The protein binding of itraconazole and fluconazole in the serum of patients with insulin-dependent (IDDM) and non-insulin-dependent (NIDDM) diabetes mellitus was investigated in vitro. The unbound percentage of itraconazole in patients with IDDM and NIDDM was significantly higher than that in healthy volunteers. In contrast, there were no significant differences in fluconazole protein binding. A negative correlation was established between itraconazole protein binding and albumin concentration, and a positive correlation with free fatty acid concentration. The existence of a larger percentage of unbound itraconazole in diabetes patients could imply a change in drug disposition and an alteration in the effect of the drug. This should be taken into consideration in long duration treatment, especially in view of the non-linear kinetics of itraconazole.

Macrovascular and microvascular complications of diabetes may be associated with different environmental factors. To investigate this further, a prevalence study of 503 Mexican type II diabetic subjects was carried out while their patterns of nutrition were constrained by government food subsidies. Average daily dietary intakes were 1866 kcal; 46.5% as carbohydrate, 13.7 mmol cholesterol, 8.7 g fiber, and a polyunsaturated/saturated fat ratio of 0.98. With respect to macrovascular disease, 49.3% of patients had evidence of peripheral vascular disease, and 21.6% myocardial ischemia, 6.0% angina, 10.8% EKG evidence of ischemia, 4.8% EKG evidence of myocardial infarction. Only 1.2% (six patients) had a clear history of completed stroke, and all were hypertensive. Six patients had also undergone amputations for diabetic gangrene. Tabulation of the means of clinical characteristics according to presence or absence of myocardial ischemia showed that higher cholesterol, calorie, and fat intake, higher mean blood pressure, higher serum cholesterol, and serum triglyceride levels were found in those with myocardial ischemia. Patients with peripheral vascular disease were more commonly smokers. Stepwise logistic regression revealed significant positive associations between myocardial ischemia and dietary cholesterol, serum cholesterol, and mean blood pressure. In contrast, the presence of peripheral vascular disease was significantly related only to smoking and retinopathy. There were no associations between macrovascular complications and duration of diabetes in the multivariate analysis, and they occurred with equal frequency in men and women. Prospective studies of atherosclerosis in maturity-onset diabetes should assess and seek to modify dietary cholesterol, serum cholesterol, and hypertension.

In the original online version of this article Oreste Claudio Buonomo's family name was misspelled.The original article was corrected.

Boron (B) is an essential element for plants. B availability depends on the physical and chemical characteristics of the soil and the quality of irrigation water. Under natural conditions, both toxic and deficit concentrations can occur and should be managed for crop production. However, the range between deficiency and toxicity is narrow. The objective of this study was to determine the response of cherry trees to deficient (0.04 mg kg−1), adequate (1.1 mg kg−1), and toxic (3.75 mg kg−1) B concentrations in the soil by measuring growth, biomass, photosynthetic parameters, visual symptoms, and morphological changes. Plants treated with a toxic dose had more spurs and shorter internodes than those treated with adequate and deficient doses. The white root weight (50.5 g) at low B concentrations had the most roots compared with the adequate (33.0 g) and toxic (22.0 g) concentrations. The stem weight and biomass partitioning were higher for white roots and stems at B-deficient and -adequate doses than at toxic doses. The net photosynthesis (Pn) and transpiration rate (E) were significantly higher in plants with adequate concentrations of B. Stomatal conductance (Gs) was higher in B-deficient plants. Morphological and visual differences were observed between treatments. The results showed that it is essential to adequately manage B in cherry crops to avoid the adverse effects of both low and toxic concentrations.

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