Статьи журнала - Cardiometry

Все статьи: 571

Changes in the energy activity of blood lymphocytes and morphometric parameters of the brain in a model of brain damage in rats

Changes in the energy activity of blood lymphocytes and morphometric parameters of the brain in a model of brain damage in rats

Khunderyakova N.V., Medvedeva V.P., Polyakova T.V., Mironov V.V., Bulgin I.V., Mikhailova G.R., Penkov N.V., Mironova G.D.

Статья

is known that Parkinson’s disease (PD) being a neurodegenerative disease is accompanied by increased levels of reactive oxygen species, oxidative stress and impaired mitochondrial activity. It has been shown that the development of malignant tumors can be accompanied by disorders that mimic PD.

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Changes in the functional activity of the hypothalamic-pituitaryadrenal axis in rats of both sexes with Guerin's carcinoma against the background of hypothyroidism

Changes in the functional activity of the hypothalamic-pituitaryadrenal axis in rats of both sexes with Guerin's carcinoma against the background of hypothyroidism

Kit O.I., Frantsiyants E.M., Bandovkina V.A., Kaplieva I.V., Surikova E.I., Neskubina I.V., Cheryarina N.D., Trepitaki L.K., Pogorelova Y.A., Goroshinskaya I.A., Zhukova G.V., Arakelova A.Y., Vaschenko L.N., Kovalenko V.A., Bykadorova O.V., Kuligina A.S.

Статья научная

The hypothalamic-pituitary-adrenal axis (HPA) makes the body’s response to various stress factors, interacting with the thyroid and gonadal axis. The aim of our work was to study the effect by induced hypothyroidism on changes in the functioning of the HPA axis in rats with Guerin’s carcinoma of both sexes. Materials and methods. The experiment was performed in white outbred rats of both sexes. Hypothyroidism was induced in animals by medication for 30 days with Mercazolil, and then Guerin’s carcinoma was transplanted (the main group). The reference groups covered animals with the independent growth of Guerin’s carcinoma and with independent hypothyroidism, as well as intact animals (the normal conditions). On day 18 of the tumor growth, the animals were sacrificed, and, using standard ELISA kits, in the serum and the homogenates of the adrenal glands, the tumor and the perifocal zone, the level of cortisol was determined; in the homogenates of the hypothalamus we measured the concentration of CT-releasing hormone (CRH) and in the pituitary gland the concentration of ACTH. Results. Induced hypothyroidism both in males and females caused adrenal insufficiency. The growth of Guerin’s carcinoma increased the level of CT-releasing hormone in males by 9.6 times and cortisol in the adrenal glands in females and males by 1.3 times and 2.3 times (p function show_abstract() { $('#abstract1').hide(); $('#abstract2').show(); $('#abstract_expand').hide(); }

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Chemical composition and nutritional value of the fish grown under the conditions of a natural hot spring of the Almaty region

Chemical composition and nutritional value of the fish grown under the conditions of a natural hot spring of the Almaty region

Dinara Zh. Moldagalieva, Yasin M. Uzakov, Nurzhan B. Sarsembaeva

Статья научная

The article presents the results of the study of the nutritional, biological value and the chemical composition of the Nile tilapia fish, grown in the natural hot spring of Chondzhy, using different formulations of grower feed. Also, the chemical composition and nutritional value of the sharptooth catfish were investigated for comparative analysis. Nutritional value was characterized by the content of water, nitrogenous matter, lipids, minerals, carbohydrates and vitamins. It was found that this feed additive is completely harmless, does not have negative consequences.

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Chronic gastritis in pediatrics

Chronic gastritis in pediatrics

Gabueva Nina V., Kalinchuk Violetta S., Radchenko Diana R., Donchenko Stepan A., Panesh Anzhela A., Popov Semen A.

Статья научная

Chronic gastritis is one of the most common diseases of the gastrointestinal tract. High rates of gastritis in children are associated with poor nutrition, physical inactivity, drug abuse, bad habits, a number of concomitant diseases, immune disorders, allergization of the body, and stress. Although a significant proportion in the structure of chronic gastritis is occupied by gastritis associated with Helicobacter pylori infection, many clinical forms are diagnosed that are not associated with the presence of a microbial pathogen in the gastric mucosa. The goal is to highlight the problem of chronic gastritis in children, including risk factors, etiology, clinical manifestations, diagnosis and treatment.

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Chronic neurogenic pain is responsible for changes in concentrations of biogenic amines in the brain in urokinase knockout mice with melanoma B16/F10

Chronic neurogenic pain is responsible for changes in concentrations of biogenic amines in the brain in urokinase knockout mice with melanoma B16/F10

Frantsiyants Elena M., Bandovkina Valeriya A., Kaplieva Irina V., Surikova Ekaterina I., Neskubina Irina V., Cheryarina Natalia D., Pozdnyakova Viktoria V., Kit Oleg I.

Статья научная

Our aim is to study special features of actions and effects of chronic neurogenic pain on concentrations of biogenic amines in the brain in tumor-bearing urokinase knockout mice (uPA). Materials and methods Our research work has been conducted in female/male mice line C57BL/6 (uPA+/+) n=48 and line C57BL/6-Plautm1.1Bug-ThisPlauGFDhu/GFDhu (uPA) -/-) n = 48 with targeted mutation of protein incapable of binding to receptor of the urokinase-type plasminogen activator, i.e. in the urokinase knockout (uPA) mice. The animals of each line have been divided into subgroups (n= 6) as follows: the intact animals, the chronic neurogenic pain mice (CNP), the mice with the growth of inoculated melanoma (B16/F10) and the mice with combination melanoma growth plus chronic neurogenic pain (B16/F10 + CNP). In 10% of the brain homogenates, with the use of standard analysis system method ELISA (Cusabio. China), we have determined concentrations of adrenaline (A), noradrenaline (NA), dopamine (DA), histamine, serotonin (5HT) and 5-hydroxyindoleacetic acid (5-HIAA). Obtained statistic data have been processed using the Statistica 10.0 package. Results The concentration of biogenic amines in the brain in the intact uPA-/- mice has been found to be higher than in the intact uPA+/+ animals, and the response to the growth of inoculatedmelanoma B16/F10 and CNP under single-factor action and combined-action variants depends both on the sex and the condition of the urokinase gene. In the uPA-/- female/male mice in response to the only CNP and the only B16/F10 growth the serotonergic system in the brain has been activated. In contrast thereto, in case of the melanoma growth against the CNP background, we have revealed a decrease in the level of 5HT, DA in the female/male mice and NA in the female animals. Conclusion One of the factors resulting in cancellation of the genetically determined inhibition of the growth of inoculated melanoma B16/F10 under its combination with developing CNP in the uPA-/- mice is suppression of their noradrenergic, serotonergic and dopaminergic systems, initially activated in the intact uPA-/- animals to compensate their urokinase deficit.

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Chronobiological methods of human body self-regulation reserve evaluation

Chronobiological methods of human body self-regulation reserve evaluation

Zaguskin Sergey N., Gurov Yuriy E., Bakuzova Gina N., Svishcheva Irina D., Zaguskina Svetlana N.

Статья научная

Aims Chronodiagnostical methods for evaluating reserve and unfavourable responses of human cardiac function and under prolonged stress load. Materials and methods 24-h ECG R–R interval recording of Holter-monitoring ECG recording and 1-h IPI and RespI recordings of healthy young and elderly subjects, post- MI patients, subjects suffered from chronic cerebral ischemia leading to a cognitive decline, healthy subjects following post-stress load, as well as R– R intervals recordings of the AHA ECG database of heart failure and AF. Chronodiagnostics, using non-linear symbolic dynamics method and redundancy quotient of ECG PI, RespI and R– R intervals; differential temperature survey to evaluate cellular immunity; biocontrolled laser therapy. Results Self-regulation reserve reduction of oxygen transfer body systems and increase in unfavourable response probability under stress load are accompanied by the amplitude and fluctuation increase of redundancy quotient in the ECG IPI, RespI and R–R intervals, as well as increase of hierarchical desynchronosis with dominating sympathicotonia and vagotonia, decrease in cellular immunity, reduction in rate spectrum of the ECG IPI and R–R intervals...

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Circulating disialoganglioside GD2 in neuroblastoma diagnosis

Circulating disialoganglioside GD2 in neuroblastoma diagnosis

Mollaev M.D., Ivanov N.S., Litvin E.A., Kara V.V., Kholodenko R.V., Maschan M.A., Kachanov D.Yu., Shamanskaya T.V., Larin S.S.

Статья

Neuroblastoma is one of the most common solid tumors in children, characterized by high clinical heterogeneity and low predictability of the progression course. To assess the prognosis and response to therapy, protein tumor markers are often used, such as neuron-specific enolase, lactate dehydrogenase, ferritin as well as catecholamine metabolites: homovanillic acid, vanillylmandelic acid, 3-methoxytyramine, meta- and normetanephrine. Immunocytochemical studies have shown that many neuroblastomas are characterized by high surface expression of disialogangliaside GD2. In this case, well-differentiated tumors are often characterized by a lower level of GD2. It is known that GD2 can be detached from the cell surface and transported in the bloodstream as a part of the low density lipoprotein composition. In this connection, it is assumed that the concentration of GD2 in blood may depend on the presence of the tumor, its grade and mass.

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Clinical and epidemiological features of the detection and course of the infectious disease tuberculosis depending on the presence of concomitant pathology

Clinical and epidemiological features of the detection and course of the infectious disease tuberculosis depending on the presence of concomitant pathology

Davletbaeva Nina V., Sharipov Raul A., Daminov E.A., Davletbaev R.N., Tyulkova Tatiana E.

Статья научная

The article is devoted to the most pressing issues of studying the clinical and epidemiological features concerning the detection and course of tuberculosis infection in patients with concomitant pathologies. Such pathologies include cancer, diseases of the endocrine system, of the respiratory system (chronic bronchitis, pneumoconiosis), gastric ulcer, pathology of the urinary system, exhaustion due to insufficient nutrition, smoking. Using genetically engineered biological drugs (GEBPs) in practice reduces the activity of inflammatory phenomena due to suppression of the immune response, but increases the risk of developing infectious diseases, primarily tuberculosis. Immunosuppressive therapy in organ transplant patients is also associated with the risk of developing tuberculosis. A special nature of immune disorders develops during HIV infection, a comorbid disease in patients with tuberculosis. The diseases listed above create a medical risk group in patients with immunocompromise, which is the basis for the development of tuberculosis. In addition to the risk of developing infection, patients with concomitant diseases have unfavorable results from treatment tuberculosis, which does not allow achieving abacillation in a short time, thereby maintaining a reservoir of infection in society. In this regard, the purpose of our research was to study the clinical and epidemiological features of the detection and course of tuberculosis infection in patients with concomitant pathology A study was conducted using a continuous sampling method for the period from December 2020 to August 2021. 67 medical records of an inpatient at the state budgetary healthcare institution “Republican Clinical Anti-TB Dispensary” (Ufa) were analyzed. The groups were formed based on the detection of concomitant pathology (main, n=33) and its absence (control, n=34). To achieve the goal of the study, a comparative analysis of methods for detecting tuberculosis and clinical manifestations of tuberculosis was performed; prevalence of the process, detection of the fact of bacterial excretion and drug sensitivity from December 2020 to August 2021. 67 case histories of Mycobacterium tuberculosis (MBT) in patients of the studied groups were analyzed. Statistical data processing was performed using licensed software Statistica 6.0 when calculating two types of data: discrete and interval. To assess the chances of detecting the studied factor in both groups, the indicator (OR) was used to calculate the 95% confidence interval (CI). Interval indicators were studied by t-test for independent samples, with Livigne’s correction

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Clinical and laboratory indicators of patients with type 2 diabetes mellitus on the background of freeze-dried camel milk «shubat extra» medication

Clinical and laboratory indicators of patients with type 2 diabetes mellitus on the background of freeze-dried camel milk «shubat extra» medication

Botakoz B. Myrzakhmetova, Khadisha Sh. Kashikova, Gaukhar A. Tolegen, Aisulu A. Zholdybaeva, Tulegen Gauһar, Berdimurat Nazimgul, Aziza M. Altayeva, Balkanai Gulzira

Статья научная

Camel milk is a natural product that has dietic and medicinal properties. Camel milk is widely used in the field of non-conventional medicine. It is scientifically proven that camel milk has the ability to help in the medical treatment of cancer and leukemia, due to the presence of substances that eliminate out of the body the compounds that provoke the development of cancer. In addition, such milk is used during the treatment of tuberculosis, ulcers and some other problems with the gastrointestinal tract. This product is recommended to use for problems with the pancreas, liver and intestines, as well as diabetes mellitus. The goal of research was to study the clinical parameters of patients with type 2 diabetes mellitus. The study group consisted of 15 patients with medium severity. The patients took freeze-dried shubat (camel milk) for 60 days. As a result of the treatment, an improvement in clinical symptomatology and laboratory parameters was achieved in all patients with diabetes mellitus. The results of the study showed the therapeutic and dietary potential of camel milk, due to its unique quality composition.

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Cognitive and ethical reasons for the dissident movement in epidemiology

Cognitive and ethical reasons for the dissident movement in epidemiology

Bocharova Тatyana I., Kokoreva Elena B., Shakolyukova Valentina D.

Статья научная

The article discusses several fundamental reasons for the emergence of such a significant phenomenon as the anti-vaccination movement. An attempt is made to classify the causes thereof. The theory of the phases of the vaccination cycle by Robert Chen is presented herein. A concept of cognitive simplicity and design of illusory patterns to strengthen psychological control over a stressful situation was developed by the Moscow anthropologist Alexandra Arkhipova. The decision to refuse vaccination is often accompanied by an inability to properly rank associated risks and distrust of science. The level of distrust by citizens in the government and healthcare system activity, and, conversely, excessive trust in some populist personalities, is also an important reason for the dissent in epidemiology. This article provides numerous examples from the history of smallpox, cholera and coronavirus epidemics. In conclusion, the article considers the problem of the trust and mutual responsibility in a society.

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Cognitive, emotional-affective, anxiety and autonomic disorders in patients with a new coronavirus infection (COVID-19) in the acute period

Cognitive, emotional-affective, anxiety and autonomic disorders in patients with a new coronavirus infection (COVID-19) in the acute period

Melnikov K.N., Kondratyev V.P.

Статья научная

The purpose of this work is to identify neuropsychiatric functions in patients at Department No. 1 responsible for medical care of patients with a new coronavirus infection at the Samara City Hospital No. 7. Appropriate scales and questionnaires were used for this purpose. Cognitive impairments were found in 86% of the cases, emotional-affective impairments of varying severity in half of the subjects, an increase in reactive and personal anxiety was revealed, and vegetative disorders were observed in 78% of the subjects. Based on these data, it can be assumed that the new coronavirus infection affects the functioning of the nervous system of patients.

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Coincidence of renal artery stenosis and coronary artery stenosis

Coincidence of renal artery stenosis and coronary artery stenosis

Nough Hossein, Najarzadegan Mohammad Reza, Naghedi Aryan, Riazi Ali Reza, Hadiani Leila, Namayandeh Seyede Mahdieh

Статья научная

Aims The aim of this study was to investigate the prevalence of renal artery stenosis in patients with severe coronary artery disease or stenosis of the left main coronary artery. Materials and methods This cross-sectional study was performed on 264 patients with a history of severe hypertension who were candidates for coronary artery angiography in Yazd Afshar Hospital. During coronary angiography, renal angiography was performed on all of the patients. At the same time, we investigated the renal artery stenosis and its association with a history of diabetes mellitus, high body mass index (BMI), hyperlipidemia, and other cardiovascular risk factors. Renal artery stenosis was defined based on luminal narrowing: mild (50%), moderate (75%), and severe (75%) decrease in luminal diameter. Collected data were analyzed by SPSS software (version 18.0). Results Among 264 patients, 54.92% were males and 45.08 % were females with the average age of 58.0±8.6. 83.71% of the patients had coronary artery disease and included 52.94% hyperglycemic, 63.39% diabetic, and 29.86% smokers...

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Combination of type I diabetes mellitus and diabetes associated with GCK gene mutation: features of the clinical course in puberty

Combination of type I diabetes mellitus and diabetes associated with GCK gene mutation: features of the clinical course in puberty

Cherkasova Yulia B., Pavlov Bogdan V., Sokolova Alyona I., Gladyshev Mikhail A., Kurochkin Artem D., Dukova Alexandra A., Sklyarov Bogdan A.

Статья научная

This article discusses a clinical case of the manifestation of MODY2 diabetes, which complicated the course of type I diabetes mellitus in a patient of puberty. For 9 months, the dynamics of the patient's condition was monitored, who was on inpatient treatment in the endocrinology department of the State Medical Institution of the Tambov City Hospital for the entire period of observation. The criteria for daily monitoring of the patient's clinical condition were: blood glucose and glycated hemoglobin, the level of glucosuria, the concentration of ketone bodies in the blood and acetone in the urine. The patient underwent insulin therapy and infusion therapy. Despite the ongoing treatment, including, among other things, the treatment of complications of the underlying disease, by the 6th month the patient's condition worsened to an extremely severe degree. Additional laboratory and instrumental diagnostic studies were conducted, including a molecular genetic study for diabetes typing, the results of which made it possible to determine the cause of the progressive course of type I diabetes mellitus, which was the clinical manifestation of MODY2 diabetes with the development of insulin tolerance against the background of hormonal adjustment of puberty. The problem of timely and accurate diagnosis, and, accordingly, correct treatment, of type I diabetes mellitus combined with MODY2 diabetes, remains urgent and serious, due to the difficulty of interpreting differential diagnostic criteria with progressive type I diabetes mellitus of childhood and adolescence, which in turn can lead to multiple complications, including fatal exodus.

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Comparative analysis of characteristics of electrodes to estimate accuracy in recording long-term ECG signal parameters

Comparative analysis of characteristics of electrodes to estimate accuracy in recording long-term ECG signal parameters

Altay Yeldos A., Kremlev Artem S., Nuralinov Omirbek M., Vlasov Sergei M., Penskoi Aleksandr V., Zimenko Konstantin A., Margun Alexey A.

Статья научная

This paper presents some results of a comparative analysis of characteristics of electrodes to estimate the accuracy of recording long-term ECG signal parameters. To obtain the characteristics of the analyzed electrodes of various types, the resistance values of the contact conductive substance of each of them were measured. The relationship of the measured characteristics of the electrodes is analyzed, and the accuracy of recording ECG signal parameters, using the basics of statistical decisions, is estimated. The analysis results show that the harder the contact conductive substance of the electrodes, the more accurately recorded ECG signal parameters.

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Comparative analysis of diagnostic accuracy between MRI and CT scans in detecting skull base ENT pathologies

Comparative analysis of diagnostic accuracy between MRI and CT scans in detecting skull base ENT pathologies

Iqbal Andleeb, Khursheed Sahar, Ibrahim Mukhtar, Ali Ramzan, Munir Sultan Badar, Khan Tahir Hussain, Lodhi Kashif

Статья научная

Background: Skull base ENT (Ear, Nose, and Throat) pathologies present a diagnostic challenge due to their intricate location. Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scans are commonly used diagnostic tools for detecting these pathologies. This study aims to associate the diagnostic exactness of MRI and CT scans in detecting skull base ENT pathologies.

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Comparative assessment of cytotoxicity and accumulation of lithium and boron in skin melanoma cells in vitro

Comparative assessment of cytotoxicity and accumulation of lithium and boron in skin melanoma cells in vitro

Kasatova A.I., Taskaeva Yu.S., Razumov I.A., Taskaev S.Yu., Bgatova N.P.

Статья

Boron neutron capture therapy (BNCT) is a binary radiation therapy modality based on the high capability of the non-radioactive isotope 10B to absorb thermal neutrons. The use of alternative isotope 6Li for lithium neutron capture therapy (LiNCT) may be a promising area in the treatment of oncological diseases, but at present the data on the possibilities of lithium accumulation in tumor cells are limited to some sporadic studies.

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Comparative clinical analysis of the cardiometric method the thermodilution and the Fick method

Comparative clinical analysis of the cardiometric method the thermodilution and the Fick method

Rudenko M.Y.

Ред. заметка

A brief comparative clinical analysis of the cardiometric method, thermodilution and the Fick method is presented below herein. It is shown that the cardiometric method makes it possible to obtain the values of a complete set of hemodynamic parameters in each cardiac cycle with recording as many cardiac cycles as required, monitor the state of the patient’s cardiovascular system in real time and obtain information about the dynamics of changes in its performance under the influence of external and internal impacts. It allows not only obtaining numerical values of hemodynamic parameters, but also qualitatively assessing the main functions of the cardiovascular system performance

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Comparative evaluation of the effectiveness of a local hemostatic agent modified with a bio-organic composition

Comparative evaluation of the effectiveness of a local hemostatic agent modified with a bio-organic composition

Budko E.V., Yampolsky L.M., Chernikova D.A., Khabarov A.A.

Статья научная

Constant attention to the study of the experience of using hemostatic products proposed for local bleeding arrest encourages new developments in this field. Modern hemostatics are porous multilayer systems with an inclusion of active coagulants. The results of the assessment of hemostatic activity obtained with the help of clinical and laboratory methods often do not lend themselves to cross-checking and statistical processing, and do not allow us to study objects with different physical and chemical properties. Methods of chemometrics, namely planimetry, allow you to visualize the parameters of sorption and hemocoagulation activity. A comparative planimetric study of commercial local hemostatic agents like Celox powder, sponges and napkins of various companies, zeolite powder, as well as new hemostatic compositions, which were given provisionally label A52 and A58, was carried out. It is shown that the hemostatic composition labeled as A52 leads to the activation of absorbent materials, the formation of a stable volumetric primary and secondary thrombus. A comparative evaluation of the effectiveness of a new hemostatic agent in an acute experiment shows a high expression of hemostasis (the time of primary hemostasis is 15-20 seconds) and no recurrence of bleeding for the studied samples compared to the reference.

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Comparative study between sugammedex and neostigmine as a reversal agent of rocuronium for pediatric patients 2-12 years old going for surgery under general anaesthesia

Comparative study between sugammedex and neostigmine as a reversal agent of rocuronium for pediatric patients 2-12 years old going for surgery under general anaesthesia

Abed H.E.A., Abdelaziz A.M.R.

Статья научная

Aim. The neuromuscular blocker has long been used during surgical procedures. The neuromuscular blockade produced by rocuronium can be reversed with sugammadex and neostigmine as reversal agents. This systematic review aims to determine the impact of sugammadex and neostigmine comparison as a reversal agent of rocuronium for pediatric patients 2-12 years old going for surgery under general anesthesia. Materials and Methods. This review examined recent studies assessing the impact of sugammadex and neostigmine comparison as a reversal agent of rocuronium for pediatric patients 2-12 years old going for surgery under general anesthesia. Data were searched from Google Scholar, PubMed, Hindawi, Anesthesiology, MEDLINE, and CENTRAL using keywords’ General Anesthesia,’ ‘Reversal Agent,’ ‘Rocuronium for Pediatric Patients,’ ‘Neuromuscular Blockers,’ ‘Sugammadex and Neostigmine,’ ‘Role of Analgesics.’ The review followed PRISMA guidelines. Results. The initial search for publications comparing sugammadex and neostigmine as a reversal agent of rocuronium for pediatric patients yielded 9000 papers, from which 600 were selected. The reviews’ articles were further analyzed to ensure they were pertinent to the Comparative Impact of Reversal Agents (Sugammadex And Neostigmine) of Rocuronium for Pediatric Patients. Around 319 references were examined for their potential applicability to the medical field of anesthesia. A total of 15 articles were included, with preference given to those published from 2014 to 2023 during the last ten years. Conclusion. The particular relaxant-binding medication promptly and successfully alleviates rocuronium-induced neuromuscular blockade in pediatric surgery patients. Considering the study’s outcomes, it can be concluded that sugammadex may restore any level of steroidal muscle relaxant-induced neuromuscular block faster than neostigmine.

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Comparative study of glycemic control and treatment satisfaction for patients with type 1 diabetes on sensor augmented insulin pump, insulin pump and multiple daily insulin injection: cross sectional study

Comparative study of glycemic control and treatment satisfaction for patients with type 1 diabetes on sensor augmented insulin pump, insulin pump and multiple daily insulin injection: cross sectional study

Alshahrani A.A., Almutairi F.S.

Статья научная

BACKGROUND: All patients with T1DM are on life-long insulin injection . However, since last decades with evolving diabetes technology ,there is a paucity of research on glycemic and self satisfaction effectiveness of new insulin pump and CGM devices in Saudi Arabia population whom they have different lifestyle and race. PATIENTS AND METHODS: A cross-sectional study was con-ducted at King Abdulaziz Medical City Endocrine Center in Ri-yadh, Saudi Arabia. The study focused on a sample of patients with type 1 diabetes aged 14 years and above using either a sensor-augmented insulin pump (Medtronic MiniMed 640G, 740G), insulin pump without a sensor (Medtronic Paradigm VEO 754), or multiple daily insulin injections for at least 6 months.

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