Monetary reinforcement for self-monitoring of blood glucose among young people with type 1 diabetes: evaluating effects on psychosocial functioning.

AIMS: To explore the auxiliary psychosocial effects of a monetary reinforcement intervention targeting self-monitoring of blood glucose among young people with Type 1 diabetes. METHODS: Sixty young people with Type 1 diabetes, HbA1c concentrations between 58 and 119 mmol/mol (7.5-13.0%), and average self-monitoring of blood glucose <4 times per day were randomized to either enhanced usual care or a 24-week intervention of monetary rewards for self-monitoring of blood glucose and associated behaviours (e.g. uploading glucose meters). Data were collected from the young people and their parents at baseline, during the intervention (6, 12 and 24 weeks) and after the intervention (36 weeks). RESULTS: Linear mixed models were used to evaluate the intervention effects on psychosocial outcomes, adjusting for corresponding baseline levels and potential moderation by baseline level. The intervention reduced diabetes distress at week 6 among young people who had average and high baseline distress. It also reduced diabetes distress at weeks 12 and 24 among those with low baseline distress. The intervention also reduced young person-reported diabetes-related family conflict and diabetes-related interference among those with high baseline scores in these areas; however, the intervention worsened young person-reported diabetes interference among those with low baseline interference. Effects were medium-sized and time-limited. CONCLUSIONS: Findings indicate predominantly positive impacts of monetary reinforcement interventions on psychosocial outcomes, although effects varied by outcome and time point. Whereas early improvements in diabetes distress were observed for all who received the intervention, improvements in other areas varied according to the level of psychosocial challenge at baseline. Incorporating psychosocial interventions may bolster and maintain effects over time.

K Shell Fluorescence Parameters by Impact of 5.96 keV Photons on Ti and Its Compounds.

K shell fluorescence parameters of pure Ti and some of its compounds have been determined experimentally using an Ultra-LEGe detector with resolution 150 eV at 5.9 keV. The samples were excited 5.96 keV photons emitted from a (55)Fe radioisotope source with 50 mCi activity. The experimental values of the K shell fluorescence parameters have been compared with the experimental and theoretical values available in the literature for pure Ti.

L shell X-ray fluorescence parameters of Pb in phthalocyanine complexes.

The L shell X-ray intensity ratios Li/Lα (i=l, ß and γ), the production cross-sections σ(Li) (i=l, α, ß and γ) and the L3 subshell fluorescence yields ω(L3) have been investigated for the element Pb in the phthalocyanine complexes. The measurements have been performed using an (241)Am annular radioactive source and an Ultra-LEGe detector with a resolution of 150 eV at 5.9 keV. The experimental values have been compared with the theoretical values of pure Pb element.

Measurement of L(III) Subshell Absorption Jump Parameters of Hafnium.

The L(III) subshell absorption jump ratio and jump factor of hafnium have been measured using two different ways which are X-ray attenuation method and Energy Dispersive X-ray Fluorescence technique. The results obtained both ways have been compared with theoretical values. They are in good agreement with each other.

Closer to ideal insulin action: ultra fast acting insulins.

Mimicking physiologic insulin action has been the main goal of diabetes therapy since the discovery of insulin. The evolution of insulin therapy from animal insulin to recombinant insulin analogs has improved diabetes treatment significantly over the course of years. Nevertheless, the rapid-acting insulin analog pharmacokinetics and pharmacodynamics are still far from replicating physiologic insulin action resulting in poorly controlled after meal blood glucose levels. The slow action of insulin analogs has been a stumbling block for the development artificial pancreas systems that require a fast responding insulin to blood glucose changes. This review explains the rationale behind the undeniable need for ultra-fast acting insulins from a clinical and research perspective and summarizes ongoing and future projects to accelerate insulin action.

Incentivizing behaviour change to improve diabetes care.

Behavioural economics refers to the study of psychological and cognitive factors that relate to decision-making processes. This field is being applied increasingly to health care settings, in which patients receive tangible reinforcers or incentives for meeting objective behavioural criteria consistent with healthy lifestyles. This article reviews the background and efficacy of reinforcement interventions in general, and then as applied to behaviours related to diabetes prevention and management. Specifically, reinforcement interventions have been applied with some notable success towards promoting greater attendance at medical appointments, enhancing weight loss efforts, augmenting exercising regimes, improving medication adherence and increasing blood glucose monitoring. Suggestions for promising areas of future research are provided, keeping in mind the controversial nature of these interventions.

Apoptosis-mediated cytotoxic effects of ibandronic acid on hormone- and drug-refractory prostate cancer cells and human breast cancer cells.

Over 80% of patients with advanced breast and prostate cancer ultimately develop bone metastases. Ibandronic acid has proven efficacy for treatment of bone metastasis secondary to breast cancer. This study was designed to investigate the cytotoxic and apoptotic effects of ibandronic acid on hormone- and drug-refractory prostate carcinoma DU-145 and human breast cancer MCF-7 cell lines. Cytotoxicity was evaluated using an XTT cell proliferation kit, and apoptosis was assessed by enzyme-linked immunosorbent assay (histone-DNA fragmentation) and measurement of caspase 3/7 activity. With increasing concentrations of ibandronic acid there was a dose- and time-dependent decrease in cell numbers. MCF-7 cells were more resistant than DU-145 cells (half maximal inhibitory concentrations of 122 and 90 microM, respectively). Ibandronic acid induced apoptosis in both cell lines. The study showed an apoptosis-mediated cytotoxic effect for ibandronic acid (in addition to the already known osteoclast inhibiting effect) in breast cancer patients with bone metastases; which was also observed in prostate cancer cells. Further clinical studies involving breast and prostate cancer patients with bone metastases are warranted to confirm these findings.

Targeting apoptosis in the hormone- and drug-resistant prostate cancer cell line, DU-145, by gossypol/zoledronic acid combination.

Possible synergistic cytotoxic and apoptotic effects of gossypol with zoledronic acid on DU-145 cells were explored, along with the rationale behind any observed synergism due to the different apoptotic proteins involved. XTT cell proliferation assay was used to assess the cytotoxicity, and DNA fragmentation and caspase 3/7 activity were measured to verify apoptosis. Human Apoptosis Array was used to evaluate apoptotic proteins. The synergistic cytotoxic combination treatment had a versatile effect on apoptotic proteins, through inhibition of anti-apoptotic proteins (including cIAP-1, cIAP-2, survivin, livin, claspin, p53, p21, PON-2 and heat shock proteins) and concurrently the induction of pro-apoptotic proteins (Bad, Bax, Fas, FADD, cleaved caspase-3 and p27). Both drugs had a minimal toxicity profile comparing to cytotoxic agents. Combination treatments targeting many pivotal apoptosis-related proteins may be a rationale option for treatment of prostate cancer.

Docetaxel/zoledronic acid combination triggers apoptosis synergistically through downregulating antiapoptotic Bcl-2 protein level in hormone-refractory prostate cancer cells.

Docetaxel, a semi-synthetic taxane analogue, is used effectively in the treatment of metastatic prostate cancer. Zoledronic acid, the most potent member of bisphosphonates, has shown pleiotropic anti-tumoral effects on prostate cancer cells. We have explored the possible additive/synergistic effects and the apoptotic pathways induced by combination treatment of docetaxel and zoledronic acid in hormone and drug refractory, PC-3 and DU-145 prostate cancer cells. Combination of docetaxel and zoledronic acid synergistically inhibits cell growth in PC-3 and DU-145 cells. Moreover, this effect was due to downregulation of antiapoptotic protein Bcl-2 in PC-3 and DU-145 cells. In conclusion, docetaxel/zoledronic acid combination is potentially a novel and effective approach for the treatment of prostate cancer.

Cypermethrin-induced histopathological and biochemical changes in Nile tilapia (Oreochromis niloticus), and the protective and recuperative effect of ascorbic acid.

The objective of this study was to investigate the effects of ascorbic acid on the toxicity of cypermethrin's on histopathological lesions in tissues and protein, glycogen levels in Oreochromis niloticus. Nile tilapia was exposed to 0.22 and 0.44 µg/l cypermethrin+control diet, 0.22 and 0.44 µg/l cypermethrin+ascorbic acid supplemented diet for 20 days. The fish were allowed recuperation period of 15 days in pesticide-free water and fed with ascorbic acid suplementation diet. In light microscopic investigation, histopathological lesions were observed in the gill, liver and kidney. The severity of lesions accreted depending on increased pesticide concentration and control diet. Some of the lesions were reversible or at least were less pronounced after recuperation period. Protein levels decreased in some groups after treatment period according to control groups (p<0.05). The highest depletions in liver, muscle and gill protein levels were found in 0.44 µg/l cypermethrin+ascorbic acid supplemented diet group (62.23%), in 0.22 µg/l cypermethrin+control diet group (53.12%) and in 0.44 µg/l cypermethrin+control diet group (61.87%) after 10 days, respectively. These levels increased at the end of the recuperation period. The highest depletion in liver glycogen levels was found in 0.22 µg/l cypermethrin+control diet group (50.50%) after 10 days (p<0.05). At the end of recuperation period, there was no difference between the groups (except 0.22 µg/l cypermethrin+ascorbic acid supplemented diet group) and controls. The decrease of muscle glycogen, except 0.22 µg/l cypermethrin+ascorbic acid supplemented diet group, was recorded at the end of 10 and 20 days. In the recuperation period, an increase was observed at all groups. These results revealed that the histopathology, protein and glycogen can work as good indicators of stress of a toxicant on fish. Ascorbic acid serves fish as an antitoxic agent against pesticide toxicity.

Docetaxel and platinum combination chemotherapy in locally advanced or metastatic head and neck cancer.

PURPOSE: To assess the efficacy and toxicity of the docetaxel and platinum combination in patients with locoregionally advanced or metastatic squamous cell carcinoma of the head and neck (SCCHN). PATIENTS AND METHODS: A total of 24 patients with metastatic or locoregionally advanced SCCHN treated with docetaxel and platinum combination chemotherapy were retrospectively reviewed. All of them had histologically proven SCCHN, measurable disease and ECOG performance status of 2 or less, and were treated with docetaxel 75 mg/m(2) as a 60 min i.v. infusion on day 1, followed by cisplatin 75 mg/m(2) or carboplatin AUC 6 as a 60 min i.v. infusion on day 1 every 3 weeks, until disease progression or unacceptable toxicity. Patients were evaluated for response, survival and toxicity. RESULTS: Seven (29%) patients showed partial response (PR) and 1 (4%) complete response (CR) for an overall response rate of 33%. Twelve (50%) patients had stable disease (SD). Disease control rate was 83%. The median follow-up time was 26.4 months (range 2-127), the median time to progression 16 months (range 2-20), and the median overall survival 19 months (range 2-22). Grade 3-4 hematologic toxicity occurred in 13 (54%) patients. Febrile neutropenia was seen in 5 (21%) patients. CONCLUSION: Docetaxel plus cisplatin or carboplatin is an effective regimen with acceptable safety profile for palliation of locally advanced or metastatic SCCHN.

The effects of monocrotophos to different tissues of freshwater fish Cirrhinus mrigala.

The histopathological effects of monocrotophos on the gill, kidney and intestine tissues of the Cirrhinus mrigala were determined by light microscopy. The changes in the gills were characterized by epithelial hyperplasia, aneurysm, epithelial necrosis, desquamation, epithelial lifting, oedema, lamellar fusion and curling of secondary lamellae. Pycnotic nuclei in tubular epithelium, hypertrophied epithelial cells of renal tubules, contraction of the glomerulus and expansion of space inside the Bowman's capsule were observed in the kidney tissues of fish after exposure to monocrotophos. In the intestine tissues of fish exposed to monocrotophos, oedema, necrosis and atrophy of epithelial cells were observed.

Sunblocking efficiency of various TiO(2)-loaded solid lipid nanoparticle formulations(1).

In this study, titanium dioxide (TiO(2)) was incorporated into solid lipid nanoparticle (SLN) formulations using both classical and novel preparation methods. The SLNs were investigated by evaluating their stabilities and physicochemical characteristics. UV-protection abilities of formulations were investigated using in vitro Transpore and Sun To See(TM) test methods. Results have been discussed by comparing the classical SLN formulation with the novel SLN, hybrid SLN (H-SLN) and the emulsion formulations. The results showed the superiority of the H-SLN formulations compared with the classical SLN; all SLN formulations were better when compared with the emulsion formulations considering the UV protection. Incorporation of TiO(2) as a sunscreen agent into SLN formulations gives opportunity to produce stable and safe formulations with reduced amount but high UV-protection ability.

Histopathology of gills in mosquitofish, Gambusia affinis after long-term exposure to sublethal concentrations of malathion.

The histopathological effects of malathion, an organophosphate pesticide, on the gill tissues in mosquitofish, Gambusia affinis, were determined by light microscope. The fish were exposed to sublethal concentrations (0.01 and 0.02 mg/L) of malathion for 10, 20 and 30 days. Histological examination of the gills treated with malathion showed a variety of histopathological effects. The gill lesions included necrosis and desquamation of secondary lamellar epithelium, lifting up of epithelium, intraepithelial oedema, fusion of adjacent secondary lamellae, haemorrhage at primary lamellae, disorganization and rupture in seconder lamellae, hypertrophy and hyperplasia of epithelial cells. These alterations were time- and dose-dependent.

The histopathological effects of thiodan on the liver and gut of mosquitofish, Gambusia affinis.

Thiodan (33.7% endosulfan), a polychlorinated cyclodiene insecticide, was evaluated for its histopathological effects on mosquitofish, Gambusia affinis, by light microscopy. Fish were exposed to doses of 0.00 (control), 1.00, 2.50, and 5.00 microg/L on days 7, 14, 21, and 30. No histopathological effects were apparent at control group. The histopathological alterations were characterized as oedema, degeneration, accumulation of lymphocytes in the lamina propria, disintegration of villuses, pycnotic state of nuclei, and necrosis in gut; degeneration, hypertrophy, sinusoids enlargement, hemorrhage, pycnosis position of nuclei, vacuolization of cell cytoplasm, infiltration of mononuclear lymphocyte, and congestion in liver. These alterations were time- and dose-dependent.

Biofeedback assisted relaxation in essential hypertension: short-term follow-up of contributing effects of pharmacotherapy on blood pressure and heart rate. "Brief communication".

The present study was designed to evaluate the possible beneficial effects of biofeedback-assisted relaxation to pharmacotherapy on blood pressure and heart rate in patients with essential hypertension. Twenty patients with essential hypertension and without any complications or end-organ damage participated in the study. All the patients were using anti-hypertensive drugs. The study protocol consisted of an interview, 10 days baseline, 10 biofeedback-assisted relaxation sessions and a 10-day post-treatment period. Interview blood pressure (BP) and heart rate (HR) measurements, baseline mean values of systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR recorded during the 1st, 10th and 20th minutes of each session and the post-treatment mean values were evaluated. Significant differences were found between the mean values of SBP, DBP and HR after the whole treatment protocol (Wilcoxon signed-ranks test). The mean values of SBP, DBP and HR measurements recorded during the 1st, 10th and 20th minutes of the biofeedback-assisted relaxation sessions, which were evaluated by repeated measures of ANOVA on ranks test, showed a significant decrease only for the 10th minute values at the end of the whole treatment program. Despite a short follow-up, it was suggested that these results were encouraging considering the fact that once the patients are thoroughly instructed in home practice of relaxation and encouraged to develop their own strategies for relaxation, the long term outcome may also be promising.