Cerebral structural and functional changes in type 1 diabetes

Both type 1 and type 2 diabetes mellitus are known to cause widespread complications in numerous organ systems, including the brain. In this review we will discuss the structural changes that have been identified in humans with type 1 diabetes using magnetic resonance imaging. We will also review how diabetes, hyperglycemia, and hypoglycemia have been found to alter neurocognitive function in patients with this disease. Potential mechanisms that may underlie the development of the cerebral structural and function changes seen in patients with type 1 diabetes will then be presented.

Impacts of culture on driver knowledge and safety device usage among Hispanic farm workers

This study examines Hispanic migrant farm workers' driving behaviors and knowledge of the laws. These laborers worked and drove in California's agricultural region up to 8 months a year. Results are based on 167 face-to-face interviews conducted in Spanish at five labor camps and 126 observations conducted at these same camps in California. Most drivers were male licensed drivers (79%), who learned to drive at ages 8-14 in Mexico (42%). Those licensed in Mexico versus the US received more citations and unlicensed drivers were rated with poor driving skills. Drivers reported 'always' using seat belts (86%), yet admitted not buckling up within the previous 2 months. Observational data showed that only 37% used belts and 55% of drivers riding alone were belted. Reasons for non-use reflected cultural and economic issues and lack of effective media safety campaigns for this group. Most (75%) drivers with children (< 4 years) said they used child safety seats and others with 1+ children (< 4 years) used no safety seats (20%) or only one seat (53%). Observations showed that regardless of the number of riders aged 0-4, the number of car seats never exceeded one. In 66% of the cars where a single child was carried and where two children were carried, no car seats were used. In all of these cases there were other passengers and drivers who were not belted.

Brimonidine in the prevention of intraocular pressure elevation following argon laser trabeculoplasty

OBJECTIVE

To evaluate the efficacy of 0.5% brimonidine tartrate, an alpha 2-adrenergic agonist, in preventing intraocular pressure (IOP) elevation following argon laser trabeculoplasty.

DESIGN

In a multicenter, double-masked, randomized study, 248 patients (248 eyes) who underwent argon laser trabeculoplasty were allocated to four treatment groups: (1) brimonidine administered before and after the procedure; (2) brimonidine administered before the procedure; (3) brimonidine administered after the procedure; and (4) a vehicle administered before and after the procedure.

RESULTS

In the first 3 hours after argon laser trabeculoplasty, only one (0.54%) of the 183 brimonidine-treated patients had a postlaser IOP increase of 10 mm Hg or more, while increases of this magnitude occurred in 13 (23%) of the 56 patients who received only the vehicle (P < .001). The three brimonidine-treatment groups demonstrated significant mean reductions in IOP from the pretrabeculoplasty level (-4 to -8 mm Hg), whereas the vehicle-treated group showed an increase in mean IOP (4 mm Hg). Side effects associated with brimonidine treatment included conjunctival blanching (40.9%), lid retraction (7.6%), and a slight lowering of the systolic blood pressure.

CONCLUSIONS

One drop of 0.5% brimonidine administered either before or after surgery was found to be efficacious and safe in preventing posttrabeculoplasty elevations in IOP.