Urinary excretion of calcium, inorganic phosphorus, magnesium, glucose, and creatinine was measur... more Urinary excretion of calcium, inorganic phosphorus, magnesium, glucose, and creatinine was measured in first-void spot urine samples collected 4 days apart in 220 insulin-dependent diabetic (IDDM) children (mean age 11.9 yr) attending a summer camp. A single control urine sample was obtained from 33 healthy nondiabetic siblings (mean age 11.2 yr). Mean ± SD urinary calciumcreatinine ratios (UCa/cr) did not significantly differ between IDDM and control subjects (0.14 ± 0.09 vs. 0.12 ± 0.09, respectively, P = 0.156). Mean urinary magnesium-creatinine ratios (UMg/Cr) were elevated in IDDM compared with control subjects (0.15 ± 0.06 vs. 0.08 ± 0.03, respectively, P = 0.0001). Similarly, mean urinary phosphorus-creatinine ratios (UP/cr) were significantly increased over those in control subjects (1.12 ± 0.33 vs. 0.40 ± 0.22, respectively, P = 0.0001). Uca/cr′ UMg/Cr′, and Up/Cr were correlated with increasing mean urine glucose content (P = 0.0001). No correlations were found when Uca/cr′ UMg/Cr′, or Up/Cr were compared with patient age, duration of diabetes, glycosylated hemoglobin, or insulin dosage. Urine losses of phosphorus and magnesium were present even when glycemic control was considered good by several methods (glycosylated hemoglobin, short-term glycemic index, or urinary glucose content). Glomerular hyperfiltration was unable to account for increased urinary mineral content. In conclusion, the data indicate that urinary excretion of phosphorus and magnesium is elevated in children with IDDM, regardless of glycemic control. In the presence of glucosuria, this loss is further enhanced. Urinary calcium excretion is significantly higher only during periods of glucosuria. The data suggest that children with IDDM could be at risk for mineral deficiencies in the absence of intensive insulin management.
By the most recent estimates, 34.2 million people in the U.S. have diabetes (1). At the same time... more By the most recent estimates, 34.2 million people in the U.S. have diabetes (1). At the same time, 88 million people are at increased risk for developing type 2 diabetes. The U.S. also sees an increasing prevalence of both type 1 and type 2 diabetes in children and adolescents (2). Thus, more than 122 million Americans are at risk for developing devastating complications associated with chronic hyperglycemia (1). Diabetes self-management education and support (DSMES) is a critical element of care for all people with diabetes (PWD). "The purpose of DSMES is to give PWD the knowledge, skills, and confidence to accept responsibility for their self-management. This includes collaborating with their healthcare team, making informed decisions, solving problems, developing personal goals and action plans, and coping with emotions and life stresses" (3). DSMES interventions include activities that support PWD to implement and sustain the self-management behaviors and strategies to improve diabetes and related cardiometabolic conditions and quality of life on an ongoing basis. Despite progress in diabetes treatment modalities, glycemic and cardiometabolic outcomes continue to decline in the U.S. (4). Now, more than ever, the provision of DSMES is a vital component of the full treatment for diabetes. PWD are at risk for distress, life stress, and clinical depression, which can lead to poor health outcomes (5). The National Standards for Diabetes Self-Management Education and Support (hereinafter referred to as the National Standards) encourage the DSMES team to acknowledge and address the emotional burden of living with and managing diabetes-diabetes distress-and to consider the multitude of daily demands and decisions required of PWD, their families, and caregivers (6-9). To further illustrate, PWD generally visit their primary care physician (PCP)/other qualified healthcare professional two to four times per year, where the average appointment lasts 15-20 min and addresses four or more health conditions (10). This equates to the person with diabetes (PWD) spending less than 1% of their life with their healthcare professionals (10). Therefore, diabetes management decisions largely fall on PWD and/or caregivers, further highlighting the importance of increasing access to DSMES services that support ongoing self-management and decision making. The National Standards define timely, evidence-based, quality DSMES services that meet or exceed the Centers for Medicare & Medicaid Services quality standards. While the acronym DSMES is used in the literature and in current practice, it is important to note that the term diabetes self-management training (DSMT) is exclusively used when describing the Medicare benefit for diabetes self-management. The Medicare benefit for DSMT was established by the Balanced Budget Act (BBA) of 1997 with a final rule (65 FR 83130) published on 29 December 2000, implementing the BBA provisions and DSMT regulations (Title 42 of the Code of Federal Regulation sections 410.140 to 410.146). The DSMT benefit has reimbursement guidelines outside of the National Standards.
There is evidence in several cell systems suggesting that the GnRH receptor couples to multiple G... more There is evidence in several cell systems suggesting that the GnRH receptor couples to multiple G proteins. Presently there are no published studies showing GnRH receptor coupling to G i ␣, G s ␣, and G q/11 ␣ in a single cell type. To examine this possibility we measured palmitoylation of G proteins in response to GnRH receptor occupancy, since this event is a measure of Gprotein activation by cognate receptors. GnRH stimulated time (0-120 min)-and dose (10 Ϫ12-10 Ϫ6 g/ml)-dependent palmitoylation of both G i ␣ and G s ␣. Palmitoylation is G-protein activation dependent; accordingly, pertussis toxin (100 ng/ml; PTX), phorbol myristic acid (100 ng/ml), and Antide (50 nM; a GnRH antagonist) did not stimulate palmitoylation of G i ␣ or G s ␣ above basal levels. However, cholera toxin (5 g/ml), an activator of G s ␣, stimulated palmitoylation of G s ␣ but not G i ␣. We used a lactotrope-derived cell line expressing the GnRH receptor (GGH 3) to examine whether the ability of the receptor to couple multiple G proteins is gonadotroph specific. GGH 3 cells were transfected with specific cDNA coding for different G proteins, and agonist-stimulated second messenger production was assessed. Buserelin (a GnRH agonist) stimulated increased cAMP release in G s ␣ cDNA-transfected GGH 3 cells, whereas in G i ␣ cDNA-transfected cells, both inositol phosphate (IP) production and cAMP release were decreased in response to buserelin. Transfection of G q ␣, G 11 ␣, G 14 ␣, and G 15 ␣ cDNA into GGH 3 cells resulted in an increased IP production in response to buserelin, indicating that GnRH receptor couples to this PTX-insensitive G-protein family. The observations presented in this study provide evidence for GnRH receptor coupling to multiple G proteins in a single cell type.
In this article, Stephen W. Ponder, MD, emphasizes the initial workup and medical management of t... more In this article, Stephen W. Ponder, MD, emphasizes the initial workup and medical management of type 2 diabetes in children and adolescents, including comorbidities.
Disaster Medicine and Public Health Preparedness, Feb 1, 2020
ABSTRACTThe 2017 Atlantic hurricane season was especially memorable for 3 major hurricanes—Harvey... more ABSTRACTThe 2017 Atlantic hurricane season was especially memorable for 3 major hurricanes—Harvey, Irma, and Maria—that devastated population centers across Texas, Florida, and Puerto Rico, respectively. Each storm had unique hazard properties that posed distinctive challenges for persons living with type 1 diabetes (T1D). Diabetes care specialists and educators took on leadership roles for coordinating care and establishing insulin supply lifelines for people with T1D living in the hardest-hit neighborhoods affected by these extreme storms. Strategies and resources were customized for each population. Diabetes specialists strategized to provide mutual support and shared insulins and supplies across sites.
Purpose The purpose of this review study was to determine and categorize common causes of intermi... more Purpose The purpose of this review study was to determine and categorize common causes of intermittent hyperglycemia and suggest potential measures to prevent and treat the identified causes. Methods A literature review was conducted to obtain relevant information on hyperglycemia and continuous subcutaneous insulin infusion (CSII). Medical departments from Novo/Nordisk, Eli Lilly and Company, and Sanofi/Aventis were contacted requesting information on their insulin temperature stability, the compatibility of insulin with insulin/pump reservoirs, and tubing sets/catheters. Endocri- nologists, Certified Diabetes Educators, and pump manufacturing company trainers were interviewed for their clinical observations and to determine the incidence of reported hyperglycemia and relationships to pump failures. Results Causes of intermittent hyperglycemia in CSII patients included problems with mechanical evaluation of the pump, basal/bolus review, reservoir/tubing, catheter site selection/placement, and insulin compatibility/stability. Conclusions As more patients and health care providers strive to improve control of diabetes, use of insulin pump therapy will continue to increase. Unexplained hyperglycemia will continue to occur, which can lead to increased health care costs due to complications such as diabetic ketoacidosis. Evaluation of patient techniques and pump programming can uncover many potential causes, and the health care provider can assist in patient education to prevent further episodes.
Journal of Veterinary Pharmacology and Therapeutics, Dec 1, 1980
Xylazine administered subcutaneously (s.c.; 1-4 mg/kg) or intravenously (i.v.; 0.5-2 mg/kg) to ca... more Xylazine administered subcutaneously (s.c.; 1-4 mg/kg) or intravenously (i.v.; 0.5-2 mg/kg) to cats consistently caused dose-related decreases in body temperature which were maximal 3-4 h after injection and lasted for a t least 12 h. Otherwise the animals appeared t o have recovered fully from the central nervous system effects of the drug within 1.5-3.5 h. Xylazine-induced hypothermia developed more rapidly in cats placed in a 4OC environment and, in contrast, was replaced by a hyperthermic response in cats placed in a 32OC environment. These changes in body temperature were not opposed by compensatory thermoregulatory effector activity such as shivering or tachypnea. This pattern of responses at varied environmental temperatures is indicative of a general depression of thermoregulation. Thus, animals given xylazine should not be exposed to extreme heat or cold for several hours to avoid development of hyper-or hypothermia.
Archives of pediatrics & adolescent medicine, Dec 1, 1990
Lumbar spine (L-2, L-3, L-4) bone mineral density was measured in 184 healthy boys and girls aged... more Lumbar spine (L-2, L-3, L-4) bone mineral density was measured in 184 healthy boys and girls aged 5.00 through 11.99 years by dual photon absorptiometry. Weight, height, age, triceps skinfold thickness, and midarm circumference were also measured. Weight, height, and age were highly correlated with bone mineral density. In the population studied, a quadratic regression equation using body weight as the independent variable best described bone mineral density: bone mineral density = 0.3209 + [0.0168 (weight)] - [0.0001 (weight2)].
(D-ala2)-methionine-enkephalinamide (DAME) was injected into the third cerebral ventricle of unre... more (D-ala2)-methionine-enkephalinamide (DAME) was injected into the third cerebral ventricle of unrestrained cats. At ambient temperature (Ta) = 22 degrees C, 3.1-50 micrograms caused dose-related hyperthermias. As dosage was increased, the hyperthermias diminished and in some cats hypothermia developed. Hyperthermia was not due to pyrogenic contamination or prostaglandin synthesis since it was not altered by pretreatment with a large IV dose of indomethacin. However, pretreatment with naloxone did cause a dose-related reduction in the hyperthermia. A low dose of DAME (12.5 micrograms) also caused hyperthermia at Ta = 4 and 32 degrees C, indicative of an increase in the level about which body temperature was regulated. On the other hand, a dose of 200 micrograms, which caused hyperthermia Ta = 22 and 32 degrees C, usually caused hypothermia at Ta = 4 degrees C, perhaps due to impairment of thermoregulatory control mechanisms. The response to DAME in the cold was reduced by naloxone pretreatment or reversed by subsequent injection of naloxone. Differences in hyperthermic patterns over a range of TaS and the lack of hypothermogenic action of morphine indicate that DAME alters thermoregulation in the cat by acting on morphine-insensitive, but naloxone-sensitive receptors. Central injection of beta-endorphin (5-50 micrograms) caused a dose-related hyperthermia. (Des-tyr1)-leucine-enkephalin (10-250 micrograms) was weakly hyperthermogenic, and kyotorphin (500 micrograms) did not consistently alter body temperature.
The mechanisms for the biphasic response of unrestrained cats to centrally administered pentazoci... more The mechanisms for the biphasic response of unrestrained cats to centrally administered pentazocine were examined by injecting 1 mg pentazocine into the third cerebral ventricle at various ambient temperatures (TaS). The initial phase was hyperthermia at Ta = 34 degrees C, but at Ta = 22 degrees C hypothermia, which was enhanced at Ta = 0 degrees C, developed. The second phase was an increase in body temperature that occurred at all three TaS. No evidence was seen of compensatory thermoregulatory effector activity during development of either phase. The first phase can be attributed to general depression of thermoregulation whereas the second phase was likely due to an increase in the level about which body temperature was regulated. Ethylketocyclazocine (250-1000 micrograms) caused a very similar, dose-related change in temperature, neither phase of which, as reported previously for pentazocine, was reduced by a large dose of nalaxone. Thus both agonists appear to act on the same receptors to alter thermoregulation in the cat. These receptors are distinct from the naloxone-sensitive receptors stimulated by morphine.
Spinal bone mineral density (BMD) and anthropometric measures were studied in 312 nonobese and 23... more Spinal bone mineral density (BMD) and anthropometric measures were studied in 312 nonobese and 23 obese black, white, and Hispanic children and adolescents age 5.00-18.99 years. In adolescents BMD correlated with age, weight, height, fat-free density, body mass index, and midarm circumference. Utilizing the entire group of 312 nonobese subjects, mean Z scores were calculated for comparison versus reference subgroups for bone mineral density index (BMDI, BMD/weight). BMDI was greater for black than for white and Hispanic children and adolescents across all ages studied. Female adolescents accumulated spinal mineral more rapidly than male adolescents. Black males had greater mineral than white and Hispanic males. Differences in BMDI between subgroups could not be explained by differences in body weight or spinal vertebral size. BMDI proved a more sensitive measure for comparing subgroups than did BMD. The study provides normative data and a quantitative methodology for analyzing differences in spinal mineral between groups of children and adolescents.
Urinary excretion of calcium, inorganic phosphorus, magnesium, glucose, and creatinine was measur... more Urinary excretion of calcium, inorganic phosphorus, magnesium, glucose, and creatinine was measured in first-void spot urine samples collected 4 days apart in 220 insulin-dependent diabetic (IDDM) children (mean age 11.9 yr) attending a summer camp. A single control urine sample was obtained from 33 healthy nondiabetic siblings (mean age 11.2 yr). Mean ± SD urinary calciumcreatinine ratios (UCa/cr) did not significantly differ between IDDM and control subjects (0.14 ± 0.09 vs. 0.12 ± 0.09, respectively, P = 0.156). Mean urinary magnesium-creatinine ratios (UMg/Cr) were elevated in IDDM compared with control subjects (0.15 ± 0.06 vs. 0.08 ± 0.03, respectively, P = 0.0001). Similarly, mean urinary phosphorus-creatinine ratios (UP/cr) were significantly increased over those in control subjects (1.12 ± 0.33 vs. 0.40 ± 0.22, respectively, P = 0.0001). Uca/cr′ UMg/Cr′, and Up/Cr were correlated with increasing mean urine glucose content (P = 0.0001). No correlations were found when Uca/cr′ UMg/Cr′, or Up/Cr were compared with patient age, duration of diabetes, glycosylated hemoglobin, or insulin dosage. Urine losses of phosphorus and magnesium were present even when glycemic control was considered good by several methods (glycosylated hemoglobin, short-term glycemic index, or urinary glucose content). Glomerular hyperfiltration was unable to account for increased urinary mineral content. In conclusion, the data indicate that urinary excretion of phosphorus and magnesium is elevated in children with IDDM, regardless of glycemic control. In the presence of glucosuria, this loss is further enhanced. Urinary calcium excretion is significantly higher only during periods of glucosuria. The data suggest that children with IDDM could be at risk for mineral deficiencies in the absence of intensive insulin management.
By the most recent estimates, 34.2 million people in the U.S. have diabetes (1). At the same time... more By the most recent estimates, 34.2 million people in the U.S. have diabetes (1). At the same time, 88 million people are at increased risk for developing type 2 diabetes. The U.S. also sees an increasing prevalence of both type 1 and type 2 diabetes in children and adolescents (2). Thus, more than 122 million Americans are at risk for developing devastating complications associated with chronic hyperglycemia (1). Diabetes self-management education and support (DSMES) is a critical element of care for all people with diabetes (PWD). "The purpose of DSMES is to give PWD the knowledge, skills, and confidence to accept responsibility for their self-management. This includes collaborating with their healthcare team, making informed decisions, solving problems, developing personal goals and action plans, and coping with emotions and life stresses" (3). DSMES interventions include activities that support PWD to implement and sustain the self-management behaviors and strategies to improve diabetes and related cardiometabolic conditions and quality of life on an ongoing basis. Despite progress in diabetes treatment modalities, glycemic and cardiometabolic outcomes continue to decline in the U.S. (4). Now, more than ever, the provision of DSMES is a vital component of the full treatment for diabetes. PWD are at risk for distress, life stress, and clinical depression, which can lead to poor health outcomes (5). The National Standards for Diabetes Self-Management Education and Support (hereinafter referred to as the National Standards) encourage the DSMES team to acknowledge and address the emotional burden of living with and managing diabetes-diabetes distress-and to consider the multitude of daily demands and decisions required of PWD, their families, and caregivers (6-9). To further illustrate, PWD generally visit their primary care physician (PCP)/other qualified healthcare professional two to four times per year, where the average appointment lasts 15-20 min and addresses four or more health conditions (10). This equates to the person with diabetes (PWD) spending less than 1% of their life with their healthcare professionals (10). Therefore, diabetes management decisions largely fall on PWD and/or caregivers, further highlighting the importance of increasing access to DSMES services that support ongoing self-management and decision making. The National Standards define timely, evidence-based, quality DSMES services that meet or exceed the Centers for Medicare & Medicaid Services quality standards. While the acronym DSMES is used in the literature and in current practice, it is important to note that the term diabetes self-management training (DSMT) is exclusively used when describing the Medicare benefit for diabetes self-management. The Medicare benefit for DSMT was established by the Balanced Budget Act (BBA) of 1997 with a final rule (65 FR 83130) published on 29 December 2000, implementing the BBA provisions and DSMT regulations (Title 42 of the Code of Federal Regulation sections 410.140 to 410.146). The DSMT benefit has reimbursement guidelines outside of the National Standards.
There is evidence in several cell systems suggesting that the GnRH receptor couples to multiple G... more There is evidence in several cell systems suggesting that the GnRH receptor couples to multiple G proteins. Presently there are no published studies showing GnRH receptor coupling to G i ␣, G s ␣, and G q/11 ␣ in a single cell type. To examine this possibility we measured palmitoylation of G proteins in response to GnRH receptor occupancy, since this event is a measure of Gprotein activation by cognate receptors. GnRH stimulated time (0-120 min)-and dose (10 Ϫ12-10 Ϫ6 g/ml)-dependent palmitoylation of both G i ␣ and G s ␣. Palmitoylation is G-protein activation dependent; accordingly, pertussis toxin (100 ng/ml; PTX), phorbol myristic acid (100 ng/ml), and Antide (50 nM; a GnRH antagonist) did not stimulate palmitoylation of G i ␣ or G s ␣ above basal levels. However, cholera toxin (5 g/ml), an activator of G s ␣, stimulated palmitoylation of G s ␣ but not G i ␣. We used a lactotrope-derived cell line expressing the GnRH receptor (GGH 3) to examine whether the ability of the receptor to couple multiple G proteins is gonadotroph specific. GGH 3 cells were transfected with specific cDNA coding for different G proteins, and agonist-stimulated second messenger production was assessed. Buserelin (a GnRH agonist) stimulated increased cAMP release in G s ␣ cDNA-transfected GGH 3 cells, whereas in G i ␣ cDNA-transfected cells, both inositol phosphate (IP) production and cAMP release were decreased in response to buserelin. Transfection of G q ␣, G 11 ␣, G 14 ␣, and G 15 ␣ cDNA into GGH 3 cells resulted in an increased IP production in response to buserelin, indicating that GnRH receptor couples to this PTX-insensitive G-protein family. The observations presented in this study provide evidence for GnRH receptor coupling to multiple G proteins in a single cell type.
In this article, Stephen W. Ponder, MD, emphasizes the initial workup and medical management of t... more In this article, Stephen W. Ponder, MD, emphasizes the initial workup and medical management of type 2 diabetes in children and adolescents, including comorbidities.
Disaster Medicine and Public Health Preparedness, Feb 1, 2020
ABSTRACTThe 2017 Atlantic hurricane season was especially memorable for 3 major hurricanes—Harvey... more ABSTRACTThe 2017 Atlantic hurricane season was especially memorable for 3 major hurricanes—Harvey, Irma, and Maria—that devastated population centers across Texas, Florida, and Puerto Rico, respectively. Each storm had unique hazard properties that posed distinctive challenges for persons living with type 1 diabetes (T1D). Diabetes care specialists and educators took on leadership roles for coordinating care and establishing insulin supply lifelines for people with T1D living in the hardest-hit neighborhoods affected by these extreme storms. Strategies and resources were customized for each population. Diabetes specialists strategized to provide mutual support and shared insulins and supplies across sites.
Purpose The purpose of this review study was to determine and categorize common causes of intermi... more Purpose The purpose of this review study was to determine and categorize common causes of intermittent hyperglycemia and suggest potential measures to prevent and treat the identified causes. Methods A literature review was conducted to obtain relevant information on hyperglycemia and continuous subcutaneous insulin infusion (CSII). Medical departments from Novo/Nordisk, Eli Lilly and Company, and Sanofi/Aventis were contacted requesting information on their insulin temperature stability, the compatibility of insulin with insulin/pump reservoirs, and tubing sets/catheters. Endocri- nologists, Certified Diabetes Educators, and pump manufacturing company trainers were interviewed for their clinical observations and to determine the incidence of reported hyperglycemia and relationships to pump failures. Results Causes of intermittent hyperglycemia in CSII patients included problems with mechanical evaluation of the pump, basal/bolus review, reservoir/tubing, catheter site selection/placement, and insulin compatibility/stability. Conclusions As more patients and health care providers strive to improve control of diabetes, use of insulin pump therapy will continue to increase. Unexplained hyperglycemia will continue to occur, which can lead to increased health care costs due to complications such as diabetic ketoacidosis. Evaluation of patient techniques and pump programming can uncover many potential causes, and the health care provider can assist in patient education to prevent further episodes.
Journal of Veterinary Pharmacology and Therapeutics, Dec 1, 1980
Xylazine administered subcutaneously (s.c.; 1-4 mg/kg) or intravenously (i.v.; 0.5-2 mg/kg) to ca... more Xylazine administered subcutaneously (s.c.; 1-4 mg/kg) or intravenously (i.v.; 0.5-2 mg/kg) to cats consistently caused dose-related decreases in body temperature which were maximal 3-4 h after injection and lasted for a t least 12 h. Otherwise the animals appeared t o have recovered fully from the central nervous system effects of the drug within 1.5-3.5 h. Xylazine-induced hypothermia developed more rapidly in cats placed in a 4OC environment and, in contrast, was replaced by a hyperthermic response in cats placed in a 32OC environment. These changes in body temperature were not opposed by compensatory thermoregulatory effector activity such as shivering or tachypnea. This pattern of responses at varied environmental temperatures is indicative of a general depression of thermoregulation. Thus, animals given xylazine should not be exposed to extreme heat or cold for several hours to avoid development of hyper-or hypothermia.
Archives of pediatrics & adolescent medicine, Dec 1, 1990
Lumbar spine (L-2, L-3, L-4) bone mineral density was measured in 184 healthy boys and girls aged... more Lumbar spine (L-2, L-3, L-4) bone mineral density was measured in 184 healthy boys and girls aged 5.00 through 11.99 years by dual photon absorptiometry. Weight, height, age, triceps skinfold thickness, and midarm circumference were also measured. Weight, height, and age were highly correlated with bone mineral density. In the population studied, a quadratic regression equation using body weight as the independent variable best described bone mineral density: bone mineral density = 0.3209 + [0.0168 (weight)] - [0.0001 (weight2)].
(D-ala2)-methionine-enkephalinamide (DAME) was injected into the third cerebral ventricle of unre... more (D-ala2)-methionine-enkephalinamide (DAME) was injected into the third cerebral ventricle of unrestrained cats. At ambient temperature (Ta) = 22 degrees C, 3.1-50 micrograms caused dose-related hyperthermias. As dosage was increased, the hyperthermias diminished and in some cats hypothermia developed. Hyperthermia was not due to pyrogenic contamination or prostaglandin synthesis since it was not altered by pretreatment with a large IV dose of indomethacin. However, pretreatment with naloxone did cause a dose-related reduction in the hyperthermia. A low dose of DAME (12.5 micrograms) also caused hyperthermia at Ta = 4 and 32 degrees C, indicative of an increase in the level about which body temperature was regulated. On the other hand, a dose of 200 micrograms, which caused hyperthermia Ta = 22 and 32 degrees C, usually caused hypothermia at Ta = 4 degrees C, perhaps due to impairment of thermoregulatory control mechanisms. The response to DAME in the cold was reduced by naloxone pretreatment or reversed by subsequent injection of naloxone. Differences in hyperthermic patterns over a range of TaS and the lack of hypothermogenic action of morphine indicate that DAME alters thermoregulation in the cat by acting on morphine-insensitive, but naloxone-sensitive receptors. Central injection of beta-endorphin (5-50 micrograms) caused a dose-related hyperthermia. (Des-tyr1)-leucine-enkephalin (10-250 micrograms) was weakly hyperthermogenic, and kyotorphin (500 micrograms) did not consistently alter body temperature.
The mechanisms for the biphasic response of unrestrained cats to centrally administered pentazoci... more The mechanisms for the biphasic response of unrestrained cats to centrally administered pentazocine were examined by injecting 1 mg pentazocine into the third cerebral ventricle at various ambient temperatures (TaS). The initial phase was hyperthermia at Ta = 34 degrees C, but at Ta = 22 degrees C hypothermia, which was enhanced at Ta = 0 degrees C, developed. The second phase was an increase in body temperature that occurred at all three TaS. No evidence was seen of compensatory thermoregulatory effector activity during development of either phase. The first phase can be attributed to general depression of thermoregulation whereas the second phase was likely due to an increase in the level about which body temperature was regulated. Ethylketocyclazocine (250-1000 micrograms) caused a very similar, dose-related change in temperature, neither phase of which, as reported previously for pentazocine, was reduced by a large dose of nalaxone. Thus both agonists appear to act on the same receptors to alter thermoregulation in the cat. These receptors are distinct from the naloxone-sensitive receptors stimulated by morphine.
Spinal bone mineral density (BMD) and anthropometric measures were studied in 312 nonobese and 23... more Spinal bone mineral density (BMD) and anthropometric measures were studied in 312 nonobese and 23 obese black, white, and Hispanic children and adolescents age 5.00-18.99 years. In adolescents BMD correlated with age, weight, height, fat-free density, body mass index, and midarm circumference. Utilizing the entire group of 312 nonobese subjects, mean Z scores were calculated for comparison versus reference subgroups for bone mineral density index (BMDI, BMD/weight). BMDI was greater for black than for white and Hispanic children and adolescents across all ages studied. Female adolescents accumulated spinal mineral more rapidly than male adolescents. Black males had greater mineral than white and Hispanic males. Differences in BMDI between subgroups could not be explained by differences in body weight or spinal vertebral size. BMDI proved a more sensitive measure for comparing subgroups than did BMD. The study provides normative data and a quantitative methodology for analyzing differences in spinal mineral between groups of children and adolescents.
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