Shared Medical Appointments and Their Effects on Achieving Diabetes Mellitus Goals in a Veteran Population.

Patients who participated in shared medical appointments experienced significant improvements in glycemic control.

Rates of in vivo methylation of desipramine and nortriptyline.

Routine monitoring of an 81-year-old man receiving treatment with nortriptyline for generalized anxiety disorder and depression revealed plasma concentrations of both amitriptyline and nortriptyline. In humans, the tricyclic antidepressant (TCA) tertiary amines imipramine and amitriptyline are typically metabolized by demethylation to the secondary active metabolites desipramine and nortriptyline, respectively. However, to our knowledge, methylation of secondary amine TCAs has been reported in only one case report of nortriptyline overdose and in two studies involving desipramine.

Age-related changes in ecosystem structure and function and effects on water and carbon exchange in ponderosa pine.

As forests age, their structure and productivity change, yet in some cases, annual rates of water loss remain unchanged. To identify mechanisms that might explain such observations, and to determine if widely different age classes of forests differ functionally, we examined young (Y, approximately 25 years), mature (M, approximately 90 years) and old (O, approximately 250 years) ponderosa pine (Pinus ponderosa Dougl. ex P.

An evaluation of ozone exposure metrics for a seasonally drought-stressed ponderosa pine ecosystem.

Ozone stress has become an increasingly significant factor in cases of forest decline reported throughout the world. Current metrics to estimate ozone exposure for forest trees are derived from atmospheric concentrations and assume that the forest is physiologically active at all times of the growing season. This may be inaccurate in regions with a Mediterranean climate, such as California and the Pacific Northwest, where peak physiological activity occurs early in the season to take advantage of high soil moisture and does not correspond to peak ozone concentrations.