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3D visualization as a communicative aid in pharmaceutical advice-giving over distance.

https://arctichealth.org/en/permalink/ahliterature132831
Source
J Med Internet Res. 2011;13(3):e50
Publication Type
Article
Date
2011
Author
Ostlund M
Dahlbäck N
Petersson GI
Author Affiliation
eHealth Institute, Linnaeus University, Kalmar, Sweden. martin.ostlund@lnu.se
Source
J Med Internet Res. 2011;13(3):e50
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Diabetes Mellitus, Type 2 - drug therapy
Drug Interactions
Drug-Related Side Effects and Adverse Reactions
Female
Health Services Research
Humans
Imaging, Three-Dimensional - methods
Male
Middle Aged
Patient Education as Topic - methods
Pharmaceutical Services - utilization
Program Evaluation
Remote Consultation - methods
Sweden
Telemedicine - methods
Young Adult
Abstract
Medication misuse results in considerable problems for both patient and society. It is a complex problem with many contributing factors, including timely access to product information.
To investigate the value of 3-dimensional (3D) visualization paired with video conferencing as a tool for pharmaceutical advice over distance in terms of accessibility and ease of use for the advice seeker.
We created a Web-based communication service called AssistancePlus that allows an advisor to demonstrate the physical handling of a complex pharmaceutical product to an advice seeker with the aid of 3D visualization and audio/video conferencing. AssistancePlus was tested in 2 separate user studies performed in a usability lab, under realistic settings and emulating a real usage situation. In the first study, 10 pharmacy students were assisted by 2 advisors from the Swedish National Co-operation of Pharmacies' call centre on the use of an asthma inhaler. The student-advisor interview sessions were filmed on video to qualitatively explore their experience of giving and receiving advice with the aid of 3D visualization. In the second study, 3 advisors from the same call centre instructed 23 participants recruited from the general public on the use of 2 products: (1) an insulin injection pen, and (2) a growth hormone injection syringe. First, participants received advice on one product in an audio-recorded telephone call and for the other product in a video-recorded AssistancePlus session (product order balanced). In conjunction with the AssistancePlus session, participants answered a questionnaire regarding accessibility, perceived expressiveness, and general usefulness of 3D visualization for advice-giving over distance compared with the telephone and were given a short interview focusing on their experience of the 3D features.
In both studies, participants found the AssistancePlus service helpful in providing clear and exact instructions. In the second study, directly comparing AssistancePlus and the telephone, AssistancePlus was judged positively for ease of communication (P = .001), personal contact (P = .001), explanatory power (P
Notes
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PubMed ID
21771714 View in PubMed
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Acarbose for the treatment of type II diabetes: the results of a Canadian multi-centre trial.

https://arctichealth.org/en/permalink/ahliterature214600
Source
Diabetes Res Clin Pract. 1995 Aug;28 Suppl:S167-72
Publication Type
Article
Date
Aug-1995
Author
R G Josse
Author Affiliation
Division of Endocrinology and Metabolism, St. Michael's Hospital, University of Toronto, Ontario, Canada.
Source
Diabetes Res Clin Pract. 1995 Aug;28 Suppl:S167-72
Date
Aug-1995
Language
English
Publication Type
Article
Keywords
Acarbose
Blood Glucose - drug effects - metabolism
Canada
Diabetes Mellitus, Type 2 - drug therapy
Diabetic diet
Female
Hemoglobin A, Glycosylated - analysis
Humans
Hypoglycemic agents - therapeutic use
Insulin - therapeutic use
Male
Metformin - therapeutic use
Middle Aged
Placebos
Sulfonylurea Compounds - therapeutic use
Time Factors
Trisaccharides - therapeutic use
Abstract
The treatment of Type II diabetes (NIDDM) includes an appropriate diet and prudent exercise program. If these measures are insufficient to control the blood sugar, oral agents (sulphonylureas or biguanides) or insulin are added to the therapeutic regimen. Although the diet prescription has undergone some changes and refinements, this approach has been the traditional treatment for NIDDM for nearly 40 years. Recently a new class of oral agents, the alpha-glucosidase inhibitors, has become available. These drugs are competitive inhibitors of the alpha-glucosidase enzymes in the brush border of the bowel wall. They act to slow and delay the rate of carbohydrate absorption, thereby decreasing postprandial hyperglycemia. A recent study was designed to evaluate the long-term efficacy of acarbose, an alpha-glucosidase inhibitor, in improving the glycemic control of patients with NIDDM who were sub-optimally controlled on either diet alone, or diet plus sulphonylurea, metformin or insulin. A total of 354 patients with NIDDM were studied, 77 on diet alone, 83 on metformin, 103 and sulphonylurea and 91 on insulin. Subjects in each treatment stratum were randomized, double-blind to either acarbose or placebo, for 1 year. At baseline and every 3 months thereafter, fasting and postprandial glucose and C-peptide, HbA1c and fasting lipids were measured. Compared to placebo, acarbose treatment resulted in a decrease in mean postprandial glucose in all four strata (19 +/- 0.8 to 15.3 +/- 0.7 mmol/l: P
Notes
Erratum In: Diabetes Res Clin Pract 1995 Sep;29(3):215
PubMed ID
8529510 View in PubMed
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Activation of PPARgamma by metabolites from the flowers of purple coneflower (Echinacea purpurea).

https://arctichealth.org/en/permalink/ahliterature99024
Source
J Nat Prod. 2009 May 22;72(5):933-7
Publication Type
Article
Date
May-22-2009
Author
Kathrine B Christensen
Rasmus K Petersen
Sidsel Petersen
Karsten Kristiansen
Lars P Christensen
Author Affiliation
Department of Food Science, University of Aarhus, Kirstinebjergvej 10, 5792 Aarslev, Denmark. kbch@kbm.sdu.dk
Source
J Nat Prod. 2009 May 22;72(5):933-7
Date
May-22-2009
Language
English
Publication Type
Article
Keywords
3T3-L1 Cells
Animals
Denmark
Diabetes Mellitus, Type 2 - drug therapy
Echinacea - chemistry
Fatty Acids, Unsaturated - chemistry - isolation & purification - pharmacology
Flowers - chemistry
Glucose - metabolism
Insulin Resistance - physiology
Mice
PPAR gamma - drug effects - metabolism
Plants, Medicinal - chemistry
Abstract
Thiazolidinediones are insulin sensitizing drugs that target the peroxisome proliferator-activated receptor (PPAR) gamma. An n-hexane extract of the flowers of Echinacea purpurea was found to activate PPARgamma without stimulating adipocyte differentiation. Bioassay-guided fractionations yielded five alkamides, of which one was new, and three fatty acids that all activated PPARgamma. The new alkamide hexadeca-2E,9Z,12Z,14E-tetraenoic acid isobutylamide (5) was identified by analysis of spectroscopic data and found to activate PPARgamma with no concurrent stimulation of adipocyte differentiation. Compound 5 was further shown to increase insulin-stimulated glucose uptake. The data suggest that flowers of E. purpurea contain compounds with potential to manage insulin resistance and type 2 diabetes.
PubMed ID
19374389 View in PubMed
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Adipogenic constituents from the bark of Larix laricina du Roi (K. Koch; Pinaceae), an important medicinal plant used traditionally by the Cree of Eeyou Istchee (Quebec, Canada) for the treatment of type 2 diabetes symptoms.

https://arctichealth.org/en/permalink/ahliterature124851
Source
J Ethnopharmacol. 2012 Jun 14;141(3):1051-7
Publication Type
Article
Date
Jun-14-2012
Author
Nan Shang
José A Guerrero-Analco
Lina Musallam
Ammar Saleem
Asim Muhammad
Brendan Walshe-Roussel
Alain Cuerrier
John T Arnason
Pierre S Haddad
Author Affiliation
Natural Health Products and Metabolic Disease Laboratory, Department of Pharmacology, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada.
Source
J Ethnopharmacol. 2012 Jun 14;141(3):1051-7
Date
Jun-14-2012
Language
English
Publication Type
Article
Keywords
3T3-L1 Cells
Adipogenesis - drug effects
Animals
Diabetes Mellitus, Type 2 - drug therapy
Humans
Hypoglycemic Agents - analysis - pharmacology
Indians, North American
Larix
Medicine, Traditional
Mice
Plant Bark - chemistry
Plant Extracts - analysis - pharmacology
Plants, Medicinal
Quebec
Triterpenes - analysis - pharmacology
Abstract
Diabetes is a growing epidemic worldwide, especially among indigenous populations. Larix laricina was identified through an ethnobotanical survey as a traditional medicine used by Healers and Elders of the Cree of Eeyou Istchee of northern Quebec to treat symptoms of diabetes and subsequent in vitro screening confirmed its potential.
We used a bioassay-guided fractionation approach to isolate the active principles responsible for the adipogenic activity of the organic extract (80% EtOH) of the bark of Larix laricina. Post-confluent 3T3-L1 cells were differentiated in the presence or absence of the crude extract, fractions or isolates of Larix laricina for 7 days, then triglycerides content was measured using AdipoRed reagent.
We identified a new cycloartane triterpene (compound 1), which strongly enhanced adipogenesis in 3T3-L1 cells with an EC(50) of 7.7 µM. It is responsible for two thirds of the activity of the active fraction of Larix laricina. The structure of compound 1 was established on the basis of spectroscopic methods (IR, HREIMS, 1D and 2D NMR) as 23-oxo-3a-hydroxycycloart-24-en-26-oic acid. We also identified several known compounds, including three labdane-type diterpenes (compounds 2-4), two tetrahydrofuran-type lignans (compounds 5-6), three stilbenes (compounds 7-9), and taxifolin (compound 10). Compound 2 (13-epitorulosol) also potentiated adipogenesis (EC(50) 8.2 µM) and this is the first report of a biological activity for this compound.
This is the first report of putative antidiabetic principles isolated from Larix laricina, therefore increasing the interest in medicinal plants from the Cree pharmacopeia.
PubMed ID
22542642 View in PubMed
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[ADOPT study: which first-line glucose-lowering oral medication in type 2 diabetes?].

https://arctichealth.org/en/permalink/ahliterature164781
Source
Rev Med Liege. 2007 Jan;62(1):48-52
Publication Type
Article
Date
Jan-2007
Author
A J Scheen
Author Affiliation
Université de Liège, Belgique.
Source
Rev Med Liege. 2007 Jan;62(1):48-52
Date
Jan-2007
Language
French
Publication Type
Article
Keywords
Administration, Oral
Belgium
Canada
Cost-Benefit Analysis
Diabetes Mellitus, Type 2 - drug therapy - economics
Double-Blind Method
European Union
Glyburide - therapeutic use
Humans
Hypoglycemic agents - therapeutic use
Metformin - therapeutic use
Middle Aged
Quality of Life
Thiazolidinediones - therapeutic use
Treatment Outcome
United States
Abstract
ADOPT ("A Diabetes Outcome Progression Trial") is a double-blind, controlled clinical trial that aims at assessing the efficacy of rosiglitazone, as compared to metformin or glibenclamide, in maintaining long-term glycaemic control in patients with recently diagnosed type 2 diabetes. It randomized 4,360 patients who were followed for a median of 4.0 years. The cumulative incidence of monotherapy failure (defined as a confirmed level of fasting plasma glucose level of more than 180 mg/dl) averaged at 5 years 15% with rosiglitazone, 21% with metformin, and 34% with glibenclamide. This represents a risk reduction for rosiglitazone of 32% as compared to metformin and 63% as compared to glibenclamide (P
PubMed ID
17343130 View in PubMed
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Adverse cardiovascular events during treatment with glyburide (glibenclamide) or gliclazide in a high-risk population.

https://arctichealth.org/en/permalink/ahliterature121375
Source
Diabet Med. 2012 Dec;29(12):1524-8
Publication Type
Article
Date
Dec-2012
Author
D N Juurlink
T. Gomes
B R Shah
M M Mamdani
Author Affiliation
Department of Medicine, University of Toronto, Toronto, ON, Canada. dnj@ices.on.ca
Source
Diabet Med. 2012 Dec;29(12):1524-8
Date
Dec-2012
Language
English
Publication Type
Article
Keywords
Aged
Angioplasty, Balloon, Coronary - adverse effects
Cohort Studies
Diabetes Mellitus, Type 2 - drug therapy - mortality - physiopathology
Diabetic Angiopathies - drug therapy - mortality - physiopathology
Female
Follow-Up Studies
Gliclazide - administration & dosage - adverse effects
Glyburide - administration & dosage - adverse effects
Humans
Incidence
Ischemic Preconditioning
Male
Myocardial Infarction - drug therapy - mortality - physiopathology
Myocardium
Ontario - epidemiology
Risk factors
Sulfonylurea Compounds - administration & dosage - adverse effects
Treatment Outcome
Abstract
Sulphonylureas promote insulin release by inhibiting pancreatic potassium channels. Older sulphonylureas such as glyburide (glibenclamide), but not newer ones such as gliclazide, antagonize similar channels in myocardium, interfering with the protective effects of ischaemic preconditioning. Whether this imparts a higher risk of adverse cardiac events is unknown.
We conducted a population-based cohort study of patients aged 66 years and older who were hospitalized for acute myocardial infarction or who underwent percutaneous coronary intervention between 1 April 2007 and 31 March 2010 while receiving either glyburide or gliclazide. We used a high-dimensional propensity score matching process to ensure similarity of glyburide- and gliclazide-treated patients. The primary outcome was a composite of death or hospitalization for myocardial infarction or heart failure.
During the 2-year study period, we matched 1690 patients treated with glyburide to 984 patients treated with gliclazide at the time of hospitalization for acute myocardial infarction or percutaneous coronary intervention. We found no difference in the risk of the composite outcome among patients receiving glyburide (adjusted hazard ratio 1.01; 95% CI 0.86-1.18). We found similar results in secondary analyses of each outcome individually, and in two supplementary analyses (haemorrhage and pneumonia) in which we anticipated no difference between the two patient groups.
Among older patients hospitalized for acute myocardial infarction or percutaneous coronary intervention, treatment with glyburide is not associated with an increased risk of future adverse cardiovascular events relative to gliclazide, suggesting that the effect of glyburide on ischaemic preconditioning is of little clinical relevance.
PubMed ID
22913620 View in PubMed
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'Aiming for the stars'--GPs' dilemmas in the prevention of cardiovascular disease in type 2 diabetes patients: focus group interviews.

https://arctichealth.org/en/permalink/ahliterature90067
Source
Fam Pract. 2009 Apr;26(2):109-14
Publication Type
Article
Date
Apr-2009
Author
Fhärm Eva
Rolandsson Olov
Johansson Eva E
Author Affiliation
Family Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. eva.fharm@vll.se
Source
Fam Pract. 2009 Apr;26(2):109-14
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Cardiovascular Diseases - prevention & control
Combined Modality Therapy
Communication
Diabetes Complications - prevention & control
Diabetes Mellitus, Type 2 - drug therapy
Diabetic Angiopathies - prevention & control
Family Practice
Female
Focus Groups
Guideline Adherence
Humans
Life Style
Male
Physician's Role
Physician-Patient Relations
Sick Role
Sweden
Abstract
BACKGROUND: Studies have revealed low adherence to guidelines for treatment of diabetes and cardiovascular risk factors. OBJECTIVE: To explore GPs' experiences regarding treatment practice in type 2 diabetes with specific focus on the prevention of cardiovascular disease. METHODS: Fourteen experienced GPs from nine health care centres with group practices were interviewed in focus groups. The interviews were digitally recorded, transcribed verbatim and analysed by qualitative content analysis. RESULTS: The overall theme was 'dilemmas' in GPs' treatment practice for type 2 diabetes patients. Five main dilemma categories were identified. First, the GPs were hesitant about labelling someone who feels healthy as ill. Second, regarding communicating a diabetes diagnosis and its consequences; should the patient be frightened or comforted? Third, the GPs experienced uncertainty in their role; were they to take responsibility for the care or not? Fourth, the GPs expressed a conflict between lifestyle changes and drug treatment. Fifth, the GPs described difficulties in integrating science into reality. CONCLUSIONS: The five dilemmas in the GPs' approach to diabetes patients and the treatment of their cardiovascular risk were related to the GPs' professional role and communication with the patient. To consider these dilemmas in educational efforts is probably essential to achieve improved diabetes care and guideline adherence.
PubMed ID
19208737 View in PubMed
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[Alarming increase of the number of metformin intoxications. Ten times doubled number of inquiries to the Swedish Poison Information Center since 2000]

https://arctichealth.org/en/permalink/ahliterature88867
Source
Lakartidningen. 2009 Apr 1-7;106(14):994
Publication Type
Article

All-Cause and Cause-Specific Mortality among Users of Basal Insulins NPH, Detemir, and Glargine.

https://arctichealth.org/en/permalink/ahliterature275159
Source
PLoS One. 2016;11(3):e0151910
Publication Type
Article
Date
2016
Author
Arto Y Strandberg
Fabian J Hoti
Timo E Strandberg
Solomon Christopher
Jari Haukka
Pasi Korhonen
Source
PLoS One. 2016;11(3):e0151910
Date
2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cardiovascular Diseases - epidemiology - mortality
Cause of Death
Cohort Studies
Databases, Factual
Diabetes Mellitus, Type 2 - drug therapy
Female
Finland
Gastrointestinal Diseases - epidemiology - mortality
Humans
Hypoglycemic agents - therapeutic use
Insulin Glargine - therapeutic use
Insulin, Isophane - therapeutic use
Insulin, Long-Acting - therapeutic use
Male
Middle Aged
Neoplasms - epidemiology - mortality
Risk
Abstract
Insulin therapy in type 2 diabetes may increase mortality and cancer incidence, but the impact of different types of basal insulins on these endpoints is unclear. Compared to the traditional NPH insulin, the newer, longer-acting insulin analogues detemir and glargine have shown benefits in randomized controlled trials. Whether these advantages translate into lower mortality among users in real life is unknown.
To estimate the differences in all-cause and cause-specific mortality rates between new users of basal insulins in a population-based study in Finland.
23 751 individuals aged =40 with type 2 diabetes, who initiated basal insulin therapy in 2006-2009 were identified from national registers, with comprehensive data for mortality, causes of death, and background variables. Propensity score matching was performed on characteristics. Follow-up time was up to 4 years (median 1.7 years).
2078 deaths incurred. With NPH as reference, the adjusted HRs for all-cause mortality were 0.39 (95% CI, 0.30-0.50) for detemir, and 0.55 (95% CI, 0.44-0.69) for glargine. As compared to glargine, the HR was 0.71 (95% CI, 0.54-0.93) among detemir users. Compared to NPH, the mortality risk for both cardiovascular causes as well as cancer were also significantly lower for glargine, and especially for detemir in adjusted analysis. Furthermore, the results were robust in various sensitivity analyses.
In real clinical practice, mortality was substantially higher among users of NPH insulin as compared to insulins detemir or glargine. Considering the large number of patients who require insulin therapy, this difference in risk may have major clinical and public health implications. Due to limitations of the observational study design, further investigation using an interventional study design is warranted.
Notes
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PubMed ID
27031113 View in PubMed
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[Androgen metabolism in men with diabetes mellitus type II depending on sensitivity to insulin and androgens]

https://arctichealth.org/en/permalink/ahliterature90418
Source
Lik Sprava. 2008 Apr-Jun;(3-4):3-10
Publication Type
Article
Author
Korpacheva-Zinych O V
Savyts'ka V V
Source
Lik Sprava. 2008 Apr-Jun;(3-4):3-10
Language
Ukrainian
Publication Type
Article
Keywords
17-Ketosteroids - metabolism
Androgens - metabolism - secretion
Diabetes Mellitus, Type 2 - drug therapy - metabolism
Humans
Hypoglycemic agents - therapeutic use
Insulin Resistance
Male
Abstract
The article presents data on 17-ketosteroid excretion in patients with diabetes mellitus types II depending on age, sex and degree of diabetes mellitus compensation. It was established that 17-ketosteroid excretion and their fractions are considerably increased in men with diabetes mellitus types II in comparison with a control group and it is more evident in patients with insulin resistant diabetes mellitus. Obtained results showed possibility of the participation of changed steroid metabolism in pathogenesis of androgen disorders in aged male patients with diabetes mellitus types II depending on insulin sensitivity.
PubMed ID
19145814 View in PubMed
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161 records – page 1 of 17.