Regeneration of Pancreatic ß-Islet Cells in a Type-II Diabetic.

A case report is presented in which a type-II diabetic patient significantly improved his dysfunctional ß-islet cells using a combination of a strenuous exercise program, cyclical ketogenic diet, and oral GABA/probiotic supplementation. The patient was diagnosed with type-II diabetes at the age of 41 which then progressed through a typical series of treatment changes over 14 years. Treatment periods consisted of metformin therapy alone for 4 years followed by a metformin/glyburide combination therapy for 6 years, and eventually an insulin/metformin combination therapy for 4 years. One year after the initiation of insulin, the patient increased the level of strenuous physical activity (hiking and weight lifting) and adopted a ketogenic diet. Oral GABA and probiotic supplementation were also initiated at the age of 52.7. By the age of 55, the patient no longer required any insulin and is currently being managed with metformin alone. C-peptide values indicate a functional improvement of the ß-islet cells during the time of insulin/GABA/probiotic treatment.

Socioeconomic deprivation and the burden of head and neck cancer-Regional variations of incidence and mortality in Merseyside and Cheshire, North West, England.

OBJECTIVES: The aim of this longitudinal study was to examine the distribution of head and neck cancer (HANC) disease burden across the region comparing it to national trends. DESIGN: We undertook a retrospective study of routine data combining it with indicators of deprivation and lifestyle at small geographical areas within the 9 Local Authorities (LAs) of Merseyside and Cheshire Network (MCCN) for head and neck cancers. Data from the North West of England and England were used as comparator regions. SETTING: This research was undertaken by the Cheshire and Merseyside Public Health Collaborative, UK. PARTICIPANTS: The Merseyside and Cheshire region serves a population of 2.2 million. Routine data allowed us to identify HANC patients diagnosed with cancers coded ICD C00-C14 and C30-C32 within 3 cohorts 1998-2000, 2008-2010 and 2009-2011 for our analysis. MAIN OUTCOME MEASURES: Directly age-standardised incidence rates and directly age-standardised mortality rates in the LAs and comparator regions were measured. Lifestyle and deprivation indicators were plotted against them and measured by Pearson's correlation coefficients. RESULTS: The incidence of head and neck cancer has increased across the region from 1998-2000 to 2008-2010 with a peak incidence for Liverpool males at 35/100 000 population. Certain Middle Super Output Areas contribute disproportionately to the significant effect of incidence and mortality within LAs. Income deprivation had the strongest correlation with incidence (r = .59) and mortality (r = .53) of head and neck cancer. CONCLUSION: Our study emphasises notable geographical variations within the region which need to be addressed through public health measures.

Influence of deprivation on health-related quality of life of patients with cancer of the head and neck in Merseyside and Cheshire.

The incidence of cancer of the head and neck, and the outcome of treatment in terms of survival and health-related quality of life (HRQoL), is linked to deprivation. We have explored the association of social deprivation with HRQoL and with fear of recurrence in patients treated for cancer of the head and neck in Merseyside and Cheshire. In 2013, we posted cross-sectional surveys to 805 patients treated for oral, oropharyngeal, or laryngeal tumours. We used the University of Washington quality of life score (UW-QoLv4) to measure HRQoL, a 7-item questionnaire to measure fear of recurrence, and the 2010 Index of Multiple Deprivation (IMD) to measure deprivation. There was a 60% (448) response to the survey, with response ranging from 52% (167/322) from those living in the most deprived national quartile of residential areas to 74% (110/148) living in the least deprived quartile. Relative to the national distribution, the sample was notably deprived as 37% (167/448) lived in the most deprived quartile. After adjusting for clinical and personal characteristics, the results suggest a residual association between deprivation and overall quality of life (QoL), particularly socioemotional function. The association seemed weaker in regard to fear of recurrence and physical function. Our findings emphasise the need to explore ways to encourage more patients to attend follow-up appointments as this might improve their QoL, reduce distress, and help them to improve their life-style. It could also have an impact on survival.

Treatment of poisoning by soman.

The efficacies of a number of drug treatment combinations in protecting guinea pigs against the lethal and incapacitating effects of soman (and sarin) have been determined. Incapacitation was studied using a swimming test which is a measure of gross motor performance. The drug combinations employed had no effect on the swimming performance of unpoisoned animals. Pyridostigmine pretreatment supported by postpoisoning therapy with atropine, pralidoxime mesylate (P2S), and diazepam protected guinea pigs against the lethal actions of soman and sarin, but the treatment was less effective in protecting against the agent-induced decrements in swimming performance. Replacing pyridostigmine (a quaternary carbamate) by physostigmine (which readily enters the CNS) and introducing aprophen (an anti-cholinergic drug with a range of pharmacological actions) improved the protection achieved against both lethality and incapacitation. When the postpoisoning therapy was omitted, pretreatment with physostigmine and aprophen (or some other anti-cholinergic drug) gave significant levels of protection against both soman- and sarin-induced lethality and incapacitation. It is concluded that a number of different pharmacological actions are required to antagonize nerve agent-induced incapacitation and that they, and their relative importance, remain to be identified.

A swimming test for assessing effects of drugs upon motor performance in the guinea-pig (Cavia porcellus).

A swimming test was developed to provide a method for assessing gross motor behaviour in the guinea-pig (Cavia porcellus). The simplicity of the procedure enables a large number of animals to be tested in a short time. Learning was not required of the animals, thereby simplifying the interpretation of the effects of drugs. Control animals were highly motivated to complete the task and the variability in swimming times was small. The acetylcholinesterase inhibitor sarin significantly increased swimming time in a dose-related manner and did not affect "turning behaviour" during the swim. Alcohol, diazepam and amphetamine increased swimming time but only in the larger doses tested. Diazepam also increased turning behaviour. The suitability of the test for measuring effects of drugs upon gross motor behaviour in the guinea-pig is discussed.

An improved method for detecting drug effects in the open field.

A double test cross-over design was applied to the testing of rats in the open field. When used to examine the effects of atropine, chlorpromazine and lysergic acid diethylamide (LSD) on open field behaviour, this design proved 4--40 times more sensitive than the previously popular single test design. In no case was the double test design less sensitive. Results are discussed in relation to screening of medically useful compounds.