Type I insulin dependent diabetes mellitus (IDDM) is thought to result from chronic, cell-mediate... more Type I insulin dependent diabetes mellitus (IDDM) is thought to result from chronic, cell-mediated, 'autoimmune' islet damage. Antibody testing is extensively used to define and follow the pre-diabetic population. However, the assay for cell mediated immunity (CMI) should be more predictive of impending disease. This report shows that it is possible to detect human islet reactive CM1 in the IDDM patient. Groups of athymic CD-1 nu/nu mice were injected intraperitoneally with either mononuclear blood cells (MBCs) or plasma from 10 newly diagnosed Type I diabetic patients and 10 normal control subjects. Both glycemic control and histopathology were used to assay islet specific CM1 in diabetic individuals. None of the injected mice showed any impairment of glycemic control. However, MBCs from six of 10 diabetic patients, but from none of the 10 normal subjects, induced significant mononuclear cell infiltrate in the pancreas of the recipient mice (P=O.O05). The infiltrate was focused on the islet tissue and no damage was seen in control tissues. No histological abnormalities were observed when plasma was transferred. We conclude that cellular reactivity seen in this model is tissue specific and disease associated. Our findings provide evidence that CM1 to human islet tissue can be detected in IDDM patients.
Portacaval shunt was performed in ten patients with homozygous and two with heterozygous familial... more Portacaval shunt was performed in ten patients with homozygous and two with heterozygous familial hypercholesterolemia (FH). Total serum cholesterol was lowered by 20% to 55.4% during follow-up periods of 14 months to almost 9 years, with commensurate decreases in LDL cholesterol. The effect on HDL cholesterol and triglyceride levels was variable. Tendinocuteous xanthomas diminished or disappeared. Growth and development in children proceeded or accelerated. There was no detectable emotional or intellectual deterioration. Hepatic failure did not occur, although blood ammonia concentrations and serum alkline phosphatase levels increased relative to preoperative values. Cardiac symptoms were often improved, but evidence of reversal of cardiovascular lesions was inconclusive. Three patients with pre-existing heart disease died of cardiac complications after 4 months, 18½ months, and
There is a need for better and earlier markers of clinical renal damage in subjects with Type I d... more There is a need for better and earlier markers of clinical renal damage in subjects with Type I diabetes. In this prospective study, exercise albumin excretion rates (AERs) were studied longitudinally for a 4-year period in 187 young subjects with Type I diabetes. For this time period, 54% of subjects continued to have normal overnight and exercise AERs, 11% had continuously elevated exercise and overnight AERs, 11% developed an elevated exercise AER with the overnight AER remaining normal, and 12% had a normal overnight AER throughout the study, with initially elevated exercise levels later decreasing to normal. This improvement in exercise AER was associated with improved glycosylated hemoglobin (HbA1) values for 64% of the subjects (p = 0.0004, paired t test). Five percent of subjects, who initially had only an elevated exercise AER, developed a consistently elevated overnight AER. Seven of these nine subjects showed either worsening (greater than 10%) or no improvement in their HbA1 values from the initial to the final study periods. Five percent of subjects continued to have an elevated exercise and normal overnight AER throughout the study. These results show that the elevated exercise AER represents a definite transitional stage between a normal and an abnormal (greater than 30 micrograms/min) overnight AER. In addition, a "window" exists during which an elevated exercise AER may be reversed by improved glucose control, but if this improvement does not occur, progression to an increased overnight AER is likely to result.
To evaluate the effects of oral contraceptives (OCs) as a possible risk factor for early diabetic... more To evaluate the effects of oral contraceptives (OCs) as a possible risk factor for early diabetic renal and/or retinal complications. A retrospective case-control study. A university hospital diabetes clinic. Forty-three diabetic women who used OCs for 1 year or longer (mean, 3.4 years; range, 1.0 to 7.0 years) were compared with a computer-matched control group of 43 diabetic women who never used OCs. Hemoglobin A1c levels, albumin excretion rates, and mean retinopathy scores. The mean +/- SEM age and duration of diabetes were 22.7 +/- 0.5 years (range, 17.1 to 30.5 years) and 13.8 +/- 0.8 years, respectively, for the study group. The mean longitudinal hemoglobin A1c values were similar for study subjects and control subjects. The final mean albumin excretion rates, reflecting diabetic renal damage, and the mean eye grades were not significantly different between the groups. The use of OCs among young women with insulin-dependent diabetes mellitus does not pose an additional risk for the development of early diabetic retinopathy and/or nephropathy.
OBJECTIVE-The aim of this study was to develop a partial closed-loop system to safely prevent noc... more OBJECTIVE-The aim of this study was to develop a partial closed-loop system to safely prevent nocturnal hypoglycemia by suspending insulin delivery when hypoglycemia is predicted in type 1 diabetes. RESEARCH DESIGN AND METHODS-Forty subjects with type 1 diabetes (age range 12-39 years) were studied overnight in the hospital. For the first 14 subjects, hypoglycemia (Ͻ60 mg/dl) was induced by gradually increasing the basal insulin infusion rate (without the use of pump shutoff algorithms). During the subsequent 26 patient studies, pump shutoff occurred when either three of five (n ϭ 10) or two of five (n ϭ 16) algorithms predicted hypoglycemia based on the glucose levels measured with the FreeStyle Navigator (Abbott Diabetes Care). RESULTS-The standardized protocol induced hypoglycemia on 13 (93%) of the 14 nights. With use of a voting scheme that required three algorithms to trigger insulin pump suspension, nocturnal hypoglycemia was prevented during 6 (60%) of 10 nights. When the voting scheme was changed to require only two algorithms to predict hypoglycemia to trigger pump suspension, hypoglycemia was prevented during 12 (75%) of 16 nights. In the latter study, there were 25 predictions of hypoglycemia because some subjects had multiple hypoglycemic events during a night, and hypoglycemia was prevented for 84% of these events. CONCLUSIONS-Using algorithms to shut off the insulin pump when hypoglycemia is predicted, it is possible to prevent hypoglycemia on 75% of nights (84% of events) when it would otherwise be predicted to occur.
The issues that are of chief interest to Insurance Companies as investors are the loans raised by... more The issues that are of chief interest to Insurance Companies as investors are the loans raised by Foreign and Colonial Governments and Municipalities, principally in the form of bonds, and Foreign and Home Corporations in the form of bonds, debenture stocks, ordinary stocks, &c. When these borrowers want money—and they have apparently much needed it during the past three years and are needing it now—they set about the attainment of their desires by calling in the help of their financial agents or advisers who may be either a financial house or a bank. The usual methods in this country are for the Issuing House to buy up the loan at an agreed figure and subsequently to issue the loan at their own price, making what profit they can, or to act merely as agents for the borrower, charging a commission for their work and the advice they give.
The objective of this study was to describe a pilot trial of using an omega-3 fatty acid (docosah... more The objective of this study was to describe a pilot trial of using an omega-3 fatty acid (docosahexaenoic acid [DHA]) to prevent islet cell autoimmunity in infants with an increased risk for developing type 1 diabetes (T1D). Infants from pregnant mothers who either have T1D (or the father or a previous child has T1D) and who entered the study in the third trimester or infants younger than age 5 months having a first-degree family member with T1D were eligible for the study. Infants from either group also had to have an increased genetic (HLA) risk for T1D (or multiple first-degree relatives with T1D) to be eligible. The study is a multicenter, 2-arm, randomized, doublemasked clinical trial that will last 4 years (1 year of recruitment and 3 years of treatment). Treatment with DHA (or control) began in the last trimester of pregnancy or in the first 5 months after birth. Inflammatory mediators, including cytokines, chemokines, eicosanoids, and C-reactive protein, are being measured along with fatty acids in maternal and infant blood. Ninety-eight infants were enrolled (41 during pregnancy and 57 in the 5 months after birth). HLA results of the 97 eligible infants (1 infant had a protective 0602 allele and was thus ineligible) showed that 90 have DR3 and/or DR4. Seven infants were enrolled without DR3/4 but who instead had multiple first-degree relatives with T1D. Compliance has been excellent, and no families have discontinued participation. Intervention trials in this high-risk group are feasible but require significant effort to identify potential participants.
... 4200 E. Ninth, Denver, Colorado 80220. PEDIATRICS, Vol. 47, No. 3, March 1971 491 ARTICLES IN... more ... 4200 E. Ninth, Denver, Colorado 80220. PEDIATRICS, Vol. 47, No. 3, March 1971 491 ARTICLES INTRA-UTERINE UNDERNUTRITION AND BRAIN DEVELOPMENT H. Peter Chase, MD, Carol S. Dabiere, BS, N. Noreen Welch, BA, and Donough O'Brien, MD, FRCPE ...
American journal of diseases of children (1960), 1971
Page 1. Nutritional Status of Preschool Mexican-American Migrant Farm Children H. Peter Chase, MD... more Page 1. Nutritional Status of Preschool Mexican-American Migrant Farm Children H. Peter Chase, MD; Vijay Kumar, MD; Janice M. Dodds, MEd; Howard E. Sauberlich, PhD, Robert M. Hunter, PhD; Robert S. Burton, MS; and Vaughn Spalding, RN, Denver ...
... Starzl CharlesW. Putnam H.Peter Chase KendrickA. ... per 100 ml. In 1967, at age 7 years, she... more ... Starzl CharlesW. Putnam H.Peter Chase KendrickA. ... per 100 ml. In 1967, at age 7 years, she was given cholestyramine, 12 g. per day, and had a rise in the cholesterol level from 637 mg. per 100 ml. to 894 mg. per 100 ml. Prothrombin levels at that time fell from 100 to 70. ...
Ten children with CF in matched pairs were infused with either Intralipid or with 10% glucose on ... more Ten children with CF in matched pairs were infused with either Intralipid or with 10% glucose on a double blind basis every other week for one year. Although statistically there was significantly greater gain in height and weight in the study year compared to the previous year only for the test group, both groups improved more than expected. Cumulative data analysis showed greater improvement for the Intralipid group (23 of a possible 45 points) compared to the glucose group (-2 points; P less than .02). This study indicates the need to better define the role of nutrition in the pathophysiology of CF. Meanwhile, it is recommended that all children with CF have plasma linoleic acid levels measured at least once yearly, and if levels are low, appropriate supplements should be given.
Type I insulin dependent diabetes mellitus (IDDM) is thought to result from chronic, cell-mediate... more Type I insulin dependent diabetes mellitus (IDDM) is thought to result from chronic, cell-mediated, 'autoimmune' islet damage. Antibody testing is extensively used to define and follow the pre-diabetic population. However, the assay for cell mediated immunity (CMI) should be more predictive of impending disease. This report shows that it is possible to detect human islet reactive CM1 in the IDDM patient. Groups of athymic CD-1 nu/nu mice were injected intraperitoneally with either mononuclear blood cells (MBCs) or plasma from 10 newly diagnosed Type I diabetic patients and 10 normal control subjects. Both glycemic control and histopathology were used to assay islet specific CM1 in diabetic individuals. None of the injected mice showed any impairment of glycemic control. However, MBCs from six of 10 diabetic patients, but from none of the 10 normal subjects, induced significant mononuclear cell infiltrate in the pancreas of the recipient mice (P=O.O05). The infiltrate was focused on the islet tissue and no damage was seen in control tissues. No histological abnormalities were observed when plasma was transferred. We conclude that cellular reactivity seen in this model is tissue specific and disease associated. Our findings provide evidence that CM1 to human islet tissue can be detected in IDDM patients.
Portacaval shunt was performed in ten patients with homozygous and two with heterozygous familial... more Portacaval shunt was performed in ten patients with homozygous and two with heterozygous familial hypercholesterolemia (FH). Total serum cholesterol was lowered by 20% to 55.4% during follow-up periods of 14 months to almost 9 years, with commensurate decreases in LDL cholesterol. The effect on HDL cholesterol and triglyceride levels was variable. Tendinocuteous xanthomas diminished or disappeared. Growth and development in children proceeded or accelerated. There was no detectable emotional or intellectual deterioration. Hepatic failure did not occur, although blood ammonia concentrations and serum alkline phosphatase levels increased relative to preoperative values. Cardiac symptoms were often improved, but evidence of reversal of cardiovascular lesions was inconclusive. Three patients with pre-existing heart disease died of cardiac complications after 4 months, 18½ months, and
There is a need for better and earlier markers of clinical renal damage in subjects with Type I d... more There is a need for better and earlier markers of clinical renal damage in subjects with Type I diabetes. In this prospective study, exercise albumin excretion rates (AERs) were studied longitudinally for a 4-year period in 187 young subjects with Type I diabetes. For this time period, 54% of subjects continued to have normal overnight and exercise AERs, 11% had continuously elevated exercise and overnight AERs, 11% developed an elevated exercise AER with the overnight AER remaining normal, and 12% had a normal overnight AER throughout the study, with initially elevated exercise levels later decreasing to normal. This improvement in exercise AER was associated with improved glycosylated hemoglobin (HbA1) values for 64% of the subjects (p = 0.0004, paired t test). Five percent of subjects, who initially had only an elevated exercise AER, developed a consistently elevated overnight AER. Seven of these nine subjects showed either worsening (greater than 10%) or no improvement in their HbA1 values from the initial to the final study periods. Five percent of subjects continued to have an elevated exercise and normal overnight AER throughout the study. These results show that the elevated exercise AER represents a definite transitional stage between a normal and an abnormal (greater than 30 micrograms/min) overnight AER. In addition, a "window" exists during which an elevated exercise AER may be reversed by improved glucose control, but if this improvement does not occur, progression to an increased overnight AER is likely to result.
To evaluate the effects of oral contraceptives (OCs) as a possible risk factor for early diabetic... more To evaluate the effects of oral contraceptives (OCs) as a possible risk factor for early diabetic renal and/or retinal complications. A retrospective case-control study. A university hospital diabetes clinic. Forty-three diabetic women who used OCs for 1 year or longer (mean, 3.4 years; range, 1.0 to 7.0 years) were compared with a computer-matched control group of 43 diabetic women who never used OCs. Hemoglobin A1c levels, albumin excretion rates, and mean retinopathy scores. The mean +/- SEM age and duration of diabetes were 22.7 +/- 0.5 years (range, 17.1 to 30.5 years) and 13.8 +/- 0.8 years, respectively, for the study group. The mean longitudinal hemoglobin A1c values were similar for study subjects and control subjects. The final mean albumin excretion rates, reflecting diabetic renal damage, and the mean eye grades were not significantly different between the groups. The use of OCs among young women with insulin-dependent diabetes mellitus does not pose an additional risk for the development of early diabetic retinopathy and/or nephropathy.
OBJECTIVE-The aim of this study was to develop a partial closed-loop system to safely prevent noc... more OBJECTIVE-The aim of this study was to develop a partial closed-loop system to safely prevent nocturnal hypoglycemia by suspending insulin delivery when hypoglycemia is predicted in type 1 diabetes. RESEARCH DESIGN AND METHODS-Forty subjects with type 1 diabetes (age range 12-39 years) were studied overnight in the hospital. For the first 14 subjects, hypoglycemia (Ͻ60 mg/dl) was induced by gradually increasing the basal insulin infusion rate (without the use of pump shutoff algorithms). During the subsequent 26 patient studies, pump shutoff occurred when either three of five (n ϭ 10) or two of five (n ϭ 16) algorithms predicted hypoglycemia based on the glucose levels measured with the FreeStyle Navigator (Abbott Diabetes Care). RESULTS-The standardized protocol induced hypoglycemia on 13 (93%) of the 14 nights. With use of a voting scheme that required three algorithms to trigger insulin pump suspension, nocturnal hypoglycemia was prevented during 6 (60%) of 10 nights. When the voting scheme was changed to require only two algorithms to predict hypoglycemia to trigger pump suspension, hypoglycemia was prevented during 12 (75%) of 16 nights. In the latter study, there were 25 predictions of hypoglycemia because some subjects had multiple hypoglycemic events during a night, and hypoglycemia was prevented for 84% of these events. CONCLUSIONS-Using algorithms to shut off the insulin pump when hypoglycemia is predicted, it is possible to prevent hypoglycemia on 75% of nights (84% of events) when it would otherwise be predicted to occur.
The issues that are of chief interest to Insurance Companies as investors are the loans raised by... more The issues that are of chief interest to Insurance Companies as investors are the loans raised by Foreign and Colonial Governments and Municipalities, principally in the form of bonds, and Foreign and Home Corporations in the form of bonds, debenture stocks, ordinary stocks, &c. When these borrowers want money—and they have apparently much needed it during the past three years and are needing it now—they set about the attainment of their desires by calling in the help of their financial agents or advisers who may be either a financial house or a bank. The usual methods in this country are for the Issuing House to buy up the loan at an agreed figure and subsequently to issue the loan at their own price, making what profit they can, or to act merely as agents for the borrower, charging a commission for their work and the advice they give.
The objective of this study was to describe a pilot trial of using an omega-3 fatty acid (docosah... more The objective of this study was to describe a pilot trial of using an omega-3 fatty acid (docosahexaenoic acid [DHA]) to prevent islet cell autoimmunity in infants with an increased risk for developing type 1 diabetes (T1D). Infants from pregnant mothers who either have T1D (or the father or a previous child has T1D) and who entered the study in the third trimester or infants younger than age 5 months having a first-degree family member with T1D were eligible for the study. Infants from either group also had to have an increased genetic (HLA) risk for T1D (or multiple first-degree relatives with T1D) to be eligible. The study is a multicenter, 2-arm, randomized, doublemasked clinical trial that will last 4 years (1 year of recruitment and 3 years of treatment). Treatment with DHA (or control) began in the last trimester of pregnancy or in the first 5 months after birth. Inflammatory mediators, including cytokines, chemokines, eicosanoids, and C-reactive protein, are being measured along with fatty acids in maternal and infant blood. Ninety-eight infants were enrolled (41 during pregnancy and 57 in the 5 months after birth). HLA results of the 97 eligible infants (1 infant had a protective 0602 allele and was thus ineligible) showed that 90 have DR3 and/or DR4. Seven infants were enrolled without DR3/4 but who instead had multiple first-degree relatives with T1D. Compliance has been excellent, and no families have discontinued participation. Intervention trials in this high-risk group are feasible but require significant effort to identify potential participants.
... 4200 E. Ninth, Denver, Colorado 80220. PEDIATRICS, Vol. 47, No. 3, March 1971 491 ARTICLES IN... more ... 4200 E. Ninth, Denver, Colorado 80220. PEDIATRICS, Vol. 47, No. 3, March 1971 491 ARTICLES INTRA-UTERINE UNDERNUTRITION AND BRAIN DEVELOPMENT H. Peter Chase, MD, Carol S. Dabiere, BS, N. Noreen Welch, BA, and Donough O'Brien, MD, FRCPE ...
American journal of diseases of children (1960), 1971
Page 1. Nutritional Status of Preschool Mexican-American Migrant Farm Children H. Peter Chase, MD... more Page 1. Nutritional Status of Preschool Mexican-American Migrant Farm Children H. Peter Chase, MD; Vijay Kumar, MD; Janice M. Dodds, MEd; Howard E. Sauberlich, PhD, Robert M. Hunter, PhD; Robert S. Burton, MS; and Vaughn Spalding, RN, Denver ...
... Starzl CharlesW. Putnam H.Peter Chase KendrickA. ... per 100 ml. In 1967, at age 7 years, she... more ... Starzl CharlesW. Putnam H.Peter Chase KendrickA. ... per 100 ml. In 1967, at age 7 years, she was given cholestyramine, 12 g. per day, and had a rise in the cholesterol level from 637 mg. per 100 ml. to 894 mg. per 100 ml. Prothrombin levels at that time fell from 100 to 70. ...
Ten children with CF in matched pairs were infused with either Intralipid or with 10% glucose on ... more Ten children with CF in matched pairs were infused with either Intralipid or with 10% glucose on a double blind basis every other week for one year. Although statistically there was significantly greater gain in height and weight in the study year compared to the previous year only for the test group, both groups improved more than expected. Cumulative data analysis showed greater improvement for the Intralipid group (23 of a possible 45 points) compared to the glucose group (-2 points; P less than .02). This study indicates the need to better define the role of nutrition in the pathophysiology of CF. Meanwhile, it is recommended that all children with CF have plasma linoleic acid levels measured at least once yearly, and if levels are low, appropriate supplements should be given.
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