bluuebunny/crossref_metadata_2025 huggingface dataset:
The Neuronal Toxic Factor in Serum of Type 1 Diabetic Patients is a Complement‐fixing Autoantibody
Authors: Pittenger G. L. , Liu D. , Vinik A. I.
Published: July 2009

Type 1 diabetes is an autoimmune disease resulting in destruction of pancreatic β cells. Many of the pancreatic β cell autoantigens are also neuronal cell components. Using adrenergic neuroblastoma cells, we have previously demonstrated that humoral mechanisms may contribute to the development of diabetic neuropathy in Type 1 patients. We hypothesize that the toxic factor in Type 1 diabetic serum is an immunoglobulin. When neuroblastoma cells were exposed to immunoglobulins precipitated from serum of Type 1 diabetes patients with neuropathy, cell growth was significantly inhibited by day 5 (3.8 ± 2.4 times 105 cells) compared to cells cultured with immunoglobulins from control (8.2 ± 2.3 times 105 cells) or Type 2 diabetic serum (7.0 ± 3.0 times 105 cells). The inhibitory effect (3.2 ± 0.9 times 105 cells) could be removed from Type 1 diabetic serum by affinity precipitation with protein A‐agarose (8.0 ± 0.8 times 105 cells). Mild heat denaturing of the serum reversed the inhibitory effect (3.8 ± 0.9 vs 1.4 ± 1.4 times 105 cells), indicating a requirement for complement. Immunofluorescent labelling with anti‐IgG secondary antibody of cells exposed to Type 1 diabetic serum indicated recognition of a membrane‐bound antigen. The studies in this report support the hypothesis that autoimmune neuronal destruction may contribute to the development of diabetic autonomic neuropathy in patients with Type 1 diabetes.
Effects of Glucose and SNK‐860, an Aldose Reductase Inhibitor, on the Polyol Pathway and Chemiluminescence Response of Human Neutrophils in vitro
Authors: Kawamura T. , Suzuki K. , Matsumae H. , Sano T. , Sakamoto N. , Hotta N.
Published: July 2009

An in vitro incubation study was conducted to investigate whether increased activity of the polyol pathway in human neutrophils under diabetic conditions resulted in a decrease of superoxide anion produced by NADPH oxidase on the membrane of neutrophils. Lucigenin‐enhanced chemiluminescence (CL) to phorbol myristate acetate as respiratory burst and sorbitol levels in neutrophils after incubation with glucose and an aldose reductase (AR) inhibitor, SNK‐860 (SNK) were measured. Sorbitol levels increased from 0.210 ± 0.029 nmol 107 cells −1 in 5 mmol I−1 glucose to 0.446 ± 0.036 nmol 107 cells−1 in 40 mmol I−1 glucose, while CL decreased from 0.542 ± 0.034 cpm cell−1 in 5 mmol I−1 glucose to 0.430 ± 0.018 cpm cell−1 in 40 mmol I−1 glucose. The addition of 10 μmol I−1 SNK normalized the increased sorbitol levels in neutrophils exposed to 40 mmol I−1 glucose and improved, but did not normalize, the decrease in CL induced by 40 mmol I−1 glucose (p < 0.001). Galactose (40 mmol I−1) also reduced CL, which was improved by the addition of SNK (p < 0.01). These results suggest that impaired respiratory burst induced by high‐glucose concentrations is caused by competition for NADPH resulting from increased polyol pathway activity and/or glycation and that an AR inhibitor may be capable in part of preventing increased susceptibility to infection in diabetic patients.
A Reproducibility Study of Technetium‐99m Macroaggregated Albumin Foot Perfusion Imaging in Patients with Diabetes Mellitus
Authors: Sturrock N. D. C. , Perkins A. C. , Wastie M. L. , Blackband K. R. , Moriarty K. T.
Published: July 2009

The reproducibility of Technetium‐99m macroaggregated albumin (99mTc‐MAA) foot perfusion imaging was assessed in 14 diabetic patients with foot ulcers. Bilateral femoral intra‐arterial injections of 99mTc‐MAA were administered and the feet imaged with a gamma camera. Patients returned 1 week later for a repeat study. The scans of 10 patients including one unilateral amputee were evaluated. Of these 19 limbs there were 4 failed injections (21%). The remaining 15 completed repeat studies were analysed both subjectively and semiquantitatively by 2 different observers who were blind to the patient's name and scan date. Subjectively the images of each individual were similar with reports highlighting the same abnormalities. Semiquantitatively areas of increased uptake on both images were significantly correlated for each individual (Pearson's Rho correlation coefficient = 0.96, r2 = 0.92, p<0.0001) as were areas of poor uptake reported, reflecting decreased tissue perfusion (Pearson's Rho = 0.93, r2 = 0.86, p<0.0001). There were no side‐effects. 99mTc‐MAA has proven to be a safe, generally acceptable, and reproducible technique for assessing tissue perfusion in the extremities which provides an accurate means of differentiating viable from non‐viable tissue in patients with foot ulcers.
The Natural Course of Microalbuminuria in Insulin‐dependent Diabetes: A 10‐year Prospective Study
Authors: Mathiesen E.R. , Rønn B. , Storm B. , Foght H. , Deckert T.
Published: July 2009

The purpose of this study was to describe the clinical course in patients followed right from the onset of microalbuminuria to the development of diabetic nephropathy. A 10‐year prospective follow‐up of 209 consecutive normotensive insulin‐dependent diabetic patients with normal urinary albumin excretion (UAE <30 mg 24 h−1), age 34 (18–50) years and duration of diabetes 17 (10–30) years was performed. Twenty‐four‐hour urinary albumin excretion was measured every 4 months, glycated haemoglobin and supine blood pressure was measured annually. Two‐hundred (96%) patients completed 10 (range 5–10) years follow‐up. Twenty‐nine (15%) patients developed persistent microalbuminuria (UAE 30–300 mg 24 h−1). Eight of these have progressed to nephropathy and one had died of diabetic nephropathy. Multiple stepwise logistic regression analysis demonstrated baseline urinary albumin excretion (p = 0.0016) and glycated haemoglobin (p = 0.0014) but not blood pressure as predictors of development of microalbuminuria within the following 10 years. The median annual increase in urinary albumin excretion was 27 (range 17–65)% in the 29 patients developing microalbuminuria. The median duration from onset of microalbuminuria to development of nephropathy was 7 years. The prevalence of patients receiving antihypertensive treatment (BP > 140/90 mmHg) increased from 10% at onset of microalbuminuria to 45% 4 years after onset of microalbuminuria. The prevalence of patients with proliferative retinopathy increased from 7% at onset of microalbuminuria to 28% 4 years after onset of microalbuminuria. The incidence of persistent microalbuminuria in normotensive insulin‐dependent diabetic patients is 2% per year, and development of persistent microalbuminuria is a strong predictor of overt nephropathy. Development of hypertension is frequent in the early course of microalbuminuria and treatment modalities for normotensive patients with microalbuminuria are urgently needed.
Coagulation Activation in Type 2 Diabetes Mellitus: the Higher Coronary Risk of Female Diabetic Patients
Authors: Chan P. , Pan W.H.
Published: July 2009

Thrombophilia in diabetic patients is a well‐recognized phenomenon which constitutes an additional risk of coronary heart disease. This study included 1980 ethnic Chinese people (835 male, 1145 female); age range: 45 to 69 years, including 280 Type 2 diabetic patients (male 125, female 155). Haemostatic parameters measured were fibrinogen, prothrombin time, activated partial thromboplastin time (APTT), factor VIIc, factor VIIIc, antithrombin III, and plasminogen. Compared with a control group, male diabetic patients showed significantly shorter APTT (25.6 ± 3.7 vs 27.5 ± 3.6 s, p<0.001), and elevated factor VIIIc (171.1 ± 77.48 vs 131.16 ± 52.23%, p<0.0001), whereas female diabetic patients showed significantly shorter APTT (24.9 ± 4.2 vs 26.5 ± 3.9 s, p<0.001) and elevated fibrinogen (10.6 ± 3.3 vs 9.8 ± 2.6 μmol 1−1, p<0.05), factor VIIc (150.4 ± 68.7 vs 135.3 ± 32.3%, p<0.001), factor VIIIc (190.1 ± 92.6 vs 141.1 ± 62.4%, p<0.0001), and plasminogen (140.3 ± 41.9 vs 128.4 ± 38.7%, p<0.01). This study showed that Chinese diabetic patients had coagulation activation, and that female diabetic patients seemed to constitute a higher risk group for coronary heart disease than males.
The Splanchnic Circulation and Postural Hypotension in Diabetic Autonomic Neuropathy
Authors: Purewal T.S. , Goss D.E. , Zanone M.M. , Edmonds M.E. , Watkins P.J.
Published: July 2009

Postural hypotension results from sympathetic failure to cause superior peripheral vasoconstriction. The importance of the splanchnic circulation was studied by measuring mesenteric artery blood flow with duplex Doppler scanning. Nine normal and 9 Type 1 diabetic controls were compared to 8 Type 1 patients with autonomic neuropathy whose pressure fell 40–113 mmHg (range) on tilting. Measurements were made supine and after vertical tilt, fasting without insulin and after a 550 kcal meal. Superior mesenteric artery diameter decreased on tilting in normal controls but not in diabetic control or neuropathy groups (supine vs tilted: controls. 6.3 ± 0.9 to 5 ± 0.9 mm, p = 0.004, diabetic controls: 6.0 ± 0.6 to 6.0 ± 1.0 mm, and neuropathy group: 6.4 ± 0.9 to 5.6 ± 0.9 mm), but proportional blood flow changes were similar in all subjects (controls: 407 ± 154 to 255 ± 67 ml min−1 (‐31%, p = 0.03), diabetic controls: 379 ± 140 to 306 ± 149 ml min−1 (‐8%, p = 0.28), neuropathy group: 639 ± 371 to 435 ± 142 ml min−1 (‐23%, p = 0.10). Postprandially supine superior mesenteric artery flow increased in all subjects but this did not affect the degree of systolic blood pressure drop on tilting (fasting vs postprandial blood flow: controls: 407 ± 154 to 775 ± 400 ml min−1 (p = 0.04), diabetic controls: 379 ± 140 to 691 ± 262 ml min−1 (p = 0.01), neuropathy group: 639 ± 371 to 943 ± 468 ml min−1 (p < 0.06)). The similarity of superior mesenteric artery responses to tilting in the three groups, and the lack of exacerbation of postural hypotension in the presence of postprandial hyperaemia indicates that control of splanchnic blood flow is less important in the aetiology of diabetic autonomic postural hypotension than previously thought.
Nesidioblastosis in an Elderly Patient
Authors: Walmsley D. , Matheson N.A. , Ewen S. , Himsworth R.L. , Bevan J.S.
Published: July 2009

We report an 84‐year‐old woman with hypoglycaemia and hyperinsulinaemia caused by diffuse nesidioblastosis. This is the oldest case of nesidioblastosis so far recorded. The case illustrates some of the difficulties in diagnosing inappropriate hyperinsulinaemia and the benefits of surgery, even in old age. Hypoglycaemia should be considered in patients with variable mental function.
Differences in Joint Mobility and Foot Pressures Between Black and White Diabetic Patients
Authors: Veves A. , Sarnow M.R. , Giurini J.M. , Rosenblum B.I. , Lyons T.E. , Chrzan J.S. , Habershaw G.M.
Published: July 2009

Limited joint mobility is common in diabetes and is related to high foot pressures and foot ulceration. We have examined the differences in joint mobility and foot pressures in four groups matched for age, sex, and duration of diabetes: 31 white diabetic, 33 white non‐diabetic, 24 black diabetic, and 22 non‐diabetic black subjects. Joint mobility was assessed using a goniometer at the fifth metacarpal, first metatarsal, and subtalar joints. In‐shoe and without shoes foot pressures were measured using an F‐Scan system. Neuropathy was evaluated using clinical symptoms (Neuropathy Symptom Score), signs (Neuropathy Disability Score), and Vibration Perception Threshold. There was no difference between white and black diabetic patients in Neuropathy Symptom Score, Neuropathy Disability Score, and Vibration Perception Threshold. Subtalar joint mobility was significantly reduced in white diabetic patients (22 ± 7°) compared to white controls (26 ± 4°, black diabetic patients (25 ± 5°), and black controls (29 ± 7°), and increased in black controls compared to white controls and black diabetic patients (level of statistical significance p < 0.05). Without shoes foot pressures were higher in white diabetic patients (8.31 ± 400 kg cm−2) compared to white controls (6.81 ± 2.31 kg cma2), black diabetic patients (6.2 ± 2.53 kg cm−2) and black controls (5.00 ± 1.24 kg cm−2) and lower in black controls compared to white and black diabetic patients (p < 0.05 in all cases). We conclude that racial differences exist in joint mobility and foot pressures between black and white subjects. Thus, in black diabetic patients the joint mobility, although reduced compared to black healthy subjects, is increased when compared to white diabetic patients. This contributes to lower foot pressures, comparable to non‐diabetic white subjects and probably reduces the risk of foot ulceration in black diabetic patients.
Reduction of Gangrene and Amputations in Diabetic Renal Transplant Patients: the Role of a Special Foot Clinic
Authors: Foster A.V.M. , Snowden S. , Grenfell A. , Watkins P.J. , Edmonds M.E.
Published: July 2009

This 4‐year prospective study investigated the reasons for high levels of gangrene and major amputation in diabetic renal transplant patients and whether regular mutli‐disciplinary foot care could reduce morbidity. All foot lesions were documented and investigated in 50 diabetic patients, mean age 49.2 ± 11.0 (SD) years, duration of diabetes 25.3 ± 9.0 years, time since renal transplantation 60.2 ± 35.1 months, who attended a special foot clinic monthly for education, vascular and neurological assessment, podiatry and footwear. Foot lesions included: neuropathic ulcers, ischaemic ulcers, traumatic lesions, Charcot's arthropathy, pathological fracture. Treatment included antibiotics, podiatry, footwear, and angioplasty or distal bypass where appropriate. Only 13 patients were deemed ischaemic but peripheral neuropathy was a very common finding (mean VPT 24.8 ± 12.9 V). Gangrene and major amputations showed a decrease on previous years and healing times for lesions were similar to those previously reported in diabetic patients without renal transplants. The majority of foot lesions, both in soft tissue and bone, were related to neuropathy and trauma and responded well to optimal foot care within the renal unit. Gangrene and major amputations were usually preventable.
No Important Differences in Glycaemic Responses to Common Fruits in Type 2 Diabetic Patients
Authors: Lunetta M. , Di Mauro M. , Crimi S. , Mughini L.
Published: July 2009

The aim of this study was to determine the glycaemic indices (GIs), peak incremental indices (PI), and time of peak increment (TPI) of eight kinds of fruits and their relationship with the type and amount of simple sugars directly assayed in the fruits. Sixty‐one type 2 diabetic patients randomized into eight groups—one for each category of fruit—participated in the study. GIs consisted of the following: pears = 60 ± 4.9; apples = 63 ± 8.3; oranges = 68 ± 6.5; grapes = 70 ± 7.5; plums = 75 ± 8.4; peaches = 80 ± 7.4; apricots = 82 ± 9.1; bananas = 83 ± 8.5. The PI values (mmol l−1) were the following: grapes = 2.52 ± 0.26; apples = 3.13 ± 0.75; pears = 3.48 ± 0.55; oranges = 4.02 ± 0.42; peaches = 4.07 ± 0.38; apricots = 4.08 ± 0.47; plums = 4.2 ± 0.45; bananas = 4.45 ± 0.39. There was no statistical differences in GI, and PI, within the different fruits. TPI of grapes (43.3 ± 5.2 min), oranges (45 ± 5.6 min), and peaches (45 ± 5.6 min) were statistical different (p < 0.01) in respect to apricots (81.4 ± 5.5 min). GIs were positively correlated with total glucose contained in the fruits (p < 0.05) and with PI (p < 0.0002); negatively with fructose both free (p < 0.02) and total (sum of free and present in sucrose (p < 0.05). On the basis of these findings, there is unlikely to be a difference of biological importance related to GI and PI of fruits, whereas the significance of TPI remains still to be evaluated.
Relation of Fetal Growth to Adult Muscle Mass and Glucose Tolerance
Authors: Phillips D.I.W.
Published: July 2009

Recent studies show reduced fetal growth is associated with insulin resistance and a raised prevalence of glucose intolerance in adult life. Because early growth retardation in animal models leads to permanent changes in body composition and a reduction in the mass of muscle, a major insulin sensitive tissue, reduced adult muscle mass could explain the link between impaired fetal growth and glucose intolerance. To investigate this hypothesis, muscle mass has been determined in a group of men and women aged around 50 who were born in Preston, Lancashire and compared with their birthweight or body size at birth and their current insulin resistance and glucose tolerance. Subjects who had lower birthweights were shorter and lighter but their weight adjusted for height (BMI) was similar to that of other subjects. Much of the difference in weight was accounted for by a reduction in muscle mass. Muscle mass as estimated by the urinary creatinine excretion rose from 18.8 % of body weight in women who had birthweights of 2.5 kg or less to 24.7% of bodyweight in those with birthweights of 3.4 kg or more. Trends in men were similar. Regression analysis showed that adult muscle mass was predicted by low birthweight (p = 0.004), low placental weight (p = 0.02), and small head circumference (p = 0.02) but not, however, by thinness at birth, the birth measurement most predictive of insulin resistance. In addition there were no significant relationships between muscle mass and insulin resistance or glucose tolerance in either men or women. These results may be explained by the existence of two populations of babies both characterized by low birthweight. Babies who are symmetrically small at birth have reduced muscle mass in adult life. They do not, however, have increased insulin resistance or a tendency to develop glucose intolerance. Thin babies have a normal adult muscle mass; their tendency to develop insulin resistance or glucose intolerance is not explained by alterations in muscle mass.
Ethnic Differences in the Perception of a Video Developed for a Multiethnic Diabetes Prevention Programme in South Auckland, New Zealand
Authors: Fleming C. , Simmons D. , Leakehe L. , Voyle J.
Published: July 2009

Videos were developed to help increase diabetes awareness among local Maori, Pacific Islands and European communities. The Maori and Pacific Islands versions incorporated modifications to the basic content to make them more appropriate for the target audience. Lay audiences, comprising 108 Europeans, 94 Maori and 90 Pacific Islands people in 12 different sites, viewed the version of the video tailored to their ethnic group. The Maori version was also viewed by 32 Diabetes Nurse Specialists. Likert scale ratings and openended questions were used to evaluate the video. The video was rated highly by all audiences and most subjects were able to repeat the main messages of the video. Compared with Maori and Pacific Islands subjects, Europeans found the video the easiest to understand but gained the least information. Maori and Pacific Islands subjects would have preferred a longer video (> 17 minutes). Different viewing sites revealed evidence of within‐ethnic‐group heterogeneity. Pacific Islands subjects particularly appreciated the educational components, while Maori and Europeans were more likely to comment on presentation. Audio‐visual material is perceived differently by different ethnic groups, such differences need to be addressed when embarking on diabetes awareness campaigns.
Are Frozen Urine Samples Acceptable for Estimating Albumin Excretion in Research?
Authors: Shield J.P.H. , Hunt L.P. , Morgan J.E. , Pennock C.A.
Published: July 2009

Timed urine collections from diabetic children and adolescents were assessed for urinary albumin excretion rate (μg min−1) before and after freezing at −20 °C. Freezing had the effect of changing the estimation such that frozen values could differ from that of the fresh, by as much as one half to twice as much. The variation depended on the concentration defining the initial albumin excretion rate but was not influenced by the length of storage when frozen. We conclude that researchers should be aware that freezing and storing of urine samples prior to albumin concentration assessments can affect the absolute values obtained. It would appear more appropriate to analyse samples prior to freezing to be certain of obtaining true prevalence estimates of microalbuminuria.
DIAMOND: a Computerized System for the Management and Evaluation of District‐wide Diabetes Care
Authors: Kopelman P. G. , Michell J. C. , Sanderson A. J.
Published: July 2009

A computerized diabetic clinic management system, DIAMOND, has been developed with the collaboration of local general practitioners (GPs) to assist communication about diabetic patients across the district. DIAMOND is written in a Windows format using Microsoft Access and its dataset is in line with BDA and Diabcare recommendations. DIAMOND is user‐friendly and includes displays and help messages throughout and does not require advanced computer knowledge. The main index contains two primary tables: a patient registration table with demographic data and an episode table with clinically important physical and biochemical measures. All entered data are coded to facilitate audit and an audit function, which automatically presents data, either numerically or graphically, is included in the report facility. DIAMOND also incorporates a system for patient education and training (PEATS) which may be operated by a health professional or the patient. Over 4500 patients in Newham are presently registered on DIAMOND with in excess of 15000 episodes. Evaluation of this information is providing important clinical information both within individual GP practices and district‐wide to assist future plans for health care provision.
Dead in Bed Syndrome in Young Diabetic Patients in Norway
Authors: Thordarson H. , Søvik O.
Published: July 2009

The incidence of unexplained deaths (‘dead in bed syndrome’) in Norwegian diabetic patients under the age of 40 was investigated during the period 1981–1990. During this 10‐year period there were 240 deaths of all causes in the age group 0–39 years. Sixteen of these cases fulfilled the following criteria of the ‘dead in bed syndrome’: (1) patient found dead in an undisturbed bed; (2) patient observed to be in good health condition the day before; (3) no clinical evidence of late complications (except background retinopathy in two cases). Of the 16 cases ascertained, 10 were males and 6 females. The age range was 7–35 years, and the duration of diabetes varied between a few months and 26 years. Autopsy, performed in 13 cases, did not reveal any cause of death. Nine patients had been using insulin regimens with multiple daily doses. Twelve patients were reported as having had frequent episodes of hypoglycaemia, with nocturnal episodes in 10 cases. There was apparently an increasing incidence of unexplained deaths during the study period, with 12 of 16 cases occurring in the years 1988 to 1990.
Marked Hyperinsulinaemia in Postmenopausal, Healthy Indian (Asian) Women
Authors: Berger G.M.B. , Naidoo J. , Gounden N. , Gouws E.
Published: July 2009

The effect of the menopause on insulin metabolism has not received specific attention in populations prone to non‐insulin‐dependent (Type 2) diabetes mellitus (NIDDM). Insignificant or slight alterations in insulin levels have been reported in postmenopausal women of mainly European ancestry. We thus report on the results of a cross‐sectional study on the correlates of fasting insulin levels in 177 healthy, Indian nurses aged between 25 and 55 years. Fasting insulin concentration was markedly higher in the 75 postmenopausal subjects (23.9 mU I‐1) than in the 102 premenopausal women (11.7 mU I‐1 (p < 0.0001). Forty‐three (57 %) of the postmenopausal subjects had insulin values more than 20 mU I‐1 (the upper normal limit). Stepwise regression analysis on the entire group revealed menopause (p < 0.0001), waist: hip ratio (p = 0.0001), apolipoprotein E genotype (p = 0.002), and the testosterone: sex hormone binding globulin ratio (p = 0.0002) as statistically significant, independent predictors of log insulin levels. Age did not account for the difference between premenopausal and postmenopausal subjects. The apolipoprotein E genotype emerged as a significant correlate of insulin levels, only in postmenopausal women: εE3/3, 26.3 mU I‐1; εE3/4, 51.8 mU I‐1 (p = 0.0007). Hyperinsulinaemic postmenopausal subjects had higher fasting glucose levels than normoinsulinemic nurses (p = 0.03), but glycosylated haemoglobin and fructosamine values were all within the normal range. Thus fasting hyperinsulinaemia was marked and common among a group of healthy, postmenopausal Indian nurses below the age of 55 years, suggesting that the menopausal transition may permit or provoke insulin resistance in this susceptible population.
Plasma Lipid Peroxidation and Hyperglycaemia: a Connection Through Hyperinsulinaemia?
Authors: Uusitupa M.I.J. , Niskanen L.K. , Salonen J.T. , Nyyssönen K.
Published: July 2009

Increased lipid peroxidation has been commonly observed in diabetic patients as compared to control subjects. However, studies on the relationship to metabolic control have yielded conflicting results and no data are available on the relationship of hyperinsulinaemia to lipid peroxidation. We investigated, in well‐characterized groups of 93 patients with non‐insulin‐dependent diabetes mellitus, 22 subjects with impaired glucose tolerance (IGT) and 96 subjects with normal glucose tolerance (NGT), the determinants of plasma lipid peroxidation measured by plasma thiobarbituric acid reactive substances (TBARS). These were significantly higher in subjects with IGT (1.04 ± 0.48 μmol I‐1) and in NIDDM patients (1.00 ± 0.48 μmol I‐1) than in those with NGT (0.75 ± 0.46 μmol I‐1; p < 0.05). The glucose tolerance status was the major determinant of increased lipid peroxidation even after controlling for the effects of age, sex, body mass index, physical activity, use of alcohol, smoking, and the use of diuretics. In regression analyses the major determinants of plasma TBARS were fasting plasma glucose, insulin, and apolipoprotein A1 (inversely) levels. To conclude, plasma TBARS were increased in impaired glucose tolerance and in diabetes and they were related to prevailing plasma glucose and insulin levels, suggesting a role for insulin resistance in increased lipid peroxidation process. On the contrary, apolipoprotein A1 may have protective effects in this respect.
Indications of Low Sex Hormone Binding Globulin (SHBG) in Young Females with Type 1 Diabetes, and an Independent Association to Microalbuminuria
Authors: Rudberg Susanne , Persson B.
Published: July 2009

Sex hormone binding globulin (SHBG) is normally decreased during puberty and inversely related to insulin resistance. Microalbuminuria is rare before puberty in Type 1 diabetes implicating that sex hormones may contribute to its development. We investigated SHBG levels in young females with >5 years of Type 1 diabetes, and the association to microalbuminuria. Ten diabetic females with, and 15 without microalbuminuria, and 17 healthy controls in pubertal stage 4–5 were compared regarding anthropometric data, fasting serum levels of SHBG, testosterone, insulin, insulin‐like growth factor‐1 (IGF‐1), lipids and lipoproteins. Multiple regression analyses were performed to study variables with independent influences on SHBG and albumin excretion rate (AER), respectively, in Type 1 diabetes. SHBG was lower and testosterone/SHBG ratio higher in normoalbuminuric females with diabetes than in controls. This was further emphasized in diabetic patients with microalbuminuria. IGF‐1 was lower in Type 1 diabetes than in controls, and significantly decreased in microalbuminuric as compared to normoalbuminuric diabetic patients. IGF‐1 was only correlated to SHBG in healthy controls. In Type 1 diabetes, applying stepwise multiple regression analysis, insulin dose, BMI, and HbA1c had a significant and independent inverse influence on SHBG (r2 = 0.77, p < 0.001). With log AER as the dependent variable, low SHBG, low IGF‐1, HbA1c, and age added to the regression (r2 = 0.65, p = 0.004), whereas BMI, insulin dose and blood pressure did not. In conclusion, SHBG is decreased in young females with Type 1 diabetes, influenced by increased insulin requirements, BMI and HbA1c. In turn, low SHBG seems to be independently associated to elevated AER in these patients. Prospective studies are necessary to confirm our results.
Low health‐related quality of life is associated with all‐cause mortality in patients with diabetes on haemodialysis: the Japan Dialysis Outcomes and Practice Pattern Study
Authors: Hayashino Y. , Fukuhara S. , Akiba T. , Akizawa T. , Asano Y. , Saito S. , Kurokawa K.
Published: July 2009

Aims  Whether health‐related quality of life (HRQoL) can be accurately predicted in patients with extremely low HRQoL as a result of diabetic complications is unclear. We investigated the impact of HRQoL on mortality risk in patients with diabetes on haemodialysis.

Methods  Data from the Dialysis Outcomes Practice Pattern Study (DOPPS) were analysed for randomly selected patients receiving haemodialysis in Japan. Information regarding the diagnosis of diabetes and clinical events during follow‐up was abstracted from the medical records at baseline and HRQoL was assessed by a self‐reported short form (SF)‐36 questionnaire. The association between physical component score and mental component score in the SF‐36 and mortality risk was analysed using a Cox proportional hazard model.

Results  Data from 527 patients with diabetes on haemodialysis were analysed. The mortality age‐adjusted hazard ratio of having a physical component score greater than or equal to the median was 0.27 [95% confidence interval (CI) 0.08–0.96] and the multivariable‐adjusted mortality hazard ratio of having an mental component score greater than or equal to the median was 1.21 (95% CI 0.44–3.35).

Conclusions  The physical component score derived from the SF‐36 is an independent risk factor for mortality in patients with diabetes on haemodialysis who generally had very low HRQoL scores. Baseline mental component score was not predictive of mortality. Patient self‐reporting regarding the physical component of health status may aid in risk stratification and clinical decision making for patients with diabetes on haemodialysis.
Can peer educators influence healthy eating in people with diabetes? Results of a randomized controlled trial
Authors: Cade J. E. , Kirk S. F. L. , Nelson P. , Hollins L. , Deakin T. , Greenwood D. C. , Harvey E. L.
Published: July 2009

Aims  To assess whether the Expert Patient Programme (EPP), adapted for people with Type 2 diabetes, can be used to promote healthy eating to improve glycaemic control.

Methods  Adults with Type 2 diabetes (n = 317) were randomized to receive either a diabetes‐specific EPP (n = 162) or individual one‐off appointments with a dietitian (control group) (n = 155). The diabetes‐specific EPP followed the standard National Health Service programme although all participants in the group had diabetes only, rather than a mix of chronic conditions. Participants attended a group session for 2 h once per week for 6 weeks. In addition, a final seventh‐week 2‐h session was included that was specific to issues concerning diabetes. Outcomes were assessed at baseline, 6 and 12 months.

Results  There were no statistically significant differences between the control and the intervention group in any of the clinical outcomes measured. There was no significant difference between the groups in any dietary outcome. There was a higher starch intake in the EPP group, although this did not reach statistical significance (effect size for starch adjusted for baseline values 8.8 g; 95% CI −1.3 to 18.9). There was some loss of participants between baseline measurement and randomization, although this did not appear to have had an important impact on baseline balance.

Conclusions  In this study of people with Type 2 diabetes, the EPP approach was not effective in changing measures of diabetes control or diet.
Relative and absolute contributions of postprandial and fasting plasma glucose to daytime hyperglycaemia and HbA1c in subjects with Type 2 diabetes
Authors: Peter R. , Dunseath G. , Luzio S. D. , Chudleigh R. , Choudhury S. R. , Owens D. R.
Published: July 2009

Aims  To determine the relative and absolute contributions of postprandial glucose (PPG) and fasting or preprandial plasma glucose (FPG) to daytime hyperglycaemia and HbA1c respectively, in persons with type 2 diabetes (T2DM).

Methods  Subjects (n = 52; 37men) had 12hr plasma glucose (PG) profiles determined in response to three serial identical test meals. PPG exposure was calculated for each meal. Excess hyperglycaemia was calculated above a PG concentration of 5.5mmol/l. Fasting hyperglycaemia was the difference between excess hyperglycaemia and PPG exposure. Subjects were divided into three groups according to HbA1c‐(Gp1:<7.3%;Gp2:7.3%‐8.0%;Gp3:>8.0%) and the relative contribution of PPG exposure and fasting hyperglycaemia to excess hyperglycaemia calculated for each meal. The absolute contribution of PPG and fasting hyperglycaemia to excess HbA1c (mean HbA1c–5.1%) was also calculated.

Results  The relative contributions of PPG exposure to excess hyperglycaemia for the three groups were: 58.3%, 54.3% and 35.4% (P = 0.483—Group 1 vs. Group 2; P = 0.002—Group 2 vs. Group 3) for meal 1; 69.8%, 54.7% and 23.7% (P = 0.163—Group 1 vs. Group 2; P = 0.005—Group 2 vs. Group 3) for meal 2; 85.8%, 70.2% and 48.6% (P = 0.153—Group 1 vs. Group 2; P = 0.046—Group 2 vs. Group 3) for meal 3. Absolute contributions of PPG to excess HbA1c in the three groups were 1.4%, 1.6% and 1.3% (P = NS).

Conclusion  The relative contribution of postprandial glucose to excess hyperglycaemia decreases as glycaemic control deteriorates, being dominant with HbA1c≤ 7.3%, irrespective of the timing of the meal during the day. However, the absolute contribution of postprandial glucose to excess HbA1c does not differ significantly (∼1.5%) with varying glycaemic control.
The relation between an adverse psychological and social environment in childhood and the development of adult obesity: a systematic literature review
Authors: Vámosi M. , Heitmann B. L. , Kyvik K. O.
Published: July 2009

The prevalence of obesity is on a global‐wide increase, but still the aetiology of adult obesity is poorly understood. It has been shown that overweight children suffer from adverse psychological events, but less is known about the potential effects of adverse psychological factors among normal weight children for later development of obesity. The purpose of this study was to systematically review current literature on associations between psychological factors in childhood and development of obesity in adulthood. A systematic search was conducted in three electronic databases MEDLINE (silverplatter 1977–2008), PsycINFO (1972–2008) and PsycINFO Weekly (week 1 January 2007–week 3 July 2008) to identify studies of interest. Six prospective and two retrospective studies were identified. Psychosocial factors related to adult obesity were lack of childhood care, abuse and childhood anxiety disorders. In addition, depression in adolescence tended to be related to adult obesity but among young girls only. Learning difficulties and scholastic proficiencies below average were also risk factors. The current literature suggests that specific psychosocial factors in childhood may act as determinants for developing obesity in adulthood.
The Relevance of Coercion: Some Preliminaries*
Authors: STAVROPOULOS NICOS
Published: July 2009

Many philosophers take the view that, while coercion is a prominent and enduring feature of legal practice, its existence does not reflect a deep, constitutive property of law and therefore coercion plays at best a very limited role in the explanation of law's nature. This view has become more or less the orthodoxy in modern jurisprudence. I argue that an interesting and plausible possible role for coercion in the explanation of law is untouched by the arguments in support of the orthodox view. Since my main purpose is to clear the ground for the alternative, I spell out the orthodox view in some detail. I then briefly sketch the alternative. Finally, I turn to Jules Coleman's discussion of the alternative.
COMPETITIVE INNOVATION WITH CODIFIED AND TACIT KNOWLEDGE*
Authors: Haruyama Tetsugen
Published: July 2009

R&D‐based models of endogenous technical progress rest on a premise that technical progress is driven by profit‐seeking entrepreneurs. This literature led to a dominant view that endogenous technical advance is not consistent with perfect competition with constant returns to scale. Departing from this dominant perspective, we demonstrate that technical progress endogenously occurs in a perfectly competitive economy under constant returns to scale in rivalrous inputs. Our result is based on a hypothesis that R&D creates codified and tacit knowledge as joint products. Empirical and case studies are discussed to support the hypothesis. Using the model, we demonstrate that stronger patent protection can encourage or discourage R&D, depending on the size of an economy.
VAGUE PARTS AND VAGUE IDENTITY
Authors: BARNES ELIZABETH , WILLIAMS J. R. G.
Published: July 2009

We discuss arguments against the thesis that the world itself can be vague. The first section of the paper distinguishes dialectically effective from ineffective arguments against metaphysical vagueness. The second section constructs an argument against metaphysical vagueness that promises to be of the dialectically effective sort: an argument against objects with vague parts. Firstly, cases of vague parthood commit one to cases of vague identity. But we argue that Evans' famous argument against will not on its own enable one to complete the reductio in the present context. We provide a metaphysical premise that would complete the reductio, but note that it seems deniable. We conclude by drawing general morals from our case study.
Children’s Height and Parental Unemployment: A Large-Scale Anthropometric Study on Eastern Germany, 1994–2006
Authors: Baten Jörg , Böhm Andreas
Published: July 2009

The average height of children is an indicator of the quality of nutrition and healthcare. In this study, we assess the effect of unemployment and other factors on this variable. In the Eastern German Land of Brandenburg, a dataset of 253,050 preschool height measurements was compiled and complemented with information on parents’ schooling and employment status. Unemployment might have negative psychological effects, with an impact on parental care. Both a panel analysis of districts and an assessment at the individual level yield the result that increasing unemployment, net out-migration and fertility were in fact reducing height.
Individualism–collectivism and the role of goal orientation in organizational training
Authors: Rogers Altovise , Spitzmueller Christiane
Published: July 2009

This research examines how individualism–collectivism and goal orientation impact training effectiveness through study of an internationally diverse sample of engineers who were undergoing technical training. In light of contemporary views of individualism–collectivism, we argue that collectivism will moderate the influence of learning and performance goal orientations on training by shaping the impact of one's perceived social context on existing performance concerns and goals. Using a sample from a large multinational corporation, we examined the effects of individualism–collectivism and goal orientation on training transfer intentions, motivation to learn, and test performance. Mixed support for our hypotheses was found. Collectivists were found to exhibit higher levels of training transfer intentions and motivation to learn. However, when collectivism was combined with a performance goal orientation, its effects on training outcomes were diminished. Applications for organizations and future extensions of the present research are discussed.
Summary and Overview
Authors: Appleyard Reginald , Stahl Charles W.
Published: July 2009

Summary and Overview
The SACD method and the XLRS squamometry tests revisited
Authors: Piérard‐Franchimont C. , Henry F. , Piérard G.E.
Published: July 2009

Synopsis

The assessment of many aspects of the structure and biological dynamics of the stratum corneum can be conducted using calibrated stripping with adhesive‐coated discs (SACD). Squamometry entails staining SACD samples with a toluidine blue‐basic fuschsin ethanol‐based solution and reading the colorimetric variable Chroma C* representing the squamometry index. Four main variants of squamometry index have been designed so far. Squamometry X refers to the assessment of xerosis and any scaly condition. Squamometry L explores the intercorneocyte cohesiveness impaired by ultraviolet light. Squamometry R evaluates stratum corneum renewal and squamometry S assesses the effect of surfactants on corneocyte integrity. This latter variant is related to, although not similar to, the ex‐vivo corneosurfametry bioassay. All squamometry tests are rapid, reliable, sensitive and cheap.

Résumé

L’évaluation de nombreux aspects de la structure et de la dynamique biologique de la couche cornée bénéficie de la collecte calibrée de cornéocytes par des pastilles auto‐adhésives. La squamométrie consiste à colorer ces échantillons par une solution alcoolique de bleu de toluidine et de fuchsine basique, suivi de la lecture colorimétrique du Chroma C* dont la valeur représente l’index de squamométrie. Quatre variantes principales de la squamométrie ont été décrites à ce jour. La squamométrie X s’applique à l’évaluation des xéroses et de divers états squameux. La squamométrie L évalue l’impact de la lumière ultraviolette sur la cohésion intercornéocytaire. La squamométrie R étudie la dynamique du renouvellement de la couche cornée. La squamométrie S est adaptée à l’évaluation de l’effet de surfactants sur l’intégrité des cornéocytes. Cette variante est apparentée sans être identique au bioessai de corneosurfamétrie. Les différents tests de squamométrie sont rapides, fiables, sensibles et peu onéreux.
Are Triptans with Enhanced Lipophilicity Used for the Acute Treatment of Migraine Associated with an Increased Consulting Rate for Depressive Illness?
Authors: Millson D , Frischer M , Croft P , Goadsby PJ
Published: July 2009

Sumatriptan, the first marketed triptan, acts predominantly as a peripheral 5-HT1B/1D agonist. Recently launched (naratriptan and zolmitriptan) triptans with enhanced lipophilicity (TEL) may theoretically reduce central 5-HT levels, potentially exacerbating depressive illness. The aim of this study was to compare depressive illness patient consulting rates (PCR) between the newer triptans and sumatriptan treated patients. Migraine-diagnosed patients were identified from the West Midlands General Practice Research Database (GPRD). Univariate and logistic regression analyses were used to determine the relationship between age, sex, migraine duration, prior depression, prior and current triptan medication and the current PCR for depression. Of a total patient database of 642 000 patients 21 331 (3.3%) had a diagnosis of migraine. From 1993 to 1997, sumatriptan-treated migraineurs had significantly higher depression PCRs (22.3%) compared with non-triptan users (19.3%), a difference of 6.4% (95% confidence interval (CI) 4.6–8.4%, P < 0.001). In the year (April 1997 to March 1998) following the launch of the TELs, depression PCRs were significantly higher among patients using these compounds compared with sumatriptan-treated patients (5.1%, CI 1.8–12.0%, P < 0.05). However, after taking account of prior depression (odds ratio (OR) 6.45, 95% CI 3.63–11.43), TELs were not significantly associated with depression (OR 0.27, 95% CI 0.03–2.13). Furthermore, rates of newly diagnosed depression after treatment were similar in the two triptan groups (sumatriptan 4.2%; TELs 3.9%). Although, the TELs are being prescribed to patients with higher pre-existing rates of depression, they are not associated with subsequently increased consulting for depressive illness compared with patients taking sumatriptan. This study highlights the potential to use GPRD to test targeted hypotheses exploring pharmacovigilance issues for patients using new medicines.
Acquisition of and withdrawal from cocaine self‐administration regulates 5‐HT1B mRNA expression in rat striatum
Authors: Neumaier John F. , McDevitt Ross A. , Polis Ilham Y. , Parsons Loren H.
Published: July 2009

This study investigated how different stages of cocaine self‐administration in rats affect the expression of two serotonin receptors in dorsal and ventral striatum, the 5‐HT1B and 5‐HT6 subtypes, which have both been implicated in mediating some aspects of cocaine‐related behaviors. In the first experiment, rats were trained to work for saccharin (oral) or cocaine (i.v.) reinforcers. We found that continuous access to cocaine for 23 days did not change the level of 5‐HT1B mRNA expression compared to control animals receiving saccharin. However, a single cocaine session, given either by self‐administration or non‐contingently, increased 5‐HT1B mRNA in dorsal striatum, whereas forced abstinence for two weeks after cocaine reduced 5‐HT1B mRNA expression in the same subregion. 5‐HT6 mRNA was not changed by any of these treatments. A follow‐up experiment investigated the effects of limited versus extended access to cocaine as well as forced abstinence, and we found that 14 days of forced abstinence significantly reduced 5‐HT1B mRNA throughout the dorsal and ventral striatum compared to no withdrawal. These results suggest that the influence of 5‐HT1B receptors in striatal projection neurons may be increased during cocaine acquisition and reduced after forced abstinence and may therefore be targets for pharmacological intervention in addiction.
Fragile X mental retardation protein is required for chemically‐induced long‐term potentiation of the hippocampus in adult mice
Authors: Shang Yuze , Wang Hansen , Mercaldo Valentina , Li Xiangyao , Chen Tao , Zhuo Min
Published: July 2009

Fragile X syndrome (FXS), a common form of inherited mental retardation, is caused by the lack of fragile X mental retardation protein (FMRP). The animal model of FXS, Fmr1 knockout mice, have deficits in the Morris water maze and trace fear memory tests, showing impairment in hippocampus‐dependent learning and memory. However, results for synaptic long‐term potentiation (LTP), a key cellular model for learning and memory, remain inconclusive in the hippocampus of Fmr1 knockout mice. Here, we demonstrate that FMRP is required for glycine induced LTP (Gly‐LTP) in the CA1 of hippocampus. This form of LTP requires activation of post‐synaptic NMDA receptors and metabotropic glutamateric receptors, as well as the subsequent activation of extracellular signal‐regulated kinase (ERK) 1/2. However, paired‐pulse facilitation was not affected by glycine treatment. Genetic deletion of FMRP interrupted the phosphorylation of ERK1/2, suggesting the possible role of FMRP in the regulation of the activity of ERK1/2. Our study provide strong evidences that FMRP participates in Gly‐LTP in the hippocampus by regulating the phosphorylation of ERK1/2, and that improper regulation of these signaling pathways may contribute to the learning and memory deficits observed in FXS.