ABSTRACT
We conducted a pilot study of the effectiveness of individual counselling sessions provided by a dietician through telemedicine for patients with diabetes. All participants received a single group education session via videoconference. Those who were randomized to the intervention also received two additional follow-up sessions, four and eight weeks later. Glycosylated haemoglobin and total cholesterol were measured at the start and again 16 weeks later. The patients completed diabetes quality-of-life and telemedicine patient satisfaction surveys. Thirty-two participants consented to participate. Complete data were collected on 13 intervention and 13 control patients. There was a 1% fall in HbA(1c) in the intervention group from pre- to post-assessment, although this was not significant. The control group showed a significantly larger fall in HbA(1c) levels than the intervention group (P = 0.043). Total cholesterol decreased in both groups, although not significantly. All control and intervention group participants indicated that they would participate in videoconferencing nutritional counselling again. The results suggest that providing nutritional therapy via videoconferencing may be useful in assisting patients to manage their conditions.
Subject(s)
Diabetes Mellitus/diet therapy , Health Education/methods , Telemedicine/organization & administration , Videoconferencing/organization & administration , Adolescent , Adult , Aged , Cholesterol/metabolism , Glycated Hemoglobin/metabolism , Humans , Middle Aged , Patient Satisfaction , Pilot Projects , Quality of Life , Telemedicine/standards , Videoconferencing/standards , Young AdultABSTRACT
In the rat, the Na,K-ATPase alpha4 isoform exhibits unique enzymatic characteristics and is important for sperm motility. In this work, we studied expression, localization and function of alpha4 in human spermatozoa. We show two catalytically active Na,K-ATPase alpha polypeptides with different ouabain affinity and identified expression of alpha1, alpha4, beta1 and beta3 isoforms in the gametes. In addition, human sperm presented two Na,K-ATPases composed of alpha4, alpha4beta1 and alpha4beta3. Kinetic analysis of these isozymes produced in insect cells showed that, compared with human alpha1beta1, alpha4beta1 and alpha4beta3 exhibit higher Na(+) and lower K(+) affinity and higher sensitivity to ouabain. These particular enzymatic properties suggested a role for alpha4 in sperm function. Using computer-assisted sperm analysis (CASA), we found that ouabain inhibition of alpha4 significantly decreased percentage sperm motility. In contrast, ouabain did not affect linearity of forward progression, amplitude of lateral head displacement, beat cross frequency and sperm straight-line, curvilinear or average path velocities. This suggests a primary role of alpha4 in flagellar motility. Accordingly, we found alpha4 in the sperm tail, predominating in the mid-piece of the flagellum. Therefore, similar to the rat ortholog, human Na,K-ATPase alpha4 isoform has a distinct activity that is essential for sperm function.
