Short-term effects on patient satisfaction of continuous glucose monitoring with the GlucoDay with real-time and retrospective access to glucose values: a crossover study.

BACKGROUND: This randomized crossover trial examines the effect of continuous glucose monitoring (CGM) with real-time access (RTA) to glucose data versus CGM with a retrospective analysis (RA) of glucose data regarding satisfaction with CGM and other patient-reported outcomes. METHODS: Participants used the CGM device (GlucoDay, Menarini Diagnostics, Florence, Italy) twice. In one study phase, patients were allowed RTA to, and in the other phase RA of, current glucose values. The order of these two conditions was randomized. At baseline and after the first and second trials, subjects completed questionnaires (Continuous Glucose Monitoring Satisfaction Scale) about perceived satisfaction with CGM. They also completed the Problem Areas in Diabetes Questionnaire, a state anxiety scale (State-Trait Anxiety Inventory), and a depression scale (Center of Epidemiological Studies-Depression Scale). RESULTS: Fifty patients with type 1 diabetes (41.7 +/- 12.3 years old, diabetes duration of 14.75 +/- 11.9 years, 48% female, hemoglobin A1c 8.1 +/- 1.5%, years of education 10.3 +/- 2.1 years) participated in this study. At baseline patients perceived CGM as rather advantageous, but after RA and RTA the perceived benefits were reduced (baseline, 101.0 +/- 16.0; RA, 95.7 +/- 20.2; RTA, 93.6 +/- 22.8; P < 0.01). However, there was no significant difference between RA and RTA. Also, there was no significant effect on diabetes-related distress or state anxiety, but a positive effect on depression scores. CONCLUSIONS: There was no specific, significant, negative or positive effect of RA versus RTA on satisfaction with CGM. Exposing patients with type 1 diabetes to their current glucose values does not seem to have a specific negative impact on the appraisal of CGM or more generic patient-reported outcomes.

Type III DNA restriction and modification systems EcoP1 and EcoP15. Nucleotide sequence of the EcoP1 operon, the EcoP15 mod gene and some EcoP1 mod mutants.

This paper presents the nucleotide sequence of the mod-res operon of phage P1, which encodes the two structural genes for the EcoP1 type III restriction and modification system. We have also sequenced the mod gene of the allelic EcoP15 system. The mod gene product is responsible for binding the system-specific DNA recognition sequences in both restriction and modification; it also catalyses the modification reaction. A comparison of the two mod gene product sequences shows that they have conserved amino and carboxyl ends but have completely different sequences in the middle of the molecules. Two alleles of the EcoP1 mod gene that are defective in modification but not in restriction were also sequenced. The mutations in both alleles lie within the non-conserved regions.

The nature of an intragenic suppressor of the Escherichia coli dnaA508 temperature-sensitive mutation.

Escherichia coli strain E508 (dnaA508) is temperature-sensitive for dnaA function. A mutant with an intragenic suppressor of the dnaA508 mutation, called PR1, has been isolated. The suppressor mutation(s) allow initiation of DNA synthesis at 42 degrees C and, like dnaA cold-sensitive mutants, PR1 grows poorly at 32 degrees C. Two-dimensional gel analysis indicates that DnaA protein is overproduced in PR1. Transcriptional analysis indicates two to three times the number of dnaA and dnaN transcripts in PR1, as compared to a wild-type dnaA+ strain. The dnaA gene from PR1 has been cloned and found to complement the original dnaA508 mutation, as well as dnaA46, but not dnaA5. Sequencing of the dnaAPR1 gene reveals three separate base changes, two of which result in nonconservative amino acid substitutions and the third is a change in the start codon from GTG to ATG.

Extracellular proteases of Aspergillus flavus. Fungal keratitis, proteases, and pathogenesis.

To get a better understanding of the possible role of proteases in the pathogenesis of fungal keratitis, the extracellular proteases of a clinical isolate of Aspergillus flavus, from a severe case of keratitis, were identified and partially characterized. This strain, designated CU226/88, was grown with a variety of substrates as nitrogen sources, under conditions that would be expected to derepress the production of extracellular proteases. When grown on minimal medium with milk protein as a nitrogen source, the fungus appeared to produce primarily a metalloprotease, which has a zinc cofactor. When grown with insoluble collagen or elastin as a nitrogen source, a serine protease and cysteine protease, as well as the metalloprotease, are produced. Strain CU226/88 can grow with collagen, but not elastin, as the sole source of carbon as well as nitrogen. It is possible that the collagenase activity is a mediator of the severe corneal destruction caused by this isolate.

Coronary artery calcium score: influence of the reconstruction interval on cardiac risk stratification in asymptomatic patients using dual-source computed tomography.

PURPOSE: To evaluate the impact of the reconstruction interval on coronary calcium score and cardiac risk stratification using dual-source computed tomography (DSCT). MATERIALS AND METHODS: DSCT coronary calcium scoring was performed in 61 consecutive patients, and five data sets per patient were reconstructed within diastole (50 - 70 % of the R-R interval). The Agatston score, volumetric score and the relative variability were assessed for all reconstructions. To assess the individual cardiovascular risk, patients were assigned to risk groups based on age and gender-matched percentile ranks. RESULTS: The mean Agatston score was 184.8 ± 377.9 (relative variability 47 % ± 52 %). The mean volumetric score was 164.4 ± 310.1 (relative variability 49 % ± 58 %). There was a negative correlation between the total Agatston score and the relative variability (r = -0.37; p < 0.01). Depending on the reconstruction interval used, 18 predominantly young patients were assigned to more than one risk group. CONCLUSION: Despite the increased temporal resolution of DSCT examinations, the Agatston and volumetric scores depend on the reconstruction time within the cardiac cycle. The fact that the greatest relative variability for both the Agatston score and the volumetric score was found in young patients with small amounts of coronary calcium may result in different treatment strategies for young patients depending on the reconstruction used. Therefore, more accurate risk stratification may require the analysis of multiple reconstruction intervals.

[What advantage are there in using gentamycin-PMMA-chains in the treatment of posttraumatic osteomyelitis, osteoarthritis and soft tissue infections?]. / Welche Vorteile bietet die Anwendung von Gentamycin-PMMA-ketten bei der Behandlung der posttraumatischen Osteomyelitis, Osteoarthritis und von Weichteilinfektionen?

The use of gentamicin-polymethylmethacrylate (PMMA) bead chains permits the depositing of a high dose of gentamicin at the place of the infection. Short indications on the experimental basis and hints regarding the practical application are given. It follows the discussion of the results in 34 patients with chronic posttraumatic osteomyelitis, arthritis due to infection, diabetic and arteriosclerotic gangrene and the infections of the soft tissues. Primary wound healing was achieved in 70%. Discussion of interesting cases. The advantages of the use of gentamicin-PMMA bead chains in infection cases are emphasized.

Concerning the influence of integrated episomes on chromosomal replication in Escherichia coli.

Two strains of Escherichia coli K12, C600, and DG163, in which the origins and directions of DNA replication had been mapped previously, were made lysogenic for lambda and lambdai434. The origins of replication in these lysogenic strains were located with respect to the prophage location by chromosome alignment and subsequent hybridization of (3)H-labeled lambda vir DNA with newly replicated and "old" DNA. The results obtained are consistent with similar origins of replication observed in the nonlysogenic strains. These findings suggest that DNA replication in these cells is under the control of the E. coli chromosomal replicon and is independent of the presence of the lambda replicon as predicted by the Jacob, Brenner, and Cuzin model of DNA replication.

Regulation of DNA synthesis and capacity for initiation in DNA temperature sensitive mutants of Escherichia coli. II. Requirements for acquisition and expression of initiation capacity.

This paper deals with the conditions that are necessary for the acquisition and expression of initiation potential in dnaA temperature sensitive mutants after they have been held for periods of time at nonpermissive temperature and then returned to permissive temperature in the presence of chloramphenicol. The following conditions were found to be essential: (1) 40-60 min at nonpermissive temperature during which time protein synthesis must occur; this period must be followed by (2) return to permissive temperature under which conditions active dnaA product is present, and (3) protein synthesis must be blocked during the first 10-20 min immediately after return to permissive temperature (when initiation takes place). In order for expression of the initiation potential (4) the chloramphenicol must be removed to allow the progression of the replication forks which had been initiated to occur and (5) the recA+ phenotype appears to be required for acquisition or expression (or both) of the initiation potential.

Effect of nalidixic acid on semionservative replication and repair synthesis after ultraviolet irradiation in Escherichia coli.

Both semiconservative deoxyribonucleic acid replication and "extensive repair" synthesis, after ultraviolet irradiation, appear to be blocked by nalidixic acid. These findings suggest that the agent(s) responsible for both of these modes of replication, or some necessary common process or structure, is affected by this drug.

[Indications for and results of interlocking nailing in lower leg fractures]. / Indikationen und Resultate der Verriegelungsnagelung bei Unterschenkelfrakturen.

At the clinic for Traumatology at the University Hospital of Zürich between 1981-1986 53 tibial fractures in 52 patients have been treated with interlocking nails. The system of Grosse and Kempf was utilized. The fractures were produced by a variety of mechanisms of injury, of which 70% were caused by traffic accidents. Associated injuries to other organ systems were sustained by 44% of the patients, overall there were 13% considered to have multiple trauma. 21% of the fractures were open. 21% required stable fixation, 17% were dynamized. The remaining 79% fractures were treated with dynamic nailings. A bridging callus was observed after an average of 6 weeks, and cortical bridging at 18 weeks following nailing. Complications included local infection around the proximal transversal screws in 2 and osteomyelitis in 1 case.

Gamma-ray induction of deoxyribonucleic acid synthesis in temperature-sensitive DNA initiation mutants of Escherichia coli.

DNA synthesis was followed after gamma-ray irradiation of several different temperature-sensitive mutants with defects in the initiation process. The results indicate that only dnaA and dnaI mutants show induction of supplementary DNA synthesis after gamma-ray irradiation. The induction of DNA synthesis by gamma-ray irradiation was also shown to be recA+ dependent in the dna5 mutant.