Prevention of hypoglycemia by intermittent-scanning continuous glucose monitoring device combined with structured education in patients with type 1 diabetes mellitus : A randomized, crossover trial

Aims: We conducted a randomized, crossover trial to compare intermittent-scanning continuous glucose monitoring (isCGM) device with structured education (Intervention) to self-monitoring of blood glucose (SMBG) (Control) in the reduction of time below range. Methods: This crossover trial involved 104 adults with type 1 diabetes mellitus (T1DM) using multiple daily injections. Participants were randomly allocated to either sequence Intervention/Control or sequence Control/Intervention. During the Intervention period which lasted 84 days, participants used the first-generation FreeStyle Libre (Abbott Diabetes Care, Alameda, CA, USA) and received structured education on how to prevent hypoglycemia based on the trend arrow and by frequent sensor scanning (≥10 times a day). Confirmatory SMBG was conducted before dosing insulin. The Control period lasted 84 days. The primary endpoint was the decrease in the time below range (TBR; <70 mg/dL). Results: The time below range was significantly reduced in the Intervention arm compared to the Control arm (2.42 ± 1.68 h/day [10.1 %±7.0 %] vs 3.10 ± 2.28 h/day [12.9 %±9.5 %], P = 0.012). The ratio of high-risk participants with low blood glucose index >5 was significantly reduced (8.6 % vs 23.7 %, P < 0.001). Conclusions: The use of isCGM combined with structured education significantly reduced the time below range in patients with T1DM

Análisis de la morfometría y de la dimensión fractal en la lesión del tejido muscular esquelético expuesto en la combinación de los tratamientos de crioterapia y ultrasonido

The aim of this study was to analyze the effects of an association of cryotherapy and therapeutic ultrasound on the treatment of muscle injured by impact. Fifty-five Wistar rats were divided into five groups (n = 11), Acute Injury (AI), Injury (I), Cryotherapy (CR), Therapeutic Ultrasound (TU) and Association of Cryotherapy and Therapeutic Ultrasound (CRTU). The CR and CRTU groups received applications of Cryotherapy three times (immediately, 24 and 48 h after injury) of 20 minutes duration. The TU and CRTU groups received applications of Therapeutic Ultrasound for seven days, for five minutes, in pulsed mode, 0.5 w/cm intensity, frequency 1 MHz. Body mass and gastrocnemius mass were analyzed. In addition to histological slides stained with hematoxylin and eosin used for morphometric analysis, picrosirius dye was used for quantification of collagen by Fractal Dimension (FD). The results of the intra-group analysis showed lower body mass and gastrocnemius in the CRTU group in relation to the AI (p = 0.001), I (p = 0.001), CR (p = 0.001) and TU groups (p = 0.001), and lower values of FD to quantify collagen in the CRTU group in relation to the AI (p = 0.007) and CR groups (p = 0.014). In summary, the present study showed that the association of Cryotherapy with Therapeutic Ultrasound promoted better results in the aspects analyzed compared to application of the therapies in isolation34310761082El objetivo del estudio fue evaluar los efectos de la asociación de las técnicas de crioterapia y ultrasonido terapéutico en el tratamiento de la lesión muscular por impacto. Fueron utilizadas 55 ratas Wistar, expuestas a lesión y separadas en grupos (n = 11): Lesión aguda (LA), Lesión (L), Crioterapia (CR), Ultrasonido Terapéutico (UT) y Crioterapia + Ultrasonido Terapéutico (CRUT). Los grupos CR y CRUT recibieron la aplicación, durante 20 minutos, en tres momentos (inmediatamente, 24 y 48 horas, después de la lesión). Los grupos UT y CRUT, recibieron UT por siete días, con una duración de cinco minutos, en modo pulsado, con una intensidad de 0,5 W/cm2 y frecuencia de 1 MHz. Fueran medidos el peso corporal y el peso de los músculos gastrocnemios y se realizaron cortes histológicos del músculo gastrocnemio, los cuales fueron teñidos con hematoxilina-eosina (HE) para el análisis morfométrico y con picrosirius para el análisis del colágeno por dimensión fractal (DF). Los resultados de los análisis intragrupo demostraron una menor disminución de la masa coporal y muscular en el grupo CRUT. Además, fue observado un valor inferior en la morfometría en el grupo CRUT en comparación a los grupos LA (p = 0,001), L (p = 0,001), CR (p = 0,001) y UT (p = 0,001), y un menor valor de la DF con respecto al colágeno en el grupo CRUT en comparación a los grupos LA (p = 0,007) y CR (p = 0,014). En síntesis, el presente estudio demostró que el protocolo de asociación de las técnicas de CR y UT causaron mayores respuestas benéficas en los aspectos analizados en comparación a los protocolos con los tratamientos aplicados de forma aisladasem informaçã

Concurrent training effect on muscle fibers in Wistar rats

The aim of the present study was to determine the modeling of muscle fibers in rats submitted to different exercise protocols. Fifty-five Wistar rats were submitted divided into four different groups: Control group (CG; N=16); endurance training group (ETG; N=13), strength training group (STG; N=13) and concurrent training group (CTG; N=13). The intensity of endurance training was determined by the critical workload. Statistical analysis involved the Kruskal-Wallis test for multiple comparisons, followed by Dunn's post test (p0.05) occurred in the STG and CTG at both four (mean: 2952,95 +/- 878,39 mean: 2988,84 +/- 822,58) and eight weeks respectively (mean: 3020,26 +/- 800.91; mean: 3104,91 +/- 817,87). The findings demonstrate similar results obtained with strength training and concurrent training, with a greater increase in muscle fiber area in both groups in comparison to the control group and group submitted to endurance training.O objetivo deste estudo foi observar a modelação das fibras musculares de ratos submetidos a diferentes protocolos de treinamento físico. Foram utilizados 55 animais da raça Wistar, dos quais foram submetidos a quatro diferentes tratamentos, sendo estes: o grupo controle (CTLE), treinamento aeróbio (TAE), treinamento de força (TAN) e treinamento concorrente (TCc). A intensidade do treinamento aeróbio foi determinada pela carga crítica de trabalho. Utilizou-se o teste de Kruscal-Wallis para comparações múltiplas, com pós-teste de Dunn, adotou-se o valor de significância de 5% (p=0,05). Observou-se que os grupos de animais treinados mostraram aumento na área de secção transversa (AST) das fibras musculares. Não foi verificada diferença significante (p>0,05) entre os grupos TAN e TCc, tanto em quatro (média:2952,95 ± 878,39 média:2988,84 ± 822,58) como após oito semanas (média:3020,26 ± 800,91; média:3104,91 ± 817,87). Os protocolos de TAN e TCc não se diferenciaram entre si e demonstraram aumento da AST quando comparados aos demais grupos de animais.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES