The reliability and validity of the Japanese version of the Diabetes Family Behavior Checklist (DFBC) for assessing the relationship between type 2 diabetes mellitus patients and their families with respect to adherence to treatment regimen.

AIMS: An appropriate questionnaire for assessing family support of self-management behavior of Japanese Type 2 diabetes patients has yet to be developed. We produced a Japanese version of the Diabetes Family Behavior Checklist (DFBC) and tested its reliability and validity. METHODS: The study enrolled Japanese patients with Type 2 diabetes mellitus who were living with their families: 158 patients in the Insulin Group and 169 in the Oral Hypoglycemic Agents Group. The external validity of the DFBC was tested with questionnaires of self-managed dietary and exercise behaviors, the Appraisal of Diabetes Scale (ADS), and HbA1c. RESULTS: The DFBC comprised two components: "Negative" and "Positive" feedbacks. Cronbach's alpha in the subcategories was ≥0.93, and the test-retest showed an intraclass correlation coefficient of 0.89. "Positive" and "Negative" scores correlated with self-managed dietary and/or exercise behaviors, the ADS scores in the both Groups. For patients having HbA1c levels of ≤6.8% there was a correlation between their "Positive" and "Negative" scores and the scores of their families in both Groups. CONCLUSION: The DFBC showed evidence of validity and reliability and may be a useful tool for quick assessment of self-managed treatment behavior of Japanese Type 2 diabetes patients and support received from their family.

The reliability and validity of the Japanese version of the Appraisal of Diabetes Scale for type 2 diabetes patients.

AIMS: An appropriate questionnaire for measurement of the psychological burden of self-management or behavior modification in type-2 diabetes patients has yet to be developed in Japan. This study was conducted to test the reliability and validity of the Japanese version of the Appraisal of Diabetes Scale (ADS). METHODS: the study enrolled 346 Japanese patients with type 2 diabetes: 200 men and 146 women who were 63.2 ± 10.1 and 62.2 ± 11.9 years of age and had HbA1c levels of 6.9 ± 1.2% and 7.3 ± 1.9%, respectively. RESULTS: the questionnaire was divided into three components: "Psychological impact of diabetes", "Sense of self-control", and "Efforts for symptom management". Cronbach's alpha was 0.746-0.628. Significant correlations were observed between "Sense of self-control" and self-managed dietary and exercise behaviors and HbA1c levels; between "Psychological impact of diabetes" and various treatments, symptoms causing anxiety, and HbA1c levels; and between "Efforts for symptom management" and dietary and nutritional behaviors. The questionnaire showed better evidence of internal consistency, test-retest reliability and validity. CONCLUSION: our results suggested that the Japanese version of ADS may be a useful tool for the quick assessment of common anxieties and motivation toward treatment in patients with type 2 diabetes.

Acute inflammation and immunoresponses induced by ortho-phthalaldehyde in mice.

ortho-Phthalaldehyde (OPA) has been used as a safe alternative disinfectant instead of glutaraldehyde; however, recently some adverse effects of OPA were reported in patients and medical professions. We examined the acute toxicity of OPA in male ICR mice injected with 0.125-0.5% OPA and killed some animals 1 day after a single OPA injection, and others 1 or 13 days after two OPA injections 5 days apart. Hematology, blood cell counts, specific antibody production, organ weights, hepatic enzymes, hepatic histopathology and gene expression of cytochrome P450 (CYP) mRNA in liver were examined. Single OPA injections elevated leukocyte counts, the proportion of neutrophils, alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Two OPA injections dose-dependently increased leukocyte counts, the proportion of neutrophils, ALT and AST, and decreased alkaline phosphatase. Leukocyte counts and proportions of neutrophils normalized 13 days after the second of two injections. However, both ALT and AST remained high in mice given higher OPA doses. Significant increased liver-to-body weight ratio and mild hepatic lesions were observed. Gene expression of CYP1a1 and CYP2e1 revealed a tendency of up-regulation 1 day after two OPA injections. However, expression of these genes was then down-regulated 13 days after OPA injections. OPA induced specific IgE and IgG significantly in the sera, suggesting that OPA acts as a hapten. Overall, OPA caused acute inflammation and acted as a haptenic allergen, although it caused only mild liver injury. Such evidence suggested that careful washing and prevention of exposure were needed after OPA disinfection of medical instruments.

ortho-Phthalaldehyde enhances allergen-specific IgE production without allergen-specific IgG in ovalbumin-sensitized mice.

ortho-Phthalaldehyde (OPA) is commonly used as a safer and more effective chemical disinfectant for use with medical devices in hospitals. However, the cases of patients with occupational bronchial asthma or contact dermatitis are recently reported among workers in the medical professions who were exposed to OPA disinfectant. Mechanism of allergic reaction associated with OPA is poorly understood. The purpose of this study is that OPA may act as an immunological adjuvant in the allergic reaction accompanied by enhanced specific-IgE production in response to allergen challenge in OVA-sensitized mice. OPA induced increase of total cell numbers, and reflected infiltration of neutrophils in BAL fluid after allergen challenge in sensitized mice, dose-dependently. However, total protein concentration in BAL fluid did not change in the all of groups. The OPA induced up-regulation of eotaxin and monocyte chemotactic protein-1 mRNAs in the lung as well as the increase in OVA-specific IgE in sensitized mice compared with non-sensitized controlled mice without increase in the level of OVA-specific IgG. Cytokines IL-4 and IL-5 mRNA were expressed by allergen (OVA) challenge in both lungs collected from OPA-administrated-sensitized and OPA-administrated-nonsensitized mice. From these data, we concluded that low concentration of OPA that enhanced the OVA-induced recruitment of neutrophils to the lung and the production of allergen-specific IgE, suggesting that OPA acts as an immunological adjuvant.