Diabet. Med. 27, 685–690 (2010)
Aim To explore the impact of sharing personalized written clinical information with diabetes outpatients on patient involvement in the clinical consultation.
Methods ...One hundred and six patients attending diabetes outpatient clinics for a review visit were allocated to receive either a patient information sheet containing personalized clinical information (prior to their consultation) or no information sheet. Both groups were compared by observing the number of patients raising any of the 17 topics included on the patient information sheet, the number of topics raised by each individual and the proportion of the total consultation time in which the patient was involved in conversation. A mean patient score was calculated by summing the number of topics raised by each patient.
Results Patients in the intervention group were more likely to initiate a conversation on all 17 topics during the consultation than those in the control group. These differences were significant for all topics except glycated haemoglobin (HbA1c) and diabetes complications. The mean patient score was significantly higher in the intervention group (5 vs. 1, P < 0.005), with the highest patient score in the intervention group being 14 compared with 4 in the control group. The mean patient conversation time for the intervention group was significantly longer than for the control group (6.34 vs. 3.34 min, P < 0.01). The overall consultation time did not significantly differ between groups.
Conclusions Providing patients with personalized clinical information in a routine clinical setting can increase patients’ involvement in the consultation without significantly increasing the length of the consultation.
Background and Purpose
Patients with irritable bowel syndrome suffer from chronic visceral pain (CVP) and limited analgesic therapeutic options are currently available. We have shown that α‐conotoxin ...Vc1.1 induced activation of GABAB receptors on the peripheral endings of colonic afferents and reduced nociceptive signalling from the viscera. However, the analgesic efficacy of more stable, cyclized versions of Vc1.1 on CVP remains to be determined.
Experimental Approach
Using ex vivo colonic afferent preparations from mice, we determined the inhibitory actions of cyclized Vc1.1 (cVc1.1) and two cVc1.1 analogues on mouse colonic nociceptors in healthy and chronic visceral hypersensitivity (CVH) states. Using whole‐cell patch clamp recordings, we also assessed the inhibitory actions of these peptides on the neuronal excitability of colonic innervating dorsal root ganglion neurons. In vivo, the analgesic efficacy of these analogues was assessed by determining the visceromotor response to colorectal distension in healthy and CVH mice.
Key Results
cVc1.1 and the cVc1.1 analogues, C2H,C8FcVc1.1 and N9WcVc1.1, all caused concentration‐dependent inhibition of colonic nociceptors from healthy mice. Inhibition by these peptides was greater than those evoked by linear Vc1.1 and was substantially greater in colonic nociceptors from CVH mice. cVc1.1 also reduced excitability of colonic dorsal root ganglion neurons, with greater effect in CVH neurons. CVH mice treated with cVc1.1 intra‐colonically displayed reduced pain responses to noxious colorectal distension compared with vehicle‐treated CVH mice.
Conclusions and Implications
Cyclic versions of Vc1.1 evoked significant anti‐nociceptive actions in CVH states, suggesting that they could be novel candidates for treatment of CVP.
Linked Articles
This article is part of a themed section on Recent Advances in Targeting Ion Channels to Treat Chronic Pain. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.12/issuetoc
Data from the ITRS2003 roadmap for 2010 predicts voltages for microprocessors in hand-held electronics will decrease to 0.8V with current and power increasing to 4A and 3W, respectively. ...Consequently, low power converters will move to multimegahertz frequencies with a resulting reduction in capacitor and inductor values by factors of 5 and 20, respectively. Values required at 10 MHz, for a low power buck converter, are estimated at 130 nH and 0.6 uF, compatible with the integration of magnetics onto silicon and the concept of power supply-on-chip (PSOC). A review of magnetics-on-silicon shows that inductance values of 20 to 40nH/mm/sup 2/ can be achieved for winding resistances less than 1/spl Omega/. A 1-/spl mu/H inductance can be achieved at 5 MHz with dc resistance of 1/spl Omega/ and a Q of four. Thin film magnetic materials, compatible with semiconductor processing, offer power loss density that is lower than ferrite by a factor of 5 at 10 MHz. Other data reported includes, lowest dc resistance values of 120 m/spl Omega/ for an inductance of 120 nH; highest Q of 15 for an inductance of 350 nH and a current of 1 A for a 1- /spl mu/H inductor. Future technology challenges include reducing losses using high resistivity, laminated magnetic materials, and increasing current carrying capability using high aspect-ratio, electroplated copper conductors. Compatible technologies are available in the power switch, control, and packaging space. Integrated capacitor technology is still a long-term challenge with maximum reported values of 400 nF/cm/sup 2/.
Constipation encompasses symptoms of decreased colonic motility or difficulty with the defecation process. As a broad definition, this can be inclusive of functional constipation (FC) or colonic ...inertia, obstructed defecation (OD), and irritable bowel syndrome-constipation type (IBS-CS). After excluding IBS-C, FC and OD diagnosis and management require a multidisciplinary approach often involving nutritionists, pelvic floor therapists, urogynecologists, and colon and rectal surgeons. Differentiating the presence or absence of each can direct therapy and prognosticate chances for improvement in this often complex combination of disorders.
α-Conotoxins are disulfide-rich peptides that target nicotinic acetylcholine receptors. Recently we identified several α-conotoxins that also modulate voltage-gated calcium channels by acting as G ...protein-coupled GABA(B) receptor (GABA(B)R) agonists. These α-conotoxins are promising drug leads for the treatment of chronic pain. To elucidate the diversity of α-conotoxins that act through this mechanism, we synthesized and characterized a set of peptides with homology to α-conotoxins known to inhibit high voltage-activated calcium channels via GABA(B)R activation. Remarkably, all disulfide isomers of the active α-conotoxins Pu1.2 and Pn1.2, and the previously studied Vc1.1 showed similar levels of biological activity. Structure determination by NMR spectroscopy helped us identify a simplified biologically active eight residue peptide motif containing a single disulfide bond that is an excellent lead molecule for developing a new generation of analgesic peptide drugs.
This paper presents a low-profile thin-film microfabricated inductor on silicon and its performance in a high-frequency low-power DC/DC converter. The design of the inductors has focused on ...maximizing efficiency while maintaining a relatively flat frequency response up to 30 MHz. The inductance at 20 MHz is approximately 150 nH with a resistance of 1.8 ¿. The performance of the microinductor has been compared to two conventional commercially available 150-nH chip inductors. One of the chip inductors has a magnetic-material core and the other is an air core. The maximum efficiency of the microinductor, which relates the power loss of the microinductor to output power loss of the converter, is measured to be approximately 93% at 20 MHz. The low-power DC/DC converter operates in the tens of milliwatts output power range, with an input voltage of 1.8 V and an output voltage programmable between 0 and 1.8 V. The converter maximum efficiency when using the microinductor on silicon is 78.5% at 20 MHz, which is approximately 2% lower than the efficiency using the conventional chip inductors.
This paper discusses the use of printed circuit board (PCB) integrated inductors for low power DC/DC buck converters. Coreless, magnetic plates and closed core structures are compared in terms of ...achievable inductance, power handling and efficiency in a footprint of 10 /spl times/ 10 mm/sup 2/. The magnetic layers consist of electroplated NiFe, so that the process is fully compatible with standard PCB process. Analytic and finite element method (FEM) methods are applied to predict inductor performance for typical current waveforms encountered in a buck converter. Conventional magnetic design procedures are applied to define optimum winding and core structures for typical inductor specifications. A 4.7 /spl mu/H PCB integrated inductor with dc current handling of up to 500 mA is presented. This inductor is employed in a 1.5 W buck converter using a commercial control integrated circuit (IC). The footprint of the entire converter measures 10 /spl times/ 10 mm/sup 2/ and is built on top of the integrated inductor to demonstrate the concept of integrated passives in power electronic circuits to achieve ultra flat and compact converter solutions.
Synergistic multimodality therapy is needed for breast cancer. Breast cancer frequently has p53 mutations that result in cells less likely to undergo apoptosis when exposed to DNA damaging therapies. ...Taxol (paclitaxel) is more effective in the presence of mutant p53.90Y-labeled DOTA-peptide-ChL6 (90Y-ChL6, where ChL6 is chimeric L6 antibody and DOTA is 1,4,7,10-tetraazacyclododecane-N,N′,N′ ′,N′ ′ ′-tetraacetic acid) is a novel radioimmunoconjugate for targeting radiation to cancer. It has a stable metal chelator and a peptide linker that can be catabolized by hepatic lysozymes. This study was designed to assess potential synergism between Taxol and90Y-ChL6 in a highly anaplastic breast cancer model, HBT 3477. There was no tumor response in mice receiving ChL6 or Taxol alone. In mice receiving90Y-ChL6 alone, 79% (15 of 19) of tumors responded although none were cured. If Taxol was administered 24-72 hours before90Y-ChL6, again, 79% (23 of 29) of tumors responded but 21% were cured. When Taxol was administered 6 or 24 hours after90Y-ChL6, 100% (46 of 46) of tumors responded and 48% were cured. Taxol given with90Y-ChL6 did not substantially increase toxicity. Enhancement of the therapeutic effect when Taxol was added to90Y-ChL6 therapy for HBT 3477 xenografts was striking. The synergistic therapeutic effect of Taxol with90Y-ChL6 may relate to the p53 mutant status and BCL2 expression in HBT 3477 cells, observations that increase the likelihood that the results of this study are relevant to therapy for breast cancer in patients. In conclusion, Taxol seemed to be synergistic with90Y-ChL6 in this human breast cancer model. Up to 50% of these anaplastic breast cancer xenografts were cured by combined modality therapy.
The removal of radioactivity from liquid scintillator has been studied in preparation of a low background phase of KamLAND. This paper describes the methods and techniques developed to measure and ...efficiently extract radon decay products from liquid scintillator. We report the radio-isotope reduction factors obtained when applying various extraction methods. During this study, distillation was identified as the most efficient method for removing radon-born lead from liquid scintillator.
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