Type 2 diabetes management in nurse-led primary healthcare settings in urban and rural Cameroon

AimsTo implement a protocol-driven primary nurse-led care for type 2 diabetes in rural and urban Cameroon.MethodsWe set-up three primary healthcare clinics in Yaounde (Capital city) and two in the Bafut rural health district. Participants were 225 (17% rural) patients with known or newly diagnosed type 2 diabetes, not requiring insulin, referred either from a baseline survey (38 patients, 17%), or secondarily attracted to the clinics. Protocol-driven glucose and blood pressure control were delivered by trained nurses. The main outcomes were trajectories of fasting capillary glucose and blood pressure indices, and differences in the mean levels between baseline and final visits.ResultsThe total duration of follow-up was 1110 patient-months. During follow-up, there was a significant downward trend in fasting capillary glucose overall (p < 0.001) and in most subgroups of participants. Between baseline and final visits, mean fasting capillary glucose dropped by 1.6 mmol/L (95% CI: 0.8–2.3; p ≤ 0.001). Among those with hypertension, blood pressure also decreased significantly for systolic and marginally for diastolic blood pressure. No major significant change was noticed for body weight.ConclusionsNurses may be potential alternatives to improve access to diabetes care in settings where physicians are not available.     

Validation of aerosol low-level activities by comparison with a deep underground laboratory

The activities on air filters of the radionuclides ⁴⁰K and ¹³⁷Cs were measured in an above ground laboratory and compared with the activities measured in an underground laboratory. The average relative differences were lower than 20% for ¹³⁷Cs and ⁴⁰K. The temporal series of these radionuclides in the period 2006–2010 are also presented. These results form the baseline of these radionuclides in the studied period, and are particularly interesting because they correspond to the radioactive background in Barcelona before the Fukushima accident.     

Impact of acute alcohol consumption on lethality of suicide methods

BackgroundThe influence of acute alcohol consumption on the factors related to suicide remains understudied. Thus, the present study investigated the relationship between blood alcohol content (BAC) and the lethality of suicide methods.MethodsAutopsy data on 315 South Korean suicide completers with a positive BAC were collected from a nationwide pool between May 2015 and November 2015, and the methods were dichotomised as suicide methods of low lethality (SMLL; drug/chemical overdose and sharp objects, n = 67) and suicide methods of high lethality (SMHL; everything else, n = 243). BAC at the time of autopsy and various suicide-related factors of these two groups were compared with logistic regression analyses.ResultsCompared to suicide completers with a BAC in the lowest range of 0.011–0.049%, suicide completers with a BAC in the range of 0.150–0.199% were more likely to use SMHL (odds ratio [OR]: 3.644, 95% confidence interval [CI]: 1.221–10.874). Additionally, the adoption of SMHL was significantly associated with the absence of a psychiatric illness (OR: 0.433, 95% CI: 0.222–0.843) and a younger age; the OR for high BAC among subjects in their 40s was 0.266 (95% CI: 0.083–0.856); in their 50s, 0.183 (95% CI: 0.055–0.615); and in their 60s, 0.057 (95% CI: 0.015–0.216).ConclusionsThe relationship between BAC and suicide method lethality was represented by a bell-shaped pattern in which suicide methods of high lethality were more likely to be used by suicide completers with mid-range BAC levels. The increased impulsivity and impairments in particular executive functions, including planning and organization, associated with acute alcohol use may influence the selection of a particular suicide method based on its lethality.     

胃肠道肿瘤的光动力治疗及其进展

光动力疗法是一种新型的肿瘤治疗方法,与传统治疗比,其优势在于高选择性和低毒性。目前光动力疗法已用于胃癌、结直肠癌、肛管鳞癌等胃肠道肿瘤,且部分患者疗效显著,但仍缺少大样本量的临床随机对照研究。笔者就近年来国内外光动力疗法治疗胃肠道肿瘤的文献进行综述,为临床治疗及科研提供参考。     

mTOR-FABP4 signal is activated in brain arteriovenous malformations in humans

Journal of Molecular Medicine - Arteriovenous malformations (AVMs) are the most common types of cerebral vascular malformations, which are dynamic lesions with de novo growth potentials. The...     

Substituted 2-hydroxy-N-(arylalkyl)benzamide sensitizes cancer cells to metabolic stress by disrupting actin cytoskeleton and inhibiting autophagic flux

N-((R)-1-(4-chlorophenylcarbamoyl)-2-phenylethyl)-5-chloro-2-hydroxybenzamide (Compound 6k), was recently isolated during the preparation of amino acids esters with salicylanilides. We show here that 6k disrupts the dynamics of actin cytoskeleton in human melanoma cells, affecting processes essential for the maintenance and expansion of tumours such as cell adhesion, motility, proliferation, vesicular transport, and autophagic flux. We demonstrated that inhibition of autophagy by 6k increased the sensitivity of melanoma cells to metabolic stress induced by rotenone or nutrient starvation and potentiated the anti-proliferative activity of small molecule multikinase inhibitor sorafenib. Since autophagy plays an important role in survival of cancer cells subjected to chemotherapy, the above mentioned properties are interesting from clinical point of view as 6k could promote metabolic stress within the tumour microenvironment and potentiate the effect of cytostatics in combination therapy.