Detection of hypoglycemia with the GlucoWatch biographer

WSTĘP. Hipoglikiemia jest częstym, ostrym powikłaniem leczenia cukrzycy. Urządzenie monitorujące GlucoWatch zapewnia częste automatyczne pomiary glukozy z możliwością ustawienia progu alarmu niskiej glikemii. W badaniu przeanalizowano działanie biomonitora jako urządzenia służącego wykrywaniu hipoglikemii zdefiniowanej jako stężenie glukozy we krwi Ł 3,9 mmol/l. MATERIAŁ I METODY. Analizy dokonano w czterech badaniach klinicznych, w których biomonitor zastosowano 1091 razy, co pozwoliło uzyskać 14 487 par pomiarów (odczyt z biomonitora i stężenie glukozy we krwi). WYNIKI. Wyniki wskazują, że wraz z podwyższaniem granicy alarmu niskiej glikemii liczba rzeczywiście dodatnich alarmów (sygnał dźwiękowy i glikemia Ł 3,9 mmol/l) i fałszywie dodatnich alarmów (sygnał dźwiękowy, ale glikemia > 3,9 mmol/l) wzrasta. Po analizie wyników w zależności od poziomów sygnałów niskiej glikemii określono krzywe charakterystyki operatora odbiornika, które odpowiadają urządzeniu diagnostycznemu o wysokiej użyteczności. Ustawienie alarmu na poziomie 1,1–1,7 mmol/l powyżej hipoglikemii wydaje się optymalnym rozwiązaniem dla każdego użytkownika, dającym najlepszą proporcję wyników prawdziwie dodatnich i fałszywie dodatnich. Analiza tych samych danych dotyczących stężenia glukozy we krwi, względem metody typowej samokontroli (2–4 pomiary dziennie), wskazuje, że wykrywanych jest mniej incydentów hipoglikemii niż za pomocą urządzenia monitorującego. WNIOSKI. Częste i automatyczne odczyty stężenia glukozy we krwi pozwalają na efektywniejsze wykrywanie hipoglikemii.INTRODUCTION. Hypoglycemia is a common acute complication of diabetes therapy. The GlucoWatch biographer provides frequent and automatic glucose measurements with an adjustable low-glucose alarm. We have analyzed the performance of the biographer low-glucose alarm relative to hypoglycemia as defined by blood glucose £ 3.9 mmol/l. MATERIAL AND METHODS. The analysis was based on 1,091 biographer uses from four clinical trials, which generated 14,487 paired (biographer and blood glucose) readings. RESULTS. The results show that as the low-glucose alert level of the biographer is increased, the number of true positive alerts (alarm sounds and blood glucose £ 3.9 mmol/l) and false positive alerts (alarm sounds but blood glucose > 3.9 mmol/l) increased. When analyzed as a function of varying low-glucose alert levels, the results show receiver operator characteristic curves consistent with a highly useful diagnostic tool. Setting the alert level from 1.1 to 1.7 mmol/l above the level of concern is likely to optimize the trade-off between true positives and false positives for each user. When the same blood glucose data are analyzed for typical monitoring practices (two or four measurements per day), the results show that fewer hypoglycemic events are detected than those detected with the biographer. CONCLUSIONS. The frequent and automatic nature of the biographer readings allows more effective detection of hypoglycemia than that achieved with current medical practice

The Role of Host Genetics in Susceptibility to Influenza: A Systematic Review

Background: The World Health Organization has identified studies of the role of host genetics on susceptibility to severe influenza as a priority. A systematic review was conducted to summarize the current state of evidence on the role of host genetics in susceptibility to influenza (PROSPERO registration number: CRD42011001380). Methods and Findings: PubMed, Web of Science, the Cochrane Library, and OpenSIGLE were searched using a pre-defined strategy for all entries up to the date of the search. Two reviewers independently screened the title and abstract of 1,371 unique articles, and 72 full text publications were selected for inclusion. Mouse models clearly demonstrate that host genetics plays a critical role in susceptibility to a range of human and avian influenza viruses. The Mx genes encoding interferon inducible proteins are the best studied but their relevance to susceptibility in humans is unknown. Although the MxA gene should be considered a candidate gene for further study in humans, over 100 other candidate genes have been proposed. There are however no data associating any of these candidate genes to susceptibility in humans, with the only published study in humans being under-powered. One genealogy study presents moderate evidence of a heritable component to the risk of influenza-associated death, and while the marked familial aggregation of H5N1 cases is suggestive of host genetic factors, this remains unproven. Conclusion: The fundamental question ‘‘Is susceptibility to severe influenza in humans heritable?’ ’ remains unanswered. No

Electrical conductivity, viscosity, and density of a two-component ionic system at its critical point

The density, viscosity, and electrical conductivity of a system composed of a fused salt in a low dielectric constant solvent were examined at a temperature just above the liquid-liquid critical point. The system examined was tetra-n-butylammonium picrate (TNBAP) in 1-chloroheptane. The conductivity decreased to a minimum near 0.001 mol/dm3 and then increased rapidly through the region of the critical concentration. The data in the region of the minimum were fit by using the method of Fuoss and Kraus to determine the ion-pair and ion-triplet dissociation constants. An extrapolation of these equilibria toward the critical region indicated a rapidly increasing importance of ion triplets at the expense of the neutral ion pairs. The conductivity results were also compared to a recent cluster-equilibrium treatment of the restrictive primitive model (RPM). This treatment of the RPM also shows an increasing importance of charged clusters, at the expense of neutral clusters, as the concentration approaches that of the critical point. The dielectric constant of 1-chloroheptane was also measured over a range of temperature

Thermal effects in magnesium and calcium oxides

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Nuclear magnetic resonance studies of hydrogen bonding. II. Alcohols

This article does not have an abstract