Biomedical subjects

Gary Adams

Publications and source records attributed to Gary Adams.

4 recordsLinked to original sources

PubMed2007

Insulin-based regimens decrease mortality rates in critically ill patients: a systematic review.

OBJECTIVES: To determine whether treatment with glucose-insulin-potassium (GIK), insulin and glucose, or insulin by itself is beneficial in limiting organ damage after acute myocardial infarction (AMI) and reducing mortality and morbidity among critically ill hyperglycaemic patients. METHODS: Systematic review of randomized controlled trials. MAIN OUTCOME MEASURE: To assess whether tight glycaemic control reduces morbidity and mortality. STUDIES REVIEWED: Randomized controlled trials of insulin-based regimens in the treatment of critically ill patients. RESULTS: Nine hundred and twenty-four potentially relevant studies were identified and screened for retrieval. Of these, 16 randomized controlled trials met the inclusion criteria (Table 1). Ten studies examined the effects of GIK, and six of these studies reported a mortality reduction with GIK treatment in addition to enhanced myocardial performance. Five studies examined the administration of insulin. Among these studies, tight glycaemic control of blood glucose in one study was shown to reduce morbidity and mortality of patients in intensive care. Only one study examined insulin/glucose therapy, and it showed a post-myocardial infarction mortality reduction of one year. CONCLUSIONS: There is increasing evidence that maintaining normoglycaemia and treatment with insulin-based regimens is beneficial in limiting organ damage and significantly reduces both morbidity and mortality in critically ill patients who require intensive care therapy.

Blood Glucose↗

PubMed2006

Encapsulation of RIN-m5F cells within Ba2+ cross-linked alginate beads affects proliferation and insulin secretion.

The viability, proliferation and insulin production of RIN-m5F cells when loaded into alginate beads to form a 3D culture system has been investigated. The mechanism of alginate cross-linking (calcium ions vs barium ions), the addition of poly(L-lysine) (PLL) and poly(L-ornithine (PLO) and presence of different extra-cellular matrix proteins (ECM) influence the RIN-m5F cell behaviour. Cells in calcium alginate beads (CAB) proliferated and produced more insulin per cell than monolayer culture, but the physical properties of the beads were poor and they ruptured within a few days of culture. Barium alginate beads (BABs) provided a stable encapsulation method. Addition of PLL and PLO at concentrations above 0.1% w/v with the culture medium increased cell proliferation. With the addition of ECMs after bead formation there was a further increase in cell proliferation for certain combinations of ECM and PLO. It was concluded that RIN-m5F-loaded Ba-alginate beads (BABs), when incorporated with varying concentrations of poly (L) lysine (PLL), poly (L) ornithine (PLO) in the presence of extra-cellular matrix proteins (ECMs) were superior to both tissue culture and RIN-m5F-loaded Ca-alginate beads (CABs) in terms of physical stability, cell proliferation and insulin production.

Alginates↗

PubMed2005

Future alternative therapies in a quest to halt aberrations in diabetes mellitus.

Under normal physiological conditions, euglycaemia is maintained principally by the homeostatic balance of insulin and glucagon which are secreted from the pancreas. In both type 1 and type 2 diabetes mellitus there is a substantial and chronic increase in the circulating glucose concentration. This elevation in glucose levels is accompanied by a plethora of other biochemical disturbances, including disruption of carbohydrate, fat and protein metabolism. Clinical manifestations of diabetes, which arise from the metabolic disturbances vary between individuals but are often a serious threat to quality and length of life. Pancreas transplantation (Tx) and islet modifications are methods used to restore endogenous insulin secretion in insulin-dependent diabetic patients. In order for this to be achieved successfully, however, some of the problems such as hyperglycemia states (> 150 mg/dl), which may harm pancreatic graft beta cells, immunorejection, the effects of immunosuppression, for example, must be overcome. Considering these problems, therefore, it seems logical that the replacement of the islet tissue itself, either by transplanting a vascularised pancreatic allograft or by transplanting modified pancreatic islet cells, provides a better alternative therapeutic approach than simply replacing insulin that has been lost. This review will show the recent development in the use of pancreatic islets and their modification in a quest to halt the aberrations seen in diabetes mellitus.

Diabetes Mellitus↗

PubMed2004

Posttraumatic stress disorder symptoms, physical health, and health care utilization 50 years after repeated exposure to a toxic gas.

The posttraumatic sequelae of contaminant exposure are a contemporary international concern due to the threats posed to military personnel and civilians by war and bioterrorism. The role of PTSD symptoms as a mediator between potentially traumatic toxin exposure and physical health outcomes was examined with structural equation modeling in a probability sample of 302 male World War II-era U.S. military veterans 50 years after exposure to mustard gas tests. Controlling for age and psychological distress, the most parsimonious structural model involved PTSD symptoms mediating the relationship between toxin exposure and physical health problems, and physical health problems mediating the relationship between PTSD symptoms and outpatient health care utilization. Implications for researchers, mental health clinicians, and health care providers are discussed.

Aged↗