Use and Effectiveness of Continuous Subcutaneous Insulin Infusion (CSII) and Multiple Daily Insulin Injection Therapy (MIT) in Children, Adolescents and Young Adults with Type 1 Diabetes Mellitus.

UNLABELLED: Today continuous subcutaneous insulin infusion (CSII) is frequently used in children and adolescents with type 1 diabetes mellitus. The present cross-sectional trial aimed to document current practice, quality of diabetes control and incidence of acute complications in different age-groups under CSII vs. multiple daily insulin injection therapy (MIT). Moreover the survey analyzed socio-demographic backgrounds of the patients. PATIENTS AND METHODS: A total of 901 patients (age 11.5±4.0, diabetes duration 4.0±3.6 years) was entered in the database. Clinical data, laboratory parameters and, using a standardized questionnaire, socio-demographic data were assessed. For age-related analyses patients were allocated to 4 groups: pre-school children (< 6 years), pre-adolescents (≥ 6 and<11 years), adolescents (≥ 11 and<16 years) and young adults (≥ 16 and<22 years). RESULTS: Of the cohort n=194 had a CSII, n=707 had a MIT. Patients with CSII vs. MIT had a longer diabetes duration, they used more frequently insulin analogues, performed more frequently blood-glucose self-tests and had a lower insulin dosage per kilogram body weight. In respect of HbA1c, the mean amplitude of blood-glucose excursions, but also of lipids, creatinine, microalbuminuria and blood pressure, there were no differences in neither age-group between patients with CSII and MIT. In patients with CSII and MIT, there was a tendency (p<0.05) towards an increase in HbA1c in adolescents and young adults and there was a decrease (p<0.05 for tendency) in the frequency of hypoglycaemia from the age group of young adults to pre-school children. Adolescents and young adults with CSII had a higher educational level. Pre-adolescents, adolescents and young adults with CSII have also better diabetes-related knowledge. Moreover, in all age-groups, the parents of patients with CSII had mostly a lower unemployment rate and higher educational levels. CONCLUSIONS: The present analyses demonstrate that in all age-groups CSII provides convenient and flexible insulin delivery during routine treatment of type 1 diabetes. There is reasonable quality of diabetes control accompanied by a low incidence of hypoglycaemia and ketoacidosis. However, under CSII and MIT there is an increase of HbA1c towards adolescence. It must also highlighted that CSII seems to be expansive and that CSII is more frequently used in patients with better educational levels and deriving from higher social classes.

Are two interventions worse than none? Joint primary and secondary prevention of eating disorders in college females.

Prevention programs for eating disorders attempt to simultaneously prevent new cases from arising (primary prevention) and encourage students who already have symptoms to seek early treatment (secondary prevention), even though ideal strategies for these 2 types of prevention may be incompatible with each other. In the present study, an eating disorder prevention program was evaluated in a simple of female college freshmen. In the intervention, classmates who had recovered from eating disorders described their experiences and provided information about eating disorders. At follow-up, intervention participants had slightly more symptoms of eating disorders than did controls. The program may have been ineffective in preventing eating disorders because by reducing the stigma of these disorders (to encourage students with problems to seek help), the program may have inadvertently normalized them.

Sequence analysis of oligodeoxyribonucleotides by mass spectrometry. 2. Application of computerized pattern recognition to sequence determination of di-, tri-, and tetranucleotides.

A novel strategy for the sequence analysis of oligodeoxyribonucleotides has been devised which is based upon the analysis of intact underivatized oligonucleotides by mass spectrometry followed by interpretation of the mass-spectral data by computerized pattern-recognition techniques. The pyrolytic and electron-impact conditions of the mass spectrometer permit the cleavage of oligonucleotides of varying chain length and composition, yielding reproducible fragmentations and characteristic m/e values which can be used to reveal purine and/or pyrimidine base sequence information. The selection of optimum features (which are the ratios of peak heights of specific ions, or the linear combination of such ratios) has been done by an interactive feature selection method employing multidimensional k nearest-neighbor analysis and two-dimensional feature-space plots (nonlinear mappings) of the mass-spectral data. Features have been found which allow 100% classification accuracy in predicting the 5' and 3' terminus of all of the dinucleotides commonly found in DNA. Other specific features have been found which indicate adjacent nucleotides within a tetranucleotide. Knowledge of the adjacent nucleotide pairs present, in conjunction with the information as to the 3' or 5' position of the residues in each pair, permits the reconstruction of the sequence of the tetranucleotide.

Quantitative analysis and pattern recognition of two-dimensional electrophoresis gels.

We describe a system, both hardware and software, that provides quantitative analysis and data reduction of two-dimensional electrophoresis gels. Image-analysis techniques are used to determine spot intensities and to match spot patterns among many gels. A pattern-recognition program is used to extract the useful information contained in the spot lists. The application of this technology to a study of supernates from bacterial cultures is described.