, It is the familiar cause of disease of low blood sugar. Conclusion To the existence premature,low birth weight,huge,suffocate,infection,feed to keep difficul-ty etc. have low blood sugar dangerous factor of new born, All should normal regulations monitor blood sugar, As early as possible make a diagnosis and give treatment, Early breast feed, early feed sugar water, repair a liquid

  11. Experimental observation of internal water curing of concrete

    DEFF Research Database (Denmark)

    Lura, Pietro; Jensen, Ole Mejlhede

    2007-01-01

    Internal water curing has a significant effect on concrete. In addition to affecting hydration and moisture distribution, it influences most concrete properties, such as strength, shrinkage, cracking, and durability. The following paper is an overview of experimental methods to study internal water...... curing of concrete and its consequences. The special techniques needed to study internal water curing are dealt with along with the consequences of this process. Examples of applications are given and new measuring techniques that may potentially be applied to this field are addressed....

  12. Micro-leakage of a Fissure Sealant Cured Using Quartz-tungsten-halogen and Plasma Arc Light Curing Units.

    Science.gov (United States)

    Bahrololoomi, Zahra; Soleimani, Ali Asghar; Jafari, Najmeh; Varkesh, Bentolhoda

    2014-01-01

    Background and aims. Newer curing units such as plasma arc can polymerize the sealants in much shorter curing times. The aim of this study was to compare the effect of two different curing units on the micro-leakage of a fissure sealant material. Materials and methods. Sixty two extracted premolars without caries were randomly divided into two groups of 31 samples. Occlusal surfaces of all teeth were cleansed. Then, teeth surfaces were etched by 37% phosphoric acid. After rinsing and drying, occlusal surfaces of teeth were sealed by a fissure sealant. The sealant was then cured using either a halogen light curing unit or a plasma arc curing light. After sealing, the teeth were thermocycled for 500 cycles. The teeth were then sectioned and examined for micro-leakage. Statistical analyses were performed with Mann-Whitney test. Results. There was no significant difference between two groups regarding micro-leakage (P = 0.42). Conclusion. Results showed that there was no significant difference between two different curing units. Therefore, plasma arc unit might be a useful alternative for sealant polymerization.

  13. Concurrent Therapy with a Low-carbohydrate Diet and Miglitol Remarkably Improved the Postprandial Blood Glucose and Insulin Levels in a Patient with Reactive Hypoglycemia due to Late Dumping Syndrome.

    Science.gov (United States)

    Hirose, Sachie; Iwahashi, Yasuyuki; Seo, Akane; Sumiyoshi, Michitaka; Takahashi, Tetsuya; Tamori, Yoshikazu

    2016-01-01

    Reactive hypoglycemia induced by late dumping syndrome is often observed after gastrectomy. However, no effective therapy has yet been fully established. We herein describe a case in which concurrent therapy with a low-carbohydrate diet using low-glycemic-index food and an alpha-glucosidase inhibitor, miglitol, very effectively ameliorated the postprandial fluctuations in the blood glucose and plasma insulin levels in a patient with reactive hypoglycemia due to late dumping syndrome following total gastrectomy. The administration of miglitol under a low-carbohydrate diet using low-glycemic-index food may therefore be an ideal treatment for reactive hypoglycemia due to late dumping syndrome.

  14. Proteomics Identification of Differentially Expressed Proteins Relevant for Nicotine Synthesis in Flue-Cured Tobacco Roots Before and After Decapitation

    Institute of Scientific and Technical Information of China (English)

    LIU Wei-qun; GUO Hong-xiang; LI Hao

    2008-01-01

    Nicotine is a secondary substance synthesized in tobacco roots.In flue-cured tobacco planting,tobacco decapitation is an effective practice to promote nicotine biosynthesis by regulation of the redistribution of total nitrogen amounts,However,proteins relevant to nicotine synthesis in tobacco roots has not been identified and characterized yet.It is important to explore the regulation of nicotine biosynthesis in tobacco roots.To identify the proteins relevant to nicotine synthesis,the protein patterns in roots of flue-cured tobacco (cv.K326) before and after decapitation were analyzed.In the present study,the protein patterns in roots of flue-cured tobacco were analyzed by two-dimensional electrophoresis (2-DE),and the differentially-expressed spots were identified by matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF-MS). Paired comparison of 2-DE maps revealed 26 spots of differentially-expressed proteins in roots before and after decapitation.Furthermore,nine differentially-expressed spots were identified.There were four proteins which were enzymes possibly involved in nicotine biosynthesis.In addition,the roles of the four enzymes in nicotine biosynthesis were discussed in a putative network.Our results would contribute to the understanding of the regulation pathway of nicotine biosynthesis and further to the molecular manipulation on the nicotine contents in flue-cured tobacco.

  15. Measuring Vapors To Monitor the State of Cure of a Resin

    Science.gov (United States)

    Cramer, Elliott; Perey, Daniel F.; Yost, William T.

    2006-01-01

    A proposed noninvasive method of monitoring the cure path and the state of cure of an epoxy or other resin involves measurement of the concentration( s) of one or more compound(s) in the vaporous effluent emitted during the curing process. The method is based on the following general ideas: (1) The concentrations of the effluent compounds in the vicinity of the curing resin are approximately proportional to the instantaneous rate of curing. (2) As curing proceeds at a given temperature, subsequent decreases in the concentrations are indicative of approaching completion of cure; that is, the lower are the concentrations, the more nearly complete is the cure.

  16. The effect of curing light and chemical catalyst on the degree of conversion of two dual cured resin luting cements.

    Science.gov (United States)

    Souza-Junior, Eduardo José; Prieto, Lúcia Trazzi; Soares, Giulliana Panfiglio; Dias, Carlos Tadeu dos Santos; Aguiar, Flávio Henrique Baggio; Paulillo, Luís Alexandre Maffei Sartini

    2012-01-01

    The aim of this study was to evaluate the influence of different curing lights and chemical catalysts on the degree of conversion of resin luting cements. A total of 60 disk-shaped specimens of RelyX ARC or Panavia F of diameter 5 mm and thickness 0.5 mm were prepared and the respective chemical catalyst (Scotchbond Multi-Purpose Plus or ED Primer) was added. The specimens were light-cured using different curing units (an argon ion laser, an LED or a quartz-tungsten-halogen light) through shade A2 composite disks of diameter 10 mm and thickness 2 mm. After 24 h of dry storage at 37°C, the degree of conversion of the resin luting cements was measured by Fourier-transformed infrared spectroscopy. For statistical analysis, ANOVA and the Tukey test were used, with p ≤ 0.05. Panavia F when used without catalyst and cured using the LED or the argon ion laser showed degree of conversion values significantly lower than RelyX ARC, with and without catalyst, and cured with any of the light sources. Therefore, the degree of conversion of Panavia F with ED Primer cured with the quartz-tungsten-halogen light was significantly different from that of RelyX ARC regardless of the use of the chemical catalyst and light curing source. In conclusion, RelyX ARC can be cured satisfactorily with the argon ion laser, LED or quartz-tungsten-halogen light with or without a chemical catalyst. To obtain a satisfactory degree of conversion, Panavia F luting cement should be used with ED Primer and cured with halogen light.

  17. Comparative Study of Alkali-Activated Fly Ash Manufactured Under Pulsed Microwave Curing and Thermal Oven Curing

    OpenAIRE

    Shi, Shi; Bai, Yun; Li, H.; Xu, D. L.; Basheer, P. A. Muhammed

    2014-01-01

    This paper compares the alkali-activated fly ash (AAFA) manufactured with thermal oven curing and pulsed microwave curing methods. Fly ash activated by 8M NaOH solution at a liquid to solid ratio of 0.3 was cured by thermal oven at 85°C and domestic microwave oven, respectively. Apart from compressive strength test, the temperature profiles of AAFA samples were captured by thermal camera. Reaction products of AAFA were characterised with XRD, FTIR and TG/DTG, while the microstructure of AAFA ...

  18. Curing of Epoxy Resin Induced by Femtosecond Laser Pulse

    Institute of Scientific and Technical Information of China (English)

    LI Yubin; ZHANG Zuoguang

    2005-01-01

    The possibility of curing of epoxy resin induced by femtosecond laser beam was explored through choosing different initiators . Absorption spectroscopy, infrared spectroscopy (IR), stereomicroscopy and scanning electron microscopy (SEM) were applied to analyze the structure of epoxy resin systems after irradiation with a femtosecond laser beam. The experimental results show that the epoxy resin systems containing diaryliodonium salts can be cured by irradiation of Jemtosecond laser pulse, while the systems containing benzoin can not be cured. It is found that diaryliodonium salts decompose under the irradiation of femtosecond laser pulse through multi ( two ) -photon absorption, initiating the ring-opening polymerization of epoxy resin. And the appearance of cured area has a sheet structure consisting of many tiny lamellar structures.

  19. Cure monitoring using ultrasonic guided waves in wires.

    Science.gov (United States)

    Vogt, T; Lowe, M; Cawley, P

    2003-09-01

    The possibility of using ultrasonic guided waves for monitoring the cure process of epoxy resins is investigated. The two techniques presented use a wire waveguide which is partly embedded in the resin. The first technique is based on the measurement of attenuation due to leakage of bulk waves into the resin surrounding the waveguide. The second technique measures the reflection of the guided wave that occurs at the point where the waveguide enters the resin. Both the attenuation and the reflection coefficient change significantly during cure, and the numerical methods to relate these to the material properties of the curing resin are presented in this paper. The results from the modeling are experimentally verified and show good agreement. The applicability of each testing method is discussed, and typical cure-monitoring curves are presented.

  20. effect of light curing unit characteristics on light intensity output ...

    African Journals Online (AJOL)

    2013-09-09

    Sep 9, 2013 ... Objective: To determine the characteristics of light curing units (LCUs) in dental clinics in Nairobi and ... generation which has dogged the new generation of. LEDs without ..... Knezevic A, Tarle Z, Meniga A, Sutalo J, Pichler G.