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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper reports the results of a prospective controlled trial of a program addressing reduction of onset distress and better future adaptation in adults who were enrolled at the time of diagnosis of type I diabetes mellitus. Patients were assigned randomly to either standard intensive treatment and patient education with the distress reduction program (N = 10) or to standard intensive treatment and patient education without this program (N = 13). Prospective follow-up of patients with multiple validated measures of treatment outcome showed less anxious coping behavior, less depression and less denial at the 9-month follow-up and less denial at the 15-month follow-up in the group with the distress reduction program, but no differences in metabolic control between the two groups at any time. We conclude that our program has a positive impact on the crisis at diabetes onset; the lower denial in the treatment group may lead to improved regimen adherence in the long term.
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PMID:A program to reduce onset distress in unselected type I diabetic patients: effects on psychological variables and metabolic control. 774 98

Tested the hypothesis that memory dysfunction mediated the decline in verbal intellectual performance (as measured by the WISC-R Vocabulary test) that we detected previously in a prospective study of children who developed IDDM between the ages of 8 to 13 years. Three tests of verbal learning and memory were administered to 57 diabetic youths at end-of-study who had been followed for 8 years, on average. Memory performance at end-of-study was predicted only by Vocabulary test score at study entry. IDDM duration, long-term metabolic control, depression/anxiety, demographic variables, or blood glucose level at the time of assessment were not associated with memory test scores. Stepwise multiple regression revealed that level of performance on a test of short-term or working memory was associated with magnitude of decline in verbal intellectual performance over time, providing partial support for our hypothesis.
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PMID:Verbal intellectual and verbal memory performance of youths with childhood-onset insulin-dependent diabetes mellitus. 793 33

The relationships between psychosocial adjustment and subsequent glycaemic control were prospectively examined in forty-three adult patients during the first 2 yr after onset of type 1 diabetes mellitus. Decreasing depression was the single psychosocial parameter that changed over time. No correlations were found between the decrease in HbA1c levels and psychological variables at 8- and 16-month follow-ups. Global and specific coping features such as high control attitude, low coping anxiety and low emotional attribution correlated significantly with the decrease in HbA1c levels at the 2-yr follow-up, whereas stressful life events, depression, state-trait anxiety did not correlate. In a regression analysis coping explained 22% variance of the 2 yr decrease in HbA1c levels. We conclude that coping is a better predictor for metabolic control than emotional adaptation and life events. Metabolic control might deteriorate with prolonged stage of the disease being a first sign for psychophysiological coping exhaustion.
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PMID:Psychological moderator variables and metabolic control in recent onset type 1 diabetic patients--a two year longitudinal study. 802 64

The activities of protein kinase C, total, Mg2 and Na+, K(+)-dependent ATPases in red cell membranes were compared in 46 patients with insulin independent, 30 ones with insulin dependent diabetes mellitus with various degrees of vascular disorders, and in 17 patients with atherosclerosis with the predominant involvement of the main vessels of the lower limbs. Diabetes mellitus and the progress of vascular disorders were associated with a more marked depression of protein kinase C, total and Na+, K(+)-dependent ATPase activities, this being particularly characteristic of the patients with insulin-independent diabetes and macrovascular disorders. Inhibited activities of protein kinase C and ATPases in red cell membranes in the course of diabetic vascular disorders progress evidence their contribution to the pathogenesis of diabetic angiopathy.
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PMID:[Activity of membrane-bound protein kinase C and ATPase in erythrocytes in diabetic angiopathy]. 805 53

In a longitudinal study we examined 43 patients with type 1 diabetes one week after onset as well as 8 and 24 month later in order to analyze the psychological role of denial processes in correlation to metabolic functions. Only depression decreased over the studied period while coping and denial remained stable. However, the adaptive function of denial after onset with low anxiety, good coping and few complaints became maladaptive over the first two years and the correlation of denial with a centripetal kinship behavior loosened. The destructive effect of denial was indicated only by delayed requests for assistance while no correlation could be shown for phase-specific internal restructuring of the psychological function of denial to compliance and metabolic control.
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PMID:[Phase-specific function of denial in type 1 diabetic patients after disease onset]. 814 41

A cohort of children with newly diagnosed diabetes (n = 68) from four diabetes treatment centers in northeastern states were compared with a cohort of healthy peers (n = 40) 6 weeks following the diagnosis of diabetes in the ill children. Instruments used included the Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), Coping Inventory (COPE), Child & Adolescent Adjustment Profile (CAAP), and Self Perception Profile for Children (SPPC). Results indicated no demographic differences between the two groups and no differences in scores on CDI, STAIC-state anxiety, and all subscales of the CAAP and SPPC. However, the children with diabetes were reported to demonstrate less withdrawal (11.6 +/- 3.0 versus 12.4 +/- 2.3) than their healthy peers and were more likely to cope by ventilating feelings (19.7 +/- 2.0 versus 18.7 +/- 2.2). Parents reported that children with IDDM were less healthy (p < .001). These data suggest a less severe initial psychologic response to diabetes than might be expected and that there are differences in coping patterns among children with IDDM and children without chronic illness.
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PMID:Initial adaptation in children with newly diagnosed diabetes and healthy children. 815 79

Psychologic factors have been considered to play an important role in the etiology of chronic prostatitis. Earlier studies are often based on a psychoanalytical perspective and seldomly used quantitative approaches. In the present study quantitative tests are used to investigate personality variables which are suggested in the literature as underlying chronic prostatitis. A group of 50 chronic prostatitis patients was compared with a group of 50 patients seen for a vasectomy. Psychologic measures were taken by means of a personality inventory (NVM, Dutch short form of the MMPI), a symptom checklist (SLC-90), and a depression inventory (IDD). Results showed statistically significant differences between the groups, with the chronic prostatitis patients scoring consistently higher on the measures than vasectomy patients. However, these differences in scores were not of a great magnitude and minor compared with differences in scores from psychiatric patients. Discriminant analysis suggested somatization and depression to be the key variables to distinguish chronic prostatitis patients from vasectomy patients. Overall, it seemed unfounded to label chronic prostatitis patients "neurotic" or "psychopathologic," and it was impossible to conclude that there are personality variables that specifically identify the chronic prostatitis patients.
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PMID:Personality variables involved in chronic prostatitis. 825 99

The relationship between waist to hip ratio (WHR) and psychosocial factors has seldom been investigated, although both may contribute to cardiovascular risk. Therefore, these variables were examined in adults with insulin-dependent diabetes mellitus ([IDDM] N = 592; mean age, 29 years; mean duration, 20 years), a population at increased risk of developing cardiovascular disease. Moreover, the association between changes in psychosocial factors and change in WHR was considered. After adjusting for body mass index (BMI), WHR in men was correlated with higher levels of depressive symptomatology (r = .19, P < .001), greater anxiety (r = .13, P < .05), less social support (r = -.20, P < .01), and lower type A scores (r = -.25, P < .001). In women, WHR was significantly correlated with higher levels of depressive symptomatology (r = .18, P < .01), greater stress (r = .16, P < .01), and alcohol consumption (r = .12, P < .05). For both sexes, smokers had a significantly greater mean WHR than nonsmokers (P < .01). For men, multiple regression analyses adjusting for BMI and age demonstrated that smoking, lower income, less exercise, and lower type A scores were the most significant variables associated with WHR. In women, the independent predictors of WHR were a history of smoking, lower educational level, and depressive symptomatology. The most significant independent predictors of change in WHR from baseline to 2-year follow-up study were change in weight (men), change in BMI (women), and change in depression scores (both sexes). These results suggest that psychosocial factors may affect cardiovascular disease risk through their influence on body fat distribution, and both may be important in identifying those most at risk for cardiovascular disease in populations with IDDM.
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PMID:Waist to hip ratio and psychosocial factors in adults with insulin-dependent diabetes mellitus: the Pittsburgh Epidemiology of Diabetes Complications study. 859 1

Magnesium ions (Mg2+) are pivotal in the transfer, storage and utilization of energy; Mg2+ regulates and catalyzes some 300-odd enzyme systems in mammals. The intracellular level of free Mg2+ ([Mg2+]i) regulates intermediary metabolism, DNA and RNA synthesis and structure, cell growth, reproduction, and membrane structure. Mg2+ has numerous physiological roles among which are control of neuronal activity, cardiac excitability, neuromuscular transmission, muscular contraction, vasomotor tone, blood pressure and peripheral blood flow. Mg2+ modulates and controls cell Ca2+ entry and Ca2+ release from sarcoplasmic and endoplasmic reticular membranes. Since the turn of this century, there has been a steady and progressive decline of dietary Mg intake to where much of the Western World population is ingesting less than an optimum RDA. Geographic regions low in soil and water Mg demonstrate increased cardiovascular morbidity and mortality. Dietary deficiency of Mg2+ results in loss of cellular K+ and gain of cellular Na+ and calcium ions (Ca2+). Blood normally contains Mg2+ bound to proteins, Mg2+ complexed to small anion ligands and free ionized Mg2+ (IMg2+). Most clinical laboratories only now assess the total Mg, which consists of all three Mg fractions. Estimation of the IMg2+ level in serum or plasma by analysis of ultrafiltrates (complexed Mg + IMg2+) is somewhat unsatisfactory, as the methods employed do not distinguish the truly ionized form from Mg2+ bound to organic and inorganic anions. Because the levels of these ligands can vary significantly in numerous pathological states, it is desirable to directly measure the levels of IMg2+ in complex matrices such as whole blood, plasma and serum. Using novel ion selective electrodes (ISE's), we have found that there is virtually no difference in IMg2+, irrespective of whether one samples whole blood, plasma or serum. These data demonstrate that the mean concentration of IMg2+ in blood is about 600 mumoles/litre (0.54-0.65 mmol/L, 95% Cl); 65-72% of total Mg being free or biologically-active Mg2+. Use of the NOVA and KONE ISE's for IMg2+ on plasma and sera from patients with a variety of pathophysiologic and disease syndromes (e.g., long-term renal transplants, liver transplants, during and before cardiac surgery, ischemic heart disease [IHD], headaches, pregnancy, neonatal period, non-insulin dependent diabetes (NIDDM), end-stage renal disease [ESRD], hemodialyse [HEM], and continuous ambulatory peritoneal dialysis (CAPD), hypertension, myocardial infarction [AMI] and after excessive dietary intake of Mg), has revealed interesting data. The results indicate that long-term renal transplant patients, headache, pregnant, NIDDM, ESRD, HEM, CAPD, AMI, hypertensive, and IHD subjects exhibit, on the average significant depression in IMg2+ but not TMg. Use of 31P-NMR spectroscopy on red blood cells, from several of these disease states, to assess free intracellular Mg ([Mg2+]i demonstrates a high correlation (r = 0.5-0.8) between IMg2+ and [Mg2+]i. Increased dietary load of Mg, for only 6 days, in human volunteers, resulted in significant elevations in serum IMg2+ but not TMg. Correlations between the clinical course of several of the above disease syndromes and the fall in IMg2+ and [Mg2+]i were found. The ICa2+/IMg2+ ratio appears, from our data, to be an important guide for signs of peripheral vasoconstriction, ischemia or spasm and possibly atherogenesis. Overall, our data point to important uses for ISE's for IMg2+ in the diagnosis and treatment of disease states.
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PMID:Role of magnesium in patho-physiological processes and the clinical utility of magnesium ion selective electrodes. 886 38

The emotional condition and cognitive function of 37 insulin requiring (IDD) and 46 non-insulin requiring (NIDD) diabetics (in stable conditions) were compared, using the Hospital Anxiety and Depressive Scale (HAD) and the Mini-Mental State Examination (MMSE). About 5% of IDD and 4% of NIDD had threshold score for clinical anxiety; while 37.8% of IDD and 15.2% of NIDD had depression. The prevalence rate of depression for the entire cohort was 25.3%, while the rate for anxiety was 4.8%. Only the illiterates among IDD had up to threshold score for depression. The most common reported symptoms were, the feelings of not being able to enjoy things as usual, and not looking forward with enjoyment to things. Cognitive function was predominantly normal, not being significantly associated with HAD scale scores, age, duration of illness and level of education. Compared with previous reports in the same hospital, diabetics experienced significantly less depressive symptoms than cancer patients. The findings are similar to reports from developed countries in showing that IDD subjects are more emotionally disturbed than NIDD subjects; and that depression is a commonly feature of chronic debilitating illness. Clinicians need to be sensitive to the emotional condition of their patients, because depression impairs the ability to comply with treatment and therefore mars prognosis.
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PMID:The psychological condition of a cohort of Nigerian diabetic subjects. 911 56


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