Exercise responses in patients with IDDM

OBJECTIVE: The hemodynamic, respiratory, and metabolic responses to exercise were studied in IDDM patients and control subjects to detect diabetic cardiomyopathy. RESEARCH DESIGN AND METHODS: Eight subjects aged 25-40 years with diabetes of at least 10 years' duration were compared with eight control subjects aged 21-46 years. All subjects underwent a progressive incremental bicycle exercise test with measurement of gas exchange, blood glucose, lactate, fat metabolite, and catecholamine levels and two steady-state exercise tests with measurement of cardiac output by a CO2 rebreathing method. A new first-pass radionuclide method was used to measure cardiac ejection fractions (EFs) at rest, peak exercise, and steady-state exercise. RESULTS: The peak achieved oxygen consumption was similar in the diabetic and control subjects (29.9 [25.1-34.6] and 31.4 [26.9-35.9] ml.min-1.kg-1, respectively; mean [95% CI]). There were no significant differences in heart rate, double product, ventilation, respiratory exchange ratio, or ventilatory equivalents for oxygen and CO2 during the incremental test. Glucose levels were higher in the diabetic subjects, but there were no significant differences in levels of lactate, catecholamines, free fatty acids, glycerol, or beta-hydroxybutyrate. Left ventricular EF fell from rest to peak exercise within the diabetic group (66.0% [59.6-72.4] at rest; 53.6% [45.6-61.6] at peak; P < 0.05) but this did not differ significantly from the control group (58.7% [52.3-65.1] at rest; 60.3% [48.9-71.7] at peak). Right ventricular EFs were similar in each group, and there was no reduction in peak filling rate to suggest diastolic dysfunction. The cardiac output responses to exercise were also similar in the two groups. CONCLUSIONS: There is no evidence of impairment of the exercise response in subjects with long-standing diabetes, and the apparent fall in left ventricular EF at peak exercise could be related to hemodynamic adaptation.     

Knowledge, attitude and behavior among patients with Chlamydia. Perspectives for prevention

Patients with chlamydial infections (Ct) attending the outpatient Venereal Disease Clinic of Copenhagen from July 1-November 30 1995 were asked to fill in a questionnaire focusing upon knowledge, attitude and behaviour related to sexually transmitted diseases (STDs) in order to strengthen the future prevention of Ct. The questionnaire was answered by 37 men and 35 women with a median age of 27 and 21 years and a median number of three and two sexual partners within the last six months, respectively. Half of the patients had previously had an STD, and 92% had been tested for HIV, of whom one homosexual man was known HIV-positive. Notification about exposure from a partner was the reason for attending for 24%. All but one were in favour of partner notification, but only 6% wanted provider referral. During last intercourse condoms had neither been used with a steady partner by 75% especially by the young and women, who thought themselves safe, nor with a casual partner by 52% especially among the young and men, mainly because of thoughtlessness or perception of low risk. Before the actual STD diagnosis only 49% were able to name one symptom and 35% one complication related to Ct. A majority (79%) stated, that fear of catching another Ct would lead to better protection, and 70% found that more information would have a preventive effect. Future Ct prevention programs in Denmark should include intensified chlamydial screening and partner notification together with centrally produced mass media information supplemented by individual counselling.     

Amount of information about the attitude object and attitude–behavior consistency.

The synthesis of 2 separate lines of inquiry—research on information integration and longitudinal studies of attitudes—prompted the hypothesis that the degree of consistency between attitudes and behavior will increase as a function of the amount of information available about the attitude object. This hypothesis was tested in 3 longitudinal studies, ranging in length from 4 days to 4 mo, that investigated the following behaviors: voting for candidates for political office, voting for 2 social-policy election initiatives, and having an influenza vaccination. Ss were 62 undergraduates (Study 1), 270 undergraduates (Study 2), and 299 27–92 yr old veterans (Study 3). In support of the hypothesis, amount of information moderated the consistency between attitudes and behavior in each study, and the significance of this relation remained even after controlling for the effects of other potential moderators, including prior direct behavioral experience with the attitude object and attitude certainty. Consistent with previous research, direct behavioral experience was also a determinant of attitude–behavior consistency, and this relation was independent of the effect of amount of information for the behavior of having an influenza vaccination. Discussion focuses on the interrelation among moderators of attitude–behavior consistency and on the theoretical implications of the findings. (52 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nitric oxide and ocular blood flow in patients with IDDM

PURPOSE: Color Doppler imaging (CDI) is a relatively new technique that allows quantification of blood flow velocity in orbital and ocular vasculature. Despite the numerous clinical studies that have used CDI, repeatability of this technique and agreement between observers have not been documented. METHODS: The authors performed a prospective investigation of the repeatability and agreement between observers on ophthalmic artery blood flow velocity measurements in 35 patients (35 eyes). RESULTS: Results on the estimated error of measurement (variability between repeated readings on the same subject) indicate good repeatability of the measurements; in fact, the measurement variances were only 5.6% for the peak systolic velocity, 11.4% for the end diastolic velocity, and 6.2% for the mean envelope velocity. The statistical analysis of repeatability showed a very narrow 95% confidence interval for both observers. The measurement of agreement between the two observers demonstrated the existence of a good concordance of the measurements taken by each observer on each subject. CONCLUSIONS: Results suggest that CDI is a reliable tool for quantitative assessment of ophthalmic artery blood flow velocity.     

Self-monitoring and the attitude–behavior relation.

130 undergraduates responded to 3 questionnaires over a 6-wk period before and after the 1980 presidential election. The questionnaires assessed self-monitoring tendency, attitudes, and intentions with respect to voting in the election and smoking marihuana, and included self-reports of actual behavior. Low self-monitors tended to exhibit stronger attitude–behavior correlations than high self-monitors. There was, however, no difference in the predictability of intentions from attitudes, a finding that disconfirmed the perceived relevance interpretation of the effect of self-monitoring. Instead, the difference was located in the relation between intentions and behavior; low self-monitors exhibited significantly stronger intention–behavior correlations than did high self-monitors. Findings support the interpretation that the 2 types of individuals are equally aware of the implications of their attitudes, but that high self-monitors, being sensitive to situational demands, are less likely to carry out their previously formed intentions than low self-monitors, who are more attentive to internal cues. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Eating behavior of overweight and nonoverweight persons in the natural environment

The eating behaviors of 34 overweight and 37 nonoverweight male and female customers of a quick-service diner were observed for differences in speed of eating as a function of weight, sex, and type of meal selected. Results show that the overweight Ss took fewer bites and chews, spent less time in nonchewing activities, and finished eating sooner. Several sex differences were also noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Platelet cNOS activity is reduced in patients with IDDM and NIDDM

Several studies in vitro and in vivo suggest that the nitric oxide (NO) production is impaired in diabetes mellitus. Reduced levels of NO could contribute to vascular alteration facilitating platelet-vascular wall interaction, adhesion of monocytes to endothelium, vascular smooth muscle proliferation and by decreasing endothelium-dependent vasodilation. In this study we evaluated the activity of the constitutive nitric oxide synthase (cNOS) in platelets of patients with insulin-dependent diabetes mellitus (IDDM) and with non-insulin-dependent diabetes mellitus (NIDDM). When compared to that of normal subjects, cNOS activity is significantly lower in patients with IDDM and with NIDDM (1.57 +/- 0.25 vs. 0.66 +/- 0.10 fmol/min/10(9) PLTs and 1.57 +/- 0.25 vs. 0.67 +/- 0.08, respectively; p<0.005). These data demonstrate that the platelet cNOS activity is decreased in diabetes mellitus.     

Using self-efficacy in assessing self-care to the IDDM patients

The purpose of this study was to test an Self-Efficacy Scale for IDDM patients to assess their self-care performances. Data were collected by convenience sampling method from 72 patients with IDDM at southern Taiwan from February 5 to June 15, 1995. Two instruments were used in this study: the Insulin Management Diabetes Self-Efficacy Scale (IMDSES) and Diabetes Self-Care Scale. The following results were obtained. 1. Subjects had average levels of self-efficacy. The IMDSES Scale total mean was 70.59 (SD = 16.59). The highest and the lowest mean in all IMDSES subscales were blood sugar monitor (76.29, SD = 16.37) and the foot care (63.37, SD = 26.92) respectively. 2. Subjects had average levels of self-care. The Diabetes Self-Care Scale total mean was 68.80 (SD = 18.45). The highest and the lowest mean in all Diabetes subscale were insulin adjustment (75.01, SD = 20.22) and the foot care (61.07, SD = 27.70) 3. There was a strong correlation between the IMDSES Scale and the Diabetes Self-Care Scale (r = 0.94, p < 0.01). In addition, there were significant Pearson correlations between each of the all Diabetes Self-Efficacy subscales and their related Self-Care subscales (r = 0.93 approximately 0.62, p < 0.01). These results supported the theoretical perspective of Bandura's self-efficacy. Individual with higher levels of self-efficacy were better able to manage their diabetes self-care. Implications of these findings for nursing practice and research are discussed.     

Age and family relationship accentuate the risk of insulin-dependent diabetes mellitus (IDDM) in relatives of patients with IDDM

The international community of diabetologists is rapidly becoming involved in intervention trials aimed at preventing insulin-dependent diabetes in high risk relatives. Whereas age and relationship to a proband with insulin-dependent diabetes mellitus interacting with detected islet cell autoantibodies (ICA) are risk factors, their independent contribution to that risk remains unclear. In a prospective study of 6851 nondiabetic relatives of 2742 probands conducted between 1979-1993, we found age, but not relationship, to be a dramatic risk variable in ICA-positive persons as estimated by the Cox regression model. The 5-yr risk of insulin-dependent diabetes mellitus was 66% for those found to have ICA detectable before age 10 yr, falling progressively to less than 16% for ICA-positive relatives over age 40 yr. In ICA-negative relatives, age and relationship are independent prognostic variables.     

Linkage and association between a CD4 gene polymorphism and IDDM in Danish IDDM patients. The Danish IDDM Epidemiology and Genetics Group, and The Danish Study Group of Diabetes in Childhood

PURPOSE: Our purpose was to determine the neuroradiologic findings of Marinesco-Sj?gren syndrome on plain skull radiographs, CT, and MR images. METHODS: Eight patients with proved Marinesco-Sj?gren syndrome (age range, 4 to 56 years) had a total of nine CT scans, seven MR imaging studies, and two plain radiographic examinations of the skull. The findings were reviewed retrospectively, with particular attention to the size of the posterior fossa and cerebellum. RESULTS: All patients had hypoplastic cerebellar hemispheres and a hypoplastic vermis in a small posterior fossa. One patient had a midline posterior fossa cyst and another had agenesis of the corpus callosum. CONCLUSION: Hypoplasia of the cerebellar hemispheres and the vermis and a small posterior fossa are the most prominent neuroradiologic findings in Marinesco-Sj?gren syndrome.     

Attitude organization and the attitude–behavior relationship.

The validity of a single-component model of attitude was assessed and compared with a 2-component (affective/cognitive) conceptualization of attitude. Confirmatory factor analysis was employed in a reanalysis of data previously reported by N. Fishbein and I. Ajzen (see record 1974-24385-001). A total of 125 undergraduates from 2 samples completed 5 scales measuring attitudes toward religion. Convergent validity, in the sense of uniform consistency of responses, did not hold for the single-component model but was achieved for the 2-component model. Further, the 2-component model of attitude predicted scaled, but not unscaled, multiple-act behavior criteria, and the predictive validity of the relationship between the 2-component model and single-act behavior criteria was not supported. (51 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predisposition to essential hypertension and development of diabetic nephropathy in IDDM patients

The immunosuppressive and antiinflammatory cytokine interleukin (IL) 10 selectively upregulates the expression of the CC chemokine receptors CCR5, 2, and 1 in human monocytes by prolonging their mRNA half-life. IL-10-stimulated monocytes display an increased number of cell surface receptors for, and better chemotactic responsiveness to, relevant agonists than do control cells. In addition, IL-10-stimulated monocytes are more efficiently infected by HIV BaL. This effect was associated to the enhancement of viral entry through CCR5. These data add support to an emerging paradigm in which pro- and antiinflammatory molecules exert reciprocal and opposing influence on chemokine agonist production and receptor expression.     

Familial and perinatal risk factors for micro- and macroalbuminuria in young IDDM patients

It has been suggested that hereditary risk for hypertension and cardiovascular disease (CVD) as well as intrauterine growth may be involved in the pathogenesis of diabetic nephropathy. In the present study, we investigated the influence of familial and perinatal risk factors on the occurrence of micro- and macroalbuminuria in young IDDM patients. A cohort of 1,150 young patients with > or =5 years' duration of IDDM was screened for microalbuminuria. Data on family history of hypertension, CVD, IDDM, and NIDDM; perinatal factors such as birth weight, gestational age, and duration of breastfeeding; and maternal education, smoking, hypertension, and proteinuria during pregnancy were collected. We identified 75 patients with an albumin excretion rate > or =15 microg/min in more than two overnight urinary samples and compared them in a nested case-control study with three normoalbuminuric control subjects per patient from the same cohort, matched for diabetes duration. Perinatal factors were analyzed in all patients born at term (+/- 2 weeks), 59 of the 75 patients and 155 of the 225 control subjects. In univariate analysis, hypertension in parents (odds ratio [OR] 4.21), CVD in parents and grandparents (OR 1.26), maternal smoking during pregnancy (OR 3.21), and a low level of maternal education (OR 2.33) were significantly associated with the development of micro- and macroalbuminuria. When adjusted for other familial and perinatal factors, current mean blood pressure, HbA1c, smoking, BMI, sex, age, and postpubertal diabetes duration, using logistic regression analyses, only parental hypertension in all patients and maternal smoking during pregnancy and low level of maternal education in full-term patients were independent risk factors. When patients with poor glycemic control were analyzed separately, familial CVD, poor metabolic control, parental hypertension, maternal smoking during pregnancy, and level of maternal education were independent risk factors, with the adjusted OR markedly increased, compared with the matched subgroup with better HbA1c. In conclusion, familial hypertension and CVD, maternal smoking during pregnancy, and low level of maternal education may independently increase the risk for incipient nephropathy in full-term offspring who later develop IDDM. Current poor glycemic control seemed to increase the effect of these risk factors.     

Brainstem auditory evoked potentials and visually evoked potentials in young patients with IDDM

OBJECTIVE: To investigate whether young IDDM patients develop central nervous dysfunction and to establish a possible relationship with various disease parameters. RESEARCH DESIGN AND METHODS: Thirty-two patients, aged 13.5 +/- 2 years, with disease duration of 6 +/- 2.6 years and age of onset of 7.7 +/- 3.2 years (group 1), and 21 patients with short-term disease, age 9.7 +/- 3.5 years, duration of disease < 2 years and age of onset of 9.4 +/- 3.3 years (group 2) were compared with age- and sex-matched control subjects. Exclusion criteria were clinical signs of neuropathy, retinopathy, nephropathy, or hearing impairment. Neurophysiological studies included auditory and visually evoked potentials (EPs). RESULTS: Patients in group 1 revealed increased P100 latencies of visually EPs (103.4 +/- 4.5 vs. 96.8 +/- 3.7 ms) and interpeak latencies I-V of auditory EPs (4.16 +/- 0.10 vs. 3.99 +/- 0.09 ms) and had abnormal latencies (values outside 2.5 SD) in 37%. However, short-term patients (group 2) had results within normal limits compared with control subjects. In group 1, longer disease duration and younger age at onset correlated with an increase of P100 latency (P < 0.001) and IPL I-V (P < 0.001). Patients with a history of severe hypoglycemic episodes had increased latencies compared with patients without hypoglycemia (P < 0.05). Furthermore, metabolic control during the last 2 years was related to P100 latencies (P < 0.05). CONCLUSIONS: EPs noninvasively detect subclinical central nervous system involvement in children and adolescents with IDDM. Most important risk factors are duration of disease and frequency of severe hypoglycemia.     

十堰市大学生艾滋病知识行为与态度现状调查

世界卫生组织认为性健康教育包括性生理、性心理及性道德三方面内容,是指通过丰富和提高人格、人际交往和情爱方式达到性行为(广义的)在肉休、感情、理智和社会诸方面的圆满协调,从而达到人的全面发展和社会进步(1).