The hippocampal fimbria of cuprizone-treated animals as a structure for studying neuroprotection in multiple sclerosis.

OBJECTIVE AND DESIGN: It has been demonstrated that changes in the normal-appearing white matter (NAWM) in multiple sclerosis precede the appearance of classical lesions. The understanding of NAWM biology in an established disease model might help to clarify why some of them progress to active demyelinating lesions. MATERIAL OR SUBJECTS: C57BL6 male mice (19-21 g) were used in this study. TREATMENT: Demyelination was induced by feeding mice a diet containing 0.2% cuprizone for up to 5 weeks. METHODS: Routine stainings (luxol fast blue, and hematoxylin and eosin) and immunohistochemistry were performed to assess myelin status and the inflammatory infiltrate. RESULTS: We demonstrated that, in the toxic demyelination cuprizone model, the corpus callosum is severely demyelinated after a 5-week cuprizone challenge (acute demyelination) whereas the fimbria of the hippocampus appear normal in routine myelin stainings. Microgliosis but not astrogliosis is evident after acute demyelination in the fimbria. Interestingly, both regions, the fimbria and the corpus callosum, demonstrated early oligodendrocyte apoptosis as well as intense microglia accumulation and activation. However, only the corpus callosum progresses to actively demyelination lesions whereas the fimbria does not. CONCLUSIONS: The applied model appears suitable for elucidating pathways which promote progression of affected tissue to an active lesion.

A multinational, multi-centre, observational, cross-sectional survey assessing diabetes secondary care in Central and Eastern Europe (DEPAC Survey).

AIMS: The objective of this study was to assess diabetes care in outpatient diabetes clinics in the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia and Slovenia. METHODS: Questionnaires for each randomly enrolled patient were completed by an endocrinologist or diabetologist. Data concerning age, sex, diabetes duration, diabetes type, treatment type, glycated haemoglobin (HbA(1c)), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C), blood pressure (BP) and short- and long-term diabetes complications were recorded. Questionnaires were analysed centrally for each country and stratified for Type 1 diabetes (T1D), Type 2 diabetes (T2D) and other types of diabetes. RESULTS: Data on 10 950 individuals were analysed (mean population age 56.2 years; females 52%; T1D 22.9%; T2D 75.3%; mean time from diagnosis 11 years). Patients with HbA(1c) within target (< 6.5%): T1D 13.1%, T2D 21.4%; for TC levels (< 4.5 mmol/l): T1D 37%, T2D 20%; for TG levels (< 1.7 mmol/l): T1D 78%, T2D 44%; for HDL-C (> 1.1 mmol/l): T1D 81%, T2D 60%; for LDL-C (< 2.5 mmol/l): T1D 36%, T2D 23%; for BP (< 130/80 mm Hg): T1D 42%, T2D 9%. The prevalence of severe hypoglycaemia (within the last 6 months) was 12% in T1D and 2% in T2D. Prevalence of diabetic ketoacidosis was 0.3-6.6%, blindness 0.15-1.3% and diabetic nephropathy 19-42%. CONCLUSIONS: The data show the current quality of care and potential areas for improvement. The quality of care is generally comparable with that in Western Europe.

[The economic efficiency of timely diagnosis and early treatment of type 2 diabetes].

Туре 2 diabetes (T2D) is frequently detected too late just after development of complications requiring expensive treatment. The costs of drugs used for the treatment of diabetic complications are much greater than the funds allocated for diabetes management. The purpose of the study was to assess the impact of timely diagnosis and early initiated treatment of T2D on the total costs of the treatment. Direct and indirect costs of the treatment of the disease and its complications, using the Atakarov model with 5% annual allowance, were estimated. It was determined that with well-timed diagnosis of T2D), the total costs per patient cold be reduced by 1736 Litas or about 503 Eros (1 Euro = 3.452S Litas) over 5 years and over 10 years it would be saved even 1712 Euros. Not only indirect costs would be reduced. A total of 700 Euros would be saved per patient over 5 years and 2045 Euros over years. With the improved diagnosis of T2D and the well-timed diagnosis in at least 50% of cases of diabetes mellitus could save 10.05 million Euros over 5 years and even 34.23 million Euros over 10 years. The timely diagnosis of the disease and its proper management would prolong the life of a patient with T2D by 2.67 months over 10 years. That of T2D saves the costs of its treatment and care and can prolong the patient's life.

[Prevalence of type 2 diabetes mellitus and other carbohydrate metabolic disturbances in an area of the Republic of Lithuania].

The prevalence of type 2 diabetes mellitus (DM2) is on the Increase in the world from year to year. The aim of this study was to estimate the prevalence of DM and other carbohydrate metabolic disturbances in the adult population (aged 45 years or more) living in an area of the Republic of Lithuania in 2003 to 2004, depending on age and gender, and the rate of DM risk factors. A random adult sample comprised 116 adults (561 males and 555 females). A questionnaire survey was conducted; anthropometric indices were defined. Carbohydrate metabolism was evaluated by the 1999 World Health Organization's recommendations. The prevalence of DM2 was 5 0%; that of glucose intolerance and impaired fasting glycemia was 22.3 and 10.8%, respectively. The prevalence of carbohydrate metabolic disturbances tended to increase with age. In patients with DM, the rate of its risk factors is much higher than that in individuals with normal carbohydrate metabolism.

Use of a hydrocapillary dressing in the management of highly exuding ulcers: a comparative study.

OBJECTIVE: To evaluate the safety and performance of Alione Hydrocapillary dressing (Coloplast A/S) in the management of highly exuding chronic venous leg ulcers and compare it with two hydropolymer dressings,Tielle and Tielle Plus (Johnson & Johnson). METHOD: A comparative clinical trial was conducted on 97 patients with an ankle brachial pressure index > or = 0.8 and a highly exuding leg ulcer. Ulcer duration was at least four weeks. Treatment continued until healing or for a maximum of 12 months. RESULTS: There was no statistically significant difference in healing time or wound area reduction between the two treatment protocols. The test dressing (Alione Hydrocapillary) had better absorption capacity and was more comfortable for the patients than the comparator dressings (Tielle/Tielle Plus) and adhered less to the wound bed.Also, more patients preferred the test dressing to their previous treatment. Although severe leakage and maceration were observed more frequently in the comparator group compared with the test group, this was not statistically significant. CONCLUSION: Both treatment protocols were safe and effective in treating highly exuding chronic venous leg ulcers. The test dressing performed as well as or better than the comparator dressings for all study parameters and more patients preferred the test dressing to their previous dressing compared with the comparator dressings.

Early age-related maculopathy and risk factors of cardiovascular disease in middle-aged Lithuanian urban population.

PURPOSE: To assess the prevalence of age-related maculopathy (ARM) in a middle-aged urban population and the relationship between ARM and the main risk factors of cardiovascular disease (CVD). METHODS: The survey according to the WHO MONICA study protocol was carried out in Kaunas city, Lithuania, from 2001 to 2002. A total of 1403 persons aged 35 to 64 years were screened (626 men and 777 women: response rate 62.4%). Ophthalmologic investigation was performed for 1337 respondents (594 men and 743 women). Analysis of the relationship between ARM and risk factors of CVD was performed in case-control subdivision matching for sex, age, and education level. RESULTS: Early ARM was diagnosed in 7.4% of men and 5.4% of women. Rate of current smoking in case and control groups did not differ in men but in case group of women it was greater than in control group. Mean systolic and diastolic blood pressure and body mass index (BMI) in male case group and mean fasting blood glucose concentration in female case group were higher than in corresponding control groups. Frequency of diastolic hypertension (diastolic blood pressure > or = 90 mmHg) and obesity (BMI > or = 30 kg/m2) in male case group was higher than in control group. ARM was not associated with cholesterol and triglyceride levels in men and women. CONCLUSIONS: Early ARM in middle-aged Lithuanian urban population was associated with current smoking in women but not in men; it was associated with diastolic blood pressure and BMI in men and with fasting glucose level in women.

[A program for the prevention of diabetes mellitus in Lithuania]. / Programma bor'by s sakharnym diabetom v Litovskoi SSR.

The Programme on Diabetes Mellitus Control is a constituent part of Integrated Programme on Chronic Non-infectious Diseases Control. The epidemiological evidence has demonstrated the high prevalence of deranged carbohydrate metabolism in the republic. Registers of carbohydrate metabolism disorders were created for the children's population of the Republic and the adult population of Kaunas and two agricultural-industrial regions. A school for diabetic patients and the society 'Insula' were organised. The research-practical programme is implemented in stages.

[Lipid metabolism and the activity of cardiospecific enzymes in diabetes mellitus]. / Sostoianie lipidnogo obmena i aktivnosti kardiospetsificheskikh fermentov pri sakharnom diabete.

The paper provides representative data on the indices of lipid metabolism and the activity of cardiospecific (lactate dehydrogenase--LDH, creatine phosphokinase--CPK) in patients with diabetes mellitus, Type I and II, (male inhabitants of Kaunas aged 40 to 59) which were compared with similar data on control persons randomly selected from the population during epidemiological surveys. They covered 85.3% of all detected and followed-up patients of this age with diabetes mellitus. Total and HDL cholesterol and triglycerides were determined by the enzymatic methods, LDH by the spectrophotometric method and CPK by the fluorometric method. It was shown that patients with Type II diabetes mellitus (insulin-independent) in addition to a raised concentration of glucose on an empty stomach were characterized by an increase in the level of cholesterol up to 6.34-0.51 mmol/l and especially triglycerides up to 5.98-1.78 mmol/l as compared to the control values (5.39-0.11 and 1.48-0.12 mmol, respectively). The concentration of HDL cholesterol and CPK and LDH activity in the patients did not differ from the control level.

[Malondialdehyde, alpha-tocopherol and retinol content of the blood serum in male diabetics]. / Soderzhanie malondial'degida, al'fa-tokoferola i retinola v syvorotke krovi bol'nykh sakharnym diabetom muzhchin.

The average concentration of malondialdehyde (MDA) in diabetes mellitus males was not higher than in the age-matched controls whereas alpha-tocopherol levels in diabetes mellitus significantly exceeded the normal disregarding the pattern of the disease and closely correlated with the concentration of triglycerides. Lower concentration of retinol in comparison with the control group was observed in the patients. Relative levels of alpha-tocopherol/MDA and retinol/MDA were age-dependent: in patients under 30 and above 50 the levels of alpha-tocopherol/MDA were significantly higher than in their normal age-matches while in 31-50-old ones no elevation in the above mentioned levels was observed. Retinol/MDA levels were significantly lower in the latter age group. The data are indicative of decreased levels of alpha-tocopherol and retinol in diabetes mellitus patients aged 31-50.

[Performing and interpretating the glucose tolerance test]. / O provedenii i interpretatsii gliukozotolerantnogo testa.

Certain conditions like drug use, diet, physical activity, etc., must be adhered to while running the glucose tolerance test. The Second WHO Expert Committee on Diabetes Mellitus (1979) suggested that the oral glucose tolerance test should be carried out with 75 g of glucose (for children 1.75 g/kg of ideal body mass but not over 75 g). During epidemiological investigations a glucose solution should be prepared by a constant concentration method using an areometer. Schematic interpretation expressed in the rectangular coordinate system reflecting diagnosis was offered for the estimation of findings.