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Biomedical subjects

J R Daniel

Publications and source records attributed to J R Daniel.

11 recordsLinked to original sources
PubMed1997

Metformin and insulin: is there a role for combination therapy?

OBJECTIVE: To review the literature on concomitant insulin and metformin therapy in patients with type 1 diabetes to determine the potential for combination therapy. DATA SOURCES: A MEDLINE and bibliographic search (1966-1996) of the literature pertaining to metformin and phenformin and their combined use with insulin in the treatment of patients with type 1 diabetes mellitus was performed. STUDY SELECTION: All human studies using metformin with insulin were included in the analysis. Studies using phenformin with insulin were also included due to its similarities to metformin. DATA SYNTHESIS: The recent availability of metformin provides some new options for treating diabetes mellitus. One possibility is the use of this medication in conjunction with insulin in patients with type 1 diabetes. Although this seems like a potentially beneficial combination, there is currently no recommendation for use in this manner. Experience with combination metformin and insulin therapy has consistently demonstrated a reduction in insulin requirements. Studies have not been of necessary size or duration to definitively prove the benefits of this insulin dose reduction or any other benefits of combination therapy. CONCLUSIONS: When metformin is added to insulin therapy, insulin requirements are likely to decrease. Although one would anticipate benefits from reduction in circulating insulin concentrations, the studies do not provide data to determine if benefits of combination therapy outweigh risks. Further studies of larger size and longer duration are needed before the use of metformin with insulin can be routinely recommended in patients with type 1 diabetes.

Cross-Over Studies↗
PubMed1995

Extrapyramidal symptoms associated with calcium-channel blockers.

Flunarizine and cinnarizine have been well documented to cause EPS. Other CCBs, on rare occasions, also have been reported to cause EPS. Theoretical explanations for these events include the inhibition of calcium influx into striatal cells and direct dopaminergic antagonistic properties. In addition, the chemical structures of flunarizine and cinnarizine, which are related to neuroleptics, may explain the relatively greater incidence of EPS with these agents. Suggested risk factors for acquiring EPS with flunarizine or cinnarizine use appear to be age, although experience with using these agents in younger patients is limited, and a family history of tremors and/or Parkinson's disease. The onset and type of presentation is unpredictable and, in most instances, discontinuation of the medication relieves the symptoms within a few days to months. Pharmacologic management of EPS with continued use of the offending agent generally has not been of clinical benefit. In conclusion, patients receiving CCBs, particularly flunarizine and cinnarizine, should be monitored for EPS.

Basal Ganglia Diseases↗
PubMed1990

Synthesis of sweet-tasting methylthio derivatives of D-fructose and sucrose.

1,6-Di-S-methyl-1,6-dithio-D-fructofuranose and its bis(S-oxide) and bis(S,S-dioxide) are described. On examination for sweetness, the oxygenated compounds were neutral but the parent compound was 15-20 times sweeter than sucrose, and 1',6'-di-S-methyl-1',6'-dithiosucrose was slightly less sweet than sucrose.

Carbohydrate Sequence↗
PubMed1989

Enhanced detection of preinvasive breast cancer: combined role of mammography and needle localization biopsy.

Several recent reports have described an increase in the incidence of preinvasive carcinoma of the breast. To determine the incidence of preinvasive breast cancer at our institution, the results of 469 consecutive outpatient breast biopsies performed at Walter Reed Army Medical Center between July 1, 1985, and January 1, 1987, were reviewed. During this time period, 256 biopsies were performed on palpable masses, and 213 needle localization biopsies were performed on mammographically suspicious lesions. The overall incidence of cancer was 15.4%. Needle localization biopsies yielded a diagnosis of cancer in 17.8% of cases, as did 13.3% of biopsies performed on palpable masses. Eight of 38 (21.1%) carcinomas identified by mammography were preinvasive at the time of diagnosis. Only one of 34 (2.9%) cancers identified because of a breast mass was preinvasive. We conclude that screening mammography is an invaluable tool for the detection of preinvasive carcinoma of the breast and that the increased use of mammography will result in an increase in the incidence of detection of this lesion.

Adolescent↗
PubMed1984

Synthesis of 3-C-(hydroxymethyl)erythritol and 3-C-methylerythritol.

3-C-(Hydroxymethyl)erythritol was prepared from 3-C-(hydroxymethyl)-2,3-O-isopropylidene-D-erythro-tetrofuranose (4) by hydrolysis followed by reduction, or by reduction followed by hydrolysis. Monotosylation of 4, followed by reduction with lithium aluminum hydride and hydrolysis, afforded 3-C-methylerythritol.

Erythritol↗
PubMed1979

Biomolecules bearing the S- or SeAsMe2 function: amino acid and steroid derivatives.

A series of molecules of the type GXAsMe2 have been synthesized in which X is S or Se and G is a moiety such as an amino acid, a di- or tripeptide, or a lipid. The compounds have been characterized by NMR, mass spectroscopy, and elemental analysis. Cysteine was found to react directly with dimethylarsinic acid to yield cystine and S-dimethylarsinocysteine (1). This reaction occurs also with other biomolecules containing thiol groups and raises serious questions concerning the use of cacodylate buffers in the study of enzyme kinetics and in sample preparation for electron microscopy. In the presence of dimethylchloroarsine and diethylamine, homocysteine thiolactone reacts to form both the dipeptide and the S-AsMe2 bond. Results of carcinostatic, bacteriostatic, and fungicidal testing of these compounds are reported. A hypothesis is advanced to explain the observed carcinostatic action of the dimethylarsino group.

Amino Acids↗
PubMedDate not supplied

An approach to leprosy work in south Bombay--a preliminary communication.

The city of Bombay with its teeming eight million citizens is characterised by varied types of living pattern in its different parts and the approach to leprosy control work should be flexible to suit these facets of living conditions. Earlier reports (Ganapati and Girija 1979) have indicated the possibility of the successful application of techniques based on mass surveys in North Bombay where people belonging to low socio-economic strata live in somewhat organised slums or shanty towns. However, extreme South Bombay is marked by the paucity of such vast slums and one is struck by the more permanent multistoreyed housing structures. Living in commercial establishments as well as footpath dwelling are common. This presentation consists of an attempt to gauge the leprosy problems in this part of the city taking advantage of 425 patients registered at a leprosy clinic run in conjunction with the dermatology out patient department of a big general hospital over a period of 40 months. 212 cases (50%) hailing from South Bombay proper were the subject matter for analysis. 66% (140) belonged to progressive types of leprosy classifiable as BT through LL and of the Ridley-Jopling classification and 30.7% were bacteriologically positive. 42.9% of the patients had some degree of deformity. Males formed 80% of the sample and 76% were above 15 years of age. Analysis of duration of residence revealed that 68% were living in Bombay for over six years and 53.5% were residing in the city for 11 years or more. This finding is contrary to the expectation of leprosy patients in Bombay belonging to a "floating population". Attempts at field work revealed the following findings: Slum pockets being few (only four), patients were expected to live in residential buildings; but it was found that 25% of population were staying in work places. 17% were footpath dwellers and 18.9% shared their accommodation with people other than family members. 10.4% were domestic servants staying in the residences of their employees. The labour class constituted 50.5% the unemployed housewives group formed 21.7% and beggers 0.9%. 4.2% only were slum dwellers. Locating and examining contacts of patients was difficult as 42.9% could not be traced owing to faulty addresses or patients having changed residences or shifted to native places. Of the 111 patients (52.3%) contacted, 26.4% were living with families and 26.1% were staying alone or with others.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗