Molecular Investigation of Tularemia Outbreaks,Spain, 1997–2008

Tularemia outbreaks occurred in northwestern Spain in 1997–1998 and 2007–2008 and affected >1,000 persons. We assessed isolates involved in these outbreaks by using pulsed-field gel electrophoresis with 2 restriction enzymes and multilocus variable number tandem repeat analysis of 16 genomic loci of Francisella tularensis, the cause of this disease. Isolates were divided into 3 pulsotypes by pulsed-field gel electrophoresis and 8 allelic profiles by multilocus variable number tandem repeat analysis. Isolates obtained from the second tularemia outbreak had the same genotypes as isolates obtained from the first outbreak. Both outbreaks were caused by genotypes of genetic subclade B.Br:FTNF002–00, which is widely distributed in countries in central and western Europe. Thus, reemergence of tularemia in Spain was not caused by the reintroduction of exotic strains, but probably by persistence of local reservoirs of infection.     

Determining the risk of diabulimia and its relationship with diet quality and nutritional status of adolescents with type 1 diabetes

IntroductionDiabulimia is known as an eating disorder specific to individuals with diabetes.ObjectivesIn this study, it was aimed to determine the diabulimia risk and to evaluate the possible relationships between diabulimia risk and diet quality, anthropometric measurements, and biochemical parameters of adolescents with type 1 diabetes.Material and methodsIn total, 110 adolescents (male: 51.8%, female: 48.2%) with type 1 diabetes between 10–19 years were included in the study. Sociodemographic characteristics and information about diabetes of adolescents were collected using a questionnaire prepared by the researchers through face-to-face interview technique. Anthropometric measurements and 3-day food consumption records were obtained to evaluate their nutritional status, and their biochemical parameters were obtained from hospital files to evaluate their metabolic status. The diet quality was evaluated using the Healthy Eating Index-2015. Diabetes Eating Problem Survey was administered to individuals and it was accepted that diabetics with a total score of ≥ 20 were at risk of diabetes-related eating disorders.Results/ConclusionAmong the 110 adolescents included in this study, 31.8% were found to be at risk of diabulimia. There was a significant relationship between the groups with and without diabulimia risk in terms of diet quality scores (P < 0.05). All individuals with a risk of diabulimia as well as 86.8% of individuals without a risk of diabulimia had high HbA1c levels (P < 0.05). Diet quality, some anthropometric measurements and biochemical parameters of adolescents at risk of diabulimia should be improved. It is important to periodically evaluate the risk of diabulimia, the diet quality, and the nutritional status of adolescents with type 1 diabetes to reduce the occurrence of short and long-term complications.     

Pharmacy Student Performance on Constructed-Response Versus Selected-Response Calculations Questions

Objective. To introduce PharmD students to changes in calculations question types (constructed-response versus selected-response questions); measure and compare student performance on constructed-response and selected-response questions in a pharmaceutics course; and collect student feedback on the use of differing question types.Methods A pharmaceutics/pharmaceutical calculations examination was administered that included 15 pairs of questions; each pair consisted of a constructed-response question and a similar selected-response question. An online questionnaire was conducted to collect student feedback.Results. Of the 15 topics, the class scored higher on the constructed-response question for 4 topics and higher on the selected-response question for 10 topics. Eighty percent of the class preferred selected-response questions, although 47.8% felt constructed-response questions better prepared them for a career in healthcare.Conclusions. Students correctly answered more selected-response questions than constructed-response questions and felt more confident in doing so. Additional constructed-response teaching and testing methods should be incorporated into pharmacy education.     

驻景丸加减治疗甲状腺功能减退性心脏病心肾阳虚型20例

目的评价驻景丸加减治疗甲状腺功能减退性心脏病心肾阳虚型的临床疗效。方法选取甲状腺功能减退性心脏病心肾阳虚型患者40例，随机分为治疗组和对照组。治疗组给予驻景丸加减联合左甲状腺素，对照组单纯给予左甲状腺素，观察临床疗效。结果治疗组总有效率为95．00％，对照组总有效率为80．00％，治疗组优于对照组（P〈0．01）。结论驻景丸加减联合左甲状腺素疗法优于单纯西药治疗。     

胰岛素泵与利拉鲁肽治疗老年超重2型糖尿病的疗效与安全性

目的:探讨胰岛素泵与利拉鲁肽治疗在老年超重2型糖尿病患者中的应用效果。方法:将68例老年超重2型糖尿病患者分为观察组(胰岛素泵)和对照组(利拉鲁肽)各34例,对比其治疗效果。结果:与对照组相比,观察组患者的治疗有效率(94.12%>73.53%)、SF-36评分((78.82±4.24)分>(69.14±5.16)分)相对更高(P<0.05),并发症发生率(8.82%<32.35%)、FBG((6.29±1.05)<(8.04±1.16)mmol/L)、2h PBG((8.74±1.38)<(10.39±1.57)mmol/L)、BMI((23.51±2.04)<(27.75±2.36)kg/m²)相对更低(P<0.05)。结论:老年超重2型糖尿病的临床治疗,胰岛素泵治疗在疗效和安全性方面具有显著优势。     

The effect of universal adhesives on dentine collagen

ObjectivesThe purpose of the study was to evaluate the integrity of dentine type I collagen after self-etching (SE) treatments with strong and mild universal adhesives.MethodsCoronal dentine specimens (n = 10/product) were imaged by optical microscopy and analyzed by ATR-FTIR spectroscopy before and after treatment with 32% phosphoric acid gel (PA-negative control), 17% neutral EDTA (ED-positive control) conditioners and Adhese Universal (AD), Clearfil Universal Bond Quick (CQ), G-Premio Bond (GP), Prelude One (PR) and Scotchbond Universal (SB) adhesives. From the spectroscopic analysis the following parameters were determined: a) Extent of dentine demineralization (DM%) and b) percentage area of the Amide I curve-fitted components of β-turns, 3₁₀-helix/β-turns, α-helix, random coils, β-sheets and collagen maturation (R) index. Statistical analysis was performed by one-way ANOVA (DM%), paired t-test/Wilcoxon test (Amide I components) and Spearman correlation coefficient (DM% vs Amide I components) at an a = 0.05 level.ResultsPA, ED and GP removed the smear-layer and opened tubule orifices, whereas all other treatments removed only the intratubular smear-layer fraction. The ranking of the statistically significant differences in DM% was PA > GP > ED > AD, SB, CQ, PR, with AD being significantly different from PR. Regarding the Amide I components, PA demonstrated a significant reduction in β-turns, α-helices and an increase in β-sheets, GP a reduction in β-turns, AD an increase in β-turns and random coils, and CQ an increase in β-turns. PR, SB and ED showed insignificant differences in all the Amide I components. Significant correlations were found between DM%-random coils and DM%-R.SignificanceThe universal adhesives used in the SE mode induced none to minimal changes in dentine collagen structure, without evidence of the destabilization pattern observed after conventional phosphoric acid treatments.