Systemic effects of epidural methylprednisolone injection on glucose tolerance in diabetic patients

ABSTRACT: BACKGROUND: Several studies have shown that in diabetic patients, the glycemic profile was disturbed after intra-articular injection of corticosteroids. Little is known about the impact of epidural injection in such patients. The goal of this study was double, at first comparing the glycaemic profile in diabetic patients after a unique injection of 80 mg of acetate methylprednisolone either intra-articular or epidural and secondly to compare the amount of systemic diffusion of the drug after both procedures. METHODS: Seventeen patients were included. Glycemic changes were compared in 9 diabetic patients following intra-articular (4 patients) and epidural injections (5 patients). Epidural injections were performed using the sacral route under fluoroscopic control in patients with lumbar spinal stenosis. Diabetes control had to stable for more than 10 days and the renal function to be preserved. Blood glucose was monitored using a validated continuous measuring device (GMS, Medtronic) the day before and for two days following the injection. Results were expressed in the form of daily glycemic profiles and as by mean, peak and minimal values +/ SD. The urinary excretion of methylprednisolone after the 2 routes of injection was analyzed in 8 patients (4 in each group). Urine samples were cropped one hour before the injections, then 4 times during the first day and 3 times a week for 2 weeks. The measurements included the free and conjugated fraction RESULTS: The glycaemic profile remains unchanged with no significant changes in the group of the 5 diabetic patients receiving epidural injections. On the other end, the average peak and mean values were enhanced up to 3 mmol/l above baseline two days after the infiltration in the groups of the 4 diabetic patients infiltrated intra-articular. The mean urinary excretion of the steroid was about ten times higher in the intra-articular versus epidural group: 7000 ng/ml versus 700 ng/ml. Looking at each individual there were marked differences especially after intra-articular injections. CONCLUSION: This is the first study to show that a single epidural steroid injection of 80 mg depot methylprednisolone had no effect on the glycemic control in diabetic patients. The absence of glycemic control changes correlated well with the very low urinary excretion of the drug after epidural injection. Trial registration NCT01420497

Dyslexia in SNS: an Exploratory Study to Investigate Expressions of Identity and Multimodal Literacies

The paradigm of neurodiversity provides a theoretical scaffold to challenge the idea of dyslexia as a deficit, by considering how difficulties related to literacy may reflect possible cognitive strengths and opportunities for learning. In this paper we adopt this perspective which associates dyslexia with strengths in visual, oral and three-dimensional thinking. Our goal is to understand if and how the multimodal affordances of SNS mediate participation and new literacies for dyslexic youth, and how these affordances interact with identity work. Seven young people struggling with literacy were interviewed about their use of SNS. Our results show that the visual affordances of SNS enable new forms of participation and expression, furthering our understanding of visual literacies. Nonetheless, despite the pervasive use of visual affordances to perform identity work, we also find that young people's learning differences are not always obviated but re-constructed, or even confronted in SNS

Acceptance and Use of Mobile Devices and Apps by Elderly People

International audienceCurrently, there is an increase in the number of older generation groups. These demographic changes obviously cause serious social and economic problems. Therefore, there is a need to prolong an active life of elderly people, who want to lead active, fulfilling and quality life in a sense of their inclusion, socialization and independence. This can be achieved not only by continuous support from their family members, but current trends show an important role of information and communication technologies (ICT) in this process. The purpose of this study is to explore the acceptance and use of mobile technology, specifically mobile devices and applications by elderly people, both from the technical and sociological point of view. The methods used in this study include a method of literature review of available sources, a method of comparison and evaluation of the findings from the selected studies on this topic. The findings show that although there is a number of mobile apps for the elderly on the market, they do not usually meet specific needs of these people such as their physical and cognitive impairments or relevant technical specifications of mobile device designed for this group of people. In addition, since the use of mobile technologies by elderly people is quite a new field of research, there are almost no research studies which would prove acceptance of these mobile apps. Therefore, there is a need of vast and detailed research in this area and also find a solution to this complex technological and sociological issue

SSETI ESEO New Zealand Ground Station Project

The paper outlines the currently ongoing project aimed at developing a fully operational Student Space Exploration and Technology Initiative (SSETI) New Zealand Ground Station for the European Student Earth Orbiter (ESAO) satellite scheduled for launching in 2009. The proposed ground station will provide additional satellite communication facilities enabling efficient data exchange with the ESSAO when it passes over the Pacific region, i.e., when its communication with the Europe-based Ground Stations is limited or not possible. The ground station will be linked to the Mission Control Center in europe via secure tunnels over the Internet to relay telemetry data and telecommand information