ABSTRACT
Cornstarch has been the primary treatment for glycogen storage disease type Ia (GSD Ia) for over 35 years. When cornstarch was first described as a treatment, few people survived beyond early childhood. As the prognosis for this population has improved, the need to ensure appropriate cornstarch dosing for different age groups has become imperative. Records from 115 patients (10-62 years of age) with GSD Ia evaluated at our center between 2015 and 2017 were reviewed. Data collected included weight, age, genetic mutation, amount and frequency of cornstarch doses, body mass index, gender, 24-hour glucose and lactate concentrations, and biochemical markers of metabolic control. The data demonstrate that adult treatment needs vary greatly from younger age groups, and the required cornstarch support decreases with age (P < .001). The required number of doses, however, did not change with a mean of six doses (range 4-8) daily in all age groups. General laboratory findings across time demonstrate that significantly reducing the amount of starch required to maintain euglycemia with aging can be done without sacrificing metabolic control. Carbohydrate requirements decrease with aging, and older patients were found to require less cornstarch. Failure to lower the cornstarch doses contributes to over-treatment in adults with GSD Ia. Not only does this lead to worsening hepatomegaly and excessive weight gain, but over-treatment contributes to relative hyperinsulinism and rebound hypoglycemia. This knowledge is essential in designing nutritional therapies for the aging GSD population.
Subject(s)
Blood Glucose/metabolism , Glycogen Storage Disease Type I/diet therapy , Starch/metabolism , Starch/pharmacology , Adolescent , Adult , Biomarkers , Child , Female , Glycogen Storage Disease Type I/blood , Glycogen Storage Disease Type I/metabolism , Humans , Hypoglycemia/prevention & control , Linear Models , Male , Middle Aged , Retrospective Studies , United States , Young AdultABSTRACT
OBJECTIVES: To determine the efficacy of adapted tango for improving mobility, motor-cognitive function, and gait; to determine whether former dance experience was associated with improvements; and to evaluate participant satisfaction, changes in depression, and quality of life. DESIGN: Quasi-experimental, two-group, repeated-measures preintervention, postintervention, and 3-month postintervention study. SETTING: Diverse senior independent living communities in an urban metropolitan area. PARTICIPANTS: Individuals aged 59 to 95 (73% aged 80 and older; 31% nonwhite, 72% female) (N = 74). INTERVENTION: Participants were assigned to 20 sessions of 90-minute tango (n = 62) or health education (n = 12) classes over 12 weeks. MEASUREMENTS: Mobility, motor-cognitive function, gait, cognition, and psychosocial function were evaluated before, immediately after, and 3 months after the intervention. Two (groups) by two (before and after) repeated-measures analyses of variance with post hoc comparisons were used to evaluate differences in primary analyses. Secondary analyses from immediately after to 3 months after were used to examine the data for retention of any gains. RESULTS: Forty-four tango and 10 education participants completed 20 sessions. Significant group by time interactions revealed that tango improved mobility (P = .006), backward and fast gait speeds (P < .001), and motor-cognitive function (P = .03). Education improved depression (P = .001). No relationship was noted between previous dance experience and improvements. Gains were maintained 3 months after the intervention. CONCLUSION: Adapted tango may improve mobility, gait and motor-cognitive function more than health education classes in older adults. Further research is necessary to confirm these findings.
Subject(s)
Dancing , Gait , Motor Skills , Movement , Aged , Aged, 80 and over , Cognition , Depression/therapy , Female , Georgia/epidemiology , Health Education , Humans , Independent Living , Male , Middle Aged , Neuropsychological Tests , Postural Balance , Urban PopulationABSTRACT
The alkane content of the silks of nine maize genotypes was analyzed to investigate the role of silk wax in resistance to Fusarium graminearum. Silk samples were collected 2, 4, 6, and 8 days after silk emergence and divided into three sections: exposed silk, silk channel silk, and silk that is under the husk and overlying the kernels. Four major unbranched alkanes (C(25), C(27), C(29), and C(31)) and three isoalkanes (C(27i), C(29i), and C(31i)) were identified. Total alkane contents were highest in the exposed silk followed by the silk channel silk, with the lowest in the youngest silk closest to the kernels. In the silk channel and overlying kernel silks, the moderately resistant inbred CO272 consistently had the highest alkane content. None of the other inbreds with improved resistance had as high a level of alkanes as CO272, indicating that alkane content is not a major mechanism of resistance.
