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BACKGROUND: We conducted a clinical research study to determine the effect of self-monitoring of blood glucose (SMBG) on glycaemic control and the value of a putatively less painful blood sampling technique on SMBG in oral hypoglycaemic agent-treated type 2 diabetes patients; SMBG has not been broadly applied in non-insulin-treated patients in Japan. METHODS: One hundred thirty-seven subjects were recruited for the 24-week, prospective, comparison study and randomized into three groups: 46, no SMBG group; 46, fingertip group; and 45, palm group. The primary endpoint was change in HbA(1c) . The secondary endpoints were SMBG compliance, dropout rate, treatment changes, and patient's and physician's satisfaction. RESULTS: Six subjects in the fingertip group (13.2%) and one subject in the palm group (2.2%) were dropped because of pain. A(1C) level of all subjects at 24-week was decreased more in the fingertip (-0.23%) and palm (-0.16%) groups than that in the no SMBG group (+0.31%) (p < 0.05). SMBG compliance was higher in the fingertip group (2.17 times/day) than that in the palm group (1.65 times/day) (p < 0.05). A(1C) level of treatment-unchanged subjects was decreased more in the fingertip (-0.25%) and palm (-0.21%) groups than that in the no SMBG group (+0.30%) (p < 0.05). SMBG compliance was higher in the fingertip group (2.24 times/day) than that in the palm group (1.65 times/day) (p < 0.05). Patient's questionnaire showed that 84.1% of the fingertip group and 90.2% of the palm group were satisfied with SMBG. Physician's satisfaction was higher in the palm group (94.0%) than that in the fingertip group (80.0%) (p < 0.05). CONCLUSION: SMBG is beneficial for glycaemic control, and palm blood sampling is a useful procedure for oral hypoglycaemic agent-treated type 2 diabetes. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Collision-induced dissociation (CID) patterns of the phosphine-protected Au-based clusters [PdAu 8 (PPh 3 ) 8 ] 2+ ( PdAu8 ) and [Au 9 (PPh 3 ) 8 ] 3+ ( Au9 ), featuring crown-shaped M@Au 8 (M = Pd, Au) cores, were investigated. For PdAu8 , ordinary sequential PPh 3 losses ( PdAu8 → [PdAu 8 (PPh 3 ) m ] 2+ + (8 - m )PPh 3 ( m = 7, 6, 5)) were observed. In contrast, Au9 underwent cluster-core fission ( Au9 → [Au 6 (PPh 3 ) 6 ] 2+ ( Au6 ) + [Au 3 (PPh 3 ) 2 ] + ( Au3 )) upon sufficiently high energy collision, associated with splitting the number of valence electrons in the superatomic orbitals from 6e ( Au9 ) into 4e ( Au6 ) and 2e ( Au3 ). Density functional theory calculations revealed oblate and prolate cores of Au9 and Au6 with semiclosed superatomic electron configurations of (1S) 2 (1P x ) 2 (1P y ) 2 and (1S) 2 (1P z ) 2 , respectively. This result indicated a significant deformation of the cluster-core motif during the CID process. We attribute the clear difference between PdAu8 and Au9 to the softer Au-Au bond in Au9 and propose that the collision-induced structural deformation plays a critical role in the fission.

Objective: The management of diabetes mellitus includes controlling the blood glucose level, body weight, blood pressure and serum lipid level. The coexistence of diabetes and a high low-density lipoprotein cholesterol (LDL-C) level promotes atherosclerosis of the coronary arteries and increases the risk of coronary artery disease (CAD). We compared the rates of attainment of LDL-C goals in type 2 diabetes patients receiving primary and secondary prevention therapy, the former without a history of CAD and the latter with a history of CAD. Because patients receiving secondary prevention are at greater risk of coronary events, LDL-C management is especially important in this group. This study was designed to determine how frequently diabetic patients attain their LDL-C goals and identify the reasons for the lack of attainment., Methods: The groups were distinguished according to the patients' medical records. Contributory factors for the patients not achieving their goals were recorded in a questionnaire filled out by each patient's physician., Results: The overall attainment rate in both groups was 61%. The most frequent impediment in both groups was "an LDL-C level above or below the goal at every hospital visit" followed by "continuously sufficient effects of dietary therapy only" and the "management of LDL-C by other departments or hospitals," the latter reflecting the increasing problems of polydisease and polypharmacy in diabetes care., Conclusion: Polydisease and polypharmacy issues in diabetes patients with a history of CAD constitute a growing barrier to medication adherence and the attainment of treatment goals.

Quantum sieving of activated carbon fibers (ACFs) and their fluorides was observed for H(2) and D(2) adsorption at 20 K. Fluorination reduced the slit-shaped pore width of ACFs by 0.2 nm. The activated carbon fibers can act as highly efficient quantum sieves for H(2) and D(2), because the effective size of an H(2) molecule is larger than that of a D(2) molecule due to the uncertainty principle and the molecular size difference between H(2) and D(2) is significant in the micropore space. The D(2)/H(2) selectivity of ACFs evaluated by ideal adsorption solution theory was larger than that of the fluorinated ACFs.

The aims of this study were to examine levels of the crosslinking components of collagen, pyridinoline (Pyr) and deoxypyridinoline (D-Pyr) which are bone resorption markers, in patients with rheumatoid arthritis (RA), and to determine their association with disease activity and bone mineral density (BMD). These bone resorption markers were measured in 35 postmenopausal women with RA, 30 age-matched female patients with osteoarthritis of the knee (controls), and 47 patients with bone fracture. The mean BMD in the RA patients was lower than that in the control group, and the Z-score (number of standard deviations above and below the normal mean after comparison with age and sex matched normal control values) was significantly lower. Mean levels of Pyr and D-Pyr were significantly higher in the RA patients than in the control group, and the Pyr/D-Pyr ratio was also higher in the RA patients than in the other groups. Regarding the relationship between the bone resorption markers and RA activity, Pyr increased as the Lansbury's joint score (number of swollen joints corrected for joint size according Lansbury) rose, showing a normal correlation; D-Pyr also showed a normal correlation. Pyr and D-Pyr were high in patients with a high erythrocyte sedimentation rate, showing a normal correlation. Only Pyr increased with increases in C-reactive protein (CRP), showing a normal correlation. These findings suggested that a high value for Pyr (which includes a large amount of collagen type II) indicated that RA activity was affected more by synovitis, rather than by systemic osteoporosis.

The in vivo and in vitro drug release profiles from a self-setting bioactive CaO-SiO2-P2O5 glass bone cement containing indomethacin as a model drug were investigated. The cement containing 2% and 5% indomethacin (IMC) powder hardened within 5 min after mixing with ammonium phosphate buffer. After setting, in vitro drug release from drug-loaded cement pellets in a simulated body fluid (SBF) at pH 7.25 and 37 degrees C continued for two weeks. The hardened cement gradually formed low-crystallinity hydroxyapatite during the drug release test in SBF. An IMC-loaded cement device (2% and 5% drug) was implanted in the subcutaneous tissue on the back of rats. The in vivo IMC release from the cement increased and attained maximum levels (Cmax of 2% and 5% drug-loaded cements was 0.27 and 3.37 micrograms/ml, respectively) at Tmax, 3 and 0.5 d, respectively, upon subcutaneous (s.c.) administration in rats. This suggested that the s.c. administration of the cement provided IMC release for a much longer period than s.c. administration of the solution, and the plasma IMC concentration was dependent on the drug concentration in the cement. The plasma IMC concentration and the area under the curve from 2% and 5% IMC-loaded cements in rats were dependent on the concentration of IMC in the cements. The in vivo IMC concentration in plasma obtained by the deconvolution method was much lower than that delivered in SBF in vitro. Scanning electron microscopy and photomicrographs of cross sections showed that the bioactive bone cement had excellent biocompatibility with the surrounding soft tissues.

The use of self-setting bioactive calcium phosphate cement containing indomethacin as a model drug in bovine bone was investigated by means of an in vitro drug release test, mercury porosimetry, and scanning electron microscopy (SEM). Calcium phosphate cements containing 2 and 5% indomethacin after being mixed with dilute phosphoric acid were applied to defect sites and the medullary cavity of bovine bone and transformed into hydroxyapatite. The in vitro drug release from the cement loaded on the defect site into a simulated body fluid (SBF) containing 2.5 mM Ca2+ and 1.0 mM HPO4(2+) or 0.1 M phosphate buffer at pH 7.25 and 37 degrees C continued for more than 3 weeks. The release profiles of the drug-loaded cements in phosphate buffer were linear using the Higuchi plot; however, that was not the case for SBF. The drug release in SBF was much lower than that in phosphate buffer. The total pore volume of the cement after the drug release test in SBF was lower than its initial value. However, the pore size of 0.1-0.01 microns after drug release in phosphate buffer was higher than that seen in SBF. The micropore distribution results suggested that hydroxyapatite crystallized from SBF and the pore volume in the cement decreased after drug release. However, in phosphate buffer it appeared to dissolve. The SEM observations for cements loaded on the bone after drug release in phosphate buffer suggested that there was a boundary layer between the cement and natural bone, but this was not the case in SBF, where the cement bonded with the natural bone. The drug release rates from the cement-loaded bone were significantly higher than those from cement loaded on the dissolution holder. The results suggested that cement formation and drug release were affected by the presence of protein from natural bone. The drug release rates from the cement loaded on the defective bone were slower than those from the medullary cavity.