Postprandial self-monitoring of urine glucose reflects glycaemic control in people with relatively well controlled Type 2 diabetes mellitus not treated with insulin: a retrospective cohort study.

AIM: To analyse the association of self-monitoring of urine glucose with HbA1c concentration in people with Type 2 diabetes not treated with insulin. METHODS: We studied the association of postprandial self-monitored urine glucose with HbA1c concentrations in 264 people with Type 2 diabetes (mean age 62.4 years, time since diagnosis of diabetes 6.8 years and HbA1c 50 mmol/l). All patients took part in a diabetes treatment and teaching programme. HbA1c values were adjusted according to the Diabetes Control and Complication Trial. RESULTS: The mean ( ± sd) HbA1c concentration for the patients with constant negative urine glucose tests (56.1% of patients) was 46 ( ± 6) mmol/mol [6.4 ( ± 0.6)%]. This was significantly lower than in patients with < 50% positive urine glucose tests (33.3% of patients): mean ( ± sd) HbA1c was 53 ( ± 8) mmol/mol [7.0( ± 0.7)%] and also lower than in patients with ≥50% positive tests (10.6% of patients): mean ( ± sd) HbA1c of 57 ( ± 8) mmol/mol [7.4 ( ± 0.7)%]; P < 0.001. There was a significant correlation between the urine glucose test results and HbA1c (r = 0.416; P < 0.001). CONCLUSION: HbA1c concentrations were observed to be in the near-normal range for people with Type 2 diabetes not receiving insulin treatment who were negative for postprandial glucosuria. Urine glucose self-monitoring is a cheap and effective method to determine the quality of glucose control.

[Contribution of professional nursing to the life style of patients with dementia]. / Der Beitrag professioneller Pflege zur Lebensweltgestaltung von Menschen mit Demenz.

The care of older people with dementia increasingly requires that the family be involved in that care. The goals of the care giver are to continue daily life rhythms, offer greatest normality, and support the quality of life. This article describes the most important approaches and strategies from the perspective of daily living.

[The role of nursing care in geriatric rehabilitation]. / Die Rolle der Pflege in der geriatrischen Rehabilitation.

This article intends to present goals, tasks and focus points in different kinds of institutions of geriatric rehabilitation. This is be done under the aspects of: 1. Accompanying handicappeds during their disease. 2. Nursing orientated of activities in daily life. 3. Nursing with a multiprofessional team and its role within the rehabilitative concept. Besides this, goals and development strategies in professional nursing will be worked out.

Time estimation and the experience of time in endogenous depression (Melancholia): an experimental investigation.

The importance of disturbances in time experience in endogenous depression (melancholia) has long been under discussion. In the present study alterations of time experience were examined by means of time estimation experiments. 25 endogenous depressive patients (according to ICD-9) underestimated prospectively a 30-second interval by 6 s, whereas 12 healthy controls overestimated this interval by more than 10 s. The results are based on eight successive measurements over a period of 2 days. In the endogenous depressives, a feeling of being unwell was accompanied by a more pronounced time estimation error than a relatively good state of well-being. The influence of various patient data on the results of time estimation is also discussed in detail. The findings show clearly that time estimation provides a satisfactory delineation between depressive patients and healthy controls.

The daily course of the symptomatology and the impaired time estimation in endogenous depression (melancholia).

The importance of 'typical' diurnal variations in mood (depression worse in the morning) as a diagnostic criterion of endogenous depression has been challenged in previous investigations. Disturbance in time experience may contribute towards an understanding of diurnal variation in depressive symptomatology. To examine this hypothesis a series of time estimation experiments was conducted in the course of the day. Twenty-five endogenous depressive patients (according to ICD-9) and 12 healthy controls were asked to estimate prospectively a 30-s interval on two successive days at 7.30 a.m., 11.30 a.m., 3.30 p.m. and 7.30 p.m. Simultaneously the subjects assessed their state of well-being using a visual analogue mood scale. A circadian rhythm of time estimation errors could not be detected; even in daily courses with 'typical' diurnal variations an increasingly favourable self-assessment of well-being was not accompanied by a corresponding diurnal fluctuation of time estimation. These results cast additional doubts on the significance of 'typical' diurnal variations in depressive symptomatology.

Release of cell-associated concanavalin A by methyl alpha-D-mannopyranoside reveals three binding states of concanavalin-A receptors on mouse fibroblasts.

Based on the partial reversibility of concanavalin A binding by saturating concentrations of methyl alpha-D-mannopyranoside (MeManp) three states of cellular association could be characterized: type I, most rapidly established and most tightly bound, not released by MeManp at 0 degrees C or at 37 degrees C; type II, most loosely bound, released by MeManp at 0 degrees C, therefore not critically dependent on the temperature at which the release reaction is performed; type III, intermediate strength of binding, released by MeManp only at 37 degrees C, thus reflecting the temperature-sensitive nature of these cell complexes. A similar temperature dependence was found for cell-bound concanavalin A when it was displaced by an excess of the same lectin. The types of binding are seen irrespective of the temperature at which the cellular association was established. About 10% of the concanavalin A molecules bind to receptor structures in a saturable way and represent the type I association. Type I association is clearly distinct from types II and III. Type II seems to be the precursor of type III. Most of the type II associations can be converted into type III associations since ConA-cell complexes originally sensitive to the action of MeManp at low temperature gradually do become resistant after prolonged association at the same temperature. The temperature dependence in binding to cells was, however, not related to receptor mobility since glutaraldehyde-treated cells had most of the release properties that were observed in untreated cells and which did not markedly differ between 3T3 cells and their SV40-transformed counterparts. In contrast to cellular binding, dissociation of concanavalin A from Sephadex beads by saturating concentrations of MeManp was complete irrespective of temperature.

Monoclonal antibodies to influenza A virus FM1 (H1N1) proteins require individual conditions for optimal reactivity in binding assays.

The physical environments for optimal display of individual antigenic determinant sites on influenza A/FM/1/47 virus, with preference of its haemagglutinin, were established with monoclonal antibodies based on an enzyme-linked binding assay (ELISA). Comparisons were made with requirements of serum-derived antibodies to form immune complexes. Two-coating buffers revealed profound differences in their inherent capacities to provide antigenic reactivity; this activity became further altered when, after adsorption, the antigens were briefly exposed to either methanol or formaldehyde. Ionic strength started to become restrictive on formation of immune complexes above 0.2 M NaC1. The binding of the monoclonal antibodies to the haemagglutinin was charge-dependent. The form of its presentation, located on the viral surface or as an isolated component, further modified the pH-requirements for its optimal display in antigenic reactivity. The binding of serum-derived antibodies differed markedly and showed a dependence neither on the charge nor on the structural form of the haemagglutinin. Pretreatment of the haemagglutinin on the viral surface with small concentrations (0.025-0.05%) of Triton X-100, sodium dodecyl sulphate (SDS) and cetyltrimethyl ammonium bromide (CTAB), strongly changes the accessibility of its determinant sites, while deoxycholate (DOC) and octyl-beta-D-glucoside (OG) were not effective at the same concentrations. None of these detergents, however, altered the binding properties of the isolated component. Instead, some of them even improved its capacity to form immune complexes.

Clinical and surgical aspects of hypothalamic hamartoma associated with precocious puberty in a 15-month-old boy.

A case is reviewed of precocious puberty associated with hypothalamic hamartoma in a 15-month-old boy. The authors believe this to be the first documented case in which significant reductions occurred in the level of serum testosterone and in the result of the luteinizing hormone-releasing hormone (LHRH) infusion test following surgical removal of the tumor. Such surgery appears to be safe when a planned microsurgical course is employed.