Long-term improvement of metabolic control without increased risk of hypoglycaemia by intensive insulin regimens in type 1 diabetes patients treated in a regular clinical setting.

AIM: To evaluate if intensive insulin regimen with multiple daily injections (MDI) is successful for treating type 1 diabetes patients over a long period of time in a regular clinical setting. METHOD: This is a prospective, observational seven-year study. Fifty-nine (35 male) type 1 diabetic patients with bad metabolic control (HbA1c> or =9%), aged 31.9 years, range 18-47 were included in the present study. All of them had had at least 5 years of diabetes duration after diagnosis and showed negative responses of serum C-peptide to a standard breakfast. The main control variables are: Metabolic control measured by serum HbA1c values (values < 6.2 % was the treatment objective) and the frequency of hypoglycaemic episodes (episodes/patient-month). RESULTS: Significant decreases in mean+/-SD HbA1c values in this group of patients were observed from the first year of follow-up, with the mean values being: 7.5+/-1.5%, 7.2+/-1.8%, 7.6+/-1.6%, 7.1+/-1.7%, 7+/-1.4, 6.6+/-1.6% and 6.8+/-1.4% for the first, second, third, fourth, fifth, sixth and seventh years of follow-up respectively. Sixteen %, 27.5%, 15.7%, 33.3%, 28.6%, 42% and 33% of the patients reached the treatment objective (HbA1c values<6.2%) for each year of follow-up. Throughout the study period the rate of severe hypoglycaemia (episodes/patient-year) was 0.32+/-0.2 which was not significantly different compared with the value of 0.28+/-0.1 observed the year before the study began. Similarly frequencies of mild/moderate hypoglycaemia episodes (episodes/patient-month) varies between 16.5+/-4 and 21.7+/-5, which are not significantly different from the value of 17.7+/-6 observed the year before the study began. CONCLUSION: Long-term improvement in metabolic control was observed in this group of type 1 diabetes patients with previous bad control, during treatment in a regular clinical setting. A considerable percentage of type 1 diabetic patients with MDI reached the treatment objective in every year of follow-up. Furthermore improvement in metabolic control is not associated with significantly increased frequency of hypoglycaemia episodes.     

Walking and talking activities as nursing therapy for improving quality of life among older adults

Objective

The most prominent problem resulting from decreased body function in older adults is declining quality of life. Walking and talking among older adults in peer group may become a nursing therapy to improve their quality of life. The objective of this study was to identify the impact of walking and talking intervention of quality of life among community dwelling older adults in Depok, Indonesia.

Pharmacological aspects of fisetin

Over the past decades, epidemiological studies have concluded that a diet rich in plant-derived products plays a pivotal role in human health. Fisetin (3,3',4',...     

Oxygen-enriched surface modification for improving the dispersion of iron oxide on a porous carbon surface and its application as carbon molecular sieves (CMS) for CO2/CH4 separation

The separation of CO₂/CH₄ can be enhanced by impregnating porous carbon with iron oxide. Dispersion of iron oxide is one of the critical factors which supports the separation process performance. Iron oxide dispersion can be enhanced by enriching the oxygen functional groups on the carbon surface. This study investigates three distinct oxidation processes: oxidation with a 10% H₂O₂ solution, ozonation with distilled water, and ozonation with a 10% H₂O₂ solution. The research steps included the following: (i) oxidation, (ii) impregnation of iron oxide followed by calcination, (iii) material characterization, and (iv) material performance analysis. Materials were characterized using N₂ sorption analysis, X-ray diffraction analysis (XRD), scanning electron microscopy-energy dispersive X-ray spectroscopy analysis (SEM-EDX), and Fourier transform infrared analysis (FT-IR). Iron oxide was well dispersed on the carbon surface, as evidenced by the elemental mapping of materials. In addition, the oxygen functional groups increased significantly in the range of 28.6–79.7% following the oxidation process, as indicated by the elemental component using SEM-EDX analysis. The impregnation of iron oxide on oxidized carbon ozonated with distilled water (COA–Fe) obtained a maximum CO₂ uptake capacity of 3.0 mmol g⁻¹ and CO₂/CH₄ selectivity increased by up to 190% at a temperature of 30 °C and pressure of 1 atm. Furthermore, the enhancement of CO₂/CH₄ separation up to 1.45 times was the best performance achieved by COA–Fe. Thus, improving iron oxide dispersion on oxidized carbon surfaces has a potential application in CO₂/CH₄ separation.

The separation of CO₂/CH₄ can be enhanced by impregnating porous carbon with iron oxide.     

Functional maturation of periodontal mechanoreceptors during development in rats

The influence of development on periodontal mechanoreceptors (PMRs) was investigated in four groups of male Wistar albino rats aged 1, 3, 5 weeks and 6 months using an in vitro jaw-nerve preparation. The mean values of conduction velocities of the nerve innervating PMRs in 5-week and 6-month groups were significantly higher than those in the other two groups. All fiber types obtained in the 5-week and 6-month groups were Abeta. The mechanical thresholds of 5-week and 6-month groups were significantly higher than those of 1- and 3-week groups. These data suggest that the response properties of rat's PMRs are matured by 5-week after birth, when functional molar occlusion and transition of dietary contents from liquid to hard-diet can be achieved.     

Age-related changes in growth hormone (GH)-releasing hormone and somatostatin neurons in the hypothalamus and in GH cells in the anterior pituitary of female mice

We have observed growth hormone-releasing hormone (GHRH)-immunoreactive (ir) neurons in the arcuate nucleus (ARC), somatostatin (SS)-ir neurons in the periventricular nucleus (PeN), and pituitary growth hormone (GH)-ir cells in female C57BL/6J mice at 2 months old (2 M), 4, 12 and 23 M, using immunocytochemical and morphometric methods. The number of GHRH-ir neurons decreased with age. The number of SS-ir neurons increased from 2 to 4 M, but decreased after 4 M. The volume of the anterior pituitary and the number of adenohypophysial parenchymal cells fell from 12 to 23 M. The proportion of GH-ir cells decreased significantly from 2 to 4 M and decreased in number from 12 to 23 M as well as in size from 2 to 4 M and from 12 to 23 M. Our results show that both GHRH-ir neurons and SS-ir neurons are fewer in old female mice, but the ratio of the number of SS-ir neurons to GHRH-ir neurons increases in old females. We suggest that the fall in the number and size of GH-ir cells in the pituitary gland with age may be involved in the increase in the ratio of the number of SS-ir neurons to GHRH-ir neurons in the hypothalamus in female mice, as well as in males.     

Establishment of a practical enzymatic assay method for determination of isovaleryl-CoA dehydrogenase activity using high-performance liquid chromatography

BACKGROUND: Isovaleric acidemia (IVA) is one of the various target disorders for tandem mass spectrometry (MS/MS) newborn screening. In the diagnosis of IVA, no enzymatic assay method for isovaleryl-CoA dehydrogenase (IVD) activity has been reported whereby the production of enoyl-CoA species was directly detected. We established a direct assay method to detect 3-methylcrotonyl-CoA (MC-CoA) production using high-performance liquid chromatography (HPLC). METHODS: Isovaleryl-CoA dehydrogenase crude enzyme was prepared by sonicating lymphocytes in peripheral blood. Aliquots were incubated with isovaleryl-CoA, flavin adenine dinucleotide, and phenazine methosulfate. 3-Methylcrotonyl-CoA produced in the samples was separated by HPLC and detected using an ultraviolet spectrophotometer. RESULTS: The detection of MC-CoA was reproducible depending upon the concentration of the substrates, the incubation time, and the number of cells contained in the crude enzyme solution. We applied this assay to three patients diagnosed with IVA and showed that neither of them had detectable residual activity. Only a few hours were required from the initial blood sampling to the end of the assay. CONCLUSIONS: These results demonstrate that this method for detecting MC-CoA production, using HPLC, is a practical assay for determining IVD activity. It can be a useful confirmatory test for IVA cases detected through MS/MS screening of newborns.     

The role of PKK in the immunization programme

A mid term evaluation of the immunization programme had been carried out in East Java from November 27, 1987 to December 6, 1987. The team consisted of various multidisciplines comprising members of the WHO (3), the Department of Health (4) the Medical Faculty (1), the PKK group (1), and Bangdes. Data showed that the Posyandu, the Health Centres, Hospitals and private doctors contributed to the programme by 69%, 28%, 2% and 1% respectively. It was obvious that although not satisfactory, the Posyandu was by far the most committed, reflecting the role of the PKK group especially in terms of encouraging mothers to bring their children to the Posyandu. As one face facts of low educated mothers, mothers being trapped in their routine daily activities, or having had inconvenient medical experience, a low motivation towards immunization might be anticipated, which in turn leads to a low coverage of immunization. Taking into consideration of how the PKK group plays its role in the immunization programme, attempts made to improve knowledge on immunizable diseases and their measures for prevention would undoubtedly be an important means of support to gain the aim of immunization.