An Identification of the Risk Factors Implicated in Diabetic Ketoacidosis (DKA)

Background: Despite improvements in therapy and disease monitoring, diabetic ketoacidosis (DKA) remains a potentially fatal consequence. This retrospective study was undertaken to establish and identify those risk factors that are responsible for the onset of DKA. Methods: The medical records of 77 patients from Addington Hospital, who satisfied the criteria for inclusion into the study of DKA, were reviewed (60 type 1 diabetes mellitus (DM) patients and 17 type 2 DM patients). Results: More juveniles were admitted for multiple DKA episodes (65%) than non-juveniles (35%). DKA occurred in 23% of newly diagnosed type 1 DM on first presentation. Infection was present in 40% of type 1 DM patients with single DKA episodes and in 45% of type 1 DM patients with multiple DKA episodes. A total of 23.2% of all admissions for single DKA involved non-compliance of medication usage and was implicated in 32% of multiple DKA episodes Family and/or school problems presented in 7% of single DKA episodes and 4% in multiple DKA episodes. In the present study, the overall mortality rate was 2.5% (n=2). Conclusion: This study showed that the most important risk factors implicated in DKA were infection, non-compliance and newly diagnosed diabetes, followed by family and/or school problems, low socio-economic status and omission of insulin. South African Family Practice Vol. 49 (10) 2007: pp. 15a-15

An evaluation of postprandial glucose excursions in type 2 diabetic mellitus subjects on Monotard® HM (ge) versus Humulin N® or Humulin L® insulin, each in combination with metformin

Background There is increasing evidence that postprandial hyperglycaemia is implicated in the development of macro- and microvascular diabetic complications. Thus, control of postprandial glucose levels (PPG), in addition to control of fasting blood glucose (FBG), will ensure overall glycaemic control in diabetic patients. This study evaluated the effectiveness of a current anti-diabetic regimen on PPG in patients with type 2 diabetes mellitus. Methods A total of 31 type 2 diabetic subjects on combination treatment of either Humulin N® (HN), Monotard HM (ge)® (M) or Humulin L® (HL) insulin, with metformin, participated in a controlled, prospective, one-day visit study at a tertiary referral state diabetes clinic. The objective was to evaluate the effectiveness of the combination treatment of either M (n = 11) versus HN (n = 10) or HL (n = 10) insulin, each in combination with metformin, on PPG in this study cohort. Each subject was given a standardised meal after completing baseline procedures. Prescribed insulin doses were taken the night prior to the study day and metformin doses were taken with the standardised meal on the following morning, the study day. After completion of the meal, blood glucose levels were determined every half an hour at 0, 30, 60, 90, 120 and 150 minutes, thus providing a postprandial glucose profile for each subject. The data was analysed using ANOVA. Results The study cohort was South African, predominantly of Indian origin (54.8%), with a mean age of 59.2 ± 8 years, and 71% of the cohort was female. The subjects had a mean duration of diabetes of 11.4 ± 6.6 years, with 71% (n = 22) having a positive family history. The study cohort was obese (BMI 32.3 ± 6.2kg/m2, WHR 0.9 ± 0.1). A total of 61.3% (n = 19) of the study cohort was hypertensive, while 29% (n = 9) presented with at least one cardiovascular event and 48.3% (n = 15) had high total cholesterol. On entry to the study, the mean (± SD) FBG (10.3 ± 3.7mmol/l), fructosamine (369.9 ± 78.8￭mol/l) and glycosylated haemoglobin (9 ± 2%) were elevated. Each insulin group, HN, M and HL, was statistically matched for the above-mentioned and was therefore compared. There was no statistically significant difference in the effectiveness of HN, M and HL, each in combination with metformin, on postprandial glucose levels (AUC glucose 0-150 minutes was 2100, 2212.5 and 2362.5mmol.min.l-1, per group respectively). Each insulin group presented with mean postprandial hyperglycaemia (PPH) at all time intervals (30, 60, 90, 120 and 150 minutes). Peak glucose levels were observed at 90 (16mmol/l), 90 (16.9mmol/l) and 60 minutes (17.6mmol/l) for HN, M and HL groups respectively. Since there was no statistically significant difference in PPH between and amongst the insulin groups at 60, 90 and 120 minutes, an approximation of PPG at 60 minutes would not adversely affect the determination of PPG compared to the recommended two hours. Within the HN, M and HL groups, a statistically significant difference in blood glucose levels was observed at 0 and 120 minutes (p = 0.003, 0.009 and 0.019 respectively). Groups with a higher FBG (at 0 minutes) had higher PPG (at 120 minutes), thus showing that the extent of FBG determines the degree of postprandial glycaemia. Conclusion In this study, HN, M and HL, each in combination with metformin, were not effective in controlling postprandial hyperglycaemia. HN was most effective in lowering the postprandial profile, although this was not statistically significant. The current treatment of the study cohort was also reviewed, as both FBG and PPG were not controlled. The use of a combination of short/rapid-acting insulin with a newly- formulated basal insulin is recommended, as both FBG and PPG should be treated to achieve overall glycaemic control. South African Family Practice Vol. 49 (5) 2007: pp. 1

Electron - nuclear recoil discrimination by pulse shape analysis

In the framework of the ``ULTIMA'' project, we use ultra cold superfluid 3He bolometers for the direct detection of single particle events, aimed for a future use as a dark matter detector. One parameter of the pulse shape observed after such an event is the thermalization time constant. Until now it was believed that this parameter only depends on geometrical factors and superfluid 3He properties, and that it is independent of the nature of the incident particles. In this report we show new results which demonstrate that a difference for muon- and neutron events, as well as events simulated by heater pulses exist. The possibility to use this difference for event discrimination in a future dark matter detector will be discussed.Comment: Proseedings of QFS 2007, Kazan, Russia; 8 pages, 4 figures. Submited to J. Low Temp. Phy

Probing neutralino dark matter in the MSSM & the NMSSM with directional detection

We investigate the capability of directional detectors to probe neutralino dark matter in the Minimal Supersymmetric Standard Model and the Next-to-Minimal Supersymmetric Standard Model with parameters defined at the weak scale. We show that directional detectors such as the future MIMAC detector will probe spin dependent dark matter scattering on nucleons that are beyond the reach of current spin independent detectors. The complementarity between indirect searches, in particular using gamma rays from dwarf spheroidal galaxies, spin dependent and spin independent direct search techniques is emphasized. We comment on the impact of the negative results on squark searches at the LHC. Finally, we investigate how the fundamental parameters of the models can be constrained in the event of a dark matter signal.Comment: 21 pages, 16 figure

Nuclear spin structure in dark matter search: The finite momentum transfer limit

Spin-dependent elastic scattering of weakly interacting massive dark matter particles (WIMP) off nuclei is reviewed. All available, within different nuclear models, structure functions S(q) for finite momentum transfer (q>0) are presented. These functions describe the recoil energy dependence of the differential event rate due to the spin-dependent WIMP-nucleon interactions. This paper, together with the previous paper ``Nuclear spin structure in dark matter search: The zero momentum transfer limit'', completes our review of the nuclear spin structure calculations involved in the problem of direct dark matter search.Comment: 39 pages, 12 figures, a review in revtex

Direct Search for Dark Matter - Striking the Balance - and the Future

Weakly Interacting Massive Particles (WIMPs) are among the main candidates for the relic dark matter (DM). The idea of the direct DM detection relies on elastic spin-dependent (SD) and spin-independent (SI) interaction of WIMPs with target nuclei. In this review paper the relevant formulae for WIMP event rate calculations are collected. For estimations of the WIMP-proton and WIMP-neutron SD and SI cross sections the effective low-energy minimal supersymmetric standard model is used. The traditional one-coupling-dominance approach for evaluation of the exclusion curves is described. Further, the mixed spin-scalar coupling approach is discussed. It is demonstrated, taking the high-spin Ge-73 dark matter experiment HDMS as an example, how one can drastically improve the sensitivity of the exclusion curves within the mixed spin-scalar coupling approach, as well as due to a new procedure of background subtraction from the measured spectrum. A general discussion on the information obtained from exclusion curves is given. The necessity of clear WIMP direct detection signatures for a solution of the dark matter problem, is pointed out.Comment: LaTeX, 49 pages, 14 figures, 185 reference

The NIKA instrument: results and perspectives towards a permanent KID based camera for the Pico Veleta observatory

The New IRAM KIDs Array (NIKA) is a pathfinder instrument devoted to millimetric astronomy. In 2009 it was the first multiplexed KID camera on the sky; currently it is installed at the focal plane of the IRAM 30-meters telescope at Pico Veleta (Spain). We present preliminary data from the last observational run and the ongoing developments devoted to the next NIKA-2 kilopixels camera, to be commissioned in 2015. We also report on the latest laboratory measurements, and recent improvements in detector cosmetics and read-out electronics. Furthermore, we describe a new acquisition strategy allowing us to improve the photometric accuracy, and the related automatic tuning procedure.Comment: 24th International Symposium on Space Terahertz Technology, ISSTT 2013, April 8 to 10, 2013, Groningen, the Netherland

First Results on In-Beam gamma Spectroscopy of Neutron-Rich Na and Mg Isotopes at REX-ISOLDE

After the successful commissioning of the radioactive beam experiment at ISOLDE (REX-ISOLDE) - an accelerator for exotic nuclei produced by ISOLDE - first physics experiments using these beams were performed. Initial experiments focused on the region of deformation in the vicinity of the neutron-rich Na and Mg isotopes. Preliminary results show the high potential and physics opportunities offered by the exotic isotope accelerator REX in conjunction with the modern Germanium gamma spectrometer MINIBALL.Comment: 7 pages, RNB6 conference contributio

Latest NIKA results and the NIKA-2 project

NIKA (New IRAM KID Arrays) is a dual-band imaging instrument installed at the IRAM (Institut de RadioAstronomie Millimetrique) 30-meter telescope at Pico Veleta (Spain). Two distinct Kinetic Inductance Detectors (KID) focal planes allow the camera to simultaneously image a field-of-view of about 2 arc-min in the bands 125 to 175 GHz (150 GHz) and 200 to 280 GHz (240 GHz). The sensitivity and stability achieved during the last commissioning Run in June 2013 allows opening the instrument to general observers. We report here the latest results, in particular in terms of sensitivity, now comparable to the state-of-the-art Transition Edge Sensors (TES) bolometers, relative and absolute photometry. We describe briefly the next generation NIKA-2 instrument, selected by IRAM to occupy, from 2015, the continuum imager/polarimeter slot at the 30-m telescope.Comment: Proceedings of Low Temperature Detectors 15 (LTD-15), Pasadena, June 201

High resolution SZ observations at the IRAM 30-m telescope with NIKA

High resolution observations of the thermal Sunyaev-Zel'dovich (tSZ) effect are necessary to allow the use of clusters of galaxies as a probe for large scale structures at high redshifts. With its high resolution and dual-band capability at millimeter wavelengths, the NIKA camera can play a significant role in this context. NIKA is based on newly developed Kinetic Inductance Detectors (KIDs) and operates at the IRAM 30m telescope, Pico Veleta, Spain. In this paper, we give the status of the NIKA camera, focussing on the KID technology. We then present observations of three galaxy clusters: RX J1347.5-1145 as a demonstrator of the NIKA capabilities and the recent observations of CL J1226.9+3332 (z = 0.89) and MACS J0717.5+3745 (z = 0.55). We also discuss prospects for the final NIKA2 camera, which will have a 6.5 arcminute field of view with about 5000 detectors in two bands at 150 and 260 GHz