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JOHN J. CAI, 1 DONALD A. MORGAN, 1 WILLIAM G. HAYNES, 1 JAMES B. MARTINS, 1 AND HON-CHI LEE2 1 Department of Internal Medicine, University of Iowa College of Medicine, and Veterans Administration Medical Center, Iowa City, Iowa 52242; and 2 Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905
Between January 1997 and January 1999, 313 patients undergoing kidney transplantation in the university hospitals of Rotterdam, Utrecht, and Nijmegen in the Netherlands entered a study that evaluated the cyclosporine-sparing effect of MMF in the first 6 mo after transplantation, the results of which have been published in this journal 7 ; . After completion of 6 mo follow-up, 212 68% ; of 313 of these patients were enrolled and randomized to participate in this subsequent multicenter, open-label trial of CsA or Pred withdrawal. During the first 6 mo after transplantation, 22 patients had lost their graft and 8 patients died with a functioning graft. Excluded from randomization were patients with two or more acute rejections during the first 6 mo after transplantation n 15 ; , patients with biopsyproven chronic vascular rejection n 3 ; , patients with proteinuria of more than 3 g d patients with an unstable graft function n 9 ; , and patients not treated with triple drug therapy MMF, CsA, Pred ; at the time of randomization n 29 ; . the time of randomization, seven patients refused to participate in the study. In five cases, the treating physician decided not to ask the patient for participation because of multiple HLA-mismatches, previous severe acute rejection, or liver function disturbances. One patient was lost to follow-up before randomization. The study design was approved by the institutional review boards of the three participating hospitals, and written informed consent was obtained from all participants and thiamin.
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ASSESSING GERIATRIC PERCEPTION OF EXUBERA, AN INHALED INSULIN. Margaret M. Wolf * , Michael J. Rush, Tracy D. Carlson, Kelly M. Shields, Karen L. Kier Physicians Inc., 750 W. High St., Suite 250, Lima, OH, 45801 MaggieMWolf gmail Objective: Many patients are reluctant to initiate insulin therapy. The purpose of this study is to assess whether there is a patient perceived stigma associated with insulin use in a community based geriatric population and if orally inhaled insulin shares the same psychological implications. Methodology: A survey was designed to assess patient perception of injected and inhaled insulin. The survey was developed in conjunction with clinical faculty members. The face validity of the survey was tested and a pilot test was performed. Patient demographics, as well as diabetes severity and previous medical management for diabetes were also included. The sample population includes non insulin dependent diabetic patients seen in the previous six months at a pharmacist-run diabetes clinic in an internal medicine office. Surveys will be completed in the office before a diabetes appointment. Survey questions will be analyzed for reliability using Cronbach's alpha. Survey responses will be analyzed using descriptive statistics. The survey outcome may allow a better understanding of geriatric perception of insulin and if inhaled insulin would be a viable treatment option in patients reluctant to start insulin therapy. Results to follow. Learning Objectives: Identify the barriers associated with insulin initiation. Discuss previous research with psychological insulin resistance. Self Assessment Questions: T F 75% of patients have a fear of daily injections. List the seven areas of psychological insulin resistance.
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Independent of the inhibition of protein and lipid glycosylation. Biochem J, 374, 307-314. Mizukami, H., Mi, Y., Wada, R., Kono, M., Yamashita, T., Liu, Y., Werth, N., Sandhoff, R., Sandhoff, K. and Proia, R.L. 2002 ; Systemic inflammation in glucocerebrosidase-deficient mice with minimal glucosylceramide storage. J Clin Invest, 109, 1215-1221. Morjani, H., Aouali, N., Belhoussine, R., Veldman, R.J., Levade, T. and Manfait, M. 2001 ; Elevation of glucosylceramide in multidrug-resistant cancer cells and accumulation in cytoplasmic droplets. Int J Cancer, 94, 157165. Norflus, F., Tifft, C.J., McDonald, M.P., Goldstein, G., Crawley, J.N., Hoffmann, A., Sandhoff, K., Suzuki, K. and Proia, R.L. 1998 ; Bone marrow transplantation prolongs life span and ameliorates neurologic manifestations in Sandhoff disease mice. J Clin Invest, 101, 1881-1888. Norris-Cervetto, E., Callaghan, R., Platt, F.M., Dwek, R.A. and Butters, T.D. 2004 ; Inhibition of glucosylceramide synthase does not reverse drug resistance in cancer cells. J Biol Chem, 279, 40412-40418. Pastores, G.M. and Barnett, N.L. 2003 ; Substrate reduction therapy: miglustat as a remedy for symptomatic patients with Gaucher disease type 1. Expert Opin. Investig. Drugs, 12, 273-281. Platt, F.M. and Butters, T.D. 1998 ; New therapeutic prospects for the glycosphingolipid lysosomal storage diseases. Biochem Pharmacol, 56, 421430. Platt, F.M., Jeyakumar, M., Andersson, U., Heare, T., Dwek, R.A. and Butters, T.D. 2003 ; Substrate reduction therapy in mouse models of the glycosphingolipidoses. Philos Trans R Soc Lond B Biol Sci, 358, 947-954. Platt, F.M., Neises, G.R., Dwek, R.A. and Butters, T.D. 1994a ; NButyldeoxynojirimycin Is a Novel Inhibitor of Glycolipid Biosynthesis. J Biol Chem, 269, 8362-8365. Platt, F.M., Neises, G.R., Karlsson, G.B., Dwek, R.A. and Butters, T.D. 1994b ; N-butyldeoxygalactonojirimycin inhibits glycolipid biosynthesis but does not affect N-linked oligosaccharide processing. J Biol Chem, 269, 27108-27114. Platt, F.M., Neises, G.R., Reinkensmeier, G., Townsend, M.J., Perry, V.H., Proia, R.L., Winchester, B., Dwek, R.A. and Butters, T.D. 1997 ; Prevention of.
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18. KACHI, S.; ISHIH, A. & TERADA, M. - Effects of PF1022A on adult Angiostrongylus cantonensis in the pulmonary arteries and larvae migrating into the central nervous system of rats. Parasit. Res., 81: 631-637, 1995. KACHI, S.; TERADA, M. & HASHIMOTO, H. - Influence of PF1022A on the motility of Angiostrongylus cantonensis in vitro. Parasit. Res., 83: 578-582, 1997. KACHI, S.; TERADA, M. & HASHIMOTO, H. - Effects of amorphous and polymorphs of PF1022A, a new antinematode drug, on Angiostrongylus costaricensis in mice. Jap. J. Pharmacol., 77: 235-245, 1998. KAMATH, V.R.; MENON, S.; BHOPALE, M.K.; DESHPANDE, V.R. & RENAPURKAR, D.M. - Experimental chemotherapy of Angiostrongylus cantonensis infection in mice with flubendazole, levamisole and their combination. Folia Parasit. Praha ; , 34: 87-92, 1987. KAMATH, V.R.; MENON, S. & RENAPURKAR, D.M. - Larvicidal effect of perbendazole on experimental infection of Angiostrongylus cantonensis in mice. Chemotherapy, 33: 445-447, 1987. KANDA, S. & MAKI, J. - In vitro observation on egg release by Angiostrongylus cantonensis from rats treated with flubendazole. Kitasato Arch. exp. Med., 65: 155-158, 1992. KASS, I.S.; WANG, C.C.; WALROND, J.P. & STRETTON, A.O. - Avermectin B1a paralyzing anthelmintic that affects interneurons and inhibitory motoneurons in Ascaris. Proc. nat. Acad. Sci. Wash. ; , 77: 6211-6215, 1980. LAMBERTUCCI, J.R.; MODHA, J.; CURTIS, R. & DOENHOFF, M. - The association of steroids and schistosomicides in the treatment of experimental schistosomiasis. Trans. roy. Soc. trop. Med. Hyg., 83: 354-357, 1989. LEE, H.H. & TERADA, M. - In vitro effects of milbemycin oxime: mechanism of action against Angiostrongylus cantonensis and Dirofilaria immitis. Parasit. Res., 78: 349353, 1992. MAKI, J. & KANDA, S. - Higher sensitivity of the developing larvae of Angiostrongylus cantonensis than the adult worms to flubendazole and mebendazole. Kitasato Arch. exp. Med., 65: 131-136, 1992. MAKI, J. & YANAGISAWA, T. - A comparison of the effects of flubendazole and thiabendazole on the larvae of Angiostrongylus cantonensis, Trichinella spirallis, Diphyllobothrium erinacei and Hymenolepis nana in mice. Parasitology, 87: 525531, 1983. MAKI, J. & YANAGISAWA, T. - Larvicidal effect of flubendazole on Angiostrongylus cantonensis in mice with various worm burdens. J. Helminth., 59: 301-302, 1985. MAKI, J. & YANAGISAWA, T. - Studies on anthelmintic effects of flubendazole and mebendazole on the rat lungworm Angiostrongylus cantonensis in mice and rats. J. Parasit., 72: 512-516, 1986. MAKI, J. & YANAGISAWA, T. - Effect of flubendazole on the number of first-stage larvae of Angiostrongylus cantonensis released in the faeces of treated rats. J. Helminth., 64: 87-95, 1990. MORERA, P. & CSPEDES, R. Angiostrongilosis abdominal. Una nueva parasitosis humana. Acta md. costarric., 14: 159-173, 1971. MORERA, P. & BONTEMPO, I. - Accin de algunos antihelmnticos sobre Angiostrongylus costaricensis. Rev. md. Hosp. nac. Nins Costa Rica ; , 20: 165174, 1985. MORERA, P. - Angiostrongilase abdominal. Um problema de Sade Pblica? Rev. Soc. bras. Med. trop., 21: 81-83, 1988. PAUL, S.M.; SKOLNICK, P. & ZATZ, M. - Avermectin B1a: an irreversible activator of the gamma-aminobutyric receptor complex. Biochem. biophys. Res. Commun., 96: 632-638, 1980 and ting.
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