Streptozotocin diabetes in the rat diminishes the synthesis of both monounsaturated and polyunsaturated fatty acids. Rat liver microsomal fatty acid composition and fatty acid desaturation were studied in the streptozotocin diabetic rat. The major alterations in fatty acid composition found in the diabetic rat were decreased proportions of palmitoleic, oleic and arachidonic acids and an increased proportion of linoleic and docosahexaeneoic acids. These findings, other than the increased docosahexaeneoic acid, probably result from the diminished liver microscomal δ9 and δ6 desaturase activities found in these animals. These changes are not due to the diminished weight gain of the diabetic animals since restricting food intake of control animals to achieve a similar weight gain failed to reproduce either the changes in fatty acid composition or the decrease in fatty acid desaturation. The increased food intake of the diabetic animal may contribute to the altered proportions of linleic and arachidonic acids since limiting food intake in diabetic animals to that of normal controls diminished the magnitude of these changes. Insulin therapy for 2 days not only reverses and overcorrects the diminished desaturase activities, but likewise reverses and overcorrects the altered fatty acid composition, with the exception of the diminished arachidonic aicd levels which are further decreased following insulin therapy. These findings strongly suggest that most of the changes in fatty acid composition in the diabetic rat are indeed caused by the diminished fatty acid desaturase activities.
One-hundred-ninety elderly (mean age 75.8 years), disabled patients at risk of being institutionalized due to stroke, acute medical problems, dementia, and other illnesses completed a rehabilitation program at the Geriatric Rehabilitation Unit (GRU). A retrospective study to measure possible impacts of rehabilitation on functional status and placement at discharge from the GRU and on living situation 1 year postdischarge showed an improvement of functional status after rehabilitation in nearly all patients. By discharge, the number of patients with partial or total activities of daily living (ADL) independence increased from 87 to 173, ambulatory patients increased from 42 to 127, continent patients from 89 to 141 and mentally clear patients from 40 to 91. Higher ratings in these parameters at discharge were associated with better placement and significantly lower mortality 1 year postdischarge. Patients placed in noninstitutional settings had a lower (21%) mortality rate when compared with patients placed in nursing homes (mortality 45%). The GRU program is clearly associated with improved outcome of care.
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