A B S T R A C T The purpose of the present study was to investigate the regulation of insulin biosynthesis during the perinatal period. The incorporation of [3H]leucine into total immunoreactive insulin (IRI) and into IRI fractions was measured by a specific immunoprecipitation procedure after incubation, extraction, and gel filtration in isolated 3-day-old rat pancreases without prior isolation of islets. IRI fractions were identified by their elution profile, their immunological properties, and their ability to compete with the binding of "I-insulin in rat liver plasma membranes. No specific incorporation of [3H]leucine was found in the IRI eluted in the void volume, making it unlikely that this fraction behaves as a precursor of (pro)insulin in this system. In all conditions tested, the incorporation of [8H]leucine was linearly correlated with time. Optimal concentration of glucose (11 mM cose and was not modified by any further increase in glucose concentrations up to 27.5 mM. Theophylline or dbcAMP at 10 mM concentration did not reverse the somatostatin inhibitory effect on either insulin biosynthesis or release. Somatostatin also inhibited both processes in isolated islets from the 3-day-old rat pancreas. High Ca"+ concentration in the incubation medium reversed the inhibitory effect of somatostatin on glucoseinduced insulin biosynthesis as well as release. In both systems the inhibitory effect of somatostatin on insulin biosynthesis and release correlated well. Glipizide (10-100 ,M) and tolbutamide (400 ELM) inhibited the stimulatory effect of glucose, dbcAMP, and theophylline on [8H]leucine incorporation into IRI. The concentrations of glipizide that were effective in inhibiting [3H]leucine incorporation into IRI were smaller than those required to inhibit the phosphodiesterase activity in isolated islets of 3-day-old rat pancreas.These data suggest the following conclusions: (a) the role of the cAMP-phosphodiesterase system on insulin biosynthesis is likely to be greater in newborns than in adults; (b) the greater effectiveness of glucose and the cAMP system on insulin biosynthesis than on insulin release might possibly be related to the rapid accumulation of pancreatic IRI which is observed in the perinatal period; (c) somatostatin, by direct interaction with the endocrine tissue, can inhibit glucose and cAMPinduced insulin biosynthesis as well as release; calcium reverses this inhibition; (d) sulfonylureas inhibit insulin biosynthesis in newborn rat pancreas an effect which has
We have studied the binding of ml-GLP-l(7-36)amide to normal rat islet cells and rat insulinoma-derived RINm5F cells, and found it is time-and temperature-dependent, and directly proportional to cell concentration. In both cell types, the Scatchard plot demonstrates the presence of high-and low-affinity binding sites. The 50% inhibition of the maximal binding to 0.4 nM 1251-GLP-l(7-36)amide was obtained when cells were incubated in the presence of about 3.0 nM of unlabelled peptide. Glucagon, oxyntomodulin and GLP-l(7-36)amide at high concentrations (10 aM) do not compete with the 1251-GLP-l(7-36)amide binding. In pancreatic tumoral cells there seems to be a direct correlation between the maximal binding, the number of high-affinity binding sites and the amount of intracellular insulin.
IntroductionThe studies about the comorbidity of major depressive disorder (MDD) and bipolar disorder (BD) have increased in the last years. The comorbidity with Axis I psychiatric disorders complicates the diagnosis, prognosis and treatment.ObjectivesTo analyze the prevalence of affective disorders associated with another Axis I psychiatric disorders to treat correctly from the beginning of the diagnosis and to improve the course of the disorder and the quality of life of these patientsMethodsThe subjects who participated in the study were diagnosed of bipolar I disorder, bipolar II disorder and MDD, according to DSM-IV-TR criteria. The sample (n = 114) was divided into three groups: MDD (n = 58), BD (n = 31) and a control group of healthy subjects (n = 25). The diagnosis and stability were assessed using the MINI International Neuropsyquiatric Interview and the Hamilton Depression Rating Scale (HDRS).ResultsBD had a significantly association with risk of suicide (38%), anxiety disorder (3.3%) and social phobia (12.9%). It was also reported a significant association between MDD and risk of suicide (71%), manic/hypomanic episodes (25.9%), anxiety disorder (37.9%), social phobia (25.9%) and generalized anxiety disorder (37.9%).ConclusionsIt is necessary for clinical practice an integrative model which takes into account the comorbidity of affective disorders to improve the response to treatment and the prognosis of these mental disorders
IntroductionRecent epidemiological studies suggest that the prevalence of bipolar disorder might be misdiagnosed initially as unipolar depression due to the difficulty to detect episodes of hypomania. The Hypomania Checklist (HCL-32), validated in Spanish, is a self-report questionnaire with 32 hypomania items designed to screen for hypomanic episodes.ObjectivesTo examine the prevalence of hypomania in patients with unipolar depression. Corroborate the efficacy of the HCL-32 to detect symptoms of hypomania.MethodsThe presence of hypomanic symptoms was assessed by the HCL-32 in a sample of 128 subjects diagnosed with bipolar I disorder (n = 30), bipolar II disorder (n = 1), unipolar depression (n = 57), and anxiety disorder (n = 15) according to DSM-IV-TR criteria. A control group of healthy subjects was selected (n = 25).ResultsThe discriminative capacity was analyzed by the ROC curve. The AUC was 0.65 which did not indicate a good capacity. The sensitivity (S), specificity (E) and prevalence (P) of hypomania in unipolar patients for the following cut-off points were :14: S = 81.6%,95%CI(69.8, 93.5); E = 30.1%,95%CI(19.7,40.6); P = 74.1%; 15: S = 77.6%,95%CI(64.9,90.3); E = 37.4%,95%CI(26.3,48.4); P = 67.2%; 16: S = 59.2%,95%CI(44.4,73.9); E = 55.4%,95%CI(44.1,74.0); P = 51.7%; 17: S = 55.1%,95%CI(40.2,70.1); E = 57.8%,95%CI(46.6,69.1); P = 48.3%.ConclusionsThe HCL-32 has a high sensitivity but a low specificity as screening instrument. This might explain the high proportion of hypomania found in this study. The difference with previous studies is that our sample was heterogeneous, unstable and serious. This suggests that the HCL-32 is not valid for any psychiatric sample. Future research should develop more specific instruments with better external validity.
Method:A database search using the MeSH search terms: hypertension, risk factors, nurses, nurse-patient relations, health behaviour, patient compliance, lifestyle, patient education, health promotion, self-care, attitude, motivation, adaptation, models, social support, communication and ambulatory care facilities. Results: Factors related to the patients' predispositions and abilities to change lifestyle and adhere to treatment were attitudes and beliefs, view of health, personality and traits, need for autonomy, and level of perceived vulnerability, hardiness, self-efficacy, control, sense of coherence, and social support and network. Values can be considered the basis for decision-making and the concept of health is tied into one's belief systems. Traits are factors that persistently determine our conduct in many different situations.Patients' need for autonomy should be respected through informed consent to help patients making own decisions. The degree of vulnerability changes with the degree of environmental support and personal resources. Scoring high on locus of control, hardiness and sense of coherence buffer the impact of stressful life-events. Self-efficacy is a belief in oneself to use and implement available skills. Social support is a feeling of belonging and being valued. Having social networks is crucial for psychological health. In the counselling session it is essential to obtain a shared decision-making made in concordance between patient and nurse. The outcome of the counselling should be behavioural change with the goal of adherence to treatment and maintenance of new behaviours. To achieve this the patient has to develop self-care agencies through coping resources by means of nursing agencies, i.e. interventions. A model, according to Orem's self-care deficit theory of nursing, was constructed to describe factors influencing patients in the communication with the nurse in counselling sessions. The organising nursing system facilitating patients' self-care resources in hypertension care should be added. Conclusion: To have knowledge of patients' predispositions to change behaviour and to adhere with medication are prerequisites for successful nursing in hypertension care.
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