Short-term effects on patient satisfaction of continuous glucose monitoring with the GlucoDay with real-time and retrospective access to glucose values: a crossover study.

BACKGROUND: This randomized crossover trial examines the effect of continuous glucose monitoring (CGM) with real-time access (RTA) to glucose data versus CGM with a retrospective analysis (RA) of glucose data regarding satisfaction with CGM and other patient-reported outcomes. METHODS: Participants used the CGM device (GlucoDay, Menarini Diagnostics, Florence, Italy) twice. In one study phase, patients were allowed RTA to, and in the other phase RA of, current glucose values. The order of these two conditions was randomized. At baseline and after the first and second trials, subjects completed questionnaires (Continuous Glucose Monitoring Satisfaction Scale) about perceived satisfaction with CGM. They also completed the Problem Areas in Diabetes Questionnaire, a state anxiety scale (State-Trait Anxiety Inventory), and a depression scale (Center of Epidemiological Studies-Depression Scale). RESULTS: Fifty patients with type 1 diabetes (41.7 +/- 12.3 years old, diabetes duration of 14.75 +/- 11.9 years, 48% female, hemoglobin A1c 8.1 +/- 1.5%, years of education 10.3 +/- 2.1 years) participated in this study. At baseline patients perceived CGM as rather advantageous, but after RA and RTA the perceived benefits were reduced (baseline, 101.0 +/- 16.0; RA, 95.7 +/- 20.2; RTA, 93.6 +/- 22.8; P < 0.01). However, there was no significant difference between RA and RTA. Also, there was no significant effect on diabetes-related distress or state anxiety, but a positive effect on depression scores. CONCLUSIONS: There was no specific, significant, negative or positive effect of RA versus RTA on satisfaction with CGM. Exposing patients with type 1 diabetes to their current glucose values does not seem to have a specific negative impact on the appraisal of CGM or more generic patient-reported outcomes.

Feasibility of constructed wetlands for removing chlorothalonil and chlorpyrifos from aqueous mixtures.

Chlorpyrifos (an insecticide) and chlorothalonil (a fungicide) are transported in stormwater runoff and can be lethal to receiving aquatic system biota. This study determined removal rates of chlorpyrifos and chlorothalonil in simulated stormwater runoff treated in constructed wetland mesocosms. Using sentinel species, Ceriodaphnia dubia and Pimephales promelas, observed declines in toxicity of the simulated runoff after treatment were 98 and 100%, respectively. First order removal rates were 0.039/h for chlorpyrifos and 0.295/h for chlorothalonil in these experiments. Constructed wetland mesocosms were effective for decreasing concentrations of chlorpyrifos and chlorothalonil in simulated stormwater runoff, and decreasing P. promelas and C. dubia mortality resulting from these exposures. The results from this study indicate that constructed wetlands could be part of an efficient mitigation strategy for stormwater runoff containing these pesticides.

Comparative toxicity of chlorothalonil: Ceriodaphnia dubia and Pimephales promelas.

Chlorothalonil is a commonly used fungicide in rural and urban environments and can be incidentally introduced into aquatic systems through rainfall runoff or direct overspray and drift from aerial applications. Few studies have been published regarding risks to aquatic organisms exposed to chlorothalonil, so this study was performed to provide a first-order risk characterization for receiving system biota. Definitive laboratory toxicity tests were conducted with aqueous solutions of chlorothalonil and sentinel aquatic organisms (Ceriodaphnia dubia Richard and Pimephales promelas Rafinesque). P. promelas was more sensitive (7-day potency=6.1% mortality/mug/L) than C. dubia (7-day potency=0.94% mortality/mug/L) to chlorothalonil exposures. All mortality of P. promelas and C. dubia resulting from these chlorothalonil exposures occurred within the first 96h and no sublethal effects (i.e., growth or reproduction) were detected under these experimental conditions following 7-day exposures.

Comparative toxicity of chlorothalonil and chlorpyrifos: Ceriodaphnia dubia and Pimephales promelas.

This study was done to characterize responses of Ceriodaphnia dubia Richard and Pimephales promelas Rafinesque exposed to aqueous solutions of chlorothalonil (tetrachloroisophthalonitrile) and chlorpyrifos (O,O-diethyl O-3,5,6-trichloro-2-pyridyl phosphorothioate). Chlorothalonil (a fungicide) and chlorpyrifos (an insecticide) are intensely used in agricultural, silvicultural, and urban settings. These pesticides may enter aquatic systems through several pathways including rainfall runoff. C. dubia and P. promelas have been used to monitor surface waters and discern the effects of pesticides that contaminate those waters. Modified static renewal exposures (7 or 10 days) with individual solutions of chlorothalonil and chlorpyrifos were used to obtain mortality data for C. dubia and P. promelas, from which potency curves were derived, as well as sublethal effects data (reproduction or growth). In these experiments P. promelas was more sensitive to chlorothalonil, and C. dubia was more sensitive to chlorpyrifos. Lower and upper thresholds (i.e., LC(0) and LC(100)) for 7-day P. promelas exposures to chlorothalonil were 14.4 and 30.8 microg/L, respectively, in contrast to the lower and upper threshold values, 103 and 210 microg/L, respectively, for C. dubia. Ten-day exposures of C. dubia to chlorpyrifos resulted in lower and upper threshold values of 0.05 and 0.09 microg/L, whereas 10-day exposures of P. promelas to chlorpyrifos yielded threshold values of 26 and 274 microg/L. The results of this study illustrated differences in species' sensitivities to chlorothalonil and chlorpyrifos as well as differences in the duration of the exposure necessary to illustrate effects that might be elicited from pesticide exposures.

Algicidal effectiveness of Clearigate, Cutrine-Plus, and copper sulfate and margins of safety associated with their use.

Laboratory studies of algicide toxicity to algal species provide information to improve the efficacy and efficiency of copper-containing algicides in actual field situations. The objectives of this study were (1) to measure the influence of copper form, initial concentration, and duration of exposure on the response of Raphidocelis subcapitata, a planktonic freshwater green alga; (2) to determine the contact time required for these copper-containing algicides (Clearigate, Cutrine-Plus, and copper sulfate) and the target species to obtain control; (3) to measure the critical burden of the three algicides required to obtain control of R. subcapitata; (4) to measure the residence time of the copper applied as the algicides in the water column of three waters having different water characteristics ( i.e., alkalinity, hardness, pH, and conductivity); and (5) to contrast exposures of copper (as algicides) required to control algae and the lower thresholds causing adverse effects on sensitive nontarget animal species. Algal control (EC(100)) was accomplished at 55.8, 117.5, and 187.5 microg Cu/L for CuSO(4), Cutrine-Plus and Clearigate with a contact time of 3 days in all cases. The critical burdens of copper (concentration sorbed by the algae) were 4.2, 7.3, and 7.9 microg Cu/mg algae (dry weight) for CuSO(4), Cutrine-Plus, and Clearigate, respectively. Because algicide toxicity generally decreases as cell density increases, the density of cells in algal blooms may hamper algicide effectiveness even at maximum label application rates. Determinations of critical burdens for algicides and target algal species provide necessary information to forecast the performance of algicide applications in field situations. The margin of safety ( i.e., the difference between the concentration where control of algae was obtained and the lower threshold concentration causing adverse effects on nontarget species) was greatest for Cutrine-Plus. However, the margins of safety are minimal (< 0, 12.5, and 82.5 microg Cu/L for Ceriodaphnia dubia exposed to CuSO(4), Clearigate, and Cutrine-Plus, respectively) when they are applied according to their labels.

[Pharmaceutical and biologic availability of chlorpromazine from macromolecule-containing tablets]. / Zur pharmazeutischen und biologischen Verfügbarkeit von Chlorpromazin aus makromolekülhaltigen Tabletten.

The use of sufficiently high concentrations of polyvinylpyrrolidone (PVP), hydroxyethyl cellulose (HEC) and methyl cellulose (MC) in tablet formulations leads to depot preparations of the prolonged- or sustained-release type. Having swollen up with the dissolution medium, the tablets form a hydrated matrix from which the active agent diffuses for a considerable time at constant speed. The verification of the bioavailability of chlorpromazine from PVP-, MC- and HEC-containing tablets and of a macromoleculefree standard preparation on rabbits showed considerable differences among the plasma curves. With reference to the standard preparation, the cellulose-containing preparations have a relative bioavailability of 38.8 and 45.7%, respectively. The constancy of the plasma level values for almost 8 h is remarkable. The plasma level profile of these formulations corresponds to that of a depot form of the sustained-release type.

[In the vivo release of drugs from hydrogels]. / Zur in-vivo-Freisetzung von Arzneistoffen aus Hydrogelen.

The in vivo release of chlorpromazine and dioxopromethazine from equiviscous methyl cellulose and polyvinylpyrrolidone hydrogels has been determined in 8 volunteers and brought in relation to results obtained from in vitro studies. For all the individual variations observed, the availability of the drugs was, as a rule, greater from the hydrogels based on the loosely-binding methyl cellulose (e.g., more than doubled) than from the hydrogels based on polyvinylpyrrolidone. Whereas the in vivo and in vitro liberation rates of chlorpromazine (which has a relatively great association power) were of comparable magnitude, the in vivo release of dioxopromethazine was considerably lower as was to be expected considering the results from in vitro studies. Obviously, physico-chemical factors (in the present case, the coefficient of distribution) super-impose the effect of the binding on the bioavailability. Already 10 min after application of the hydrogels, the liberation rate amounted up to 73%.

[Interactions between macromolecular adjuvants and drugs. Part 17: On the effect of macromolecular adjuvants on the dissolution rate of chlorpromazine from dosage forms (author's transl)]. / Wechselwirkungen zwishchen makromolekularen Hilfsstoffen und Arzneistoffen 17. Mitteilung: Zum Einfluss von makromolekularen Hilfsstoffen auf die Auflösungsgeschwindigkeit des Chlorpromazins aus Arzneiformen.

The determination of the dissolution rate of chlorpromazine from tablets and triturations containing macromolecular adjuvants by means of a modification of the flow-through type cell according to Langenbucher evidenced a decrease in the dissolution rate produced by polyvinylpyrrolidone, methyl-cellulose and hydroxyethyl-cellulose. It was found that the decrease in the dissolution rate is not due to the confirmed, relatively marked tendency of chlorpromazine to form complexes, but to gel formation.