Patient education: interpretation of medical terms as a key part of diabetes mellitus treatment

Background: Only a little percent of chronically ill patients was found to follow physicians’ prescriptions. One of the reasons for this issue is misunderstanding of recommendations due to inappropriate interpretation of medical terms, contained in medical advice. Aims: The study is aimed to evaluate the quality of patient interpretation of the most frequently used medical terms in diabetes mellitus field (DM) and to evaluate the impact of misunderstanding on diabetes control. Materials and methods: 13 endocrinologists composed 2 lists of the most frequently used terms – one list for DM type 1 and one for DM type 2. We selected 10 terms for DM type 1 and 10 terms for DM type 2, mentioned by the most of participated doctors, and created 2 kinds of questionnaire for patients. Patients were to explain the terms in written if they were aware of terms’ meaning. Three independent researchers evaluated every answer according to a 0 to 10 scale, where 0 was for totally incorrect or no answer, and 10 was for a completely correct answer. Patients also filled in the forms about their social and demographic parameters. Statistical analysis was conducted with the use of Wilcoxon Test and linear regression model. Results: 89 patients with DM type 1 (27% men, HbA1c (mean±SD) 7,95±1,77%) and 86 patients with DM type 2 (27% men, HbA1c (mean±SD) 8,11±1,91%) were included into the study. Patients with type 1 DM received a greater overall score for understanding the terms than those with type 2 DM (p <0.0001) – 57.84±22.66 and 39.33±22.02 from 100, respectively. 38 (42.7%) participants with DM type 1 reported that they know all 10 terms, but only 15 (16.8%) respondents understand terms correctly. In the group of type 2 DM patients 9 (10.5%) of all answered yes for all the terms, but really know terms only 2 (2.3%) participants. In both groups, the total score of the terms knowledge did not correlate with the HbA1c level (р=0.698 and р=0.319 for type 1 and type 2 DM groups, respectively). Conclusion: The most of patients with DM do not understand relevant medical terms properly. Some patients are in the wrong belief that they have no misunderstandings with their consulting doctors. However, terms understanding does not influence on glycemic control (HbA1c level). During the medical consultation, endocrinologists should check if a patient understands their advice properly to improve understanding and compliance of patients

Protective Effect of PBCA Nanoparticles Loaded with Thymulin Against the Relapsing-Remitting Form of Experimental Autoimmune Encephalomyelitis in Mice

Relapsing–remitting experimental autoimmune encephalomyelitis (rEAE) in mice is a model that closely resembles relapsing–remitting multiple sclerosis in humans. This study aims to investigate a new approach to modulation of the inflammatory response in rEAE mice using a thymic peptide thymulin bound to polybutylcyanoacrylate (PBCA) nanoparticles. PBCA nanoparticles were used to prolong the presence of thymulin in the blood. Cytokine levels in blood were measured by ELISA; NF-κB and SAPK/JNK cascade activation, as well as Hsp72 and p53 protein expression, were measured by Western blotting. Animal health statuses were estimated using severity scores. Results showed that the cytokine response in rEAE was multi-staged: an early phase was accompanied by an increase in plasma interferon-γ, while the interleukin (IL)-17 response was markedly increased at a later stage. The stages were attributed to rEAE induction and maintenance phases. Thymulin significantly alleviated symptoms of rEAE and lowered plasma cytokine levels both in early and later stages of rEAE, and decreased NF-κB and SAPK/JNK cascade activation. Thymulin modulated NF-kappaB pathway activity via site-specific phosphorylation of RelA/p65 protein (at Ser276 and Ser536). The effect of nanoparticle-bound thymulin was more pronounced than the effect of free thymulin. Therefore, PBCA–thymulin can be considered a prospective treatment for this pathology

Method of Mapping for Semantic Static Constructions into Syntactic Constructions in the Design of Information-Active Systems

The design of information-active systems provides the formation of the model representation of automated tasks, which is invariant to the environment and means of software and hardware implementation. The syntactic (info-logical) model representation of applied problems will be adequate to initial requirements only if they provide meaningful unity. It is determined by the initial formation of a knowledge model or conceptual representation of applied tasks. The conjugation of semantic and syntactic static constructions is based on the regularity of mapping in the framework of the methodology of intellectual labor automation. The formal description of connections (mapping) of semantic (conceptual) and syntactic (info-logical) representations on the basis of the regularity of mapping allows limiting the set of possible relations and connections in verbal syntactical constructions for representation of subject tasks and providing completeness of the formalized (syntactic) representations at the expense of their semantic addition

Method of Mapping for Semantic Static Constructions into Syntactic Constructions in the Design of Information-Active Systems

The design of information-active systems provides the formation of the model representation of automated tasks, which is invariant to the environment and means of software and hardware implementation. The syntactic (info-logical) model representation of applied problems will be adequate to initial requirements only if they provide meaningful unity. It is determined by the initial formation of a knowledge model or conceptual representation of applied tasks. The conjugation of semantic and syntactic static constructions is based on the regularity of mapping in the framework of the methodology of intellectual labor automation. The formal description of connections (mapping) of semantic (conceptual) and syntactic (info-logical) representations on the basis of the regularity of mapping allows limiting the set of possible relations and connections in verbal syntactical constructions for representation of subject tasks and providing completeness of the formalized (syntactic) representations at the expense of their semantic addition

Peroxiredoxin 6 Attenuates Alloxan-Induced Type 1 Diabetes Mellitus in Mice and Cytokine-Induced Cytotoxicity in RIN-m5F Beta Cells

Type 1 diabetes is associated with the destruction of pancreatic beta cells, which is mediated via an autoimmune mechanism and consequent inflammatory processes. In this article, we describe a beneficial effect of peroxiredoxin 6 (PRDX6) in a type 1 diabetes mouse model. The main idea of this study was based on the well-known data that oxidative stress plays an important role in pathogenesis of diabetes and its associated complications. We hypothesised that PRDX6, which is well known for its various biological functions, including antioxidant activity, may provide an antidiabetic effect. It was shown that PRDX6 prevented hyperglycemia, lowered the mortality rate, restored the plasma cytokine profile, reversed the splenic cell apoptosis, and reduced the β cell destruction in Langerhans islets in mice with a severe form of alloxan-induced diabetes. In addition, PRDX6 protected rat insulinoma RIN-m5F β cells, cultured with TNF-α and IL-1β, against the cytokine-induced cytotoxicity and reduced the apoptotic cell death and production of ROS. Signal transduction studies showed that PRDX6 prevented the activation of NF-κB and c-Jun N-terminal kinase signaling cascades in RIN-m5F β cells cultured with cytokines. In conclusion, there is a prospect for therapeutic application of PRDX6 to delay or even prevent β cell apoptosis in type 1 diabetes

Peroxiredoxin 6 Applied after Exposure Attenuates Damaging Effects of X-ray Radiation in 3T3 Mouse Fibroblasts

Although many different classes of antioxidants have been evaluated as radioprotectors, none of them are in widespread clinical use because of their low efficiency. The goal of our study was to evaluate the potential of the antioxidant protein peroxiredoxin 6 (Prdx6) to increase the radioresistance of 3T3 fibroblasts when Prdx6 was applied after exposure to 6 Gy X-ray. In the present study, we analyzed the mRNA expression profiles of genes associated with proliferation, apoptosis, cellular stress, senescence, and the production of corresponding proteins from biological samples after exposure of 3T3 cells to X-ray radiation and application of Prdx6. Our results suggested that Prdx6 treatment normalized p53 and NF-κB/p65 expression, p21 levels, DNA repair-associated genes (XRCC4, XRCC5, H2AX, Apex1), TLR expression, cytokine production (TNF-α and IL-6), and apoptosis, as evidenced by decreased caspase 3 level in irradiated 3T3 cells. In addition, Prdx6 treatment reduced senescence, as evidenced by the decreased percentage of SA-β-Gal positive cells in cultured 3T3 fibroblasts. Importantly, the activity of the NRF2 gene, an important regulator of the antioxidant cellular machinery, was completely suppressed by irradiation but was restored by post-irradiation Prdx6 treatment. These data support the radioprotective therapeutic efficacy of Prdx6

Thymulin, free or bound to PBCA nanoparticles, protects mice against chronic septic inflammation.

In the present work, we aimed to study the effects of free and polybutylcyanoacrylate nanoparticle-bound thymulin on immune cell activity in mice with chronic inflammation. NF-κB, MAPK, and PKC-θ signaling pathway activity was assessed, alongside Hsp72, Hsp90-α, and TLR4 expression and levels of apoptosis. In addition, plasma cytokines and blood and brain melatonin and serotonin levels were measured. In mice treated with gradually raised doses of lipopolysaccharide, significant increases in the activity of the signaling pathways tested, heat-shock protein and TLR4 expression, lymphocyte apoptosis, and plasma proinflammatory cytokine levels were noted. Moreover, we observed significantly heightened serotonin concentrations in the plasma and especially the brains of mice with inflammation. In contrast, melatonin levels were reduced in the tissues examined, particularly so in the brain. Treatment of these mice with thymulin alleviated fever, reduced apoptosis, increased splenic cell number, and decreased cytokine production, Hsp72, Hsp90, and TLR4 expression, and the activity of the signaling pathways examined. In addition, thymulin partially restored brain and blood serotonin and melatonin levels. Thus, thymulin suppressed the proinflammatory response in LPS-treated mice, indicating the potential of thymulin co-therapy in the treatment of sepsis. Nanoparticle-bound thymulin was more effective in several respects

Splenic cell number and body temperature of mice on the 8th day of LPS injection.

<p>Splenic cell number and body temperature of mice on the 8th day of LPS injection.</p

Effects of thymulin (free or bound to PBCA nanoparticles) on apoptosis of splenic lymphocytes from mice with inflammation.

<p>The groups used in this experiment were the same as those in Figs <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0197601#pone.0197601.g002" target="_blank">2</a> and <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0197601#pone.0197601.g003" target="_blank">3</a> (1, control; 2, IB; 3, IB+TM; 4, IB+TMN). Western blot analysis of extracts from isolated mouse lymphocytes was performed using the indicated antibodies or an anti-GAPDH antibody (bottom). Images of blots show a single representative experiment using one mouse. The histograms below the protein bands show quantified protein levels expressed in mean relative units (relative to the internal control), and are the results of blot densitometry using the program QAPA and data from five animals. Black columns represent caspase-3 and clear columns cleaved caspase-3. *Significantly different from the control group (p<0.05). ^Significantly different from the IB group (p<0.05).</p