25 resultados para Continuous glucose monitoring

em Repositório Institucional UNESP - Universidade Estadual Paulista "Julio de Mesquita Filho"


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Exenatide extended-release (ER) is a microencapsulated formulation of the glucagon-like peptide 1-receptor agonist exenatide: It has a protracted pharmacokinetic profile that allows a once-weekly injection with comparable efficacy to insulin with an improved safety profile in type II diabetic people. Here, we studied the pharmacology of exenatide ER in 6 healthy cats. A single subcutaneous injection of exenatide ER (0.13 mg/kg) was administered on day 0. Exenatide concentrations were measured for 12 wk. A hyperglycemic clamp (target = 225 mg/dL) was performed on days 7 (clamp I) and 21 (clamp II) with measurements of insulin and glucagon concentrations. Glucose tolerance was defined as the amount of glucose required to maintain hyperglycemia during the clamp. Continuous glucose monitoring was performed on weeks 0, 2, and 6 after injection. Plasma concentrations of exenatide peaked at 1 h and 4 wk after injection. Comparing clamp I with clamp II, fasting blood glucose decreased (mean standard deviation = 11 8 mg/dL, P = 0.02), glucose tolerance improved (median [range] +33% 14%-138%], P = 0.04), insulin concentrations increased (+36.5% [-9.9% to 274.1%], P = 0.02), and glucagon concentrations decreased (-4.7% [0%-12.1%], P = 0.005). Compared with preinjection values on continuous glucose monitoring, glucose concentrations decreased and the frequency of readings <50 mg/dL increased at 2 and 6 wk after injection of exenatide ER. This did not correspond to clinical hypoglycemia. No other side effects were observed throughout the study. Exenatide ER was safe and effective in improving glucose tolerance 3 wk after a single injection. Further evaluation is needed to determine its safety, efficacy, and duration of action in diabetic cats. (C) 2015 Elsevier Inc. All rights reserved.

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The assessment of welfare issues has been a challenge for poultry producers, and lately welfare standards needs to be reached in order to agree with international market demand. This research proposes the use of continuous behavior monitoring in order to contribute for assessing welfare. A software was developed using the language Clarium. The software managed the recording of data as well as the data searching in the database Firebird. Both software and the observational methodology were tested in a trial conducted inside an environmental chamber, using three genetics of broiler breeders. Behavioral pattern was recorded and correlated to ambient thermal and aerial variation. Monitoring video cameras were placed on the roof facing the used for registering the bird's behavior. From video camera images were recorded during the total period when the ambient was bright, and for analyzing the video images a sample of 15min observation in the morning and 15 min in the afternoon was used, adding up to 30 min daily observation. A specific model so-called behavior was developed inside the software for counting specific behavior and its frequency of occurrence, as well as its duration. Electronic identification was recorded for 24h period. Behavioral video recording images was related to the data recorded using electronic identification.. Statistical analysis of data allowed to identify behavioral differences related to the change in thermal environment, and ultimately indicating thermal stress and departure from welfare conditions.

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A prática do karatê pode promover adaptações benéficas sobre os componentes da aptidão física relacionada com a saúde. Dentre esses componentes, o consumo máximo de oxigênio (VO2max) é um importante indicador de aptidão cardiorrespiratória, como também forte preditor de risco de morte por doença cardiovascular. Estudos anteriores avaliaram as respostas da Frequência Cardíaca na modalidade de karatê durante protocolos elaborados pelos pesquisadores que simularam o treinamento. No entanto, esses resultados devem ser interpretados com cautela, uma vez que protocolos podem comprometer a validade ecológica do comportamento da FC. Dessa forma, o objetivo deste estudo foi, através do monitoramento da FC, investigar a distribuição da intensidade durante uma sessão de treinamento de karatê (ST) com a validade ecológica preservada. Nove atletas (M (DP) = 22 (5,2) anos; 60,3 (12,9) kg; 170,0 (0,10) cm; 11,6 (5,7) % gordura) realizaram teste incremental máximo (T I) e uma ST, com monitoramento contínuo da FC, distribuída posteriormente conforme método proposto por Edwards. O tempo médio de duração da ST foi de 91,3 (11,9) minutos (IC95% = 82,0 - 100,5). Os valores de FC média e máxima da ST foram equivalentes a 72% (IC95% = 66-78%) e 94% (IC95% = 89-99%) da FC máxima alcançada durante T I (FCmax), respectivamente. Durante 79,9% (IC95% = 65,7-94,1%) do tempo total da ST, os karatecas permaneceram em uma intensidade superior a 60% da FCmax. Deste modo, conclui-se que a intensidade da ST de karatê atende às recomendações do ACSM com relação à intensidade, duração e frequência semanal, apresentando-se como uma interessante alternativa de exercícios físicos para promoção da aptidão cardiorrespiratória.

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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

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Insulin resistance is a common risk factor in chronic kidney disease patients contributing to the high cardiovascular burden, even in the absence of diabetes. Glucose-based peritoneal dialysis (PD) solutions are thought to intensify insulin resistance due to the continuous glucose absorption from the peritoneal cavity. The aim of our study was to analyse the effect of the substitution of glucose for icodextrin on insulin resistance in non-diabetic PD patients in a multicentric randomized clinical trial. This was a multicenter, open-label study with balanced randomization (1:1) and two parallel-groups. Inclusion criteria were non-diabetic adult patients on automated peritoneal dialysis (APD) for at least 3 months on therapy prior to randomization. Patients assigned to the intervention group were treated with 2L of icodextrin 7.5%, and the control group with glucose 2.5% during the long dwell and, at night in the cycler, with a prescription of standard glucose-based PD solution only in both groups. The primary end-point was the change in insulin resistance measured by homeostatic model assessment (HOMA) index at 90 days. Sixty patients were included in the intervention (n = 33) or the control (n = 27) groups. There was no difference between groups at baseline. After adjustment for pre-intervention HOMA index levels, the group treated with icodextrin had the lower post-intervention levels at 90 days in both intention to treat [1.49 (95% CI: 1.23-1.74) versus 1.89 (95% CI: 1.62-2.17)], (F = 4.643, P = 0.03, partial η(2) = 0.078); and the treated analysis [1.47 (95% CI: 1.01-1.84) versus 2.18 (95% CI: 1.81-2.55)], (F = 7.488, P = 0.01, partial η(2) = 0.195). The substitution of glucose for icodextrin for the long dwell improved insulin resistance measured by HOMA index in non-diabetic APD patients.

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Different procedures for obtaining a needle biosensor for the determination of glucose to be inserted subcutaneously in vivo, have been compared. Platinum wires with a diameter of 75 mum, teflon-coated were inserted in hypodermic needles and fixed with a two-component epoxy resin. Using a dip-coating procedure, several layers were deposited on electrodes. The first coating was cellulose acetate, the second was immobilized glucose oxidase (GOD) mixed with bovine serum albumin (BSA) and glutaraldheyde, the third coating was a polyurethane coating obtained with commercially available products. A large number of electrodes have been tried and statistically evaluated but they seem to be affected by poor reproducibility evidenced by a large spreading in successive calibration curves. Then, the polyurethane coating has been replaced by a thin polycarbonate membrane salinized and fixed on the tip of the needle. Reproducible results were achieved and first results of in vivo measurements on rabbits are reported.

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Objective: HIV infection is exacerbated through additional pro-atherogenic mechanisms related to the processes of immune activation, inflammation, coagulation, and the modification of lipoproteins (e.g., particles of high density lipoprotein), contributing to increased cardiovascular risk. The aim of this study was to analyze the serum concentrations of myeloperoxidase (MPO) and other laboratory parameters in HIV-infected patients treated or not with antiretroviral drugs compared to non-infected individuals.Materials/Methods: The study included 154 volunteers: 47 non-infected individuals (control group - CON), 27 infected and untreated individuals (NTARv group) and 80 treated individuals (TARV group). We analyzed the counts of CD4+ lymphocytes and the viral load of the infected patients, along with the blood count, fasting glucose, total serum cholesterol (CHOL), HDL cholesterol, LDL cholesterol, triglycerides, MPO and high-sensitivity C-reactive protein (CRP) of all study participants.Results: There were significant increases in glucose, CHOL, LDL cholesterol, and triglycerides in the TARV group and significant reductions in the levels of HDL cholesterol for the TARV and NTARV groups. Significantly elevated levels of Hs-CRP were observed only in the TARV group, while levels of MPO were significantly higher in the TARV and NTARV groups compared to the control group. A correlation of MPO with Hs-CRP (r = 0.21, p = 0.032) was observed for HIV-infected patients, but MPO did not correlate significantly with the other analyzed parameters.Conclusions: The investigation of early biomarkers for cardiovascular risk evaluation, such as MPO, contributes to the clinical monitoring of HIV-infected individuals. The serum levels of MPO correlated with Hs-CRP and were high in HIV-infected individuals, indicating a possible predictor of cardiovascular events in these patients. (c) 2012 Elsevier B.V. All rights reserved.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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To investigate the feasibility and validity of sampling blood from the carpal pad in hospitalised healthy and diabetic dogs. METHODS The carpal pad was compared to the ear as a sampling site in 60 dogs (30 healthy and 30 diabetic dogs). RESULTS Lancing the pads was very well tolerated. The average glucose concentrations in blood samples obtained from the ears and carpal pads exhibited a strong positive correlation (r = 0.938) and there were no significant differences between them (P = 0.914). In addition, 98.3% of the values obtained were clinically acceptable when assessed by the error grid analysis. CLINICAL SIGNIFICANCE The carpal pad is a good alternative sampling site for home monitoring, especially in animals with a soft and/or light-coloured pad.

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The objective of this work is to introduce and demonstrate the technical feasibility of the continuous flash fermentation for the production of butanol. The evaluation was carried out through mathematical modeling and computer simulation which is a good approach in such a process development stage. The process consists of three interconnected units, as follows: the fermentor, the cell retention system (tangential microfiltration) and the vacuum flash vessel (responsible for the continuous recovery of butanol from the broth). The efficiency of this process was experimentally validated for the ethanol fermentation, whose main results are also shown. With the proposed design the concentration of butanol in the fermentor was lowered from 11.3 to 7.8 g/l, which represented a significant reduction in the inhibitory effect. As a result, the final concentration of butanol was 28.2 g/l for a broth with 140 g/l of glucose. Solvents productivity and yield were, respectively, 11.7 g/l.h and 33.5 % for a sugar conversion of 95.6 %. Positive aspects about the flash fermentation process are the solvents productivity, the use of concentrated sugar solution and the final butanol concentration. The last two features can be responsible for a meaningful reduction in the distillation costs and result in environmental benefits due to lower quantities of wastewater generated by the process. © 2008 Berkeley Electronic Press. All rights reserved.

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Although glucocorticoids are widely used as antiinflammatory agents in clinical therapies, they may cause serious side effects that include insulin resistance and hyperinsulinemia. To study the potential functional adaptations of the islet of Langerhans to in vivo glucocorticoid treatment, adult Wistar rats received dexamethasone (DEX) for 5 consecutive days, whereas controls (CTL) received only saline. The analysis of insulin release in freshly isolated islets showed an enhanced secretion in response to glucose in DEX-treated rats. The study of Ca2 2+ signals by fluorescence microscopy also demonstrated a higher response to glucose in islets from DEX-treated animals. However, no differences in Ca2 2+signals were found between both groups with tolbutamide or KCl, indicating that the alterations were probably related to metabolism. Thus, mitochondrial function was explored by monitoring oxidation of nicotinamide dinucleotide phosphate autofluorescence and mitochondrial membrane potential. Both parameters revealed a higher response to glucose in islets from DEX-treated rats. The mRNA and protein content of glucose transporter-2, glucokinase, and pyruvate kinase was similar in both groups, indicating that changes in these proteins were probably not involved in the increased mitochondrial function. Additionally,weexplored the status of Ca2 2+-dependent signaling kinases. Unlike calmodulin kinase II, we found an augmented phosphorylation level of protein kinase Cα as well as an increased response of the phospholipase C/inositol 1,4,5-triphosphate pathway in DEX-treated rats. Finally, an increased number of docked secretory granules were observed in the β-cells of DEX animals using transmission electron microscopy. Thus, these results demonstrate that islets from glucocorticoid-treated rats develop several adaptations that lead to an enhanced stimulus-secretion coupling and secretory capacity. Copyright © 2010 by The Endocrine Society.