WorldWideScience

Sample records for asymptomatic diabetic patients

  1. Endothelial progenitor cells in long-standing asymptomatic type 1 diabetic patients with or without diabetic nephropathy

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Jacobsen, Peter Karl; Lajer, Maria

    2011-01-01

    A decrease in the number and dysfunction of endothelial progenitor cells (EPC) may increase the risk for progression of cardiovascular disease (CVD) in type 1 diabetic patients with diabetic nephropathy (DN). Our aim was to evaluate EPC numbers in asymptomatic CVD type 1 diabetic patients...... with or without DN and to study the effect of CVD and medication on EPC numbers. Methods: We examined EPC numbers in 37 type 1 diabetic patients with DN and 35 type 1 diabetic patients with long-standing normoalbuminuria. Patients were without symptoms of CVD and the prevalence of CVD was previously shown...... with CVD (p > 0.05). Conventional risk factors were significantly higher in patients with DN and they received more CVD-preventive treatment. All patients receiving simvastatin or calcium-channel blockers had higher numbers of EPC compared to patients not treated with these drugs. Conclusions: Asymptomatic...

  2. Myocardial perfusion scintigraphy in the detection of silent ischemia in asymptomatic diabetic patients

    Energy Technology Data Exchange (ETDEWEB)

    Oki, Glaucia Celeste Rossatto [Clinica Diagnoson and Hospital Aristides Maltez, Salvador, BA (Brazil). Servicos de Medicina Nuclear; Pavin, Elizabeth Joao; Parisi, Maria Candida R. [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Internal Medicine. Service of Endocrinology; Coelho, Otavio Rizzi; Almeida, Raitany C. [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Internal Medicine. Service of Cardiology; Etchebehere, Elba Cristina Sa de Camargo; Ramos, Celso Dario, E-mail: cdramos@unicamp.br [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Radiology. Service of Nuclear Medicine; Camargo, Edwaldo Eduardo [Hospital Sirio-Libanes, Campinas, SP (Brazil). Service of Nuclear Medicine

    2013-01-15

    Objective: This study was aimed to evaluate myocardial perfusion in asymptomatic patients with type 1 (DM1) and type 2 diabetes mellitus (DM2) without previous diagnoses of coronary artery disease (CAD) or cerebral infarction. Materials and Methods: Fifty-nine consecutive asymptomatic patients (16 DM1, 43 DM2) underwent myocardial perfusion scintigraphy with {sup 99m}Tc-sestamibi (MPS). They were evaluated for body mass index, metabolic control of DM, type of therapy, systemic arterial hypertension, dyslipidemia, nephropathy, retinopathy, peripheral neuropathy, smoking, and familial history of CAD. Results: MPS was abnormal in 15 patients (25.4%): 12 (20.3%) with perfusion abnormalities, and 3 with isolated left ventricular dysfunction. The strongest predictors for abnormal myocardial perfusion were: age 60 years and above (p = 0.017; odds ratio [OR] = 6.0), peripheral neuropathy (p = 0.028; OR = 6.1), nephropathy (p = 0.031; OR = 5.6), and stress ECG positive for ischemia (p = 0.049; OR = 4.08). Conclusion: Silent myocardial ischemia occurs in more than one in five asymptomatic diabetic patients. The strongest predictors of ischemia in this study were: patient age, peripheral neuropathy, nephropathy, retinopathy and a stress ECG positive for ischemia. (author)

  3. Plasma copeptin as marker of cardiovascular disease in asymptomatic type 2 diabetes patients

    DEFF Research Database (Denmark)

    Bar-Shalom, Dana; Poulsen, Mikael K; Rasmussen, Lars M;

    2014-01-01

    for sub-clinical CVD. A total of 302 T2DM patients referred to the Diabetes Clinic at Odense University Hospital, Denmark, entered the study. None of the patients had known or suspected CVD. As a control group, 30 healthy adults were recruited from the DanRisk study - a random sample of middle-aged Danes....... A variety of clinical investigations were performed, including blood pressure measurements, carotid intima media thickness evaluation and myocardial perfusion scintigraphy. Blood sample analyses included copeptin measurements. Median plasma copeptin concentrations were similar in the T2DM group......Recently, copeptin was found associated with cardiovascular disease (CVD) and all-cause mortality in type 2 diabetes mellitus (T2DM) patients treated in primary care. This study aimed to evaluate whether plasma copeptin correlated to CVD in asymptomatic T2DM patients intensively investigated...

  4. ECHOCARDIOGRAPHIC EVALUATION OF DIASTOLIC DYSFUNCTION IN ASYMPTOMATIC TYPE 2 DIABETES MELLITUS PATIENTS

    Directory of Open Access Journals (Sweden)

    Madhumathi

    2014-01-01

    % was used as echo diagnostic criteria for LV diastolic dysfunction. RESULTS : Our study consisted of 50 patients with type 2 DM, 30(60% were females and 20(40% males. Majority of patients were in the age group of 40 – 70 years. Diastolic dysfuncti on was present in 24(48% patients out of whom 8 were males and 16 females. The maximum number of patients with LV diastolic dysfunction was in age group 50 – 59 years. There was a linear increase in prevalence of diastolic dysfunction with increasing age, increased duration of diabetes mellitus and increasing HbA1c levels. There was also significant correlation between LV diastolic dysfunction (LVDD and microangiopathy. Out of 13 patients who had diabetic retinopathy, 8 patients had LVDD and out of 11 pati ents with microalbuminuria, 9 patients had LVDD. CONCLUSION : LV diastolic dysfunction is an early manifestation of diabetic cardiomyopathy. Its prevalence correlates with duration of diabetes, HbA1c values and presence of microangiopathy. LVDD contributes s ignificantly to morbidity of congestive heart failure in diabetic patients. Echocardiography is a very useful noninvasive tool in detecting LVDD in asymptomatic type 2 DM patients.

  5. Dysregulation of coronary microvascular reactivity in asymptomatic patients with type 2 diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Momose, Mitsuru; Neverve, Jodi; Nekolla, Stephan G.; Schwaiger, Markus; Bengel, Frank M. [Nuklearmedizinische Klinik und Poliklinik der Technischen Universitaet Muenchen, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675 Munich (Germany); Abletshauser, Claudia [Department of Medicine, Novartis Pharma GmbH, Nuernberg (Germany); Schnell, Oliver; Standl, Eberhard [Institut fuer Diabetesforschung, Munich (Germany)

    2002-12-01

    In diabetic patients, a number of studies have suggested an impairment of vascular reactivity in response to vasodilatory stimuli. The pattern of dysregulation at the coronary microcirculatory level, however, has not been clearly defined. Thus, it was the aim of this study to characterise coronary microvascular function non-invasively in a homogeneous group of asymptomatic type 2 diabetic patients. In 46 patients with type 2 diabetes, myocardial blood flow (MBF) was quantified at baseline, in response to cold pressor test (CPT) and during adenosine-mediated vasodilation using positron emission tomography and nitrogen-13 ammonia. None of the patients had been treated with insulin, and none had symptoms of cardiac disease. Decreased MBF during CPT, indicating microvascular dysregulation, was observed in 16 patients (CPT-), while 30 patients demonstrated increased MBF during CPT (CPT+). Response to CPT was mildly, but significantly correlated with response to adenosine (r=0.44, P=0.0035). There was no difference in HbA1c, serum lipid levels or serum endothelial markers between the groups. Microvascular dysregulation in the CPT- group was associated with elevated baseline MBF (P<0.0001), reduced baseline vascular resistance (P=0.0026) and an abnormal increase in resistance during CPT (P=0.0002). In conclusion, coronary microvascular dysregulation is present in approximately one-third of asymptomatic, non-insulin-treated type 2 diabetic patients. Elevated baseline blood flow and reduced microvascular resistance at rest are characteristics of this dysregulation. These data suggest a state of activation of endothelial-dependent vasodilation at baseline which appears to limit the flow response to stress conditions. (orig.)

  6. Prognostic Value Of Normal Myocardial Perfusion Imaging In Asymptomatic Diabetic Patients With Moderate And High Calcium Scores

    Directory of Open Access Journals (Sweden)

    Mitevska Irena Peovska

    2015-06-01

    Full Text Available The purpose of this study was to evaluate the intermediate prognostic value of normal myocardial perfusion imaging (MPI in asymptomatic diabetic patients with intermediate and high coronary artery calcium (CAC scores. Methods: A total of 115 asymptomatic diabetic patients with no known coronary artery disease (CAD underwent MPI after multi-slice computed tomography CAC assessment for the detection of suspected CAD. The study included 75 patients with normal MPI results. A 17-segment model for myocardial perfusion and function analysis was used. Patients were divided into three groups: I gr-20 patients with a diabetes duration between 1-5 years; II gr-24 patients with a diabetes duration 5-10 years; and III gr-31 patients with a diabetes duration >10 years. End points (cardiac death, non-fatal myocardial infarction, heart failure, new angina, revascularization were assessed at 6, 12 and 24 months.

  7. Routine MRI findings of the asymptomatic foot in diabetic patients with unilateral Charcot foot

    Directory of Open Access Journals (Sweden)

    Poll Ludger W

    2010-04-01

    Full Text Available Abstract Background Imaging studies of bones in patients with sensory deficits are scarce. Aim To investigate bone MR images of the lower limb in diabetic patients with severe sensory polyneuropathy, and in control subjects without sensory deficits. Methods Routine T1 weighted and T2-fat-suppressed-STIR-sequences without contrast media were performed of the asymptomatic foot in 10 diabetic patients with polyneuropathy and unilateral inactive Charcot foot, and in 10 matched and 10 younger, non-obese unmatched control subjects. Simultaneously, a Gadolinium containing phantom was also assessed for reference. T1 weighted signal intensity (SI was recorded at representative regions of interest at the peritendineal soft tissue, the tibia, the calcaneus, and at the phantom. Any abnormal skeletal morphology was also recorded. Results Mean SI at the soft tissue, the calcaneus, and the tibia, respectively, was 105%, 105% and 84% of that at the phantom in the matched and unmatched control subjects, compared to 102% (soft tissue, 112% (calcaneus and 64% (tibia in the patients; differences of tibia vs. calcaneus or soft tissue were highly significant (p Conclusion MR imaging did not reveal grossly abnormal bone marrow signalling in the limbs with severe sensory polyneuropathy, but occult sequelae of previous traumatic injuries.

  8. Noninvasive Cardiovascular Risk Assessment of the Asymptomatic Diabetic Patient: The Imaging Council of the American College of Cardiology.

    Science.gov (United States)

    Budoff, Matthew J; Raggi, Paolo; Beller, George A; Berman, Daniel S; Druz, Regina S; Malik, Shaista; Rigolin, Vera H; Weigold, Wm Guy; Soman, Prem

    2016-02-01

    Increased cardiovascular morbidity and mortality in patients with type 2 diabetes is well established; diabetes is associated with at least a 2-fold increased risk of coronary heart disease. Approximately two-thirds of deaths among persons with diabetes are related to cardiovascular disease. Previously, diabetes was regarded as a "coronary risk equivalent," implying a high 10-year cardiovascular risk for every diabetes patient. Following the original study by Haffner et al., multiple studies from different cohorts provided varying conclusions on the validity of the concept of coronary risk equivalency in patients with diabetes. New guidelines have started to acknowledge the heterogeneity in risk and include different treatment recommendations for diabetic patients without other risk factors who are considered to be at lower risk. Furthermore, guidelines have suggested that further risk stratification in patients with diabetes is warranted before universal treatment. The Imaging Council of the American College of Cardiology systematically reviewed all modalities commonly used for risk stratification in persons with diabetes mellitus and summarized the data and recommendations. This document reviews the evidence regarding the use of noninvasive testing to stratify asymptomatic patients with diabetes with regard to coronary heart disease risk and develops an algorithm for screening based on available data.

  9. Circulating Malondialdehyde-Modified LDL-Related Variables and Coronary Artery Stenosis in Asymptomatic Patients with Type 2 Diabetes

    OpenAIRE

    Kazuya Fujihara; Hiroaki Suzuki; Akira Sato; Satoru Kodama; Yoriko Heianza; Kazumi Saito; Hitoshi Iwasaki; Kazuto Kobayashi; Shigeru Yatoh; Akimitsu Takahashi; Naoya Yahagi; Hiroaki Yagyu; Hirohito Sone; Hitoshi Shimano

    2015-01-01

    Aims. To elucidate the levels of malondialdehyde-modified LDL (MDA-LDL)-related variables for predicting coronary artery stenosis (CAS) by coronary CT angiography (CCTA) in asymptomatic patients with type 2 diabetes (T2DM). Methods. Enrolled were 36 Japanese patients with T2DM who underwent CCTA and in whom MDA-LDL levels were measured. Definition of CAS was luminal narrowing of ≥50%. Trends through tertiles of each MDA-LDL-related variable were analyzed with a general linear model. The abili...

  10. Prevalence and predictors of an abnormal stress myocardial perfusion study in asymptomatic patients with type 2 diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Scholte, Arthur J.H.A.; Schuijf, Joanne D.; Wall, Ernst E. van der; Bax, Jeroen J. [Leiden University Medical Center, Department of Cardiology, Albinusdreef 2, PO Box 9600, Leiden (Netherlands); Kharagjitsingh, Antje V. [Medisch Centrum Haaglanden, Department of Internal Medicine, The Hague (Netherlands); Dibbets-Schneider, Petra; Stokkel, Marcel P. [Leiden University Medical Center, Department of Nuclear Medicine, Leiden (Netherlands)

    2009-04-15

    The purpose of this study was to evaluate the prevalence of an abnormal stress myocardial perfusion study in a cohort of truly asymptomatic patients with type 2 diabetes mellitus using myocardial perfusion imaging by means of single photon emission computed tomography (SPECT). Secondly, we determined which clinical characteristics may predict an abnormal stress myocardial perfusion study in this population. A total of 120 asymptomatic patients (mean age 53{+-}10 years) with type 2 diabetes mellitus and one or more risk factors for coronary artery disease were prospectively recruited from an outpatient diabetes clinic. All patients underwent myocardial perfusion imaging by means of adenosine {sup 99m}Tc sestamibi SPECT. Images were evaluated for the presence of perfusion abnormalities as well as other nonperfusion abnormalities that may indicate extensive ischaemia, including left ventricular dysfunction (defined as a left ventricular ejection fraction <45%), transient ischaemic dilatation and adenosine-induced ST segment depression. Multivariable analysis was performed using a backward selection strategy to identify potential predictors for an abnormal stress myocardial perfusion study. Finally, all patients were followed up for 12 months to determine the occurrence of cardiovascular events: (1) cardiac death, (2) nonfatal myocardial infarction, (3) unstable angina requiring hospitalization, (4) revascularization, or (5) stroke. Of the 120 patients, 40 (33%) had an abnormal stress study, including myocardial perfusion abnormalities in 30 patients (25%). In 10 patients (8%), indicators of extensive (possibly balanced ischaemia) were observed in the absence of abnormal perfusion. The multivariable analysis identified current smoking, duration of diabetes and the cholesterol/high-density lipoprotein (HDL) ratio as independent predictors of an abnormal stress study. During a follow-up period of 12 months six patients (5%) had a cardiovascular event. The current study

  11. Potential association between coronary artery disease and the inflammatory biomarker YKL-40 in asymptomatic patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Kim Hyun

    2012-07-01

    Full Text Available Abstract Background Inflammation plays an important role in coronary artery disease from the initiation of endothelial dysfunction to plaque formation to final rupture of the plaque. In this study, we investigated the potential pathophysiological and clinical relevance of novel cytokines secreted from various cells including adipocytes, endothelial cells, and inflammatory cells, in predicting coronary artery disease (CAD in asymptomatic subjects with type 2 diabetes mellitus. Methods We enrolled a total of 70 asymptomatic type 2 diabetic patients without a documented history of cardiovascular disease, and determined serum levels of chemerin, omentin-1, YKL-40, and sCD26. We performed coronary computed tomographic angiography (cCTA in all subjects, and defined coronary artery stenosis ≥ 50 % as significant CAD in this study. Results Subjects were classified into two groups: patients with suspected coronary artery stenosis on cCTA (group I, n = 41 and patients without any evidence of stenosis on cCTA (group II, n = 29. Group I showed significantly higher YLK-40 levels and lower HDL-C levels than group II (p = 0.038, 0.036, respectively. Levels of chemerin, omentin-1, and sCD26 were not significantly different between the two groups. Serum YKL-40 levels were positively correlated with systolic/diastolic BP, fasting/postprandial triglyceride levels, and Framingham risk score. Furthermore, YKL-40 levels showed moderate correlation with the degree of coronary artery stenosis and the coronary artery calcium score determined from cCTA. In multivariate logistic analysis, after adjusting for age, gender, smoking history, hypertension, and LDL-cholesterol, YLK-40 levels showed only borderline significance. Conclusions YKL-40, which is secreted primarily from inflammatory cells, was associated with several CVD risk factors and was elevated in type 2 diabetic patients with suspected coronary artery stensosis on cCTA. These results suggest

  12. The Use of Different Irrigation Techniques to Decrease Bacterial Loads in Healthy and Diabetic Patients with Asymptomatic Apical Periodontitis

    Science.gov (United States)

    Ghoneim, Mai; Saber, Shehab ElDin; El-Badry, Tarek; Obeid, Maram; Hassib, Nehal

    2016-01-01

    BACKGROUND: Diabetes mellitus is a multisystem disease which weakens the human’s immunity. Subsequently, it worsens the sequelae of apical periodontitis by raising a fierce bacterial trait due to the impaired host response. AIM: This study aimed to estimate bacterial reduction after using different irrigation techniques in systemically healthy and diabetic patients with asymptomatic apical periodontitis. MATERIAL AND METHODS: Enterococcus faecalis, Peptostreptococcus micros, and Fusobacterium necleatum bacteria were chosen, as they are the most common and prevailing strains found in periodontitis. Bacterial samples were retrieved from necrotic root canals of systemically healthy and diabetic patients, before and after endodontic cleaning and shaping by using two different irrigation techniques; the conventional one and the EndoVac system. Quantitive polymerase chain reaction (qPCR) was utilised to detect the reduction in the bacterial count. RESULTS: The EndoVac irrigation system was effective in reducing bacteria, especially Peptostreptococcus micros in the diabetic group when compared to conventional irrigation technique with a statistically significant difference. CONCLUSION: The EndoVac can be considered as a promising tool in combination with irrigant solution to defeat the bacterial colonies living in the root canal system. Additional studies ought to be done to improve the means of bacterial clearance mainly in immune-compromised individuals. PMID:28028421

  13. Asymptomatic bacteriuria and urinary tract infections in special patient groups : women with diabetes mellitus and pregnant women

    NARCIS (Netherlands)

    Schneeberger, Caroline; Kazemier, Brenda M.; Geerlings, Suzanne E.

    2014-01-01

    Purpose of reviewAsymptomatic bacteriuria (ASB) and urinary tract infections (UTIs) in women with diabetes mellitus and during pregnancy are common and can have far-reaching consequences for the woman and neonate. This review describes epidemiology, risk factors, complications and treatment of UTI a

  14. Relationship between glycemic control and coronary artery disease severity, prevalence and plaque characteristics by computed tomography coronary angiography in asymptomatic type 2 diabetic patients.

    Science.gov (United States)

    Tavares, C A F; Rassi, C H R E; Fahel, M G; Wajchenberg, B L; Rochitte, C E; Lerario, A C

    2016-10-01

    Evaluate whether glycemic control in type 2 diabetes (DM2) asymptomatic for coronary artery disease (CAD) affects not only the presence and magnitude of CAD but also the characteristics of plaque vulnerability using multidetector row computed coronary tomography (MDCT). Acute coronary syndrome (ACS) is frequently observed in asymptomatic DM2 patients. Positive vessel remodeling (PR) and low-attenuation plaques (LAP) identified by MDCT have been demonstrated to be characteristics of subsequent culprit lesions of ACS. However, little is known regarding plaque characteristics in asymptomatic diabetic patients and their relationship with glycemic control. Ninety asymptomatic DM2 patients, aged 40-65 years old, underwent MDCT. The presence of atherosclerotic obstruction, defined as coronary stenosis ≥50 %, and plaque characteristics were compared between two groups of patients with A1c patients, 38 (42.2 %) presented with coronary atherosclerotic plaques, 11 had A1c patients had significant lumen obstruction higher than 50 %: 3 in the A1c patients, the simultaneous presence of two vulnerability plaque characteristics (PR and LAP) were observed more frequently in the A1c ≥ 7 group (n = 8) than in the A1c patients with A1c ≥ 7 % have a higher frequency of CAD and a higher proportion of vulnerable atherosclerotic coronary plaque by MDCT compared to patients with DM2 with A1c < 7 in our study.

  15. Long-Term Risk of Cardiovascular Disease among Type 2 Diabetic Patients with Asymptomatic Intracranial Atherosclerosis: A Prospective Cohort Study

    Science.gov (United States)

    Duan, Jian Gang; Chen, Xiang Yan; Lau, Alex; Wong, Adrian; Thomas, G. Neil; Tomlinson, Brian; Liu, Roxanna; Chan, Juliana C. N.; Leung, Thomas W.; Mok, Vincent; Wong, Ka Sing

    2014-01-01

    Objective To investigate whether asymptomatic middle cerebral artery (MCA) stenosis is associated with risk of cardiovascular disease (CVD) in Chinese with type 2 diabetes. Methods In this prospective cohort study, 2,144 Hong Kong Chinese with type 2 diabetes and without history of stroke or atrial fibrillation were recruited in 1994–1996 and followed up for a median of 14.51 years. Participants were assessed at baseline for MCA stenosis using transcranial Doppler. We performed survival analysis to assess the association between asymptomatic MCA stenosis and first CVD event, defined as ischemic stroke, acute coronary syndrome (ACS) or cardiovascular death. Results Of the 2,144 subjects, MCA stenosis at baseline was detected in 264 (12.3%). Rates of stroke, ACS and cardiovascular death per 100 were, respectively, 2.24, 2.92 and 1.11 among participants with stenosis, higher than among those without stenosis. Ten-year cumulative occurrence of stroke, ACS and cardiovascular death in subjects with MCA stenosis was 20%, 24% and 10%, respectively, higher than the corresponding values for subjects without stenosis(all P<0.001). After adjusting for covariates, MCA stenosis was found to be an independent predictor of stroke [hazard ratio (HR) 1.40, 95%CI 1.05–1.86; P = 0.02], ACS (HR 1.35, 95%CI 1.04–1.75; P = 0.02) and cardiovascular death(HR 1.56, 95%CI 1.04–2.33; P = 0.03). Conclusions Asymptomatic MCA stenosis is a risk factor for CVD in Chinese with type 2 diabetes, and detection of asymptomatic MCA stenosis by transcranial Doppler can identify diabetic individuals at high risk of future CVD. This finding is particularly important for diabetic individuals in Asia, where intracranial atherosclerosis is common. PMID:25192283

  16. Long-term risk of cardiovascular disease among type 2 diabetic patients with asymptomatic intracranial atherosclerosis: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Jian Gang Duan

    Full Text Available To investigate whether asymptomatic middle cerebral artery (MCA stenosis is associated with risk of cardiovascular disease (CVD in Chinese with type 2 diabetes.In this prospective cohort study, 2,144 Hong Kong Chinese with type 2 diabetes and without history of stroke or atrial fibrillation were recruited in 1994-1996 and followed up for a median of 14.51 years. Participants were assessed at baseline for MCA stenosis using transcranial Doppler. We performed survival analysis to assess the association between asymptomatic MCA stenosis and first CVD event, defined as ischemic stroke, acute coronary syndrome (ACS or cardiovascular death.Of the 2,144 subjects, MCA stenosis at baseline was detected in 264 (12.3%. Rates of stroke, ACS and cardiovascular death per 100 were, respectively, 2.24, 2.92 and 1.11 among participants with stenosis, higher than among those without stenosis. Ten-year cumulative occurrence of stroke, ACS and cardiovascular death in subjects with MCA stenosis was 20%, 24% and 10%, respectively, higher than the corresponding values for subjects without stenosis(all P<0.001. After adjusting for covariates, MCA stenosis was found to be an independent predictor of stroke [hazard ratio (HR 1.40, 95%CI 1.05-1.86; P = 0.02], ACS (HR 1.35, 95%CI 1.04-1.75; P = 0.02 and cardiovascular death(HR 1.56, 95%CI 1.04-2.33; P = 0.03.Asymptomatic MCA stenosis is a risk factor for CVD in Chinese with type 2 diabetes, and detection of asymptomatic MCA stenosis by transcranial Doppler can identify diabetic individuals at high risk of future CVD. This finding is particularly important for diabetic individuals in Asia, where intracranial atherosclerosis is common.

  17. Vitamin D levels and asymptomatic coronary artery disease in type 2 diabetic patients with elevated urinary albumin excretion rate

    DEFF Research Database (Denmark)

    Joergensen, Christel; Reinhard, Henrik; Schmedes, Anne;

    2012-01-01

    Coronary artery disease (CAD) is the major cause of morbidity and mortality in type 2 diabetic patients. Severe vitamin D deficiency has been shown to predict cardiovascular mortality in type 2 diabetic patients.......Coronary artery disease (CAD) is the major cause of morbidity and mortality in type 2 diabetic patients. Severe vitamin D deficiency has been shown to predict cardiovascular mortality in type 2 diabetic patients....

  18. Elevated NT-proBNP and coronary calcium score in relation to coronary artery disease in asymptomatic type 2 diabetic patients with elevated urinary albumin excretion rate

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Hansen, Peter R; Persson, Frederik;

    2011-01-01

    Elevated plasma N-terminal (NT)-proBNP levels and coronary calcium score (CCS) not only predicts myocardial ischaemia and coronary artery stenosis but also adverse cardiovascular events and mortality in type 2 diabetic patients with an increased urinary albumin excretion rate (UAER), whereas low...... levels are associated with low frequency of coronary artery disease (CAD) and good prognosis. The underlying causes of poor prognosis in patients with elevated NT-proBNP are not known; thus, we investigated the role of putative asymptomatic CAD in type 2 diabetic patients with UAER >30 mg/24 h...... and elevated P-NT-proBNP and/or CCS....

  19. Early detection of left ventricular dysfunction in asymptomatic diabetic patient using strain and strain rate echocardiographic imaging

    Directory of Open Access Journals (Sweden)

    Rania Gaber

    2014-03-01

    Conclusion: Type 2 diabetes mellitus deteriorate both LV systolic and diastolic performance. Strain and strain rate by tissue Doppler Imaging is superior to conventional Doppler in early detection and evaluation of systolic and diastolic dysfunction in type 2 diabetic patients.

  20. Cardiovascular events in Japanese asymptomatic patients with type 2 diabetes: a 1-year interim report of a J-ACCESS 2 investigation using myocardial perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, Kenichi [Kanazawa University Hospital, Department of Nuclear Medicine, Kanazawa (Japan); Yamasaki, Yoshimitsu [Osaka University, Center for Advanced Science and Innovation, Osaka (Japan); Kusuoka, Hideo [National Hospital Organization Osaka National Hospital, Osaka (Japan); Izumi, Tohru [Kitasato University, Department of Cardiology and Internal Medicine, Sagamihara (Japan); Kashiwagi, Atsunori [Shiga University of Medical Science, Department of Medicine, Ohtsu (Japan); Kawamori, Ryuzo [Juntendo University, Department of Medicine, Metabolism and Endocrinology, School of Medicine, Tokyo (Japan); Shimamoto, Kazuaki [Sapporo Medical University School of Medicine, Second Department of Internal Medicine, Sapporo (Japan); Yamada, Nobuhiro [University of Tsukuba, Division of Metabolism and Endocrinology, Department of Internal Medicine, Faculty of Medicine, Tsukuba (Japan); Nishimura, Tsunehiko [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science, 465 Kajii-cho, Kawara-machi, Hirokoji, Kamigyo-ku, Kyoto (Japan)

    2009-12-15

    Diabetic patients have a high risk for cardiovascular events. The role of myocardial perfusion imaging was investigated in asymptomatic diabetic patients to evaluate short-term prognosis in a Japanese population. A total of 506 asymptomatic patients {>=}50 years of age who had carotid artery maximum intima-media thickness {>=}1.1 mm, urinary albumin excretion of {>=}30 mg/g creatinine, with additional criteria of abdominal obesity, low HDL cholesterol, high triglyceride level, and hypertension were enrolled and followed up over a 3-year period. Gated SPECT with stress-rest protocol was performed and analyzed by summed defect scores and QGS software. One-year cardiovascular events were analyzed. Myocardial ischemia was observed in 17% of patients, and abnormal perfusion findings of ischemia and/or scar were observed in 32% of patients. By the end of the 1-year follow-up, 33 (6.5%) cardiovascular events occurred including 6 all-cause deaths. Patients with summed stress score (SSS) >8 had a higher incidence of either death or cardiovascular events. Event-free survival rates for SSS 0-3, 4-8, 9-13, and {>=}14 were 0.96, 0.95, 0.82, and 0.76, respectively. Multivariate Cox regression analysis showed that significant variables were SSS, history of cerebrovascular accident, and electrocardiographic abnormality at rest. The 1-year interim summary showed that cardiovascular events were significantly higher in patients with SPECT abnormality, although hard cardiac event rate was relatively low. Targeted treatment strategy is required for asymptomatic but potentially high-risk diabetic patients. (orig.)

  1. Prognostic significance of stress myocardial ECG-gated perfusion imaging in asymptomatic patients with diabetic chronic kidney disease on initiation of haemodialysis

    Energy Technology Data Exchange (ETDEWEB)

    Momose, Mitsuru; Kondo, Chisato; Kobayashi, Hideki; Kusakabe, Kiyoko [Tokyo Women' s Medical University, School of Medicine, Department of Radiology, Shinjuku-ku, Tokyo (Japan); Babazono, Tetsuya [Tokyo Women' s Medical University, School of Medicine, Diabetes Centre, Shinjuku-ku, Tokyo (Japan); Nakajima, Takatomo [Tokyo Women' s Medical University, School of Medicine, Department of Cardiology, Shinjuku-ku, Tokyo (Japan)

    2009-08-15

    Diabetic patients with chronic kidney disease (CKD) frequently develop cardiac events within several years of the initiation of haemodialysis. The present study assesses the prognostic significance of stress myocardial ECG-gated perfusion imaging (MPI) in patients with diabetic CKD requiring haemodialysis. Fifty-five asymptomatic patients with diabetic stage V CKD and no history of heart disease scheduled to start haemodialysis were enrolled in this study (56{+-}11 years old; 49 with type 2 diabetes mellitus). All patients underwent {sup 201}Tl stress ECG-gated MPI 1 month before or after the initiation of haemodialysis to assess myocardial involvement. We evaluated SPECT images using 17-segment defect scores graded on a 5-point scale, summed stress score (SSS) and summed difference scores (SDS). The patients were followed up for at least 2 years (42{+-}15 months) to determine coronary intervention (CI) and heart failure (HF) as soft events and acute myocardial infarction (AMI) and all causes of deaths as hard events. The frequencies of myocardial ischaemia, resting perfusion defects, low ejection fraction and left ventricular (LV) dilatation were 24,20,29 and 49%, respectively. Ten events (18%) developed during the follow-up period including four CI, one HF, one AMI and four sudden deaths. Multivariate Cox analysis selected SDS (p=0.0011) and haemoglobin A{sub 1c} (HbA{sub 1c}) (p=0.0076) as independent prognostic indicators for all events. Myocardial ischaemia, in addition to glycaemic control, is a strong prognostic marker for asymptomatic patients with diabetic CKD who are scheduled to start haemodialysis. Stress MPI is highly recommended for the management and therapeutic stratification of such patients. (orig.)

  2. Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy.

    Science.gov (United States)

    Sung, Jia-Ying; Tani, Jowy; Chang, Tsui-San; Lin, Cindy Shin-Yi

    2017-01-01

    This study investigated sensory and motor nerve excitability properties to elucidate the development of diabetic neuropathy. A total of 109 type 2 diabetes patients were recruited, and 106 were analyzed. According to neuropathy severity, patients were categorized into G0, G1, and G2+3 groups using the total neuropathy score-reduced (TNSr). Patients in the G0 group were asymptomatic and had a TNSr score of 0. Sensory and motor nerve excitability data from diabetic patients were compared with data from 33 healthy controls. Clinical assessment, nerve conduction studies, and sensory and motor nerve excitability testing data were analyzed to determine axonal dysfunction in diabetic neuropathy. In the G0 group, sensory excitability testing revealed increased stimulus for the 50% sensory nerve action potential (Pmotor excitability only had significantly increased stimulus for the 50% compound motor nerve action potential (Pdevelopment of axonal dysfunction in sensory axons occurred prior to and in a different fashion from motor axons. Additionally, sensory nerve excitability tests can detect axonal dysfunction even in asymptomatic patients. These insights further our understanding of diabetic neuropathy and enable the early detection of sensory axonal abnormalities, which may provide a basis for neuroprotective therapeutic approaches.

  3. Detection of silent myocardial ischemia in asymptomatic patients with diabetes: results of a randomized trial and meta-analysis assessing the effectiveness of systematic screening

    Directory of Open Access Journals (Sweden)

    Penfornis Alfred

    2011-01-01

    Full Text Available Abstract Background Most guidelines recommend a systematic screening of asymptomatic high risk patients with diabetes for silent ischemia, but the clinical benefit of this strategy has not been demonstrated compared with the simple control of cardiovascular risk factors. We sought to determine whether referring asymptomatic diabetic patients for screening of silent ischemia decreases the risk of cardiovascular events compared with usual care. Methods DYNAMIT was a prospective, randomized, open, blinded end-point multicenter trial run between 2000 and 2005, with a 3.5 year mean follow-up in ambulatory care in 45 French hospitals. The study included 631 male and female with diabetes aged 63.9 ± 5.1 years, with no evidence of coronary artery disease and at least 2 additional cardiovascular risk factors, receiving appropriate medical treatment. The patients were randomized centrally to either screening for silent ischemia using a bicycle exercise test or Dipyridamole Single Photon Emission Computed Tomography (N = 316, or follow-up without screening (N = 315. The main study end point was time to death from all causes, non-fatal myocardial infarction, non-fatal stroke, or heart failure requiring hospitalization or emergency service intervention. The results of a meta-analysis of DYNAMIT and DIAD, a similar study, are also presented. Results The study was discontinued prematurely because of difficulties in recruitment and a lower-than expected event rate. Follow-up was complete for 98.9% patients regarding mortality and for 97.5% regarding the main study end point. Silent ischemia detection procedure was positive or uncertain in 68 (21.5% patients of the screening group. There was no significant difference between the screening and the usual care group for the main outcome (hazard ratio = 1.00 95%CI 0.59 to 1.71. The meta-analysis of these and DIAD results gave similar results, with narrower confidence intervals for each endpoint. Conclusions These

  4. Asymptomatic bacteriuria in postmenopausal women with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    George Kasyan

    2013-05-01

    Full Text Available Introduction. An evaluation of efficacy of the management of urinary tract infections by using local forms of Estriol in postmenopausal women with type II diabetes and asymptomatic bacteriuria.Material and methods. The study was conducted in two stages. The first stage: a prospective cross–sectional study to identify patients with asymptomatic bacteriuria. During this stage, 414 postmenopausal women with type II diabetes, but without clinical symptoms of urinary tract infection, were investigated. In the second stage, women with asymptomatic bacteriuria (87 women were randomized to two groups: the first group was the main group receiving 0.5 mg of Estriol as a vaginal cream, the second group was the control group. The study lasted 12 months.Results. After 12 months of the study, asymptomatic bacteriuria was revealed in 19.4% of women in the group 1 and 68.4% of women in the group 2 (р <0.001, and symptomatic urinary tract infection in 8.3% of women in the group 1 and 18.4% of women in the group 2 (р <0.001. There was no connection revealed between asymptomatic bacteriuria and НвА1с. Using Estriol in group 1 led to an increase in VHI, the appearance of lactobacilli in the vaginal smear, and the decrease of symptom frequency in atrophic vaginitis. In group 2, there were no significant changes revealed.Conclusions. Usage of local forms of Estriol effectively prevents and decreases the frequency of asymptomatic bacteriuria and urinary tract infection in postmenopausal women suffering with diabetesmellitus.

  5. High bacterial load in asymptomatic diabetic patients with neurotrophic ulcers retards wound healing after application of Dermagraft.

    Science.gov (United States)

    Browne, A C; Vearncombe, M; Sibbald, R G

    2001-10-01

    Diabetic neuropathic foot ulcers are a major healthcare burden. These chronic wounds always have a bacterial load, and although normal flora is not harmful, increased tissue burden may impede healing before clinical signs of infection are evident. In this study, chronic noninfected diabetic neuropathic foot ulcers (those with adequate blood supply and pressure offloading) were assessed for bacterial burden immediately before the application of a skin substitute. Eight patients with diabetic neuropathic foot ulcers greater than 1 cm2 and free of necrotic tissue had 3-mm tissue biopsies taken from the ulcer base for quantitative bacteriology. Five of the eight patients (75%) had greater or equal to 10(5) colony forming units/gram organisms present despite the absence of clinical signs of infection. Wound healing rates were linked to bacterial load as determined from quantitative biopsy--no growth was associated with a wound healing rate of 0.2 cm per week, 10(5) to 10(6) colony forming units/gram was associated with a healing rate of 0.15 cm per week, and greater than 10(6) colony forming units/gram was associated with 0.05 cm/per week healing rate. High bacterial burden impeded healing both before and after the application of the skin substitute. The authors will change their clinical practice to assess all diabetic neuropathic foot ulcers using quantitative skin biopsies before applying skin substitutes. All patients will be treated with combination antibiotics and repeat biopsies obtained with decreased bacterial burden (< 10(6) colony forming units/gram) prior to using any bioengineered skin substitute or growth factor treatment.

  6. Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy

    Science.gov (United States)

    Sung, Jia-Ying; Tani, Jowy; Chang, Tsui-San; Lin, Cindy Shin-Yi

    2017-01-01

    This study investigated sensory and motor nerve excitability properties to elucidate the development of diabetic neuropathy. A total of 109 type 2 diabetes patients were recruited, and 106 were analyzed. According to neuropathy severity, patients were categorized into G0, G1, and G2+3 groups using the total neuropathy score-reduced (TNSr). Patients in the G0 group were asymptomatic and had a TNSr score of 0. Sensory and motor nerve excitability data from diabetic patients were compared with data from 33 healthy controls. Clinical assessment, nerve conduction studies, and sensory and motor nerve excitability testing data were analyzed to determine axonal dysfunction in diabetic neuropathy. In the G0 group, sensory excitability testing revealed increased stimulus for the 50% sensory nerve action potential (P<0.05), shortened strength-duration time constant (P<0.01), increased superexcitability (P<0.01), decreased subexcitability (P<0.05), decreased accommodation to depolarizing current (P<0.01), and a trend of decreased accommodation to hyperpolarizing current in threshold electrotonus. All the changes progressed into G1 (TNSr 1–8) and G2+3 (TNSr 9–24) groups. In contrast, motor excitability only had significantly increased stimulus for the 50% compound motor nerve action potential (P<0.01) in the G0 group. This study revealed that the development of axonal dysfunction in sensory axons occurred prior to and in a different fashion from motor axons. Additionally, sensory nerve excitability tests can detect axonal dysfunction even in asymptomatic patients. These insights further our understanding of diabetic neuropathy and enable the early detection of sensory axonal abnormalities, which may provide a basis for neuroprotective therapeutic approaches. PMID:28182728

  7. NT-proBNP levels, atherosclerosis and vascular function in asymptomatic type 2 diabetic patients with microalbuminuria: peripheral reactive hyperaemia index but not NT-proBNP is an independent predictor of coronary atherosclerosis

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Wiinberg, Niels; Hansen, Peter R

    2011-01-01

    for atherosclerosis is unclear. We examined the interrelationship between P-NT-proBNP, presence of atherosclerosis and/or vascular dysfunction in the coronary, carotid and peripheral arteries in asymptomatic type 2 diabetic patients with microalbuminuria that received intensive multifactorial treatment. METHODS...... AND RESULTS: P-NT-proBNP was measured in 200 asymptomatic type 2 patients without known cardiac disease that received intensive multifactorial treatment for CV risk reduction. Patients were examined for coronary, carotid and peripheral atherosclerosis, as defined by coronary calcium score=400, carotid intima...

  8. NT-proBNP levels, atherosclerosis and vascular function in asymptomatic type 2 diabetic patients with microalbuminuria: peripheral reactive hyperaemia index but not NT-proBNP is an independent predictor of coronary atherosclerosis

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Wiinberg, Niels; Hansen, Peter R

    2011-01-01

    for atherosclerosis is unclear. We examined the interrelationship between P-NT-proBNP, presence of atherosclerosis and/or vascular dysfunction in the coronary, carotid and peripheral arteries in asymptomatic type 2 diabetic patients with microalbuminuria that received intensive multifactorial treatment. METHODS...... AND RESULTS: P-NT-proBNP was measured in 200 asymptomatic type 2 patients without known cardiac disease that received intensive multifactorial treatment for CV risk reduction. Patients were examined for coronary, carotid and peripheral atherosclerosis, as defined by coronary calcium score≥400, carotid intima...

  9. History taking and leukocyturia predict the presence of asymptomatic bacteriuria in women with diabetes mellitus

    NARCIS (Netherlands)

    Meiland, R; Geerlings, SE; Stolk, RP; Hoes, AW; Hoepelman, AIM

    2004-01-01

    Objective: To investigate the accuracy of history taking to diagnose asymptomatic bacteriuria (ASB) in diabetic women, and the added value of leukocyturia. Methods: Data were obtained from a multicenter study including 465 women with diabetes. Many patient characteristics were considered as potentia

  10. Consequences of asymptomatic bacteriuria in women with diabetes mellitus

    NARCIS (Netherlands)

    Geerlings, SE; Stolk, RP; Camps, MJL; Netten, PM; Collet, JT; Schneeberger, PM; Hoepelman, AIM

    2001-01-01

    Background: Women with diabetes mellitus (DM) have asymptomatic bacteriuria (ASB) more often than women without DM. It is unknown, however, what the consequences of ASB are in these women. Objectives: To compare women with DM with and without ASB for the development of symptomatic urinary tract infe

  11. Asymptomatic cardiovascular manifestations in diabetes mellitus: Left ventricular diastolic dysfunction and silent myocardial ischemia

    Directory of Open Access Journals (Sweden)

    Seferović-Mitrović Jelena P.

    2011-01-01

    Full Text Available Introduction. Several cardiovascular manifestations in patients with diabetes may be asymptomatic. Left ventricular diastolic dysfunction (LVDD is considered to be the earliest metabolic myocardial lesion in these patients, and can be diagnosed with tissue Doppler echocardiography. Silent myocardial ischemia (SMI is a characteristic and frequently described form of ischemic heart disease in patients with diabetes. Objective. The aim of the study was to assess the prevalence of LVDD and SMI in patients with type 2 diabetes, as well as to compare demographic, clinical, and metabolic data among defined groups (patients with LVDD, patients with SMI and patients with type 2 diabetes, without LVDD and SMI. Methods. We investigated 104 type 2 diabetic patients (mean age 55.4±9.1 years, 64.4% males with normal blood pressure, prehypertension and arterial hypertension stage I. Study design included basic laboratory assessment and cardiological workup (transthoracic echocardiography and tissue Doppler, as well as the exercise stress echocardiography. Results. LVDD was diagnosed in twelve patients (11.5%, while SMI was revealed in six patients (5.8%. Less patients with LVDD were using metformin, in comparison to other two groups (χ2 =12.152; p=0.002. Values of HDL cholesterol (F=4.515; p=0.013 and apolipoprotein A1 (F=5.128; p= 0.008 were significantly higher in patients with LVDD. Conclusion. The study confirmed asymptomatic cardiovascular complications in 17.3% patients with type 2 diabetes.

  12. A prospective two-center study on the associations between microalbuminuria, coronary atherosclerosis and long-term clinical outcome in asymptomatic patients with type 2 diabetes mellitus: evaluation by coronary CT angiography.

    Science.gov (United States)

    Kim, Jin-Jin; Hwang, Byung-Hee; Choi, Ik Jun; Choo, Eun-Ho; Lim, Sungmin; Koh, Yoon-Seok; Lee, Jong Min; Kim, Pum-Joon; Seung, Ki-Bae; Lee, Seung-Hwan; Cho, Jae-Hyung; Jung, Jung Im; Chang, Kiyuk

    2015-01-01

    This study assessed the associations between microalbuminuria in asymptomatic patients with type 2 diabetes and the presence, extent, and severity of coronary atherosclerosis, as measured by coronary computed tomography angiography (CCTA), and the long-term clinical outcomes. In total, the study enrolled 284 consecutive eligible asymptomatic patients with type 2 diabetes and without known coronary artery disease (CAD), who then underwent CCTA and 24 h urine albumin measurements. Microalbuminuria was defined as 30-300 mg/day urinary albumin excretion. Obstructive CAD, as measured by CCTA, was defined as maximum intra-luminal stenosis ≥50 %. Patients with and without microalbuminuria were compared in terms of obstructive CAD prevalence, and the extent and severity of coronary atherosclerosis. They were evaluated using the following data: coronary artery calcium score (CACS), atheroma burden obstructive score (ABOS), segment involvement score (SIS) and segment stenosis score (SSS). All-cause mortality within a follow-up period of 5 years was also compared. Compared to patients without microalbuminuria, patients with microalbuminuria were more likely to have obstructive CAD (p = 0.004). Microalbuminuria was associated with higher ABOS (p = 0.010), SIS (p = 0.029), and SSS (p = 0.011), except for CACS (p = 0.058). Multivariable analyses adjusted for conventional cardiovascular risk factors revealed that microalbuminuria was an independent predictor of obstructive CAD [odds ratio 2.255, confidence intervals (CI) 1.121-4.538, p = 0.023] and all-cause mortality (hazard ratio 3.469, CI 1.319-9.121, p = 0.012). In asymptomatic patients with type 2 diabetes, microalbuminuria was associated with increased risk of CAD and poorer clinical outcomes.

  13. Elevated NT-proBNP and coronary calcium score in relation to coronary artery disease in asymptomatic type 2 diabetic patients with elevated urinary albumin excretion rate

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Hansen, Peter R; Persson, Frederik;

    2011-01-01

    Elevated plasma N-terminal (NT)-proBNP levels and coronary calcium score (CCS) not only predicts myocardial ischaemia and coronary artery stenosis but also adverse cardiovascular events and mortality in type 2 diabetic patients with an increased urinary albumin excretion rate (UAER), whereas low...

  14. Recurrent Parotid Carcinosarcoma in an Asymptomatic Patient

    Directory of Open Access Journals (Sweden)

    Joshua Mansour MD

    2016-10-01

    Full Text Available In this article, we present the case of a 52-year-old male with a history of parotid carcinosarcoma with initial diagnosis being 18 months prior. Initial treatment included a combination of gamma knife surgery coupled with high dosage chemotherapy and X-ray radiation therapy. At the time of follow-up, the patient presented with no complaints and had a nearly normal physical exam with the exception of some facial nerve weakness on the same side as the initial surgery. Despite being asymptomatic, the patient had a significant progression of disease that was manifested with intracranial lesions, multiple pathologic fractures, and a dramatic increase in overall tumor burden. Ultimately, the patient decided to pursue comfort measures only and succumbed to the disease peacefully soon thereafter.

  15. Identification of asymptomatic type 2 diabetes mellitus patients with a low, intermediate and high risk of ischaemic heart disease: is there an algorithm?

    DEFF Research Database (Denmark)

    Poulsen, Mikael Kjær; Henriksen, Jan Erik; Vach, W;

    2010-01-01

    AIMS/HYPOTHESIS: The leading cause of death in type 2 diabetes is cardiovascular disease (CVD). We examined the prevalence of myocardial ischaemia in type 2 diabetes patients and tried to establish an algorithm to identify patients with a high risk of ischaemic heart disease. METHODS: Type 2...... predictors of myocardial ischaemia were: atypical or typical angina pectoris, two or more traditional risk factors for CVD, BMI >32 kg/m2, systolic blood pressure >140 mmHg, HbA1c >8.5%, high-sensitivity C-reactive protein >4.0 mg/l, N-terminal pro-brain natriuretic peptide >300 pg/ml, left atrial volume...... index >32 ml/m2, left ventricular ejection fraction risk groups (n=115), in which the prevalence of myocardial ischaemia was 15%,23% and 43%, respectively. Overall the algorithm reduced...

  16. Cardiac (82)Rb PET/CT for fast and non-invasive assessment of microvascular function and structure in asymptomatic patients with type 2 diabetes

    DEFF Research Database (Denmark)

    von Scholten, Bernt J; Hasbak, Philip; Christensen, Thomas E

    2016-01-01

    AIMS/HYPOTHESIS: Coronary flow reserve (CFR) and coronary artery calcium (CAC) represent functional and structural aspects of atherosclerosis. We examined the prevalence of reduced CFR and high CAC scores in three predefined groups of participants without known cardiovascular disease: (1) patients.......026). In multivariate regression analysis, a higher urinary albumin excretion rate (UAER) tended to predict reduced CFR in the total population (p = 0.045). When the CAC score was added, there was also a trend (p = 0.032) towards an inverse association with reduced CFR. CONCLUSIONS/INTERPRETATION: Type 2 diabetic...

  17. Asymptomatic patients of chronic obstructive pulmonary disease in China

    Institute of Scientific and Technical Information of China (English)

    LU Ming; WANG Chang-zheng; NI Dian-tao; WANG Xiao-ping; WANG Da-li; LIU Sheng-ming; L(U) Jia-chun; SHEN Ning; DING Yan-ling; RAN Pi-xin; YAO Wan-zhen; ZHONG Nan-shan; ZHOU Yu-min; WANG Chen; CHEN Ping; KANG Jian; HUANG Shao-guang; CHEN Bao-yuan

    2010-01-01

    Background Chronic obstructive pulmonary disease (COPD) has a variable natural history and not all individuals follow the same course. This study aimed to identify the prevalence and characteristics of asymptomatic COPD patients from a population-based survey in China.Methods A multistage cluster sampling strategy was used in a population from seven different provinces/cities. All residents (over 40 years old) were interviewed with a standardized questionnaire and spirometry.Post-bronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) of less than 70% was defined as the diagnostic criterion of COPD. All COPD patients screened were divided into symptomatic group and asymptomatic group according to the presence or absence of chronic respiratory symptoms. Socio-demographic,personal and exposure variables were collected and analyzed.Results Among the 1668 patients who were diagnosed with COPD from the 25 627 sampling subjects, 589 (35.3%)were asymptomatic. The age, sex, body mass index (BMI),rural and urban distributions, smoking habit and education levels were similar in the two groups. A total of 64.7% of the asymptomatic patients had no comorbidities. Cardiovascular diseases and lung cancer were more common among symptomatic COPD patients than asymptomatic group.Asymptomatic COPD group were less likely to present with poor ventilation in the kitchen, a family history of respiratory disease and recurrent childhood cough. Asymptomatic COPD patients had significantly higher FEV1 (73.1% vs. 61.0%), FVC (91.9% vs. 82.0%), and a higher ratio of FEV1/FVC (62.9% vs.58.7%) (all P <0.001) than symptomatic group. More asymptomatic patients were underdiagnosed (91.9% vs.54.3%, P<0.001) than symptomatic patients.Conclusions This large population-based survey confirmed a high prevalence of asymptomatic COPD patients in China. More use of spirometry screening test may be important to the early detection of COPD.

  18. Nutritional profile of asymptomatic alcoholic patients

    Directory of Open Access Journals (Sweden)

    Maria Beatriz Sobral-Oliveira

    2011-06-01

    Full Text Available CONTEXT: Alcoholism may interfere with nutritional status, but reports are often troubled by uncertainties about ingested diet and organ function, as well as by ongoing abuse and associated conditions. OBJECTIVE: To identify nutritional and body compartment changes in stable alcoholics without confounding clinical and dietetic variables, a prospective observational pilot study was designed. Three well-matched populations were considered: subjects with chronic alcoholic pancreatitis, alcoholics without visceral disease, and healthy never-drinking adults (controls. METHODS: Subjects (n = 60 were asymptomatic males with adequate diet, no superimposed disease or complication, and alcohol-free for at least 6 months. After exclusions, 48 patients were compared. Variables encompassed dietary recall, bioimpedance analysis, biochemical profile and inflammatory markers. Main outcome measures were body fat, lean body mass, serum lipids, C-reactive protein, and selected minerals and vitamins. RESULTS: Both alcoholic populations suffered from reduced lean body mass (P = 0.001, with well-maintained body fat.Magnesium was depleted, and values of vitamin D and B12 correlated with alcohol abuse. LDL and total cholesterol was increased in alcoholics without pancreatitis (P = 0.04, but not in those with visceral damage. C-reactive protein and serum amyloid A correlated with duration of excessive drinking (P = 0.01. CONCLUSIONS: Undernutrition (diminished lean body mass, risk of magnesium and vitamin deficiencies contrasted with dyslipidemia and increased cardiovascular risk. This second danger was masked during chronic pancreatitis but not in alcoholics without visceral disease. Further studies should focus special requirements of this population.

  19. Asymptomatic bacteriuria and urinary tract infections in women : focus on diabetes mellitus and pregnancy

    NARCIS (Netherlands)

    Schneeberger, Caroline

    2014-01-01

    There is a shortage of evidence for clinical guidelines on diagnosis and management of both asymptomatic bacteriuria (the presence of bacteria in urine without symptoms of an infection) and urinary tract infections in women with diabetes and pregnant women. Asymptomatic bacteriuria and urinary tract

  20. Diagnosis and management of patients with asymptomatic severe aortic stenosis

    Institute of Scientific and Technical Information of China (English)

    Minako Katayama; Hari P Chaliki

    2016-01-01

    Aortic stenosis(AS) is a disease that progresses slowly for years without symptoms, so patients need to be carefully managed with appropriate follow up and referred for aortic valve replacement in a timely manner. Development of symptoms is a clear indication for aortic valve intervention in patients with severe AS. The decision for early surgery in patients with asymptomatic severe AS is more complex. In this review, we discuss how to identify high-risk patients with asymptomatic severe AS who may benefit from early surgery.

  1. The Celiac Disease and Diabetes-Dietary Intervention and Evaluation Trial (CD-DIET) protocol: a randomised controlled study to evaluate treatment of asymptomatic coeliac disease in type 1 diabetes

    OpenAIRE

    Mahmud, Farid H.; De Melo, Emilia N; Noordin, Karima; Assor, Esther; Sahota, Kamaljeet; Davies-Shaw, Jolie; Cutz, Ernest; Somers, Gino; Lawson, Margaret; David R Mack; Gallego, Patricia; McDonald, Charlotte; Beaton, Melanie D; Bax, Kevin; Saibil, Fred

    2015-01-01

    Introduction Coeliac disease (CD) is an autoimmune condition characterised by gluten-induced intestinal inflammation, and observed at a 5–10 fold greater prevalence in type 1 diabetes. While universal screening for CD in patients with diabetes is frequently advocated, objective data is limited as to benefits on diabetes control, bone health or quality of life related to the adoption of a gluten-free diet (GFD) in the large proportion of patients with diabetes with asymptomatic CD. The Celiac ...

  2. Asymptomatic bacteriuria may be considered a complication in women with diabetes

    NARCIS (Netherlands)

    Geerlings, SE; Stolk, RP; Camps, MJL; Netten, PM; Hoekstra, JBL; Bouter, KP; Bravenboer, B; Collet, JT; Jansz, AR; Hoepelman, AIM

    2000-01-01

    OBJECTIVE - To study the prevalence of and risk factors for asymptomatic bacteriuria (ASB) in women with and without diabetes. RESEARCH DESIGN AND METHODS - A total of 636 nonpregnant women with diabetes (type 1 and type 2) who were 18-75 years of age and had no abnormalities of the urinary tract, a

  3. Asymptomatic brain metastases in patients with cutaneous metastatic malignant melanoma

    DEFF Research Database (Denmark)

    Zukauskaite, Ruta; Schmidt, Henrik; Asmussen, Jon T

    2013-01-01

    The aim of the study was to identify the frequency of asymptomatic brain metastases detected by computed tomography (CT) scans in patients with metastatic cutaneous melanoma referred to first-line systemic treatment. Between 1995 and 2009, 697 Danish patients were screened with a contrast...

  4. Screening asymptomatic patients with diabetes for unknown coronary artery disease: Does it reduce risk? An open-label randomized trial comparing a strategy based on exercise testing aimed at revascularization with management based on pharmacological/behavioural treatment of traditional risk factors. DADDY-D Trial (Does coronary Atherosclerosis Deserve to be Diagnosed and treated early in Diabetics?

    Directory of Open Access Journals (Sweden)

    Romano Stefania

    2009-12-01

    Full Text Available Abstract Background Coronary artery disease is the leading cause of morbidity and mortality in patients with type 2 diabetes. Screening for asymptomatic coronary artery disease with treatment by means of revascularization seems to be an appealing option for prevention. The utility of such a strategy has never been challenged in a randomized trial. Methods/Design In the present study a cohort of diabetic patients without any symptoms and without known coronary artery disease will be screened at two diabetes outpatients services. Those with intermediate or high risk (equal or greater than 10% according to the Italian risk chart will be asked to participate and enrolled. They will be seen and followed in order to provide the best adherence to medical therapy. Half of the patients will be randomized to undergo an exercise tolerance testing while the other group will continue to be regularly seen at diabetes outpatients services. Best medical/behavioral therapy will be offered to both groups. Those patients with a positive exercise tolerance testing will be studied by coronary angiography and treated according to the severity of coronary lesions by percutaneous stenting or surgery. The objective of the study is to evaluate the efficacy of the screening strategy aimed at revascularization. A cost-effectiveness analysis will be performed at the end of the follow up. Discussion The study will provide useful information about prevention and treatment of diabetic patients at high risk of coronary events. It will be made clearer if detection of silent coronary artery disease has to be recommended and followed by treatment. Given the simplicity of the study protocol, it will be easily transferable to the real world. Trial registration (ClinicalTrials.gov: NCT00547872

  5. Asymptomatic Effluent Protozoa Colonization in Peritoneal Dialysis Patients.

    Science.gov (United States)

    Simões-Silva, Liliana; Correia, Inês; Barbosa, Joana; Santos-Araujo, Carla; Sousa, Maria João; Pestana, Manuel; Soares-Silva, Isabel; Sampaio-Maia, Benedita

    Currently, chronic kidney disease (CKD) is a global health problem. Considering the impaired immunity of CKD patients, the relevance of infection in peritoneal dialysis (PD), and the increased prevalence of parasites in CKD patients, protozoa colonization was evaluated in PD effluent from CKD patients undergoing PD. Overnight PD effluent was obtained from 49 asymptomatic stable PD patients. Protozoa analysis was performed microscopically by searching cysts and trophozoites in direct wet mount of PD effluent and after staining smears. Protozoa were found in PD effluent of 10.2% of evaluated PD patients, namely Blastocystis hominis, in 2 patients, and Entamoeba sp., Giardia sp., and Endolimax nana in the other 3 patients, respectively. None of these patients presented clinical signs or symptoms of peritonitis at the time of protozoa screening. Our results demonstrate that PD effluent may be susceptible to asymptomatic protozoa colonization. The clinical impact of this finding should be further investigated.

  6. Acute Obstructive Suppurative Pancreatic Ductitis in an Asymptomatic Patient

    Directory of Open Access Journals (Sweden)

    Eisha Wali

    2015-01-01

    Full Text Available Acute obstructive suppurative pancreatic ductitis (AOSPD, defined as suppuration from the pancreatic duct without associated pseudocyst, abscess, or necrosis, is a rare complication of chronic pancreatitis. We present the first case of AOSPD in an asymptomatic patient with a polymicrobial infection and review the literature on this rare clinical entity.

  7. Asymptomatic spinal arachnoiditis in patients with tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Srivastava, T. [Department of Neurology, CN Centre, All India Institute of Medical Sciences, New Delhi (India); Department of Medicine, S.P. Medical College, Bikaner, Rajasthan (India); Kochar, D.K. [Department of Medicine, S.P. Medical College, Bikaner, Rajasthan (India)

    2003-10-01

    Spinal arachnoiditis is one of the common and disabling complication of tuberculous meningitis (TBM). We focused on early diagnosis of spinal arachnoiditis by spinal MRI in asymptomatic patients in whom neurological examination was normal. We studied 16 patients with a diagnosis of probable or highly probable TBM with symptoms for less than 1 month; three had radiological evidence of spinal arachnoiditis. High cerebrospinal fluid protein appeared to be a risk factor for development of spinal arachnoiditis. MRI is sensitive to detect early spinal arachnoiditis. Earlier diagnosis may be helpful in management of spinal arachnoiditis in TBM. (orig.)

  8. Echocardiographic findings in asymptomatic systemic lupus erythematosus patients.

    Science.gov (United States)

    Mohammed, Abdel GaffarA; Alghamdi, Abdulaziz A; ALjahlan, Mohammad A; Al-Homood, Ibrahim A

    2017-03-01

    The aim of this study is to use transthoracic echocardiographic (TTE) imaging methods to identify cardiac dysfunction in asymptomatic systemic lupus erythematosus (SLE) patients and to determine the association between echocardiographic findings and serology. This is a prospective cross-sectional study where 50 patients with confirmed diagnoses of SLE were recruited from rheumatology outpatient clinics. Clinical and serological evaluation to confirm the diagnosis of lupus was done in all patients. Fifty SLE patients, 46 (92%) females and 4 (8%) males, were recruited. Anti-double-stranded DNA (Anti-dsDNA), anticardiolipin, lupus anticoagulant, and anti-β2-glycoproteins were positive in 52.1, 32.6, 13.3, and 15.6%, respectively. Transthoracic echocardiogram revealed mitral regurgitation in 16 patients (32%), pericardial effusion in16 patients (32%), aortic regurgitation in five patients (10%), and tricuspid regurgitation in 10 patients (20%). Eleven patients had left ventricular hypertrophy (22%), and eight patients had ventricular systolic dysfunction (16%). Only four patients had ventricular diastolic dysfunction (8%). A significant association between mitral and tricuspid valve regurgitation and positive anti-dsDNA (p lupus anticoagulant, and anti-β 2 glycoprotein antibodies were also associated with mitral valve regurgitation (p values 0.044, 0.006, and 0.023), respectively. Active disease assessed by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) was found to be associated with increased risk of mitral valvular leaflet thickening (p value 0.028). Performing regular transthoracic echocardiogram in asymptomatic SLE patients is important for early detection and appropriate treatment of cardiac lesions. Clinically quiescent but serologically active disease and presence of antiphospholipid antibodies were associated with structural heart abnormalities.

  9. Asymptomatic ST-depression during exercise testing in children and adolescents with type 1 diabetes mellitus and autonomic dysfunction

    Directory of Open Access Journals (Sweden)

    Dmitry Nikitich Laptev

    2015-04-01

    Full Text Available Aim. The aim of this study was to investigate cardiac autonomic function as assessed by ST dynamics during and post-exercise in children and adolescents with type 1 diabetes mellitus (T1DM.Materials and methods. The study included 71 young patients with T1DM. The patients were aged 9–18 years and had no history of macrovascular disease or renal disease, including microalbuminuria. Cardiac autonomic function was assessed using cardiovascular tests and 24-h ECG monitoring with automatic calculation of QT interval and heart rate variability parameters. Each patient underwent the physical working capacity 170 test.Results. The prevalence of cardiovascular autonomic neuropathy (CAN was 30.9%. The frequency of asymptomatic ST-segment depression increased during exercise in 10 (45.5% patients with CAN (CAN+ compared with 9 (18.4% patients without CAN (CAN-; p=0.042. During the recovery period, asymptomatic ST-segment depression was present in the first minute in 8 (36.4% CAN+ patients compared with 1 (2% CAN- patient (p=0.0003 and in the second minute in 5 (22.7% CAN+ patients compared with 1 (2% CAN- patient (p=0.0095.Conclusion. Children and adolescents with T1DM and impaired autonomic function have increased prevalence of asymptomatic ST-segment depression during and post-exercise. The presence of cardiovascular risk factors in children and adolescents with T1DM and CAN may contribute to the increased cardiovascular morbidity and mortality during adulthood in patients with T1DM.

  10. Cardiotoxicity in Asymptomatic Patients Receiving Adjuvant 5-fluorouracil

    DEFF Research Database (Denmark)

    Nielsen, Karin; Polk, Anne; Nielsen, Dorte Lisbet

    2014-01-01

    Evolving evidence of cardiotoxicity in cancer patients treated with 5-fluorouracil (5-FU) has been reported. We report two different clinical manifestations of asymptomatic 5-FU-associated cardiotoxicity in patients operated for colorectal cancer and treated with adjuvant chemotherapy of 5-FU...... (bolus-injection and continuous infusion for 46 hours), folinic acid and oxaliplatin (FOLFOX). For a research study evaluating cardiac events during 5-FU treatment, Holter monitoring, electrocardiogram (ECG) and echocardiography were done and cardiac markers monitored before and during the first...... and hyperlipidemia as well as an incidental finding of negative T-waves in electrocardiogram years before 5-FU treatment. No subjective cardiac symptoms were described during infusion, but approximately 12 hours after infusion she suffered from cardiac arrest but was revived. Subsequent analysis of the Holter...

  11. Fenofibrate for patients with asymptomatic primary biliary cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Kazufumi Dohmen; Toshihiko Mizuta; Makoto Nakamuta; Naoya Shimohashi; Hiromi Ishibashi; Kyosuke Yamamoto

    2004-01-01

    AIM: Primary biliary cirrhosis (PBC) is a chronic, cholestatic disease of autoimmune etiology, the histology of which shows a destruction of the intrahepatic bile duct and portal inflammation. Ursodeoxycholic acid (UDCA) is now used as a first-line drug for asymptomatic PBC (aPBC) because it is reported that UDCA decreases mortality and prolongs the time of liver transplantation. However, only 20-30% of patients respond fully to UDCA. Recently, lipoproteinlowering agents have been found to be effective for PBC. The aim of this study was to examine the safety and efficacy of fenofibrate, a member of the fibrate class of hypolipidemic and anti-inflammatory agent via peroxysome proliferatory activated receptor α, in patients with aPBC. METHODS: Fenofibrate was administered for twelve weeks in nine patients with aPBC who failed to respond to UDCA. UDCA was used along with fenofibrate during the study. The data from aPBC patients were analyzed to assess the biochemical effect of fenofibrate during the study. RESULTS: The serum levels of alkaline phosphatase (ALP) (285±114.8 IU/L) and immunoglobulin M (IgM) (255.8±85.9 mg/dl) significantly decreased to 186.9±76.2 IU/L and 192.9±67.5 mg/dL respectively, after fenofibrate treatment in patients with aPBC (P<0.05). Moreover, the titer of antimitochondrial antibody (AMA) also decreased in 4 of 9 patients with aPBC. No adverse reactions were observed in any patients.CONCLUSION: Fenofibrate appears to be significantly effective in treating patients with aPBC who respond incompletely to UDCA alone. Although the mechanism of fenofibrate on aPBC has not yet been fully clarified, combination therapy using fenofibrate and UDCA might be related to the anti-immunological effects, such as the suppression of AMA production as well as its anti inflammatory effect.

  12. Sonographic evaluation of the shoulder in asymptomatic elderly subjects with diabetes

    Directory of Open Access Journals (Sweden)

    Salini Vincenzo

    2010-12-01

    Full Text Available Abstract Background The prevalence of rotator cuff tears increases with age and several studies have shown that diabetes is associated with symptomatic shoulder pathologies. Aim of our research was to evaluate the prevalence of shoulder lesions in a population of asymptomatic elderly subjects, normal and with non insulin - dependent diabetes mellitus. Methods The study was performed on 48 subjects with diabetes and 32 controls (mean age: 71.5 ± 4.8 and 70.7 ± 4.5, respectively, who did not complain shoulder pain or dysfunction. An ultrasound examination was performed on both shoulders according to a standard protocol, utilizing multiplanar scans. Results Tendons thickness was greater in diabetics than in controls (Supraspinatus Tendon: 6.2 ± 0.09 mm vs 5.2 ± 0.7 mm, p vs 3.2 ± 0.4 mm, p vs 20.3%, p vs 7.8%, p Subjects with diabetes exhibited more tears in the Supraspinatus Tendon (Minor tears: 15 (15.8% vs 2 (3.1%, p vs 5 (7.8%, p = ns, but not in the long head of Biceps. More effusions in subacromial bursa were observed in diabetics (23.9% vs 10.9%, p vs 10.9%, p In both groups, pathological findings were prevalent on the dominant side, but no difference related to duration of diabetes was found. Conclusions Our results suggest that age - related rotator cuff tendon degenerative changes are more common in diabetics. Ultrasound is an useful tool for discovering in pre - symptomatic stages the subjects that may undergo shoulder symptomatic pathologies.

  13. Basal longitudinal strain predicts future aortic valve replacement in asymptomatic patients with aortic stenosis

    DEFF Research Database (Denmark)

    Carstensen, Helle Gervig; Larsen, Linnea Hornbech; Hassager, Christian

    2016-01-01

    of myocardial dysfunction and predictors of outcome in asymptomatic aortic stenosis. Aortic stenosis and ischaemic heart disease share risk factors and longitudinal function can be severely reduced in both conditions, why some of the previous findings of impaired regional longitudinal function in asymptomatic...... aortic stenosis could in fact be explained by silent ischaemic heart disease. METHODS AND RESULTS: Prospective follow-up of 104 asymptomatic patients with moderate-severe aortic stenosis defined as an aortic valve area ...: In contrast to GLS, reduced BLS is a significant predictor of future AVR in asymptomatic patients with aortic stenosis, independently of clinical characteristics, conventional echocardiographic measures, and coronary pathology....

  14. Single-centre experience with mitral valve repair in asymptomatic patients with severe mitral valve regurgitation

    NARCIS (Netherlands)

    W.J. van Leeuwen (Wouter); S.J. Head (Stuart); L.E. de Groot-de Laat (Lotte); M.L. Geleijnse (Marcel); A.J.J.C. Bogers (Ad); L.A. van Herwerden (Lex); A.P. Kappetein (Arie Pieter)

    2013-01-01

    textabstractOBJECTIVES: Guidelines recommend surgical mitral valve repair in selected patients with asymptomatic severe mitral valve regurgitation (MR), but the role of repair remains a matter of debate. Survival analyses of operated asymptomatic patients have been reported, but long-term haemodynam

  15. Additive prognostic value of plasma N-terminal pro-brain natriuretic peptide and coronary artery calcification for cardiovascular events and mortality in asymptomatic patients with type 2 diabetes

    DEFF Research Database (Denmark)

    von Scholten, Bernt Johan; Reinhard, Henrik; Hansen, Tine Willum;

    2015-01-01

    BACKGROUND: In patients with type 2 diabetes, cardiovascular disease (CVD) is the major cause of morbidity and mortality. We evaluated the combination of NT-proBNP and coronary artery calcium score (CAC) for prediction of combined fatal and non-fatal CVD and mortality in patients with type 2...... treatment. Patients with baseline NT-proBNP > 45.2 ng/L and/or CAC ≥ 400 were stratified as high-risk patients (n = 133). Occurrence of fatal- and nonfatal CVD (n = 40) and mortality (n = 26), was traced after 6.1 years (median). RESULTS: High-risk patients had a higher risk of the composite CVD endpoint...... (adjusted hazard ratio [HR] 10.6 (95 % confidence interval [CI] 2.4-46.3); p = 0.002) and mortality (adjusted HR 5.3 (95 % CI 1.2-24.0); p = 0.032) compared to low-risk patients. In adjusted continuous analysis, both higher NT-proBNP and CAC were strong predictors of the composite CVD endpoint and mortality...

  16. Incremental prognostic value of coronary computed tomographic angiography over coronary artery calcium score for risk prediction of major adverse cardiac events in asymptomatic diabetic individuals

    NARCIS (Netherlands)

    J.K. Min (James); T.M. LaBounty (Troy); M. Gomez (Millie); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); M.J. Budoff (Matthew); F. Cademartiri (Filippo); T.Q. Callister (Tracy); H.-J. Chang (Hyuk-Jae); V.Y. Cheng (Victor); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); R.C. Cury (Ricardo); A. Delago (Augustin); A.M. Dunning (Allison); G.M. Feuchtner (Gudrun); M. Hadamitzky (Martin); J. Hausleiter (Jörg); P.A. Kaufmann (Philipp); Y-J. Kim (Yong-Jin); J. Leipsic (Jonathon); F.Y. Lin (Fay); E. Maffei (Erica); G.L. Raff (Gilbert); L.J. Shaw (Leslee); T.C. Villines (Todd); D.S. Berman (Daniel)

    2014-01-01

    textabstractBackground: Coronary artery disease (CAD) diagnosis by coronary computed tomographic angiography (CCTA) is useful for identification of symptomatic diabetic individuals at heightened risk for death. Whether CCTA-detected CAD enables improved risk assessment of asymptomatic diabetic indiv

  17. Left ventricular systolic function in selected type 1 diabetic patients with or without diabetic retinopathy and microalbuminuria.

    Science.gov (United States)

    Bućan, Kajo; Bojić, Lovro; Fabijanić, Damir; Galetović, Davor; Čapkun, Vesna; Utrobičić, Dobrila Karlica; Bućan, Ivona

    2014-12-01

    Vascular endothelial dysfunction is a basic etiologic factor for the development of late clinical complications in patients with diabetes mellitus type 1, such as diabetic retinopathy, diabetic nephropathy (which is characterized at the very beginning by microalbuminuria), and left ventricular cardiac dysfunction. The aims of this study were to determine the prevalence of asymptomatic left ventricular systolic dysfunction in patients with diabetes mellitus type 1 and with or without diabetic retinopathy and microalbuminuria, and to correlate the duration of diabetes with the dynamics of diabetic retinopathy, microalbuminuria and asymptomatic left ventricular dysfunction development in these patients. One-hundred and twenty selected patients with diabetes mellitus type 1 were examined by ophthalmologist and cardiologist. All patients underwent ergometric testing and two-dimensional (2-D) echocardiography with pulsed Doppler. Patients were divided into three groups according to their fundus findings and microalbuminuria: (1) patients without diabetic retinopathy and without microalbuminuria (n = 40); (2) patients with diabetic retinopathy without microalbuminuria (n = 40); and (3) patients with diabetic retinopathy and microalbuminuria (n = 40). All three groups of patients with diabetes mellitus type 1 (with low cardiovascular risk, regulated blood sugar, and without diabetic neuropathy) had echocardiographic values in the normal range. We found no statistically significant correlation between the duration of diabetes mellitus type 1 and echocardiographic values.

  18. Mortality in asymptomatic vs. symptomatic patients surgically treated for non-small cell lung cancer (NSCLC)

    DEFF Research Database (Denmark)

    Madsen, Kirsten Riis; Bødtger, Uffe

    , tobacco pack years, or FEV1. Former malignancy was significantly more prevalent among asymptomatic than symptomatic subjects (33 % vs. 11%), with insignificant differences in prevalence of other co-morbidities or in post-surgical TNM (82% vs 85% in stages IA-IIB). 12-months mortality was insignificantly...... higher in asymptomatic than symptomatic subjects (23% vs. 12%), and in patients with former malignancy compared to patients with no former cancer (17% vs. 16%). Discussion: Symptoms at diagnosis per se appear unrelated to mortality in patients with NSCLC referred for surgery. Asymptomatic patients were...

  19. ECHOCARDIOGRAPHIC EVALUATION OF DIASTOLIC DYSFUNCTION IN ASYMPTOMATIC TYPE 2 DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Suresh

    2015-08-01

    Full Text Available Diabetes mellitus is one of the most common diseases in the world and is acquiring epidemic proportions. Its prevalence is growing in both developed and developing countries. India is the Diabetic Capital Of the world. I ndians are genetically more susceptible to diabetes compared to other races. Cardiovascular complications are known to be the main cause of morbidity and death in diabetic patients. In diabetic patients there is an increased rate of ischemic heart disease and cardiomyopathy which may lead to heart failure (Diastolic heart failure. Despite similar left ventricular systolic function, patients with diabetes have more pronounced heart failure symptoms, use more diuretics, and have an adverse prognosis compared with those without diabetes; one putative explanation for these discrepancies is diastolic dysfunction of the left ventricle in diabetes mellitus. Left ventricular diastolic dysfunction represents an early stage of heart failure, without any clinical mani festations. In the view of these above facts the present study was conducted to assess the diastolic dysfunction in diabetic patients. MATERIAL AND METHODS: This cross sectional study comprising 50 cases was conducted in the Department of Medicine, Pt. Jaw aharlal Nehru Memorial Medical College and Dr. B.R.A.M. Hospital, Raipur (C.G. from July 2013 to July 2014 in diabetic patients without evidence of cardiovascular involvement and blood pressure less than 140/90mmHg were studied. Permission of ethical comm ittee was taken. 26 patients were female and 24 were male. LVDD was evaluated by Doppler echocardiography, which included E/A ratio; left atrial size was assessed in relation with age/sex, duration of diabetes and HbA1c level. RESULTS: Results showed that diastolic dysfunction was present in 35 (70 % of the patients. Among males diastolic dysfunction was present in 17 cases (70.83%. Among females diastolic dysfunction was present in 18 cases (69.23%. Diastolic dysfunction

  20. Risk factors for asymptomatic ventricular dysfunction in rheumatoid arthritis patients.

    Science.gov (United States)

    Garza-García, Carlos; Rocío, Sánchez-Santillán; Orea-Tejeda, Arturo; Castillo-Martínez, Lilia; Eduardo, Canseco; López-Campos, José Luis; Keirns-Davis, Candace

    2013-01-01

    Objective. The aim of the study was to describe echocardiographic abnormalities in patients with rheumatoid arthritis, concurrent systemic comorbidities, rheumatologic clinical activity, serologic markers of rheumatoid arthritis, and inflammatory activity. Methods. In an observational, cross-sectional study, rheumatoid arthritis outpatients were included (n = 105). Conventional transthoracic echocardiographic variables were compared between patients with arthritis and non-RA controls (n = 41). For rheumatoid arthritis patients, articular activity and rheumatologic and inflammatory markers were obtained. Results. Ventricular dysfunction was found in 54.3% of the population: systolic (18.1%), diastolic (32.4%), and/or right (24.8%), with lower ejection fraction (P Pulmonary hypertension was found in 46.9%. Other echocardiographic findings included increased left atrial diameter (P = 0.01), aortic diameter (P = 0.01), ventricular septum (P = 0.01), left ventricular posterior wall (P = 0.013), and right ventricular (P = 0.01) and atrial diameters compared to control subjects. Rheumatoid factor and anti-CCP antibodies levels were significantly elevated in cases with ventricular dysfunction. Angina and myocardial infarction, diabetes, and dyslipidemia were the main risk factors for ventricular dysfunction. Conclusions. Ventricular dysfunction is common in rheumatoid arthritis and associated with longer disease duration and increased serologic markers of rheumatoid arthritis. Screening for cardiac abnormalities should be considered in this kind of patients.

  1. Risk stratification in asymptomatic and symptomatic patients with carotid artery stenosis

    OpenAIRE

    den Hartog, A.G.

    2013-01-01

    The overall aim of this thesis is to explore and assess the risks that patients with carotid artery disease, whether asymptomatic or symptomatic, are exposed to, and to explore whether patients that may be subject to relatively higher risk can be identified by imaging. Although large randomized trials have proven carotid endarterectomy (CEA) to be beneficial compared to best medical treatment alone, revascularization of patients with asymptomatic carotid artery stenosis (ACAS) remains a matte...

  2. Accessory wandering spleen: Report of a case of laparoscopic approach in an asymptomatic patient

    Directory of Open Access Journals (Sweden)

    Alessandro Perin

    2014-01-01

    CONCLUSION: We suggest performing surgery with a laparoscopic approach in patients with accessory wandering spleen, though asymptomatic, because of the risk of serious complications in case of accessory spleen torsion.

  3. Effect of lipid lowering on new-onset atrial fibrillation in patients with asymptomatic aortic stenosis

    DEFF Research Database (Denmark)

    Bang, Casper N; Greve, Anders M; Boman, Kurt

    2012-01-01

    Lipid-lowering drugs, particularly statins, have anti-inflammatory and antioxidant properties that may prevent atrial fibrillation (AF). This effect has not been investigated on new-onset AF in asymptomatic patients with aortic stenosis (AS).......Lipid-lowering drugs, particularly statins, have anti-inflammatory and antioxidant properties that may prevent atrial fibrillation (AF). This effect has not been investigated on new-onset AF in asymptomatic patients with aortic stenosis (AS)....

  4. Dengue Patients Exhibit Higher Levels of PrM and E Antibodies Than Their Asymptomatic Counterparts

    OpenAIRE

    Adeline Syin Lian Yeo; Anusyah Rathakrishnan; Seok Mui Wang; Sasheela Ponnampalavanar; Rishya Manikam; Jameela Sathar; Santha Kumari Natkunam; Shamala Devi Sekaran

    2015-01-01

    Dengue virus infection is a common tropical disease which often occurs without being detected. These asymptomatic cases provide information in relation to the manifestation of immunological aspects. In this study, we developed an ELISA method to compare neutralizing effects of dengue prM and E antibodies between dengue patients and their asymptomatic household members. Recombinant D2 premembrane (prM) was constructed, cloned, and tested for antigenicity. The recombinant protein was purified a...

  5. Temporal Cortex Morphology in Mesial Temporal Lobe Epilepsy Patients and Their Asymptomatic Siblings.

    Science.gov (United States)

    Alhusaini, Saud; Whelan, Christopher D; Doherty, Colin P; Delanty, Norman; Fitzsimons, Mary; Cavalleri, Gianpiero L

    2016-03-01

    Temporal cortex abnormalities are common in patients with mesial temporal lobe epilepsy due to hippocampal sclerosis (MTLE+HS) and believed to be relevant to the underlying mechanisms. In the present study, we set out to determine the familiarity of temporal cortex morphologic alterations in a cohort of MTLE+HS patients and their asymptomatic siblings. A surface-based morphometry (SBM) method was applied to process MRI data acquired from 140 individuals (50 patients with unilateral MTLE+HS, 50 asymptomatic siblings of patients, and 40 healthy controls). Using a region-of-interest approach, alterations in temporal cortex morphology were determined in patients and their asymptomatic siblings by comparing with the controls. Alterations in temporal cortex morphology were identified in MTLE+HS patients ipsilaterally within the anterio-medial regions, including the entorhinal cortex, parahippocampal gyrus, and temporal pole. Subtle but similar pattern of morphology changes with a medium effect size were also noted in the asymptomatic siblings. These localized alterations were related to volume loss that appeared driven by shared contractions in cerebral cortex surface area. These findings indicate that temporal cortex morphologic alterations are common to patients and their asymptomatic siblings and suggest that such localized traits are possibly heritable.

  6. A new screening pathway for identifying asymptomatic patients using dental panoramic radiographs

    Science.gov (United States)

    Hayashi, Tatsuro; Matsumoto, Takuya; Sawagashira, Tsuyoshi; Tagami, Motoki; Katsumata, Akitoshi; Hayashi, Yoshinori; Muramatsu, Chisako; Zhou, Xiangrong; Iida, Yukihiro; Matsuoka, Masato; Katagi, Kiyoji; Fujita, Hiroshi

    2012-03-01

    To identify asymptomatic patients is the challenging task and the essential first step in diagnosis. Findings of dental panoramic radiographs include not only dental conditions but also radiographic signs that are suggestive of possible systemic diseases such as osteoporosis, arteriosclerosis, and maxillary sinusitis. Detection of such signs on panoramic radiographs has a potential to provide supplemental benefits for patients. However, it is not easy for general dental practitioners to pay careful attention to such signs. We addressed the development of a computer-aided detection (CAD) system that detects radiographic signs of pathology on panoramic images, and the design of the framework of new screening pathway by cooperation of dentists and our CAD system. The performance evaluation of our CAD system showed the sensitivity and specificity in the identification of osteoporotic patients were 92.6 % and 100 %, respectively, and those of the maxillary sinus abnormality were 89.6 % and 73.6 %, respectively. The detection rate of carotid artery calcifications that suggests the need for further medical evaluation was approximately 93.6 % with 4.4 false-positives per image. To validate the utility of the new screening pathway, preliminary clinical trials by using our CAD system were conducted. To date, 223 panoramic images were processed and 4 asymptomatic patients with suspected osteoporosis, 7 asymptomatic patients with suspected calcifications, and 40 asymptomatic patients with suspected maxillary sinusitis were detected in our initial trial. It was suggested that our new screening pathway could be useful to identify asymptomatic patients with systemic diseases.

  7. Increased frequency of anti-retina antibodies in asymptomatic patients with chronic t. gondii infection

    Science.gov (United States)

    Cursino, Sylvia Regina Temer; da Costa, Thaís Boccia; Yamamoto, Joyce Hisae; Meireles, Luciana Regina; Silva, Maria Antonieta Longo Galvão; de Andrade Junior, Heitor Franco

    2010-01-01

    PURPOSE: To search for anti-retina antibodies that serve as markers for eye disease in uveitis. MATERIALS AND METHODS: Stored sera from patients with uveitis, ocular toxoplasmosis (n = 30) and non-infectious, immune-mediated uveitis (n = 50) and from asymptomatic individuals who were positive (n = 250) and negative (n = 250) for anti-Toxoplasma antibodies were tested. Serum anti-retina IgG was detected by an optimized ELISA using a solid-phase whole human retina extract, bovine S-antigen or interphotoreceptor retinoid-binding protein. RESULTS: Uveitis patients showed a higher mean reactivity to whole human retina extract, interphotoreceptor retinoid-binding protein and S-antigen in comparison to the asymptomatic population. These findings were independent of the uveitis origin and allowed the determination of the lower anti-retina antibody cut-off for the three antigens. Asymptomatic anti-Toxoplasma serum-positive individuals showed a higher frequency of anti-human whole retina extract antibodies in comparison to asymptomatic anti-Toxoplasma serum-negative patients. The bovine S-antigen and interphotoreceptor retinoid-binding protein ELISAs also showed a higher mean reactivity in the uveitis groups compared to the asymptomatic group, but the observed reactivities were lower and overlapped without discrimination. CONCLUSION: We detected higher levels of anti-retina antibodies in uveitis patients and in a small fraction of asymptomatic patients with chronic toxoplasmosis. The presence of anti-retina antibodies in sera might be a marker of eye disease in asymptomatic patients, especially when whole human retina extract is used in a solid-phase ELISA. PMID:21120306

  8. Increased frequency of anti-retina antibodies in asymptomatic patients with chronic t. gondii infection

    Directory of Open Access Journals (Sweden)

    Sylvia Regina Temer Cursino

    2010-01-01

    Full Text Available PURPOSE: To search for anti-retina antibodies that serve as markers for eye disease in uveitis. MATERIALS AND METHODS: Stored sera from patients with uveitis, ocular toxoplasmosis (n = 30 and non-infectious, immune-mediated uveitis (n = 50 and from asymptomatic individuals who were positive (n = 250 and negative (n = 250 for anti-Toxoplasma antibodies were tested. Serum anti-retina IgG was detected by an optimized ELISA using a solid-phase whole human retina extract, bovine S-antigen or interphotoreceptor retinoid-binding protein. RESULTS: Uveitis patients showed a higher mean reactivity to whole human retina extract, interphotoreceptor retinoid-binding protein and S-antigen in comparison to the asymptomatic population. These findings were independent of the uveitis origin and allowed the determination of the lower anti-retina antibody cut-off for the three antigens. Asymptomatic anti-Toxoplasma serum-positive individuals showed a higher frequency of antihuman whole retina extract antibodies in comparison to asymptomatic anti-Toxoplasma serum-negative patients. The bovine S-antigen and interphotoreceptor retinoid-binding protein ELISAs also showed a higher mean reactivity in the uveitis groups compared to the asymptomatic group, but the observed reactivities were lower and overlapped without discrimination. CONCLUSION: We detected higher levels of anti-retina antibodies in uveitis patients and in a small fraction of asymptomatic patients with chronic toxoplasmosis. The presence of anti-retina antibodies in sera might be a marker of eye disease in asymptomatic patients, especially when whole human retina extract is used in a solid-phase ELISA.

  9. Postoperative lumbar MR imaging with contrast enhancement. Comparison between symptomatic and asymptomatic patients

    Energy Technology Data Exchange (ETDEWEB)

    Grane, P. [Dept. of Neuroradiology, Karolinska Hospital, Stockholm (Sweden); Tullberg, T. [Dept. of Orthopaedics, St. Goeran`s Hospital, Stockholm (Sweden); Rydberg, J. [Dept. of Radiology, St. Goeran`s Hospital, Stockholm (Sweden); Lindgren, L. [Dept. of Neurosurgery, Karolinska Hospital, Stockholm (Sweden)

    1995-05-01

    Contrast-enhanced MR imaging of the spine after surgery for lumbar disk herniation almost always shows pathologic changes. To investigate to what extent these changes are correlated to patients` actual clinical symptoms, we compared the postoperative MR findings in 19 asymptomatic patients with 42 symptomatic patients (43 levels). The asymptomatic patients underwent MR examination one year after surgery. Twenty-six of the symptomatic patients underwent MR one year of less after surgery, and in 16 patients (17 levels) MR was performed more than one year after surgery. Sixteen percent of the asymptomatic and 42% of the symptomatic patients had disk herniation at the level of previous surgery. Most of the herniated disks were found in the symptomatic patients less than one year after surgery. The amount of epidural scar tissue, displacement and thickening of nerve roots, and compression of the dural sac were also studied. Disk herniation as a probable cause of recurrent sciatica was a common finding among symptomatic patients examined one year or less after surgery. In comparing asymptomatic patients and symptomatic patients with more than one year between surgery and MR examination, no significant radiologic differences, including disk herniation, were found. (orig.).

  10. Is it possible that this patient is asymptomatic? The role of multidetector ct angiography in detection of ulcerated plaques in patients with asymptomatic carotid stenosis: Case report

    Directory of Open Access Journals (Sweden)

    Tanasković Slobodan

    2015-01-01

    Full Text Available Introduction. Although intervention in patients with symptomatic carotid disease is generally accepted as beneficial, the management of asymptomatic disease is still controversial. We wanted to introduce and discuss treatment options in a patient with asymptomatic carotid stenosis and high embolic potential lesions of common and internal carotid artery detected by multidetector computed tomography (MDCT. Case Outline. A 78-year-old female patient was admitted to our institution for diagnostics and surgical treatment of asymptomatic high-grade carotid stenosis. Upon admission, color duplex ultrasonography of the carotid arteries revealed the left common carotid artery (CCA stenosis of 50% and the ipsilateral internal carotid artery (ICA stenosis of 60%, while the right CCA was narrowed by 60% and the ipsilateral ICA by 80%. Because of the left subclavian artery (LSA occlusion, also described by ultrasonography, MDCT angiography was performed to assess arterial morphology for possible angioplasty. In addition to LSA occlusion, MDCT angiography surprisingly revealed significant left CCA (>80% and ICA (>70% narrowing by ulcerated plaques with high embolic potential. Surgical treatment of the left CCA and ICA was indicated and Dacron® tubular graft interposition was performed. The postoperative course was uneventful and the patient was discharged from the Institute on the third postoperative day. After the six-month follow-up the patient was doing well with well-preserved graft patency. Conclusion. Although color duplex ultrasonography is reliable and safe imaging modality in carotid stenosis diagnosis, MDCT angiography plays a significant role in patients with asymptomatic carotid stenosis since plaques with high embolic potential could be detected, which, if left untreated, could have severe neurological ischemic consequences. [Projekat Ministarstva nauke Republike Srbije, br. 41002

  11. Colon perforation after esophagogastroduodenoscopy in an asymptomatic diverticulitis patient

    Directory of Open Access Journals (Sweden)

    Li-Wen Huang

    2016-03-01

    Full Text Available Esophagogastroduodenoscopy (EGD is regarded as a relatively safe procedure; however, it carries a very low incidence of severe adverse events. Perforation is a rare complication of EGD, and it may further lead to pneumoperitoneum or pneumoretroperitoneum. The occurrence of large bowel perforation after EGD is extremely rare, and it has never been reported in the international literature. Herein, we present a case of concurrence of pneumoperitoneum and pneumoretroperitoneum as a result of sigmoid perforation after EGD. In our case, the probable mechanism of the perforation may have stemmed from the excessive inflation of air that passed through the gastrointestinal tract to the sigmoid colon, causing the increased intraluminal pressure, and then prompting a healed asymptomatic diverticulitis leak again.

  12. Risk stratification in asymptomatic and symptomatic patients with carotid artery stenosis

    NARCIS (Netherlands)

    den Hartog, A.G.

    2013-01-01

    The overall aim of this thesis is to explore and assess the risks that patients with carotid artery disease, whether asymptomatic or symptomatic, are exposed to, and to explore whether patients that may be subject to relatively higher risk can be identified by imaging. Although large randomized tria

  13. Dengue patients exhibit higher levels of PrM and E antibodies than their asymptomatic counterparts.

    Science.gov (United States)

    Yeo, Adeline Syin Lian; Rathakrishnan, Anusyah; Wang, Seok Mui; Ponnampalavanar, Sasheela; Manikam, Rishya; Sathar, Jameela; Kumari Natkunam, Santha; Sekaran, Shamala Devi

    2015-01-01

    Dengue virus infection is a common tropical disease which often occurs without being detected. These asymptomatic cases provide information in relation to the manifestation of immunological aspects. In this study, we developed an ELISA method to compare neutralizing effects of dengue prM and E antibodies between dengue patients and their asymptomatic household members. Recombinant D2 premembrane (prM) was constructed, cloned, and tested for antigenicity. The recombinant protein was purified and tested with controls by using an indirect ELISA method. Positive dengue serum samples with their asymptomatic pair were then carried out onto the developed ELISA. In addition, commercially available recombinant envelope (E) protein was used to develop an ELISA which was tested with the same set of serum samples in the prM ELISA. Asymptomatic individuals showed preexisting heterotypic neutralizing antibodies. The recombinant prM was antigenically reactive in the developed ELISA. Dengue patients had higher prM and E antibodies compared to their household members. Our study highlights the neutralizing antibodies levels with respect to dengue prM and E between dengue patients and asymptomatic individuals.

  14. Daily physical activities of patients with chronic pain or fatigue versus asymptomatic controls : a systematic review

    NARCIS (Netherlands)

    Weering, van Marit; Vollenbroek-Hutten, M.M.R.; Kotte, E.M.; Hermens, H.J.

    2007-01-01

    Objective: To gain an insight into the daily physical activity levels of patients with chronic pain or fatigue compared with asymptomatic controls. Data sources: MEDLINE, EMBASE, PsycINFO, Picarta, Cochrane Database of Systematic Reviews, reference tracking and a manual search of relevant journals.

  15. Asymptomatic Herpes Simplex Virus Shedding in STI Patients

    Institute of Scientific and Technical Information of China (English)

    叶兴东; 颜景兰; 朱慧兰; 张莉; 佟菊贞

    2002-01-01

    Objective: This study examined Herpes Simplex Virus(HSV) subclinical shedding in the genital tract of patients withgenital herpes (GH) or non-gonoccal urethritis (NGU). Method: Swabs were collected after exposure to rash andgenital tract during GH relapse or remission on a weekly basisfor four to six weeks. NGU patients with negative chlamydiaand mycoplasma tests were also swabbed for a similarduration. All swabs underwent HSV DNA detection withquantitative PCR. Result: There was a significant difference in the rate ofasymptomatic HSV shedding in urinary tracts comparing GHand the control group and comparing NGU and the controlgroup (P<0.05). The rate of HSV shedding was 22%, 9.8%and 3.3% for GH, NGU and control groups respectively. Therate of HSV shedding was 21.7% (20/92) for patients withactive GH and 23% for those in remission. The HSV positiverate was significantly higher in the group with patients whohad more than six relapses within one year compared to thegroup of patients with less than six GH relapses. Conclusion: There is HSV subclinical shedding in theirgenital tract during active GH and remission. SubclinicalHSV shedding is more common in patients with more than sixGH relapses per year compared to GH patients with fewerrelapses. Approximately 9.9% of NGU patients with negativechlamydia, mycoplasma testing was found to have subclinicalHSV infection.

  16. Prevalence and risk factors of asymptomatic peripheral arterial disease in patients with COPD in Taiwan.

    Directory of Open Access Journals (Sweden)

    Ming-Shian Lin

    Full Text Available AIM: Chronic obstructive pulmonary disease (COPD is an independent risk factor for cardiovascular morbidity and mortality. The aim of this study was to determine the prevalence of asymptomatic peripheral arterial disease (PAD and the associated risk factors for patients with COPD. METHODS: This prospective cross-sectional study enrolled 427 COPD patients (mean age: 70.0 years without PAD symptoms consecutively. Demographic data, lung function and cardiovascular risk factors were recorded. The ankle-brachial index (ABI was used to detect PAD (ABI<0.90. RESULTS: The overall prevalence of asymptomatic PAD in the COPD patients was 8% (2.5% in the younger participants (<65 years of age, n = 118 and 10% in the elderly participants (≥65 years of age, n = 309. The COPD patients with asymptomatic PAD had a significantly higher rate of hyperlipidemia (47.1% vs. 10.4% and hypertension (79.4% vs. 45.8% than those without asymptomatic PAD (p<0.05. There was no significant difference in lung function (forced vital capacity and forced expiratory volume in one second between the two groups. In multivariate logistic regression, hyperlipidemia was the strongest independent factor for PAD (odds ratio (OR: 6.89, p<0.005, followed by old age (OR: 4.80, hypertension (OR: 3.39 and smoking burden (pack-years, OR: 1.02. CONCLUSIONS: The prevalence of asymptomatic PAD among COPD patients in Taiwan is lower than in Western countries. Hyperlipidemia, old age, hypertension, and smoking burden were the associated cardiovascular risk factors. However, there was no association between lung function and PAD in the COPD patients.

  17. Pulse pressure and michigan neuropathy screening instrument are independently associated with asymptomatic peripheral arterial disease among type 2 diabetes community residents: A community-based screening program in Taiwan

    Directory of Open Access Journals (Sweden)

    Li-Chi Fan

    2013-12-01

    Full Text Available Background: Peripheral arterial disease (PAD is one of the major manifestations of systemic atherosclerosis and plays an important role in low-extremity amputation in type 2 diabetic patients. The aim of this study was to explore the prevalence and risk factors for asymptomatic PAD in type 2 diabetic community residents. Methods: This cross-sectional study enrolled 552 type 2 diabetic adults (232 men and 320 women without subjective symptoms of intermittent claudication. We defined the PAD group as an ankle-brachial index (ABI ≤ 0.90, and the normal group as an ABI 0.91-1.30. Their clinical characteristics, Michigan Neuropathy Screening Instrument (MNSI scores and blood pressure were compared. Results: We discovered that 51 patients have asymptomatic PAD. Univariate logistic regression analysis revealed that age, history of stroke, longer duration of diabetes (> 10 years, unemployment or retirement, pulse pressure, systolic blood pressure, and high MNSI score (> 2 were risk factors for PAD. By multivariate logistic regression analysis, pulse pressure, high MNSI score, age, and history of stroke were independent risk factors with odds ratios (95% confidence intervals, CI of 1.032 (1.012-1.053, 2.359 (1.274-4.370, 1.050 (1.010-1.091, and 5.152 (1.985-13.368, respectively. Furthermore, the prevalence of PAD increased significantly with increment in the pulse pressure and MNSI. Conclusions: In summary, the overall prevalence of asymptomatic PAD in the type 2 diabetic adults was 9.2%. Age, history of stroke, pulse pressure and MNSI score may provide important clinical information. Primary care physicians should be aware of asymptomatic patients with high pulse pressure and MNSI scores.

  18. Impact of QRS duration and morphology on the risk of sudden cardiac death in asymptomatic patients with aortic stenosis

    DEFF Research Database (Denmark)

    Greve, Anders M; Gerdts, Eva; Boman, Kurt

    2012-01-01

    The aim of the study was to examine the predictive value of QRS duration and morphology during watchful waiting in asymptomatic patients with aortic stenosis (AS).......The aim of the study was to examine the predictive value of QRS duration and morphology during watchful waiting in asymptomatic patients with aortic stenosis (AS)....

  19. High Prevalence of Esophageal Dysmotility in Asymptomatic Obese Patients

    Directory of Open Access Journals (Sweden)

    Justin Côté-Daigneault

    2014-01-01

    Full Text Available BACKGROUND: Obesity is an important health problem affecting >500 million people worldwide. Esophageal dysmotility is a gastrointestinal pathology associated with obesity; however, its prevalence and characteristics remain unclear. Esophageal dysmotilities have a high prevalence among obese patients regardless of gastrointestinal symptoms.

  20. Is asymptomatic peripheral arterial disease associated with walking endurance in patients with COPD?

    Directory of Open Access Journals (Sweden)

    Sun KS

    2015-07-01

    Full Text Available Kuo-Shao Sun,1,2* Ming-Shian Lin,1,2* Yi-Jen Chen,1,2 Yih-Yuan Chen,3 Solomon Chih-Cheng Chen,4 Wei Chen1,5,6 1Division of Pulmonary and Critical Care Medicine, 2Department of Respiratory Care, Chang Gung University of Science and Technology, 3Department of Internal Medicine, 4Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, 5College of Nursing, Dayeh University, Changhua, 6Department of Respiratory Therapy, China Medical University, Taichung, Taiwan, Republic of China *These authors contributed equally to this work Objective: Symptomatic peripheral arterial disease (PAD is associated with impaired walking endurance in patients with chronic obstructive pulmonary disease (COPD. However, it is unknown whether asymptomatic PAD is associated with impaired walking endurance in patients with COPD. Methods: This prospective cross-sectional study enrolled 200 COPD patients (mean age: 70.9 years who volunteered to perform ankle-brachial index (ABI and 6-minute walk test (6MWT consecutively. Demographic data, lung function, dyspnea scales, and cardiovascular risk factors were recorded. The ABI was used to detect PAD (ABI <0.90. All patients were free of PAD symptoms at enrollment. Results: Of the 200 COPD patients, 17 (8.5% were diagnosed with asymptomatic PAD. The COPD patients without asymptomatic PAD did not walk significantly further on the 6MWT than the COPD patients with asymptomatic PAD (439±86 m vs 408±74 m, P=0.159. The strongest correlation with the distance walked on the 6MWT was Medical Research Council dyspnea scale (r2=-0.667, P<0.001, followed by oxygen-cost diagram (r2=0.582, P<0.001 and forced expiratory volume in 1 second (r2=0.532, P<0.001. In multivariate linear regression analysis, only age, forced expiratory volume in 1 second, and baseline pulse oximetry were independently correlated with the distance covered on the 6MWT (P<0.05. However, body mass index, baseline heart rate, and

  1. Esophageal clearance scintigraphy in, diabetic patients; A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Karayalcin, B.; Karayalcin, U.; Aburano, Tamio; Nakajima, Kenichi; Hisada, Kinichi; Morise, Toshio; Okada, Toshihide; Takeda, Ryoyu (Kanazawa Univ. (Japan). School of Medicine)

    1992-05-01

    The aim of this preliminary study was to evaluate the predictive value of esophageal clearance scintigraphy (ECS) in the diagnosis of esophageal autonomic neuropathy in diabetic patients without any esophageal symptoms. A single swallon ECS was performed in 12 diabetic patients and 15 normal volunteers, and esophageal transit time (ETT) and esophageal (Es) T 1/2 values were calculated. ETT and Es 1/2 were found to be significantly prolonged in the diabetic group (p<0.01 and p<0.05, respectively). In this preliminary study, our results strongly suggest that ECS may be an important noninvasive diagnostic tool in the evaluation of diabetic patients with asymptomatic esophageal autonomic neuropathy. (author).

  2. ANEMIA IN HEMODIALYSIS PATIENTS: DIABETIC VS NON DIABETIC PATIENTS

    Directory of Open Access Journals (Sweden)

    SH SHAHIDI

    2002-12-01

    Full Text Available Introduction. One of the characteristic signs of uremic syndrome is anemia. One of major factors that affects on severity of anemia in ESRD is underlying diseas. The porpuse of this study is to compaire anemia between diabetic and non diabetic ESRD patients. Methods. In a case control study we compared the mean valuse of Hb, Het, MCV, MCH, MCHC, BUN, Cr and duration of dialysis between diabetic and nondiabetic patients on chronic hemodialyis. some variables (such as age, sex, use of erythropoietin, nonderolone decaonats, folic acid, ferrous sulfate, transfusion and blood loss in recent three months and acquired kidney cysts were matched between cases and controls. Results. Means of Hb were 9±1.3 and 8 ± 1.7 in diabetic and non diabetic patients (P<0.05. Mean corposcular volume in diabetic patients (91±3.1 fl was more higher than non diabetic ones (87.1 ± 8.9 (P < 0.05. Other indices had no differences between two groups (P > 0.05. Discussion. Severity of anemia in patients with diabetic nephropathy is milder that other patients with ESRD. So, Anemia as an indicator of chronocity of renal disease in diabetics is missleading.

  3. Asymptomatic and persistent elevation of pancreatic enzymes in an ulcerative colitis patient.

    Science.gov (United States)

    Liverani, Elisa; Leonardi, Filippo; Castellani, Lucia; Cardamone, Carla; Belluzzi, Andrea

    2013-01-01

    Azathioprine has been extensively used in the management of inflammatory bowel diseases. It might cause pancreatic damage in the form of either asymptomatic elevation in serum amylase/lipase or overt acute pancreatitis. Here we report the case of a 61-year-old patient with ulcerative colitis who had been treated with azathioprine for three years, achieving clinical remission. During treatment he presented an asymptomatic elevation of serum pancreatic enzymes, without any signs of pancreatitis at imaging. This evidence brought us to reassess the drug dosage, without achieving a normalization of biochemical analysis. Autoimmune pancreatitis was excluded. One year after the suspension of azathioprine, we still face persistent high levels of amylase/lipase. Normalization of enzymatic values in patients who develop intolerance to azathioprine, in the form of either asymptomatic elevation in serum amylase/lipase or overt acute pancreatitis, is usually achieved in about two months after stopping drug intake. Asymptomatic elevation in serum pancreatic enzymes in the absence of pancreatic disease is reported in the literature and defined as "Gullo's syndrome," but nobody of the subjects studied had been treated in the past with pancreatotoxic drugs. Might this case be defined as "benign pancreatic hyperenzymemia"?

  4. Asymptomatic and Persistent Elevation of Pancreatic Enzymes in an Ulcerative Colitis Patient

    Directory of Open Access Journals (Sweden)

    Elisa Liverani

    2013-01-01

    Full Text Available Azathioprine has been extensively used in the management of inflammatory bowel diseases. It might cause pancreatic damage in the form of either asymptomatic elevation in serum amylase/lipase or overt acute pancreatitis. Here we report the case of a 61-year-old patient with ulcerative colitis who had been treated with azathioprine for three years, achieving clinical remission. During treatment he presented an asymptomatic elevation of serum pancreatic enzymes, without any signs of pancreatitis at imaging. This evidence brought us to reassess the drug dosage, without achieving a normalization of biochemical analysis. Autoimmune pancreatitis was excluded. One year after the suspension of azathioprine, we still face persistent high levels of amylase/lipase. Normalization of enzymatic values in patients who develop intolerance to azathioprine, in the form of either asymptomatic elevation in serum amylase/lipase or overt acute pancreatitis, is usually achieved in about two months after stopping drug intake. Asymptomatic elevation in serum pancreatic enzymes in the absence of pancreatic disease is reported in the literature and defined as “Gullo’s syndrome,” but nobody of the subjects studied had been treated in the past with pancreatotoxic drugs. Might this case be defined as “benign pancreatic hyperenzymemia”?

  5. A risk score for predicting mortality in patients with asymptomatic mild to moderate aortic stenosis

    DEFF Research Database (Denmark)

    Holme, Ingar; Pedersen, Terje R; Boman, Kurt

    2012-01-01

    BackgroundPrognostic information for asymptomatic patients with aortic stenosis (AS) from prospective studies is scarce and there is no risk score available to assess mortality.ObjectivesTo develop an easily calculable score, from which clinicians could stratify patients into high and lower risk...... of mortality, using data from the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study.MethodA search for significant prognostic factors (p...

  6. Right coronary wall cmr in the older asymptomatic advance cohort: positive remodeling and associations with type 2 diabetes and coronary calcium

    Directory of Open Access Journals (Sweden)

    Courtney Brian K

    2010-12-01

    Full Text Available Abstract Background Coronary wall cardiovascular magnetic resonance (CMR is a promising noninvasive approach to assess subclinical atherosclerosis, but data are limited in subjects over 60 years old, who are at increased risk. The purpose of the study was to evaluate coronary wall CMR in an asymptomatic older cohort. Results Cross-sectional images of the proximal right coronary artery (RCA were acquired using spiral black-blood coronary CMR (0.7 mm resolution in 223 older, community-based patients without a history of cardiovascular disease (age 60-72 years old, 38% female. Coronary measurements (total vessel area, lumen area, wall area, and wall thickness had small intra- and inter-observer variabilities (r = 0.93~0.99, all p Conclusions Right coronary wall CMR in asymptomatic older subjects showed increased coronary atherosclerosis in subjects with type 2 diabetes as well as coronary calcification. Coronary wall CMR may contribute to the noninvasive assessment of subclinical coronary atherosclerosis in older, at-risk patient groups.

  7. MRA of the intracranial circulation in asymptomatic patients with sickle cell disease

    Energy Technology Data Exchange (ETDEWEB)

    Gillams, A.R. [Department of Radiology, Boston City Hospital Imaging Foundation, Boston, MA (United States)]|[Academic Department of Medical Imaging, Middlesex Hospital, London (United Kingdom); McMahon, L.; Weinberg, G. [Boston City Hospital Sickle Cell Centre, Boston, MA (United States); Carter, A.P. [Department of Radiology, Boston City Hospital Imaging Foundation, Boston, MA (United States)

    1998-05-01

    Background. MR angiography (MRA) provides a mechanism for non-invasively studying blood flow, thus providing a new opportunity to study the intracranial circulation in asymptomatic sickle cell disease (SCD) patients. Although conventional angiography is the gold standard for the depiction of vascular anatomy, this is too invasive for an asymptomatic population. Objective. To establish the range of appearances in asymptomatic SCD patients and to correlate brain MRI results (either sub-clinical abnormalities or normal brain parenchyma) with the MRA findings. Materials and methods. Brain MRI and MRA of the intracranial circulation was performed on 22 patients (13 male and 9 female, median age 7.5 years, range 1.3-20 years). Fourteen were homozygous SS and eight were SC. The median haematocrit at the time of MRI was 25.9 (range 13.8-33.3). Results. On MR imaging, four patients had infarcts in eight vascular territories (six anterior and two posterior). In 3/4 of anterior vascular territories with infarction, long ({>=} 6 mm) segments of abnormal signal were seen at the internal carotid artery bifurcation with associated reduced distal flow. Short focal areas of abnormal signal were commonly seen where vessels branched, bifurcated or curved and were not associated with infarcts. These areas probably represent turbulence-related dephasing secondary to high velocity flow found in SCD. Conclusion. Long segments ({>=} 6 mm) of abnormal signal with reduced distal flow correlated with sub-clinical infarction. (orig.) With 3 figs., 1 tab., 24 refs.

  8. Prevalence of upper airway obstruction in patients with apparently asymptomatic euthyroid multi nodular goitre

    Directory of Open Access Journals (Sweden)

    Sunil K Menon

    2011-01-01

    Full Text Available Aims: To study the prevalence of upper airway obstruction (UAO in "apparently asymptomatic" patients with euthyroid multinodular goitre (MNG and find correlation between clinical features, UAO on pulmonary function test (PFT and tracheal narrowing on computerised tomography (CT. Materials and Methods: Consecutive patients with apparently asymptomatic euthyroid MNG attending thyroid clinic in a tertiary centre underwent clinical examination to elicit features of UAO, PFT, and CT of neck and chest. Statistical Analysis Used: Statistical analysis was done with SPSS version 11.5 using paired t-test, Chi square test, and Fisher′s exact test. P value of <0.05 was considered to be significant. Results: Fifty-six patients (52 females and four males were studied. The prevalence of UAO (PFT and significant tracheal narrowing (CT was 14.3%. and 9.3%, respectively. Clinical features failed to predict UAO or significant tracheal narrowing. Tracheal narrowing (CT did not correlate with UAO (PFT. Volume of goitre significantly correlated with degree of tracheal narrowing. Conclusions: Clinical features do not predict UAO on PFT or tracheal narrowing on CT in apparently asymptomatic patients with euthyroid MNG.

  9. Immune response in diarrheal patients and asymptomatic carrier with CS6-producing enterotoxigenic Escherichia coli infection.

    Science.gov (United States)

    Puiprom, Orapim; Chantaroj, Siriporn; Matsuda, Shigeaki; Sawanpanyalert, Pathom; Honda, Takeshi; Iida, Tetsuya; Taniguchi, Tooru

    2012-11-01

    Enterotoxigenic Escherichia coli (ETEC) is one of the major causes of diarrhea in children and travelers in developing countries. ETEC colonization factors (CFs) are virulence determinants considered as protective antigens and major targets for vaccine development against ETEC infections. One of the most prevalent CFs, coli surface antigen 6 (CS6), a non-fimbrial polymeric protein consisting of two major subunits, CssA and CssB, is produced by approximately 25-35% of ETEC worldwide. We could isolate only CS6-producing ETEC strains from two diarrheal patients and one asymptomatic carrier, but we could not detect CssA- or CssB-specific antibodies in the feces and blood of two patients convalescing from natural ETEC infection and of an asymptomatic carrier using western blotting. Therefore, in order to protect against infection with CS6-producing ETEC, protective levels of CS6 immunity should be incorporated in any future vaccines against ETEC.

  10. Asymptomatic neurocognitive disorders in patients infected by HIV: fact or fiction?

    Directory of Open Access Journals (Sweden)

    Torti Carlo

    2011-12-01

    Full Text Available Abstract Neurocognitive disorders are emerging as a possible complication in patients infected with HIV. Even if asymptomatic, neurocognitive abnormalities are frequently detected using a battery of tests. This supported the creation of asymptomatic neurocognitive impairment (ANI as a new entity. In a recent article published in BMC Infectious Diseases, Magnus Gisslén and colleagues applied a statistical approach, concluding that there is an overestimation of the actual problem. In fact, about 20% of patients are classified as neurocognitively impaired without a clear impact on daily activities. In the present commentary, we discuss the clinical implications of their findings. Although a cautious approach would indicate a stricter follow-up of patients affected by this disorder, it is premature to consider it as a proper disease. Based on a review of the data in the current literature we conclude that it is urgent to conduct more studies to estimate the overall risk of progression of the asymptomatic neurocognitive impairment. Moreover, it is important to understand whether new biomarkers or neuroimaging tools can help to identify better the most at risk population. Please see related article: http://www.biomedcentral.com/1471-2334/11/356

  11. Asymptomatic pontine and extra-pontine lesions in a patient with end-stage renal disease

    Directory of Open Access Journals (Sweden)

    Raj Kanwar Yadav

    2016-01-01

    Full Text Available Osmotic demyelination syndrome leading to central pontine/extra-pontine myelinolysis (CPM/EPM occurs mainly in patients with history of alcohol abuse, malnourishment, following liver transplantation and less commonly, in association with other systemic diseases. Asymptomatic CPM/EPM is rare. Patients with end-stage renal disease (ESRD who develop CPM/EPM are usually symptomatic with florid neurologic manifestations. Herein, we present a patient with ESRD on maintenance hemodialysis who was incidentally detected to have pontine and extra-pontine lesions suggestive of myelinolysis without any neurologic signs or symptoms.

  12. A Mixed Methods Feasibility Trial of PKCι Inhibition with Auranofin in Asymptomatic Patients with Ovarian Cancer

    Science.gov (United States)

    Jatoi, Aminah; Breitkopf, Carmen Radecki; Foster, Nathan R.; Block, Matthew S.; Grudem, Megan; Hendrickson, Andrea Wahner; Carlson, Rachel E.; Barrette, Brigitte; Karlin, Nina; Fields, Alan P.

    2015-01-01

    Purpose This trial was undertaken to 1) determine the feasibility of enrolling asymptomatic ovarian cancer patients with Ca-125 elevation to a trial with the PKCι inhibitor, auranofin, and 2) understand patients’ perceptions of Ca-125 monitoring. Methods Asymptomatic ovarian cancer patients with Ca-125 elevation received auranofin 3 mg orally twice/day and were evaluated. Patients participated in interviews about Ca-125 monitoring. Results Ten patients were enrolled in slightly over 6 months, exceeding our anticipated rate. Four manifested stable Ca-125 levels for 1 month or longer. The median progression-free survival was 2.8 months (95% confidence interval: 1.3, 3.8 months); auranofin was well tolerated. One patient had baseline and monthly Ca-125 levels of 5570, 6085, 3511, and 2230 units/mL, respectively, stopped auranofin because of radiographic progression at 3 months, and manifested an increase in Ca-125 to 7168 units/mL approximately 3 months later. Patient interviews revealed: 1) the important role of Ca-125 in cancer monitoring; 2) ardent advocacy for Ca-125 testing; and 3) evolution toward the Ca-125 assuming a life of its own. Conclusions This study showed feasibility; and patients favored Ca-125 monitoring. One patient had a decline in Ca-125, suggesting that PKCι inhibition merits further study in ovarian cancer. PMID:25502607

  13. Protease activity in Giardia duodenalis trophozoites of axenic strains isolated from symptomatic and asymptomatic patients

    Directory of Open Access Journals (Sweden)

    Guimarães Semíramis

    2003-01-01

    Full Text Available We have examined by gelatin-SDS-PAGE the protease activity in cell lysates of Giardia duodenalis trophozoites of two axenic strains isolated in Brazil from a symptomatic patient (BTU-11 and an asymptomatic carrier (BTU-10, and the reference strain Portland 1 (P1. The proteolysis band patterns showed differences among strains isolated from asymptomatic and symptomatic individuals. The lysate of the strain BTU-10, showed only five hydrolysis bands, while a greater number of bands (10-11 bands was seen in strains BTU-11 and P1. The protease activity in all lysates was inhibited by cysteine (E-64 and iodoacetamide and serine proteases (TPCK and TLCK inhibitors, but not by PMSF and EDTA. In general, the results revealed protease activities in G. duodenalis trophozoites of Brazilian axenic strains and the predominance of cysteine proteinases. It should be stressed the inter-strain difference in hydrolysis band patterns observed between strains isolated from symptomatic patients and the strain obtained from an asymptomatic carrier.

  14. Uncommon Asymptomatic Unilateral Complete Duplicated Collecting System and Giant Ectopic Ureterocele in Middle-Age Patient

    Directory of Open Access Journals (Sweden)

    Halil Serin

    2014-02-01

    Full Text Available Ureterocele is a common pediatric urologic problem, but has been reported seldom in adults. Most duplex system ureteroceles existent as urinary tract infections at an early age, with adult presentation being uncommon. Urinary stasis in the dilated distal ureter often lends to urinary infection and stone formation; precluding the most common offering symptoms of dysuria, urgency, and recurrent urinary tract infections. Ižn duplex system ureteroceles to poorly or non-functioning moieties, heminephroureterectomy is an definite solution. We present a case of rarely middle-age asymptomatic obstructive giant ureterocele. We intended to emphasize that patient with obstructive, giant, ectopic ureterocele and duplicated collecting system may have asymptomatic course.

  15. The diabetic patient in Ramadan.

    Science.gov (United States)

    Chamsi-Pasha, Hassan; Aljabri, Khalid S

    2014-04-01

    During the month of Ramadan, all healthy, adult Muslims are required to fast from dawn to sunset. Fasting during Ramadan involves abstaining from food, water, beverages, smoking, oral drugs, and sexual intercourse. Although the Quran exempts chronically ill from fasting, many Muslims with diabetes still fast during Ramadan. Patients with diabetes who fast during the month of Ramadan can have acute complications. The risk of complications in fasting individuals with diabetes increases with longer periods of fasting. All patients with diabetes who wish to fast during Ramadan should be prepared by undergoing a medical assessment and engaging in a structured education program to undertake the fast as safely as possible. Although some guidelines do exist, there is an overwhelming need for better designed clinical trials which could provide us with evidence-based information and guidance in the management of patients with diabetes fasting Ramadan.

  16. Wilson's disease in an adult asymptomatic patient: a potential role for modifying factors of copper metabolism.

    Science.gov (United States)

    Loudianos, Georgios; Incollu, Simona; Mameli, Eva; Lepori, Maria B

    2016-01-01

    Diagnosis of Wilson's disease (WD) still remains a challenge since no single test has an accuracy of 100%. Molecular testing for ATP7B gene mutations can help reach the diagnosis when routine testing is equivocal. We herein report an asymptomatic WD patient diagnosed accidentally by genetic analysis. Th is case suggests that WD is a challenge even in particular contexts such as family screening. Genetic testing of ATP7B gene should be recommended in the family members of WD patients with minimal alterations of specific tests such as ceruloplasmin, and presence of steatosis or increased body mass index.

  17. The Evaluation of a Borderline Long QT Interval in an Asymptomatic Patient.

    Science.gov (United States)

    Obeyesekere, Manoj N; Leong-Sit, Peter; Gula, Lorne J; Yee, Raymond; Skanes, Allan C; Klein, George J; Krahn, Andrew D

    2012-06-01

    QT prolongation on resting electrocardiography (ECG) is common, and the clinician is often challenged by the dilemma of excluding acquired causes and recognizing potential congenital long QT syndrome (LQTS). The hallmark of LQTS is an abnormally long QT interval. However, a normal or borderline long QT interval may be observed in up to 50% of patients with LQTS because of the intermittent nature of QT prolongation. This review presents an approach to evaluating the asymptomatic patient with a borderline long QT interval, which incorporates a comprehensive clinical assessment, rest and provocative ECG testing, and genetic testing when appropriate.

  18. SuPAR Predicts Cardiovascular Events and Mortality in Patients With Asymptomatic Aortic Stenosis

    DEFF Research Database (Denmark)

    Hodges, Gethin W; Bang, Casper N; Eugen-Olsen, Jesper

    2016-01-01

    BACKGROUND: Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory marker associated with subclinical cardiovascular damage and cardiovascular events. Whether suPAR is of prognostic value in asymptomatic patients with aortic stenosis (AS) remains unknown. METHODS: Plasma su......PAR levels were measured in 1503 patients with a mean age of 68 years who were recruited in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. Cox regression analysis was performed to evaluate associations between suPAR and the composite end points of ischemic cardiovascular events (ICEs), aortic...

  19. Evaluation of cardiovascular anomalies in patients with asymptomatic turner syndrome using multidetector computed tomography.

    Science.gov (United States)

    Lee, Sun Hee; Jung, Ji Mi; Song, Min Seob; Choi, Seok jin; Chung, Woo Yeong

    2013-08-01

    Turner syndrome is well known to be associated with significant cardiovascular abnormalities. This paper studied the incidence of cardiovascular abnormalities in asymptomatic adolescent patients with Turner syndrome using multidetector computed tomography (MDCT) instead of echocardiography. Twenty subjects diagnosed with Turner syndrome who had no cardiac symptoms were included. Blood pressure and electrocardiography (ECG) was checked. Cardiovascular abnormalities were checked by MDCT. According to the ECG results, 11 had a prolonged QTc interval, 5 had a posterior fascicular block, 3 had a ventricular conduction disorder. MDCT revealed vascular abnormalities in 13 patients (65%). Three patients had an aberrant right subclavian artery, 2 had dilatation of left subclavian artery, and others had an aortic root dilatation, aortic diverticulum, and abnormal left vertebral artery. As for venous abnormalities, 3 patients had partial anomalous pulmonary venous return and 2 had a persistent left superior vena cava. This study found cardiovascular abnormalities in 65% of asymptomatic Turner syndrome patients using MDCT. Even though, there are no cardiac symptoms in Turner syndrome patients, a complete evaluation of the heart with echocardiography or MDCT at transition period to adults must be performed.

  20. Open and hidden agendas of "asymptomatic" patients who request check-up exams

    Directory of Open Access Journals (Sweden)

    Nüesch Reto

    2011-04-01

    Full Text Available Abstract Background Current guidelines for a check-up recommend routine screening not triggered by specific symptoms for some known risk factors and diseases in the general population. Patients' perceptions and expectations regarding a check-up exam may differ from these principles. However, quantitative and qualitative data about the discrepancy between patient- and provider expectations for this type of clinic consultation is lacking. Methods For a year, we prospectively enrolled 66 patients who explicitly requested a "check-up" at our medical outpatient division. All patients actively denied upon prompting having any symptoms or specific health concerns at the time they made their appointment. All consultations were videotaped and analysed for information about spontaneously mentioned symptoms and reasons for the clinic consultation ("open agendas" and for cues to hidden patient agendas using the Roter interaction analysis system (RIAS. Results All patients initially declared to be asymptomatic but this was ultimately the case in only 7 out of 66 patients. The remaining 59 patients spontaneously mentioned a mean of 4.2 ± 3.3 symptoms during their first consultation. In 23 patients a total of 31 hidden agendas were revealed. The primary categories for hidden agendas were health concerns, psychosocial concerns and the patient's concept of disease. Conclusions The majority of patients requesting a general check-up tend to be motivated by specific symptoms and health concerns and are not "asymptomatic" patients who primarily come for preventive issues. Furthermore, physicians must be alert for possible hidden agendas, as one in three patients have one or more hidden reasons for requesting a check-up.

  1. Hallux ulceration in diabetic patients.

    Science.gov (United States)

    ElMakki Ahmed, Mohamed; Tamimi, Abdulhakim O; Mahadi, Seif I; Widatalla, Abubakr H; Shawer, Mohamed A

    2010-01-01

    We undertook a prospective cohort study to assess risk factors associated with hallux ulceration, and to determine the incidence of healing or amputation, in consecutive patients with diabetes mellitus who were treated over the observation period extending from September 2004 to March 2005, at the Jabir Abu Eliz Diabetic Centre, Khartoum City, Sudan. There were 122 diabetic patients in the cohort (92 males and 30 females) with an overall mean age of 58 +/- 9 years. Fifty-three percent of patients had complete healing within 8 weeks and 43% healed within 20 weeks. The overall mean time to healing was 16 +/- 8 weeks. In 32 (26.2%) patients, osteomyelitic bone was removed, leaving a healed and boneless hallux. The hallux was amputated in 17 (13.9%) patients; in 2 (1.6%) patients it was followed by forefoot amputation and in 7 (5.7%) patients by below-the-knee amputation. In 90 (73.8%) patients the initial lesion was a blister. In conclusion, hallux ulceration is common in patients with diabetes mellitus and is usually preceded by a blister. Neuropathy, foot deformity, and wearing new shoes are common causative factors; and ischemia, osteomyelitis, any form of wound infection, and the size of the ulcer are main outcome determinants. Complete healing occurred in 103 (85%) of diabetic patients with a hallux ulcer. Vascular intervention is important relative to limb salvage when ischemia is the main cause of the ulcer.

  2. Periodontal health and diabetes awareness among Saudi diabetes patients

    OpenAIRE

    Bahammam MA

    2015-01-01

    Maha A BahammamDepartment of Periodontology, King Abdulaziz University Faculty of Dentistry, Jeddah, Kingdom of Saudi ArabiaPurpose: This study aimed to examine diabetic patients in Jeddah, Saudi Arabia, regarding their general diabetic and oral health-related awareness and practices, their awareness of the association of diabetes with periodontal disease, and their sources of diabetes-related information.Methods: Diabetic patients (n=454) who were receiving care at...

  3. Incremental prognostic value of coronary computed tomographic angiography over coronary artery calcium score for risk prediction of major adverse cardiac events in asymptomatic diabetic individuals

    Science.gov (United States)

    Min, James K.; Labounty, Troy M.; Gomez, Millie J.; Achenbach, Stephan; Al-Mallah, Mouaz; Budoff, Matthew J.; Cademartiri, Filippo; Callister, Tracy Q.; Chang, Hyuk-Jae; Cheng, Victor; Chinnaiyan, Kavitha M.; Chow, Benjamin; Cury, Ricardo; Delago, Augustin; Dunning, Allison; Feuchtner, Gudrun; Hadamitzky, Martin; Hausleiter, Jorg; Kaufmann, Philipp; Kim, Yong-Jin; Leipsic, Jonathon; Lin, Fay Y.; Maffei, Erica; Raff, Gilbert; Shaw, Leslee J.; Villines, Todd C.; Berman, Daniel S.

    2015-01-01

    Background Coronary artery disease (CAD) diagnosis by coronary computed tomographic angiography (CCTA) is useful for identification of symptomatic diabetic individuals at heightened risk for death. Whether CCTA-detected CAD enables improved risk assessment of asymptomatic diabetic individuals beyond clinical risk factors and coronary artery calcium scoring (CACS) remains unexplored. Methods From a prospective 12-center international registry of 27,125 individuals undergoing CCTA, we identified 400 asymptomatic diabetic individuals without known CAD. Coronary stenosis by CCTA was graded as 0%, 1–49%, 50–69%, and ≥70%. CAD was judged on a per-patient, per-vessel and per-segment basis as maximal stenosis severity, number of vessels with ≥50% stenosis, and coronary segments weighted for stenosis severity (segment stenosis score), respectively. We assessed major adverse cardiovascular events (MACE) – inclusive of mortality, nonfatal myocardial infarction (MI), and late target vessel revascularization ≥90 days (REV) – and evaluated the incremental utility of CCTA for risk prediction, discrimination and reclassification. Results Mean age was 60.4 ± 9.9 years; 65.0% were male. At a mean follow-up 2.4 ± 1.1 years, 33 MACE occurred (13 deaths, 8 MI, 12 REV) [8.25%; annualized rate 3.4%]. By univariate analysis, per-patient maximal stenosis [hazards ratio (HR) 2.24 per stenosis grade, 95% confidence interval (CI) 1.61–3.10, p < 0.001], increasing numbers of obstructive vessels (HR 2.30 per vessel, 95% CI 1.75–3.03, p < 0.001) and segment stenosis score (HR 1.14 per segment, 95% CI 1.09–1.19, p < 0.001) were associated with increased MACE. After adjustment for CAD risk factors and CACS, maximal stenosis (HR 1.80 per grade, 95% CI 1.18–2.75, p = 0.006), number of obstructive vessels (HR 1.85 per vessel, 95% CI 1.29–2.65, p < 0.001) and segment stenosis score (HR 1.11 per segment, 95% CI 1.05–1.18, p < 0.001) were associated with increased risk of

  4. [Anti-neutrophil cytoplasmic antibodies (ANCA) in patients with symptomatic and asymptomatic HIV infection].

    Science.gov (United States)

    Habegger de Sorrentino, A; Motta, P; Iliovich, E; Sorrentino, A P

    1997-01-01

    The cytopathic effect of HIV on CD4 T cells, as well as the active autoimmune mechanism occurring during infection, have been documented. Of the cytokines involved in the pathogenesis of AIDS, the main one produced by the monocyte-macrophage series is tumor necrosis factor alfa (TNF alpha). This cytokine induces antigens such as proteinase 3 (Pr 3) or mieloperoxidase (MPO). Anti-neutrophil cytoplasmic antibodies (ANCA) are directed against this type of PMN antigens. In the present paper, the role of anti-neutrophil cytoplasmic antibodies (ANCA) in HIV infected patients as responsible for autoimmune phenomena in relation to opportunistic infections, was studied. A total of 88 serum samples belonging to 49 asymptomatic and 39 symptomatic HIV infected patients were tested for ANCA by an indirect immunofluorescence (IIF) test over a neutrophil substrate. ANCA were detected in 53.8% of symptomatic patients as compared to 4.1% in asymptomatic cases (p tuberculosis is a frequent finding in HIV infected patients from Northeastern Argentina. When the presence of ANCA in TB(+) HIV(+) and TB(+) HIV(-) patients was studied, it was seen that positive-ANCA significantly correlated with the first group (p pulmonar TB, could indicate that the virus may not be responsible for the induction of these antibodies.

  5. The Association between Myocardial Iron Load and Ventricular Repolarization Parameters in Asymptomatic Beta-Thalassemia Patients

    Directory of Open Access Journals (Sweden)

    Mehmet Kayrak

    2012-01-01

    Full Text Available Previous studies have demonstrated impaired ventricular repolarization in patients with β-TM. However, the effect of iron overload with cardiac T2* magnetic resonance imaging (MRI on cardiac repolarization remains unclear yet. We aimed to examine relationship between repolarization parameters and iron loading using cardiac T2* MRI in asymptomatic β-TM patients. Twenty-two β-TM patients and 22 age- and gender-matched healthy controls were enrolled to the study. From the 12-lead surface electrocardiography, regional and transmyocardial repolarization parameters were evaluated manually by two experienced cardiologists. All patients were also undergone MRI for cardiac T2* evaluation. Cardiac T2* score <20 msec was considered as iron overload status. Of the QT parameters, QT duration, corrected QT interval, and QT peak duration were significantly longer in the β-TM group compared to the healthy controls. Tp−Te and Tp−Te dispersions were also significantly prolonged in β-TM group compared to healthy controls. (Tp-Te/QT was similar between groups. There was no correlation between repolarization parameters and cardiac T2* MRI values. In conclusion, although repolarization parameters were prolonged in asymptomatic β-TM patients compared with control, we could not find any relation between ECG findings and cardiac iron load.

  6. Disseminated histoplasmosis presenting as diabetic keto-acidosis in an immunocompetent patient.

    Science.gov (United States)

    Niknam, Negin; Malhotra, Prashant; Kim, Angela; Koenig, Seth

    2017-01-06

    Histoplasma capsulatum causes a spectrum of manifestations from asymptomatic to fatal disseminated disease. Disseminated histoplasmosis is mostly seen in endemic areas among immunocompromised patients such as those with AIDS. Here, we present a patient living in a non-endemic area with previously undiagnosed diabetes mellitus, who presented with septic shock and diabetic ketoacidosis (DKA), and was ultimately diagnosed with disseminated histoplasmosis. The patient rapidly recovered on administration of intravenous liposomal amphotericin followed by oral itraconazole. Uncontrolled diabetes may be a risk factor for disseminated or severe histoplasmosis in otherwise immunocompetent patients.

  7. Rosuvastatin in diabetic hemodialysis patients

    DEFF Research Database (Denmark)

    Holdaas, Hallvard; Holme, Ingar; Schmieder, Roland E;

    2011-01-01

    A randomized, placebo-controlled trial in diabetic patients receiving hemodialysis showed no effect of atorvastatin on a composite cardiovascular endpoint, but analysis of the component cardiac endpoints suggested that atorvastatin may significantly reduce risk. Because the AURORA (A Study...... to Evaluate the Use of Rosuvastatin in Subjects on Regular Hemodialysis: An Assessment of Survival and Cardiovascular Events) trial included patients with and without diabetes, we conducted a post hoc analysis to determine whether rosuvastatin might reduce the risk of cardiac events in diabetic patients...... receiving hemodialysis. Among the 731 participants with diabetes, traditional risk factors such as LDL-C, smoking, and BP did not associate with cardiac events (cardiac death and nonfatal myocardial infarction). At baseline, only age and high-sensitivity C-reactive protein were independent risk factors...

  8. Classification and Prognostic Evaluation of Left Ventricular Remodeling in Patients With Asymptomatic Heart Failure.

    Science.gov (United States)

    Pugliese, Nicola Riccardo; Fabiani, Iacopo; La Carrubba, Salvatore; Conte, Lorenzo; Antonini-Canterin, Francesco; Colonna, Paolo; Caso, Pio; Benedetto, Frank; Santini, Veronica; Carerj, Scipione; Romano, Maria Francesca; Citro, Rodolfo; Di Bello, Vitantonio

    2017-01-01

    Patients with asymptomatic heart failure (HF; stage A and B) are characterized by maladaptive left ventricular (LV) remodeling. Classic 4-group classification of remodeling considers only LV mass index and relative wall thickness as variables. Complex remodeling classification (CRC) includes also LV end-diastolic volume index. Main aim was to assess the prognostic impact of CRC in stage A and B HF. A total of 1,750 asymptomatic subjects underwent echocardiographic examination as a screening evaluation in the presence of cardiovascular risk factors. LV dysfunction, both systolic (ejection fraction) and diastolic (transmitral flow velocity pattern), was evaluated, together with LV remodeling. We considered a composite end point: all-cause death, myocardial infarction, coronary revascularizations, cerebrovascular events, and acute pulmonary edema. CRC was suitable for 1,729 patients (men 53.6%; age 58.3 ± 13 years). Two hundred thirty-eight patients presented systolic dysfunction (ejection fraction remodeling, 47 eccentric remodeling, 350 concentric hypertrophy, 29 mixed hypertrophy, 86 dilated hypertrophy, and 53 eccentric hypertrophy. Age and gender distribution was noticed (p remodeling classification, systolic, and diastolic dysfunction), CRC was independent predictor of primary end point (p = 0.044, hazard ratio 1.101, 95% CI 1.003 to 1.21), confirmed in a logistic regression (p <0.03). In conclusion, CRC could help physicians in prognostic stratification of patients in stage A and B HF.

  9. Surgery in asymptomatic patients with colorectal cancer and unresectable liver metastases: the authors' experience

    Directory of Open Access Journals (Sweden)

    Boselli C

    2013-03-01

    Full Text Available Carlo Boselli,1 Claudio Renzi,2 Alessandro Gemini,1 Elisa Castellani,1 Stefano Trastulli,2 Jacopo Desiderio,2 Alessia Corsi,2 Francesco Barberini,1 Roberto Cirocchi,2 Alberto Santoro,3 Amilcare Parisi,4 Adriano Redler,3 Giuseppe Noya1 1Department of General and Oncologic Surgery, University of Perugia, Perugia, 2Department of General Surgery, University of Perugia, St Maria Hospital, Terni, 3Department of Surgical Sciences, Sapienza University of Rome, Rome, 4Department of Digestive Surgery, St Maria Hospital, Terni, Italy Purpose: In asymptomatic patients with Stage IV colorectal cancer, the debate continues over the efficacy of primary resection compared to chemotherapy alone. The aim of this study was to define the optimal management for asymptomatic patients with colorectal cancer and unresectable liver metastases. Patients and methods: Patients receiving elective surgery (n = 17 were compared to patients receiving chemotherapy only (n = 31. Data concerning patients' demographics, location of primary tumor, comorbidities, performance status, Child–Pugh score, extension of liver metastases, size of primary, and other secondary locations were collected. Results: Thirty-day mortality after chemotherapy was lower than that after surgical resection (19.3% versus 29.4%; not significant. In patients with >75% hepatic involvement, mortality at 1 month was higher after receiving surgical treatment than after chemotherapy alone (50% versus 25%. In patients with <75% hepatic involvement, 30-day mortality was similar in both groups (not significant. Thirty-day mortality in patients with Stage T3 was lower in those receiving chemotherapy (16.7% versus 30%; not significant. Overall survival was similar in both groups. The risk of all-cause death after elective surgery (2.1 was significantly higher than in patients receiving chemotherapy only (P = 0.035. Conclusion: This study demonstrated that in palliative treatment of asymptomatic unresectable Stage

  10. A Rare Case of Sarcina ventriculi of the Stomach in an Asymptomatic Patient.

    Science.gov (United States)

    Haroon Al Rasheed, Mohamed Rizwan; Kim, George J; Senseng, Carmencita

    2016-04-01

    Sarcina ventriculi is a gram-positive coccus that grows in a tetrad arrangement in the stomach. In the past 35 years, less than 20 cases have been reported in the literature, and it has been associated with life-threatening complications such as emphysematous gastritis and perforation. Treatment of S ventriculi generally consists of proton pump inhibitors with or without adjuvant antibiotic therapy. We report the first ever case of S ventriculi, including the morphological and immunohistochemical features, occurring in an asymptomatic patient with a history of Helicobacter pylori gastric ulcers.

  11. Pulmonary Findings on Computed Tomography in Asymptomatic Total Joint Arthroplasty Patients.

    Science.gov (United States)

    Vigdorchik, Jonathan M; Riesgo, Aldo M; Lincoln, Denis; Markel, David C

    2016-08-01

    An increase in the diagnosis of pulmonary embolus (PE) in the early postoperative period has been attributed to the use of multidetector 64-slice computed tomographic (CT) scans. It was suspected that this finding was the result of marrow or fat emboli that are commonly associated with arthroplasty rather than a true venous thromboembolic phenomenon. The purpose of this study was to determine the baseline pulmonary findings in asymptomatic patients after total joint arthroplasty (TJA). Over a 1-year period, an institutional review board-approved prospective study of 20 asymptomatic patients using a multidetector 64-slice CT scanner was performed. Overall, 15 TKAs and 5 total hip arthroplasties were included for analysis. All of the CT scans were negative for PE. There were no signs of microemboli or fat emboli on any scan. No patient went on to develop a PE at 2 years postoperatively. Despite the fact that emboli are created during TJA, if emboli are seen on a CT scan postoperatively, they should be assumed to be real events with clinical sequelae. If pulmonary symptoms develop postoperatively, they should not simply be assumed to be the result of fat or marrow embolism.

  12. Subclinical Coronary Plaque Burden in Asymptomatic Relatives of Patients With Documented Premature Coronary Artery Disease

    DEFF Research Database (Denmark)

    Christiansen, Morten Krogh; Jensen, Jesper Møller; Bøtker, Hans Erik;

    Introduction: A family history of premature coronary artery disease (CAD) is a well-known risk factor for adverse coronary events with age of onset being inversely related to the degree of heritability. Hypothesis: We hypothesized that asymptomatic first degree relatives, of patients with premature...... CAD, suffer a high burden of subclinical coronary atherosclerosis. Methods: First degree relatives, aged 30-65 years, of patients with a documented coronary revascularization procedure before the age of 40 years, were invited to participate in the study. Participants were matched by age, sex...... and absence of a family history, with patients referred for coronary CT angiography (CTA) because of atypical angina or non-anginal chest pain. A pooled blinded analysis was performed. The main outcome measure was the number of plaque-affected coronary segments. Results: 88 relatives and 88 symptomatic...

  13. "Evaluation of Trichomonas Vaginalis Isolates from Symptomatic and Asymptomatic Patients in Mouse Model"

    Directory of Open Access Journals (Sweden)

    Z Valadkhani

    2004-07-01

    Full Text Available Trichomoniasis, a worldwide prevalent infection, is a perfect example of interplay between the infecting parasite and the host, on which the presentation of disease depends. To study the pathogenesis, animal model is required for establishment of infection. In this study, by using strains of Trichomonas vaginalis isolated from vaginal swabs and/or urine samples and maintained in axenic form from 10 symptomatic and 10 asymptomatic female patients, the infections in BALB/c mice have been evaluated. Based on parasitic load, experimental peak infection in vagina of estradiol and L. acidophilus treated female BALB/c mice was observable on 5th post infection day. This was significantly higher in mice infected with isolates from symptomatic patients in comparison to the other group. Gradual increase up to day 5 followed by decline in parasites, polymorphs and vaginal epithelial cells was observed in mice infected with isolates from symptomatic subjects in contrast to mice infected with asymptomatic patients’ isolates or control animals at all time intervals.

  14. Should incidental asymptomatic angiographic stenoses and occlusions be treated in patients with peripheral arterial disease?

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2009-09-01

    The clinical importance of angiographically detected asymptomatic lower-limb stenoses and occlusions is unknown. This study aims to (i) assess the clinical outcome of asymptomatic lesions in the lower limb, (ii) identify predictors of clinical deterioration, and (iii) determine which asymptomatic lower-limb lesions should be treated at presentation.

  15. Renal Biopsy in Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Eugenia Espinel

    2015-05-01

    Full Text Available The majority of diabetic patients with renal involvement are not biopsied. Studies evaluating histological findings in renal biopsies performed in diabetic patients have shown that approximately one third of the cases will show pure diabetic nephropathy, one third a non-diabetic condition and another third will show diabetic nephropathy with a superimposed disease. Early diagnosis of treatable non-diabetic diseases in diabetic patients is important to ameliorate renal prognosis. The publication of the International Consensus Document for the classification of type 1 and type 2 diabetes has provided common criteria for the classification of diabetic nephropathy and its utility to stratify risk for renal failure has already been demonstrated in different retrospective studies. The availability of new drugs with the potential to modify the natural history of diabetic nephropathy has raised the question whether renal biopsies may allow a better design of clinical trials aimed to delay the progression of chronic kidney disease in diabetic patients.

  16. Diabetic vitrectomy in a large type 1 diabetes patient population

    DEFF Research Database (Denmark)

    Ostri, Christoffer; la Cour, Morten; Lund-Andersen, Henrik

    2014-01-01

    1996 and 2010. Surgical history was obtained from The Danish National Patient Register. RESULTS: The population consisted of 3980 patients with type 1 diabetes. Median follow-up was 10.0 years. In total, 106 patients underwent diabetic vitrectomy in the observation period. Surgery indications were......Hg, diabetes duration, age, gender and nephropathy were not associated with an increased risk of reaching diabetic vitrectomy (p > 0.05 for all variables). CONCLUSIONS: Diabetic vitrectomy is rarely required in a type 1 diabetes population with varying degrees of retinopathy, but the risk increases markedly...... nonclearing vitreous haemorrhage (43%) or tractional retinal detachment (57%). The cumulative incidence rates of diabetic vitrectomy were 1.6% after 5 years and 2.9% after 10 years. When excluding patients with no or mild diabetic retinopathy, the corresponding rates were higher; 3.7% and 6.4%, respectively...

  17. Evaluation of Asymptomatic Peripheral Arterial Disease by Ankle-brachial Index in Patients with Concomitant Coronary Arterial Disease

    Directory of Open Access Journals (Sweden)

    Hosein Vakili

    2012-12-01

    Full Text Available Background: Peripheral arterial disease is associated with adverse cardiovascular outcomes. As such, it is found that screening for peripheral arterial disease (PAD improves risk assessment. Thus, intensive risk factor modification and medical treatment in these patients are necessary. Objectives: The purpose of this study was to determine the prevalence of asymptomatic peripheral arterial disease in patients with concomitant coronary arterial disease. Methods: Asymptomatic peripheral arterial disease was investigated in 400 patients (60% males, 40% females, aged 59.7± 11.3 with a documented coronary arterial disease. Results: Among patients with documented CAD, 12% had asymptomatic PAD with the ABI ratio of less than 0.9. Conclusions: It is advisable to screen for PAD not only as a disease but also as a risk assessment method for atherosclerosis.

  18. Molecular Characterization of Trichomonas vaginalis Strains Based on Identifying Their Probable Variations in Asymptomatic Patients

    Science.gov (United States)

    SPOTIN, Adel; EGHTEDAR, Sanaz TAGHIZADEH; SHAHBAZI, Abbas; SALEHPOUR, Asghar; SARAFRAZ, Seddigheh; SHARIATZADEH, Seyyed Ali; MAHAMI-OSKOUEI, Mahmoud

    2016-01-01

    Background: The aim of this study was to identify the Trichomonas vaginalis strains/haplotypes based on identifying their probable variations in asymptomatic patients referred to Tabriz health centers, northwestern Iran. Methods: Sampling was taken from 50-suspected women to T. vaginalis in northwestern Iran. The obtained samples were smeared and cultured. Fifty DNA samples were extracted, amplified and identified by nested polymerase chain reaction and PCR-RFLP of actin gene using two endonuclease enzymes: MseI and RsaI. To reconfirm, the amplicons of actin gene were directly sequenced in order to identify the strains/haplotypes. Results: PCR-RFLP patterns, sequencing and phylogenetic analyses revealed definitely the presence of the G (n=22; 73.4%) and E (n=8; 26.6%) strains. Multiple alignments findings of genotype G showed five haplotypes and two amino acid substitutions in codons 192 and 211 although, no remarkable unique haplotype was found in genotype E. Conclusion: The accurate identification of T. vaginalis strains based on discrimination of their unknown haplotypes particularly those which are impacted on protein translation should be considered in parasite status, drug resistance, mixed infection with HIV and monitoring of asymptomatic trichomoniasis in the region. PMID:28127362

  19. Profile of Type 2 Diabetic Patients Referred to Electroneurography Laboratory

    Directory of Open Access Journals (Sweden)

    Ufuk Emre

    2010-05-01

    Full Text Available Objective: In this study, we aimed to assess the presence of minor complications in patients with type 2 diabetes mellitus (DM referred to electroneurography (ENG laboratory for evaluation of neuropathy. In addition, the relationship between duration of disease, electrophysiologic findings, neurological examination findings, plasma glycated hemoglobin A1C levels, glucose levels and microvascular complications were examined. Materials and Methods: One hundred seventy patients with type 2 diabetes were included. Age, gender, duration of disease, results of ophthalmological examinations, neuropathic complaints, electrophysiological examination results, neurological examination findings and laboratory examination results including blood glucose and A1C levels, presence of albuminuria were recorded retrospectively. Results: Abnormal ENG findings were found in one hundred forty patients (82.4%. In all patients, the rate of retinopathy was 34.1% and the rate of albuminuria was 19.4%. The rate of polyneuropathy (PNP( was 78.2% in patients with abnormal neurologic examination. Neuropathic complaints and PNP were found to be related with the presence of retinopathy. The rate of retinopathy was higher in patients with albuminuria. Significant relationship was found between disease duration and retinopathy, PNP and neuropathic complaints. Conclusions: This study emphasizes that detailed history, neurological and ophthalmological examinations are easy, cost-effective and reliable examinations in follow-up of type 2 diabetics. ENG examination, which needs time and money, should be done in asymptomatic cases or for differential diagnosis of neuropathies with clues not related with diabetic neuropathy. Turk Jem 2010; 14: 10-4

  20. Clinical and Imaging Features Associated with an Increased Risk of Late Stroke in Patients with Asymptomatic Carotid Disease

    DEFF Research Database (Denmark)

    Naylor, A R; Schroeder, T V; Sillesen, H

    2014-01-01

    BACKGROUND: The 2011 American Heart Association Guidelines on the management of asymptomatic carotid disease recommends that carotid endarterectomy (CEA) (with carotid artery stenting (CAS) as an alternative) may be considered in highly selected patients with 70-99% stenoses. However, no guidance...... was provided as to what "highly selected" meant. This caveat is, however, important as up to 95% of asymptomatic individuals undergoing prophylactic CEA or CAS will ultimately undergo an unnecessary procedure. Even if the procedural risk following CEA or CAS could be reduced to 0%; 93% of patients would still....../CAS. METHODS: Review of clinical and/or imaging based scoring systems, predictive algorithms and imaging parameters that may be associated with an increased (or decreased) risk of stroke in patients with asymptomatic carotid disease. RESULTS: Parameters associated with an increased risk of late stroke include...

  1. Risk of thyroid cancer in euthyroid asymptomatic patients with thyroid nodules with an emphasis on family history of thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    JHwang, Shin Hye; Kim, Eun Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Kwak, Jin Young [Dept. of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-04-15

    To determine the factors associated with thyroid cancer, focusing on first-degree family history and ultrasonography (US) features, in euthyroid asymptomatic patients with thyroid nodules. This retrospective study included 1310 thyroid nodules of 1254 euthyroid asymptomatic patients who underwent US-guided fine-needle aspiration biopsy between November 2012 and August 2013. Nodule size and clinical risk factors- such as patient age, gender, first-degree family history of thyroid cancer, multiplicity on US and serum thyroid stimulating hormone (TSH) levels - were considered together with US features to compare benign and malignant nodules. Multiple logistic regression analysis was performed to assess the risk of thyroid malignancy according to clinical and US characteristics. Although all of the clinical factors and US findings were significantly different between patients with benign and malignant nodules, a solitary lesion on US (p = 0.041–0.043), US features and male gender (p < 0.001) were significant independent risk factors for thyroid malignancy in a multivariate analysis. Patient age, a first-degree family history of thyroid cancer and high normal serum TSH levels did not independently significantly increase the risk of thyroid cancer. However, multicollinearity existed between US assessment and patient age, first-degree family history of thyroid cancer and serum TSH values. Ultrasonography findings should be the primary criterion used to decide the management of euthyroid asymptomatic patients with thyroid nodules. The concept of first-degree family history as a risk factor for thyroid malignancy should be further studied in asymptomatic patients.

  2. VARIATION IN PRACTICE OF THE DIAGNOSTIC WORKUP OF ASYMPTOMATIC PATIENTS DIAGNOSED WITH INVASIVE BREAST CANCER

    Directory of Open Access Journals (Sweden)

    Anees eChagpar

    2016-03-01

    Full Text Available Introduction:Breast cancer is frequently diagnosed, yet variation remains in terms of practice patterns in presurgical workup. We sought to determine factors associated with this variation.Methods:An anonymous web-based survey was distributed to surgeons regarding their practices. Statistical analyses were conducted using SPSS.Results:253 surgeons responded to the survey. 17.0% were in academic practice, 37.5%% were hospital employed, and 41.5% were in private practice. 53.3% claimed that > 50% of their practice was breast-related. Surgeons were asked how often they would use various tests in the workup of an otherwise healthy asymptomatic patients, presenting with a non-palpable mammographic abnormality and a core needle biopsy showing invasive breast cancer. 23.5% stated they always would obtain a breast ultrasound, 17.2% stated they never would. 12.8% stated they never order a breast MRI; 4.1% always would. Workup of patients did not vary significantly based on number of years in practice nor practice setting. However, those whose practice was >50% breast were more likely to state that they would always order a breast ultrasound (32.5% vs. 12.9%, p<0.001, and less likely to state they would never order a breast MRI (3.4% vs. 25.8%, p<0.001. However, the proportions of surgeons who would always order a breast MRI was similar in the two groups (3.4% and 3.2%, respectively. Conclusions:These data highlight the lack of uniformity in the workup of asymptomatic patients presenting with non-palpable breast cancers, pointing to potential areas for improving value by minimizing variability.

  3. [Caries status in diabetic patients].

    Science.gov (United States)

    Albrecht, M; Bánóczy, J; Dinya, E; Tamás, G

    1991-09-01

    Clinical dental examination of 1600 diabetics (815 type 1 insulin dependent and 761 type 2 non-insulin dependent patients) has been performed according to the WHD criteria. According to examination results higher DMF mean value, less uncared of teeth with caries (D) and, in the age group of 19 years and above 30 years, more edentulousness has been found than with healthy individuals. The number of filled and crowded teeth (F) below the age of 35 years in diabetics (p 0.0001), above 45 years in the control group (p 0.0001) was higher. Concerning cared of teeth there was no deviation in the number of filled teeth between diabetic and healthy individuals whereas the number of crown covered teeth was higher with diabetics. (p 0.01). As to the distribution of individuals with healthy teeth and toothless ones it was found characteristic that while among diabetic individuals but 1%, in the control 1.4% possessed retained healthy teeth. The number of completely toothless individuals was higher (11.83%) with diabetics than with healthy individuals (2.25%).

  4. Preoperative Evaluation of Patients with Diabetes Mellitus.

    Science.gov (United States)

    Miller, Joshua D; Richman, Deborah C

    2016-03-01

    There are more than 29 million people in the United States with diabetes; it is estimated that by 2050, one in 3 individuals will have the disease. At least 50% of patients with diabetes are expected to undergo surgery in their lifetime. Complications from uncontrolled diabetes can impact multiple organ systems and affect perioperative risk. In this review, the authors discuss principles in diabetes management that will assist the perioperative clinician in caring for patients with diabetes.

  5. The immunophenotypic fingerprint of patients with primary antibody deficiencies is partially present in their asymptomatic first-degree relatives.

    Science.gov (United States)

    Bogaert, Delfien J A; De Bruyne, Marieke; Debacker, Veronique; Depuydt, Pauline; De Preter, Katleen; Bonroy, Carolien; Philippé, Jan; Bordon, Victoria; Lambrecht, Bart N; Kerre, Tessa; Cerutti, Andrea; Vermaelen, Karim Y; Haerynck, Filomeen; Dullaers, Melissa

    2017-01-01

    The etiology of primary antibody deficiencies is largely unknown. Beside rare monogenic forms, the majority of cases seem to have a more complex genetic basis. Whereas common variable immunodeficiency has been investigated in depth, there are only a few reports on milder primary antibody deficiencies such as idiopathic primary hypogammaglobulinemia and IgG subclass deficiency. We performed flow cytometric immunophenotyping in 33 patients with common variable immunodeficiency, 23 with idiopathic primary hypogammaglobulinemia and 21 with IgG subclass deficiency, as well as in 47 asymptomatic first-degree family members of patients and 101 unrelated healthy controls. All three groups of patients showed decreased memory B- and naïve T-cell subsets and decreased B-cell activating factor receptor expression. In contrast, circulating follicular helper T-cell frequency and expression of inducible T-cell co-stimulator and chemokine receptors were only significantly altered in patients with common variable immunodeficiency. Asymptomatic first-degree family members of patients demonstrated similar, albeit intermediate, alterations in naïve and memory B- and T-cell subsets. About 13% of asymptomatic relatives had an abnormal peripheral B-cell composition. Furthermore, asymptomatic relatives showed decreased levels of CD4(+) recent thymic emigrants and increased central memory T cells. Serum IgG and IgM levels were also significantly lower in asymptomatic relatives than in healthy controls. We conclude that, in our cohort, the immunophenotypic landscape of primary antibody deficiencies comprises a spectrum, in which some alterations are shared between all primary antibody deficiencies whereas others are only associated with common variable immunodeficiency. Importantly, asymptomatic first-degree family members of patients were found to have an intermediate phenotype for peripheral B- and T-cell subsets.

  6. The impact of HIV infection on blood leukocyte responsiveness to bacterial stimulation in asymptomatic patients and patients with bloodstream infection

    Directory of Open Access Journals (Sweden)

    Michaëla A M Huson

    2016-05-01

    Full Text Available Introduction: HIV-induced changes in cytokine responses to bacteria may influence susceptibility to bacterial infections and the consequent inflammatory response. Methods: We examined the impact of HIV on whole blood responsiveness to bacterial stimulation in asymptomatic subjects and patients with bacterial bloodstream infection (BSI. Whole blood was stimulated ex vivo with two bacterial Toll-like receptor agonists (lipopolysaccharide and lipoteichoic acid and two pathogens (Streptococcus pneumoniae and non-typhoidal Salmonella, which are relevant in HIV-positive patients. Production of interferon-γ, tumour necrosis factor-α, interleukin-1β and interleukin-6 was used as a read-out. Results: In asymptomatic subjects, HIV infection was associated with reduced interferon-γ, release after stimulation and priming of the pro-inflammatory cytokine response to non-typhoidal Salmonella. In patients with BSI, we found no such priming effect, nor was there evidence for more profound sepsis-induced immunosuppression in BSI patients with HIV co-infection. Conclusions: These results suggest a complex effect of HIV on leukocyte responses to bacteria. However, in patients with sepsis, leukocyte responses were equally blunted in patients with and without HIV infection.

  7. Disseminated infection with Strongyloides stercoralis in a diabetic patient

    Directory of Open Access Journals (Sweden)

    Murali A

    2010-01-01

    Full Text Available A 58-year-old male diabetic who was operated for carcinoma larynx 4 years back was admitted with exertional dyspnoea and bilateral leg swelling for the past 2 years. Over the last 2 months, there was a progressive worsening of symptoms. Echocardiography done 2 years back showed pericardial effusion. Echo done during the current admission also showed pericardial effusion with preserved left ventricular function; cytological examination of the pericardial fluid showed larvae of Strongyloides stercoralis. He was treated with antinematodal drugs. A follow-up echo done at discharge showed no pericardial effusion and the patient was completely asymptomatic. To our knowledge, this is the first reported case of Strongyloides pericardial effusion in a diabetic patient.

  8. Reliability of treating asymptomatic traumatic type II dens fractures in patients over age 80: A retrospective series

    Directory of Open Access Journals (Sweden)

    Eric Momin

    2015-01-01

    Full Text Available Background: Management of type II odontoid fractures in elderly remains controversial to whether surgical treatment is favored over conservative one. This is a study of geriatric patients with asymptomatic type II dens fractures who after sustaining a fall were initially evaluated at community hospitals. They were placed in a rigid collar and were followed up in a spine clinic. Purpose: To assess the reliability of treating very old patients with type II dens fracture conservatively and whether surgical intervention if needed would affect the clinical outcome. Study Design: Retrospective study with the literature review. Patient Sample: Consecutive patients above 80 years of age, who sustained a clinically asymptomatic type II dens fracture and were observed after a conservative treatment plan, was initiated. Outcome Measures: Outcome measures included self-reported worsening neck pain, neurological function, and radiographic measures over the follow-up period. Materials and Methods: A retrospective clinical analysis of 5 active geriatric patients with type II asymptomatic dens fracture. After evaluating them, treatment options were discussed with patients and their family members. The decision was to continue to follow them with a rigid collar very closely since they were reluctant to undergo any surgical procedure. Results: Patients were followed for an average of 29 months. They were observed for any worsening neck pain, neurological deficit, or deterioration of fracture on follow-up imaging studies. At last follow-up, 2 of 5 patients continued to be asymptomatic, the 3 rd died of unrelated causes while 2 others required surgeries at least 1-year post injury. Conclusions: Treatment of type II dens fractures in the elderly is controversial. Independent elderly patients who are asymptomatic at presentation may be safe to be followed up very closely with a neck brace and serial X-ray. Converting to surgical treatment can be done safely when

  9. Clinical Guidance on Screening Chronic Kidney Disease in Type 2 Diabetic Patients for Family Physicians

    Directory of Open Access Journals (Sweden)

    Seyed Esmaeil Managheb

    2015-10-01

    Full Text Available Incidence of diabetes is increasing in developing countries as well as Iran. Half of the patients are not aware of their disease so screening of diabetes is necessary. Lifestyle changes in society, high-saturated fat diet and decreased physical activity are the factors that influence the growing rate of diabetes in Iran.1 The need for addressing type 2 diabetes has been clarified for family physicians.2 Diabetes is a common disease that is associated with significant morbidity and mortality. It has an asymptomatic stage that may be present for up to several years before diagnosis.3 Diabetes is the leading cause of kidney disease.4 In a study among patients over 45 years with type 2 diabetes, these results were reported: 22% suffered from retinopathy, 7% had impaired vision, 6% had kidney diseases, 9% had clinical symptoms, and 19.1% were at risk for foot ulcers.5 Early treatment of type 2 diabetes can reduce or delay complications.6 Optimal glycemia and BP are important in the prevention of diabetic chronic kidney disease (CKD.4 Therapeutic goals in patients with complications, such as CKD, include maintaining renal function and stopping the trend of renal deterioration.5 Progression of diabetic nephropathy can be slowed through the use of some medications.4 How to screen and manage chronic kidney disease in patients with type 2 diabetes is shown in Figure 1.

  10. EP Testing in Asymptomatic Brugada Patients with Recurrent Palpitations. Just do it!

    Directory of Open Access Journals (Sweden)

    Filippo Maria Cauti

    2016-09-01

    Full Text Available Brugada syndrome is a rare heritable arrhythmogenic disease characterized by a coved ST segment elevation in the right precordial leads and by an increased risk of sudden cardiac arrest as a result of polymorphic ventricular tachyarrhythmias or ventricular fibrillation (1. Although implantable cardioverter defibrillators are considered to be the main therapy in patients with a history of ventricular arrhythmias or syncope, risk stratification in cases without these symptoms remains controversial. Patients with confirmed Brugada pattern and a history of palpitations without major events should be scheduled for risk stratification. Even though its value has been questioned, inducibility of VTs/VF at programmed electric stimulation is widely used to select candidates to receive a prophylactic implantable cardiac defibrillator in these categories. Herein, we report a patient with type I Electrocardiogram (ECG pattern induced at the Ajmaline test and a family history of sudden cardiac death who had episodes of palpitations. We describe and discuss our management proving the importance of complete electrophysiological testing in the setting of Brugada asymptomatic patients’ risk stratification.

  11. AIDS Cholangiopathy in an Asymptomatic, Previously Undiagnosed Late-Stage HIV-Positive Patient from Kenya

    Directory of Open Access Journals (Sweden)

    Yiming Gao

    2011-01-01

    Full Text Available AIDS-associated cholangiopathy is a form of biliary tract inflammation with stricture formation seen in AIDS patients who are severely immunosuppressed. It is no longer common in countries in which HAART therapy is widely employed but is still seen in underdeveloped countries. The majority of patients are symptomatic at the time of presentation. Herein, we describe a seventy-four-year-old woman who presented with unilateral leg swelling after a prolonged airplane flight. She was otherwise entirely asymptomatic. Routine laboratory testing was notable for a hypochromic microcytic anemia, slight leukopenia, and mild hypoalbuminemia. Liver enzymes were all elevated. Deep venous thrombosis was confirmed, and a CT scan of the chest disclosed no pulmonary emboli. However, the visualized portion of the abdomen showed dilatation of the common bile and pancreatic ducts. This was confirmed on ultrasonography and MRCP, and no obstructive lesions were noted. An ERCP revealed a dilated common bile duct without filling defects or strictures. A balloon occlusion cholangiogram showed strictures and beading of the intrahepatic ducts. Shortly thereafter, serology for HIV returned positive along with a depressed CD4 cell count, and the patient was diagnosed with AIDS-associated cholangiography.

  12. Dental loss among ambulatory patients with diabetes

    Directory of Open Access Journals (Sweden)

    Kenneth E. Izuora

    2016-06-01

    Conclusions: Dental loss is common in patients with diabetes and is associated with older age, diabetic retinopathy and not flossing. In order to reduce dental loss among patients with diabetes, regular flossing should be emphasized as an important component of dental care.

  13. Left Atrial Volume as Predictor of Valve Replacement and Cardiovascular Events in Patients with Asymptomatic Mild to Moderate Aortic Stenosis

    DEFF Research Database (Denmark)

    Dalsgaard, Morten; Egstrup, Kenneth; Wachtell, Kristian

    2013-01-01

    Left atrial (LA) size is known to increase with chronically increased left ventricular (LV) filling pressure. We hypothesized that LA volume was predictive of aortic valve replacement (AVR) and cardiovascular events in a large cohort of patients with asymptomatic mild to moderate aortic valve...... stenosis....

  14. Current strategy for treatment of patients with Wolff-Parkinson-White syndrome and asymptomatic preexcitation in Europe

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Dagres, Nikolaos; Dobreanu, Dan

    2013-01-01

    The aims of this survey was to provide insight into treatment activity, the strategy of treatment, and risk stratification of patients with asymptomatic and symptomatic ventricular pre-excitation across Europe. Fifty-eight centres, members of the European Heart Rhythm Association EP research...

  15. Evaluating a Hospitalist-Based Intervention to Decrease Unnecessary Antimicrobial Use in Patients With Asymptomatic Bacteriuria.

    Science.gov (United States)

    Hartley, Sarah E; Kuhn, Latoya; Valley, Staci; Washer, Laraine L; Gandhi, Tejal; Meddings, Jennifer; Robida, Michelle; Sabnis, Salas; Chenoweth, Carol; Malani, Anurag N; Saint, Sanjay; Flanders, Scott A

    2016-09-01

    OBJECTIVE Inappropriate treatment of asymptomatic bacteriuria (ASB) in the hospital setting is common. We sought to evaluate the treatment rate of ASB at the 3 hospitals and assess the impact of a hospitalist-focused improvement intervention. DESIGN Prospective, interventional trial. SETTING Two community hospitals and a tertiary-care academic center. PATIENTS Adult patients with a positive urine culture admitted to hospitalist services were included in this study. Exclusions included pregnancy, intensive care unit admission, history of a major urinary procedure, and actively being treated for a urinary tract infection (UTI) at the time of admission or >48 hours prior to urine collection. INTERVENTIONS An educational intervention using a pocket card was implemented at all sites followed by a pharmacist-based intervention at the academic center. Medical records of the first 50 eligible patients at each site were reviewed at baseline and after each intervention for signs and symptoms of UTI, microbiological results, antimicrobials used, and duration of treatment for positive urine cultures. Diagnosis of ASB was determined through adjudication by 2 hospitalists and 2 infectious diseases physicians. RESULTS Treatment rates of ASB decreased (23.5%; P=.001) after the educational intervention. Reductions in treatment rates for ASB differed by site and were greatest in patients without classic signs and symptoms of UTI (34.1%; P<.001) or urinary catheters (31.2%; P<.001). The pharmacist-based intervention was most effective at reducing ASB treatment rates in catheterized patients. CONCLUSIONS A hospitalist-focused educational intervention significantly reduced ASB treatment rates. The impact varied across sites and by patient characteristics, suggesting that a tailored approach may be useful. Infect Control Hosp Epidemiol 2016;37:1044-1051.

  16. Osteoprotegerin and coronary artery disease in type 2 diabetic patients with microalbuminuria

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Nybo, Mads; Hansen, Peter R

    2011-01-01

    Plasma osteoprotegerin (P-OPG) is an independent predictor of cardiovascular disease in diabetic and other populations. OPG is a bone-related glycopeptide produced by vascular smooth muscle cells and increased P-OPG may reflect arterial damage. We investigated the correlation between P-OPG and co......-OPG and coronary artery disease (CAD) in asymptomatic type 2 diabetic patients with microalbuminuria.......Plasma osteoprotegerin (P-OPG) is an independent predictor of cardiovascular disease in diabetic and other populations. OPG is a bone-related glycopeptide produced by vascular smooth muscle cells and increased P-OPG may reflect arterial damage. We investigated the correlation between P...

  17. Indistinguishable cellular changes in gastric mucosa between helicobacter pylori infected asymptomatic tribal and duodenal ulcer patients

    Institute of Scientific and Technical Information of China (English)

    Dhira Rani Saha; Simanti Datta; Santanu Chattopadhyay; Rajashree Patra; Ronita De; Krishnan Rajendran; Abhijit Chowdhury; Thandavaryan Ramamurthy; Asish Kumar Mukhopadhyay

    2009-01-01

    AIM: To investigate the changing pattern of different histological parameters occurring in the stomach tissue of Helicobacter pylori (H pylori) infected tribal populations and duodenal ulcer patients among ethnic Bengalis and correlation of the genotypes of H pylori with different histological parameters.METHODS: One hundred and twelve adult individuals were enrolled into this study between 2002 and 2004. Among them, 72 had clinical features of duodenal ulcer (DU) from ethnic Bengali population and 40 were asymptomatic ethnic tribals. Endoscopic gastric biopsy samples were processed for histology, genotyping and rapid urease test. Histologically,haematoxylin and eosin staining was applied to assess the pathomorphological changes and a modified Giemsa staining was used for better detection of Hpylori. For intestinal metaplasia, special stainings, i.e.AIcian blue periodic acid-Schiff and high iron diamineAIcian blue staining, were performed. PCR was performed on bacterial DNA to characterize the presence or absence of virulence-associated genes, like cagA, and distribution of different alleles of vacA and iceA .RESULTS: Intraglandular neutrophil infiltration, a hallmark of activity of gastritis, was present in 34 (94%) of tribals (TRs) and 42 (84%) of DU individuals infected with Hpylori. Lymphoid follicles and aggregates, which are important landmarks in H pylori infection, were positive amongst 15 (41%) of TRs and 20 (40%) of DU subjects. Atrophic changes were observed in 60% and 27.7%, respectively, among DU cases and tribals (P > 0.003). Metaplastic changes were detected in low numbers in both groups. Moderate to severe density distribution of Hpylori in the gastric mucosa was 63% among TRs, whereas it was 62% in DU subjects. There were no significant differences in the distribution of virulence-associated genes like cagA, vacA and iceA of Hpylori strains carried by these two populations.CONCLUSION: Our study showed almost similar distribution of inflammatory

  18. CT measurement of changes in cerebral perfusion in patients with asymptomatic carotid artery stenosis undergoing carotid stenting prior to cardiac surgery: "proof of principle"

    NARCIS (Netherlands)

    Heyden, J. Van der; Waaijer, A.; Wouter, E.S. Van; Neerven, D. van; Sonker, U.; Suttorp, M.J.; Bal, E.T.; Prokop, M.

    2011-01-01

    AIMS: To identify asymptomatic patients with impaired cerebral perfusion using CT perfusion (CTP) technique during staged carotid stenting (CAS) and cardiac surgery. METHODS AND RESULTS: This is a prospective, non-randomised study in 16 neurologically asymptomatic patients designed to analyse cerebr

  19. Four-year clinical outcome in asymptomatic patients undergoing coronary computed tomography angiography

    Institute of Scientific and Technical Information of China (English)

    ZHANG Kai-yi; GAI Lu-yue; GAI Jing-jing; HE Bin; GUAN Zhi-wei

    2013-01-01

    Background Percutaneous coronary intervention (PCI) is indicated for angina with coronary stenosis.However,PCI for asymptomatic coronary stenosis remains controversial.We prospectively followed a group of patients for four years who underwent coronary computed tomography angiography (CCTA) for major adverse cardiac events (MACE).We hypothesized that the results of this trial would reliably reflect the natural outcome of the coronary disease.Methods Consecutive patients who underwent CCTA from June 2008 to May 2009 were selected.Those who could not be reached by telephone,had significant angina,had CT images that were not interpretable,or poor kidney and left ventricular (LV) function were excluded.The patients were divided into five groups:group A normal CCTA without stenosis,group B mild stenosis (1%-49%),group C moderate stenosis (50%-74%),group D severe stenosis (≥75%) and they were treated with optimal medical therapy (OMT) or PCI.The group E had PCI before the CCTA examination.The patients were then followed for MACE after different treatments.MACE included acute myocardial infarction (MI),heart failure (HF) and death.Results The patient population consisted of 419 patients.The follow-up time was (51±5) months.The age was (60±31)years.Male made up 67.78% of the population (n=284).A total of 51 cases of MACE occurred including 25 MI,eight HF and 18 all-cause deaths.There was no MACE in group A.Although MACE occurred in two patients in group B,they were not attributed to cardiac death.We further compared the MACE in groups C-E and no significant difference was found (P >0.05).However,a difference was detected among patients with unstable angina pectoris (UAP),stable angina pectoris (SAP),re-hospitalization,and cerebrovascular events from groups A-E (P <0.05).The plaque scores were used to predict MACE.The scores progressively increased significantly with lesion severity (P <0.05).Receiver operating curve (ROC) was performed to determine the

  20. High frequency of asymptomatic hyperparathyroidism in patients with fibromyalgia: random association or misdiagnosis?

    Directory of Open Access Journals (Sweden)

    Juliana Maria de Freitas Trindade Costa

    Full Text Available ABSTRACT Fibromyalgia (FM and hyperparathyroidism may present similar symptoms (musculoskeletal pain, cognitive disorders, insomnia, depression and anxiety, causing diagnostic confusion. Objectives: To determine the frequency of asymptomatic hyperparathyroidism in a sample of patients with FM and to evaluate the association of laboratory abnormalities to clinical symptoms. Methods: Cross-sectional study with 100 women with FM and 57 healthy women (comparison group. Parathyroid hormone (PTH, calcium and albumin levels were accessed, as well as symptoms in the FM group. Results: In FM group, mean serum calcium (9.6 ± 0.98 mg/dL and PTH (57.06 ± 68.98 pg/mL values were considered normal, although PTH levels had been significantly higher than in the comparison group (37.12 ± 19.02 pg/mL; p = 0.001. Hypercalcemic hyperparathyroidism was diagnosed in 6% of patients with FM, and 17% of these women exhibited only high levels of PTH, featuring a normocalcemic hyperparathyroidism, with higher frequencies than those expected for their age. There was no significant association between hyperparathyroidism and FM symptoms, except for epigastric pain, which was more frequent in the group of patients concomitantly with both diseases (p = 0.012. Conclusions: A high frequency of hyperparathyroidism was noted in women with FM versus the general population. Normocalcemic hyperparathyroidism was also more frequent in patients with FM. Longitudinal studies with greater number of patients are needed to assess whether this is an association by chance only, if the increased serum levels of PTH are part of FM pathophysiology, or even if these would not be cases of FM, but of hyperparathyroidism.

  1. The Role of Gratitude in Spiritual Well-being in Asymptomatic Heart Failure Patients.

    Science.gov (United States)

    Mills, Paul J; Redwine, Laura; Wilson, Kathleen; Pung, Meredith A; Chinh, Kelly; Greenberg, Barry H; Lunde, Ottar; Maisel, Alan; Raisinghani, Ajit; Wood, Alex; Chopra, Deepak

    2015-03-01

    Spirituality and gratitude are associated with wellbeing. Few if any studies have examined the role of gratitude in heart failure (HF) patients or whether it is a mechanism through which spirituality may exert its beneficial effects on physical and mental health in this clinical population. This study examined associations bet ween gratitude, spiritual wellbeing, sleep, mood, fatigue, cardiac-specific self-efficacy, and inflammation in 186 men and women with Stage B asymptomatic HF (age 66.5 years ±10). In correlational analysis, gratitude was associated with better sleep (r=-.25, pspirituality exerts its beneficial effects through gratitude. We found that gratitude fully mediated the relationship between spiritual wellbeing and sleep quality (z=-2.35, SE=.03, p=.02) and also the relationship between spiritual wellbeing and depressed mood (z=-4.00, SE=.075, pspiritual wellbeing and fatigue (z=-3.85, SE=.18, pspiritual wellbeing and self-efficacy (z=2.91, SE=.04, p=.003). In sum, we report that gratitude and spiritual wellbeing are related to better mood and sleep, less fatigue, and more self-efficacy, and that gratitude fully or partially mediates the beneficial effects of spiritual wellbeing on these endpoints. Efforts to increase gratitude may be a treatment for improving wellbeing in HF patients' lives and be of potential clinical value.

  2. Neuropsychological Changes and Health-related Quality of Life in Patients with Asymptomatic Primary Hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Banu Aktaş Yılmaz

    2017-03-01

    Full Text Available Purpose: Data about neuropsychological impairment and health-related quality of life (HRQOL in patients with asymptomatic primary hyperparathyroidism (APHPT is limited. We aimed to investigate the HRQOL, neuropyschological impairment, including depression, anxiety in patients with APHPT who have mildly elevated serum calcium (Ca levels. Material and Method: Thirty-seven patients with APHPT and 37 controls were included. The Beck Depression Inventory (BDI, Spielberger State-Trait Anxiety Inventory (STAI, and the General Health Questionnaire were administered in all patients, HRQOL was investigated using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36. Results: Serum levels of Ca and parathyroid hormone (PTH were significantly higher in patients than in controls [(10.92±0.66 vs. 9.49±0.66, p=0.016, and 133 (34-736 vs. 52.95 (25-75.50, p<0.001, respectively]. The levels of serum vitamin D were lower in patients than in controls [12.85 (4.0-62.50 vs. 20.30 (5.90-55.00, p=0.041]. The patient group had higher BDI scores than controls (12.49±10.34 vs. 7.46±5.33, p=0.011. Patients with APHPT showed lower scores in SF-36 mental health (60.55±20.75 vs. 69.62±14.31, p=0.034, SF-36 physical functioning (55.83±27.30 vs. 75.67±24.18, p=0.002, SF-36 social functioning (66.32±27.69 vs. 82.08±14.89, p=0.003, and SF-36 emotional role functioning (42.55±37.85 vs. 69.30±35.43, p=0.003. The patients showed higher STAI-1 scores (39.95±11.52 vs. 34.70±8.01, p=0.026. We observed that STAI-1 score positively correlated with serum Ca level (r=0.391; p=0.018; and PTH (r=0.341; p=0.042. Discussion: Our study demonstrated that patients with APHPT have more depressive and anxiety symptoms and lower HRQOL. Our results suggest that HRQOL and neuropsychological changes should also be considered during the clinical follow-up of patients with APHT.

  3. Evaluation of microalbuminuria in relation to asymptomatic bacteruria in Nigerian patients with sickle cell anemia

    Directory of Open Access Journals (Sweden)

    B A Iwalokun

    2012-01-01

    Full Text Available Studies have identified microalbuminuria (MA and asymptomatic bacteruria (ASB as co-morbid factors in sickle cell anemia (SCA. However, the relationship between these comorbid factors remains unclear and data are lacking for Nigerian patients. This study determined the prevalence of MA and ASB in a cohort of patients with SCA in a steady state, in Lagos, Nigeria. Early morning mid-stream urine samples were collected in sterile bottles from 103 patients comprising 48 males and 55 females with a mean age of 10.4 years. Aerobic culture and colony count of organisms was done using conventional methods. Serum creatinine and hematological indices, including irreversibly sickled cells (ISC, were also assayed. Of the 103 urine samples screened, 23 (22.3% had albuminuria (ALB, and consisted of nine males and 14 females (P > 0.05; 16.5% of the cases had MA (P 0.05. The prevalence of confirmed ASB was 14.6%, with females accounting for 14 of 19 probable ASB cases (P <0.05. Univariate regression analysis demonstrated a significant (P <0.05 association between age at onset of MA, hemoglobin level, reticulocyte count, ISC and occurrence of ASB, but with only ISC evolving as an independent predictor. Twenty-eight bacterial isolates predominated by Escherichia coli (39.3%; P <0.05, of whom 89.3% were multi-drug resistant, were recovered from the ASB urine samples. In conclusion, both MA and ASB are common in Nigerian SCA patients, with the former occurring from the first decade of life.

  4. Relation of left ventricular function, mass, and volume to NT-proBNP in type 1 diabetic patients

    DEFF Research Database (Denmark)

    Astrup, Anne Sofie; Kim, Won Yong; Tarnow, Lise;

    2008-01-01

    OBJECTIVES-To measure left ventricular mass (LVM), left ventricular volumes, and left ventricular function (LVF) in a cohort of type 1 diabetic patients and to correlate measures of imaging to NH2-terminal pro-brain natriuretic peptide (NT-proBNP). RESEARCH DESIGN AND METHODS-In a cross......-sectional study, all patients with type 1 diabetes underwent cardiovascular magnetic resonance imaging. We included 63 patients with diabetic nephropathy and 73 patients with normoalbuminuria. RESULTS-All patients had normal global LVF. LVM was increased in patients with diabetic nephropathy compared...... is identified in asymptomatic type 1 diabetic patients with nephropathy compared with normoalbuminuric patients. Elevated levels of NT-proBNP were associated with increased LVM, which are both markers of increased cardiovascular risk....

  5. Relation of left ventricular function, mass, and volume to NT-proBNP in type 1 diabetic patients

    DEFF Research Database (Denmark)

    Astrup, A.S.; Kim, W.Y.; Tarnow, L.;

    2008-01-01

    OBJECTIVES: To measure left ventricular mass (LVM), left ventricular volumes, and left ventricular function (LVF) in a cohort of type 1 diabetic patients and to correlate measures of imaging to NH(2)-terminal pro-brain natriuretic peptide (NT-proBNP). RESEARCH DESIGN AND METHODS: In a cross......-sectional study, all patients with type 1 diabetes underwent cardiovascular magnetic resonance imaging. We included 63 patients with diabetic nephropathy and 73 patients with normoalbuminuria. RESULTS: All patients had normal global LVF. LVM was increased in patients with diabetic nephropathy compared...... is identified in asymptomatic type 1 diabetic patients with nephropathy compared with normoalbuminuric patients. Elevated levels of NT-proBNP were associated with increased LVM, which are both markers of increased cardiovascular risk Udgivelsesdato: 2008/5...

  6. Characteristics of the Motor Units during Sternocleidomastoid Isometric Flexion among Patients with Mechanical Neck Disorder and Asymptomatic Individuals

    Science.gov (United States)

    Yang, Chia-Chi; Su, Fong-Chin; Yang, Po-Ching; Lin, Hwai-Ting

    2016-01-01

    Mechanical neck disorder is a widespread and non-neurological musculoskeletal condition resulting from modern lifestyles. Presently, the fundamental electrophysiological properties of the motor units of the sternocleidomastoid muscles and the characteristics of the short-term synchronization of the motor unit in patients with neck pain are ambiguous. This study therefore aims to clarify the fundamental electrophysiological properties of the motor units of the sternocleidomastoid muscles in patients with mechanical neck disorder and in asymptomatic individuals. We further investigated whether alterations in the degree of motor unit short-term synchronization occur. The surface electrophysiological signals of the bilateral sternal heads of the sternocleidomastoid muscles of twelve patients with mechanical neck disorder and asymptomatic individuals were detected at 25% of the maximum voluntary contraction during cervical isometric flexion and then decomposed into individual motor unit action potential trains. We found that the patients with mechanical neck disorder showed significantly higher initial and mean firing rates of the sternocleidomastoid muscles and displayed substantially lower motor unit short-term synchronization values compared with the asymptomatic subjects. Consequently, these convincing findings support the assertion that patients with mechanical neck disorder display altered neuromuscular control strategies, such as the reinforcement of motor unit recruitment firing rates in the sternocleidomastoid muscles. The motor units of these patients also revealed neural recruitment strategies with relatively poor efficiency when executing the required motor tasks. PMID:27941995

  7. Occurrence of maxillary sinus abnormalities detected by cone beam CT in asymptomatic patients

    Directory of Open Access Journals (Sweden)

    Rege Inara Carneiro

    2012-08-01

    Full Text Available Abstract Background Although cone beam computed tomography (CBCT images of the maxillofacial region allow the inspection of the entire volume of the maxillary sinus (MS, identifying anatomic variations and abnormalities in the image volume, this is frequently neglected by oral radiologists when interpreting images of areas at a distance from the dentoalveolar region, such as the full anatomical aspect of the MS. The aim of this study was to investigate maxillary sinus abnormalities in asymptomatic patients by using CBCT. Methods 1113 CBCT were evaluated by two examiners and identification of abnormalities, the presence of periapical lesions and proximity to the lower sinus wall were recorded. Data were analyzed using descriptive statistics, chi-square tests and Kappa statistics. Results Abnormalities were diagnosed in 68.2% of cases (kappa = 0.83. There was a significant difference between genders (p Conclusions Abnormalities in maxillary sinus emphasizes how important it is for the dentomaxillofacial radiologist to undertake an interpretation of the whole volume of CBCT images.

  8. Periodontal health and diabetes awareness among Saudi diabetes patients

    Directory of Open Access Journals (Sweden)

    Bahammam MA

    2015-02-01

    Full Text Available Maha A BahammamDepartment of Periodontology, King Abdulaziz University Faculty of Dentistry, Jeddah, Kingdom of Saudi ArabiaPurpose: This study aimed to examine diabetic patients in Jeddah, Saudi Arabia, regarding their general diabetic and oral health-related awareness and practices, their awareness of the association of diabetes with periodontal disease, and their sources of diabetes-related information.Methods: Diabetic patients (n=454 who were receiving care at the diabetes clinic in King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from October 2013 to May 2014, completed a six-part questionnaire assessing their sociodemographic characteristics, general and oral health awareness and practices, and sources of diabetes-related information. Descriptive statistics were used to report the results.Results: The responses indicated inadequate health-related practices in the surveyed group: 22.2% brushed their teeth twice daily, 73.6% never flossed their teeth, and while 80.2% visited a physician in the past year, only 12.6% visited a dentist during the same year. Of the respondents, 94.8% reported that they had never received advice on oral hygiene tasks in relation to diabetes from a health professional. Awareness about the diabetes and periodontal disease association was limited: 46.7% knew that diabetics have gum problems more often if their blood sugar stays very high, and only 21.8% knew that gum disease makes it harder to control blood sugar in diabetic patients. A significant association (P<0.05 was found between a higher level of education and greater general and oral awareness, as well as a significant association (P<0.05 between longer duration of disease, regular exercise, and regular visits to the physician and awareness about diabetes mellitus. Additionally, a significant association (P<0.05 was found between regular dental visits and both periodontal disease and diabetes awareness. Family and friends were the main source of

  9. Neuromuscular Characteristics of Rocuronium in Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Ahmet Topal

    2014-08-01

    Conclusion: We consider that the prolongation of onset of action time and recovery time in diabetic patients, is a complicaiton of diabetic neuropathy and diabetes may effect the pharmacodynamics of rocuronium. [Cukurova Med J 2014; 39(4.000: 807-813

  10. Assessing Optimal Blood Pressure in Patients With Asymptomatic Aortic Valve Stenosis The Simvastatin Ezetimibe in Aortic Stenosis Study (SEAS)

    DEFF Research Database (Denmark)

    Nielsen, O. W.; Sajadieh, A.; Sabbah, M.

    2016-01-01

    BACKGROUND: Evidence for treating hypertension in patients with asymptomatic aortic valve stenosis is scarce. We used data from the SEAS trial (Simvastatin Ezetimibe in Aortic Stenosis) to assess what blood pressure (BP) would be optimal. METHODS: A total of 1767 patients with asymptomatic aortic...... stenosis and no manifest atherosclerotic disease were analyzed. Outcomes were all-cause mortality, cardiovascular death, heart failure, stroke, myocardial infarction, and aortic valve replacement. BP was analyzed in Cox models as the cumulative average of serially measured BP and a time-varying covariate...... to 69 mm Hg taken as reference. Low systolic and diastolic BPs increased risk in patients with moderate aortic stenosis. With a time-varying systolic BP from 130 to 139 mm Hg used as reference, mortality was increased for systolic BP ≥160 mm Hg (HR, 1.7; P=0.033) and BP of 120 to 129 mm Hg (HR, 1.6; P=0...

  11. Gastric Strongyloidiasis in a Diabetic Patient

    Directory of Open Access Journals (Sweden)

    Şafak ERSÖZ

    2010-01-01

    Full Text Available Strongyloidiasis is a common parasitic infection. Gastric location of the parasite is quite rare. Patients at risk are those undergoing immunosuppressive therapy, individuals with malignant hematologic disorders, transplantations, diabetes mellitus, malnutrition, chronic renal failure, chronic alcohol consumption, patients with acquired immune deficiency syndrome and elderly people. We report an atypical presentation of strongyloidiasis with gastric involvement in a diabetic patient.

  12. [Diabetic patients survival rates in dialysis].

    Science.gov (United States)

    Cano, Noël

    2006-01-01

    Since the beginning of the eighties, the prevalence and incidence of diabetes have been increasing in dialysis units. In France, type 2 diabetes accounts for approximately 90% of diabetic hemodialysis patients. Among the etiologies of renal failure, diabetes is characterized by increased hospitalization rates and reduced quality of life, transplantation rates and survival. In dialysis patients, diabetes mellitus enhances the main factors leading to an increase in cardiovascular and non-cardiovascular deaths: inflammation, dyslipidemia, hypertension, increased energy expenditure, oxidative stress and plasma assymetrical dimethylarginine. The prevention of these complications includes the control of blood glucose, plasma lipids, hypertension, and anemia. The role of antioxidant therapies remains to be evaluated.

  13. Subclinical coronary atherosclerosis identified by coronary computed tomographic angiography in asymptomatic morbidly obese patients

    Directory of Open Access Journals (Sweden)

    Peter A. McCullough

    2010-09-01

    Full Text Available Obesity is a common public health problem and obese individuals in particular have a disproportionate incidence of acute coronary events. This study was undertaken to identify coronary artery lesions as well as associated clinical features, risk factors and demographics in patients with a body mass index (BMI >40 kg/m2 without known coronary artery disease (CAD. Morbidly obese subjects were prospectively recruited to undergo coronary computed tomographic angiography (CCTA using a dual-source computed tomography (CT system. CAD was defined as the presence of any atherosclerotic lesion in any one coronary artery segment. The presence, location, and severity of atherosclerosis were related to patient characteristics. Forty-one patients (28 women, mean age, 50.4±10.0 years, mean BMI, 43.8±4.8 kg/m2 served as the study population. Of these, 25 patients (61% had at least one coronary stenosis. All but 2 patients within the CAD cohort had coronary artery calcium (CAC scores >0, and most plaques identified (75.4% were non-calcified. There was a predilection of calcified and non-calcified atherosclerosis involving the left anterior descending (LAD coronary artery compared with other coronary segments. Univariate predictors of CAD included older age, dyslipidemia, and diabetes. In this preliminary study of young morbidly obese patients, CCTA detected a high prevalence of calcified and non-calcified CAD, although the later predominated.

  14. [Orthopaedic neurological diseases in patient with diabetes].

    Science.gov (United States)

    Natsume, Tadahiro; Hirata, Hitoshi

    2014-02-01

    Individuals with diabetes are at a greater risk for microvascular complications, such as retinopathy, neuropathy, and nephropathy, than are individuals without diabetes. Diabetic neuropathies are complex heterogeneous disorders that include both focal neuropathies and diffuse polyneuropathy. Entrapment neuropathy is an example of a focal neuropathy, while distal symmetric polyneuropathy is the most common type of diffuse polyneuropathy. Entrapment neuropathies are highly prevalent in the diabetic population, but they develop insidiously and progressively, making it difficult to determine their true prevalence. Entrapment neuropathies are suspected to be a more common complication of diabetes than is polyneuropathy. For example, carpal tunnel syndrome (CTS)-one of the most common entrapment neuropathies encountered in patients with diabetes-results from median nerve compression, and has been shown to occur three times more frequently in a diabetic population than in a normal healthy population. Entrapment neuropathies should be actively screened for in patients showing the signs and symptoms of neuropathy, because such patients may require surgical treatment.

  15. Elevated basal intestinal mucosal cytokine levels in asymptomatic first-degree relatives of patients with Crohn's disease

    Institute of Scientific and Technical Information of China (English)

    Anant VK Indaram; Santa Nandi; Sam Weissman; Sing Lam; Beverly Bailey; Meyer Blumstein; Ronald Greenberg; Simmy Bank

    2000-01-01

    AIM To determine levels of cytokines in colonic mucosa of asymptomatic first degree relatives of Crohn's disease patients.METHODS Cytokines (Interleukin (IL) 1-Beta,IL-2, IL-6 and IL-8) were measured using ELISA in biopsy samples of normal looking colonic mucosa of first degree relatives of Crohn's disease patients (n = 9) and from normal controls (n=10) with no family history of Crohn's disease.RESULTS Asymptomatic first degree relatives of patients with Crohn's disease had significantly higher levels of basal intestinal mucosal cytokines (IL-2, IL-6 and IL-8) than normal controls. Whether these increased cytokine levels serve as phenotypic markers for a genetic predisposition to developing Crohn's disease later on, or whether they indicate early (preclinical) damage has yet to be further defined.CONCLUSION Asymptomatic first degree relatives of Crohn's disease patients have higher levels of cytokines in their normal-looking intestinal mucosa compared to normal controls.This supports the hypothesis that increased cytokines may be a cause or an early event in the inflammatory cascade of Crohn's disease and are not merely a result of the inflammatory process.

  16. Abnormal lung gallium-67 uptake preceding pulmonary physiologic impairment in an asymptomatic patient with Pneumocystis carinii pneumonia

    Energy Technology Data Exchange (ETDEWEB)

    Reiss, T.F.; Golden, J. (Univ. of California, San Francisco (USA))

    1990-05-01

    Pneumocystis carinii pneumonia was suggested by a diffuse, bilateral pulmonary uptake of gallium-67 in an asymptomatic, homosexual male with the antibody to the immunodeficiency virus (HIV) who was undergoing staging evaluation for lymphoma clinically localized to a left inguinal lymph node. Chest radiograph and pulmonary function evaluation, including lung volumes, diffusing capacity and arterial blood gases, were within normal limits. Bronchoalveolar lavage revealed Pneumocystis carinii organisms. In this asymptomatic, HIV-positive patient, active alveolar infection, evidenced by abnormal gallium-67 scanning, predated pulmonary physiologic abnormalities. This observation raises questions concerning the natural history of this disease process and the specificity of physiologic tests for excluding disease. It also has implications for the treatment of neoplasia in the HIV-positive patient population.

  17. Comparison of erlotinib and pemetrexed as second-/third-line treatment for lung adenocarcinoma patients with asymptomatic brain metastases

    Directory of Open Access Journals (Sweden)

    He YY

    2016-04-01

    Full Text Available Yayi He,1,* Wenwen Sun,2,* Yan Wang,3,* Shengxiang Ren,1 Xuefei Li,3 Jiayu Li,3 Christopher J Rivard,4 Caicun Zhou,1 Fred R Hirsch4 1Department of Oncology, Shanghai Pulmonary Hospital, 2Clinic and Research Center of Tuberculosis, Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, 3Department of Lung Cancer and Immunology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, Shanghai, People’s Republic of China; 4Division of Medical Oncology, Department of Medicine, University of Colorado, Aurora, CO, USA *These authors contributed equally to this work Objective: Brain metastases occur in one-third of all non-small-cell lung cancer patients. Due to restrictive transport at the blood–brain barrier, many drugs provide poor control of metastases in the brain. The aim of this study was to compare erlotinib with pemetrexed as second-/third-line treatment in patients with lung adenocarcinoma with asymptomatic brain metastases.Methods: From January 2012 to June 2014, all lung adenocarcinoma patients with asymptomatic brain metastases who received treatment with erlotinib or pemetrexed as second-/third-line treatment were retrospectively reviewed. Chi-square and log-rank tests were used to perform statistical analysis.Results: The study enrolled 99 patients, of which 44 were positive for EGFR mutation. Median progression-free survival (PFS in months was not significantly different between the erlotinib- and pemetrexed-treated groups (4.2 vs 3.4 months; 95% confidence interval [CI]: 2.01–6.40 vs 2.80–5.00, respectively; P=0.635. Median PFS was found to be significantly longer in EGFR mutation–positive patients in the erlotinib-treated group (8.0 months; 95% CI 5.85–10.15 compared to the pemetrexed group (3.9 months; 95% CI: 1.25–6.55; P=0.032. The most common treatment-related side effect was mild-to-moderate rash and the most common drug-related side

  18. MANAGEMENT OF DIABETES MELLITUS IN DIABETIC PATIENTS: ISFAHAN. 1999

    Directory of Open Access Journals (Sweden)

    P ABAZARI

    2001-06-01

    Full Text Available Introduction. Diabetic control and its acute and chronic complications needed to investigate the characteristics medical and self care in diabetics. This evaluation can detect conflicts in this field and provide the possibility of better planning to arrive the ideal control of diabetes. Methods. This study was a cross sectional survey. Samples were 344 diabetic patients who were living in Isfahan. Data was collected by a questionnaire described diabetics contextual characteristics, position of medical services use, position of diabetic education, self blood glucose monitoring (SMBG, attendance to diet regimen and so on. Questionnaires were cmpeleted through interview. Results. Mean age of patients was 56.5±13.6 years. More than fifty percent (57.7 percent were female. More than one third (57.6 percent were illiterate. Patients had 1 to 40 years history of diabetes. More than one forth (27.4 percent did not seek medical advice and 61.2 percent had referred to physician only when they were encountering with a problem for example lack of insulin or oral hypoglycemic agents. Over eighty percent never had foot examination by their physicians. Only 7.4 percent, had heared about glycosylated hemoglubine. This test had not been accomplished for 95.9 percent of patients. 46.2 percent had not performed self foot examination till study time. More than eighty percent of interviewers had reported their lost blood glucose value above 130 mg/dl. Only ten percent of the study population had performed 5MBG. About fifty percent (45.3 percent, did not educated about diabetes. Only 26.8 percent reported that they always follow their dietary regimen. Discussion. Results of this survey showed irregular calls to physicians, poor blood glucose control, high rate of hospitalization due to acute and chronic diabetes complications, irregular blood glucose monitoring. Diabetes management needs more attention in our city.

  19. Efficacy of Osteoporosis Therapies in Diabetic Patients.

    Science.gov (United States)

    Schwartz, Ann V

    2017-02-01

    Diabetes is characterized by increased fracture risk and by reduced bone strength for a given density. Contributing factors may include lower bone turnover and accumulation of advanced glycation endproducts. There are concerns that the pharmacological therapies for osteoporosis, particularly anti-resorptive therapies that suppress bone turnover, may not be as effective in the setting of diabetes. This review considers clinical trials and observational studies that have assessed the efficacy of anti-resorptive and anabolic therapies in diabetic patients. Post hoc analyses of randomized trials indicate that raloxifene has similar efficacy for prevention of vertebral fractures in diabetic compared with non-diabetic patients. Evidence from randomized clinical trials is lacking for anti-fracture efficacy of other osteoporosis therapies in diabetes. However, observational studies suggest that bisphosphonates are effective in preventing fractures in diabetic patients. The great majority of diabetic patients in studies to date have been type 2, and efficacy of osteoporosis therapies in type 1 diabetic patients remains to be addressed. Further evaluation of the efficacy of osteoporosis therapies in the setting of diabetes is needed to provide optimal fracture prevention for this population.

  20. Characteristics of Yersinia enterocolitica biotype 1A strains isolated from patients and asymptomatic carriers.

    Science.gov (United States)

    Stephan, R; Joutsen, S; Hofer, E; Säde, E; Björkroth, J; Ziegler, D; Fredriksson-Ahomaa, M

    2013-07-01

    Yersinia enterocolitica biotype 1A strains are frequently isolated from the environment, foods, and animals, and also from humans with yersiniosis. There are controversial reports on the pathogenicity of biotype 1A strains. In this study, 811 fecal samples from asymptomatic humans from Switzerland were studied for the presence of Y. enterocolitica. Nine (1.1%) of the 811 samples were positive for Y. enterocolitica 1A. These strains were compared with 12 Y. enterocolitica 1A strains from Swiss patients with diarrhea isolated in the same year. Almost all (20/21) Y. enterocolitica 1A strains carried the ystB gene, seven strains carried the hreP gene, and none carried the ail, ystA, myfA, yadA, or virF genes. Most (17/21) Y. enterocolitica 1A strains belonged to two major clusters, A and B, by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Strains of cluster B were only isolated from humans with diarrhea; however, ystB and hreP genes were detected in strains from both clinical and non-clinical samples and from strains of clusters A and B. Using ribotyping, six restriction patterns among biotype 1A strains were obtained with HindIII enzyme. The most common ribotype (RT I) was found in strains isolated from humans with and without diarrhea. All biotype 1A strains had a unique NotI profile by pulsed-field gel electrophoresis (PFGE), showing a very high genetic diversity. In this study, Y. enterocolitica 1A strains from clinical and non-clinical samples could not be clearly differentiated from each other. More research is needed in order to prove that biotype 1A strains are a primary cause for human yersiniosis and not only a secondary finding.

  1. Coccidioidomycosis osteomyelitis of the knee in a 23-year-old diabetic patient

    OpenAIRE

    Lowell Ellerbrook, BS; Shaked Laks, MD

    2015-01-01

    Coccidioidomycosis is a pulmonary infection caused by the dimorphic fungi Coccidioides immitis and Coccidioidomycosis posadasii. This disease is endemic to the southwestern United States and has a predilection for immunocompromised patients. Diabetes mellitus has been shown to be a strong risk factor for acquiring this infection in these states. Most cases are asymptomatic or present with mild pulmonary symptoms. However, untreated pulmonary mycosis can lead to disseminated infection, most of...

  2. Secretin-stimulated MR cholangio-pancreatography in the evaluation of asymptomatic patients with non-specific pancreatic hyperenzymemia

    Energy Technology Data Exchange (ETDEWEB)

    Donati, Francescamaria, E-mail: fra.donati@katamail.co [2nd Department of Radiology, Pisa University-Hospital, Via Paradisa 2, I-56124 Pisa (Italy); Boraschi, Piero; Gigoni, Roberto; Salemi, Simonetta [2nd Department of Radiology, Pisa University-Hospital, Via Paradisa 2, I-56124 Pisa (Italy); Faggioni, Lorenzo; Bertucci, Cristina; Cecchi, Claudia; Bartolozzi, Carlo [Diagnostic and Interventional Radiology, University of Pisa, Via Rome 67, I-56126 Pisa (Italy); Falaschi, Fabio [2nd Department of Radiology, Pisa University-Hospital, Via Paradisa 2, I-56124 Pisa (Italy)

    2010-08-15

    Purpose: To assess the diagnostic value of secretin-stimulated MRCP (SS-MRCP) compared with conventional MRCP in asymptomatic patients with mild elevations of pancreatic enzymes. Materials and methods: Eighty asymptomatic patients with pancreatic hyperenzymemia underwent MR imaging at 1.5 T-device (Signa EXCITE, GE Healthcare). After the acquisition of axial T1w,T2w sequences, and conventional MRCP, SS-MRCP was performed using a single-slice coronal breath-hold, thick-slab, SSFSE T2w sequence, repeated every 30 s up to 15 min following intravenous injection of secretin (Secrelux, Sanochemia). Results: On the basis of the standards of reference, our final diagnoses were: negative findings (n = 23), pancreas divisum (n = 22), mild chronic pancreatitis (n = 14), inflammatory ampullary stenosis (n = 3), juxtapapillary duodenal diverticulum (n = 1), small cystic lesions (<1 cm) (n = 22; 5/22 cases associated with pancreas divisum). The image quality of SS-MRCP was significantly higher than that of conventional MRCP (p < 0.0001). Standards of reference did not differ significantly from of SS-MRCP findings (p = 0.5), while was statistically different from those of conventional MRCP (p < 0.0001). A significant difference was found between conventional MRCP and SS-MRCP findings (p < 0.0001). Conclusion: In asymptomatic patients with non-specific pancreatic hyperenzymemia SS-MRCP may represent the best non-invasive diagnostic technique, since it gives morphological and functional information.

  3. Risikostratificering af patienter med diabetes mellitus

    DEFF Research Database (Denmark)

    Qvist, Peter; Glintborg, Dorte; Andries, Alin

    2008-01-01

    with diabetes mellitus. MATERIAL AND METHODS: We included patients with diabetes from the catchment areas of four diabetes out-patient clinics in southern Denmark. Patients were risk-stratified to 3 follow-up levels (level 1 - follow-up only by their GP, level 2 - intensified follow-up by GP and/or shared care...... schemes, level 3 - follow-up only in out-patient clinics). The results were subsequently compared with the patients' actual follow-up status. RESULTS: A total of 647 patients (563 type 2 diabetes and 84 type 1 diabetes) were included from 15 GPs. Among these, 139 were stratified to level 1, 409 to level 2...

  4. The impact of asymptomatic helminth co-infection in patients with newly diagnosed tuberculosis in north-west Ethiopia.

    Directory of Open Access Journals (Sweden)

    Ebba Abate

    Full Text Available BACKGROUND: Areas endemic of helminth infection, tuberculosis (TB and HIV are to a large extent overlapping. The aim of this study was to assess the impact of asymptomatic helminth infection on the immunological response among TB patients with and without HIV, their house hold contacts and community controls. METHODOLOGY: Consecutive smear positive TB patients (n = 112, their household contacts (n = 71 and community controls (n = 112 were recruited in Gondar town, Ethiopia. Stool microscopy, HIV serology, serum IgE level, eosinophil and CD4 counts were performed and tuberculosis patients were followed up for 3 months after initiation of anti-TB treatment. RESULTS: Helminth co-infection rate was 29% in TB patients and 21% in both community control and household contacts (p = 0.3 where Ascaris lumbricoides was the most prevalent parasite. In TB patients the seroprevalence of HIV was 47% (53/112. Eosinophilia and elevated IgE level were significantly associated with asymptomatic helminth infection. During TB treatment, the worm infection rate of HIV+/TB patients declined from 31% (10/32 at week 0 to 9% (3/32 at week 2 of TB treatment, whereas HIV-/TB patients showed no change from baseline to week 2, 29% (13/45 vs. 22.2% (10/45. This trend was stable at week 8 and 12 as well. CONCLUSION: One third of smear positive TB patients were infected with helminths. Eosinophilia and elevated IgE level correlated with asymptomatic worm infection, indicating an effect on host immunity. The rate of worm infection declined during TB treatment in HIV+/TB co-infected patients whereas no decline was seen in HIV-/TB group.

  5. The Prevalance of Diabetes in Psoriatic Patients Versus the Prevalance of Psoriasis in Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Nahide Onsun

    2010-03-01

    Full Text Available Background and Design: Previous studies reported that there are some relations between psoriasis and the diabetes mellitus. However, incidence rates of diabetes mellitus in psoriasis and also incidence rates of psoriasis in diabetes mellitus are lacking.Our aim was to assess and compare incidence rates of diabetes mellitus in patients with psoriasis and incidence rates of psorasis in diabetes mellitus and also evaluate the role of psoriasis as a risk factor for diabetes mellitus. Material and Method: Four hundred eighteen patients with psoriasis and one hundred fifty four patients with diabetes were included. Blood glucose, oral glucose tolerance test (OGTT, glycolised hemoglobine (HbA1C were performed in psoriatic patients and these results were consulted with diabetes clinic. Psoriasis screening by clinical history, dermatologic examination, skin biopsy; if it is necessary were held for patients with diabetes. Results: Prevalance of diabetes was 9.3% in psoriatic patients; prevalance of psoriasis was 1.3% in diabetic patients. The proportion of diabetes was significantly higher in psoriatic patients compared to the proportion of psoriasis in diabetic patients (odds ratio (OR: 7.82, confidence interval (CI: 1.86-32.79, p=0.001. The age and sex-adjusted proportion of diabetes was significantly higher in psoriatic patients as compared the proportion of psoriasis in diabetic patients (OR: 18.35, p<0.001. Differences of mean duration of disease and mean PASİ (psorasis area severity index were not significant between the psoriatic patients without diabetes mellitus and with diabetes mellitus.Conclusion: Risk rate of diabetes is increased in psoriatic patients. Chronic inflammation may lead insulin resistance and diabetes. We think that development of diabetes in patients with psoriasis depends on chronic inflammation. Unfortunately we could not assess the role of therapeutical agents especially effect of potent corticosteroids in development of

  6. Intraocular pressure in Japanese diabetic patients

    Directory of Open Access Journals (Sweden)

    Matsuoka M

    2012-07-01

    Full Text Available Masato Matsuoka,1 Nahoko Ogata,2 Kayako Matsuyama,1 Tadanobu Yoshikawa,1 Kanji Takahashi31Department of Ophthalmology, Kansai Medical University, Takii Hospital, Osaka, 2Department of Ophthalmology, Nara Medical University, Nara, 3Department of Ophthalmology, Kansai Medical University, Hirakata Hospital, Osaka, JapanBackground: To determine whether the intraocular pressure (IOP in diabetic patients is significantly different from that in nondiabetic patients.Methods: The medical records of all patients who were initially examined in the Department of Ophthalmology, Kansai Medical University, Takii Hospital were reviewed. At the initial examination, patients had a detailed interview and underwent a comprehensive ophthalmic examinations. All patients were over 20 years of age and did not have glaucoma.Results: A total of 703 patients were evaluated. The mean (±standard error IOP of the diabetic patients was 15.5 ± 0.2 mmHg (n = 206, and was significantly higher than the 14.0 ± 0.1 mmHg (n = 497 in the nondiabetic patients (P < 0.0001. The IOP was negatively correlated with age (r = –0.202; P = 0.024 in the diabetic patients and was weakly but significantly correlated with the glycosylated hemoglobin (HbA1c level (r = 0.240; P = 0.015 in the group with diabetic retinopathy.Conclusion: The significantly higher IOP in diabetic patients and positive correlation of IOP with HbA1c levels in patients with diabetic retinopathy indicate that IOP in diabetic patients is higher, especially in those with poor control of diabetes.Keywords: diabetes mellitus, diabetic retinopathy, intraocular pressure, open-angle glaucoma

  7. Statin treatment in type 2 diabetes patients

    NARCIS (Netherlands)

    de Vries, Folgerdiena Maria

    2016-01-01

    Type 2 diabetes patients have a higher risk of developing cardiovascular and cerebrovascular diseases, therefore statins are recommended for almost all diabetes patients. Although it has been shown that statins can have substantial health and economic benefits, treatment in clinical practice is ofte

  8. Detection of myocardial ischemia with myocardial perfusion SPECT in patients with diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Seo, J. H.; Jeong, S. Y.; Bae, J. H.; Anh, B. C.; Lee, J.; Lee, K. B [Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2004-07-01

    Diabetes mellitus(DM) is a critical disease associated with higher rates of cardiovascular morbidity and mortality. Atherosclerosis accounts for 65-80% of all deaths in diabetic patients and patients with DM are known to show high prevalence of coronary artery diseases(CAD). We evaluated the incidence of scintigraphic evidence of CAD in diabetic patients and results were compared with cardiovascular symptoms and clinical factors. 169 patients with DM(mean age 629years, 68 males) were referred for evaluation of CAD between Jan 2002 and Dec 2003. 101(60%) patients were with chest pain and 68(40%) were asymptomatic. Patients underwent exercise(n=6) or adenosine stress(n=163) SPECT myocardial perfusion imaging(MPI). Exclusion criteria included history of documented myocardial infarction, prior revascularization, clinically significant valvular heart disease, left-bundle branch block on rest ECG. We evaluated symptoms associated with cardiac problem and other clinical and laboratory data to reveal correlation with presence of CAD. MPI were assessed visually and semi-quantitatively with C-Equal program. Myocardial ischemia was detected in 52(31%) patients. Among them, 41 had 1-vessel and 9 had 2-vessel disease. In 52 patients with ischemia, 28(54%) were male and 24(46%) were female. 20/68(29%) asymptomatic and 32/101(32%) symptomatic patients had ischemia. Higher prevalence of neuropathy, hypertension, higher blood glucose level, HbA1c and CRP was noted in patients with myocardial ischemia. Serum levels of cholesterol and LDL was not significantly different between patients with ischemia and with normal MPI findings. Abnormal MPI findings were not related with gender and age. These results show a high prevalence of abnormal MPI results in diabetic patients regardless of symptoms. Screening stress MPI in diabetic patients should be indicated irrespective of symptoms, especially in patients with neuropathy, hypertension, higher level of blood glucose, or increased CRP.

  9. Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence, diagnosis, and management

    Directory of Open Access Journals (Sweden)

    Nitzan O

    2015-02-01

    Full Text Available Orna Nitzan,1–3 Mazen Elias,2,4 Bibiana Chazan,1,2 Walid Saliba2,4 1Infectious Disease Unit, Ha’emek Medical Center, Afula, Israel; 2Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel; 3Infectious Disease Unit, Padeh-Poriya Medical Center, 4Department of Internal Medicine C, Ha’emek Medical Center, Afula, Israel Abstract: Urinary tract infections are more common, more severe, and carry worse outcomes in patients with type 2 diabetes mellitus. They are also more often caused by resistant pathogens. Various impairments in the immune system, poor metabolic control, and incomplete bladder emptying due to autonomic neuropathy may all contribute to the enhanced risk of urinary tract infections in these patients. The new anti-diabetic sodium glucose cotransporter 2 inhibitors have not been found to significantly increase the risk of symptomatic urinary tract infections. Symptoms of urinary tract infection are similar to patients without diabetes, though some patients with diabetic neuropathy may have altered clinical signs. Treatment depends on several factors, including: presence of symptoms, severity of systemic symptoms, if infection is localized in the bladder or also involves the kidney, presence of urologic abnormalities, accompanying metabolic alterations, and renal function. There is no indication to treat diabetic patients with asymptomatic bacteriuria. Further studies are needed to improve the treatment of patients with type 2 diabetes and urinary tract infections. Keywords: diabetes mellitus, diagnosis, management, prevalence, urinary tract infection

  10. Somatotype in Elderly Type 2 Diabetes Patients

    OpenAIRE

    Buffa, Roberto; Floris, Giovanni; F. Putzu, Paolo; Carboni, Luciano; Marini, Elisabetta

    2007-01-01

    Somatotyping is a practical technique for the description of physique. Individuals with Type 2 diabetes are characterized by physical peculiarities, such as overweight, obesity and a central pattern of body fat distribution. Somatotype applications to diabetes are limited. The objective of this study is to describe the somatotype of elderly type 2 diabetes patients. The sample consisted of 110 patients with type 2 diabetes (45 men, mean age 69.4±7.0 years; 65 women, mean age 72.9±...

  11. Depression among type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Taghreed Mohamed El-Shafie ,Entesar Omar A. El-Saghier and Iman ,Kamal Ramadan

    2011-07-01

    Full Text Available Background & Objectives: Diabetes and depression are highly prevalent conditions and have significant impact on health outcomes. The combination of depression with type 2 diabetes is a public health problem. Therefore, we aimed to assess some socio-demographic characteristics of type 2 diabetes and to investigate the relationship between type 2 diabetes and depression among patients aged from 40 to 60 years old. Methods: 125 patients diagnosed with type 2 diabetes attending diabetes clinics in the Al-Zahraa hospital were invited to participate in this cross-sectional study. Patients were interviewed using structured questionnaires to gather data on socio-demographics, clinical, self care compliance, medication usage, and diabetes complications. The MADRS was administered as a screening tool for depression level evaluation. Binary logistic regression model was used to examine association between predictor variables and risk of depression among diagnosed type 2 diabetes at 95% C.I. and P < 0.05. Results: One hundred and twenty five participants completed the interview. More than half of participants were females (58.4% and the mean age was 48 (sd = 5.9, 47.2% hypertensive, and 59.2% on insulin. More than two third (74.4% of patients were depressed; (24.8% mild, 37.6% moderate and 12% severely depressed. Almost four out of five patients (88.8% had diabetes complications, Depression was strongly associated with neuropathy, age, retinopathy, sex and cardiac complications. However, the likelihood of depression was not associated with nephropathy, hypertension and sexual dysfunction. Conclusion: The current study demonstrates a strong correlation between depression and diabetes particularly complications. In particular, patients who are depressed tended to have poorer self-care, more severe physical symptoms and were less likely to adhere to prescribed care regimens. These findings raise the possibility that improving the mental health as part of a

  12. Differences in cardiovascular risk profile between electrocardiographic hypertrophy versus strain in asymptomatic patients with aortic stenosis (from SEAS data)

    DEFF Research Database (Denmark)

    Greve, Anders M; Gerdts, Eva; Boman, Kurt;

    2011-01-01

    Electrocardiograms are routinely obtained in clinical follow-up of patients with asymptomatic aortic stenosis (AS). The association with aortic valve, left ventricular (LV) response to long-term pressure load, and clinical covariates is unclear and the clinical value is thus uncertain. Data from...... clinical examination, electrocardiogram, and echocardiogram in 1,563 patients in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study were used. Electrocardiograms were Minnesota coded for arrhythmias and atrioventricular and intraventricular blocks; LV hypertrophy was assessed by Sokolow...

  13. Left atrial volume in patients with asymptomatic aortic valve stenosis (the Simvastatin and Ezetimibe in Aortic Stenosis study)

    DEFF Research Database (Denmark)

    Dalsgaard, Morten; Egstrup, K.; Wachtell, K.

    2008-01-01

    Left atrial (LA) size is known to increase with persistently increased left ventricular (LV) filling pressure. We therefore hypothesized that LA volume might reflect the severity of aortic valve stenosis (AS). Transthoracic echocardiography was performed in 1,758 patients with asymptomatic...... AS (transaortic Doppler velocity > or =2.5 and Aortic Stenosis (SEAS) study. LA volume was measured in end-systole in the apical 4-chamber view in 1,503 patients (85%), and aortic valve area (AVA) was estimated by the continuity equation and indexed by body surface...

  14. Can fish oil supplementation improve endothelial function in asymptomatic offspring of patients with peripheral arterial disease?

    Directory of Open Access Journals (Sweden)

    Spark JI

    2013-07-01

    maintain a diary of fish oil consumption on a daily basis, and fish oil returned will be measured to confirm adherence. Participants will complete validated surveys to determine background diet and physical activity levels.Discussion: This study will examine the effectiveness of a moderate-dose fish oil intervention in reversing endothelial dysfunction in asymptomatic offspring of patients with peripheral arterial disease. It provides the opportunity to delay the progression of peripheral arterial disease using a cheap and readily available dietary supplement that has minimal side effects compared with synthetic vasoactive pharmacological medications.Keywords: omega 3 fatty acids, endothelial function, peripheral arterial disease

  15. Computed tomography for the measurement of coronary calcification in asymptomatic risk patients

    Directory of Open Access Journals (Sweden)

    Pichlbauer, Ernest

    2006-05-01

    Full Text Available Background: In 2003 nearly 20% of deaths in Germany were caused by coronary heart disease (CHD. Risk models are used to estimate the ten-year-risk of a coronary event. Coronary calcification may be seen as an additional risk factor. The amount of calcium is correlated with atherosclerotic lesions, but there is no direct correlation with the probability of a plaque rupture. Coronary calcification may be measured either by electron beam computed tomography (EBCT or multi-detector computed tomography (MDCT. Objectives: The aim of this HTA report is to investigate the diagnostic validity and cost effectiveness of computed tomography techniques in measuring coronary calcification of asymptomatic risk patients. Ethical aspects are discussed. Methods: A systematic literature research was performed in 35 international databases which yielded 1080 articles. Overall 43 publications were included for assessment, according to predefined selection criteria. Results: Measuring coronary calcification offers additional information compared with traditional risk factors. Yet at present it cannot be said - according to published literature - which population groups gain most. For determining adequate calcium score thresholds standardisation for age and sex is important. When comparing the reference standard EBCT with MDCT results are inconsistent and depend on the calcium-score value as well as on the scoring method. EBCT as a triage instrument in diagnosing CHD appears to be cost-effective. Yet it is rather not cost-effective as a refinement tool for risk stratification. Discussion: Most of the literature was published in the United States and discusses the use of EBCT as well as (traditional risk stratification by the Framingham Score. Regarding coronary calcification measured by MDCT (which is more widespread in Germany than EBCT and a risk model applicable for European populations clear recommendations based on published literature cannot be made at present

  16. Brain imaging changes associated with risk factors for cardiovascular and cerebrovascular disease in asymptomatic patients.

    Science.gov (United States)

    Friedman, Joseph I; Tang, Cheuk Y; de Haas, Hans J; Changchien, Lisa; Goliasch, Georg; Dabas, Puneet; Wang, Victoria; Fayad, Zahi A; Fuster, Valentin; Narula, Jagat

    2014-10-01

    Reviews of imaging studies assessing the brain effects of vascular risk factors typically include a substantial number of studies with subjects with a history of symptomatic cardiovascular or cerebrovascular disease and/or events, limiting our ability to disentangle the primary brain effects of vascular risk factors from those of resulting brain and cardiac damage. The objective of this study was to perform a systematic review of brain changes from imaging studies in patients with vascular risk factors but without clinically manifest cardiovascular or cerebrovascular disease or events. The 77 studies included in this review demonstrate that in persons without symptomatic cardiovascular, cerebrovascular, or peripheral vascular disease, the vascular risk factors of hypertension, diabetes mellitus, obesity, hyperlipidemia, and smoking are all independently associated with brain imaging changes before the clinical manifestation of cardiovascular or cerebrovascular disease. We conclude that the identification of brain changes associated with vascular risk factors, before the manifestation of clinically significant cerebrovascular damage, presents a window of opportunity wherein adequate treatment of these modifiable vascular risk factors may prevent the development of irreversible deleterious brain changes and potentially alter patients' clinical course.

  17. Asymptomatic cerebrovascular lesions detected by magnetic resonance imaging in patients with systemic lupus erythematosus lacking a history of neuropsychiatric events

    Energy Technology Data Exchange (ETDEWEB)

    Nomura, Kumiko; Yamano, Shigeru; Ikeda, Yukiko [Nara Medical Univ., Kashihara (Japan)] (and others)

    1999-10-01

    To clarify the extent of asymptomatic cerebrovascular involvement in systemic lupus erythematosus (SLE). Cerebral magnetic resonance imaging (MRI) findings and ultrasonography findings of 100 patients with SLE lacking present or past clinical neurologic deficits were compared with 66 age-matched volunteers to determine the combined intima-media thickness (IMT) of the common carotid artery, and tests for anti-cardiolipin antibodies (aCL). Thirty-eight patients, but only 2 controls, showed imaging abnormalities. Among 23 SLE patients with cerebrovascular lesions by MRI who underwent single-photon emission computed tomography (SPECT), 14 showed hypoperfusion of the lesion. The IMT value and prevalence of aCL did not differ between the 55 SLE patients tested and controls. SLE disease activity index (SLEDAI) as assessed by a quantitative clinical index was significantly greater in patients with brain lesions than in those without. The prevalence of asymptomatic brain lesions in SLE patients is high, and shows a relationship to disease activity. (author)

  18. Salivary Output in Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    T. Radhika

    2014-01-01

    Full Text Available Background: Diabetes Mellitus (DM is a common but complex metabolic disorder affecting various systems in the body. Oral cavity is no exception as this chronic condition exerts a huge impact on oral health. Salivary dysfunction has been reported to be a frequent oral complication in Type 2 diabetics which in turn leads to an array of oral complications because oral health is to a greater extent dependent on the quality and quantity of saliva. Aim: The aim of the present study was to evaluate and compare the salivary flow rate and prevalence of subjective symptoms of xerostomia in diabetics and non-diabetics. Materials and Methods: The study was conducted on 100 type 2 diabetic patients and 50 non-diabetic subjects. Random non-fasting plasma glucose and glycosylated hemoglobin levels were used to determine the diabetic status of the individuals. Unstimulated saliva was collected using “Spit technique”. Stimulated saliva was collected using 2% citric acid. Unstimulated and Stimulated Salivary Flow Rate (USFR and SSFR was calculated for every patient and expressed as ml/min. Xerostomia was evaluated using a multi-item inventory comprising 19 questions. Results: In our study, both whole unstimulated and stimulated salivary flow rates were decreased in diabetics compared to non-diabetics and this difference was statistically significant (p = 0.000. A greater percentage of diabetic patients perceived xerostomia symptoms compared to non-diabetics. Conclusion: Type 2 diabetics have higher prevalence of xerostomia and significantly reduced salivary flow rate compared to non-diabetics. Alterations in salivary flow create an imbalance in the homeostasis of oral environment leading to spectrum of oral ailments in these individuals

  19. Conservative management of a left ventricle cardiac fibroma in an asymptomatic child patient.

    Science.gov (United States)

    Ünsal, Handan; Ekici, Enver

    2015-07-01

    Primary cardiac tumors in infancy and childhood are rare and usually benign. Fibroma is the second most common bening cardiac tumor after rhabdomyoma. Surgery is required when fibromas cause ventricular outflow tract obstruction, ventricular dysfunction and life-threatening arrhythmia. This case report describes a 9-year-old asymptomatic male presenting with a giant left ventricular cardiac fibroma who was followed up using conservative treatment.

  20. Mucormycosis in a diabetic ketoacidosis patient

    Institute of Scientific and Technical Information of China (English)

    G Sree Vijayabala; Rajeshwari G Annigeri; Ramachandran Sudarshan

    2013-01-01

    Oral cavity is considered to be a kaleidoscope for body’s general health. Many systemic conditions do present with diverse oral manifestations. Mucormycosis involving the oral cavity is one such entity that presents as necrosis of bone in immunocompromised patients. Mucormycosis is an opportunistic fungal infection that mainly affects the patients with uncontrolled diabetes mellitus. Hereby, we report a case of mucormycosis involving the palate in a patient with diabetic ketoacidosis.

  1. Mucormycosis in a diabetic ketoacidosis patient.

    Science.gov (United States)

    Vijayabala, G Sree; Annigeri, Rajeshwari G; Sudarshan, Ramachandran

    2013-10-01

    Oral cavity is considered to be a kaleidoscope for body's general health. Many systemic conditions do present with diverse oral manifestations. Mucormycosis involving the oral cavity is one such entity that presents as necrosis of bone in immunocompromised patients. Mucormycosis is an opportunistic fungal infection that mainly affects the patients with uncontrolled diabetes mellitus. Hereby, we report a case of mucormycosis involving the palate in a patient with diabetic ketoacidosis.

  2. Diabetic ketoacidosis in a patient with acromegaly

    NARCIS (Netherlands)

    Kopff, B; Mucha, S; Wolffenbuttel, B H; Drzewoski, J

    2001-01-01

    Abnormalities of glucose metabolism are a common feature of acromegaly. Overt diabetes mellitus develops in about 10-15% of patients. We present an unusual complication of acromegaly: a 37-year old man with a 2-year history of acromegaly developed diabetic ketoacidosis 3 weeks after transsphenoidal

  3. Oxidative Stress and Anesthesia in Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Peivandi Yazdi A

    2014-04-01

    Full Text Available Free radical and peroxide production lead to intracellular damage. On the other hand, free radicals are used by the human immune system to defend against pathogens. The aging process could be limited by oxidative stress in the short term. Chronic diseases like diabetes mellitus (DM are full-stress conditions in which remarkable metabolic functional destructions might happen. There is strong evidence regarding antioxidant impairment in diabetes. Performing a particular method for anesthesia in diabetic patients might prevent or modify excessive free radical formation and oxidative stress. It seems that prescribing antioxidant drugs could promote wound healing in diabetics.  

  4. Knowledge of diabetes mellitus among diabetic and non-diabetic patients in Klinik Kesihatan Seremban.

    Science.gov (United States)

    Ding, C H; Teng, C L; Koh, C N

    2006-10-01

    The Malaysian Ministry of Health has undertaken various campaigns on healthy lifestyle and health promotion over the years. The impact of these campaigns has been mixed and not well documented. This cross-sectional study evaluated the knowledge level of patients with and without diabetes in a large urban polyclinic using a 41-item questionnaire. One hundred and forty-nine adults (83 with diabetes, 66 without diabetes) participated in this study. Patients with diabetes had higher overall knowledge scores than those without diabetes (81.8% vs 64.0%, p < 0.001). While the overall knowledge of patients without diabetes appeared to be acceptable, several areas of knowledge deficiency were identified in this group--areas that should be filled by the on-going health promotion activities.

  5. Diagnostic performance of FDG PET/CT for surveillance in asymptomatic gastric cancer patients after curative surgical resection

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Won [Catholic Kwandong University College of Medicine, Department of Nuclear Medicine, International St. Mary' s Hospital, Incheon (Korea, Republic of); Lee, Sang Mi [Soonchunhyang University Hospital, Department of Nuclear Medicine, 23-20 Byeongmyeong-dong, Dongnam-gu, Chungcheongnam-do, Cheonan (Korea, Republic of); Son, Myoung Won; Lee, Moon-Soo [Soonchunhyang University Hospital, Department of Surgery, Cheonan (Korea, Republic of)

    2016-05-15

    The present study evaluated the diagnostic performance of 2-[{sup 18}F] fluoro-2-deoxy-d-glucose (FDG) positron emission tomography/computed tomography (PET/CT) for surveillance in asymptomatic gastric cancer patients after curative surgical resection. We retrospectively recruited 190 gastric cancer patients (115 early gastric cancer patients and 75 advanced gastric cancer patients) who underwent 1-year (91 patients) or 2-year (99 patients) postoperative FDG PET/CT surveillance, along with a routine follow-up program, after curative surgical resection. All enrolled patients were asymptomatic and showed no recurrence on follow-up examinations performed before PET/CT surveillance. All PET/CT images were visually assessed and all abnormal findings on follow-up examinations including FDG PET/CT were confirmed with histopathological diagnosis or clinical follow-up. During follow-up, 19 patients (10.0 %) developed recurrence. FDG PET/CT showed abnormal findings in 37 patients (19.5 %). Among them, 16 patients (8.4 %) were diagnosed as cancer recurrence. Of 153 patients without abnormal findings on PET/CT, three patients were false-negative and diagnosed as recurrence on other follow-up examinations. The sensitivity, specificity, positive predictive value, and negative predictive value of FDG PET/CT were 84.2 %, 87.7 %, 43.2 %, and 98.0 %, respectively. Among 115 early gastric cancer patients, PET/CT detected recurrence in four patients (3.5 %) and one patient with local recurrence. Among 75 advanced gastric cancer patients, PET/CT detected recurrence in 12 patients (16.0 %), excluding two patients experiencing peritoneal recurrence. In addition, FDG PET/CT detected secondary primary cancer in six (3.2 %) out of all the patients. Post-operative FDG PET/CT surveillance showed good diagnostic ability for detecting recurrence in gastric cancer patients. FDG PET/CT could be a useful follow-up modality for gastric cancer patients, especially those with advanced gastric cancer

  6. Low-flow aortic stenosis in asymptomatic patients: valvular-arterial impedance and systolic function from the SEAS Substudy

    DEFF Research Database (Denmark)

    Cramariuc, Dana; Cioffi, Giovanni; Rieck, Ashild E

    2009-01-01

    OBJECTIVES: This study sought to assess the impact of valvuloarterial impedance on left ventricular (LV) myocardial systolic function in asymptomatic aortic valve stenosis (AS). BACKGROUND: In atherosclerotic AS, LV global load consists of combined valvular and arterial resistance to LV ejection...... Ezetimibe in Aortic Stenosis) study evaluating placebo-controlled combined simvastatin and ezetimibe treatment in AS were used to assess LV global load as valvuloarterial impedance and LV myocardial function as stress-corrected midwall shortening. The study population was divided into tertiles of global...... preserved. (An Investigational Drug on Clinical Outcomes in Patients With Aortic Stenosis [Narrowing of the Major Blood Vessel of the Heart]; NCT00092677)....

  7. Prevalence and risk factors of asymptomatic bronchiectasis in patients with rheumatoid arthritis at a tertiary care center in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Suzan Mansour Attar

    2015-01-01

    Full Text Available Introduction and Objectives: Bronchiectasis is a pulmonary manifestation that often occurs in individuals with rheumatoid arthritis (RA. Nevertheless, the prevalence of bronchiectasis in RA patients and predictors of its development/progression remain ill-defined. Our objective was to investigate the prevalence of bronchiectasis in a group of RA patients and examine possible clinical or biochemical risk factors that might contribute to its development. Methods: This was an observational study analyzing 100 RA patients with no pulmonary symptoms selected from King Abdulaziz University Hospital in the Western region of Saudi Arabia from October 2013 to 2014. Demographic, clinical and laboratory information were collected for all patients. Diagnosis was based on the 2010 American College of Rheumatology (ACR/European League Against Rheumatism (EULAR classification system, and disease activity was assessed using the 28-Joint Disease Activity Score Index with C-reactive protein; high-resolution computed tomography chest scans were performed. The prevalence of bronchiectasis was recorded and its association with different risk factors was examined using standard statistical methods. Results: All 100 patients fulfilled the ACR and EULAR classification criteria for RA diagnosis. Their mean age was 51.05 ± 13.5 years, disease duration was 6.19 ± 6.4 years and disease activity index was 4 ± 1.3 (moderate activity. A total of 35 (35% patients developed bronchiectasis. Notably, we observed significant positive associations of bronchiectasis with age, disease duration and male gender (P < 0.001, P = 0.006, P = 0.028, respectively. Conclusions: Asymptomatic bronchiectasis represents a common complication in moderately active RA patients within the Western Region of Saudi Arabia. Furthermore, several predictors of bronchiectasis development were identified, which can contribute to effective risk stratification in RA patients. Further prospective studies are

  8. Prevalence of diabetes mellitus in patients with acromegaly.

    Science.gov (United States)

    Dreval, A V; Trigolosova, I V; Misnikova, I V; Kovalyova, Y A; Tishenina, R S; Barsukov, I A; Vinogradova, A V; Wolffenbuttel, B H R

    2014-01-01

    Early carbohydrate metabolism disorders (ECMDs) and diabetes mellitus (DM) are frequently associated with acromegaly. We aimed to assess the prevalence of ECMDs in patients with acromegaly and to compare the results with those in adults without acromegaly using two population-based epidemiologic surveys. We evaluated 97 patients with acromegaly in several phases of their disease (mean age, 56 years and estimated duration of acromegaly, 12.5 years). An oral glucose tolerance test was done in those not yet diagnosed with DM to reveal asymptomatic DM or ECMDs (impaired glucose tolerance+impaired fasting glucose). Comparisons were made between patients with acromegaly and participants from the general adult population (n=435) and an adult population with multiple type 2 diabetes risk factors (n=314), matched for gender, age and BMI. DM was diagnosed in 51 patients with acromegaly (52.5%) and 14.3% of the general population (Pacromegaly than in the general population and in the high-risk group; only 22% of patients with acromegaly were normoglycaemic. The prevalence of newly diagnosed ECMDs or DM was 1.3-1.5 times higher in patients with acromegaly compared with the high-risk group. Patients with acromegaly having ECMDs or DM were older, more obese and had longer disease duration and higher IGF1 levels (Z-score). Logistic regression showed that the severity of glucose derangement was predicted by age, BMI and IGF1 levels. In patients with acromegaly, the prevalence of DM and ECMDs considerably exceeds that of the general population and of a high-risk group, and development of DM depends on age, BMI and IGF1 levels.

  9. Insulin inhalation for diabetic patients: Nursing considerations

    Directory of Open Access Journals (Sweden)

    Hanan Mohammed Mohammed

    2016-04-01

    Full Text Available Scientific knowledge has advanced to enable the development of inhaled insulin. It is a form of diabetes medication administered via the pulmonary system that studies have shown to be efficacious in the treatment of both type 1 and type 2 diabetes. Inhaled insulin is a new, safe means to deliver insulin that may increase patient compliance with insulin therapy, helping them to achieve optimal glycemic control and possibly reducing their risk of developing cardiovascular complications. However, diabetes is a chronic illness requiring lifetime intervention. Empowering patients with the knowledge of the diabetes disease process may give them the confidence to be more autonomous in managing their diabetes. HIIP gives nurse practitioners a new option that may improve their patients’ acceptance of insulin therapy, and improve glycemic control.

  10. Diversity of uropathogens and their resistogram in diabetic and non-diabetic patients in sub Himalayan region of Uttarakhand, India: A case control study

    Directory of Open Access Journals (Sweden)

    Rajat Prakash

    2014-01-01

    Full Text Available Background: Both symptomatic and asymptomatic urinary tract infections (UTIs are thought to occur more frequently in diabetic patients. Local data about the antimicrobial resistance of Uropathogens should be available for proper therapeutic interventions of UTI. Objective: To evaluate the spectrum of the Uropathogens and their profiles of antimicrobial resistance on a series of diabetic and non-diabetic patients. Materials and Methods: A Case-Control study with 100 participants was conducted targeting the Diabetic and Non-diabetic population, symptomatic or asymptomatic for UTI. Antibiotic sensitivity test was done on each of the isolates and the results of the antibiogram were compared with that of control group (nondiabetic group. The statistical analysis was done by Chi-Square Test, Fisher exact test using statistical product and service solutions formerly known as Statistical Package for the Social Sciences (SPSS 16.0 Version. Results: Most common isolate responsible for UTI was Escherichia coli followed by Klebsiella, Enterobacter, Proteus, Citrobacter, Acinetobacter and Candida. 93.3% and 86.6% of the isolates were sensitive to Amikacin and Amoxycillin-clavulanic acid respectively for Non Diabetics. Whereas isolates from diabetic group were 77.7 and 50% sensitive to Amikacin and Amoxycillin-clavulanic acid respectively. Highest resistance was seen for Cefuroxime for the isolates from both diabetic and non-diabetic group with 53.3 and 72.2% respectively. Significant difference in resistance pattern was observed in Amoxycillin-clavulanic acid, cefazolin, piperacillin- tazobactam and ticarcillin-clavulanic acid. Conclusion: Culture of urine and susceptibility testing of isolated organisms is strongly advocated in the clinical management of impending complication in diabetic individuals.

  11. New injection recommendations for patients with diabetes

    NARCIS (Netherlands)

    Frid, A.; Hirsch, L.; Gaspar, R.; Hicks, D.; Kreugel, G.; Liersch, J.; Letondeur, C.; Sauvanet, J. P.; Tubiana-Rufi, N.; Strauss, K.

    2010-01-01

    Aim: Injections administered by patients are one of the mainstays of diabetes management. Proper injection technique is vital to avoiding intramuscular injections, ensuring appropriate delivery to the subcutaneous tissues and avoiding common complications such as lipohypertrophy. Yet few formal guid

  12. Hepatic and pancreatic involvement in hereditary hemorrhagic telangiectasia: quantitative and qualitative evaluation with 64-section CT in asymptomatic adult patients

    Energy Technology Data Exchange (ETDEWEB)

    Barral, Matthias; Sirol, Marc; Hamzi, Lounis; Gayat, Etienne; Boudiaf, Mourad [Hopital Lariboisiere-APHP, Department of Abdominal Imaging, Paris (France); Place, Vinciane [Hopital Lariboisiere-APHP, Department of Abdominal Imaging, Paris (France); Universite Diderot-Paris 7, UFR de Medecine, Paris (France); Borsik, Michel [Hopital Lariboisiere-APHP, Deparment of Ear, Nose and Throat, Paris (France); Soyer, Philippe [Hopital Lariboisiere-APHP, Department of Abdominal Imaging, Paris (France); Universite Diderot-Paris 7, UFR de Medecine, Paris (France); Unite 965 INSERM/Paris7, Hopital Lariboisiere-APHP, Paris (France)

    2012-01-15

    To analyse quantitatively and qualitatively asymptomatic hepatic and pancreatic involvement in hereditary haemorrhagic telangiectasia (HHT) using 64-section helical CT. The 64-section helical CT examinations of 19 patients with HHT (8 men, 11 women; mean age, 58.6 years) were quantitatively and qualitatively analysed and compared to those of 19 control subjects who were matched for age and sex. Comparisons were made using univariate analysis. Dilated and tortuous intrahepatic arterial branches was the most discriminating independent variable (P < 0.0001) and had the highest specificity (100%; 19/19; 95%CI: 82%-100%) and accuracy (97%; 37/38; 95%CI: 86%-100%) for the diagnosis of HHT. Heterogeneous enhancement of hepatic parenchyma, intrahepatic telangiectases, hepatic artery to hepatic vein shunting, hepatic artery enlargement (i.e. diameter > 6.5 mm) and portal vein enlargement (i.e. diameter > 13 mm) were other variables that strongly correlated with the presence of HHT. Intrapancreatic telangiectases and arteriovenous malformations were found in 42% and 16% of patients with HHT, respectively. Liver and pancreatic involvement in asymptomatic HHT patients is associated with myriad suggestive findings on 64-section helical CT. It can be anticipated that familiarity with these findings would result in more confident diagnosis of HHT. (orig.)

  13. Anemia in patients with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Dimković Nada

    2007-01-01

    Full Text Available Introduction: Anemia is more common and pronounced in patients with diabetic, than in patients with non-diabetic renal disease. While several factors contribute to its pathogenesis, the failure of the kidney to increase erythropoietin in response to falling hemoglobin appears to be the dominant factor. The most frequent complications of anemia in diabetic patients include decreased quality of life and work capacity and increased cardiovascular morbidity and mortality. Material and Methods: This cross-sectional multicenter study included a total of 539 patients with type I (~20% and type II diabetes (~80% classified into five stages according to the glomerular filtration rate. Results Diabetic nephropathy appears in stage I, and progresses in all patients to the stage V (p=0.045. The presence of anemia progressively increased from stage I to stage V (from 60% to 100%, p=0.008. Only 62% of patients with anemia were treated (mainly with iron and only 3.4% received erythropoietin treatment. Hypertension was present in 90% of patients in stage I and in 100% of patients in stage V nephropathy. The presence of heart failure increased from 0% (stage I to 51% (stage IV, p=0.03. Around 62% of patients were referred to a nephrologist, and according to the logistic regression model, renal failure and presence of anemia were significant predictors of patients' referral to nephrologist. Conclusion: In a primary care setting, anemia is a frequent finding, even in the very beginning of diabetic renal disease. Currently available guidelines for management of anemia are not followed; this may explain high percentage of patients with heart failure in pre-dialysis stage. Early referral to a nephrologist and regular follow-up by an endocrinologist and cardiologist are the best way for the prevention of diabetic complications and comorbidity.

  14. Cerebral MRI in neurological asymptomatic patients with malignant melanoma; Zerebrales MRT bei neurologisch asymptomatischen Patienten mit malignem Melanom

    Energy Technology Data Exchange (ETDEWEB)

    Schlamann, M.; Goericke, S.; Forsting, M.; Wanke, I. [Inst. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitaetsklinikum Essen (Germany); Loquai, C. [Klinik und Poliklinik fuer Dermatologie, Universitatsklinikum Mainz (Germany)

    2008-02-15

    Purpose: detection of metastasis in the whole body is important for sufficient the staging of malignant melanoma. Sufficient imaging of the brain is particularly important. Although there is evidence that clinical examination is not sufficient for prediction of cerebral metastasis, MRI scan is not always regarded as reasonable in neurological asymptomatic patients. Therefore, we explored the incidence of cerebral metastasis in our patient population in relation to the stage of disease to estimate the reasonability of this examination. Materials and methods: 120 consecutive patients with malignant melanoma were retrospectively evaluated. All patients were neurologically without pathological findings and received routine staging by cranial MRI. The incidence of brain metastasis was evaluated. The examination protocol consisted of an axial orientated flair and a T1 sequence. Ten minutes after administration of contrast agent, a T1 sequence in axial and coronal orientation was performed using the magnetization transfer technique. The type of melanoma, the thickness of the tumor, the Clark level, the location of the primary tumor, and the clinical stage were recorded from the clinical records. Results: 15 (12.5%) of the 120 patients (clinical stage I: 27 patients, stage II: 29 patients, stage III: 25 patients, stage IV: 39 patients) had cerebral metastasis in MRI. 14 patients were in stage III or IV at this time. Consequently 21.8% of the patients in stage III and IV had cerebral metastasis. Only one patient in stage He had cerebral metastasis. (orig.)

  15. In situ saphenous vein bypass surgery in diabetic patients

    DEFF Research Database (Denmark)

    Jensen, L P; Schroeder, T V; Lorentzen, J E

    1992-01-01

    .005). Indication for surgery was gangrene or ulceration in 57% of diabetics, as opposed to 36% in non-diabetic patients (p = 0.0002). A femoro-popliteal bypass was performed in 18% of patients, whereas 82% received an infrapopliteal procedure, of which 42% were to the distal third of the calf or foot. Diabetic......From 1986 through to 1990 a total of 483 consecutive in situ infra-inguinal vein bypass procedures were performed in 444 patients, of whom 112 (25%) were diabetics (57 insulin dependent diabetes mellitus and 55 non-insulin-dependent diabetes mellitus). Based on a prospective vascular data registry...... this material was analysed to determine the influence of diabetes on the outcome. Preoperative risk factors were equally distributed among diabetic and non-diabetic patients, except for smoking habits (diabetics: 48%; non-diabetics: 64%, p = 0.002) and cardiac disease (diabetics: 45%; non-diabetics: 29%, p = 0...

  16. Treatment of neovascular age-related macular degeneration in patients with diabetes

    Directory of Open Access Journals (Sweden)

    Michael Cummings

    2008-06-01

    Full Text Available Michael Cummings1, José Cunha-Vaz21Academic Department of Diabetes and Endocrinology, Queen Alexandra Hospital, Portsmouth, UK; 2Department of Ophthalmology, University Hospital of Coimbra, Centre of Ophthalmology, Institute of Biomedical Research on Light and Image, Faculty of Medicine, University of Coimbra, and Association for Innovation and Biomedical Research on Light and Image, Coimbra, PortugalAbstract: The number of patients with type 2 diabetes continues to rise; an anticipated 300 million people will be affected by 2025. The immense social and economic burden of the condition is exacerbated by the initial asymptomatic nature of type 2 diabetes, resulting in a high prevalence of micro- and macrovascular complications at presentation. Diabetic retinopathy, one of the potential microvascular complications associated with diabetes, and neovascular age-related macular degeneration (AMD are the two most frequent retinal degenerative diseases, and are responsible for the majority of blindness due to retinal disease. Both conditions predominantly affect the central macula, and are associated with the presence of retinal edema and an aggressive inflammatory repair process that accelerates disease progression. The associated retinal edema and the inflammatory repair process are directly involved in the breakdown of the blood-retinal barrier (BRB. Yet, the underlying alterations to the BRB caused by the diseases are very different. The coexistence of the two conditions appears to be relatively uncommon, suggesting that diabetes may even protect patients from developing neovascular AMD. However, it is thought that the inflammatory repair responses associated with diabetic retinopathy and neovascular AMD may be cumulative and, in patients affected by both, could result in chronic diffuse cystoid edema. Treatment considerations in such patients should, therefore, include the role of retinal edema and the increased susceptibility of patients with

  17. Somatotype in elderly type 2 diabetes patients.

    Science.gov (United States)

    Buffa, Roberto; Floris, Giovanni; Putzu, Paolo F; Carboni, Luciano; Marini, Elisabetta

    2007-09-01

    Somatotyping is a practical technique for the description of physique. Individuals with Type 2 diabetes are characterized by physical peculiarities, such as overweight, obesity and a central pattern of body fat distribution. Somatotype applications to diabetes are limited. The objective of this study is to describe the somatotype of elderly type 2 diabetes patients. The sample consisted of 110 patients with type 2 diabetes (45 men, mean age 69.4 +/- 7.0 years; 65 women, mean age 72.9 +/- 7.1 years). The pathological subjects were compared with a control group consisting of 280 healthy individuals (134 men, mean age 74.2 +/- 7.3 years; 146 women, mean age 74.9 +/- 7.4 years). The Heath-Carter somatotype was applied. Diabetic men and women (mean somatotype, respectively: 6.8-5.6-0.6 and 8.6-6.4-0.2) presented significantly higher values of endomorphy than the controls (p = 0.043 in men, p = 0.003 in women); men also had a lower mesomorphic component (p = 0.000). The somatotype method revealed physical peculiarities in type 2 diabetes patients. The marked endomorphy in the pathological individuals can be related to general fatness, which is a well known disease risk factor. The somatotype appears to be a suitable technique for the assessment of physique in type 2 diabetes patients.

  18. Non-diabetic renal disease (NDRD) in patients with type 2 diabetes mellitus (type 2 DM).

    Science.gov (United States)

    Prakash, Jai

    2013-03-01

    In contrast to Type 1 diabetes mellitus (DM), the incidence of non-diabetic renal disease (NDRD) is very high in Type 2 diabetic patients. A wide spectrum of non-diabetic nephropathy (NDN) including both glomerular and tubulointerstitial lesions are reported in patients with Type 2 DM and their precise diagnosis requires histological examination of kidney tissue. Renal biopsy studies suggest that 25-50% of patients with Type 2 diabetes had glomerular lesions unrelated to or in addition to diabetic nephropathy. Histological studies confirm that NDRD can occur in isolated form without diabetic nephropathy or superimposed on diabetic nephropathy. Diabetic nephropathy can occur in absence of retinopathy and chance of getting diabetic and non-diabetic renal lesions are nearly equal in Type 2 diabetic patient in absence of diabetic retinopathy (RP). The presence of RP suggests the concurrence of DN, but does not exclude non-diabetic nephropathy. Clearly, renal biopsy is indicated in proteinuric Type 2 diabetic patients for precise diagnosis of diabetic vs non-diabetic renal disease. Appropriate treatment of NDRD is associated with good clinical outcome. Thus, it is gratifying to treat NDRD in selected patients. Besides, 40 to 60% of ESRD in Type 2 diabetic patients is not caused by diabetic nephropathy.

  19. Conservative treatment of an anterior-lateral ankle dislocation without an associated fracture in a diabetic patient: a case report

    Directory of Open Access Journals (Sweden)

    Panagiotis K. Karampinas

    2012-06-01

    Full Text Available Anterior or anterior-lateral dislocation of the ankle is a rare condition that can be treated conservatively as well as any other similar types of ankle dislocations without associated fractures. We present a case report of an anterior-lateral ankle dislocation with a concomitant avulsion injury of the ankle's anterior capsule in a diabetic patient that was treated conservatively. At the patient's visit 12 months after the initial injury, he was asymptomatic with full range of motion of the ankle joint. To our knowledge, we could not identify this type of an injury in a diabetic patient that was treated successfully with conservative treatment in the existing literature.

  20. Prospective Coronary Heart Disease Screening in Asymptomatic Hodgkin Lymphoma Patients Using Coronary Computed Tomography Angiography: Results and Risk Factor Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Girinsky, Theodore, E-mail: girinsky.theodore@orange.fr [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); M’Kacher, Radhia [Laboratory of Radiobiology and Oncology, Institut de Radiobiologie Cellulaire et Moleculaire/Direction des Sciences Vivantes/Commissariat Energie Atomique, Fontenay aux Roses (France); Lessard, Nathalie [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Koscielny, Serge [Biostatistics and Epidemiology Unit, Institut Gustave Roussy, Villejuif (France); Elfassy, Eric; Raoux, François [Department of Radiology, Marie Lannelongue, Chatenay-Malabry (France); Carde, Patrice [Department of Hematology, Institut Gustave Roussy, Villejuif (France); Santos, Marcos Dos [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Margainaud, Jean-Pierre [Department of Head and Neck Surgery, Institut Gustave Roussy, Villejuif (France); Sabatier, Laure [Laboratory of Radiobiology and Oncology, Institut de Radiobiologie Cellulaire et Moleculaire/Direction des Sciences Vivantes/Commissariat Energie Atomique, Fontenay aux Roses (France); Ghalibafian, Mithra [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Paul, Jean-François [Department of Radiology, Marie Lannelongue, Chatenay-Malabry (France)

    2014-05-01

    Purpose: To prospectively investigate the coronary artery status using coronary CT angiography (CCTA) in patients with Hodgkin lymphoma treated with combined modalities and mediastinal irradiation. Methods and Materials: All consecutive asymptomatic patients with Hodgkin lymphoma entered the study during follow-up, from August 2007 to May 2012. Coronary CT angiography was performed, and risk factors were recorded along with leukocyte telomere length (LTL) measurements. Results: One hundred seventy-nine patients entered the 5-year study. The median follow-up was 11.6 years (range, 2.1-40.2 years), and the median interval between treatment and the CCTA was 9.5 years (range, 0.5-40 years). Coronary artery abnormalities were demonstrated in 46 patients (26%). Coronary CT angiography abnormalities were detected in nearly 15% of the patients within the first 5 years after treatment. A significant increase (34%) occurred 10 years after treatment (P=.05). Stenoses were mostly nonostial. Severe stenoses were observed in 12 (6.7%) of the patients, entailing surgery with either angioplasty with stent placement or bypass grafting in 10 of them (5.5%). A multivariate analysis demonstrated that age at treatment, hypertension, and hypercholesterolemia, as well as radiation dose to the coronary artery origins, were prognostic factors. In the group of patients with LTL measurements, hypertension and LTL were the only independent risk factors. Conclusions: The findings suggest that CCTA can identify asymptomatic individuals at risk of acute coronary artery disease who might require either preventive or curative measures. Conventional risk factors and the radiation dose to coronary artery origins were independent prognostic factors. The prognostic value of LTL needs further investigation.

  1. Interest of the coronaries disease screening by myocardium scintigraphy of iterative perfusion for patients suffering of type 2 diabetes; Interet du depistage de la maladie coronaire par scintigraphie myocardique de perfusion iterative chez des patients diabetiques de type 2

    Energy Technology Data Exchange (ETDEWEB)

    Eder, V. [hopital Trousseau, CHU de Tours, Service de medecine nucleaire, 37 (France)

    2010-07-01

    Achieving iterative myocardial scintigraphy in patients of type 2 diabetes at high asymptomatic cardiovascular risk with management of risk factors has ensured a predictive negative value (N.P.V.) of 100% and 15% for detecting coronary patients. (N.C.)

  2. Cardiac autonomic neuropathy predicts cardiovascular morbidity and mortality in type 1 diabetic patients with diabetic nephropathy

    DEFF Research Database (Denmark)

    Astrup, Anne Sofie; Tarnow, Lise; Rossing, Peter

    2006-01-01

    Cardiac autonomic neuropathy (CAN) has been associated with a poor prognosis in patients with diabetes. Because CAN is common in patients with diabetic nephropathy, we evaluated the predictive value of CAN in type 1 diabetic patients with and without diabetic nephropathy....

  3. Left atrial size and function as predictors of new-onset of atrial fibrillation in patients with asymptomatic aortic stenosis

    DEFF Research Database (Denmark)

    Bang, Casper N; Dalsgaard, Morten; Greve, Anders M

    2013-01-01

    BACKGROUND: Left atrial (LA) size and function change with chronically increased left ventricular (LV) filling pressures. It remains unclear whether these variations in LA parameters can predict new-onset atrial fibrillation (AF) in asymptomatic patients with aortic stenosis (AS). METHODS: Data...... were obtained in asymptomatic patients with mild-to-moderate AS (2.5≤ transaortic Doppler velocity ≤4.0m/s), preserved LV ejection fraction (EF), no previous AF, and were enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis study. Peak-aortic velocity, LA(max) volume & LA(min) volume were...... age was 66±9.7years, aortic valve area index 0.6±0.2cm(2)/m(2), LV mass 99.2±29.7g/m(2), LA(max) volume 34.6±12.0mL/m(2), LA(min) volume 17.9±9.3mL/m(2), LA-EF 50±15% and LA(con) volume 45±21mL/m(2). Baseline LA(min) volume predicted new-onset AF in Cox multivariable analysis (HR:2.3 [95%CI:1...

  4. Asymptomatic ocular sarcoidosis

    Directory of Open Access Journals (Sweden)

    Luiz Guilherme Azevedo de Freitas

    2013-04-01

    Full Text Available Sarcoidosis is an idiopathic systemic granulomatous disease. It commonly affects the skin, lungs, kidneys, and central nervous system. In the eyes it primarily affects the uveal tract, conjunctiva, lacrimal glands and optic nerve. Here in we describe the case of a patient with systemic sarcoidosis and asymptomatic eye inflammation.

  5. Asymptomatic Borrelia burgdorferi infection.

    Science.gov (United States)

    Wormser, G P; Nadelman, R B; Nowakowski, J; Schwartz, I

    2001-10-01

    Little is known about the natural history of asymptomatic Borrelia burgdorferi infection. Our analysis of the asymptomatic infections diagnosed serologically in a recent OspA vaccine trial conducted in the United States (N Engl J Med 1998;339: 209-215), suggests that the natural history of this event is more benign than that reported for untreated patients with erythema migrans (Ann Intern Med 1987;107: 725-731). We hypothesize that this is due either to incorrect diagnosis since the specificity of the serologic criteria used to diagnose asymptomatic infection in the vaccine study is unknown, or to infection with non-pathogenic strains of B. burgdorferi. Increasing evidence indicates that the invasive potential of strains of B. burgdorferi varies according to the specific subtype. Theoretically, a serologic testing method could be devised which would distinguish infection with invasive versus non-invasive strains of B. burgdorferi, and allow testing of the second hypothesis.

  6. Risk factors of diabetic retinopathy in type 2 diabetic patients

    Institute of Scientific and Technical Information of China (English)

    CAI Xiao-ling; WANG Fang; JI Li-nong

    2006-01-01

    Background Advances in treatment have greatly reduced the risk of blindness from this disease, but because diabetes is so common, diabetic retinopathy remains an important problem. The purpose of this study is to investigate the risk factors of diabetic retinopathy (DR) in Chinese type 2 diabetic patients.Methods Totally 746 type 2 diabetic patients were selected for biochemical and clinical characteristics test and examined by the retina-camera for diabetic retinopathy and the average age was 55.9 years old.Results A total of 526 patients was classified as non-DR, 159 patients as non-proliferative-DR and 61 patients as proliferative-DR. Duration of diabetes [(66.09±72.51) months vs (143.71 ±93.27) months vs (174.30±81.91)months, P=0.00], systolic blood pressure [(131.95±47.20) mmHg vs (138.71 ±21.36) mmHg vs (147.58±24.10)mmHg, P=0.01], urine albumin [(32.79± 122.29) mg/L vs (190.96±455.65) mg/L vs (362.00±552.51) mg/L,P=0.00], glycated hemoglobin (HbA1c) [(8.68 ± 2.26)% vs (9.42±1.84)% vs (9.42±1.96)%, P=0.04],C-reactive protein (CRP) [(3.19±7.37) mg/L vs (6.36± 23.59) mg/L vs (3.02±4.34) mg/L, P=0.03],high-density lipoprotein cholesterol (HDL-C) [(1.23±0.37) mmol/L vs (1.33±0.35) mmol/L vs (1.24±0.33)mmol/L, P=0.01], uric acid (UA) [(288.51 ±90.85) mmol/L vs (300.29±101.98) mmol/L vs (337.57±115.09)mmol/L, P=0.00], creatinine (CREA) [(84.22±16.31) μmol/L vs (89.35±27.45) μmol/L vs (103.28±48.64)μmol/L, P=0.00], blood urine nitrogen (BUN) [(5.62± 1.62) mmol/L vs (6.55±2.74) mmol/L vs (8.11±3.60)mmol/L, P=0.00] were statistically different among the three groups. Logistic regression analysis showed that diabetic duration and urine albumin were two independent risk factors of DR (the OR values were 1.010 and 1.003 respectively).Conclusions Diabetic duration and urine albumin are two independent risk factors of diabetic retinopathy in elderly type 2 diabetic patients.

  7. Kidney Transplantation in the Diabetic Patient

    Directory of Open Access Journals (Sweden)

    María José Pérez-Sáez

    2015-06-01

    Full Text Available Diabetes mellitus is one of the most important causes of chronic kidney disease (CKD. In patients with advanced diabetic kidney disease, kidney transplantation (KT with or without a pancreas transplant is the treatment of choice. We aimed to review current data regarding kidney and pancreas transplant options in patients with both type 1 and 2 diabetes and the outcomes of different treatment modalities. In general, pancreas transplantation is associated with long-term survival advantages despite an increased short-term morbidity and mortality risk. This applies to simultaneous pancreas kidney transplantation or pancreas after KT compared to KT alone (either living donor or deceased. Other factors as living donor availability, comorbidities, and expected waiting time have to be considered whens electing one transplant modality, rather than a clear benefit in survival of one strategy vs. others. In selected type 2 diabetic patients, data support cautious utilization of simultaneous pancreas kidney transplantation when a living kidney donor is not an option. Pancreas and kidney transplantation seems to be the treatment of choice for most type 1 diabetic and selected type 2 diabetic patients.

  8. Intraoperative pulmonary hypertension occurred in an asymptomatic patient with pre-existent liver cirrhotic and portal hypertension

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Portopulmonary hypertension (PPH) is clinically defined as the development of pulmonary arterial hypertension complicated by portal hypertension, with or without advanced hepatic disease. Physical signs may be absent in mild to moderate PPH and only appear in a hyperdynamic circulatory state. Similar signs of advanced liver disease can be observed in severe PPH, with ascites and lower extremity edema. Pulmonary hypertension is usually diagnosed after anesthetic induction during liver transplantation (LT). We present intraoperative pulmonary hypertension in a 41-year-old male patient with hepatic cirrhosis. Since this patient had no preoperation laboratory data supporting the diagnosises of pulmonary hypertension and was asymptomatic for a number of years, it was necessary to send him to the intensive care unit after operation. Further study should be focued on the diagnosis and treatment of pulmonary arterial hypertension in order to reduce its mortality.

  9. Differences in cardiovascular risk profile between electrocardiographic hypertrophy versus strain in asymptomatic patients with aortic stenosis (from SEAS data)

    DEFF Research Database (Denmark)

    Greve, Anders M; Gerdts, Eva; Boman, Kurt

    2011-01-01

    Electrocardiograms are routinely obtained in clinical follow-up of patients with asymptomatic aortic stenosis (AS). The association with aortic valve, left ventricular (LV) response to long-term pressure load, and clinical covariates is unclear and the clinical value is thus uncertain. Data from...... clinical examination, electrocardiogram, and echocardiogram in 1,563 patients in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study were used. Electrocardiograms were Minnesota coded for arrhythmias and atrioventricular and intraventricular blocks; LV hypertrophy was assessed by Sokolow......-Lyon voltage and Cornell voltage-duration criteria; and strain by T-wave inversion and ST-segment depression. Degree of AS severity was evaluated by echocardiography as peak aortic jet velocity and LV mass was indexed by body surface area. After adjustment for age, gender, LV mass index, heart rate, systolic...

  10. Allopurinol inappropriate use in case of asymptomatic hyperuricemic patient causes fatal Allopurinol hypersensitive syndrome: lesson to all

    Directory of Open Access Journals (Sweden)

    Arvind Kumar

    2015-12-01

    Full Text Available Allopurinol is used to treat hyperuricemia (HU in a patient of gout. It is also used to prevent HU in a patient of hematological malignancies who are about to undergo chemotherapy. Allopurinol is usually well-tolerated but it occasionally induces hypersensitivity reactions that manifest after few months of therapy. Cutaneous reactions are pruritic, erythematous, or maculopapular eruptions. Rarely fatal toxic epidermal necrolysis or Stevens-Johnson syndrome may occur. Transient leukopenia or leukocytosis, eosinophilia and elevated transaminases may also occur. HU is not a disease in itself. Its level is highly variable in the general population. Uric acid level is influenced by many factors such as dietary intake of proteins, hypertension, and obesity. Only very rarely patients of AHU may progress to gout and renal stones. Not much data is available that support HU alone in an asymptomatic patient in later life shows the diseases which are associated with HU. Sometimes only lifestyle changes, diet restrictions, alcohol restrictions, and treatment of underlying acquired cause may correct HU. Here, we are presenting a rare case of allopurinol hypersensitivity syndrome in an AHU patient. Our aim is to raise awareness among physicians so that they avoid using unnecessarily allopurinol in AHU patients and also titrate the dose of allopurinol in patients of renal failure. Risk-benefit ratio must be considered in these patients before starting allopurinol. [Int J Basic Clin Pharmacol 2015; 4(6.000: 1302-1304

  11. Asymptomatic dystrophinopathy

    Energy Technology Data Exchange (ETDEWEB)

    Morrone, A. [Univ. of Pittsburgh School of Medicine, PA (United States)]|[Univ. of Florence (Italy); Hoffman, E.P.; Hoop, R.C. [Univ. of Pittsburgh School of Medicine, PA (United States)] [and others

    1997-03-31

    A 4-year-old girl was referred for evaluation for a mild but persistent serum aspartate aminotransferase (AST) elevation detected incidentally during routine blood screening for a skin infection. Serum creatine kinase activity was found to be increased. Immuno-histochemical study for dystrophin in her muscle biopsy showed results consistent with a carrier state for muscular dystrophy. Molecular work-up showed the proposita to be a carrier of a deletion mutation of exon 48 of the dystrophin gene. Four male relatives also had the deletion mutation, yet showed no clinical symptoms of muscular dystrophy (age range 8-58 yrs). Linkage analysis of the dystrophin gene in the family showed a spontaneous change of an STR45 allele, which could be due to either an intragenic double recombination event, or CA repeat length mutation leading to identical size alleles. To our knowledge, this is the first documentation of an asymptomatic dystrophinopathy in multiple males of advanced age. Based on molecular findings, this family would be given a diagnosis of Becker muscular dystrophy. This diagnosis implies the development of clinical symptoms, even though this family is clearly asymptomatic. This report underscores the caution which must be exercised when giving presymptomatic diagnoses based on molecular studies. 28 refs., 4 figs., 1 tab.

  12. Assessing the Quality of Diabetic Patients Care

    Directory of Open Access Journals (Sweden)

    Belkis Vicente Sánchez

    2012-12-01

    Full Text Available Background: to improve the efficiency and effectiveness of the actions of family doctors and nurses in this area is an indispensable requisite in order to achieve a comprehensive health care. Objective: to assess the quality of health care provided to diabetic patients by the family doctor in Abreus health area. Methods: a descriptive and observational study based on the application of tools to assess the performance of family doctors in the treatment of diabetes mellitus in the five family doctors consultation in Abreus health area from January to July 2011 was conducted. The five doctors working in these consultations, as well as the 172 diabetic patients were included in the study. At the same time, 172 randomly selected medical records were also revised. Through observation, the existence of some necessary material resources and the quality of their performance as well as the quality of medical records were evaluated. Patient criteria served to assess the quality of the health care provided. Results: scientific and technical training on diabetes mellitus has been insufficient; the necessary equipment for the appropriate care and monitoring of patients with diabetes is available; in 2.9% of medical records reviewed, interrogation appears in its complete form including the complete physical examination in 12 of them and the complete medical indications in 26. Conclusions: the quality of comprehensive medical care to diabetic patients included in the study is compromised. Doctors interviewed recognized the need to be trained in the diagnosis and treatment of diabetes in order to improve their professional performance and enhance the quality of the health care provided to these patients.

  13. Asymptomatic aneurysm of the cavernous and supraclinoid internal carotid artery in a patient with Balamuthia mandrillaris encephalitis.

    Science.gov (United States)

    Orozco, Ludwig D; Khan, Majid A; Fratkin, Jonathan D; Hanigan, William C

    2011-08-01

    This is the first report to our knowledge of the successful treatment of an asymptomatic mycotic aneurysm associated with Balamuthia mandrillaris encephalitis. A 27-year-old male with end-stage renal disease presented with generalized seizures following renal transplantation. MRI demonstrated multiple brain masses and an aneurysm of the cavernous and supraclinoid carotid artery. Autopsy of the donor's brain revealed Balamuthia encephalitis. The patient was placed on an anti-amebic regimen, his condition improved, and 126 days after the kidney transplant, MRI brain showed resolution of the aneurysm and improvement of the enhancing lesions. Balamuthia mandrillaris has been shown to cause a granulomatous encephalitis, with prominent vasculitis. This is the first report to demonstrate the risk of aneurysm formation associated with this infection. Prolonged anti-amebic treatment resulted in resolution of the aneurysm without clinical evidence of subarachnoid hemorrhage.

  14. Is there a role for coronary artery calcium scoring for management of asymptomatic patients at risk for coronary artery disease?: Clinical risk scores are not sufficient to define primary prevention treatment strategies among asymptomatic patients.

    Science.gov (United States)

    Blaha, Michael J; Silverman, Michael G; Budoff, Matthew J

    2014-03-01

    Although risk factors have proven to be useful therapeutic targets, they are poor predictors of risk. Traditional risk scores are moderately successful in predicting future CHD events and can be a starting place for general risk categorization. However, there is substantial heterogeneity between traditional risk and actual atherosclerosis burden, with event rates predominantly driven by burden of atherosclerosis. Serum biomarkers have yet to show any clinically significant incremental value to the FRS and even when combined cannot match the predictive value of atherosclerosis imaging. As clinicians, are we willing to base therapy decisions on risk models that lack optimum-achievable accuracy and limit personalization? The decision to treat a patient in primary prevention must be a careful one because the benefit of therapy in an asymptomatic patient must clearly outweigh the potential risk. CAC, in particular, provides a personalized assessment of risk and may identify patients who will be expected to derive the most, and the least, net absolute benefit from treatment. Emerging evidence hints that CAC may also promote long-term adherence to aspirin, exercise, diet, and statin therapy. When potentially lifelong treatment decisions are on the line, clinicians must arm their patients with the most accurate risk prediction tools, and subclinical atherosclerosis testing with CAC is, at the present time, superior to any combination of risk factors and serum biomarkers.

  15. Pulmonary functions in patients with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Muhammad Irfan

    2011-01-01

    Full Text Available Background: A reduction in lung capacity has been reported previously among diabetics. According to WHO estimates, Pakistan is currently eighth in the prevalence of diabetes mellitus (DM and will become fourth by the year 2025 with over 15 million individuals. This study was designed to see the impairment of lung functions on spirometry in DM patients. Objective: Our aim was to investigate the pulmonary functions tests of Pakistani patients with DM. Materials and Methods: Between January to July 2004, 128 subjects who were never-smokers and had no acute or chronic pulmonary disease were recruited. Sixty-four of these subjects had DM and 64 were healthy matched controls. All underwent screening with detailed history, anthropometry, lipid profile, and spirometric measurements at the Aga Khan University Hospital, Karachi, Pakistan. Results: The mean age of diabetics and matched control were 54.3±9 and 54.0±8 (P<0.87 years, respectively. Diabetes patients showed a significant reduction in the forced vital capacity (FVC [mean difference (95% CI - 0.36 (-0.64, -0.07 P<0.01], forced expiratory volume in one second (FEV 1 [- 0.25(-0.50, -0.003 P<0.04], and slow vital capacity (SVC [- 0.28(-0.54, -0.01 P<0.04], relative to nondiabetic controls. There was no significant difference noted in the forced expiratory ratio and maximum mid-expiratory flow between the groups. There was also a significant higher level of triglycerides noted among diabetics (P<0.001. Conclusion: Diabetic patients showed impaired lung function independent of smoking. This reduced lung function is likely to be a chronic complication of diabetes mellitus.

  16. Design and development of a decision aid to enhance shared decision making by patients with an asymptomatic abdominal aortic aneurysm

    Directory of Open Access Journals (Sweden)

    Dirk T Ubbink

    2008-11-01

    Full Text Available Dirk T Ubbink1,2, Anouk M Knops1, Sjaak Molenaar1, Astrid Goossens11Department of Quality Assurance and Process Innovation and 2Department of Surgery, Academic Medical Center, Amsterdam, The NetherlandsObjective: To design, develop, and evaluate an evidence-based decision aid (DA for patients with an asymptomatic abdominal aortic aneurysm (AAA to inform them about the pros and cons of their treatment options (ie, surgery or watchful observation and to help them make a shared decision.Methods: A multidisciplinary team defined criteria for the desired DA as to design, medical content and functionality, particularly for elderly users. Development was according to the international standard (IPDAS. Fifteen patients with an AAA, who were either treated or not yet treated, evaluated the tool.Results: A DA was developed to offer information about the disease, the risks and benefits of surgical treatment and watchful observation, and the individual possibilities and threats based on the patient’s aneurysm diameter and risk profile. The DA was improved and judged favorably by physicians and patients.Conclusion: This evidence-based DA for AAA patients, developed according to IPDAS criteria, is likely to be a simple, user-friendly tool to offer patients evidence-based information about the pros and cons of treatment options for AAA, to improve patients’ understanding of the disease and treatment options, and may support decision making based on individual values.Keywords: decision support techniques, research design, program development, abdominal aortic aneurysm, decision making

  17. Assessment of coronary artery disease and calcified coronary plaque burden by computed tomography in patients with and without diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Maffei, Erica; Seitun, Sara [Azienda Ospedaliero-Universitaria di Parma, Department of Radiology and Cardiology, Parma (Italy); Nieman, Koen; Weustink, Annick C.; Mollet, Nico R. [Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands); Martini, Chiara [Azienda Ospedaliero-Universitaria di Parma, Department of Radiology and Cardiology, Parma (Italy); Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands); Guaricci, Andrea Igoren [Azienda Ospedaliero-Universitaria di Foggia, Department of Cardiology, Foggia (Italy); Tedeschi, Carlo [Ospedale San Gennaro, Department of Cardiology, Naples (Italy); Berti, Elena; Grilli, Roberto [Regione Emilia-Romagna, Healthcare and Social Agency, Bologna (Italy); Messalli, Giancarlo [SDN Foundation, IRCCS, Naples (Italy); Cademartiri, Filippo [Azienda Ospedaliero-Universitaria di Parma, Department of Radiology and Cardiology, Parma (Italy); Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands); Azienda Ospedaliero-Universitaria - Parma, Department of Radiology, Parma (Italy)

    2011-05-15

    To compare the coronary atherosclerotic burden in patients with and without type-2 diabetes using CT Coronary Angiography (CTCA). 147 diabetic (mean age: 65 {+-} 10 years; male: 89) and 979 nondiabetic patients (mean age: 61 {+-} 13 years; male: 567) without a history of coronary artery disease (CAD) underwent CTCA. The per-patient number of diseased coronary segments was determined and each diseased segment was classified as showing obstructive lesion (luminal narrowing >50%) or not. Coronary calcium scoring (CCS) was assessed too. Diabetics showed a higher number of diseased segments (4.1 {+-} 4.2 vs. 2.1 {+-} 3.0; p < 0.0001); a higher rate of CCS > 400 (p < 0.001), obstructive CAD (37% vs. 18% of patients; p < 0.0001), and fewer normal coronary arteries (20% vs. 42%; p < 0.0001), as compared to nondiabetics. The percentage of patients with obstructive CAD paralleled increasing CCS in both groups. Diabetics with CCS {<=} 10 had a higher prevalence of coronary plaque (39.6% vs. 24.5%, p = 0.003) and obstructive CAD (12.5% vs. 3.8%, p = 0.01). Among patients with CCS {<=} 10 all diabetics with obstructive CAD had a zero CCS and one patient was asymptomatic. Diabetes was associated with higher coronary plaque burden. The present study demonstrates that the absence of coronary calcification does not exclude obstructive CAD especially in diabetics. (orig.)

  18. Diabetic patient education: determinants of success.

    Science.gov (United States)

    Day, J L

    2000-01-01

    Education/empowerment is critical if successful self-management is to be achieved. All professional patient interactions have a learning component. Clinical outcomes in diabetes are as dependent on psycho-social factors or learned behaviour as on metabolic state or therapeutic interventions. These factors include targets set, self-management skills, influence of living with diabetes, emotional factors, role of other people, perceived benefits and barriers, feelings of self-efficacy, weight concern and diet barrier. Training in learning processes and factors governing behaviour are essential for all those involved in delivery of patient care. Educational programmes should recognise the wide range of learning strategies used by different people.

  19. Clinical examination and foot pressure analysis of diabetic foot: Prospective analytical study in Indian diabetic patients.

    Directory of Open Access Journals (Sweden)

    Harshanand Popalwar

    2016-03-01

    Conclusion: Meticulous clinical examination can easily identify diabetic neuropathy and related pathological complications of diabetic foot. This shall help for early diagnosis and prevention of diabetic foot complications. Foot pressure analysis can be useful tool to screen patients of diabetic foot for abnormal high pressure point areas and can predict future risk of ulceration due to high foot pressure. This study states findings in Indian diabetic patients. [Natl J Med Res 2016; 6(1.000: 17-22

  20. Diabetic factors associated with gastrointestinal symptoms in patients with type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    Jeong; Hwan; Kim; Hyung; Seok; Park; Soon; Young; Ko; Sung; Noh; Hong; In-Kyung; Sung; Chan; Sub; Shim; Kee-Ho; Song; Dong-Lim; Kim; Sook; Kyung; Kim; Jeeyoung; Oh

    2010-01-01

    AIM: To determine whether gastrointestinal (GI) symptoms are more frequent in type 2 diabetic patients and to examine which diabetic factors are associated with the symptoms. METHODS: Consecutive subjects with diabetes and age-/gender-matched normal controls were recruited for this study. GI symptoms were assessed using a structured questionnaire divided into two GI symptomcategories (upper and lower GI symptoms), and consisting of 11 individual symptoms. In the diabetic patient group, diabetic complication...

  1. Diabetes education improves depressive state in newly diagnosed patients with type 2 diabetes

    OpenAIRE

    Chen, Bin; Zhang, Xiyao; Xu, Xiuping; LV, XIAOFENG; Yao, Lu; Huang, Xu; Guo, Xueying; Liu, Baozhu; Li, Qiang; CUI, CAN

    2013-01-01

    Objectives: The prevalence of depression is relatively high in individuals with diabetes. However, screening and monitoring of depressive state in patients with diabetes is still neglected in developing countries and the treatment of diabetes-related depression is rarely performed in these countries. In this study, our aim was to study the role of diabetes education in the improvement of depressive state in newly diagnosed patients with type 2 diabetes. Methods: The Dutch version of the cente...

  2. Modest elevation in BNP in asymptomatic hypertensive patients reflects sub-clinical cardiac remodeling, inflammation and extracellular matrix changes.

    LENUS (Irish Health Repository)

    Phelan, Dermot

    2012-11-01

    In asymptomatic subjects B-type natriuretic peptide (BNP) is associated with adverse cardiovascular outcomes even at levels well below contemporary thresholds used for the diagnosis of heart failure. The mechanisms behind these observations are unclear. We examined the hypothesis that in an asymptomatic hypertensive population BNP would be associated with sub-clinical evidence of cardiac remodeling, inflammation and extracellular matrix (ECM) alterations. We performed transthoracic echocardiography and sampled coronary sinus (CS) and peripheral serum from patients with low (n = 14) and high BNP (n = 27). Peripheral BNP was closely associated with CS levels (r = 0.92, p<0.001). CS BNP correlated significantly with CS levels of markers of collagen type I and III turnover including: PINP (r = 0.44, p = 0.008), CITP (r = 0.35, p = 0.03) and PIIINP (r = 0.35, p = 0.001), and with CS levels of inflammatory cytokines including: TNF-α (r = 0.49, p = 0.002), IL-6 (r = 0.35, p = 0.04), and IL-8 (r = 0.54, p<0.001). The high BNP group had greater CS expression of fibro-inflammatory biomarkers including: CITP (3.8±0.7 versus 5.1±1.9, p = 0.007), TNF-α (3.2±0.5 versus 3.7±1.1, p = 003), IL-6 (1.9±1.3 versus 3.4±2.7, p = 0.02) and hsCRP (1.2±1.1 versus 2.4±1.1, p = 0.04), and greater left ventricular mass index (97±20 versus 118±26 g\\/m(2), p = 0.03) and left atrial volume index (18±2 versus 21±4, p = 0.008). Our data provide insight into the mechanisms behind the observed negative prognostic impact of modest elevations in BNP and suggest that in an asymptomatic hypertensive cohort a peripheral BNP measurement may be a useful marker of an early, sub-clinical pathological process characterized by cardiac remodeling, inflammation and ECM alterations.

  3. Modest elevation in BNP in asymptomatic hypertensive patients reflects sub-clinical cardiac remodeling, inflammation and extracellular matrix changes.

    Directory of Open Access Journals (Sweden)

    Dermot Phelan

    Full Text Available In asymptomatic subjects B-type natriuretic peptide (BNP is associated with adverse cardiovascular outcomes even at levels well below contemporary thresholds used for the diagnosis of heart failure. The mechanisms behind these observations are unclear. We examined the hypothesis that in an asymptomatic hypertensive population BNP would be associated with sub-clinical evidence of cardiac remodeling, inflammation and extracellular matrix (ECM alterations. We performed transthoracic echocardiography and sampled coronary sinus (CS and peripheral serum from patients with low (n = 14 and high BNP (n = 27. Peripheral BNP was closely associated with CS levels (r = 0.92, p<0.001. CS BNP correlated significantly with CS levels of markers of collagen type I and III turnover including: PINP (r = 0.44, p = 0.008, CITP (r = 0.35, p = 0.03 and PIIINP (r = 0.35, p = 0.001, and with CS levels of inflammatory cytokines including: TNF-α (r = 0.49, p = 0.002, IL-6 (r = 0.35, p = 0.04, and IL-8 (r = 0.54, p<0.001. The high BNP group had greater CS expression of fibro-inflammatory biomarkers including: CITP (3.8±0.7 versus 5.1±1.9, p = 0.007, TNF-α (3.2±0.5 versus 3.7±1.1, p = 003, IL-6 (1.9±1.3 versus 3.4±2.7, p = 0.02 and hsCRP (1.2±1.1 versus 2.4±1.1, p = 0.04, and greater left ventricular mass index (97±20 versus 118±26 g/m(2, p = 0.03 and left atrial volume index (18±2 versus 21±4, p = 0.008. Our data provide insight into the mechanisms behind the observed negative prognostic impact of modest elevations in BNP and suggest that in an asymptomatic hypertensive cohort a peripheral BNP measurement may be a useful marker of an early, sub-clinical pathological process characterized by cardiac remodeling, inflammation and ECM alterations.

  4. Is carotid artery evaluation necessary for primary prevention in asymptomatic high-risk patients without atherosclerotic cardiovascular disease?

    Directory of Open Access Journals (Sweden)

    Kim GH

    2015-07-01

    Full Text Available GeeHee Kim,1 Ho-Joong Youn,2 Yun-Seok Choi,2 Hae Ok Jung,2 Wook Sung Chung,2 Chul-Min Kim1 1Department of Internal Medicine, St Vincent’s Hospital, The Catholic University of Korea, Suwon, 2Division of Cardiology, Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Objective: Routine measurement of the carotid intima–media thickness is not recommended in recent clinical practice guidelines for risk assessment of the first atherosclerotic cardiovascular disease (ASCVD event (the definition of which includes acute coronary syndromes, a history of myocardial infarction, stable or unstable angina, coronary or other arterial revascularization, stroke, transient ischemic attack, or peripheral arterial disease presumed to be of atherosclerotic origin. The aim of the present study was to elucidate the role of carotid artery evaluation for primary prevention of ASCVD in asymptomatic high-risk patients visiting a teaching hospital.Methods: Eight hundred seventy-three patients (487 male [55.8%], mean age 59.4±11.5 years who were statin-naive and without ASCVD, which was proven by coronary angiography or coronary CT angiography, were enrolled in this study. The patients underwent carotid scanning in the Medical Department of St Mary’s Hospital from September 2003 to March 2009. ASCVD outcomes were evaluated for median follow-up of 1,402 days.Results: A total of 119 participants experienced ASCVD events. In multivariate Cox regression analysis, age (hazard ratio [HR] =1.026, 95% confidence interval [CI] =1.002–1.050, P=0.033, history of smoking (HR =1.751, 95% CI =1.089–2.815, P=0.021, statin therapy (HR =0.388, 95% CI =0.205–0.734, P=0.004, and carotid plaques (HR =1.556, 95% CI =1.009–2.400, P=0.045 were associated with ASCVD events. In middle-aged group (45≤ age <65, n=473, history of smoking (HR =1.995, 95% CI =1.142–3.485, P=0.015, statin therapy (HR =0.320, 95% CI =0.131

  5. Emphysematous cystitis of the diabetic patient

    Directory of Open Access Journals (Sweden)

    Affes Nejmeddine

    2009-01-01

    Full Text Available Background : Emphysematous cystitis is defined by the presence of gas in the urinary bladder wall. It complicates urinary tract infections especially in diabetic patients. Aims : We present a case of emphysematous cystitis in a diabetic patient with a poor glycemia control and we discuss diagnostics and treatment items of this uncommon and serious infection. Methods and Results : A 45-year-old man was admitted to the emergency department with confusion and abdominal pain. The clinical examination found a septic shock the Ultra-sonography (US showed a cholecystitis the patient was operated without amelioration. A post operative pelvic computed tomography (CT demonstrated intramural gas in the urinary bladder, which suggested a diagnosis of emphysematous cystitis. The treatment was based on an antibiotics associated with a bladder drainage. The evolution was in favor. Conclusion : Every diabetic patient with a urinary tract infection who seems to be severely ill should have an abdominal X-ray as a minimal screening tool to detect emphysematous complications. (Nejmeddine A, Atef B, Youssef D, Ramez B, Issam BM. Emphysematous cystitis of the diabetic patient.

  6. Oral Soft Tissue Pathologies among Diabetic Patients in Rasht- 2005

    OpenAIRE

    H Hassannia; Kalantari, S; Z Mohtasham Amiri; M Rabiei

    2007-01-01

    Introduction: Diabetes can affect organs including the oral mucosa. There is a disagreement about the prevalence of oral mucosal disease in diabetic patients. We therefore decided to investigate more about that. The aim of this study was to determine the prevalence of soft tissue pathologies by assessing burning mouth and xerostomia in diabetic patients on the basis of type of diabetes and control status of diabetes. Methods: This descriptive, analytic study was done by visiting 486 known dia...

  7. Coronary artery bypass surgery in the diabetic patient.

    LENUS (Irish Health Repository)

    Maher, M

    2012-02-03

    Coronary artery and peripheral occlusive arterial disease frequently complicate diabetes mellitus, with death due to atherosclerotic coronary artery disease being three times more likely in diabetic compared to non-diabetic patients. The profile of 32 diabetic patients and 32 matched controls who underwent coronary artery bypass (CABG) is studied and their early and late postoperative outcomes are described. The mean age was 61 +\\/- 1 year in both groups. The diabetic group comprised 26 non-insulin dependent and 6 insulin dependent diabetics, who had a mean duration of diabetes of 8.5 years (range 2 months--35 years). The median number of grafts per patient performed in the diabetic group and the control group was 3.5 and 3 respectively. There was no mortality in the series, however considerably greater wound morbidity rates were encountered in the diabetic group when compared to matched controls. One renal transplant patient in the diabetic group suffered irreversible acute tubular necrosis and became dialysis dependent post-operatively. Longterm follow-up showed no longterm mortality in either group, with full relief of angina achieved in 75% of diabetic patients compared with 87.5% of matched controls. In addition diabetic patients suffered greater longterm cardiac morbidity than the control group (21.8% versus 12.5%). The results of this study suggest that CABG is a safe operation for the diabetic patient. Diabetic patients receive satisfactory symptomatic relief of angina, but suffer increased perioperative wound complications and greater incidence of longterm cardiac morbidity.

  8. Carpal Tunnel Release in Diabetic and Non-Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Mohammad H Ebrahimzadeh

    2013-09-01

    Full Text Available Background: Carpal tunnel syndrome (CTS is a compression neuropathy that causes paresthesia, pain or numbness in the territory of median nerve. The aim of this study is to compare the open surgery outcome and patients` satisfaction in carpal tunnel syndrome among diabetic and non-diabetic patients. Methods: In a retrospective cohort study from April 2011 to June 2012, patients suffered from carpal tunnel syndrome at least 6 months, without response to conservative treatment, who had the inclusion and exclusion criteria, were evaluated by the usage of MHQ and WHOQOL-BREEF tests, one month before surgery and three months after that. Carpal tunnel decompression surgery was performed by two surgeons, experienced in hand surgery, which used the same surgical method. Statistical analysis was performed by SPSS 19.0. Results: 24 of patient (34.2% were male and 46 (65.8% were female and there was no significant difference between two groups (P>0.05. MHQ total score before and after surgery was respectively 50.22±7.13 and 63.49±11.28 and this difference was significant (P

  9. Features in Angiographic Evaluation of the Diabetic Patient

    Directory of Open Access Journals (Sweden)

    Taisia Tiron Andreea

    2014-09-01

    Full Text Available Currently it is estimated that there are over 382 million patients with diabetes worldwide and their number is increasing, which makes this metabolic disorder the most common non-contagious disease, particularly related to obesity and physical inactivity. There is a close relationship between diabetes and cardiovascular disease, statistics showing that over 50% of deaths in patients with diabetes are produced by cardiovascular complications. This requires a close collaboration between diabetologists and cardiologists. The mortality caused by atherosclerotic complications is 65-80% for diabetic patients compared to 33% in non-diabetic patients. Moreover, 20% of the patients requiring coronary revascularization procedures are diabetics and over 30% of patients with angiographic exploration have diabetes. Among the patients with diabetes the coronary lesions are present in 50% of cases and the peripheral arteries lesions in 30% of cases.

  10. Hyperintense basal ganglia lesions on T1-weighted MR images in asymptomatic patients with hepatic dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Saatci, I. [Dept. of Radiology, Hacettepe Univ. Hospital, Ankara (Turkey); Cila, A. [Dept. of Radiology, Hacettepe Univ. Hospital, Ankara (Turkey); Dincer, F.F. [Dept. of Radiology, Hacettepe Univ. Hospital, Ankara (Turkey)

    1995-12-31

    Cranial MRI findings in four patients who had hepatic dysfunction, including one with sole hepatic form of Wilson`s disease, were reported. The MR examinations revealed bilateral, symmetric hyperintensity in the globus pallidus, subthalamic nuclei and mesencephalon on T1-weighted images with no corresponding abnormality on T2-weighted sequences. The basal ganglia were normal on CT examinations in all patients. None of the patients had the clinical findings of hepatic encephalopathy. The MR findings in our patients did not correlate with the degree or duration of hepatic dysfunction. (orig.)

  11. Rhinocerebral zygomycosis in a diabetic patient

    Directory of Open Access Journals (Sweden)

    Mirella Alves da Cunha

    2011-04-01

    Full Text Available Rhinocerebral zygomycosis is the most frequent form of fungal infection caused by members of the Zygomycetes class. A fatal case of rhinocerebral zygomycosis caused by Rhizopus (oryzae arrhizus with histopathological and mycological diagnosis is reported in a diabetic patient.

  12. Prevalence of thyroid dysfunction in patients with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Sriram Shanmugam

    2015-12-01

    Conclusions: The prevalence of thyroid dysfunction among type 2 Diabetes Mellitus patients is very high (21.5 % with subclinical hypothyroidism is being most common. Screening of thyroid dysfunction should be done in all diabetic patients especially in patients with poor diabetic control. [Int J Res Med Sci 2015; 3(12.000: 3629-3633

  13. Clinical Implications of Electrocardiographic Left Ventricular Strain and Hypertrophy in Asymptomatic Patients with Aortic Stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis Study

    DEFF Research Database (Denmark)

    Greve, Anders M; Boman, Kurt; Gohlke-Baerwolf, Christa

    2012-01-01

    BACKGROUND: The prognostic impact of electrocardiographic left ventricular (LV) strain and hypertrophy (LVH) in asymptomatic aortic stenosis (AS) is not well described. METHODS AND RESULTS: Data were obtained in asymptomatic patients randomized to simvastatin/ezetimibe combination vs. placebo...... in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. Primary endpoint was the first of myocardial infarction, non-hemorrhagic stroke, heart failure, aortic valve replacement (AVR) or cardiovascular death. Predictive value of electrocardiographic LV strain (defined as T-wave inversion in leads V(4...

  14. Asymptomatic hyperamylasemia and hyperlipasemia in pediatric patients with toxic epidermal necrolysis.

    Science.gov (United States)

    Dylewski, Maggie L; Prelack, Kathy; Keaney, Timothy; Sheridan, Robert L

    2010-01-01

    Although pancreatitis is rare in pediatric burn patients, elevated pancreatic enzymes have been recently observed among toxic epidermal necrolysis (TEN) patients. This clinical phenomenon has implications particularly for the nutritional management of patients involved. The objective of this study was to assess the frequency of sustained, elevated amylase, and lipase enzymes among children with TEN or Stevens Johnson Syndrome (SJS) and to evaluate the utilization of enteral nutrition support in this population. Medical records of 24 patients admitted to our hospital between January 1994 and October 2008 with TEN or SJS were retrospectively reviewed. Only patients with > or =4 consecutive measures for both amylase and lipase were included in this study (n = 10). Serial laboratory values were collected during the first 30 days of disease. Four patients (40%) had elevated amylase and lipase values, whereas six patients had values within normal limits. Patients with elevated pancreatic enzymes were significantly younger in age (4.7 +/- 1.7 years) than patients without elevated enzymes (11 +/- 5.9 years) and also had a higher incidence of sepsis. All other characteristics were similar between the groups. Enteral nutrition support was initiated within 4 days of admission in all 10 patients and did not correlate with elevated enzymes. Our findings suggest that hyperlipasemia and hyperamylasemia can occur in the pediatric population with TEN or SJS. Although the sample size in this study makes it difficult to determine the cause, sepsis may have been a contributing factor. In the absence of symptomatic pancreatitis, patients with TEN can safely meet nutritional goals orally or with standard enteral nutrition support.

  15. Comparison of different antibiotic protocols for asymptomatic bacteriuria in patients with neurogenic bladder treated with botulinum toxin A

    Directory of Open Access Journals (Sweden)

    Ana Claudia Paradella

    Full Text Available ABSTRACT Intravesical botulinum toxin A (BoNTA injection has been widely used for the treatment of detrusor overactivity in patients with neurogenic bladder due to spinal cord injury who do not respond to conventional treatment. There is no consensus about antibiotic prophylaxis for this procedure. We conducted a retrospective analysis of medical records of adult patients with spinal cord injury who underwent detrusor BoNTA injection between January of 2007 and December of 2013 in a rehabilitation hospital. Occurrence of symptomatic urinary tract infection (UTI was assessed in 3 groups in accordance with their use of antibiotics (prophylactic dosage, 3 days, more than 3 days for the treatment of asymptomatic bacteriuria. All patients were performing self or assisted clean intermittent bladder catheterization and underwent a rigid cystoscopy, under general or regional anesthesia with sedation, and the drug used was Botox®. A total of 616 procedures were performed during the study period. There were 11 identified cases of UTI (1.8% with a trend to a higher rate in the group that used antibiotics for longer time. This report shows that a single dose of antibiotics before the detrusor BoNTA injection is enough to prevent UTI. Randomized clinical trial should be conducted for definitive conclusions.

  16. Intraocular surgery in a large diabetes patient population

    DEFF Research Database (Denmark)

    Ostri, Christoffer

    2014-01-01

    population and to report surgical results. The specific objectives are to (1) estimate the incidence of diabetic vitrectomy and analyse risk factors (Study I), (2) report long-term results, prognostic factors and incidence of cataract surgery after diabetic vitrectomy (Study II), (3) report results...... and prognostic factors after cataract surgery in diabetes patients (Study III) and (4) analyse risk factors for diabetic papillopathy with emphasis on metabolic control variability (Study IV). All studies are based on a close-to-complete national surgery register and a large, closely followed diabetic...... retinopathy screening population. Study I (cohort study, 3980 type 1 diabetes patients) illustrates that diabetic vitrectomy is rarely required in a diabetes patient population with varying degrees of diabetic retinopathy. The risk of reaching diabetic vitrectomy increases fourfold with poor metabolic control...

  17. Foot Pressure Comparison Between Hallux Rigidus Patients and Normal Asymptomatic Matched Individuals Using Pedobarograph

    Directory of Open Access Journals (Sweden)

    Hadi Mohammed

    2012-06-01

    Conclusion: This study has demonstrated an increased pressure transmitted through the outer aspect of the sole of the foot in the patients suffering from hallux rigidus. This is helpful in choosing treatment options and managing hallux rigidus patients particularly when using conservative and foot wear considerations.

  18. Coagulation factor VIII activity in diabetic patients

    Directory of Open Access Journals (Sweden)

    Nermina Babić

    2011-02-01

    Full Text Available Aim To examine coagulation factor VIII activity in plasma, as a risk factor for thrombosis, in the patients with diabetes mellitus (DM. Also, to assess its relationship with ibrinogen and fasting blood glucose concentrations and with body mass index. Methods The plasma coagulation factor VIII activity, plasma levels of ibrinogen and blood glucose concentrations were measured in 30 patients with DM type 1, 30 patients with DM type 2 and in 30 healthy subjects. Body weight and body height were also measured and BMI was calculated.Results The plasma factor VIII activity in patients with DM type 1 and patients with DM type 2 was signiicantly higher than the values measured in healthy subjects. There was no signiicant difference in the factor VIII activity between patients with DM type 1 and type 2. The concentrations of ibrinogen and blood glucose in both groups of patients were signiicantly higher than in the group of healthy subjects. Patients with DM type 2 had a signiicantly higher BMI compared to healthy subjects, as well as compared to patients with DM type 1. There was a signiicant positive correlation between plasma factor VIII activity and plasma level of ibrinogen and a signiicant negative correlation between factor VIII activity and BMI in patients with DM type 2. Conclusion Diabetic patients have the elevated plasma coagulation factor VIII activity and increased ibrinogen concentration thus an increased risk of thrombosis and vascular diseases.

  19. Bone scans after total knee arthroplasty in asymptomatic patients. Cemented versus cementless

    Energy Technology Data Exchange (ETDEWEB)

    Hofmann, A.A.; Wyatt, R.W.; Daniels, A.U.; Armstrong, L.; Alazraki, N.; Taylor, A. Jr. (Univ. of Utah Medical Center, Salt Lake City (USA))

    1990-02-01

    The natural history of bone scans after total knee arthroplasty (TKA) was studied in 26 patients with 28 cemented TKAs and 29 patients with 31 cementless TKAs. The bone scans were examined at specified postoperative intervals. Radionuclide activity of the femoral, tibial, and patellar regions was measured. Six patients who developed pain postoperatively were excluded. Bone scans immediately postoperative and at three months demonstrated increased uptake, which gradually decreased to baseline levels at ten to 12 months. Radioisotope uptake was comparable in the cemented and cementless groups, but was highly variable in individual patients and in each of the follow-up periods. A single postoperative bone scan cannot differentiate component loosening from early bone remodeling. Sequential bone scans, as a supplement to the clinical examination and conventional radiography, may prove useful in the diagnosis of TKA failure.

  20. Long-term graft and patient survival following renal transplantation in diabetic patients

    DEFF Research Database (Denmark)

    Rømming Sørensen, Vibeke; Schwartz Sørensen, Søren; Feldt-Rasmussen, Bo

    2006-01-01

    , the patient survival rates in the two groups were similar. Thereafter, survival among diabetic patients was poor. Mean HbA1c was relatively high, especially after the transplantation, and this may have contributed to the more rapid progression of cardiovascular disease seen in diabetic patients......OBJECTIVE: To study long-term graft and patient survival following renal transplantation in diabetic and non-diabetic patients. MATERIAL AND METHODS: Over the time period 1985-99, 498 transplantations in 399 non-diabetic patients and 68 transplantations in 62 diabetic patients were performed....... The groups were similar with respect to age and sex. RESULTS: The patient survival rates (diabetic versus non-diabetic patients) were 88% vs 91% (p=NS) at 1 year, 68% vs 73% (p=NS) at 5 years and 31% vs 52% (psurvival rates (diabetic versus non-diabetic patients) were 72% vs 72...

  1. Candida colonisation in asymptomatic HIV patients attending a tertiary hospital in Benin City, Nigeria

    Directory of Open Access Journals (Sweden)

    Newton O. Esebelahie

    2013-03-01

    Full Text Available Background: Candidiasis is the commonest opportunistic fungal infection in patients infected with human immunodeficiency virus (HIV. CD4+ lymphocyte counts have been found to be a marker of HIV disease progression. Aim: This study focused on determining the spectrum of Candida isolates in urine, stool, and oral specimens among HIV patients in a tertiary hospital. Methods: A total of 300 subjects comprising of 200 HIV patients and 100 non-HIV subjects were used for this study. Three samples (urine, stool, and oral swab were collected from each subject. Each specimen was processed using standard microbiological techniques and emergent Candida isolates were identified with CHROMagar™ Candida and sugar fermentation tests. Results: The overall prevalence of Candida colonisation among HIV patients was 52.5%. HAART-naive patients had a significantly higher prevalence (OR = 3.65; 95% CI = 2.03–6.56; p<0.0001 than their counterpart on highly active antiretroviral therapy (HAART (OR = 1.99; 95% CI = 1.13–3.50; p=0.0232. Female gender was a significant risk factor for acquiring Candida infection (OR = 3.40; 95% CI = 1.14–10.13; p=0.0289. The effect of age on prevalence of candidiasis was observed among HIV patients on HAART (p=0.0161. A CD4+ count <200 cells/µl was a significant risk factor for acquiring candidal infection only among HAART-naive patients (OR = 4.37; 95% CI = 1.60–11.95; p=0.0042. The five species of Candida recovered from this study were C. albicans, C. krusei, C. parapsilosis, C. tropicalis, and C. glabrata. Conclusion: There is a significant relationship between antiretroviral therapy, CD4+ counts, and the prevalence of candidiasis.

  2. An evaluation of radial and ulnar artery flow characteristics in diabetic patients with carpal tunnel syndrome and the diagnostic value of ultrasonography in these patients

    Directory of Open Access Journals (Sweden)

    Ahmet Boyacı

    2014-06-01

    Full Text Available Objectives: This study aimed to research the value of ultrasonography in the diagnosis of carpal tunnel syndrome (CTS in patients with diabetes mellitus (DM and to examine the flow characteristics of the radial and ulnar arteries in diabetic patients with CTS. Methods: A total of 23 diabetic hands diagnosed with CTS from electrophysiological evaluation (DM-CTS, 47 asymptomatic diabetic hands (DM and 50 healthy hands (C as the control group were evaluated with high resolution ultrasonography. The median nerve was measured in the cross-sectional area (CSA, flattening ratio (FR and at the level of the carpal tunnel inlet [proximal (p] and the wrist crease [distal (d]. The radial and ulnar arteries were evaluated with both hands in a neutral position. Results: In the DM-CTS group, the CSA-p and CSA-d values were statistically signficantly greater compared to the DM and C groups (p0.05. The radial artery diameter was determined to be statistically significantly greater in the DM-CTS group than the C group (p<0.05. Conclusion: The median nerve CSA is significantly greater in diabetic CTS patients compared to patients with diabetes only and healthy controls. In the evaluation of CTS in diabetic patients, CSA measured with ultrasonography may be a diagnostic tool. J Clin Exp Invest 2014; 5 (2: 179-185

  3. A Case Report of Paralytic Patient Associated with Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Byoung-woo Kim

    2009-09-01

    Full Text Available Objectives : This report aimed to study of paralytic patient associated with Diabetes Mellitus. Methods : Diabetes Mellitus has one of the highest death rate, because of it induces various complications. Especially paralytic patients who associated with diabetes mellitus are slow in recovery and easy to induce many complications. So control of the diabetes mellitus is the most important thing to treatment. We observed and treated with Cheunhwasangamibang and acupunture. Results : The paralytic patient with Diabetes Mellitus was treatment with Cheunhwasangamibang and improvement was seen. Conclusions : Results in this case support a role for Cheunhwasangamibang in controlling Diabetes Mellitus

  4. Anaemia and kidney dysfunction in Caribbean Type 2 diabetic patients

    OpenAIRE

    Seales Dawn; Nwagbara Emeka; Jones-LeCointe Altheia; Ezenwaka Chidum E; Okali Fidelis

    2008-01-01

    Abstract Background Anaemia has been shown in previous studies to be a risk factor for cardiovascular disease in diabetic patients with chronic kidney disorder. This study was aimed to assess the prevalence of anaemia and kidney dysfunction in Caribbean type 2 diabetic patients that have been previously shown to have a high prevalence of the metabolic syndrome. Methods 155 type 2 diabetic patients and 51 non-diabetic subjects of African origin were studied. Anthropometric parameters were meas...

  5. Aberrant functional connectome in neurologically asymptomatic patients with end-stage renal disease.

    Directory of Open Access Journals (Sweden)

    Xiaofen Ma

    Full Text Available This study aimed to investigate the topological organization of intrinsic functional brain networks in patients with end-stage renal disease (ESRD.Resting-state functional MRI data were collected from 22 patients with ESRD (16 men, 18-61 years and 29 age- and gender-matched healthy controls (HCs, 19 men, 32-61 years. Whole-brain functional networks were obtained by calculating the interregional correlation of low-frequency fluctuations in spontaneous brain activity among 1,024 parcels that cover the entire cerebrum. Weighted graph-based models were then employed to topologically characterize these networks at different global, modular and nodal levels.Compared to HCs, the patients exhibited significant disruption in parallel information processing over the whole networks (P < 0.05. The disruption was present in all the functional modules (default mode, executive control, sensorimotor and visual networks although decreased functional connectivity was observed only within the default mode network. Regional analysis showed that the disease disproportionately weakened nodal efficiency of the default mode components and tended to preferentially affect central or hub-like regions. Intriguingly, the network abnormalities correlated with biochemical hemoglobin and serum calcium levels in the patients. Finally, the functional changes were substantively unchanged after correcting for gray matter atrophy in the patients.Our findings provide evidence for the disconnection nature of ESRD's brain and therefore have important implications for understanding the neuropathologic substrate of the disease from disrupted network organization perspective.

  6. Risk of cardiac arrhythmias during hypoglycemia in patients with type 2 diabetes and cardiovascular risk.

    Science.gov (United States)

    Chow, Elaine; Bernjak, Alan; Williams, Scott; Fawdry, Robert A; Hibbert, Steve; Freeman, Jenny; Sheridan, Paul J; Heller, Simon R

    2014-05-01

    Recent trials of intensive glycemic control suggest a possible link between hypoglycemia and excess cardiovascular mortality in patients with type 2 diabetes. Hypoglycemia might cause arrhythmias through effects on cardiac repolarization and changes in cardiac autonomic activity. Our aim was to study the risk of arrhythmias during spontaneous hypoglycemia in type 2 diabetic patients with cardiovascular risk. Twenty-five insulin-treated patients with type 2 diabetes and a history of cardiovascular disease or two or more risk factors underwent simultaneous continuous interstitial glucose and ambulatory electrocardiogram monitoring. Frequency of arrhythmias, heart rate variability, and markers of cardiac repolarization were compared between hypoglycemia and euglycemia and between hyperglycemia and euglycemia matched for time of day. There were 134 h of recording at hypoglycemia, 65 h at hyperglycemia, and 1,258 h at euglycemia. Bradycardia and atrial and ventricular ectopic counts were significantly higher during nocturnal hypoglycemia compared with euglycemia. Arrhythmias were more frequent during nocturnal versus daytime hypoglycemia. Excessive compensatory vagal activation after the counterregulatory phase may account for bradycardia and associated arrhythmias. QT intervals, corrected for heart rate, >500 ms and abnormal T-wave morphology were observed during hypoglycemia in some participants. Hypoglycemia, frequently asymptomatic and prolonged, may increase the risk of arrhythmias in patients with type 2 diabetes and high cardiovascular risk. This is a plausible mechanism that could contribute to increased cardiovascular mortality during intensive glycemic therapy.

  7. Diabetes Remission after Nonsurgical Intensive Lifestyle Intervention in Obese Patients with Type 2 Diabetes

    OpenAIRE

    Adham Mottalib; Mahmoud Sakr; Mohamed Shehabeldin; Osama Hamdy

    2015-01-01

    Partial or complete remission from type 2 diabetes was recently observed after bariatric surgeries. Limited data is available about the possibility of inducing diabetes remission through intensive weight reduction. We retrospectively evaluated diabetes remissions after one year of the Weight Achievement and Intensive Treatment (Why WAIT) program, a 12-week intensive program for diabetes weight management in real-world clinical practice. Among 120 obese patients with type 2 diabetes who comple...

  8. Double Coronary Artery Anomaly in an Elderly Asymptomatic Patient with Positive Electrocardiogram Stress Test

    Directory of Open Access Journals (Sweden)

    Giuseppe Cannavale

    2013-01-01

    Full Text Available Malignant coronary artery anomalies and myocardial bridging are more common findings in young patients with cardiac symptoms, but these two associated yet different types of anomalies in an elderly patient has been rarely described. The following case describes the diagnostic use of 128-slice coronary-computed tomography images of an 82-year-old male, former professional soccer player, who reached the age of 82 years without any symptoms of coronary heart disease. In this patient, an association of a malignant coronary artery anomaly of origin and course (left descending coronary artery originating from the right sinus of valsalva running between the aorta and the right ventricular outflow tract, together with a long myocardial bridging over the obtuse marginal branch was diagnosed by multi-slice computed tomography thanks to an initial positive electrocardiogram screening stress test.

  9. Cardiovascular autonomic neuropathy in the diabetic patients.

    Directory of Open Access Journals (Sweden)

    Maria Eugenia Niño Mantilla

    2007-11-01

    Full Text Available the dysfunction of the autonomic nervous system is a serious problem in diabetic patients. The cardiovacular autonomic neuropathy is the most important autonomic dysfuntion for it´s implication in the increasesof the mortality rate in diabetis patients. tis ethiopatogenesis is the result of a multifactorial process caused by chronic hyperglycemia, ending up in damage of the autonomic fibers thet innervate the heart and blood vessels, leading to dysfuntional hearth rate control and abnormal vascular dynamics. the associated clinical manifestations include orthotatic hypotension, excecise intolerance, intraoperative cardiovascular liability and silent myocardial ischemia. Being important its recognition, quantitative test to evaluate the cardiovascular funtion, to value its evolution and the effects of the treatment ahould be done, being the most used, the hearth rate response to standing test, and teh valsalva maneuver. the handling of this entity is done improving control of glucose blood levels its the most effective way to prevent the cardiovascular autonomic neuropathy in the diabetic patients.

  10. Predictors of diabetes distress in patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Mohammad Rashedul Islam

    2014-04-01

    Conclusion: HbA1c, treatment modalities, duration of DM, diabetic complications and average monthly family income appeared to be significant predicting factors of diabetes distress among the type 2 diabetes mellitus patients. This should be taken into consideration for effective management of patient. [Int J Res Med Sci 2014; 2(2.000: 631-638

  11. Silent diabetic cardiomyopathy in everyday practice: a clinical and echocardiographic study

    OpenAIRE

    Loncarevic, Brane; Trifunovic, Danijela; Soldatovic, Ivan; Vujisic-Tesic, Bosiljka

    2016-01-01

    Background Whether type 2 diabetes mellitus (DM) in the absence of hypertension (HTA) and coronary artery disease (CAD) affects left ventricular (LV) phenotype and function among asymptomatic DM patients that can be easily discovered in everyday practice, what is the clinical risk profile for diabetic cardiomyopathy and how HTA and CAD modulate LV structure and function above diabetic cardiomyopathy, are still incompletely answered questions. Methods In 210 DM patients (group I: 70 asymptomat...

  12. Lower limb ischaemia in patients with diabetic foot ulcers and gangrene: recognition, anatomic patterns and revascularization strategies.

    Science.gov (United States)

    Mills, Joseph L

    2016-01-01

    The confluence of several chronic conditions--in particular ageing, peripheral artery disease, diabetes, and chronic kidney disease--has created a global wave of lower limbs at risk for major amputation. While frequently asymptomatic or not lifestyle limiting, at least 1% of the population has peripheral artery disease of sufficient severity to be limb threatening. To avoid the critical error of failing to diagnose ischaemia, all patients with diabetic foot ulcers and gangrene should routinely undergo physiologic evaluation of foot perfusion. Ankle brachial index is useful when measurable, but may be falsely elevated or not obtainable in as many as 30% of patients with diabetic foot ulcers primarily because of medial calcinosis. Toe pressures and skin perfusion pressures are applicable to such patients.

  13. Asymptomatic cryptococcal antigenemia is associated with mortality among HIV-positive patients in Indonesia

    NARCIS (Netherlands)

    Ganiem, A. Rizal; Indrati, A.; Wisaksana, R.; Meijerink, H.; Ven, A. van der; Alisjahbana, B.; Crevel, R. van

    2014-01-01

    Introduction: Previous studies, mostly from Africa, have shown that serum cryptococcal antigenemia may precede the development of cryptococcal meningitis and early death among patients with advanced HIV infection. We examined cryptococcal antigenemia as a risk factor for HIV-associated mortality in

  14. Evaluation of cardiac ischaemia in cardiac asymptomatic newly diagnosed untreated patients with primary hypothyroidism

    NARCIS (Netherlands)

    Roos, A; Zoet-Nugteren, SK; Berghout, A

    2005-01-01

    Background: Hypothyroidism is regarded as a risk factor for coronary artery disease. Possible factors involved in this association are hyperlipidaemia and hypertension, both occurring with increased frequency in hypothyroid patients. The aim of our study was to evaluate signs/symptoms of cardiac isc

  15. Diabetic patients treated with dialysis: complications and quality of life

    DEFF Research Database (Denmark)

    Sørensen, V R; Mathiesen, E R; Watt, T

    2007-01-01

    AIMS/HYPOTHESIS: The aim of this study was to describe the prevalence of complications, health-related quality of life (HRQOL) and the influence of beliefs about control over health in diabetic dialysis patients. METHODS: Of 53 eligible diabetic patients on chronic dialysis during January 2004...... in our clinic, 38 (76%) completed a kidney-specific (Kidney Disease Quality of Life) and a generic (SF-36) questionnaire and were characterised in terms of cardiovascular diseases and diabetic complications. Matched groups of non-diabetic dialysis patients (n = 40) and diabetic patients with a long...... population (47 +/- 19). The diabetic dialysis patients had similar levels of kidney-specific quality of life and mental health compared with the control groups. Reduced physical health was predicted by the presence of end-stage renal disease, diabetes and short time spent in education. Among the diabetic...

  16. Disordered eating behaviors in type 1 diabetic patients

    OpenAIRE

    Larrañaga, Alejandra; Docet, María F; García-Mayor, Ricardo V.

    2011-01-01

    Patients with type 1 diabetes mellitus are at high risk for disordered eating behaviors (DEB). Due to the fact that type 1 diabetes mellitus is one of the most common chronic illnesses of childhood and adolescence, the coexistence of eating disorders (ED) and diabetes often affects adolescents and young adults. Since weight management during this state of development can be especially difficult for those with type 1 diabetes, some diabetics may restrict or omit insulin, a condition known as d...

  17. Asymptomatic "placental prolapse" with cervical funneling in a patient with complete placenta previa.

    Science.gov (United States)

    Adekola, Henry; Lam-Rachlin, Jennifer; Bronshtein, Elena; Abramowicz, Jacques S

    2015-02-01

    We describe the transvaginal sonographic findings in a patient with complete placenta previa and increased risk of preterm birth owing to a prior history of mid-trimester pregnancy loss in whom we observed a short cervix and prolapse of the placenta and fetal membranes into the endocervical canal. We believe that this could lead to antepartum hemorrhage and mandate close observation when diagnosed. We introduced the term "placental prolapse" to describe our finding.

  18. Clinical and functional correlates of foot pain in diabetic patients.

    NARCIS (Netherlands)

    Rijken, P.M.; Dekker, J.; Rauwerda, J.A.; Dekker, E.; Lankhorst, G.J.; Bakker, K.; Dooren, J.

    1998-01-01

    Purpose: patients with diabetes mellitus frequently suffer from foot pain. This pain seems to be a neglected area in studies on the diabetic foot. The purpose of this study was to identify clinical variables associated with foot pain in diabetic patients. In addition, the relationships between foot

  19. Personal models for diabetes in context and patients' health status.

    Science.gov (United States)

    Lange, Lori J; Piette, John D

    2006-06-01

    In a diverse sample of 452 adult diabetes patients, we investigated: (1) personal model dimensions for diabetes and expanded upon the literature by indexing fatalism, (2) the relationship between contextual factors and patients' beliefs about the seriousness and controllability of diabetes, and (3) the unique contribution of illness representation combinations to clinical outcomes when controlling for baseline disease severity. Major categories of predictors included patients' sociocultural characteristics, illness history (e.g., co-morbidities, diabetes complications) and recent physical symptoms. Illness representations were measured using the Personal Models of Diabetes Interview and questions that index fatalistic beliefs. Clinical outcome measures included patients' glycemic control (HbA1c) and the patient's physical and mental functions as measured by the SF-12. Analyses corroborated the literature by identifying seriousness and treatment effectiveness cognitive model dimensions for diabetes. Physical symptoms and other disease-related factors were strong predictors of patients' seriousness beliefs for diabetes, whereas sociocultural factors (education, ethnicity) best explained representations related to the controllability of diabetes (i.e., treatment effectiveness, fatalism). Seriousness beliefs were good indicators of actual glucose control, except for cases in which patients were more fatalistic and believed diabetes to be less serious. Although patients had medically consistent views of their diabetes, variations in personal models of diabetes were related to specific contextual factors and independently explained diabetes control.

  20. Hypertensive patients and diabetes : A high-risk population

    NARCIS (Netherlands)

    Bilo, HJG; Gans, ROB

    1998-01-01

    Rising worldwide rates of diabetes mellitus heighten the need to maintain adequate metabolic control in diabetic patients and to control for other cardiovascular risk factors, such as lipid profile disturbances, high blood pressure, and smoking habits. This is especially the case in diabetic patient

  1. Fod- og ankeltraume hos patient med diabetes

    DEFF Research Database (Denmark)

    Falborg, Bettina; Ebskov, Lars

    2009-01-01

    If confronted with a neuropathic patient with an acute foot-ankle trauma, including fracture, this patient is by definition Eichenholtz stage 0. This is of major importance for the treatment. Whereas the surgical handling of fractures does not differ from ordinary fracture treatment, the subsequent...... treatment of sprains and fractures with immobilisation and a non-weight bearing period is significantly prolonged, frequently doubled, in diabetic patients. Follow-up includes frequent ambulatory controls including X-rays. If the neuroarthropathy progresses, the period of treatment is adjusted accordingly...

  2. Malnutrition prevalence in hospitalized elderly diabetic patients

    Directory of Open Access Journals (Sweden)

    Alejandro Sanz París

    2013-06-01

    Full Text Available Background & aims: Malnutrition prevalence is unknown among elderly patients with diabetes mellitus. Our objectives were to determine malnutrition prevalence in elderly in patients with diabetes, and to describe their impact on prognosis. Methods: An observational multicenter study was conducted in 35 Spanish hospitals. Malnutrition was assessed with the Mini Nutritional Assessment (MNA tool. Patients were followed until discharge. Results: 1,090 subjects were included (78 ± 7.1 years; 50% males. 39.1% had risk of malnutrition, and 21.2% malnutrition. A 15.5% of the malnourished subjects and 31.9 % of those at risk had a BMI ≥ 30 kg/m². In multivariate analysis, female gender (OR = 1.38; 95% CI: 1.19-1.11, age (OR = 1.04; 95% CI: 1.02-1.06 and presence of diabetic complications (OR = 1.97; 95% CI: 1.52-2.56 were associated with malnutrition. Length of stay (LOS was longer in at-risk and malnourished patients than in well-nourished (12.7 ± 9.9 and 15.7 ± 12.8 days vs 10.7 ± 9.9 days; p < 0.0001. After adjustment by age and gender, MNA score (OR = 0.895; 95% CI 0.814-0.985 and albumin (OR = 0.441; 95% CI 0.212-0.915 were associated with mortality. MNA score was associated with the probability of home discharge (OR = 1.150; 95% CI 1.084-1.219. Conclusion: A high prevalence of malnutrition among elderly in patients with diabetes was observed, regardless of BMI. Malnutrition, albumin, and MNA score were related to LOS, mortality and home discharge.

  3. Combination of Magnetic Resonance Angiography and Computational Fluid Dynamics May Predict the Risk of Stroke in Patients with Asymptomatic Carotid Plaques

    Science.gov (United States)

    Jia, Qian; Liu, Hongbin; Li, Yanping; Wang, Xiaoxi; Jia, Jinju; Li, Yuying

    2017-01-01

    Background Atherosclerosis plaques in the carotid arteries frequently have been found in patients with stroke. However, the pathogenesis of carotid plaque from asymptomatic to cerebrovascular events is a complex process which is still not completely understood. We aimed to investigate the prognosis of asymptomatic carotid atherosclerotic plaques by use of magnetic resonance angiography (MRA) combined with computational fluid dynamics (CFD). Material/Methods We prospectively studied a cohort of 228 participants (mean age 59.21±8.48) with asymptomatic carotid atherosclerotic plaques; mean follow-up duration was 1147.56±224.84 days. Plaque morphology parameters were obtained by MRA analysis. Lumen area (LA) and total vessel area (TVA) were measured, and wall area (WA=TVA−LA) and normalized wall area index (NWI=WA/TVA) were calculated. CFD analysis was performed to evaluate hemodynamic characteristics, including wall pressure (WP) and wall shear stress (WSS). Independent risk factors for stroke were obtained by Cox regression analysis. The area under the curve (AUC) of receiver operator characteristic (ROC) and Z-statistic test were used to evaluate risk factors. Results Logistics regression analysis showed NWI (OR: 3.472, 95% CI: 2.943–4.096, P=0.11) and WSS (OR: 6.974, 95% CI: 1.070–45.453, P=0.42) were independent risk factors of stroke for patients with asymptomatic carotid plaques. The area under the ROC curve values for WSS, NWI, and WSS+NWI were 0.772, 0.798, and 0.903, respectively. Conclusions The combination of plaque morphology characteristics NWI and hemodynamic parameter WSS may predict the risk of stroke in patients with asymptomatic carotid plaques. PMID:28126983

  4. Screening for Diabetic Retinopathy and Nephropathy in Patients with Diabetes: A Nationwide Survey in Korea

    OpenAIRE

    Sang-Ho Byun; Seung Hyun Ma; Jae Kwan Jun; Kyu-Won Jung; Boyoung Park

    2013-01-01

    This study was performed to identify factors associated with screening for diabetic retinopathy and nephropathy. Data from the Korean National Health and Nutrition Examination Survey between 2007 and 2009 were analyzed. Of 24,871 participants, 1,288 patients diagnosed with diabetes at ≥30 years of age were included. 36.3% received screening for diabetic retinopathy, and 40.5% received screening for diabetic nephropathy during the previous year. Patients living in rural areas, those with less ...

  5. Single Nodula opacity of granulomatous Pneumocystis jirovecii pneumoniain an asymptomatic lymphoma patient

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Soo; Shin, Kyung Eun; Lee, Ju Hie [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    2015-04-15

    The radiologic findings of a single nodule from Pneumocystis jirovecii pneumonia (PJP) have been rarely reported. We described a case of granulomatous PJP manifesting as a solitary pulmonary nodule with a halo sign in a 69-year-old woman with diffuse large B cell lymphoma during chemotherapy. The radiologic appearance of the patient suggested an infectious lesion such as angioinvasive pulmonary aspergillosis or lymphoma involvement of the lung; however, clinical manifestations were not compatible with the diseases. The nodule was confirmed as granulomatous PJP by video-assisted thoracoscopic surgery biopsy.

  6. [Symptomatic and asymptomatic infections of Demodex spp. in eye lashes of patients of different age groups].

    Science.gov (United States)

    Kuźna-Grygiel, Wanda; Kosik-Bogacka, Danuta; Czepita, Damian; Sambor, Izabella

    2004-01-01

    Demodex folliculorum and Demodex brevis were looked for on eyelashes sampled from 481 people, aged 3 through 96. The persons studied were divided into 9 age groups. Magnitude of the infection symptoms was assessed based on macroscopic changes of eye-lid edges and on interviews with patients. An increase of the prevalence of infection and intensification of the symptoms were observed to coincide with the age increase of the persons studied. No significant differences were demonstrated between the infection frequencies of women and men. Symptoms of ocular demodecosis were more frequent only in women of group III (aged 21-30) and group V (41-50) (p < 0.05).

  7. Esophageal Perforation: A Rare Complication of Transesophageal Echocardiography in a Patient with Asymptomatic Esophagitis

    Directory of Open Access Journals (Sweden)

    Kabir Ahmed

    2012-12-01

    Full Text Available Transesophageal echocardiography (TEE is a commonly used procedure in patients with suspected endocarditis. A rare but dreadful complication of this procedure is perforation of the esophagus. We report the case of an elderly female with multiple comorbidities, who presented with polyarticular septic arthritis. TEE was performed to rule out endocarditis. Though the standard procedure protocol was followed, she developed esophageal perforation. It was managed with esophageal stenting but she developed multiorgan failure and did not survive. This case highlights the potential of severe morbidity and mortality associated with TEE. Appropriate screening must be done and high-risk individuals must be identified before such procedures are attempted.

  8. Cauda equina syndrome after spinal anaesthesia in a patient with asymptomatic tubercular arachnoiditis

    Directory of Open Access Journals (Sweden)

    Divya Sethi

    2011-01-01

    Full Text Available A 14-year-old boy underwent emergency debridement surgery of right foot under spinal anaesthesia. Four hours after the surgery, the patient developed symptoms of cauda equina syndrome (CES. Postoperative magnetic resonance imaging of the patient′s spine suggested underlying tubercular arachnoiditis. The boy was started on intravenous methylprednisolone and antitubercular therapy. He responded to the therapy and recovered completely in 2 weeks without any residual neurological deficits. We suggest that underlying pathological changes in the subarachnoid space due to tubercular arachnoiditis contributed to maldistribution of the local anaesthetic drug leading to CES.

  9. Fluorescence in situ hybridization assay detects upper urinary tract transitional cell carcinoma in patients with asymptomatic hematuria and negative urine cytology.

    Science.gov (United States)

    Huang, W T; Li, L Y; Pang, J; Ruan, X X; Sun, Q P; Yang, W J; Gao, X

    2012-01-01

    We evaluated the performance of a multiprobe FISH (fluorescence in situ hybridization) assay for noninvasive detection of upper urinary tract transitional cell carcinoma (UUT-TCC) in patients with asymptomatic hematuria and negative urine cytology. Voided urine samples from 285 patients with asymptomatic hematuria and negative urine cytology were prospectively analyzed by FISH technique. FISH assays were performed to detect chromosomal changes frequently associated with TCC, including aneuploidy of chromosomes 3, 7 and 17, and loss of the 9p21 locus. Eleven (3.9%) had a positive FISH result. Of the 11 patients, nine (81.8%) were found to have a TCC of the upper urinary tract, while no patients with negative FISH findings were found to have UUT-TCC. In this selected cohort, the sensitivity and specificity of FISH for the detection of UUT-TCC was 100% and 99.3%, respectively. Our preliminary data suggest that the clinical utility of FISH assay of chromosomes 3, 7, 9, and 17 as a noninvasive ancillary test for the diagnosis of UUT-TCC in a selected patient population with asymptomatic hematuria and negative urine cytology and by significant high sensitivity and specificity may be a reliable diagnostic approach for early detection of UUT-TCC patients. Further larger prospective and multicenter trials are needed to confirm our results.

  10. Coccidioidomycosis osteomyelitis of the knee in a 23-year-old diabetic patient

    Directory of Open Access Journals (Sweden)

    Lowell Ellerbrook, BS

    2015-01-01

    Full Text Available Coccidioidomycosis is a pulmonary infection caused by the dimorphic fungi Coccidioides immitis and Coccidioidomycosis posadasii. This disease is endemic to the southwestern United States and has a predilection for immunocompromised patients. Diabetes mellitus has been shown to be a strong risk factor for acquiring this infection in these states. Most cases are asymptomatic or present with mild pulmonary symptoms. However, untreated pulmonary mycosis can lead to disseminated infection, most often involving meningitis, osteomyelitis, or skin and soft-tissue infections. When there is arthritis, the knee is the most common site of infection. We present a case of a 23-year-old male with longstanding, uncontrolled Type 1 diabetes mellitus who was found to have pulmonary coccidioidomycosis following diagnosis of coccidioidomycosis osteomyelitis of the knee.

  11. Care of Patients with Diabetic Foot Disease in Oman

    Science.gov (United States)

    Al-Busaidi, Ibrahim S.; Abdulhadi, Nadia N.; Coppell, Kirsten J.

    2016-01-01

    Diabetes mellitus is a major public health challenge and causes substantial morbidity and mortality worldwide. Diabetic foot disease is one of the most debilitating and costly complications of diabetes. While simple preventative foot care measures can reduce the risk of lower limb ulcerations and subsequent amputations by up to 85%, they are not always implemented. In Oman, foot care for patients with diabetes is mainly provided in primary and secondary care settings. Among all lower limb amputations performed in public hospitals in Oman between 2002–2013, 47.3% were performed on patients with diabetes. The quality of foot care among patients with diabetes in Oman has not been evaluated and unidentified gaps in care may exist. This article highlights challenges in the provision of adequate foot care to Omani patients with diabetes. It concludes with suggested strategies for an integrated national diabetic foot care programme in Oman. PMID:27606104

  12. [Comparison of international recommendations for the recognition of asymptomatic high risk patients for a heart attack in Germany].

    Science.gov (United States)

    von Eckardstein, A; Schulte, H; Assmann, G

    2005-01-01

    The recommendations of the International Task Force for the Prevention of Coronary Heart Disease/International Atherosclerosis Society (ITF/IAS), the US-American Adult Treatment Panel III of the National Cholesterol Education Programs (ATP III) and the 3rd Joint European Guidelines (3JE) for the prevention coronary heart disease (CHD) show good agreement in tertiary prevention. All three guidelines recommend that patients with manifest CHD should have a blood pressure below 140/90 mm Hg and LDL-cholesterol below 2.6 mmol/l (100 mg/dl). By contrast, the three recommendations differ with respect to the prevention of cardiovascular events in asymptomatic high risk patients (secondary prevention), notably in the strategy to be used for risk assessment. Both the ITF/IAS guidelines and the 3JE guidelines can be adapted and realized in the various European countries. We therefore compared the prognostic values of the three recommendations by applying them to the data of male participants of the Prospective Cardiovascular Munster (PROCAM) Study. The ITF/IAS recommendations show the highest specificity (94.5%), positive predictive value (32.0%) and diagnostic efficacy (90.5%); the 3JE guidelines have the highest sensitivity (64.6%) but lowest specificity (77.9%), positive predictive value (17.5%) and diagnostic efficacy (77.0%). The application of the 3JE recommendations would target 25% of German men aged 35-65 years as cardiovascular high risk patients, by contrast to 7.5% through application of the ITF/IAS guidelines. In view of the limited resources in the public health systemthe application of the ITF/IAS guidelines in Germany appears more appropriate.

  13. A CLINICAL STUDY OF PULMONARY TUBERCULOSIS AMONG DIABETES MELLITUS PATIENTS

    Directory of Open Access Journals (Sweden)

    Mojjada Dhanunjaya

    2015-09-01

    Full Text Available Of all the non - tuberculosis complications associated with disease, Diabetes Mellitus exerts, the most adverse influence on the course of pulmonary tuberculosis. The combined diagnosis was invariably fatal before Specific anti tuberculous and anti - diabetic drugs were available. As per new diabetes guidelines, every diabetic patient should be under gone screening for Pulmonary Tuberculosis. We conducted a clinical study of 60 Patients with Diabetes and Pulmonary Tuberculosis. For establishment of Diagnosis Ch est X – ray and Sputum for AFB were done for pulmonary tuberculosis and both blood & Urine Sugar were done for Diabetes Mellitus.

  14. Barriers to diabetes management: patient and provider factors.

    Science.gov (United States)

    Nam, Soohyun; Chesla, Catherine; Stotts, Nancy A; Kroon, Lisa; Janson, Susan L

    2011-07-01

    Despite significant advances in diagnosis and treatment, the persistence of inadequate metabolic control continues. Poor glycemic control may be reflected by both the failure of diabetes self-management by patients as well as inadequate intervention strategies by clinicians. The purpose of this systematic review is to summarize existing knowledge regarding various barriers of diabetes management from the perspectives of both patients and clinicians. A search of PubMed, CINAHL, ERIC, and PsycINFO identified 1454 articles in English published between 1990 and 2009, addressing type 2 diabetes, patient's barriers, clinician's barriers, and self-management. Patients' adherence, attitude, beliefs, and knowledge about diabetes may affect diabetes self-management. Culture and language capabilities influence the patient's health beliefs, attitudes, health literacy, thereby affecting diabetes self-management. Other influential factors include the patient's financial resources, co-morbidities, and social support. Clinician's attitude, beliefs and knowledge about diabetes also influence diabetes management. Clinicians may further influence the patient's perception through effective communication skills and by having a well-integrated health care system. Identifying barriers to diabetes management is necessary to improve the quality of diabetes care, including the improvement of metabolic control, and diabetes self-management. Further research that considers these barriers is necessary for developing interventions for individuals with type 2 diabetes.

  15. May diabetes patients have trouble sleeping despite not having obesity?

    OpenAIRE

    Maurizio Rizzi; Giancarlo Razionale; Michele Bamberga; Massimo Barrella; Georgios D. Kotzalidis; Diana Certan; Maurizio Bevilacqua

    2014-01-01

    Obstructive sleep apnea (OSA) and periodic limb movements during sleep (PLMs) are sleep-related disorders with a high prevalence in type 2 diabetes. Commonly OSA is considered as a consequence of obesity, but several previous studies have shown the presence of OSA in non-obese diabetic patients. A previous study showed higher PLMs prevalence in patients with type 2 diabetes, compared to age-matched controls. We speculated that both OSA and PLMs may reflect the presence of diabetic autonomic n...

  16. A Case Report of Paralytic Patient Associated with Diabetes Mellitus

    OpenAIRE

    2009-01-01

    Objectives : This report aimed to study of paralytic patient associated with Diabetes Mellitus. Methods : Diabetes Mellitus has one of the highest death rate, because of it induces various complications. Especially paralytic patients who associated with diabetes mellitus are slow in recovery and easy to induce many complications. So control of the diabetes mellitus is the most important thing to treatment. We observed and treated with Cheunhwasangamibang and acupunture. Results : The pa...

  17. Psychosocial interventions for the diabetic patient

    Directory of Open Access Journals (Sweden)

    Harvey JN

    2015-01-01

    Full Text Available John N Harvey Diabetes Research Group, Wrexham Academic Unit, Bangor University, Wrexham, UK Abstract: Diabetes usually requires substantial life-long self-management by the patient. Psychological factors and the patient's health beliefs are important determinants of self-care behavior. Education has a modest influence on generating better self-care, but psychologically based interventions are clearly more effective. This review gives an overview of these interventions with some discussion of their basis in psychological theory. Some labels such as cognitive behavioral therapy and family therapy include a wide range of approaches. Randomized trials have generally produced improvement in measures of psychological well-being, but improved glycemic control has been more elusive. The influence on behavior can be very dependent on the individual therapist. Only a few trials have managed to sustain improvement in glycosylated hemoglobin beyond a year. Not all patients are prepared to engage and accept these forms of therapeutic intervention. We are still some way from moving psychological management from the trial situation into the diabetic clinic. Keywords: health beliefs, motivational interviewing, cognitive behavioral therapy, family therapy, adolescence

  18. Diabetes Stories: Use of Patient Narratives of Diabetes to Teach Patient-Centered Care

    Science.gov (United States)

    Kumagai, Arno K.; Murphy, Elizabeth A.; Ross, Paula T.

    2009-01-01

    A critical component to instituting compassionate, patient-centered diabetes care is the training of health care providers. Our institution developed the Family Centered Experience (FCE), a comprehensive 2-year preclinical program based on longitudinal conversations with patients about living with chronic illness. The goal of the FCE is to explore…

  19. Management and prognosis of atrial fibrillation in the diabetic patient

    DEFF Research Database (Denmark)

    Pallisgaard, Jannik Langtved; Lindhardt, Tommi Bo; Olesen, Jonas Bjerring

    2015-01-01

    The global burden of atrial fibrillation and diabetes mellitus (diabetes) is considerable, and prevalence rates are increasing. Diabetes is associated with an increased risk of developing atrial fibrillation; however, diabetes also influences the management and prognosis of atrial fibrillation. I...... and outcomes of heart failure and the success rates of both ablation and cardioversion in atrial fibrillation patients with diabetes. Finally, this article describes the association of HbA1c levels with the management and prognosis of atrial fibrillation patients.......The global burden of atrial fibrillation and diabetes mellitus (diabetes) is considerable, and prevalence rates are increasing. Diabetes is associated with an increased risk of developing atrial fibrillation; however, diabetes also influences the management and prognosis of atrial fibrillation...

  20. Anaemia and kidney dysfunction in Caribbean Type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Seales Dawn

    2008-08-01

    Full Text Available Abstract Background Anaemia has been shown in previous studies to be a risk factor for cardiovascular disease in diabetic patients with chronic kidney disorder. This study was aimed to assess the prevalence of anaemia and kidney dysfunction in Caribbean type 2 diabetic patients that have been previously shown to have a high prevalence of the metabolic syndrome. Methods 155 type 2 diabetic patients and 51 non-diabetic subjects of African origin were studied. Anthropometric parameters were measured and fasting blood samples were collected for glucose, creatinine, glycated hemoglobin and complete blood count. Anaemia was defined as haemoglobin 2. Comparisons for within- and between-gender, between diabetic and non-diabetic subjects were performed using Student's t-test while chi-square test was employed for categorical variables. Results The diabetic patients were older than the non-diabetic subjects. While male non-diabetic subjects had significantly higher red blood cell count (RBC, haemoglobin and hematocrit concentrations than non-diabetic female subjects (p 2, p Conclusion A high prevalence of anaemia was identified in this group of type 2 diabetic patients previously shown to have a high prevalence of the metabolic syndrome. It is therefore recommended that diagnostic laboratories in developing countries and elsewhere should include complete blood count in routine laboratory investigations in the management of diabetic patients.

  1. Evaluation of Oral Health in Type II Diabetes Mellitus Patients

    Directory of Open Access Journals (Sweden)

    Rathy Ravindran

    2015-01-01

    Full Text Available Background: Oral cav ity re flects the general health status of a person and diagnosing and treating oral manifestations of systemic disease pose a greater challenge. Even though there is strong evidence that supports the relationship between oral health and diabetes mellitus, oral health awareness is lacking among diabetic patients and health professionals. The present study was undertaken to determine the oral health status in type II diabetic patients and also to compare the oral changes in controlled diabetes and u ncontrolled diabetes. Materials and methods: Study population consists of 60 diabetic patients w hich is divided into 30 controlled and 30 uncontrolled diabetics; 60 healthy subjects. Each of these diabetic groups were again subdivided according to their duration as patients having a disease duration below 10 years 15 and patients having a disease duration above 10 years. 15 Various oral manifestations were examined and also CPI score and loss of attachment were recorded. Statistical analysis was done. Results: The most frequent oral signs and symptoms obser ved in both controlled and uncontrolled diabetic patients was perio­ dontitis followed by hyposalivation, taste dysfunction, halitosis, fissured tongue, burning mouth, angular cheilitis, ulcer and lichen planus. These oral manifestation showed an increase in distribution in diabetic patients when compared to nondia betic. Community periodo ntal index (CPI scores for assess ing periodontal status showed higher scores in diabetics than nondiabetics and also in uncontrolled diabetes than controlled diabetes. For periodontal s tatus assessment based on disease duration, patient with higher disease duration showed higher CPI scores than those with a lesser disease duration. Assess ment of loss of attachment in our study showed higher values in diabetic patients compared to healthy controls. Conclusion: From our present study, it was clear that oral manifestations in uncontrolled

  2. PREVALENCE OF DIABETIC RETINOPATHY IN PATIENTS WITH NEWLY DIAGNOSED TYPE II DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    A. Bostak

    2006-11-01

    Full Text Available Diabetic retinopathy is a common complication of type II diabetes mellitus and carries with it the threat of blindness. Accurate information regarding the incidence of diabetic retinopathy and associated risk factors is important in the prevention of its development and of the visual impairment caused by this complication. This study was designed to determine the prevalence of diabetic retinopathy in newly diagnosed patients with type II diabetes mellitus. We have also evaluated the association of diabetic retinopathy with clinical and biochemical variables. In a cross-sectional study, 152 consecutive patients with newly diagnosed type II diabetes mellitus were referred from two outpatient clinics in Tehran for ophthalmologic exam to detect retinopathy. Indirect ophthalmoscopy was performed and data regarding risk factors were extracted from routine medical records. Chi square and Mann Whitney U tests were used to analyze the data. The overall prevalence of diabetic retinopathy was 13.8 %( 21 cases: three cases with microaneurysm only, 10 with mild, 5 with moderate and 2 with severe non proliferative diabetic retinopathy. Only one patient had advanced proliferative retinopathy. The prevalence of diabetic retinopathy was positively associated with age, duration of disease, fasting plasma glucose, HbA1c, and systolic blood pressure. Diabetic retinopathy is common in newly diagnosed type II diabetes mellitus patients. Ophthalmologic consultation is essential at the time of diagnosis for all patients.

  3. Trigeminal small-fibre dysfunction in patients with diabetes mellitus

    DEFF Research Database (Denmark)

    Agostino, R.; Cruccu, G.; Iannetti, G. D.

    2000-01-01

    Objective: To investigate trigeminal small-fibre function in patients with diabetes mellitus. Methods: In 52 diabetic patients we studied the trigeminal laser evoked potentials after stimulation of the skin bordering the lower lip. In the 21 patients with the severest peripheral nerve damage we...... also studied the electrically evoked corneal reflex, Both responses are mediated by small myelinated afferents. Results: Laser evoked potentials had a longer mean latency and lower amplitude in diabetic patients than in normal subjects (P

  4. Incremental prognostic utility of coronary CT angiography for asymptomatic patients based upon extent and severity of coronary artery calcium: Results from the COronary CT Angiography EvaluatioN For Clinical Outcomes InteRnational Multicenter (CONFIRM) Study

    NARCIS (Netherlands)

    I. Cho (Iksung); H.-J. Chang (Hyuk-Jae); B.T. Hartaigh (Bríain ó); S. Shin (Sanghoon); J.M. Sung (Ji Min); F.Y. Lin (Fay); S. Achenbach (Stephan); R. Heo (Ran); D.S. Berman (Daniel); M.J. Budoff (Matthew J.); T.Q. Callister (Tracy); M. Al-Mallah (Mouaz); F. Cademartiri (Filippo); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); A.M. Dunning (Allison M.); A. Delago (Augustin); T.C. Villines (Todd); M. Hadamitzky (Martin); J. Hausleiter (Jörg); J. Leipsic (Jonathon); L.J. Shaw (Leslee); P.A. Kaufmann (Philipp A.); R.C. Cury (Ricardo); G.M. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); E. Maffei (Erica); G.L. Raff (Gilbert); G. Pontone (Gianluca); D. Andreini (Daniele); J.K. Min (James K.)

    2015-01-01

    textabstractAim Prior evidence observed no predictive utility of coronary CT angiography (CCTA) over the coronary artery calcium score (CACS) and the Framingham risk score (FRS), among asymptomatic individuals. Whether the prognostic value of CCTA differs for asymptomatic patients, when stratified b

  5. Study of diabetes mellitus among patients with hepatitis C virus

    Directory of Open Access Journals (Sweden)

    Mona Abdel Raouf

    2012-01-01

    Conclusion We can concluded that diabetic HCV patients had intermediate clinical phenotype lower BMI and LDL than control and development of type 2 diabetes mellitus in HCV patients was significantly higher in nontreated patients than treated patients. Antiviral therapy and clearance of HCV improves IR, β-cell function, the blood glucose abnormalities.

  6. Pulmonary zygomycosis in a diabetic patient

    Directory of Open Access Journals (Sweden)

    Anuradha K

    2006-01-01

    Full Text Available We report a case of pulmonary zygomycosis in an adult male diabetic patient who presented with fever and altered sensorium initially and later developed streaky haemoptysis. Bronchoscopy showed picture of necrotizing pneumonia. Sputum was negative for fungal elements on admission but later bronchial wash and repeat sputum samples were positive by microscopy and culture showed growth of Rhizopus species. Immediately the patient was put on amphotericin B but had a bout of massive haemoptysis and succumbed. A high index of suspicion is needed for an early diagnosis and aggressive treatment of this infection in view of the high mortality rate.

  7. Diabetes in patients with HIV: patient characteristics, management and screening

    NARCIS (Netherlands)

    Roerink, M.E.; Meijering, R.; Bosch, M.; Galan, B.E. de; Crevel, R. van

    2015-01-01

    BACKGROUND: As HIV management has become more successful during the past years, non-communicable diseases have become more prevalent among HIV-infected individuals. As a result, more HIV-infected patients die of cardiovascular diseases, with diabetes being one of the main risk factors. This study ev

  8. Myocardial scarring on cardiovascular magnetic resonance in asymptomatic or minimally symptomatic patients with “pure” apical hypertrophic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Kim Kyung-Hee

    2012-07-01

    Full Text Available Abstract Background Late gadolinium enhancement (LGE cardiovascular magnetic resonance (CMR enables state-of-the-art in vivo evaluations of myocardial fibrosis. Although LGE patterns have been well described in asymmetrical septal hypertrophy, conflicting results have been reported regarding the characteristics of LGE in apical hypertrophic cardiomyopathy (ApHCM. This study was undertaken to determine 1 the frequency and distribution of LGE and 2 its prognostic implication in ApHCM. Methods Forty patients with asymptomatic or minimally symptomatic pure ApHCM (age, 60.2 ± 10.4 years, 31 men were prospectively enrolled. LGE images were acquired using the inversion recovery segmented spoiled-gradient echo and phase-sensitive inversion recovery sequence, and analyzed using a 17-segment model. Summing the planimetered LGE areas in all short axis slices yielded the total volume of late enhancement, which was subsequently presented as a proportion of total LV myocardium (% LGE. Results Mean maximal apical wall thickness was 17.9±2.3mm, and mean left ventricular (LV ejection fraction was 67.7 ± 8.0%. All but one patient presented with electrocardiographic negative T wave inversion in anterolateral leads, with a mean maximum negative T wave of 7.2 ± 4.7mm. Nine patients (22.5% had giant negative T waves, defined as the amplitude of ≥10mm, in electrocardiogram. LGE was detected in 130 segments of 30 patients (75.0%, occupying 4.9 ± 5.5% of LV myocardium. LGE was mainly detected at the junction between left and right ventricles in 12 (30% and at the apex in 28 (70%, although LGE-positive areas were widely distributed, and not limited to the apex. Focal LGE at the non-hypertrophic LV segments was found in some ApHCM patients, even without LGE of hypertrophied apical segments. Over the 2-year follow-up, there was no one achieving the study end-point, defined as all-cause death, sudden cardiac death and hospitalization for heart failure

  9. Transperitoneal transport in diabetic and non-diabetic patients on peritoneal dialysis

    DEFF Research Database (Denmark)

    Graff, J; Fugleberg, Steen; Nielsen, S L

    1999-01-01

    To investigate differences in the transport characteristics of the peritoneal membrane between diabetic and non-diabetic patients on chronic peritoneal dialysis, a study was conducted in 21 non-diabetic and 18 diabetic patients. Transperitoneal transport of small solutes was evaluated in terms...... of the mass transfer area coefficients (urea, creatinine and glucose), ultra-filtration sieving coefficients (urea and creatinine) and by peritoneal equilibration test results. The capacity of the peritoneal membrane to transport macromolecules was evaluated by albumin mass transfer rates and clearances......-labelled human albumin. Despite a significantly increased transcapillary escape rate of albumin in the diabetic patients, no differences in peritoneal membrane characteristics could be demonstrated between diabetic and non-diabetic patients on peritoneal dialysis....

  10. Incidence and predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular block and dual chamber pacemaker implantation.

    LENUS (Irish Health Repository)

    Radeljic, Vjekoslav

    2012-01-31

    AIM: To evaluate predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular (AV) block, normal left ventricular systolic function, and implanted dual chamber (DDD) pacemaker. METHODS: Hundred and eighty six patients with complete AV block were admitted over one year to the Sisters of Mercy University Hospital. The study recruited patients older than 70 years, with no history of atrial fibrillation, heart failure, or reduced left ventricular systolic function. All the patients were implanted with the same pacemaker. Out of 103 patients who were eligible for the study, 81 (78%) were evaluated. Among those 81 (78%) were evaluated. Eighty one (78%) patients were evaluated. Follow-up time ranged from 12 to 33 months (average +\\/-standard deviation 23 +\\/- 5 months). Primary end-point was asymptomatic atrial fibrillation occurrence recorded by the pacemaker. Atrial fibrillation occurrence was defined as atrial high rate episodes (AHRE) lasting >5 minutes. Binary logistic regression was used to identify the predictors of development of asymptomatic atrial fibrillation. Results. The 81 patients were stratified into two groups depending on the presence of AHRE lasting >5 minutes (group 1 had AHRE>5 minutes and group 2 AHRE<5 minutes). AHRE lasting >5 minutes were detected in 49 (60%) patients after 3 months and in 53 (65%) patients after 18 moths. After 3 months, only hypertension (odds ratio [OR], 17.63; P = 0.020) was identified as a predictor of asymptomatic atrial fibrillation. After 18 months, hypertension (OR, 14.0; P = 0.036), P wave duration >100 ms in 12 lead ECG (OR, 16.5; P = 0.001), and intracardial atrial electrogram signal amplitude >4 mV (OR, 4.27; P = 0.045) were identified as predictors of atrial fibrillation. CONCLUSION: In our study population, hypertension was the most robust and constant predictor of asymptomatic atrial fibrillation after 3 months, while P wave duration >100 ms in 12-lead ECG and

  11. Platelet volume indices as predictive biomarkers for diabetic complications in Type 2 diabetic patients

    Science.gov (United States)

    Buch, Archana; Kaur, Supreet; Nair, Rahul; Jain, Ambuj

    2017-01-01

    BACKGROUND: Platelet volume indices (PVI) such as mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR) are the indicators of increased platelet activity and can be considered as potential biomarkers for diabetic complications. PURPOSE: To study PVI in Type 2 diabetics with and without complications in comparison to nondiabetic patients. MATERIALS AND METHODS: A case–control study was conducted on 300 Type 2 diabetics and 200 nondiabetics. Detailed clinical history regarding duration, hypertension, and complications was taken. PVI was obtained using automated cell counter. Fasting blood glucose, hemoglobin A1c, lipid profile, creatinine were also obtained. Diabetics were further categorized into patients with complications and without complications. Statistical analysis was performed by Statistical Package for the Social Sciences Version 17 (Chicago, IL) Student's t-test and ANOVA test. RESULTS: Platelet count was significantly decreased in diabetics (P = 0.005). MPV was significantly increased in diabetic patients with complications as compared to diabetics without complications and nondiabetic group (P diabetics with and without complications and nondiabetics (P diabetic retinopathy (P = 0.000), nephropathy (P = 0.005), and diabetic foot (P = 0.048). PDW was significantly increased in diabetic retinopathy (P = 0.035) and nephropathy (P = 0.007). P-LCR had no statistically significant correlation with diabetic complications. CONCLUSION: MPV and PDW are predictive biomarkers of diabetic vascular complications. They are more significant in microvascular complications than macrovascular complications. PMID:28367021

  12. An investigation into diabetic patients knowledge of diabetes and its ocular complications in the Western Cape

    Directory of Open Access Journals (Sweden)

    P. C. Clarke-Farr

    2005-01-01

    Full Text Available This paper presents the findings of a study which evaluated the knowledge of a sample of diabetic patients about their disease and its ocular complications. A comprehensive questionnaire was provided to diabetic patients in the Cape Town metropolitan district and its surrounds. Specifically, the questionnaire aimed to determine the patient’s knowledge of diabetes, their knowledge of the ocular complications of diabetes, the options for its management and treatment as well as a section considering other general information relating to diabetes and its ocular complications. Their subject knowledge about diabetes and its ocular complications was relatively limited as only 42% of respondents knew about the existence of two types of diabetes. Twenty nine percent of respondents believed that diabetes would not affect their eyes. Although 76% of the patients felt it very important to measure their blood sugar and 80% rated blood sugar control as very important, only 37% of the respondents measured their blood sugar on a daily basis. A particular concern was that although 96% of the respondents felt that it was important to have their eyes checked regularly, only 30% of the respondents stated that they had actually had their eyes checked every year. The results of this investigation support the need for diabetic patients to receive better patient education about diabetes and its ocular complications. Furthermore, attention needs to be paid to expanding patient access to diabetic screenings and ocular examinations in order to manage this condition effectively.

  13. [Susceptibility of induced sickle in samples of heterozygous hemoglobin S patients (sickle cell trait) suffering diabetes mellitus type 2].

    Science.gov (United States)

    Díaz-Piedra, Pablo; Cervantes-Villagrana, Alberto Rafael; Ramos-Jiménez, Raúl; Presno-Bernal, José Miguel; Cervantes-Villagrana, Rodolfo Daniel

    2015-01-01

    Hemoglobin S is an abnormal protein that induces morphological changes in erythrocyte in low-oxygen conditions. In Mexico, it is reported that up to 13.7% of the population with mutation in one allele are considered asymptomatic (sickle cell trait). The sickle cell trait and diabetes mellitus are conditions that occur together in more than one million patients worldwide. Both diseases possibly produce microvascular changes in retinopathy and acute chest syndrome. The aim of this study was to evaluate the induction of sickle cells in samples of diabetic patients with sickle cell trait to identify altered red cell parameters. We obtained samples of diabetic patients to determine hemoglobin A1c and S; furthermore, red blood cell biometrics data were analyzed. We found that older men with diabetes were susceptible to generate sickle cells and this correlated with reduced red blood cell count and an increase in media cell volume. In samples of women diabetes, there were no differences. We conclude that samples from patients with sickle cell trait and diabetes can cause sickle cells with high frequency in men, with lower red blood cells count and increased mean corpuscular volume as susceptibility parameters.

  14. Diabetes-related emotional distress in Dutch and U.S. diabetic patients

    DEFF Research Database (Denmark)

    Snoek, Frank J; Pouwer, F; Welch, G W

    2000-01-01

    OBJECTIVE: To examine the cross-cultural validity of the Problem Areas in Diabetes Scale (PAID) in Dutch and U.S. diabetic patients. RESEARCH DESIGN AND METHODS: A total of 1,472 Dutch people with diabetes completed the PAID along with other self-report measures of affect. Statistics covered...

  15. Cardiac autonomic neuropathy in patients with diabetes and no symptoms of coronary artery disease: comparison of {sup 123}I-metaiodobenzylguanidine myocardial scintigraphy and heart rate variability

    Energy Technology Data Exchange (ETDEWEB)

    Scholte, Arthur J.H.A.; Schuijf, Joanne D.; Delgado, Victoria; Kok, Jurriaan A.; Bus, Mieke T.J.; Maan, Arie C.; Wall, Ernst E. van der; Bax, Jeroen J. [Leiden University Medical Center, Department of Cardiology, Albinusdreef 2, PO Box 9600, Leiden (Netherlands); Stokkel, Marcel P.; Dibbets-Schneider, Petra [Leiden University Medical Center, Nuclear Medicine, Leiden (Netherlands); Kharagitsingh, Antje V. [Medisch Centrum Haaglanden, Department of Internal Medicine, The Hague (Netherlands)

    2010-09-15

    The purpose of this study was to evaluate the prevalence of cardiac autonomic neuropathy (CAN) in a cohort of patients with type 2 diabetes, truly asymptomatic for coronary artery disease (CAD), using heart rate variability (HRV) and {sup 123}I-metaiodobenzylguanidine ({sup 123}I-mIBG) myocardial scintigraphy. The study group comprised 88 patients with type 2 diabetes prospectively recruited from an outpatient diabetes clinic. In all patients myocardial perfusion scintigraphy, CAN by HRV and {sup 123}I-mIBG myocardial scintigraphy were performed. Two or more abnormal tests were defined as CAN-positive (ECG-based CAN) and one or fewer as CAN-negative. CAN assessed by {sup 123}I-mIBG scintigraphy was defined as abnormal if the heart-to-mediastinum ratio was <1.8, the washout rate was >25%, or the total defect score was >13. The prevalence of CAN in patients asymptomatic for CAD with type 2 diabetes and normal myocardial perfusion assessed by HRV and {sup 123}I-mIBG scintigraphy was respectively, 27% and 58%. Furthermore, in almost half of patients with normal HRV, {sup 123}I-mIBG scintigraphy showed CAN. The current study revealed a high prevalence of CAN in patients with type 2 diabetes. Secondly, disagreement between HRV and {sup 123}I-mIBG scintigraphy for the assessment of CAN was observed. (orig.)

  16. Alteration of melatonin secretion in patients with type 2 diabetes and proliferative diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Hikichi T

    2011-05-01

    Full Text Available Taiichi Hikichi1, Naohiro Tateda2, Toshiaki Miura31Department of Ophthalmology, Ohtsuka Eye Hospital, Sapporo; 2Asahikawa National College of Technology, Asahikawa; 3Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, JapanBackground: The purpose of this study was to evaluate the dynamics of plasma melatonin secretion in patients with type 2 diabetes mellitus and diabetic retinopathy.Methods: Plasma melatonin levels were measured by high-performance liquid chromatography in 56 patients. Patients were divided into a diabetic group (30 patients and a nondiabetic group (26 patients. The diabetic group was divided further into a proliferative diabetic retinopathy (PDR group (n = 14 and a nonproliferative diabetic retinopathy (NPDR group (n = 16. Plasma melatonin levels obtained at midnight and 3 am were compared between the groups.Results: Nighttime melatonin levels were significantly lower in the diabetic group than in the nondiabetic group (P < 0.03 and lower in the PDR group than in the nondiabetic and NPDR groups (P < 0.01 and P < 0.03, respectively, but no significant difference was found between the nondiabetic and NPDR groups. The daytime melatonin level did not significantly differ between the nondiabetic and diabetic groups or between the nondiabetic, NPDR, and PDR groups.Conclusion: The nighttime melatonin level is altered in patients with diabetes and PDR but not in diabetic patients without PDR. Although patients with PDR may have various dysfunctions that affect melatonin secretion more severely, advanced dysfunction of retinal light perception may cause altered melatonin secretion. Alteration of melatonin secretion may accelerate further occurrence of complications in diabetic patients.Keywords: circadian rhythm, diabetes, proliferative diabetic retinopathy, melatonin

  17. TO ASSESS THE VESTIBULAR AND AUDITORY FUNCTIONS IN PATIENTS WITH DIABETIC NEPHROPATHY IN COMPARISON WITH PATIENTS OF UNCOMPLICATED DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Shashikant N

    2015-09-01

    Full Text Available The inner ear dysfunction occurs in diabetes mellitus. The typical hearing loss described is a progressive, bilateral sensori - neural deafness of gradual onset which affects predominantly the higher frequencies. The causes are an angiopathy of the inner ear, neuronal degeneration, and electrolyte imbalance. Although the relationship between diabetes and vestibulo - cochlear dysfunction has been studied by various investi gators, the exact relationship between various complications of diabetes and inner ear dysfunction requires further detailed study. Surprisingly the incidence of hearing loss in diabetes with complications is on the rise, which creates an interest to study the vestibulo - cochlear functions in diabetic nephropathy. This was a prospective study to assess the vestibular and auditory functions in patients with diabetic nephropathy in comparison with patients of uncomplicated diabetes mellitus. The aim of this st udy is to assess the vestibular and auditory functions in patients with diabetic nephropathy in comparison with patients of uncomplicated diabetes mellitus. This study includes 60 patients, 30 patients with uncomplicated diabetes mellitus were categorized in the group I and 30 patients with diabetic nephropathy were categorized in group II.

  18. Asymptomatic bacteriuria among pregnant women

    Directory of Open Access Journals (Sweden)

    Paul Erhunmwunse Imade

    2010-06-01

    Full Text Available Background: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. In pregnancy, the apparent reduction in immunity of pregnant women tends to encourage the growth of pathogens. Aim: This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending a primary health centre in Benin City, Nigeria. Materials and Methods: A total of 1,228 pregnant women were recruited for this study. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collected from each patient into sterile universal container. The urine samples were examined microscopically and by cultural method. Identification of isolates was by standard microbiological technique. Result: A total of 556 (45.3% were positive for significant bacteriuria. There was a significant difference in the prevalence of asymptomatic bacteriuria with respect to age (P < 0.0001. Trimester did not show any significant difference (P = 0.2006 in the prevalence of asymptomatic bacteriuria. Escherichia coli was the most predominant organism followed closely by Staphylococcus aureus. Ciprofloxacin, Ceftriaxone and Augmentin were found to be the most effective antibiotics against the urinary isolates. Conclusion: Asymptomatic bacteriuria is not uncommon among antenatal patients in the population studied. Routine urine cultural test should be carried out on all antenatal patients in order to identify any unsuspecting infection. This measure will go a long way in reducing maternal and obstetric complications associated with pregnancy.

  19. Asymptomatic bacteriuria among pregnant women

    Directory of Open Access Journals (Sweden)

    Paul Erhunmwunse Imade

    2010-01-01

    Full Text Available Background: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. In pregnancy, the apparent reduction in immunity of pregnant women tends to encourage the growth of pathogens. Aim : This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending a primary health centre in Benin City, Nigeria. Materials and Methods: A total of 1,228 pregnant women were recruited for this study. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collected from each patient into sterile universal container. The urine samples were examined microscopically and by cultural method. Identification of isolates was by standard microbiological technique. Result: A total of 556 (45.3% were positive for significant bacteriuria. There was a significant difference in the prevalence of asymptomatic bacteriuria with respect to age (P < 0.0001. Trimester did not show any significant difference (P = 0.2006 in the prevalence of asymptomatic bacteriuria. Escherichia coli was the most predominant organism followed closely by Staphylococcus aureus. Ciprofloxacin, Ceftriaxone and Augmentin were found to be the most effective antibiotics against the urinary isolates. Conclusion : Asymptomatic bacteriuria is not uncommon among antenatal patients in the population studied. Routine urine cultural test should be carried out on all antenatal patients in order to identify any unsuspecting infection. This measure will go a long way in reducing maternal and obstetric complications associated with pregnancy.

  20. Socioeconomic profile of diabetic patients with and without foot problems

    Directory of Open Access Journals (Sweden)

    Aziz Nather

    2010-10-01

    Full Text Available Introduction: To identify the differences in a socioeconomic profile between two cohorts of diabetic patients – one with diabetic foot problems and another without diabetic foot problems. Materials and methods: The cohort with diabetic foot problems (including cellulitis, abscess, osteomyelitis, septic arthritis, gangrene, ulcers, or Charcot joint disease consisted of 122 diabetic patients, while the other cohort without foot problems consisted of 112 diabetic patients. Both were seen at the National University Hospital from January to April 2007. A detailed protocol was designed and the factors studied included patient profile, average monthly household income, education, compliance to diabetic medication, attendance at clinics for diabetic treatment, exercise, smoking, alcohol consumption, gender, and glycosylated haemoglobin (HbA1C level. These were studied for significant differences using univariate and stepwise multivariate logistic regression analysis. Results: With multivariate analysis, Malay ethnicity (p<0.001, education of up to secondary school only (p=0.021, low average monthly household income of less than SGD $2,000 (p=0.030, lack of exercise (at least once a week, p=0.04, and elevated HbA1C level (>7.0%; p=0.015 were found to be significantly higher in the cohort with diabetic foot problems than the cohort without. Conclusions: There are significant differences in the socioeconomic factors between diabetic patients with diabetic foot problems and those without.

  1. Prevalence of nerve-vessel contact at cisternal segments of the oculomotor nerve in asymptomatic patients evaluated with magnetic resonance images

    Institute of Scientific and Technical Information of China (English)

    WANG Jin; GONG Xiang-yang; SUN Yi; HU Xing-yue

    2010-01-01

    Background Some studies indicated that cases of idiopathic oculomotor nerve palsy can be explained by vascular compression of the oculomotor nerve. Vascular contact with or compression to the cisternal segment of the oculomotor nerve has been reported frequently in asymptomatic individuals. In this study, we retrospectively analyzed the relationship between the oculomotor nerve's cisternal segment and adjacent arteries in asymptomatic patients and the prevalence of this occurrence via magnetic resonance imaging (MRI).Method MRI of bilateral oculomotor nerves in 93 asymptomatic patients were reviewed. The oculomotor nerve-artery relationship was evaluated and classified from levels 1 to 3, representing the degrees of contact on oblique transverse and oblique sagittal reconstructed MRI. Prevalence of the nerve-artery relationship at each level was described. The correlation between the nerve-vessel relationship (levels) and the age was analyzed by Spearman's rank correlation analysis.Results Cisternal segment of the oculomotor nerve did not have contact with any artery (level 1) in 27.4% (51/186) nerves. One hundred nerves made contact with at least one artery (level 2), but their shapes or configurations were not changed; 35 nerves (18.8%) were displaced or distorted due to artery compression (level 3). The posterior cerebral artery had the greatest incidence of making contact with or compressing the cisternal segment of the oculomotor nerve (58.1%). No significant correlation between nerve-vessel relationship (levels) and the age was found in this study. Conclusions Whether oculomotor nerve contact with or compression by one or more arteries is of high prevalence in asymptomatic individuals as evidenced by MRI examination. There is no correlation with individual age. Discretion should be used when making an etiological diagnosis of vascular compression for patients with oculomotor nerve palsy. Further investigation of other causes is warranted.

  2. Dental implant survival in diabetic patients; review and recommendations

    OpenAIRE

    Dubey, Rajendra Kumar; Gupta, Deepesh Kumar; Singh, Amit Kumar

    2013-01-01

    Rising population of diabetic individuals across the world has become a big concern to the society. The persistent hyperglycemia may affect each and every tissue and consequently results in morbidity and eventually mortality in diabetic patients. A direct negative response of diabetes has been observed on oral tissues with few contradictions however, little are known about effect of diabetes on dental implant treatment and the consequent results. Many studies concerned with osteointegration a...

  3. Nutritional Intervention for a Patient with Diabetic Nephropathy

    OpenAIRE

    Kim, Hee Young

    2014-01-01

    In recent years, several studies have reported that the prevalence of diabetes mellitus is increasing every year, and also the acute and chronic complications accompanying this disease are increasing. Diabetic nephropathy is one of chronic complications of diabetes mellitus, and food intake which is burden to kidney function should be limited. At the same time, diet restriction could deteriorate quality of life of patient with diabetic nephropathy. According to the results of previous studies...

  4. Level of Knowledge of the Diabetic Patient about the Prevention of Diabetic Foot.

    Directory of Open Access Journals (Sweden)

    Georgina Jiménez Estrada

    2007-08-01

    Full Text Available Background: The education of the diabetic patient is a fundamental factor for the diabetes mellitus, even in its condition of chronic disease, it will not reach major complications. Objective: To analyze the level of knowledge about the prevention of diabetic food in patients who are carriers of diabetes mellitus. Method: A descriptive study was carried out in 5 family doctor´s offices belonging to the IV area of Cienfuegos Municipality, in a period of time among February and April 2006. The sample was formed by 68 diabetic patients to whom a survey was applied. Results: A high per cent (86.4 of our patients knew about some of the complications related to this disease. At evaluating the level of knowledge, an acceptable average was found. Conclusions: The level of knowledge in the surveyed patients was not enough. The treatment of these patients should also include these kinds of informations considering the complications the patients can suffer from.

  5. Which increases depressive symptoms in obese patients, hypertension or diabetes?

    Directory of Open Access Journals (Sweden)

    Sakir Özgür Keskek

    2013-04-01

    Full Text Available Background: Depression and obesity are common disorders. Obesity is also predictive of several chronic diseases like hypertension and diabetes. The aim of this study was to evaluate and compare depression frequency of obese patients with hypertension or diabetes. Methods: Weight, height and body mass index (BMI were measured. The definition of obesity was a body mass index (weight (kg/height (m2 ≥30 kg/m2. Obese patients with hypertension or diabetes were documented. All participants had a Beck Depression Inventory (BDI evaluation. Results: A total of 389 subjects were included, of whom 100, 101, 92, 96 participants were healthy, obese, obese with hypertension, obese with diabetes, respectively. Beck Depression Inventory scores of obese patients, obese patients with hypertension or diabetes were higher compared to the control group. BDI scores of obese patients with diabetes were higher compared to obese and obese with hypertension subjects.

  6. Dental implants in the diabetic patient: systemic and rehabilitative considerations.

    Science.gov (United States)

    Michaeli, Eli; Weinberg, Ido; Nahlieli, Oded

    2009-09-01

    Diabetes mellitus is the most prevalent endocrine disease, comprising the third highest cause of disability and morbidity in the Western world. In the past, implant placement was contraindicated in diabetic patients because of increased risk for implant failure and infection. Publications in recent years have shown success rates for dental implants in diabetic patients resembling those of the general population. Other studies, in diabetic patients, as well as in animal models, have shown an increased risk for implant failure. These results raise the question of whether diabetic patients are suitable for dental implant rehabilitation. This article reviews the literature and presents the factors used in assessing the severity of diabetes and its complications, as well as the considerations for rehabilitation planning in these patients. Integration of these factors by the dentist dictates whether as well as what type of implant-supported restoration should be preformed.

  7. [Preoperative assessment of patients with diabetes mellitus].

    Science.gov (United States)

    Takeda, Kiyoshi

    2010-07-01

    The perioperative morbidity of diabetic patients is related to preoperative end-organ damage. Due to the microvascular pathology, autonomic neuropathy is common and cardiovascular abnormalities such as hypertension, painless myocardial ischemia, and orthostatic hypotension may predispose patients to perioperative cardiovascular instability. Autonomic dysfunction also contributes to delayed gastric emptying, and preoperative administration of a histamine antagonist and a gastric emptying agent is needed. Chronic hyperglycemia leads to glycosylation of tissue proteins and the accumulation of abnormal collagen can cause stiff joint syndrome resulting in difficult tracheal intubation. The primary goal of pre and intraoperative blood glucose control is to avoid hypoglycemia and ketosis. Moreover, the tight glycemic control has been reported to improve survival in critically ill patients who were treated in the intensive care unit.

  8. Prevalence of diabetes mellitus among tuberculosis patients in Urban Puducherry

    Directory of Open Access Journals (Sweden)

    Soundararajan Raghuraman

    2014-01-01

    Full Text Available Background: Diabetes and Tuberculosis often present together and complicate each other at many levels. A collaborative framework for care and control of diabetes and tuberculosis developed by World Health Organisation and International Union against Tuberculosis and Lung Diseases emphasizes routine bi-directional screening for the two diseases. Aims: The study was to assess the prevalence of diabetes in tuberculosis patients currently on treatment. Materials and Methods: This facility-based cross-sectional study was undertaken in four randomly selected peripheral health institutions providing directly observed treatment short-course, treatment for tuberculosis patients. All cases of tuberculosis, more than 18 years of age were screened for diabetes. Risk factors like age, sex, family history of diabetes, alcohol, smoking and obesity were assessed. Results The prevalence of diabetes in tuberculosis patients was found to be 29% (known diabetics - 20.7%, new Diabetes cases - 8.3%. Diabetes was significantly associated with older age, family history of diabetes, consumption of alcohol and sputum positivity. Conclusions: Screening patients with Tuberculosis for fasting blood sugar estimation will help in early detection of diabetes

  9. Analysis of Related Factors of Nerve Electrophysiology Damage Involving with Asymptomatic Type 2 Diabetic Peripheral Neuropathy%2型糖尿病患者的无症状周围神经病神经电生理损害相关因素分析

    Institute of Scientific and Technical Information of China (English)

    牛莉; 靳娇婷; 胡芳; 张强; 李茉; 冯佳; 宋海英; 罗国刚

    2015-01-01

    Aim To explore relevant related factors with asymptomatic peripheral neuropathy of diabetic mellitus patients type 2 and provide the basis for early diagnosis and intervention.Methods 176 patients of diabetic type 2 were divided into a asymptomatic diabetic peripheral neuropathy (ADPN) group (144 cases) and a non-diabetes peripheral neuropathy (No-DPN) group (32 cases) according to nerve conduction velocity in electromyography exam. Clinical data of the two groups were comparably analyzed to investigate the related factors involving with asymptomatic peripheral neuropathy in diabetic patients. ResultsIndividual factors of diabetes duration, fasting blood glucose (FBG), body mass index (BMI), hemoglobin A (HbA1c), blood urine nitrogen (BUN), creatinine (Cr), 24 h proteinuria quantity, 24 h urinary microalbumin amount and positive ifndings from fundus examination were signiifcantly related with ADPN inducing from the single factor analysis. Logistic regression analysis showed the duration of diabetes, FBG, BMI and HbA1C were independent of the related factors in ADPN.ConclusionDiabetes duration, FBG, BMI and HbA1C can be independent of the related factors involving with ADPN based on nerve conduction velocity in which should be early diagnosed and intervened by physician.%目的:探讨2型糖尿病患者的无症状糖尿病周围神经病(ADPN)神经电生理损害的相关因素,为临床早期诊断、早期干预提供依据。方法176例2型糖尿病患者根据有无神经传导速度异常分为ADPN组(32例)和No-DPN组(144例),对比分析相关临床资料并探讨ADPN神经电生理损害的相关因素。结果单因素分析显示:ADPN组糖尿病病程、体质指数、空腹血糖、糖化血红蛋白、尿素氮、肌酐、24 h尿蛋白和尿微量白蛋白、眼底动脉血管改变与No-DPN组比较,差异有统计学意义(P<0.05);多因素Logistic回归分析显示:糖尿病病程、体质指数、空腹血糖、糖化血红蛋白

  10. Candida colonization on the denture of diabetic and non-diabetic patients

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Lotfi-Kamran

    2009-01-01

    Full Text Available Background: Oral candidiasis is a common opportunistic infection in diabetic patients. Presence of denture in the oral cavity of diabetic patients can promote Candida colonization and results in the higher incidence of oral and systemic candidiasis. The general purpose of the present study was to evaluate and compare Candida colonization in denture of diabetic patients and non-diabetic control group. Methods: In current case-control study, samples for mycological examinations were collected from the palatal impression surface of maxillary dentures from 92 edentulous patients including 46 dia-betic and 46 non-diabetic denture wearers. All samples were cultured directly on sabouraud agar me-dium and isolated colonies were counted and identified based on specific tests. Data were statistically analyzed using Mann-Whitney and Spearman correlation tests. Results: The higher density of isolated colonies was seen in diabetic group in compare with control group (P = 0.0001. There was a statistically significant correlation between the blood glucose level (P = 0.0001 and the duration of denture usage (P = 0.022 with the colonization of Candida on den-ture of diabetic patients. C. albicans was the most common isolated Candida species in both groups, though diabetic patients with dentures had more non-albicans Candida isolated from their dentures compared to non-diabetic patients. Conclusions: Mycological findings from the present study revealed that diabetes mellitus can in-crease colonization of Candida in denture and mouth. By elimination of local and systemic factors in diabetic patients and improving their oral health care, Candida colonization and the risk of oral and systemic candidiasis will be decreased.

  11. Effectiveness the pharmaceutical care in diabetic patients*

    Directory of Open Access Journals (Sweden)

    Jorge E Machado -Alba

    2011-04-01

    Full Text Available Objective: To determine the effectiveness of pharmaceutical care to improve control of type-2 diabetes mellitus. Methods: We carried out pharmacotherapeutical intervention during 19 months on patients with type-2 diabetes mellitus who were affiliate members of the contributive regime of the General System for Healthcare and Social Security in  Bogotá and Cartagena. Through an interview and evaluation of medical records, we obtained information about antidiabetic medications used, doses, other medications, along with Hemoglobin A1c level, arterial pressure, serum low-density lipoprotein cholesterol level, nephropathy screening, retinal screening, foot exams in the last year and problems associated with medication use by means of the DADER method Negative Outcomes Associated with Medication (NOM. Results: The study had a sample of 143 patients (64 intervened and 79 controls with female predominance (67.1% and 53.1%, respectively, mean age of 63.9±11.2 years. The patients in both groups were taking an average of 6.0±2.7 medications. Initial HbA1c mean was 7.7% and 7.8%, without improvement by the end of the study (7.4% for those intervened and 7.8% for the control group. Hypertension (81.1% and dyslipidemia (62.9% were the most important comorbidities. About 50.4% of NOM were of effectiveness, follows 31.3% of necessity. The mean cost per patient in controls was 1.4 greater than for the intervened group. Conclusions: Increased effectiveness of the antidiabetic therapy was not demonstrated in patients intervened with pharmacotherapeutical monitoring, but we did obtain a reduction in healthcare costs.

  12. The role of TNF-α, Fas/Fas ligand system and NT-proBNP in the early detection of asymptomatic left ventricular dysfunction in cancer patients treated with anthracyclines

    Directory of Open Access Journals (Sweden)

    Alexandros Kouloubinis

    2015-03-01

    Conclusion: SFas, sFas-L and NT-proBNP correlate with reductions in LVEF and could be used as sensitive biochemical indices for the detection of asymptomatic left ventricular dysfunction in cancer patients under cardiotoxic chemotherapy.

  13. Effect of a polyherbal formulation cream on diabetic neuropathic pain among patients with type 2 diabetes - A pilot study

    OpenAIRE

    Vijay Viswanathan; Seena Rajsekar; Bamila Selvaraj; Satyavani Kumpatla

    2016-01-01

    Background & objectives: Painful diabetic neuropathy is a common complication of diabetes and can severely limit patients′ daily functions. The aim of this pilot study was to evaluate the safety and effect of using a polyherbal formulation in reducing the symptoms of diabetic neuropathic pain in comparison with placebo among patients with type 2 diabetes. Methods: A total of 50 (M:F = 33:17) consecutive type 2 diabetes patients with painful diabetic neuropathy were enrolled in this study....

  14. Coronary artery calcium score using electron beam tomography in the patients with acute obstructive coronary arterial disease : comparative study within asymptomatic high-risk group of atherosclerosis and chronic obstructive coronary arterial disease group

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Seok Jong; Choi, Byoung Wook; Choe, Kyu Ok [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-04-01

    To compare, through analysis of the coronary artery calcium (CAC) score and the risk factors for atherosclerosis, the characteristics of acute coronary syndrome between an asymptomatic high-risk group of atherosclerosis patients and a chronic coronary arterial obstructive disease(CAOD) group. The CAC scores of an asymptomatic high-risk group of atherosclerosis patients (group I, n=284), a chronic CAOD croup (group II, n=39) and an acute coronary syndrome group (group III, n=21) were measured by electron beam tomography. Forty-seven patients with CAOD from groups II and III underwent coronary angiography, and we scrutinized age, sex and risk factors including diabetes mellitus, hypertension, obesity, smoking, hypercholesterolemia and low high-density lipoproteinemia. The numbers of stenotic coronary arterial branches and degree of stenosis revealed by coronary angiography were also recorded. We determined the differences between the three groups in terms of CAC score and the risk factors, the relationship between CAC score and risk factors, and the characteristic features of each type of CAOD group. The mean CA score of group III (135.1) was not statistically different from that of group I (135.7) or group II (365.8). Among patients aged below 50, the mean CAC score of group III (127.4) was significantly higher than that of group I (6.2), (p=0.0006). The mean CAC score at the sixth decade was also significantly different between group I(81.5) and group II (266.9). The mean age of group III (54.2 years) was significantly lower than that of group I (58.1 years) (p=0.047) and of group II (60.1) (p=0.022). There was significant correlation between the number of stenotic coronary arterial branches and log(CAC +1) (p<.01). The square root of the CAC score and the maximal degree of stenosis was also well correlated (p<.01). There was no difference in the mean number of risk factors among the three groups, though the incidence of smoking in group III was significantly

  15. Lavkulhydratdiæt til patienter med type 2-diabetes

    DEFF Research Database (Denmark)

    Gram-Kampmann, Eva-Marie; Olsen, Michael Hecht; Beck-Nielsen, Henning

    2016-01-01

    Recently, low-carbohydrate diets have increased in popularity as a method to achieve glycaemic control and weight loss in Type 2 diabetes patients. However, there is a lack of consistency and long-term results in existing studies on patients with Type 2 diabetes. In this review, we address current...... knowledge of low-carbohydrate diets and how they affect glycaemic control, diabetic dyslipidaemia, weight and markers of cardiovascular risk, and our aim is to aid medical practitioners in guiding patients with Type 2 diabetes who wish to try a low-carbohydrate diet in order to take control of their disease....

  16. [Superficial mycoses: comparative study between type 2 diabetic patients and a non-diabetic control group].

    Science.gov (United States)

    García-Humbría, Leila; Richard-Yegres, Nicole; Pérez-Blanco, Maigualida; Yegres, Francisco; Mendoza, Mireya; Acosta, Arnaldo; Hernández, Rosaura; Zárraga, Eluz

    2005-03-01

    Superficial mycoses are considered to affect more frequently patients with type 2 diabetes mellitus (DM-2), specially onychomycosis and Tinea pedis. The purpose of this study was to compare the dermatophytoses, candidiasis and Pitiriasis versicolor frequency between 40 patients with DM-2 and 40 healthy persons of either sex, 40 years old or more. Clinical, metabolic, mycologic and inmunologic studies against Candida albicans, were carried out. Both diabetics 75% (30/40) and controls 65% (26/40) presented a high frequency of superficial mycoses (no significant difference p = 0.329). Pitiriasis versicolor was not detected in diabetic patients. They presented Tinea unguium, concomitant with Tinea pedis, with a higher frequency. The predominant dermatophyte was Trichophyton rubrum 18/23 (78%) in diabetics and 8/16 (50%) in non diabetics. Candida was isolated as commensal from oral mucous: 23/40 (58%) in diabetics and 21/40 (52%) in non diabetics (serotipo A was the more frequent), and from onychomycosis: 11/40 (28%) in diabetics and 12/40 (30%) in non diabetics. The immunological response was the same in both groups: celular 100%, humoral 20%. No statistical correlation among superficial mycoses, blood glucose level, glycosylated hemoglobin values or the time suffering the disease was observed. The high susceptibility to dermatophytes and Candida sp. infection showed to be associated with age and no with the diabetic type 2 condition in those patients.

  17. Diabetes specialist nurse as main care provider for patients with type 2 diabetes

    NARCIS (Netherlands)

    Houweling, S. T.; Kleefstra, N.; van Hateren, K. J. J.; Kooy, A.; Groenier, K. H.; ten Vergert, E.; Meyboom-de Jong, B.; Bilo, H. J. G.

    2009-01-01

    Background: The objective of this study was to determine whether the management of type 2 diabetes (DM2) can be transferred from an internist to a nurse specialised in diabetes (NSD). Methods: Ninety-three patients with DM2 referred by their general practitioner were randomised; 84 patients complete

  18. Risk factors for occurrence and recurrence of diabetic foot ulcers among Iraqi diabetic patients

    Directory of Open Access Journals (Sweden)

    Samer I. Mohammed

    2016-03-01

    Full Text Available There are a few studies that discuss the medical causes for diabetic foot (DF ulcerations in Iraq, one of them in Wasit province. The aim of our study was to analyze the medical, therapeutic, and patient risk factors for developing DF ulcerations among diabetic patients in Baghdad, Iraq.

  19. Evaluation of Oral Health in Type II Diabetes Mellitus Patients

    OpenAIRE

    Rathy Ravindran; M.G. Deepa; A.K. Sruthi; Cherian Kuruvila; Priya, S.; S.Sunil; Joseph Edward; G Roopesh

    2015-01-01

    Background: Oral cav ity re flects the general health status of a person and diagnosing and treating oral manifestations of systemic disease pose a greater challenge. Even though there is strong evidence that supports the relationship between oral health and diabetes mellitus, oral health awareness is lacking among diabetic patients and health professionals. The present study was undertaken to determine the oral health status in type II diabetic patients and also...

  20. Non-diabetic renal disease in patients with type-2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Sonia Yaqub

    2012-01-01

    Full Text Available Diabetic nephropathy (DN is the leading cause of end-stage renal disease in diabetics worldwide, yet most patients with type-2 diabetes mellitus are not formally evaluated with a renal biopsy. The diagnosis is almost always based on clinical grounds. A wide spectrum of non-diabetic renal disease (NDRD is reported to occur in patients with type-2 diabetes. It has been estimated that up to one-third of all diabetic patients who present with proteinuria are suffering from NDRD. The aim of this analysis was to evaluate the prevalence and etiology of NDRD in patients with type-2 diabetes. We retrospectively reviewed the medical records of patients with type-2 diabetes who underwent kidney biopsy on clinical suspicion of NDRD (absence of diabetic retinopathy and/or neuropathy; short duration of diabetes, i.e. less than five years from January 2003 through December 2007 at the Aga Khan University Hospital, Karachi. Based on the biopsy findings, patients were grouped as Group-I, isolated NDRD; Group-II, NDRD with underlying DN; and Group-III, isolated DN. Of 68 patients studied, 75% were males and the mean age was 56 years. The mean duration of diabetes was nine years. Group-I included 34 patients (52%, Group-II included 11 patients (17% and Group-III included 23 patients (31%. Among the Group-I patients, the mean age was 56 years (41-77 years. The most common NDRDs were acute interstitial nephritis (32%, diffuse proliferative glomerulonephritis (17%; membranous nephropathy (12% and crescentic glomerulonephritis (12%. Among Group-II, the mean age was 60 years (46-71 years, and the most common lesion was interstitial nephritis superimposed on underlying DN (63% cases. Among Group-III, the mean age was 53 years (42- 80 years. The mean proteinuria was 5, 6.3 and 7.3 g/24 h of urine collection in Groups I, II and III, respectively (P = NS. The mean duration of diabetes was 7.3, 11.7 and 10.7 years in Groups I, II and III, respectively. The duration of

  1. Targeted screening for the detection of Pompe disease in patients with unclassified limb-girdle muscular dystrophy or asymptomatic hyperCKemia using dried blood: A Spanish cohort.

    Science.gov (United States)

    Gutiérrez-Rivas, E; Bautista, J; Vílchez, J J; Muelas, N; Díaz-Manera, J; Illa, I; Martínez-Arroyo, A; Olivé, M; Sanz, I; Arpa, J; Fernández-Torrón, R; López de Munáin, A; Jiménez, L; Solera, J; Lukacs, Z

    2015-07-01

    We aimed to screen for Pompe disease in patients with unclassified limb-girdle muscular dystrophy (LGMD) or asymptomatic hyperCKemia using dried blood spot (DBS) assays. Subsequently, we aimed to calculate the diagnostic delay between initial symptom presentation and the diagnosis. A prospective, multicenter, observational study was conducted in 348 patients: 146 with unclassified LGMD and 202 with asymptomatic or paucisymptomatic hyperCKemia. We quantified levels of acid alpha-glucosidase (GAA) from dried blood spots analyzed fluorometrically. The test was positive in 20 patients, and Pompe disease was confirmed by genetic testing in 16. Undiagnosed Pompe disease was detected in 7.5% of patients with LGMD and in 2.5% of patients with persistent, idiopathic elevation of serum creatine kinase. The c.-32-13 T > G mutation was found most commonly. The diagnostic delay was 15 years on average. In conclusion, DBS tests are useful and reliable screening tools for Pompe disease. We recommend the dried blood spot test to be included in the diagnostic work-up of patients with unclassified myopathies with proximal weakness and/or hyperCKemia of unknown cause and, when positive, to define the diagnosis, it will have to be confirmed by biochemical and/or molecular genetic analysis.

  2. Subclinical hyperthyroidism in patients with type 2 diabetes.

    Science.gov (United States)

    Díez, Juan J; Iglesias, Pedro

    2012-08-01

    Both subclinical hyperthyroidism and type 2 diabetes (T2D) have been associated with an increase in cardiovascular disease risk and mortality. We aimed to assess the prevalence of newly diagnosed subclinical hyperthyroidism in a cohort of patients with T2D, and also to analyse the relationships between diabetes-related characteristics and the presence of subclinical hyperthyroidism. 933 diabetic patients without previous history of thyroid disease (45.4% females, mean age 66.3 years, median duration of diabetes 10 years) were evaluated. A sample of 911 non-diabetic subjects without known thyroid dysfunction was studied as control group. Serum concentrations of thyrotropin were measured in all subjects. Subclinical hyperthyroidism was present in 4.3% of female and 3.5% of male diabetic patients. Relative risk was significant only for the female gender (OR 3.69, 95% CI 1.56-8.71). In comparison with diabetic patients without thyroid hyperfunction, patients with subclinical hyperthyroidism were older, had longer duration of diabetes, showed lower fasting glucose levels, had greater proportion of goitre and diet therapy, and had lower proportion of treatment with oral agents. Logistic regression analysis showed that age and the presence of goitre were significantly related to subclinical hyperthyroidism in patients with T2D. The risk for subclinical hyperthyroidism is increased in women with T2D. Advanced age and the presence of goitre are significantly and independently related with the presence of subclinical hyperthyroidism in diabetic population.

  3. Thyroid gland diseases in adult patients with diabetes mellitus.

    Science.gov (United States)

    Vondra, K; Vrbikova, J; Dvorakova, K

    2005-12-01

    This review concerns the relation between most frequent thyroid gland diseases and diabetes mellitus in adult patients. Special attention is paid to autoimmune thyroiditis, Graves' disease, thyroid autoimmunity in pregnant diabetic women, and iodine metabolism. We focused on mechanisms leading to coexistence of both endocrine disorders, and on distinctions in the prevalence, diagnosis, clinical course and treatment of thyroid diseases in diabetic patients. The prevalence of thyroid diseases in diabetic patients is 2-3 times higher than in nondiabetic subjects; it raises with age, and is strongly influenced by female gender and autoimmune diabetes. Clinical relevance of thyroid diseases, especially in diabetic patients, significantly increases if it is associated with deteriorated function, which always cause a number problems with metabolic compensation of diabetes. Most serious consequences are increased frequency of hypoglycaemia in hypothyroidism and development of potentially life-threatening ketoacidosis in thyrotoxicosis. In spite of that, little attention is paid to the diagnosis of thyroid diseases in diabetics, as they are diagnosed in only about half of the patients. At the end, we provide recommendations for the thyroid disease screening and diagnosis in patients with diabetes mellitus based on our experience.

  4. Detrusor overactivity in diabetic and non-diabetic patients: is there a difference?

    LENUS (Irish Health Repository)

    Golabek, Tomasz

    2013-07-22

    To compare urodynamic characteristics in patients with idiopathic detrusor overactivity (IDO) with those of an age matched cohort with diabetes mellitus (DM) and detrusor overactivity (DO). Secondly, to determine whether urodynamic features could help distinguish these two groups of patients.

  5. Higher mortality of patients on haemodialysis with pancreatic diabetes compared to type 2-diabetes

    Directory of Open Access Journals (Sweden)

    Bodlaj Gert

    2012-03-01

    Full Text Available Abstract In rare cases (1-8% diabetic patients with end-stage renal disease (ESRD suffer from diabetic nephropathy (dNP due to pancreatic diabetes mellitus (PDM. Aim of this study was to investigate differences in the outcome of patients with PDM and those with type 2 diabetes. In a retrospective study we evaluated 96 diabetic patients, who started hemodialysis (HD in our dialysis centre (1997-2005. In 12 patients PMD was diagnosed, and 84 patients had type 2 diabetes. In both groups we compared vascular risk factors and prevalence of vascular diseases at the start of dialysis. We also evaluated incidence of malnutrition, and 5-year survival in both patient groups. The vascular risk factors were similar in both patient groups, also the prevalence of vascular diseases at the initiation of HD was similar in both groups. In the patients with PDM the mean BMI (kg/m2 was lower (22 + 3 versus 25 + 3, and also their serum albumin was lower (2.7 + 0.3 versus 3.4 + 0.3 g/dl, p Conclusions in HD-treated patients with type 2 diabetes or PDM the prevalence of vascular diseases was not significantly different. The lower survival of PDM patients can be related to poor nutrition status.

  6. Prevalence of uropathogen and their antibiotic resistance pattern among diabetic patients

    Science.gov (United States)

    Nigussie, Demiss; Amsalu, Anteneh

    2017-01-01

    Objective Diabetes mellitus (DM) and antibiotic resistance is an emerging public health problem in Ethiopia. Urinary tract infections (UTIs) are common and occasionally life-threatening condition among diabetic patients. Despite, all these problems, antibiotics are prescribed empirically which may adversely affect antibiotic resistance so far. Therefore the aim of this study was to identify the etiologic agents of UTI and their antibiotic resistance pattern among diabetic patients attending diabetic clinic of Hawassa University Referral Hospital. Material and methods A cross-sectional study was conducted in a total of 240 diabetic patients from June to October, 2014. After obtaining an informed written consent, socio-demographic and clinical data were collected using pre-structured questionnaire. Clean catch mid-stream urine samples were collected and processed for identification of uropathogen through culture using standard microbiologic procedure. Antibiotic susceptibility test was carried out using Kirby-Bauer disc diffusion method. Results The overall prevalence of diabetic UTI was 13.8%. Out of the total number of patients, 11.2% and 23.1% had asymptomatic and symptomatic bacteriuria respectively. DM patients with no previous history of UTI [AOR=3.55; 95% CI=1.186–10.611] and illiterate [AOR=2.5; 95% CI=1.052–5.989] had higher odds of UTI compared with their counterparts. E. coli was the commonest isolated uropathogen followed by coagulase-negative Staphylococci. All the isolated bacteria were resistant to ampicillin but sensitive to nitrofurantoin. Gram-negative isolates demonstrated high level of resistance to trimethoprim-sulphamethoxazole in 9 (81.8%), gentamicin in 8 (72.7%) and ceftriaxone in 7 (63.6%) patients. Gram-positive bacteria showed resistance to penicillin in 14 (87.5%), norfloxacin in 10 (62.5%) and ciprofloxacin in 8 (50.0%) patients. Multidrug resistance was observed in 93.9% of the isolated uropathogens. Conclusion Illiterate DM

  7. Musculoskeletal pain in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Molsted, S; Tribler, J; Snorgaard, O

    2012-01-01

    The aims were to investigate the prevalence of musculoskeletal pain in patients with type 2 diabetes and demonstrate possible associated factors.......The aims were to investigate the prevalence of musculoskeletal pain in patients with type 2 diabetes and demonstrate possible associated factors....

  8. Vaegtanamnesen for patienter med nyopdaget type 2-diabetes--sekundaerpublikation

    DEFF Research Database (Denmark)

    Olivarius, Niels de Fine; Richelsen, Bjørn; Siersma, Volkert;

    2008-01-01

    The aim was to estimate and illustrate the weight history of 1,320 newly diagnosed diabetic patients according to patient characteristics at diagnosis. The median recalled weight gain from age 20 to diabetes diagnosis at a median age of 65.3 years was 14.7 kg. The average weight gain from 10 years...

  9. Weight history of patients with newly diagnosed Type 2 diabetes

    DEFF Research Database (Denmark)

    Olivarius, N de Fine; Richelsen, B; Siersma, V;

    2008-01-01

    newly diagnosed with diabetes aged > or = 40 years. Patients' weight at diagnosis was measured by the doctor, while patients recalled their weight approximately 1, 5 and 10 years prior to diagnosis and at age 20 years. RESULTS: Median weight gain from age 20 years to diabetes diagnosis at median age 65...

  10. Patient education for preventing diabetic foot ulceration (Review)

    NARCIS (Netherlands)

    Dorresteijn, J.A.; Kriegsman, D.M.; Assendelft, W.J.J.; Valk, G.D.

    2012-01-01

    BACKGROUND: Ulceration of the feet, which can result in loss of limbs and even death, is one of the major health problems for people with diabetes mellitus. OBJECTIVES: To assess the effects of patient education on the prevention of foot ulcers in patients with diabetes mellitus. SEARCH METHODS: Eli

  11. Efficiently screening heart failure in patients with type 2 diabetes

    NARCIS (Netherlands)

    Boonman-de Winter, Leandra J M; Rutten, Frans H; Cramer, Maarten J; Landman, Marcel J; Zuithoff, Nicolaas P A; Liem, Anho H; Hoes, Arno W

    2015-01-01

    AIMS: Our aim was to develop a screening tool for heart failure in patients with type 2 diabetes. METHODS AND RESULTS: A total of 581 consecutive patients from 21 primary care practices in The Netherlands with type 2 diabetes, in whom the diagnosis of heart failure (HF) was not known, underwent an e

  12. Cost-effectiveness of lifestyle modification in diabetic patients

    NARCIS (Netherlands)

    Jacobs-Van der Bruggen, M.A.; Baal, van P.H.; Hoogenveen, R.T.; Feenstra, T.L.; Briggs, A.H.; Lawson, K.; Feskens, E.J.M.; Baan, C.A.

    2009-01-01

    OBJECTIVE To explore the potential long-term health and economic consequences of lifestyle interventions for diabetic patients. RESEARCH DESIGN AND METHODS A literature search was performed to identify interventions for diabetic patients in which lifestyle issues were addressed. We selected recent (

  13. Markers of Antioxidant Defense in Patients with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    K. Gawlik

    2016-01-01

    Full Text Available Aims. Diabetes is considered a state of increased oxidative stress. This study evaluates blood concentrations of selected markers of antioxidant defense in patients with type 2 diabetes. Methods. The study included 80 type 2 diabetes patients and 79 apparently healthy controls. Measured markers included ferric reducing ability of plasma (FRAP, reduced glutathione (GSH, glutathione peroxidase (GPx, glutathione reductase (GR, γ-glutamyltransferase (GGT and uric acid serum, and plasma and/or hemolysate levels. Results. FRAP, uric acid, CRP, and GGT levels were significantly higher in patients with diabetes. Plasma and hemolysate GR was significantly higher whereas GPx activity was significantly lower in patients with diabetes. There were no significant differences in antioxidant defense markers between patients with and without chronic diabetes complications. Fasting serum glucose correlated with plasma GPx, plasma and hemolysate GR, FRAP, and serum GGT, and HbA1c correlated with serum GGT. Only FRAP and serum uric acid were significantly higher in obese (BMI>30 kg/m2 patients with diabetes than in nonobese patients. Conclusions. Some components of antioxidant defense such as GR, uric acid, and GGT are increased in patients with type 2 diabetes. However, the whole system cannot compensate for an enhanced production of ROS as reflected by the trend toward decreased erythrocytes GSH.

  14. Sociodemographic factors responsible for blindness in diabetic Egyptian patients

    Directory of Open Access Journals (Sweden)

    Abueleinen KGI

    2011-11-01

    Full Text Available Khaled Gamal Ibraheem Abueleinen1, Hany El-Mekawey1, Yasser Sayed Saif2, Amr Khafagy1, Hoda Ibrahim Rizk3, Eman M Eltahlawy41Department of Ophthalmology, Cairo University, Cairo, Egypt; 2Department of Ophthalmology, Beni-Suef University, Beni-Suef, Egypt; 3Department of Public Health, Cairo University, Cairo, Egypt; 4Public Health and Community Medicine National Research Center, Cairo, EgyptPurpose: To evaluate factors behind the delay in diagnosis and treatment among Egyptian patients who present with complicated diabetic retinopathy.Methods: Observational cross-sectional study of diabetic patients with advanced diabetic retinopathy. Patients were asked to answer a questionnaire to assess the impact of several sociodemographic factors.Results: A total of 397 patients agreed to take the questionnaire. Diabetic vitreous hemorrhage was the most common ocular complication and was found in 359 patients (90.4%. A total of 158 (39.8% patients knew that diabetes mellitus can be sight threatening, while 240 (60.2% were not aware until they developed sight threatening complication. A total of 179 patients (45.1% had early retirement because of visual loss related to diabetes mellitus. Multivariate logistic regression has shown that education, internist, contact with other patients, and media were respectively significant in predicting the awareness of patients about the sight-threatening effect of diabetic retinopathy.Conclusion: Patient education regarding diabetes and diabetic eye disease is essential for early detection and compliance with treatment. Illiteracy has a significant impact on development of sight-threatening diabetic complications. The internist is the first line of prophylaxis. Media has to participate more in patient education.Keywords: blindness, education, laser photocoagulation, macular edema, vitreous hemorrhage

  15. Fatal Bacillus cereus bacteremia in a patient with diabetes.

    Science.gov (United States)

    Orrett, F A

    2000-04-01

    This report describes a fatal case of Bacillus cereus septicemia in a patient with uncontrolled diabetes and re-emphasizes the potential seriousness of Bacillus infections in patients with compromised immune function.

  16. Diabetes and insurance: a survey of patient experience.

    Science.gov (United States)

    Frier, B M; Sullivan, F M; Stewart, E J

    1984-07-01

    A survey of 186 diabetic patients examined their collective experience of life and motor insurance. Some form of life insurance policy had been obtained by 150 patients, with a combined total of 204 policies, 107 of which had been agreed before the diagnosis of diabetes. Most patients had declared diabetes to the insurer but 12 patients had been refused acceptance. Only 15 patients sought alternative quotations. The premium had been loaded by 10-40% for 36 patients because of diabetes, and 48 required a medical report. Of 147 diabetic drivers, 95 (65%) had declared diabetes either to the Licensing authority, or to the motor insurer, but only 62 (42%) had informed both. Fourteen patients had been refused motor insurance cover by individual companies, and 36 patients were aware of having had their premium increased, but only 16 patients had sought alternative quotations. Major differences in attitude with regard to diabetes as a risk factor for insurance are evident, and patients should be advised to approach several companies when seeking insurance cover.

  17. Rehabilitative considerations for dental implants in the diabetic patient.

    Science.gov (United States)

    Katyayan, Preeti Agarwal; Katyayan, Manish; Shah, Rupal J

    2013-09-01

    Diabetes is a serious illness that affects many people, and there are many new cases diagnosed every year in all populations around the world. Dental implant is one of the restorative methods to replace missing teeth. As implants are directly anchored into bones, they provide stability, a more natural appearance, and minimize the risk of bone resorption. Thus, today, there is a high demand of dental implants and it is inevitable to meet diabetics who request implant treatment. However, Diabetes mellitus patients may pose contraindications to dental implants because of microvascular complications leading to slower healing process after surgery. Studies have shown that dental implantation failure rate in diabetic patients is much higher than that in non-diabetic patients. This article reviews the effect of diabetes on the osseointegration of implants and the soft tissue healing. It presents the factors used in assessing the severity of diabetes and its complications, as well as considerations for rehabilitation planning in these patients. In addition, the role of antibiotic prophylaxis has been reviewed since its effect on wound healing in diabetics is controversial. Integration of these factors by the dentist can dictate whether, as well as what type of implant supported prosthesis should be given to the diabetic patient.

  18. Diabetes Attitude Scale: validation in type-2 diabetes patients in multiple centers in China.

    Directory of Open Access Journals (Sweden)

    Qingqing Lou

    Full Text Available OBJECTIVE: The aim of the paper is to report the development and psychometric testing of Diabetes Attitude Scale. METHOD: A prospective study was performed. The cultural equivalency and content validity of the Diabetes Attitude Scale were determined by panels of endocrinologists, physiologists, nurses and dieticians. An accurate and usable translation was obtained for each of five subscales examining attitudes on need for special training, the seriousness of type-2 diabetes, the need for controlling the condition, its psychosocial impact and the degree of autonomy given to patients in decision making. The validation was derived from 5961 patients with type-2 diabetes, recruited from 50 centers in 29 provinces throughout China between March 1st and September 30th, 2010. RESULTS: The modified Diabetes Attitude Scale showed an acceptable level of internal consistency. The strength of the inter-correlations among the domains of five subscales suggests that the instrument measures related but separate domains of patients' attitudes toward diabetes. Moreover, the test-retest intraclass correlation coefficients were high enough to support the stability of the Chinese version of the third version of the scale. CONCLUSIONS: The psychometric properties of the Chinese version of Diabetes Attitude Scale demonstrated satisfactory validity and reliability and appeared to effectively evaluate attitudes toward diabetes in patients with type-2 diabetes.

  19. Disordered eating behaviors in type 1 diabetic patients.

    Science.gov (United States)

    Larrañaga, Alejandra; Docet, María F; García-Mayor, Ricardo V

    2011-11-15

    Patients with type 1 diabetes mellitus are at high risk for disordered eating behaviors (DEB). Due to the fact that type 1 diabetes mellitus is one of the most common chronic illnesses of childhood and adolescence, the coexistence of eating disorders (ED) and diabetes often affects adolescents and young adults. Since weight management during this state of development can be especially difficult for those with type 1 diabetes, some diabetics may restrict or omit insulin, a condition known as diabulimia, as a form of weight control. It has been clearly shown that ED in type 1 diabetics are associated with impaired metabolic control, more frequent episodes of ketoacidosis and an earlier than expected onset of diabetes-related microvascular complications, particularly retinopathy. The management of these conditions requires a multidisciplinary team formed by an endocrinologist/diabetologist, a nurse educator, a nutritionist, a psychologist and, frequently, a psychiatrist. The treatment of type 1 diabetes patients with DEB and ED should have the following components: diabetes treatment, nutritional management and psychological therapy. A high index of suspicion of the presence of an eating disturbance, particularly among those patients with persistent poor metabolic control, repeated episodes of ketoacidosis and/or weight and shape concerns are recommended in the initial stage of diabetes treatment, especially in young women. Given the extent of the problem and the severe medical risk associated with it, more clinical and technological research aimed to improve its treatment is critical to the future health of this at-risk population.

  20. An Electerophisioligic Study Of Autonomic Nervous System In Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Noorolahi Moghaddam H

    2003-11-01

    Full Text Available Autonomic nervous system dysfunction in diabetics can occur apart from peripheral sensorimotor polyneuropathy and sometimes leads to complaints which may be diagnosed by electrodiagnostic methods. Moreover glycemic control of these patients may prevent such a complications."nMaterials and Methods: 30 diabetic patients were compared to the same number of age and sex-matched controls regarding to electrophysiologic findings of autonomic nervous system. Symptoms referable to autonomic disorder including nightly diarrhea, dizziness, urinary incontinence, constipation, nausea, and mouth dryness were recorded in all diabetic patients. Palmar and plantar SSR and expiration to inspiration ratio (E: I and Valsalva ratio were recorded in all diabetics and control individuals by electromyography device. In addition NCS was performed on two sensory and two motor nerves in diabetic patients."nResults: There was no relation between age of diabetics and abnormal D: I ratio, Valsalva ratio and degree of electrophysiologic autonomic impairment. Also no relation between peripheral sensorimotor polyneuropathy and electrophysiologic autonomic impairment was found. Plantar SSR was absent in 80% of diabetics with orthostatic hypotension (p~ 0.019. Palmar and plantar SSR were absent in many diabetics in comparison to control group (for palmar SSR p~ 0.00 and for plantar SSR p< 0.015. There was no relation between diabetes duration since diagnosis and electrophysiologic autonomic impairment."nConclusion: According to the above mentioned findings diabetic autonomic neuropathy develops apart from peripheral sensorimotor polyneuropathy and probably with different mechanisms. Remarkable absence of palmar SSR in diabetics with orthostatic hypotension can be due to its sympathetic origin. Absence of any relation between diabetes duration and electrophysiologic autonomic impairment can be due to late diagnosis of type 2 diabetes or no pathophysiologic relation between chronic

  1. Plasma proteome analysis of patients with type 1 diabetes with diabetic nephropathy

    DEFF Research Database (Denmark)

    Overgaard, Anne Julie; Hansen, Henning Gram; Lajer, Maria

    2010-01-01

    As part of a clinical proteomics program focused on diabetes and its complications we are looking for new and better protein biomarkers for diabetic nephropathy. The search for new and better biomarkers for diabetic nephropathy has, with a few exceptions, previously focused on either hypothesis...... patients was investigated with the goal of finding improved candidate biomarkers to predict diabetic nephropathy. In order to reach lower concentration proteins in plasma a pre-fractionation step, either hexapeptide bead-based libraries or anion exchange chromatography, was performed prior to surface......-driven studies or urinary based investigations. To date only two studies have investigated the proteome of blood in search for new biomarkers, and these studies were conducted in sera from patients with type 2 diabetes. This is the first reported in depth proteomic study where plasma from type 1 diabetic...

  2. Blood-retinal barrier permeability versus diabetes duration and retinal morphology in insulin dependent diabetic patients

    DEFF Research Database (Denmark)

    Krogsaa, B; Lund-Andersen, H; Mehlsen, J;

    1987-01-01

    The blood-retinal barrier permeability to fluorescein was quantitated in 54 patients (22 females and 32 males) with insulin dependent diabetes mellitus (IDDM) of different duration. Correlation was demonstrated between permeability and diabetes duration. A normal permeability was measured...... the pattern. However, the pathologically increased permeability after ten years duration of the disease could not be demonstrated in diabetics with onset of the disease after the age of 30 years. The permeability of the blood-retinal barrier correlated well with changes in retinal morphology as seen...... in patients with up to ten years diabetes duration. A pathologically increased permeability was measured with ten to 15 years diabetes duration and during the next decade the permeability increased rapidly to 5-10 times the normal value. Onset of diabetes in the decade before and after puberty did not change...

  3. Asymptomatic bacteriuria among pregnant women

    Directory of Open Access Journals (Sweden)

    Sudha Biradar Kerure

    2013-04-01

    Full Text Available Background: Urinary tract infections (UTIs are the most common bacterial infections during pregnancy. Asymptomatic bacteriuria (ASB is a major risk factor for the development of urinary tract infections during pregnancy and with further risk of preterm birth & pyelonephritis if untreated. Aims & Objectives: This study was carried out to determine the prevalence of asymptomatic bacteriuria (ASB in pregnant women & to isolate, identify and establish antimicrobial susceptibility of pathogens. Methods: A total of 500 pregnant women were studied over a period of one year. Clean catch midstream urine sample was collected into a sterile container & then subjected to culture method. Results: Significant bacteriuria was noted in 45 patients (9%. 3% patients had insignificant bacteriuria. Growth of contaminants was noted in 8%. 80% samples were sterile with no growth. E. coli was the most common etiological agent, followed by Staphylococcus aureus. Conclusions: Asymptomatic bacteriuria is not uncommon in antenatal patients. All pregnant women should be screened by urine culture to detect asymptomatic bacteriuria at their first visit to prevent overt UTI & other complications in both mother & fetus. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 213-216

  4. Diabetes does not affect outcome in patients with Enterobacteriaceae bacteremia

    Directory of Open Access Journals (Sweden)

    Peralta Galo

    2009-06-01

    Full Text Available Abstract Background There is limited information about the effect of diabetes on the prognosis of patients with bacterial infections. We performed a retrospective cohort study to investigate possible correlations between diabetes and prognosis in patients with Enterobacteriaceae bacteremia. Methods We reviewed the medical charts of 1112 patients who were treated at a community teaching hospital for Enterobacteriaceae bacteremia from January 1997 through June 2007. Factors associated with in-hospital mortality were analyzed by logistic regression analysis. Results Among the 1112 patients with Enterobacteriaceae bacteremia, 181 (16.3% were diabetic patients; 90 patients (8.1% died while in the hospital. Compared to non-diabetic patients, diabetic patients were older (75.4 ± 11.9 years vs. 70 ± 16.6 years, p p = 0.39]. In a multivariate analysis, the variables associated with in-hospital mortality were age, the origin of the bacteremia, and the presence of immunosuppression. Diabetes was not associated with outcome. Conclusion In this cohort of patients with Enterobacteriaceae bacteremia, diabetes was not associated with a poorer prognosis.

  5. Increased tissue factor, MMP-8, and D-dimer expression in diabetic patients with unstable advanced carotid atherosclerosis

    Directory of Open Access Journals (Sweden)

    Jerzy Krupinski

    2007-09-01

    Full Text Available Jerzy Krupinski1,2, Marta M Turu1,2, M Angels Font1, Nesser Ahmed3, Matthew Sullivan3, Ana Luque1,2, Francisco Rubio1, Lina Badimon2, Mark Slevin31Department of Neurology, Stroke Unit, University Hospital of Bellvitge (HUB, Fundacio IDIBELL, Barcelona, Spain; 2Cardiovascular Research Centre, IIBB/CSIC-HSCSP-UAB, Barcelona, Spain; 3School of Biology, Chemistry and Health Science, Manchester Metropolitan University, Manchester, United KingdomAbstract: Advanced atherogenesis is characterized by the presence of markers of enhanced prothrombotic capacity, attenuated fibrinolysis, and by clinical conditions associated with defective coagulation. Diabetes may be associated with enhanced lesion instability and atherosclerotic plaque rupture. Plaques obtained from 206 patients undergoing carotid endarterectomy were divided into diabetic (type 2 and nondiabetic and analyzed by Western blotting and immunohistochemistry to detect tissue factor (TF, metalloproteinases (MMP-2, -8, -9, and fibrin/fibrinogen related antigens, and in situ zymography to detect MMP activity. Plasma samples were quantified for TF procoagulant activity, C-reactive protein, fibrinogen and D-dimer. Diabetic and symptomatic patients with hypoechogenic plaques had increased plasma TF activity and D-dimer, compared with those with hyperechogenic plaques (p = 0.03, p = 0.007, respectively. Diabetic, symptomatic patients had higher plasma D-dimer levels than asymptomatic patients (p = 0.03. There was a significant correlation between intramural TF levels and D-dimer in diabetic patients with symptomatic disease (p = 0.001, r2 = 0.4. In diabetic patients, plasma fibrinogen levels were higher in patients with hypoechogenic plaques (p = 0.007. Diabetic patients with ulcerated plaques had higher plasma D-dimer and MMP-8 levels than those with fibrous plaques (p = 0.02, p = 0.01, respectively. This data suggests that currently available circulating markers may be clinically useful to select

  6. Impact of intensive nutritional education with carbohydrate counting on diabetes control in type 2 diabetic patients

    OpenAIRE

    Christopher Zipp; Jessica Terrone Roehr; Lucia Beck Weiss; et al.

    2010-01-01

    Christopher Zipp, Jessica Terrone Roehr, Lucia Beck Weiss, Frank FilipettoDepartment of Family Medicine, School of Osteopathic Medicine, University of Medicine and Dentistry of New Jersey, Stratford, NJ, USAAbstract: This pilot study assessed the impact of an intensive carbohydrate counting educational intervention on diabetes control in type 2 diabetic patients. An experimental, prospective study design was used to assess the effect of nutritional education on diabetes control. The impact an...

  7. EFFECTS OF DIABETES ON THE AMINO TERMINAL PROBRAIN TYPE NATRIURETIC PEPTIDE (NT-PROBNP LEVELS IN ELDERLY PATIENTS

    Directory of Open Access Journals (Sweden)

    Muzaiyan Ahmed Khan

    2012-02-01

    Full Text Available The Amino terminal portion of the precursor of brain natriuretic peptide (NT-proBNP has been reported to be elevated in left ventricular dysfunction. The NT-proBNP is a split product from the proBNP molecule, and its level in the circulation is not, as the mature Brain type natriuretic peptide, dependent on the peripheral number of brain natriuretic peptide (BNP receptors. We aimed to test the hypothesis that asymptomatic left ventricular dysfunction (ALVD, as estimated by NT-proBNP, would be more prevalent in patients with type 2 diabetes without overt cardiovascular disease in comparison with matched control subjects. The study population consisted of [N=100] out of which 75 patients including Type-II diabetes and 25 matched control subjects aged 40–70 years heart disease from OPD Escorts Heart Institute and Research centre Okhla New Delhi. NT-proBNP was measured in plasma by competitive enzyme immunosorbent assay. Patients with type-II diabetes were shown to have higher NT-proBNP values than control subjects. NT-proBNP levels were independently related to diabetes after adjustment for age, sex, systolic and diastolic blood pressure, BMI, heart rate, drug treatment, serum creatinine, and cystatin-C. The secretion of NT-proBNP is increased in type-II diabetic patients, suggesting that type 2 diabetes is associated with a higher prevalence of ALVD. NT-proBNP may thus serve as a screening tool to select patients with type-II diabetes who could benefit from an echocardiographical examination.

  8. Medical Nutrition Therapy in Hospitalized Patients with Diabetes

    Science.gov (United States)

    Gosmanov, Aidar R.

    2013-01-01

    Medical nutrition therapy (MNT) plays an important role in management of hyperglycemia in hospitalized patients with diabetes mellitus. The goals of inpatient MNT are to optimize glycemic control, to provide adequate calories to meet metabolic demands, and to create a discharge plan for follow-up care. All patients with and without diabetes should undergo nutrition assessment on admission with subsequent implementation of physiologically sound caloric support. The use of a consistent carbohydrate diabetes meal-planning system has been shown to be effective in facilitating glycemic control in hospitalized patients with diabetes. This system is based on the total amount of carbohydrate offered rather than on specific calorie content at each meal, which facilitates matching the prandial insulin dose to the amount of carbohydrate consumed. In this article, we discuss general guidelines for the implementation of appropriate MNT in hospitalized patients with diabetes. PMID:21997598

  9. Subclinical onychomycosis in patients with type II diabetes

    Directory of Open Access Journals (Sweden)

    Amira Elbendary

    2015-12-01

    Full Text Available Fungal organisms could be present in the nail without any clinical manifestations. As onychomycosis in diabetics has more serious complications, early detection of such infection could be helpful to prevent them. We aim in this study to assess the possibility of detecting subclinical onychomycosis in type II diabetic patients and addressing possible associated neuropathy. A cross sectional, observational study included patients with type II diabetes with normal big toe nail. All were subjected to nail clipping of the big toe nail, followed by staining with Hematoxylin and Eosin and Periodic-Acid-Schiff (PAS stains and examined microscopically. A total of 106 patients were included, fungal infection was identified in eight specimens, all were uncontrolled diabetes, and six had neuropathy. Using the nail clipping and microscopic examination with PAS stain to detect such subclinical infection could be an applicable screening test for diabetic patients, for early detection and management of onychomycosis.

  10. Coronariopatia assintomática em chagásicos com insuficiência cardíaca: prevalência e fatores de risco Asymptomatic coronary artery disease in chagasic patients

    Directory of Open Access Journals (Sweden)

    Gustavo Carvalho

    2011-11-01

    Full Text Available FUNDAMENTO: A concomitância de doença arterial coronária assintomática em pacientes com cardiomiopatia chagásica em IC é controversa na literatura médica, pois ambas as doenças se mostram prevalentes em algumas regiões do Brasil. Objetivo: Determinar a prevalência da coronariopatia (lesões > 50% em uma população específica de pacientes com cardiomiopatia chagásica em IC classes funcionais III e IV, que não apresentavam eventos coronarianos prévios. OBJETIVO: Determinar a prevalência da coronariopatia (lesões > 50% em uma população específica de pacientes com cardiomiopatia chagásica em IC classes funcionais III e IV, que não apresentavam eventos coronarianos prévios. MÉTODOS: Realizou-se cineangiocoronariografia em 61 pacientes consecutivos, portadores de cardiomiopatia chagásica, em IC classes funcionais III e IV, para se excluir coronariopatia. Esses pacientes faziam parte do protocolo do Estudo de Terapia Celular em Cardiopatias, o qual exigia a realização de cineangiocoronariografia antes de se injetarem células-tronco. Os fatores de risco para aterosclerose também analisados nessa população foram: idade, hipertensão arterial, diabetes, dislipidemia, tabagismo e sobrepeso. RESULTADOS: Idade média 51,6 + 9,6 anos, 65,5% (n = 40 homens. A prevalência de coronariopatia encontrada nessa população foi de 1,6% (1. As prevalências dos fatores de risco foram: hipertensão arterial 18% (11, tabagismo 59% (36, diabetes 1,6% (1 e dislipidemia 6,5% (4. CONCLUSÃO: A prevalência da coronariopatia assintomática em pacientes com IC grave de etiologia chagásica é baixa e, entre os fatores de risco para doença coronária, o tabagismo foi o mais prevalente.BACKGROUND: Concomitant asymptomatic coronary artery disease in patients with Chagas cardiomyopathy in heart failure is controversial in the medical literature, as both diseases are prevalent in some regions of Brazil. OBJECTIVE: To determine the prevalence of

  11. Diabetes patient at risk score - a novel system for triaging appropriate referrals of inpatients with diabetes to the diabetes team.

    Science.gov (United States)

    Rajendran, Rajesh; Round, Rachael-Marie; Kerry, Christopher; Barker, Sarah; Rayman, Gerry

    2015-06-01

    The acceptability, uptake and effectiveness of a new referral tool - the diabetes patient at risk (DPAR) score - were evaluated and the timeliness of review of referred inpatients by the diabetes team was measured. For this, a snapshot survey of ward healthcare professionals (HCPs) and a review of all DPAR referrals to the diabetes team between 1 September 2013 and 31 January 2014 were undertaken. All referrals in November 2013 were audited for timeliness of review. 77% of HCPs agreed/strongly agreed that the tool improved access to the diabetes team. 76% of referrals were from nurses. 80% of who should have been referred were referred; the remaining had already been reviewed by the diabetes team and therefore did not require referral. Only 11% of referrals were inappropriate. All DPAR referrals were reviewed within the stipulated time period in November 2013. Overall, the DPAR system was well accepted, successfully identified appropriate referrals and facilitated referrals in a timely manner to the diabetes team.

  12. Kidney transplant in diabetic patients: modalities, indications and results

    Directory of Open Access Journals (Sweden)

    Rangel Érika B

    2009-08-01

    Full Text Available Abstract Background Diabetes is a disease of increasing worldwide prevalence and is the main cause of chronic renal failure. Type 1 diabetic patients with chronic renal failure have the following therapy options: kidney transplant from a living donor, pancreas after kidney transplant, simultaneous pancreas-kidney transplant, or awaiting a deceased donor kidney transplant. For type 2 diabetic patients, only kidney transplant from deceased or living donors are recommended. Patient survival after kidney transplant has been improving for all age ranges in comparison to the dialysis therapy. The main causes of mortality after transplant are cardiovascular and cerebrovascular events, infections and neoplasias. Five-year patient survival for type 2 diabetic patients is lower than the non-diabetics' because they are older and have higher body mass index on the occasion of the transplant and both pre- and posttransplant cardiovascular diseases prevalences. The increased postransplant cardiovascular mortality in these patients is attributed to the presence of well-known risk factors, such as insulin resistance, higher triglycerides values, lower HDL-cholesterol values, abnormalities in fibrinolysis and coagulation and endothelial dysfunction. In type 1 diabetic patients, simultaneous pancreas-kidney transplant is associated with lower prevalence of vascular diseases, including acute myocardial infarction, stroke and amputation in comparison to isolated kidney transplant and dialysis therapy. Conclusion Type 1 and 2 diabetic patients present higher survival rates after transplant in comparison to the dialysis therapy, although the prevalence of cardiovascular events and infectious complications remain higher than in the general population.

  13. Nrf2 and Redox Status in Prediabetic and Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Angélica S. Jiménez-Osorio

    2014-11-01

    Full Text Available The redox status associated with nuclear factor erythroid 2-related factor-2 (Nrf2 was evaluated in prediabetic and diabetic subjects. Total antioxidant status (TAS in plasma and erythrocytes, glutathione (GSH and malondialdehyde (MDA content and activity of antioxidant enzymes were measured as redox status markers in 259 controls, 111 prediabetics and 186 diabetic type 2 subjects. Nrf2 was measured in nuclear extract fractions from peripheral blood mononuclear cells (PBMC. Nrf2 levels were lower in prediabetic and diabetic patients. TAS, GSH and activity of glutamate cysteine ligase were lower in diabetic subjects. An increase of MDA and superoxide dismutase activity was found in diabetic subjects. These results suggest that low levels of Nrf2 are involved in the development of oxidative stress and redox status disbalance in diabetic patients.

  14. Depression in diabetic patients attending University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Birhanu AM

    2016-05-01

    Full Text Available Anteneh Messele Birhanu,1 Fekadu Mazengia Alemu,2 Tesfaye Demeke Ashenafie,3 Shitaye Alemu Balcha,4 Berihun Assefa Dachew5 1School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, 2Department of Midwifery, 3Department of Nursing, 4Department of Internal Medicine, College of Medicine and Health Sciences, 5Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia Background: Diabetes mellitus, frequently associated with comorbid depression, contributes to the double burden of individual patients and community. Depression remains undiagnosed in as many as 50%–75% of diabetes cases. This study aimed to determine the prevalence and associated factors of depression among diabetic patients attending the University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted from March to May 2014 among 422 sampled diabetic patients attending the University of Gondar Hospital Diabetic Clinic. The participants were selected using systematic random sampling. Data were collected by face-to-face interview using a standardized and pretested questionnaire linked with patient record review. Depression was assessed using the Patient Health Questionnaire-9. Data were entered to EPI INFO version 7 and analyzed by SPSS version 20 software. Binary logistic regression analysis was performed to identify factors associated with depression. Results: A total of 415 diabetic patients participated in the study with a response rate of 98.3%. The prevalence of depression among diabetic patients was found to be 15.4% (95% confidence interval (CI: 11.7–19.2. Only religion (adjusted odds ratio [AOR] =2.65 and 95% CI: 1.1–6.0 and duration of diabetes (AOR =0.27 and 95% CI: 0.07–0.92 were the factors associated with depression among diabetic patients. Conclusion: The prevalence of depression was low as compared to other

  15. Role of temporary pacing at the right ventricular outflow tract in anesthetic management of a patient with asymptomatic sick sinus syndrome.

    Science.gov (United States)

    Nag, Kusha; Nagella, Amrutha Bindu; Kumar, V R Hemanth; Singh, Dewan Roshan; Ravishankar, M

    2015-01-01

    A 60-year-old woman posted for percutaneous nephrolithotomy with ureterolithotripsy was found to have a history of hypertension and ischemic heart disease from past 6 months on regular treatment. Pulse rate was irregularly irregular in a range of 56-60/min, unresponsive to atropine, with a sinus pause on the electrocardiogram. Although the patient was asymptomatic, anticipating unmasking of the sick sinus syndrome during general anesthesia in the prone position, a temporary pacemaker was implanted at right ventricular outflow tract (RVOT) septum before the scheduled surgery. A balanced anesthesia technique with endotracheal intubation was administered. There were several episodes of continuous pacing by the temporary pacemaker intraoperatively, which may be attributed to unmasking of the sinus node dysfunction due to general anesthesia. At the end of surgery, patient was extubated after adequate reversal from neuromuscular blockade. Postoperative period remained uneventful, and the pacemaker wires were removed on the 2(nd) postoperative day. With this case report, we highlight the importance of inserting a temporary pacemaker prior to anesthesia even in an asymptomatic patient if a sinus node dysfunction is suspected preoperatively and if intraoperative access to transvenous pacing is difficult such as in prone position. Pacing at RVOT septum minimizes ventricular dyssynchrony and improves hemodynamic parameters.

  16. Evaluation of Depression, Anxiety and Stress in Diabetic and Non-Diabetic Patients

    Directory of Open Access Journals (Sweden)

    M Mirzaei

    2016-08-01

    Full Text Available Introduction: Depression is one of the most common psychiatric disorders and diabetes is one of the most common chronic diseases. Controlling the blood glucose level in the patients suffering from depression is more difficult than in healthy individuals. This study aimed to assess depression, anxiety and stress in diabetic and non-diabetic people. Methods: This cross-sectional analytical study was carried out using data from the health survey of people in Yazd province (YAHS in 2014-2015. The sample size of this study was 3514 participants. DASS21 questionnaire was used to measure stress, anxiety and depression. The data were analyzed using SPSS20. Results: The prevalence of depression, anxiety and stress in diabetic patients was 42.4%, 48.7% and 45.6% and in non-diabetic people was 35.5%, 34% and 38.3%, respectively. The study revealed a meaningful relationship between diabetes and depression, anxiety and stress. The highest rate of depression in diabetic people was found among women and single people. The highest rate of anxiety in diabetic people was found among women and the people with education levels lower than diploma and people having diabetes effects. The highest stress was observed in women as well as single people having diabetes effects (P <0.05. No significant relationship was found between the variables of age and education level with having diabetes effects as well as depression. Conclusion: Due to the prevalence of depression, anxiety and stress in diabetic patients, psychiatric consultation and the treatment of these disorders is recommended.

  17. [Antibiotic treatment in patients amputated for ischemic diabetic foot].

    Science.gov (United States)

    Fernández Montequín, J I; McCook Martínez, J; Lima Santana, B; Velasco Armas, N; Montalvo Diago, J; Mahía Vilas, M

    1991-01-01

    Thirty diabetic patients submitted to a major amputation were tested by humo-celullar assays (retarded hypersensibility assays). Reactive patients were subdivided into two groups: one group was treated postoperatively with antibiotics, and the other group was not treated. Both groups were homogeneous in age, hemoglobin concentrations, hematocrit, total proteins, glucemy and history of sepsis or leukocytosis. Five patients treated with antibiotics (33.3%) presented sepsis, one patient was reamputated and one patient died. Between the not treated patients, only three presented sepsis (20%) without any other complications. Authors conclude that the development of sepsis in reactive, diabetic, amputated patients is independent of antibiotic treatment.

  18. Association between Diabetic Polyneuropathy and Cardiovascular Complications in Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Jin Ook Chung

    2011-08-01

    Full Text Available BackgroundDiabetes mellitus is a major independent risk factor for cardiovascular disease (CVD, but high cardiovascular risk in diabetes mellitus patients is not completely explained by clustering traditional risk factors. Recently, associations between diabetic polyneuropathy (DPN and macrovasculopathy have been suggested. We aimed to assess associations between DPN and cardiovascular complications in type 2 diabetic patients.MethodsMicrovascular and cardiovascular complications were evaluated in 1,041 type 2 diabetic patients.ResultsIn patients with DPN, the age, prevalence of hypertension, diabetes duration, systolic blood pressure, pulse pressure, and hemoglobin glycation (HbA1c levels were significantly higher, while the high density lipoprotein cholesterol (HDL-C levels were lower than in those without DPN. The prevalence of CVD was higher in patients with DPN. In multivariate analysis, DPN was independently associated with CVD (odds ratio, 1.801; 95% confidence interval, 1.009 to 3.214.ConclusionOur results showed that DPN was associated with a high prevalence of cardiovascular disease in type 2 diabetic patients, but further studies are needed to investigate the causative nature of associations between DPN and CVD.

  19. Association of 2184AG Polymorphism in the RAGE Gene with Diabetic Nephropathy in Chinese Patients with Type 2 Diabetes

    OpenAIRE

    Wei Cai; Jian Li; Ji-Xiong Xu; Ying Liu; Wei Zhang; Jun-Ren Xiao; Ling-Yan Zhu; Jian-Ying Liu

    2015-01-01

    Objective. The interaction between advanced glycation end products and their cellular receptor (RAGE) has an important role in the pathogenesis of diabetic microvascular complications. The aim of this study was to investigate the relationship between the 2184A/G polymorphism in the RAGE gene and diabetic nephropathy in Chinese Han patients with type 2 diabetes mellitus. Methods. A total of 868 patients with type 2 diabetes mellitus (486 without and 382 with diabetic nephropathy) were enrolled...

  20. Increased Mortality of Patients With Diabetes Reporting Severe Hypoglycemia

    OpenAIRE

    McCoy, Rozalina G.; Van Houten, Holly K; Ziegenfuss, Jeanette Y; Nilay D. Shah; Wermers, Robert A; Smith, Steven A.

    2012-01-01

    OBJECTIVE Hypoglycemia is a cause of significant morbidity among patients with diabetes and may be associated with greater risk of death. We conducted a retrospective study to determine whether patient self-report of severe hypoglycemia is associated with increased mortality. RESEARCH DESIGN AND METHODS Adult patients (N = 1,020) seen in a specialty diabetes clinic between August 2005 and July 2006 were questioned about frequency of hypoglycemia during a preencounter interview; 7 were lost to...

  1. Association of Inter-arm Blood Pressure Difference with Asymptomatic Intracranial and Extracranial Arterial Stenosis in Hypertension Patients

    Science.gov (United States)

    Wang, Yan; Zhang, Jin; Qian, Yuesheng; Tang, Xiaofeng; Ling, Huawei; Chen, Kemin; Li, Yan; Gao, Pingjin; Zhu, Dingliang

    2016-01-01

    Inter-arm blood pressure (BP) difference has been associated with ischemic stroke. Local atherosclerosis of stroke differ among vulnerable individuals, whereas intracranial arterial stenosis (ICAS) is more frequently affected Asians, and extracranial arterial stenosis (ECAS) is more prevalent among whites. We hereby sought to explore the association of inter-arm BP difference with ICAS and ECAS in stroke-free hypertensive patients in Chinese population. All the 885 subjects were evaluated of ICAS and ECAS through computerized tomographic angiography. Both arm BP was measured simultaneously by Vascular Profiler-1000 device. In the continuous study, ICAS was significantly associated with age, male, average brachial SBP, diabetes, anti-hypertensive treatment and inter-arm DBP difference. ECAS was associated with age, inter-arm SBP and LDL. In the categorical study, subjects with the top quartile of inter-arm DBP difference (≥4 mmHg) showed significantly higher risk of ICAS (OR = 2.109; 95% CI, 1.24–3.587). And the participants with the top quartile of inter-arm SBP difference (≥6 mmHg) showed significantly higher risk of ECAS (OR = 2.288; 95% CI, 1.309–3.998). In conclusion, we reported a diverse association of inter-arm SBP/DBP difference with the ICAS/ECAS. Inter-arm DBP difference might be the early symbol of ICAS in Chinese population, which need further verification in long-term cohort study. PMID:27412818

  2. Overproduction of nitrate and S-nitrosothiols in diabetic patients

    Institute of Scientific and Technical Information of China (English)

    Junping Zhao; Chengbin Wang; Hongli Tong; Yuzhen Li; Chunxi Zhou; Yaping Tian; Shiwei Liu

    2008-01-01

    Objective The present study was designed to investigate changes in serum or plasma concentrations of nitric oxide and its derivatives in diabetic patients.Methods Serum nitrate concentration of 84 diabetic patients was measured by using an enzyme kinetic method,and the plasma S-nitrosothiols concentration of 10 cases was measured by using HPLC technique.Results Serum nitrate concentration and plasma S-nitrosothiols concentration in the diabetics were significantly higher than in control group (P<0.01 andP<0.05,respectively).The serum nitrate concentration in diabetics also had a significant positive correlation with the serum glucose concentration (R=0.7256,P<0.05),but this correlation was not found in control group.Conclusion These data showed that NO and its derivatives are overproduced in the diabetic patients.(J Geriatr Cardiol 2008;5:25-27)

  3. Inhaled insulin for controlling blood glucose in patients with diabetes

    Directory of Open Access Journals (Sweden)

    Bernard L Silverman

    2008-01-01

    Full Text Available Bernard L Silverman1, Christopher J Barnes2, Barbara N Campaigne3, Douglas B Muchmore31Alkermes, Inc, Cambridge, MA, USA; 2i3 Statprobe, Ann Arbor, MI; 3Eli Lilly and Company, Indianapolis, IN, USAAbstract: Diabetes mellitus is a significant worldwide health problem, with the incidence of type 2 diabetes increasing at alarming rates. Insulin resistance and dysregulated blood glucose control are established risk factors for microvascular complications and cardiovascular disease. Despite the recognition of diabetes as a major health issue and the availability of a growing number of medications designed to counteract its detrimental effects, real and perceived barriers remain that prevent patients from achieving optimal blood glucose control. The development and utilization of inhaled insulin as a novel insulin delivery system may positively influence patient treatment adherence and optimal glycemic control, potentially leading to a reduction in cardiovascular complications in patients with diabetes.Keywords: diabetes, inhaled insulin, cardiovascular disease, blood glucose

  4. Factors Related to Perceived Diabetes Control Are Not Related to Actual Glucose Control for Minority Patients With Diabetes

    Science.gov (United States)

    McAndrew, Lisa M.; Horowitz, Carol R.; Lancaster, Kristie J.; Leventhal, Howard

    2010-01-01

    OBJECTIVE To examine variables associated with perceived diabetes control compared with an objective measure of glucose control (A1C). RESEARCH DESIGN AND METHODS Beliefs about diabetes were assessed among 334 individuals with diabetes living in a primarily low-income, minority, urban neighborhood. Regression analyses tested associations between disease beliefs and both participants' perceptions of control and actual control (A1C). RESULTS Poorer perceived diabetes control was associated with perceiving a greater impact of diabetes, greater depressive symptoms, not following a diabetic diet, A1C, and a trend toward less exercise. Variables associated with better actual control (A1C) included higher BMI, older age, and not using insulin. CONCLUSIONS Patients' perceptions of their diabetes control are informed by subjective diabetes cues (e.g., perceived impact of diabetes and adherence to a diabetic diet), which are not related to A1C. Clinicians should take into account what cues patients are using to assess their diabetes control. PMID:20067972

  5. Angina in a diabetic patient: a case of integrated approach

    Directory of Open Access Journals (Sweden)

    Eugenio Roberto Cosentino

    2008-09-01

    Full Text Available Diabetes mellitus, both of type 1 and 2, is an important risk factor for the development of atherosclerosis: in diabetic patients vascular atherosclerotic complications are responsible of approximately 80% of all the deaths. There is no doubt that patients affections originating from diabetes and coronaropathy remain at high risk. For this reason it is essential to adopt an aggressive strategy of secondary prevention. We report a case of a patient with multiple risk factors for cardiovascular diseases: the successful management was due to an integrated approach that involved the general practitioner and cardiologist.

  6. Sleep Disturbances and Glucoregulation in Patients with Type 2 Diabetes

    OpenAIRE

    2014-01-01

    We investigated the frequency of sleep disturbances and the association between sleep disturbances and glucoregulation in type 2 diabetic patients. The frequency of sleep disturbances in 614 type 2 diabetic patients was investigated using validated sleep questionnaires. There were 381 male and 233 female patients. The mean age was 59.7 ± 11.1 yr; the mean body mass index was 24.9 ± 4.4 kg/m2; the mean HbA1c was 7.8% ± 1.5%; and the mean duration of diabetes was 10.3 ± 8.4 yr. The questionnair...

  7. Pre-diabetes and arterial stiffness in uraemic patients

    DEFF Research Database (Denmark)

    Hornum, Mads; Clausen, Peter; Kjaergaard, Jesper;

    2010-01-01

    In order to address factors of relevance for new onset diabetes mellitus and cardiovascular disease after kidney transplantation, we investigated the presence of pre-diabetes, arterial stiffness and endothelial dysfunction in patients with end-stage renal disease (ESRD) accepted for kidney...

  8. Fibrillary glomerulonephritis in a patient with type 2 diabetes mellitus.

    NARCIS (Netherlands)

    Gielen, G.A.; Wetzels, J.F.M.; Steenbergen, E.; Mudde, A.H.

    2006-01-01

    We report a 62-year-old man with documented type 2 diabetes mellitus and hypertension, who presented with a rapid deterioration in renal function. The sudden decrease in renal function in this well-controlled diabetic patient prompted us to consider a nondiabetic and nonhypertensive cause. The urina

  9. High prevalence of diabetes mellitus in patients with liver cirrhosis

    NARCIS (Netherlands)

    N. Wlazlo; H.J.B.H. Beijers; E.J. Schoon; H.P. Sauerwein; C.D.A. Stehouwer; B. Bravenboer

    2010-01-01

    P>Aims The reported prevalence of Type 2 diabetes mellitus in patients with liver cirrhosis is five times higher than in the general population. However, these data were never adjusted for classical risk factors for Type 2 diabetes. We therefore investigated the association between cirrhosis and Typ

  10. Skin and nail mycoses in patients with diabetic foot.

    Science.gov (United States)

    Papini, M; Cicoletti, M; Fabrizi, V; Landucci, P

    2013-12-01

    Diabetes mellitus affects all socioeconomic and age groups and its incidence is rapidly increasing worldwide. The diabetic foot complication represents one of the most complex and serious complications in these patients. Fungal infections can also contribute to the severity of the diabetic foot. The aim of the present study was to evaluate the prevalence of foot skin and toenail mycosis in a group of 75 patients with diabetic foot complication and in a matched control group. Diabetic patients showed onychomycosis in 53.3% and foot skin mycosis in 46.7% of the cases, with a prevalence of both fungal infections significantly higher than that observed in the control group. At least one type of these fungal infections was present in 69.3% of diabetic subjects with a highly significant difference compared to control group (Pdiabetic foot complication, and that the problem of fungal infections of the foot in diabetic subjects is still highly underestimated. Consequently, there is an important clinical rationale for careful mycological examination of diabetic foot and an adequate treatment tailored for each individual patient according to the fungal species involved.

  11. Improving patient compliance with diabetic retinopathy screening and treatment

    Directory of Open Access Journals (Sweden)

    Karinya Lewis

    2015-06-01

    Full Text Available Diabetic retinopathy is one of the many complications of diabetes. Because there are no symptoms initially, patients will not realise that they have the condition until it is at a proliferative stage or they develop macular oedema, when their vision becomes affected. Unfortunately, vision that has been lost may never be regained.

  12. May diabetes patients have trouble sleeping despite not having obesity?

    Directory of Open Access Journals (Sweden)

    Maurizio Rizzi

    2014-06-01

    Full Text Available Obstructive sleep apnea (OSA and periodic limb movements during sleep (PLMs are sleep-related disorders with a high prevalence in type 2 diabetes. Commonly OSA is considered as a consequence of obesity, but several previous studies have shown the presence of OSA in non-obese diabetic patients. A previous study showed higher PLMs prevalence in patients with type 2 diabetes, compared to age-matched controls. We speculated that both OSA and PLMs may reflect the presence of diabetic autonomic neuropathy. To test this hypothesis, we compared a group of 112 non-obese patients with type 2 diabetes with 66 age-, sex-, and body mass index- matched nondiabetic patients. Both groups have been investigated through a set of tests including the Epworth Sleepiness Scale, polysomnography, and the Orthostatic Grading Scale (OGS, a questionnaire to assess the degree of autonomic dysfunction. Diabetic patients with OSA and PLMs scored higher on the OGS than controls. Our results confirm that both OSA and PLMs are related to dysautonomy and may be unrelated to obesity in type 2 diabetes patients.

  13. CT findings of pulmonary tuberculosis in diabetic and immunocompromised patients

    Energy Technology Data Exchange (ETDEWEB)

    Takeuchi, Noriyuki; Ikezoe, Junpei; Johkoh, Tsuyoshi (Osaka Univ. (Japan). Faculty of Medicine) (and others)

    1992-01-01

    To evaluate the CT features of pulmonary tuberculosis in diabetic or immunocompromised patients, we reviewed CT of the chest in 42 adult patients with active pulmonary tuberculosis. Forty-two had some underlying diseases or immunocompromised conditions (31 diabetes mellitus, 6 malignancies, 2 long-term steroid therapy, 2 pneumoconiosis, and one anorexia nervosa). In diabetic or immunocompromised patients, a high incidence of non-segmental distribution (27%) and multiple small cavities in a cavitary lesion (45%) was observed. Unusual localization of the lesions such as lower lung field disease was observed in 18% of cases (the incidence of unusual localization in patients with no underlying disease was equal to diabetic or immunocompromised patients). (author).

  14. Úlcera penetrante de aorta ascendente en un paciente asintomático Penetrating ascending aortic ulcer in an asymptomatic patient

    Directory of Open Access Journals (Sweden)

    A. Bayona

    2012-08-01

    Full Text Available La úlcera penetrante de aorta (UPA es la ulceración de una placa aterosclerótica que afecta a la lámina elástica interna de la aorta, y que puede evolucionar hacia un hematoma de pared o una disección aórtica si se produce el paso de sangre hacia la capa media. A pesar de que se localiza más frecuentemente en la aorta descendente, puede presentar una alta mortalidad en caso de situarse en la aorta ascendente, donde la cirugía está indicada aunque el paciente se encuentre asintomático. Presentamos el caso de un paciente sin sintomatología con úlcera penetrante de aorta ascendente (UPAA ascendente sometido a sustitución de aorta ascendente por una prótesis vascular.Penetrating aortic ulcer (PAU has been defined as an atherosclerotic plaque ulceration that breaks the internal elastic lamina of the aorta, which may progress to a wall hematoma or aortic dissection in case of blood seeping into the middle layer. Although PAU is commonly located in the descending aorta, the involvement of the ascending aorta can be fatal. Therefore, surgery is indicated even in asymptomatic patients presenting an ascending PAU. We report on an asymptomatic patient with ascending PAU referred for replacement of the ascending aorta with a composite prosthetic graft.

  15. Type 2 diabetes and pre-diabetic abnormalities in patients with bipolar disorders

    DEFF Research Database (Denmark)

    Leopold, Karolina; Reif, Andreas; Haack, Sarah;

    2016-01-01

    quality were assessed. RESULTS: Diabetes mellitus was found in 7% of the patients, pre-diabetic abnormalities in 27%. The group of patients with abnormalities in the glucose metabolism had significantly lower quality of life and global functioning. Higher BMI, leptin, triglycerides and CRP levels...... metabolism and this was associated with impaired global functioning and lower quality of life. Early detection and intervention strategies fitting the needs of patient with bipolar disorder are needed to improve both physical and mental health.......BACKGROUND: Abnormalities in the glucose metabolism cause nervous and organic damage and are a cardiovascular risk factor. They could be a main cause for the increased morbidity and mortality rates found in patients with bipolar disorders. The exact prevalence of diabetes and pre-diabetic...

  16. [Efficiency of cerebrolysin in the diabetic polyneuropathy in patients with insulin-dependency diabetes mellitus].

    Science.gov (United States)

    Bogdanov, E I; Sakovets, T G

    2011-01-01

    78 patients with clinical features of diabetic polyneuropathy have been examined. 39 patients, who took cerebrolysin, compose the basic group, 39 patients, who made up control one, took milgamma. The dynamics of clinical signs of the diabetic polyneuropathy was evaluated by difference of points in the first and the second examination with the use of scales: NSC (Neuropathy Symptoms and Change) and NDS (Neuropathy Dysfunction Score); the visual analog scale (VAS) and changes of the signs of orthostatic test. For the detection of the effectiveness of treatment was estimated dynamics of neuropathic disorders represented in patient with diabetes mellitus types I and II (with secondary insulin-dependency), witch allowed to reveal the considerable therapeutic effectiveness of cerebrolysin in treatment of diabetic polyneuropathic disorders.

  17. Alcohol consumption among patients with diabetes

    DEFF Research Database (Denmark)

    Jakobsen, Mathilde L.; Larsen, Julie R.; Glumer, Charlote

    2016-01-01

    Aims: To estimate alcohol consumption among Danish adults with diabetes and to investigate whether certain comorbidities are related to a high alcohol intake. Methods: A total of 162,283 participants responded to the Danish National Health Survey 2013 (questionnaire study, response rate 54.0%). V...... are less prone to exhibit addictive behaviour and many abstain from alcohol. Fewer women with diabetes than without diabetes have an excessive drinking pattern. High alcohol consumption in men with diabetes correlates to a lower occurrence of cardiovascular events....

  18. Dyslipidemia, kidney disease, and cardiovascular disease in diabetic patients.

    Science.gov (United States)

    Chen, Szu-chi; Tseng, Chin-Hsiao

    2013-01-01

    This article reviews the relationship between dyslipidemia, chronic kidney disease, and cardiovascular diseases in patients with diabetes. Diabetes mellitus is associated with complications in the cardiovascular and renal system, and is increasing in prevalence worldwide. Modification of the multifactorial risk factors, in particular dyslipidemia, has been suggested to reduce the rates of diabetes-related complications. Dyslipidemia in diabetes is a condition that includes hypertriglyceridemia, low high-density lipoprotein levels, and increased small and dense low-density lipoprotein particles. This condition is associated with higher cardiovascular risk and mortality in diabetic patients. Current treatment guidelines focus on lowering the low-density lipoprotein cholesterol level; multiple trials have confirmed the cardiovascular benefits of treatment with statins. Chronic kidney disease also contributes to dyslipidemia, and dyslipidemia in turn is related to the occurrence and progression of diabetic nephropathy. Different patterns of dyslipidemia are associated with different stages of diabetic nephropathy. Some trials have shown that treatment with statins not only decreased the risk of cardiovascular events, but also delayed the progression of diabetic nephropathy. However, studies using statins as the sole treatment of hyperlipidemia in patients on dialysis have not shown benefits with respect to cardiovascular risk. Diabetic patients with nephropathy have a higher risk of cardiovascular events than those without nephropathy. The degree of albuminuria and the reduction in estimated glomerular filtration rate are also correlated with the risk of cardiovascular events. Treatment with angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers to reduce albuminuria in diabetic patients has been shown to decrease the risk of cardiovascular morbidity and mortality.

  19. Sensorineural hearing loss in insulin-dependent diabetic patients

    Directory of Open Access Journals (Sweden)

    Koosha A.

    2007-11-01

    Full Text Available Background: Among patients who have sensorineural hearing loss of unknown etiology, diabetes is one of the diseases to be routinely investigated. The relationship between diabetes mellitus and hearing loss is still controversial. The purpose of this study was to examine the prevalence of sensorineural hearing loss in patients with insulin-dependent diabetes mellitus (IDDM compared to control group.Methods: In a cross-sectional study pure tone audiometry (PTA and speech audiometry was performed in 62 patients with insulin-dependent diabetes mellitus (IDDM, aged under 40 years, and in 62 randomly selected age-matched non-diabetic control subjects. Subjects with otological and other metabolic diseases were excluded from the study. We applied the SPSS.10 statistical analysis software Chi-square and student's test. Results: Statistical analysis showed that the hearing of the diabetic patients were significantly worsen than the control subjects. The hearing level tended to be worsen in the diabetic patients than that in control subjects, but the differences were statistically significant only at frequencies of 250,500, 4000 and 8000 Hz p>0.05(. There wasn't statistical significant difference between sex in two study groups p>0.05(. The mean duration of diabetes was no statistically significant with hearing loss p>0.05(. The frequency of complications such as retinopathy, nephropathy, and neuropathy in the diabetic groups had no correlation with speech threshold (p>0.05(.‏ There were no significant differences between speech reception threshold, speech discrimination score and acoustic reflex in two groups.Conclusions: We conclude that type I diabetes mellitus can cause sensorineural hearing loss.

  20. Ocular surface changes in type II diabetic patients with proliferative diabetic retinopathy

    Institute of Scientific and Technical Information of China (English)

    Yan; Gao; Yan; Zhang; Yu-Sha; Ru; Xiao-Wu; Wang; Ji-Zhong; Yang; Chun-Hui; Li; Hong-Xing; Wang; Xiao-Rong; Li; Bing; Li

    2015-01-01

    AIM: To detect and analyze the changes on ocular surface and tear function in type II diabetic patients with proliferative diabetic retinopathy(PDR), an advanced stage of diabetic retinopathy(DR), using conventional ophthalmic tests and the high-resolution laser scanning confocal microscopy.METHODS: Fifty-eight patients with type II diabetes were selected. Based on the diagnostic criteria and stage classification of DR, the patients were divided into the non-DR(NDR) group and the PDR group. Thirty-six patients with cataract but no other ocular and systemic disease were included as non-diabetic controls. All the patients were subjected to the conventional clinical tests of corneal sensitivity, Schirmer I test, and corneal fluorescein staining. The non-invasive tear film break-up time(NIBUT) and tear interferometry were conducted by a Tearscope Plus. The morphology of corneal epithelia and nerve fibers was examined using the high-resolution confocal microscopy.RESULTS: The NDR group exhibited significantly declined corneal sensitivity and Schirmer I test value, as compared to the non-diabetic controls(P <0.001). The PDR group showed significantly reduced corneal sensitivity, Schirmer I test value, and NIBUT in comparison to the non-diabetic controls(P <0.001).Corneal fluorescein staining revealed the progressively injured corneal epithelia in the PDR patients. Moreover,significant decrease in the corneal epithelial density andmorphological abnormalities in the corneal epithelia and nerve fibers were also observed in the PDR patients.CONCLUSION: Ocular surface changes, including blunted corneal sensitivity, reduced tear secretion, tear film dysfunction, progressive loss of corneal epithelia and degeneration of nerve fibers, are common in type II diabetic patients, particularly in the diabetic patients with PDR. The corneal sensitivity, fluorescein staining scores,and the density of corneal epithelial cells and nerve fibers in the diabetic patients correlate with the

  1. Approach to diabetes management in patients with CVD.

    Science.gov (United States)

    Lathief, Sanam; Inzucchi, Silvio E

    2016-02-01

    Epidemiologic analyses have established a clear association between diabetes and macrovascular disease. Vascular dysfunction caused by metabolic abnormalities in patients with diabetes is associated with accelerated atherosclerosis and increased risk of myocardial infarction (MI), stroke, and peripheral arterial disease. Patients with diabetes are at two to four fold higher CV risk as compared to non-diabetic individuals, and CVD remains the leading cause of mortality in patients with this condition. One strategy to reduce CVD burden in patients with diabetes has been to focus on controlling the major metabolic abnormality in this condition, namely hyperglycemia. However, this has not been unequivocally demonstrated to reduced CV events, in contrast to controlling other CVD risk factors linked to hyperglycemia, such as blood pressure, dyslipidemia, and platelet dysfunction. However, In contradistinction, accrued data from a number of large, randomized clinical trials in both type 1 (T1DM) and type 2 diabetes (T2DM) over the past 3 decades have proven that more intensive glycemic control retards the onset and progression of microvascular disease. In this review, we will summarize the key glucose-lowering CV outcomes trials in diabetes, provide an overview of the different drugs and their impact on the CV system, and describe our approach to management of the frequently encountered patient with T2DM and coronary artery disease (CAD) and/or heart failure (HF).

  2. Immune dysfunction in patients with diabetes mellitus (DM).

    Science.gov (United States)

    Geerlings, S E; Hoepelman, A I

    1999-12-01

    Patients with diabetes mellitus (DM) have infections more often than those without DM. The course of the infections is also more complicated in this patient group. One of the possible causes of this increased prevalence of infections is defects in immunity. Besides some decreased cellular responses in vitro, no disturbances in adaptive immunity in diabetic patients have been described. Different disturbances (low complement factor 4, decreased cytokine response after stimulation) in humoral innate immunity have been described in diabetic patients. However, the clinical relevance of these findings is not clear. Concerning cellular innate immunity most studies show decreased functions (chemotaxis, phagocytosis, killing) of diabetic polymorphonuclear cells and diabetic monocytes/macrophages compared to cells of controls. In general, a better regulation of the DM leads to an improvement of these cellular functions. Furthermore, some microorganisms become more virulent in a high glucose environment. Another mechanism which can lead to the increased prevalence of infections in diabetic patients is an increased adherence of microorganisms to diabetic compared to nondiabetic cells. This has been described for Candida albicans. Possibly the carbohydrate composition of the receptor plays a role in this phenomenon.

  3. Chromium level in prediction of diabetes in pre-diabetic patients

    Directory of Open Access Journals (Sweden)

    Rahmatollah Rafiei

    2014-01-01

    Full Text Available Background: Chromium supplementations (Cr have been shown to exert beneficial effects in the management of type-2 diabetes. Prevalence of Cr deficiency in pre-diabetic patients is not well-understood, therefore, the aim of this study was to evaluate the extent of this prevalence. Materials and Methods: In this cross-sectional descriptive study, 132 pre-diabetic patients were recruited. The participants were randomly selected from those who referred to the Shariati Hospital in Isfahan, Iran. Blood samples are collected for measurement of Cr, insulin, fasting blood sugar (FBS, and two-hour post-load plasma glucose. The body mass index (BMI was calculated. Determination of Cr was carried out by atomic absorption spectrometry. Results: Thirty-four (31.5% patients had Cr deficiency and 74 (68.5% patients had normal Cr. There was no significant difference between sex, age groups (<50 years and ≥50 years and between patients with and without a family history of diabetes in both the groups. No significant differences in age, BMI, FBS or insulin were observed between two groups. In the group with a normal level of Cr, there was a significant reversed correlation between the Cr level and age, but no significant correlation existed between the Cr level and other factors in both groups. Conclusion: The levels of Cr deficiency are relatively common in patients with pre-diabetes, and it is necessary to screen patients with diabetes and pre-diabetes according to the American Diabetes Association guidelines, with regard to the Cr level and action should be taken to eliminate the Cr deficiency in these patients.

  4. Management of Diabetes Mellitus in Patients with Acquired Immunodeficiency Syndrome

    Directory of Open Access Journals (Sweden)

    Miulescu Rucsandra Dănciulescu

    2014-06-01

    Full Text Available Acquired immunodeficiency syndrome (AIDS is a human immune system disease characterized by increased susceptibility to opportunistic infections, certain cancers and neurological disorders. The syndrome is caused by the human immunodeficiency virus (HIV that is transmitted through blood or blood products, sexual contact or contaminated hypodermic needles. Antiretroviral treatment reduces the mortality and the morbidity of HIV infection but is increasingly reported to be associated with increasing reports of metabolic abnormalities. The prevalence and incidence of diabetes mellitus in patients on antiretroviral therapy is high. Recently, a joint panel of American Diabetes Association (ADA and European Association for the Study of Diabetes (EASD experts updated the treatment recommendations for type 2 diabetes (T2DM in a consensus statement which provides guidance to health care providers. The ADA and EASD consensus statement concur that intervention in T2DM should be early, intensive, and uncompromisingly focused on maintaining glycemic levels as close as possible to the nondiabetic range. Intensive glucose management has been shown to reduce microvascular complications of diabetes but no significant benefits on cardiovascular diseases. Patients with diabetes have a high risk for cardiovascular disease and the treatment of diabetes should emphasize reduction of the cardiovascular factors risk. The treatment of diabetes mellitus in AIDS patients often involves polypharmacy, which increases the risk of suboptimal adherence

  5. Diabetic patients and Ramadan fasting:how they live it?

    Institute of Scientific and Technical Information of China (English)

    Hamza Mohammad Abdulghani; Shaffi Ahmed Shaikh; Norah Abdullah Al-Rowais; Eiad Abdul-mohsin Alfaris

    2008-01-01

    Objective:To quantify the prevalence of fasting during Ramadan month among diabetic patients and to observe the factors which were deferring between fasting and non-fasting diabetic patients.Methods:A cross-sectional study was carried out at primary health care clinics.The diabetic patients were interviewed with a structured data form by trained research assistants.Patients'age,gender,marital status,weight and height,diabetes type,medication,compliance,follow up,self monitoring and any complication faced during the fasting were collected.Cardiovascular risk factors including smoking habit,hypertension,dyslipidemia and pre-existing cardiovascular diseases were also recorded.Results:Out of 920 diabetic patients,95% were suffering from DMtype 2.Overall patients who fasted the whole month of Ramadan were 84%.The proportion of type 1 and type 2 was 71% and 85% respectively.About 63% of DMtype 2 patients were treated with oral hypoglycemic agents (OHAs)alone and 2.4% with combination of OHAs and insulin.Only 42% of DMtype 1 and 36% of DMtype 2 patients has visited their physicians prior to their fast for advice.The significant differing factors which make non-fasting in diabetic patients,were medication (insulin),complications,hyperglycemia,reti-nopathy,neuropathy,nephropathy and vascular problems.Conclusions:This study has identified the factors in diabetic patients,were being compliant with medication,oral treatments and family support which lead to more likely to fast in Ramadan month.Factors which reduce fasting by these patients were acute and chronic complications,time since diagnosis and insulin treatment .Fasting would be acceptable for patients who are compliant with their diet and medication.

  6. Impact of intensive nutritional education with carbohydrate counting on diabetes control in type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Christopher Zipp

    2010-12-01

    Full Text Available Christopher Zipp, Jessica Terrone Roehr, Lucia Beck Weiss, Frank FilipettoDepartment of Family Medicine, School of Osteopathic Medicine, University of Medicine and Dentistry of New Jersey, Stratford, NJ, USAAbstract: This pilot study assessed the impact of an intensive carbohydrate counting educational intervention on diabetes control in type 2 diabetic patients. An experimental, prospective study design was used to assess the effect of nutritional education on diabetes control. The impact and efficacy of the education were measured over a 1-year period through changes in diabetes clinical markers, including hemoglobin A1c, lipid profiles, glucose levels, patients’ energy levels, and sense of well-being. Six patients were initially enrolled in the pilot study, with only three patients completing the intervention phase and the 3-month follow-up. Two patients were followed-up at the 1-year mark for their diabetes, although neither continued participation in the study beyond the 3-month mark. Marginal improvements in clinical markers at 3 months were found. However, due to the small sample size, changes in the clinical profiles may have occurred because of variables unrelated to the nutritional intervention. Further research is indicated for the control of these variables.Keywords: type 2 diabetes, nutritional education, carbohydrate counting, diabetes control

  7. The association between vitamin D deficiency and diabetic nephropathy in type 2 diabetic patients

    Institute of Scientific and Technical Information of China (English)

    李冬梅

    2013-01-01

    Objective To evaluate the association between vitamin D deficiency and diabetic nephropathy in type 2 diabetic patients.Methods A total of 594 patients with type2 diabetes were enrolled from the inpatients of the Nanjing Medical University Affiliated Nanjing Hospital.Fasting serum lipid profile,25-hydroxycalciferol vitamin D and urinary albumin excretion rate were investigated.The relationship between nephropathy and vitamin D deficiency (<20μg/L) or insufficiency (20-<30μg/L) was analyzed.Results Nephropathy was found in 177subjects (29.8%) with albuminuria in 141 and proteinu-

  8. Prevalence of Psychiatric Disorders in Patients with Diabetes Type 2

    Directory of Open Access Journals (Sweden)

    S. Alireza Sajjadi

    2012-03-01

    Full Text Available Background: Psychiatric disorders are important complications of chronic diseases such as diabetes mellitus.Materials and method: In this descriptive study, 80 patients with diabetes type 2 referred to diabetes clinic of Zahedan in 2009. They were selected by simple randomized method, screened by General Health Questionnaire and assessed by psychiatric interview, if it was necessary.Results: Totally, 67.5% required an interview and 43.75% were diagnosed with a psychiatric disorder. Major depression were more prevalent (13.5% than adjustment disorders (15%.Conclusion: High prevalence of depression and adjustment disorder in diabetic patients needs psychiatric assessment and treatment as the main part, in the diabetes clinics

  9. Hyporeninemic hypoaldosteronism in diabetic patients with chronic renal failure.

    Science.gov (United States)

    Grande Villoria, J; Macias Nunez, J F; Miralles, J M; De Castro del Pozo, S; Tabernero Romo, J M

    1988-01-01

    Plasma renin activity, plasma aldosterone levels and renal tubular capacity to excrete hydrogen ions were studied in 13 patients suffering from diabetes mellitus with a creatinine clearance of less than 40 ml/min. The results were compared with those obtained in a control group, in a group of nondiabetic subjects with chronic renal failure (CRF) and in a group of diabetic patients without CRF. Twelve of the thirteen diabetic patients with CRF had data characteristic of hyporeninemic hypoaldosteronism associated with type IV renal tubular acidosis. On comparing the results with those of the other two groups of patients, it was observed that the manifestations of the latter two groups considered separately were different from those of the problem group, although in the diabetic patients with normal glomerular filtration rate (GFR) hyporeninism but not hypoaldosteronism was present accompanied by a lower net acid excretion (p less than 0.001) due to a lower excretion of NH4 (p less than 0.05) and titratable acid (p less than 0.001) when the patients were challenged with an NH4Cl overload. We believe that a conjunction of diabetes and renal failure is necessary for the diabetic patients with a decrease in GFR to show hyporeninemic hypoaldosteronism and type IV tubular acidosis.

  10. Evaluation of New-Onset Diabetes in Patients Presenting Emergency Service with a Diabetic Ketoacidosis Attack

    Directory of Open Access Journals (Sweden)

    Yavuz Yiğit

    2013-12-01

    Full Text Available Aim: The aim of this study was to investigate the rate of new-onset diabetes mellitus (DM in patients presenting to our emergency department with diabetic ketoacidosis. Methods: We retrospectively evaluated hospital records of patients who presented to the Emergency Department at Istanbul Goztepe Research and Training Hospital between 01 April 2009 and 01 April 2011 and were diagnosed with diabetic ketoacidosis. 57 patients having complete clinical data were included in the study. Results: 45.6%of patients had type 1 DM, 33.3%- type 2 DM, and 21%of them were with new-onset DM. No statistically significant difference was found between type 1 DM, type 2 DM and new-onset DM patients with respect to arterial blood pH and HCO3 levels and serum sodium, potassium and plasma glucose levels at presentation as well as time of presentation (p>0.05, while HbA1c levels showed statistically significant difference in new-onset DM patients. Conclusion: No statistically significant difference was found between types of DM in patients diagnosed with diabetic ketoacidosis except for precipitating factors, age and HbA1c. Detecting high blood glucose levels in patients presenting to emergency room for reasons other than DM is not a rare condition. Cautious evaluation and recognition of these patients in emergency room for the possibility of undiagnosed DM is important for prevention of future diabetic ketoacidosis episodes. (The Medical Bulletin of Haseki 2013; 51: 168-72

  11. Barriers to exercise in obese patients with type 2 diabetes.

    LENUS (Irish Health Repository)

    Egan, A M

    2013-07-01

    Although regular exercise is a critical component of the management of type 2 diabetes, many patients do not meet their exercise targets. Lack of exercise is associated with obesity and adverse cardiovascular outcomes.

  12. Depression among patients with type-II diabetes mellitus.

    Science.gov (United States)

    Khan, Mohammad Akmal; Sultan, Sayed Mohammad; Nazli, Rubina; Akhtar, Tasleem; Khan, Mudasar Ahmad; Sher, Nabila; Aslam, Hina

    2014-10-01

    This study aimed to determine the frequency of depression among patients with type-II diabetes mellitus in Peshawar at Khyber Teaching Hospital, Peshawar, from March to September 2010. Depression was assessed by using Beck Depressive Inventory-II (BDI-II). Out of 140 patients with type-II diabetes, 85 (61%) were women and 55 (39%) were men. Mean age was 45±7.45 years. Eighty four (60%) patients presented with severe depression. Depression was higher in females than males and widows. Depression was high in diabetic patients, especially in females and widows. It is of essence that psychiatric attention may be necessary to be incorporated in diabetes care both for prevention and treatment.

  13. Red cell distribution width in type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Nada AM

    2015-10-01

    Full Text Available Aml Mohamed Nada Department of Internal Medicine, Unit of Endocrinology, Diabetes and Metabolism, Faculty of Medicine, Mansoura University, Mansoura, Egypt Objective: To study the indices of some elements of the complete blood count, in type 2 diabetic patients, in comparison with nondiabetic healthy controls; and to find out the effects of glycemic control and different medications on these indices. To the best of our knowledge, this study is novel in our environment and will serve as a foundation for other researchers in this field. Methods: This retrospective study included 260 type 2 diabetic patients on treatment and 44 healthy control subjects. Sex, age, weight, height, blood pressure, complete blood count, fasting plasma glucose, hemoglobin A1c (HbA1c, and lipid profile data, were available for all of the study population. For diabetic patients, data on duration of diabetes and all medications were also available. Results: Red cell distribution width (RDW was significantly higher in diabetic patients than in control subjects (P=0.008. It was also higher in patients with uncontrolled glycemia (HbA1c >7% than those with good control (HbA1c ≤7%; P=0.035. Mean platelet volume (MPV was comparable in both diabetic patients and healthy controls (P=0.238. RDW and MPV did not significantly correlate with fasting plasma glucose, HbA1c, or duration of diabetes. Both aspirin and clopidogrel did not show a significant effect on MPV. Both insulin and oral hypoglycemic agents did not show a significant effect on RDW, mean corpuscular volume, MPV, platelet count, or white blood cell count. Diabetic patients treated with indapamide or the combined thiazides and angiotensin receptor blockers showed no significant difference in RDW when compared with the control subjects. Conclusion: RDW, which is recently considered as an inflammatory marker with a significant predictive value of mortality in diseased and healthy populations, is significantly higher in

  14. A nationwide survey of diabetes education, self-management and glycemic control in patients with type 2 diabetes in China

    Institute of Scientific and Technical Information of China (English)

    GUO Xiao-hui; YUAN Li; LOU Qing-qing; SHEN Li; SUN Zi-lin; ZHAO Fang; DAI Xia; HUANG Jin; YANG Hui-ying

    2012-01-01

    Background Diabetes management could be improved by diabetes education,through influencing attitudes towards diabetes,knowledge and behaviors of patients.The purpose of this study was to characterize the impact of diabetes education on glycemic control,and to assess the attitude,knowledge and self-care behavior in patients with type 2 diabetes in China.Methods This questionnaire-based survey was conducted in 50 medical centers across China from April to July of 2010.The patients with type 2 diabetes were eligible for the study.The information of glycemic control and diabetes education was collected.The diabetes attitude scale-3 formulae,a questionnaire of diabetes knowledge and Summary of Diabetes Self-care Activities scale were used to assess attitude,knowledge and the self-care of patients,respectively.Results Among the 5961 eligible respondents (3233 males; mean age (59.50±12.48) years; mean hemoglobin A1c (HbA1c) (8.27±2.23)%),most patients (79.8%) considered themselves educated on diabetes.Compared with patients without diabetes education,their educated counterparts showed significant lower value of HbA1c,after controlling for age,gender,body mass index and duration of diabetes (P <0.01).The patients who received diabetes education also performed significant higher scores on attitude,knowledge and self-care than their uneducated counterparts.Patients with lower income or education level tended to have higher glucose levels,and showed lower percentage of patients received diabetic education.Conclusions Chinese patients with diabetes education achieved better glycemic control than un-educated patients.Our study indicates effort is required to provide professional education to patients,with emphasis on lower income and lower education level populations.

  15. Screening for diabetic retinopathy and nephropathy in patients with diabetes: a nationwide survey in Korea.

    Directory of Open Access Journals (Sweden)

    Sang-Ho Byun

    Full Text Available This study was performed to identify factors associated with screening for diabetic retinopathy and nephropathy. Data from the Korean National Health and Nutrition Examination Survey between 2007 and 2009 were analyzed. Of 24,871 participants, 1,288 patients diagnosed with diabetes at ≥30 years of age were included. 36.3% received screening for diabetic retinopathy, and 40.5% received screening for diabetic nephropathy during the previous year. Patients living in rural areas, those with less education, those who had not received education about diabetes care, and those who did not receive medical care for diabetes were screened less often for retinopathy or nephropathy. Patients with poorer self-reported health status were screened more often. Occupation, smoking status, and diabetes duration were associated with retinopathy screening. Lower family income was associated with decreased nephropathy screening. Receiving education about diabetes care and receiving medical care for diabetes were significant factors in patients with a shorter duration of diabetes (the significant odds ratio [OR] of not receiving education varied between 0.27 and 0.51, and that of not receiving medical care varied between 0.34 and 0.42. Sociodemographic factors and health-related factors as well as education and medical care influenced screening for diabetic complications among those with a longer duration of diabetes (for retinopathy and nephropathy, the significant OR of living in a rural area varied between 0.56 and 0.61; for retinopathy, the significant OR of current smokers was 0.55, and the p-trend of subjective health status was <0.001; for nephropathy, the significant OR of a monthly household income of <3000 dollars was 0.61 and the p-trends of education and subjective health status were 0.030 and 0.007, respectively. Efforts to decrease sociodemographic disparities should be combined with education about diabetes care to increase the screening, especially

  16. A Comparison of Cerebral Vasomotor Reactivity in Diabetic and Non Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Mehdi Moghaddasi

    2010-01-01

    Full Text Available

    Background: Cerebral microangiopathy is one of the most important complications in diabetes. It may interfere with cerebral vasomotor reactivity (VMR which may lead to disability, stroke or even death. The aim of the present study was to determine and compare VMR changes in diabetic and non-diabetic patients.

    Methods: Fifty three diabetic and 51 non-diabetic patients (with no other vascular abnormality were recruited. Vasomotor reactivity was evaluated with Trans-Cranial Doppler ( TCD before and after CO2 inhalation.

    Results: There were 69 (66.30% males. The mean age (SD was 41.53± 17.80.The general average of VMR was % 5.79 ± 3.00, the figures in diabetic and non diabetic patients were % 5.31 ± 2.60 and % 6.62± 2.00, respectively (p = 0.02. The average of FV change in diabetic was 42.47± 29.00 and non-daibetic patients was 53.34 ±16.70 (p = 0.04.

    Conclusion: We recommended that such non-invasive method is necessary for evaluation of cerebral vasculature in diabetic patients for better prevention.

  17. Association of adiponectin with cardiovascular events in diabetic and non-diabetic hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Amir Elokely

    2012-01-01

    Full Text Available Adiponectin is a novel collagen-like protein synthesized by white adipose tissue. Its levels are decreased in obesity, type-2 diabetes and insulin-resistant states, and are increased in chronic renal failure. It has anti-inflammatory and anti-atherogenic properties. This study was planned to evaluate the levels of adiponectin in uremic patients with and without diabetes and to find any relationship between adiponectin levels and some cardiovascular risk factors, and to determine the possible predictive value of adiponectin for cardiovascular complications (CVC. The study included 100 subjects, 20 of them were healthy subjects and served as the control group (group I, 40 were uremic non-diabetic patients (group II (half of them were without CVC, group IIA, and the other half were patients with CVC, group IIB and, lastly, 40 uremic diabetic patients (group III (half of them were without CVC, group IIIA, and the other half were patients with CVC, group IIIB. All subjects were subjected to complete clinical examination, including determination of mean arterial blood pressure (MABP, body mass index (BMI, waist to hip ratio, routine laboratory investigations, fasting plasma glucose, fasting plasma insulin, lipid profile (cholesterol, TG, LDL, HDL, determination of insulin resistance by homeostasis model assessment index (HOMA-IR and estimation of serum levels of adiponectin. There was a significant increase in serum adiponectin levels in all the uremic patients (group II and group III when compared with the control (group I group, P <0.01; also, serum adiponectin levels were significantly decreased in uremic diabetic patients (group III when compared with uremic non-diabetic patients (group II, P <0.01; but this was still higher than in the controls. The patients with CVC, whether uremic non-diabetic (group IIB or uremic diabetic (group IIIB, had a significant decrease in serum adiponectin levels when compared with patients without CVC (group IIA and

  18. Staphylococcus simulans osteitis in a diabetic patient.

    Science.gov (United States)

    Désidéri-Vaillant, C; Nédelec, Y; Guichon, J-M; Le Louarn, S; Noyer, V; Sapin-Lory, J; Le Guen, P; Nicolas, X

    2011-12-01

    Staphylococcus simulans was identified as the aetiological agent of osteitis in a diabetic woman. Its identifying characteristics and antibiogram were confirmed. Diabetic foot frequently becomes infected and the spread of infection to bone is a major causal factor behind lower-limb amputation. Early diagnosis and appropriate treatment are essential in such cases.

  19. Periodontal status among patients with diabetes in Nuuk, Greenland

    Directory of Open Access Journals (Sweden)

    Amanda Lamer Schjetlein

    2014-12-01

    Full Text Available Background: Diabetes is becoming more common in the Greenlandic population. Patients with diabetes are more prone to periodontal disease. Periodontal status may have an effect on metabolic control. Objective: The aim of this study was to estimate the prevalence of periodontitis amongst patients with diabetes in Nuuk, Greenland, and secondly, to observe if dental care was associated with improved periodontal status and metabolic control. Study design: Observational cross-sectional study and a pilot study of a dental care intervention. Methods: Sixty-two Greenlandic patients with diabetes were included in the study. Data were collected from the Electronic Medical Records (EMR, in addition to a telephone interview. Patients were offered 3 dental examinations with a 3-month interval. The dental examinations consisted of a full-mouth assessment of number of remaining teeth and assessment of periodontal status. Patients received scaling and root planing, together with information and instructions on oral hygiene. Information on glycated haemoglobin (HbA1C values was collected from the EMR at each dental examination. Results: In this study, 21.0% (13/62 of patients with diabetes had periodontitis. About 42% had less than 20 teeth. The association between diabetes and periodontitis was known by 20 out of the 62 patients. Over half of the patients had been to a dental examination within the last year. The prevalence of periodontitis decreased significantly from 21.0 to 0% (p<0.001 after 3 dental examinations. No change in HbA1C levels was observed (p=0.440. Conclusion: Periodontitis was common among patients with diabetes in Nuuk. Dental health status based on Periodontal Screening Index (PSI and bleeding on probing (BOP seemed to improve after dental health care, indicating a need for increased awareness among patients and health care professionals. HbA1C levels were not improved among the patients.

  20. Emphysematous liver abscess in diabetic patient: two cases report

    Energy Technology Data Exchange (ETDEWEB)

    Rhim, Hyun Chul; Koo, Ja Hong; Kim, Sung Tae; Kim, Yong Soo; Koh, Byung Hee; Cho, On Koo [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    1995-07-15

    There has not been any report on massive air-containing liver abscess in diabetic patients, although emphysematous cholecystitis or pyelonephritis is a well-known complication in them. Authors report two cases of emphysematous liver abscess in diabetic patient, which showed typical findings of massive air-containing hepatic abscess on ultrasonography and computed tomography, but very poor prognosis in spite of immediate and successful percutaneous drainage procedure.

  1. Sulphonylurea monotherapy for patients with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Hemmingsen, Bianca; Schroll, Jeppe B; Lund, Søren;

    2013-01-01

    Type 2 diabetes mellitus (T2DM) is a growing health problem worldwide. Whether sulphonylureas show better, equal or worse therapeutic effects in comparison with other antidiabetic interventions for patients with T2DM remains controversial.......Type 2 diabetes mellitus (T2DM) is a growing health problem worldwide. Whether sulphonylureas show better, equal or worse therapeutic effects in comparison with other antidiabetic interventions for patients with T2DM remains controversial....

  2. Rhinocerebral Mucormycosis Among Diabetic Patients: An Emerging Trend.

    Science.gov (United States)

    Reddy, Sujatha S; Rakesh, N; Chauhan, Pallavi; Sharma, Shivani

    2015-12-01

    Mucormycosis is an acute necrotic fungal infection with a fulminant course. Earlier considered a rare entity, mucormycosis is being reported with increasing frequency in recent years, possibly due to the increase in immunocompromised population especially diabetic patients. We report three cases of rhinocerebral mucormycosis among poorly controlled diabetic patients. This article emphasizes the need for further awareness of this disease, early diagnosis, and treatment to counter this opportunistic infection.

  3. Frequency of micronuclei and other nuclear abnormalities in diabetic patients

    Directory of Open Access Journals (Sweden)

    Marcelo Torquato Toneline

    2014-06-01

    Purpose: Diabetes mellitus is associated with development of vascular complications consequent to oxidative DNA damage. In the current study, we evaluated the formation of biomarkers of genotoxicity as micronucleation, budding nuclear, nuclear bridge, and other nuclear abnormalities in patients with type 2 diabetes. Methods: forty-five subjects were divided into two groups of normoglycemic controls and hyperglycemic (type 2 diabetes, were bandied about in the study. Epithelial cells of the oral mucosa were collected according to the international protocol of Thomas et al. and Bolognesi et al. All nuclear changes found were recorded, totaling analysis of 2,000 cells. This finding was correlated with age, sex, comorbidities, and drug consumption habits. Statistical analysis was performed using the Mann-Whitney test and chi-square test. Results: cells from diabetic patients showed an increased frequency of micronuclei (on average 4.7 per 2,000 cells compared with 2.0 in the control group, p < 0.001 and nuclear budding (average 6.3 per 2,000 cells against 4,1 control group, p < 0.05 when compared to the control group, indicating a higher DNA damage due to oxidative stress and possibly related vascular complications of diabetes. Conclusion: the high level of glucose in the blood appears to be involved with oxidative damage in the DNA of diabetic patients, manifested as an increase in micronuclei and nuclear budding. These nuclear changes have the potential to be used as biomarkers of cell damage in diabetic patients.

  4. Comparison of the Hospital Arrival Time and Differences in Pain Quality between Diabetic and Non-Diabetic STEMI Patients

    Directory of Open Access Journals (Sweden)

    Marina Gradišer

    2015-01-01

    Full Text Available The aim of our study was to determine whether diabetic ST segment elevation myocardial infarction (STEMI patients arrive in the emergency room (ER later than non-diabetics, compare the differences in pain quality and quantity between those groups, and measure differences in the outcome after an index hospitalization. A total of 266 patients with first presentation of STEMI were included in our study during a period of two years, 62 with diabetes and 204 without diabetes type 2. Pain intensity and quality at admission were measured using a McGill short form questionnaire. Diabetic patients did not arrive significantly later than non-diabetic (χ2; p = 0.105. Most diabetic patients described their pain as “slight” or “none” (χ2; p < 0.01, while most non-diabetic patients graded their pain as “moderate” or “severe” (χ2; p < 0.01. The quality of pain tended to be more distinct in non-diabetic patients, while diabetic patients reported mainly shortness of breath (χ2; p < 0.01. Diabetic patients were more likely to suffer a multi-vessel disease (χ2; p < 0.01, especially in the late arrival group. Therefore, cautious evaluation of diabetic patients and adequate education of target population could improve overall survival while well-organized care like a primary PCI Network program could significantly reduce CV mortality.

  5. Differential phenotypic and functional profiles of TcCA-2 -specific cytotoxic CD8+ T cells in the asymptomatic versus cardiac phase in Chagasic patients.

    Science.gov (United States)

    Egui, Adriana; Thomas, M Carmen; Carrilero, Bartolomé; Segovia, Manuel; Alonso, Carlos; Marañón, Concepción; López, Manuel Carlos

    2015-01-01

    It has been reported that the immune response mediated by T CD8+ lymphocytes plays a critical role in the control of Trypanosoma cruzi infection and that the clinical symptoms of Chagas disease appear to be related to the competence of the CD8+ T immune response against the parasite. Herewith, in silico prediction and binding assays on TAP-deficient T2 cells were used to identify potential HLA-A*02:01 ligands in the T. cruzi TcCA-2 protein. The TcCA-2-specific CD8+ T cells were functionality evaluated by Granzyme B and cytokine production in peripheral blood mononuclear cells (PBMC) from Chagas disease patients stimulated with the identified HLA-A*02:01 peptides. The specific cells were phenotypically characterized by flow cytometry using several surface markers and HLA-A*02:01 APC-labeled dextramer loaded with the peptides. In the T. cruzi TcCA-2 protein four T CD8+ epitopes were identified which are processed and presented during Chagas disease. Interestingly, a differential cellular phenotypic profile could be correlated with the severity of the disease. The TcCA-2-specific T CD8+ cells from patients with cardiac symptoms are mainly effector memory cells (TEM and TEMRA) while, those present in the asymptomatic phase are predominantly naive cells (TNAIVE). Moreover, in patients with cardiac symptoms the percentage of cells with senescence features is significantly higher than in patients at the asymptomatic phase of the disease. We consider that the identification of these new class I-restricted epitopes are helpful for designing biomarkers of sickness pathology as well as the development of immunotherapies against T. cruzi infection.

  6. Differential phenotypic and functional profiles of TcCA-2 -specific cytotoxic CD8+ T cells in the asymptomatic versus cardiac phase in Chagasic patients.

    Directory of Open Access Journals (Sweden)

    Adriana Egui

    Full Text Available It has been reported that the immune response mediated by T CD8+ lymphocytes plays a critical role in the control of Trypanosoma cruzi infection and that the clinical symptoms of Chagas disease appear to be related to the competence of the CD8+ T immune response against the parasite. Herewith, in silico prediction and binding assays on TAP-deficient T2 cells were used to identify potential HLA-A*02:01 ligands in the T. cruzi TcCA-2 protein. The TcCA-2-specific CD8+ T cells were functionality evaluated by Granzyme B and cytokine production in peripheral blood mononuclear cells (PBMC from Chagas disease patients stimulated with the identified HLA-A*02:01 peptides. The specific cells were phenotypically characterized by flow cytometry using several surface markers and HLA-A*02:01 APC-labeled dextramer loaded with the peptides. In the T. cruzi TcCA-2 protein four T CD8+ epitopes were identified which are processed and presented during Chagas disease. Interestingly, a differential cellular phenotypic profile could be correlated with the severity of the disease. The TcCA-2-specific T CD8+ cells from patients with cardiac symptoms are mainly effector memory cells (TEM and TEMRA while, those present in the asymptomatic phase are predominantly naive cells (TNAIVE. Moreover, in patients with cardiac symptoms the percentage of cells with senescence features is significantly higher than in patients at the asymptomatic phase of the disease. We consider that the identification of these new class I-restricted epitopes are helpful for designing biomarkers of sickness pathology as well as the development of immunotherapies against T. cruzi infection.

  7. Bilateral Ramsay Hunt syndrome in a diabetic patient

    Directory of Open Access Journals (Sweden)

    Goyal Amit

    2004-12-01

    Full Text Available Abstract Background Herpes zoster oticus accounts for about 10% cases of facial palsy, which is usually unilateral and complete and full recovery occurs in only about 20% of untreated patients. Bilateral herpes zoster oticus can sometime occur in immunocompromised patients, though incidence is very rare. Case presentation Diabetic male, 57 year old presented to us with bilateral facial palsy due to herpes zoster oticus. Patient was having bilateral mild to moderate sensorineural hearing loss. Patient was treated with appropriate metabolic control, anti-inflammatory drugs and intravenous acyclovir. Due to uncontrolled diabetes, glucocorticoids were not used in this patient. Significant improvement in hearing status and facial nerve functions were seen in this patient. Conclusions Herpes zoster causes severe infections in diabetic patients and can be a cause of bilateral facial palsy and bilateral Ramsay Hunt syndrome. Herpes zoster in diabetic patients should be treated with appropriate metabolic control, NSAIDS and intravenous acyclovir, which we feel should be started at the earliest. Glucocorticoids should be avoided in diabetic patients.

  8. [IMSS in Numbers: the Census of Diabetic Patients, 2004].

    Science.gov (United States)

    2006-01-01

    The census of diabetic patients at the Instituto Mexicano del Seguro Social describes the state and level of control of biologic markers, such as glucose, BMI and blood pressure of all diabetic patients attending the family medicine units during 2004. The main results show that 2,334,340 diabetic patients visited the health units of the Instituto Mexicano del Seguro Social with an average of 3.7 visits per year. Around 75% of the patients had their weight and height registered; 73%, their blood pressure, and only 28.8%, their glycemia level. One third of the patients (35.7%) had an unspecified diagnosis of diabetes mellitus and 91.3% had no complications reported. Of those with glycemia reported, 56.9% had a poor blood glucose control. Half of the diabetic patients were also diagnosed as hypertensive though 74% had good blood pressure control. The BMI reported that 40.4% were obese and 39.6% were overweight. All these data are important to measure the impact of different health interventions that point to a better control of diabetes at the IMSS.

  9. Statistical Model for Prediction of Diabetic Foot Disease in Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Raúl López Fernández

    2016-02-01

    Full Text Available Background: the need to predict and study diabetic foot problems is a critical issue and represents a major medical challenge. The reduction of its incidence can lead to positive results for improving the quality of life of patients and the impact on the socio-economic sphere, due to the high prevalence of diabetes in the working population. Objective: to design a statistical model for prediction of diabetic foot disease in type 2 diabetic patients. Methods: a descriptive study was conducted in patients attending the Diabetes Clinic in Cienfuegos from 2010 to 2013. Significant risk factors for diabetic foot disease were analyzed as variables. To design the model, binary logistic regression analysis and Chi-squared automatic interaction detection decision tree were used. Results: two models that behaved similarly based on the comparison criteria considered (percentage of correct classification, sensitivity and specificity were developed. Validation was established through the receiver operating characteristic curve. The model using Chi-squared automatic interaction detection showed the best predictive results. Conclusions: Chi-squared automatic interaction detection decision trees have an adequate predictive capacity, which can be used in the Diabetes Clinic of Cienfuegos municipality.

  10. Management of nephropathy in patients with type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Purpose To review evidence-based management of nephropathy in patients with type 2 diabetes. Data sources A literature search (MEDLINE 1966 to 2000) was performed using the key word “diabetic nephropathy". Relevant book chapters were also reviewed. Study selection Well-controlled, prospective landmark studies and expert review articles on diabetic nephropathy were selected. Data extraction Data and conclusions from the selected articles that provide solid evidence to the optimal management of diabetic nephropathy were extracted and interpreted in light of our clinical research experience with many thousands of Hong Kong Chinese patients. Results Hypertension, long diabetes duration, poor glycaemic control and central obesity are the most important risk factors. Microalbuminuria is a practical marker to predict overt nephropathy in type 2 diabetic patients. Risk factor modification, renal function monitoring and combined therapies are the current integrated approaches to manage patients with diabetic kidney disease. Optimal glycaemic control is the mainstay of treatment but effective antihypertensive therapy is also key to delaying the progression of diabetic nephropathy. Angiotensin-converting enzyme inhibitors and angiotensin Ⅱ receptor antagonists have important renoprotective actions independent of their blood pressure lowering actions. Conclusions Diabetic nephropathy is the leading cause of end-stage renal disease worldwide. Monitoring renal function and screening for microalbuminuria will allow the identification of patients with nephropathy at a very early stage for intervention. Tight glycaemic control and aggressive antihypertensive treatment as well as the use of renin-angiotensin system inhibitors should substantially delay the progression of nephropathy.

  11. Radiation-modified albumin in type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Galina Gorbenko

    2013-02-01

    Full Text Available Objectives: Diabetes mellitus has been one of the most crippling diseases that man has seen, and its prevalence has risen dramatically over the past two decades. Currently, there are over 150 million diabetics worldwide and this number is likely to increase to 300 million or more by the year 2025. Diabetes mellitus increases the risk of many disorders including cardiovascular diseases. Understanding the molecular properties of diabetic progression is a big challenge in the system biology era. The aim of this study is to determine association in albumin modifications between Chernobyl clean-up workers with and without type 2 diabetes mellitus. Methods: ABM (3-aminobenzanthrone derivative developed in Daugavpils University, Latvia has been previously shown as a potential biomarker for determination of the immune state of patients with different pathologies. In this study several aspects of plasma albumin alterations in the group of Chernobyl clean-up workers with diabetes mellitus in relation to the group of workers without diabetes mellitus and people having no professional contact with radioactivity were determined. The following parameters were examined: (1 spectral characteristics of ABM in blood plasma; (2 effective and total albumin concentration in blood plasma; and (3 quantitative parameters of albumin auto-fluorescence. Results: Screening of individuals with diabetes mellitus 25-26 years after their work in Chernobyl revealed two groups of patients differing in structural and functional properties of membrane. The revealed structural modifications of membrane are dependent on radiation-induced factors. Concomitant diseases (diabetes mellitus, cardiovascular diseases reinforce radiation-induced effects. Conclusion: ABM is a sensitive probe of albumin alterations; it can be used to elucidate the changes in protein systems. Significant differences in albumin dynamics exist between the control group (donors and that of diabetics and non-diabetics

  12. Retrograde pyelonephritis and lumbar spondylitis as a result of Salmonella typhi in a type 2 diabetes patient with neurogenic bladder.

    Science.gov (United States)

    Fukuda, Tatsuya; Bouchi, Ryotaro; Minami, Isao; Ohara, Norihiko; Nakano, Yujiro; Nishitani, Rie; Murakami, Masanori; Takeuchi, Takato; Akihisa, Momoko; Fujita, Masamichi; Izumiyama, Hajime; Hashimoto, Koshi; Yoshimoto, Takanobu; Ogawa, Yoshihiro

    2016-05-01

    We present a case of a 62-year-old diabetic woman with acute pyelonephritis and spondylitis caused by Salmonella typhi. She was admitted to Tokyo Medical Dental University Hospital, Tokyo, Japan, because of unconsciousness and was diagnosed with sepsis by retrograde pyelonephritis as a result of Salmonella typhi. Antibiotics treatment was immediately started; however, she subsequently developed lumbar spondylitis, and long-term conservative treatment with antibiotics and a fixing device were required. This is the first report of a diabetic patient who developed retrograde urinary tract infection with Salmonella typhi, followed by sepsis and spondylitis. The infection could be a result of diabetic neuropathy, presenting neurogenic bladder and hydronephrosis. The patient was successfully treated with antibiotics and became asymptomatic with normal inflammatory marker levels, and no clinical sign of recurrence was observed in the kidney and spine at 4 months.

  13. Vaccination of patients with diabetes mellitus--a retrospective study.

    Science.gov (United States)

    Mad'ar, Rastislav; Benesová, Dagmar; Brandejská, Dana; Cermáková, Miriam; Dvorková, Alena; Gazárková, Olga; Jakubalová, Silvana; Kochová, Ilona; Lastovicková, Jana; Nebáznivá, Dagmar; Orolinová, Marta; Polomis, Karel; Rehka, Václav; Sattranová, Ludmila; Schejbalová, Miriam; Slámová, Alena; Skalleová, Deanna; Sevcíková, Hana; Tkadlecová, Hana; Tmejová, Marta; Trmal, Josef; Turková, Dagmar

    2011-06-01

    402 subjects with diabetes mellitus have been vaccinated of the total of 34,000 vaccinees immunized during the study period of 9 and half months. Altogether 229 diabetic patients (56.97%) have been vaccinated'against tick-borne encephalitis (TBE) and 74 (18.4%) against viral hepatitis (41 types A+B, 30 type A, 3 type B). The average age in four most commonly administered vaccines (FSME IMMUN 0.5 ML, Twinrix Adult, Typhim Vi, and Havrix 1440) was 65, 52, 56, and 54 years, respectively. Live attenuated vaccines have been given to 6 patients with diabetes (1.49%)--- 5 travellers to endemic countries received the yellow fever vaccine Stamaril (1 female, 4 male) and one male patient varicella vaccine Varilrix. Among the least common vaccines in diabetic patients were those against invasive pneumococcal and meningococcal infections. Not a single unexpected side effect has been observed following the vaccination procedure in any diabetic patient. Based on the results of this retrospective study we can conclude that vaccination in diabetic patients is free of any ri-k- provided that there are no other contraindications, e.g. allergy to vaccine components or severe acute febrile illness. In the case of unstable glycaemia and significantly impaired immune system due to diabetes mellitus, vaccination with live attenuated vaccines should be carefully considered and measured against the risks of exposure to each and every specific infectious agent. There is no reason to be afraid of vaccination in diabetic patients provided that general contraindications are respected. On the contrary, this risk group can benefit from vaccination more remarkably since it may have some life-saving potential.

  14. Substantial reduction in the number of amputations among patients with diabetes

    DEFF Research Database (Denmark)

    Rasmussen, Benjamin S B; Yderstraede, Knud B; Carstensen, Bendix;

    2016-01-01

    as well as the incidence of further amputations, subdivided by level of amputation. RESULTS: During the period 1996-2011, a total of 2,832 amputations were performed, of which 1,285 were among patients with diabetes and 1,547 among individuals without diabetes. Relative to persons without diabetes...... in BAA rates among patients with diabetes of 9.8%, and the annual reduction in BKA for patients with diabetes was 15.1%. CONCLUSIONS/INTERPRETATION: The amputation rate in patients with diabetes is still several-fold higher than in persons without diabetes, but the improvements in diabetes care in recent...

  15. Tax secretion from peripheral blood mononuclear cells and Tax detection in plasma of patients with human T-lymphotropic virus-type 1-associated myelopathy/tropical spastic paraparesis and asymptomatic carriers.

    Science.gov (United States)

    Medina, Fernando; Quintremil, Sebastián; Alberti, Carolina; Godoy, Fabián; Pando, María E; Bustamante, Andrés; Barriga, Andrés; Cartier, Luis; Puente, Javier; Tanaka, Yuetsu; Valenzuela, María A; Ramírez, Eugenio

    2016-03-01

    Human T-lymphotropic virus-type 1 (HTLV-1) is the etiologic agent of the neurologic disease HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Tax viral protein plays a critical role in viral pathogenesis. Previous studies suggested that extracellular Tax might involve cytokine-like extracellular effects. We evaluated Tax secretion in 18 h-ex vivo peripheral blood mononuclear cells (PBMCs) cultures from 15 HAM/TSP patients and 15 asymptomatic carriers. Futhermore, Tax plasma level was evaluated from other 12 HAM/TSP patients and 10 asymptomatic carriers. Proviral load and mRNA encoding Tax were quantified by PCR and real-time RT-PCR, respectively. Intracellular Tax in CD4(+)CD25(+) cells occurred in 100% and 86.7% of HAM/TSP patients and asymptomatic carriers, respectively. Percentage of CD4(+)CD25(+) Tax+, proviral load and mRNA encoding Tax were significantly higher in HAM/TSP patients. Western blot analyses showed higher secretion levels of ubiquitinated Tax in HAM/TSP patients than in asymptomatic carriers. In HTLV-1-infected subjects, Western blot of plasma Tax showed higher levels in HAM/TSP patients than in asymptomatic carriers, whereas no Tax was found in non-infected subjects. Immunoprecipitated plasma Tax resolved on SDS-PAGE gave two major bands of 57 and 48 kDa allowing identification of Tax and Ubiquitin peptides by mass spectrometry. Relative percentage of either CD4(+)CD25(+) Tax+ cells, or Tax protein released from PBMCs, or plasma Tax, correlates neither with tax mRNA nor with proviral load. This fact could be explained by a complex regulation of Tax expression. Tax secreted from PBMCs or present in plasma could potentially become a biomarker to distinguish between HAM/TSP patients and asymptomatic carriers.

  16. Comparison of in vivo segmental foot motion during walking and step descent in patients with midfoot arthritis and matched asymptomatic control subjects.

    Science.gov (United States)

    Rao, Smita; Baumhauer, Judith F; Tome, Josh; Nawoczenski, Deborah A

    2009-05-29

    The purpose of this study was to compare in vivo segmental foot motion during walking and step descent in patients with midfoot arthritis and asymptomatic control subjects. Segmental foot motion during walking and step descent was assessed using a multi-segment foot model in 30 patients with midfoot arthritis and 20 age, gender and BMI matched controls. Peak and total range of motion (ROM), referenced to subtalar neutral, were examined for each of the following dependent variables: 1st metatarso-phalangeal (MTP1) dorsiflexion, 1st metatarsal (MT1) plantarflexion, ankle dorsiflexion, calcaneal eversion and forefoot abduction. The results showed that, compared to level walking, step descent required greater MTP1 dorsiflexion (pwalking. Patients with midfoot arthritis responded differently to the step task compared to control subjects in terms of MT1 and calcaneus eversion excursion. During walking, patients with midfoot arthritis showed significantly less MT1 plantarflexion excursion compared to control subjects (p=0.03). However, during step descent, both groups showed similar MT1 plantarflexion excursion. During walking, patients with midfoot arthritis showed similar calcaneus eversion excursion compared to control subjects. However, during step descent, patients with midfoot arthritis showed significantly greater calcaneus eversion excursion compared to control subjects (p=0.03). Independently or in combination, these motions may contribute to articular stress and consequently to symptoms in patients with midfoot arthritis.

  17. Influence of diabetes and diabetes-gender interaction on the risk of death in patients hospitalized with congestive heart failure

    DEFF Research Database (Denmark)

    Gustafsson, Ida; Brendorp, Bente; Seibaek, Marie;

    2004-01-01

    OBJECTIVES: The purpose of this study was to investigate the influence of diabetes on long-term mortality in a large cohort of patients hospitalized with heart failure (HF). BACKGROUND: Diabetes is common in HF patients, but information on the prognostic effect of diabetes is sparse. METHODS: The...

  18. Effective Nurse Communication With Type 2 Diabetes Patients : A Review

    NARCIS (Netherlands)

    Mulder, Bob C.; Lokhorst, Anne Marike; Rutten, Guy E H M; van Woerkum, Cees M J

    2015-01-01

    Many type 2 diabetes mellitus patients have difficulties reaching optimal blood glucose control. With patients treated in primary care by nurses, nurse communication plays a pivotal role in supporting patient health. The twofold aim of the present review is to categorize common barriers to nurse-pat

  19. Effective Nurse Communication With Type 2 Diabetes Patients

    NARCIS (Netherlands)

    Mulder, B.C.; Lokhorst, A.M.; Rutten, G.E.H.M.; Woerkum, van C.M.J.

    2015-01-01

    Many type 2 diabetes mellitus patients have difficulties reaching optimal blood glucose control. With patients treated in primary care by nurses, nurse communication plays a pivotal role in supporting patient health. The twofold aim of the present review is to categorize common barriers to nurse–pat

  20. Relationship of peripheral blood T cell subset levels and PD-1/PD-L1 expression levels with viral load in patients with asymptomatic HIV infection

    Institute of Scientific and Technical Information of China (English)

    Xi-Li Miao; Si-Qing Mei; Gui-Min Gao

    2016-01-01

    Objective:To study the relationship of different T cell subset levels and PD-1/PD-L1 expression levels in peripheral blood with viral load in patients with asymptomatic HIV infection.Methods:Patients with asymptomatic HIV infection treated in our hospital from April 2012 to October 2015 were selected as the HIV group of the study, healthy subjects during the same period were selected as the control group, and peripheral blood was collected to detect CD3+CD4+CD8-, CD3+CD4-CD8+, CD4+CD25+Foxp3+ and CD4+CD25+CD127low/-cell levels as well as PD-1/PD-L1 expression levels.Results:The number and percentage of CD3+CD4+CD8- cells as well as the number of CD4+CD25+Foxp3+ and CD4+CD25+CD127low/-cells in peripheral blood of HIV group were significantly lower than those of control group, the number and percentage of CD3+CD4-CD8+ cells, the percentage of CD4+CD25+Foxp3+and CD4+CD25+CD127low/- cells as well as the expression levels of PD-L1 and PD-1 on CD4+T cell surface were significantly higher than those of control group, and the expression levels of PD-L1 and PD-1 on CD8+T cell surface were not significantly different from those of control group; the greater the viral load in HIV group, the lower the percentage of CD3+CD4+CD8-, and the higher the percentage of CD3+CD4-CD8+, CD4+CD25+Foxp3+ and CD4+CD25+CD127low/-cells as well the PD-1/PD-L1 positive percentage on CD4+T cell surface in peripheral blood. Conclusions:The immune characteristics of patients with asymptomatic HIV infection are the decreased number of CD4+T cells and the increased number of CD8+T cells as well as the decreased absolute content and increased relative content of CD4+CD25+Treg cells, and PD-1/PD-L1 pathway is the molecular mechanism of HIV to act on CD4+T cells.

  1. Treatment of dyslipidemia in patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Vijayaraghavan Krishnaswami

    2010-12-01

    Full Text Available Abstract Type 2 diabetes is associated with significant cardiovascular morbidity and mortality. Although low-density lipoprotein cholesterol levels may be normal in patients with type 2 diabetes, insulin resistance drives a number of changes in lipid metabolism and lipoprotein composition that render low-density lipoprotein cholesterol and other lipoproteins more pathogenic than species found in patients without type 2 diabetes. Dyslipidemia, which affects almost 50% of patients with type 2 diabetes, is a cardiovascular risk factor characterized by elevated triglyceride levels, low high-density lipoprotein cholesterol levels, and a preponderance of small, dense, low-density lipoprotein particles. Early, aggressive pharmacological management is advocated to reduce low-density lipoprotein cholesterol levels, regardless of baseline levels. A number of lipid-lowering agents, including statins, fibrates, niacin, and bile acid sequestrants, are available to target normalization of the entire lipid profile. Despite use of combination and high-dose lipid-lowering agents, many patients with type 2 diabetes do not achieve lipid targets. This review outlines the characteristics and prevalence of dyslipidemia in patients with type 2 diabetes and discusses strategies that may reduce the risk of cardiovascular disease in this population.

  2. Blood pressure control in type 2 diabetic patients.

    Science.gov (United States)

    Grossman, Alon; Grossman, Ehud

    2017-01-06

    Diabetes mellitus (DM) and essential hypertension are common conditions that are frequently present together. Both are considered risk factors for cardiovascular disease and microvascular complications and therefore treatment of both conditions is essential. Many papers were published on blood pressure (BP) targets in diabetic patients, including several works published in the last 2 years. As a result, guidelines differ in their recommendations on BP targets in diabetic patients. The method by which to control hypertension, whether pharmacological or non-pharmacological, is also a matter of debate and has been extensively studied in the literature. In recent years, new medications were introduced for the treatment of DM, some of which also affect BP and the clinician treating hypertensive and diabetic patients should be familiar with these medications and their effect on BP. In this manuscript, we discuss the evidence supporting different BP targets in diabetics and review the various guidelines on this topic. In addition, we discuss the various options available for the treatment of hypertension in diabetics and the recommendations for a specific treatment over the other. Finally we briefly discuss the new diabetic drug classes and their influence on BP.

  3. Primary care for diabetes mellitus: perspective from older patients

    Directory of Open Access Journals (Sweden)

    Wong ELY

    2011-10-01

    Full Text Available Eliza Lai Yi Wong1, Jean Woo2, Elsie Hui3, Carrie Chan2, Wayne LS Chan2, Annie Wai Ling Cheung11School of Public Health and Primary Care, The Chinese University of Hong Kong, 2School of Public Health and Primary Care, Division of Geriatrics, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, 3Medical and Geriatric Unit, Shatin Hospital, HK SAR, Hong Kong, People’s Republic of ChinaBackground: Care of diabetes mellitus in the elderly requires an additional perspective to take into account impaired cognitive function, physical function, low level of education, and difficulty making lifestyle changes. Existing services tend to be driven by the views of tertiary and secondary care staff, rather than those of primary care staff and elderly patients. This study aimed to explore the attitudes and preferences of elderly patients with diabetes mellitus towards primary care (clinical care and community program.Method: Elderly patients with diabetes mellitus aged 60 years or above were recruited from governmental diabetes mellitus clinics and diabetes mellitus specific community centers. Three focus group discussions of 14 diabetic elderly patients were conducted and their perspectives on the new service model were assessed. Participants were interviewed according to an open-ended discussion guide which includes the following items: comments on existing clinic follow up and community program, motivation for joining the community program, and suggestions on further clinical services and community service program development.Results: Incapability of the current health service to address their special needs was a common concern in three focus group discussions. The majority highlighted the benefits of the new service program, that is, self-care knowledge and skill, attitudes to living with diabetes mellitus, and supportive network. Key facilitators included experiential learning, a group discussion platform

  4. Corneal endothelial morphology and central thickness in patients with type II diabetes mellitus

    DEFF Research Database (Denmark)

    Storr-Paulsen, Allan; Singh, Amardeep; Jeppesen, Helene;

    2014-01-01

    PURPOSE: To investigate corneal endothelial cell density and morphology in type II diabetic and non-diabetic patients and to relate potential differences to the glycaemic status. METHODS: A prospective clinical study including 107 patients with type II diabetes and 128 non-diabetic patients. Samp...

  5. Telomere length predicts all-cause mortality in patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Astrup, A S; Tarnow, L; Jorsal, Anders;

    2010-01-01

    Type 1 diabetic patients with diabetic nephropathy have increased mortality and morbidity compared with normoalbuminuric patients. Telomere length in proliferative cells is inversely related to the total number of cell divisions, and therefore to biological age. We aimed to evaluate differences...... in telomere length in patients with type 1 diabetes with or without diabetic nephropathy; we also evaluated the prognostic value of telomere length....

  6. Short term outcome of Percutanous Coronary Intervention in diabetic and non-diabetic patients

    Directory of Open Access Journals (Sweden)

    Nouzari Y

    2007-05-01

    Full Text Available Background: Despite recent improvement in coronary intervention, there are many controversies about it’s results in diabetic patients. The goal of this study is comparison of in hospital outcome of diabetics after coronary intervention with nondiabetics. Methods: In this study 115 diabetic and 115non diabetic patients who admitted for coronary intervention in our center during 1383&84 were entered in an analytic study of Cohort type. Datas about clinical, aniographic, procedural and post procedural (24hours characteristics were entered in each patient’s form. Independent T test,chi-square and Fisher’s exact test were used for analyzing datas. Results: The Diabetic Patients were most often older men, and they had higher angina class, more co-risk factors and lower ejection fractions. Diabetic’s lesions were longer and more located in proximal portion of vessels. But success rate, major complication (death, revascularization, Q Wave MI and CVA, and minor complications (coronary/peripheral arteries complication, pulmonary edema, ischemic ECG had no significant differences between two groups. Conclusion: Diabetes mellitus does not affect short outcomes of coronary intervention as an independent factor. So intervention could be done in these patients with considering favorable outcomes.

  7. Prevalence of lean type 2 diabetes mellitus in recently diagnosed type 2 diabetes mellitus patients

    Directory of Open Access Journals (Sweden)

    Prateek Chaudhary

    2013-01-01

    Full Text Available Introduction: Obesity has always been thought to be a risk factor for diabetes; however, some studies in India have reported that even lean people are prone to diabetes. We conducted this study to see if this holds true for this part of the country. Objectives: To determine the prevalence of lean type 2 diabetes mellitus (DM in recently diagnosed type 2 DM in Manipur. Materials and Methods: All recently diagnosed type 2 DM patients, within a period of 24 weeks, who attended the endocrine clinic of RIMS from Jan to Dec 2012 are included in the study. Exclusion criteria are patients with chronic diseases. Results: Out of the 181 recently diagnosed diabetics 3.9% had a BMI of <19 kg/m 2 of which five are females (5.4% of female patients and two are males (2.2% of male patients. Mean age of Lean diabetics is 54.86 ± 15.32, mean fasting glucose is 212 ± 105.5 mg% and mean postprandial glucose is 351.57 ± 167.79 mg%. DM complications were observed in 28.6% of the Lean diabetics. Conclusion: Our study shows a low prevalence rate of Lean DM in recently diagnosed type 2 DM.

  8. Coronary artery disease incidence between type II diabetic and non-diabetic patients with Leriche syndrome.

    Directory of Open Access Journals (Sweden)

    Ozeren M

    2003-10-01

    Full Text Available BACKGROUND: Coronary artery disease (CAD is the major determinant of preoperative morbidity and mortality for patients requiring major vascular surgery. The management of CAD in these patients is controversial. AIMS: The incidence and severity of CAD in diabetic and non-diabetic patients with Leriche syndrome was explored. SETTINGS AND DESIGN: 107 patients with Leriche syndrome were selected as major vascular occlusion and grouped according to their diabetic Status. Sex, age, dyslipidemia, obesity, hypertension, clinic cardiac status, coronary angiographic lesions and coronary revascularisation procedures were noted. MATERIAL & METHODS: Patients′ demographics, intra-operative and per-operative data were recorded and compared. In every patient with Leriche syndrome scheduled for elective vascular reconstruction coronary angiography was performed. Lesions were evaluated for the percentages of stenosis. Preliminary coronary bypass or percutaneous coronary intervention was recommended for those found to have advanced or severe CAD. Results of revascularisation procedures were compared. STATISTICAL ANALYSIS USED: Chi-square or Fisher exact chi-square test is used for conditional variables. Independent samples was analysed by using t-test. Kruskal-Wallis variance test was used if the variances are not homogeneous according to the Levene test. RESULTS: No difference was found in both groups except family history and obesity. Coronary angiographic investigation indicates that 59% of DIAB group and 38% of NONDIAB group patients have advanced or severe CAD which has a high probability for myocardial revascularization. Overall revascularisation rate is 37.8% in DIAB group and 45.7% in NONDIAB group (p=0,641. Preoperative mortality was found 2.7% in diabetics and 4.2% in non-diabetics (p=0.342. CONCLUSIONS: Leriche syndrome with diabetes mellitus is more likely to have advanced coronary disease than those without diabetes mellitus. Coronary angiography

  9. Thyroid cancer risk is not increased in diabetic patients.

    Directory of Open Access Journals (Sweden)

    Chin-Hsiao Tseng

    Full Text Available OBJECTIVE: This study evaluated thyroid cancer risk with regards to diabetes status and diabetes duration, and with the use of anti-diabetic drugs including sulfonylurea, metformin, insulin, acarbose, pioglitazone and rosiglitazone, by using a population-based reimbursement database in Taiwan. METHODS: A random sample of 1,000,000 subjects covered by the National Health Insurance was recruited. After excluding patients with type 1 diabetes, 999730 subjects (495673 men and 504057 women were recruited into the analyses. Logistic regression estimated the odds ratios (OR and their 95% confidence intervals (CI for independent variables including age, sex, diabetes status/duration, anti-diabetic drugs, other medications, comorbidities, living regions, occupation and examinations that might potentially lead to the diagnosis of thyroid cancer in various models. RESULTS: The diabetic patients had a significantly higher probability of receiving potential detection examinations (6.38% vs. 5.83%, P<0.0001. After multivariable-adjustment, the OR (95% CI for diabetes status was 0.816 (0.652-1.021; and for diabetes duration <1 year, 1-3 years, 3-5 years and ≥ 5 years vs. non-diabetes was 0.071 (0.010-0.507, 0.450 (0.250-0.813, 0.374 (0.203-0.689 and 1.159 (0.914-1.470, respectively. Among the anti-diabetic agents, only sulfonylurea was significantly associated with thyroid cancer, OR (95% CI: 1.882 (1.202-2.947. The OR (95% CI for insulin, metformin, acarbose, pioglitazone and rosiglitazone was 1.701 (0.860-3.364, 0.696 (0.419-1.155, 0.581 (0.202-1.674, 0.522 (0.069-3.926 and 0.669 (0.230-1.948, respectively. Furthermore, patients with benign thyroid disease or other cancer, living in Kao-Ping/Eastern regions, or receiving potential detection examinations might have a significantly higher risk; and male sex, hypertension, dyslipidemia, chronic obstructive pulmonary disease, vascular complications or use of statin, aspirin or non-steroidal anti

  10. Retrospective analysis of the prevalence of asymptomatic cerebral aneurysm in 4518 patients undergoing magnetic resonance angiography. When does cerebral aneurysm develop?

    Energy Technology Data Exchange (ETDEWEB)

    Horikoshi, Toru; Yamagata, Zentaro; Nukui, Hideaki [Yamanashi Medical Univ., Tamaho (Japan); Akiyama, Iwao [Akiyama Neurosurgical Clinic, Nirasaki, Yamanashi (Japan)

    2002-03-01

    The natural history of cerebral aneurysms was investigated by measuring the prevalence of incidentally found unruptured aneurysms in the general population and evaluating the characteristics including risk factors. 'De novo' formation of aneurysm was also demographically estimated. The prevalence of incidental aneurysm was evaluated among 4518 patients who underwent magnetic resonance (MR) angiography for various reasons in a neurosurgical institute. Double the number of patients were randomly selected from the remaining patients without aneurysm as the Control group so that sex and age group were matched to the Aneurysm group. One hundred twenty seven patients (2.8%) had diagnoses of aneurysm. The prevalence of asymptomatic aneurysm among middle-aged and elderly patients were predominant in women and increased with age in both sexes. Patients with aneurysms had significantly more hypertension and family history of subarachnoid hemorrhage compared to the controls. The prevalence was markedly increased in the 8th decade in men and the 7th decade in women, and new aneurysms seemed to develop predominantly around these decades. Cerebral aneurysms become detectable on MR angiography in the middle or later decades, and women tend to develop aneurysm earlier than men. Hypertension and family history of subarachnoid hemorrhage are probably risk factors for the development of aneurysm. (author)

  11. Depression and quality of life in patients with diabetes

    DEFF Research Database (Denmark)

    Schram, Miranda T; Baan, Caroline A; Pouwer, Francois

    2009-01-01

    Diabetes patients are known to have a worse quality of life than individuals without diabetes. They also have an increased risk for depressive symptoms, which may have an additional negative effect on their quality of life. This systematic review summarizes the current knowledge on the association...... between depressive symptoms and quality of life in individuals with diabetes. A systematic literature search using MEDLINE, Psychinfo, Social SciSearch, SciSearch and EMBASE was conducted from January 1990 until September 2007. We identified studies that compared quality of life between diabetic...... individuals with and without depressive symptoms. Twenty studies were identified, including eighteen cross-sectional and two longitudinal studies. Quality of life was measured as generic, diabetes specific and domain specific quality of life. All studies reported a negative association between depressive...

  12. Adipsia in a Diabetes Insipidus Patient.

    Science.gov (United States)

    Pereira, Maria Conceição; Vieira, Margarida M; Pereira, Joana Simões; Salgado, Duarte

    2015-01-01

    Central diabetes insipidus is a very common disorder after brain surgery or/trauma or even in the presence of brain inflammatory diseases. Polyuria and polydipsia are the clinical markers, but sometimes clinical situations are presenting with no thirst. These are not frequent but are life-treating conditions. Diagnosis is not easy, and for this reason some cases are treated late. We describe here a very infrequent oncological case of dangerous adipsic diabetes insipidus in a young girl who survived.

  13. Risk factors for major amputation in hospitalised diabetic foot patients.

    Science.gov (United States)

    Namgoong, Sik; Jung, Suyoung; Han, Seung-Kyu; Jeong, Seong-Ho; Dhong, Eun-Sang; Kim, Woo-Kyung

    2016-03-01

    Diabetic foot ulcers are the main cause of non-traumatic lower extremity amputation. The objective of this study was to evaluate the risk factors for major amputation in diabetic foot patients. Eight hundred and sixty diabetic patients were admitted to the diabetic wound centre of the Korea University Guro Hospital for foot ulcers between January 2010 and December 2013. Among them, 837 patients were successfully monitored until complete healing. Ulcers in 809 patients (96·7%) healed without major amputation and those in 28 patients (3·3%) healed with major amputation. Data of 88 potential risk factors including demographics, ulcer condition, vascularity, bioburden, neurology and serology were collected from patients in the two groups and compared. Among the 88 potential risk factors, statistically significant differences between the two groups were observed in 26 risk factors. In the univariate analysis, which was carried out for these 26 risk factors, statistically significant differences were observed in 22 risk factors. In a stepwise multiple logistic analysis, six of the 22 risk factors remained statistically significant. Multivariate-adjusted odds ratios were 11·673 for ulcers penetrating into the bone, 8·683 for dialysis, 6·740 for gastrointestinal (GI) disorders, 6·158 for hind foot ulcers, 0·641 for haemoglobin levels and 1·007 for fasting blood sugar levels. The risk factors for major amputation in diabetic foot patients were bony invasions, dialysis, GI disorders, hind foot locations, low levels of haemoglobin and elevated fasting blood sugar levels.

  14. [The hemodynamic characterization of the diabetic patient with arterial calcifications].

    Science.gov (United States)

    Vega Gómez, M E; Ley Pozo, J; Aldama Figueroa, A; Lima Santana, B; Montalvo Diago, J; Bustillo, C; Fernández Boloña, A; Gutiérrez Jiménez, O; Ramirez Muñoz, O; Martínez Hernández, R

    1993-01-01

    This study was designed to describe the presence of calcifications according to the clinical features of the diabetic patient and the hemodynamics of the calcified arteries. With this purpose, 197 lower limbs from diabetic patients (type I and II) and carbon-hydrate intolerant patients, were studied. In all of the patients, the pressure ratio leg/arm was measured. On the same way, the arterial flow velocity was recorded using the Doppler ultrasonography on the pedia and postero-tibial arteries. The arterial calcifications, evident on the radiography of the foot, were more frequent between the type I patients and the neuro-infections diabetic foot. According to the hemodynamics point of view, we found a trend of association of more pathologic arterial flow velocity curves with the presence of calcifications (specially on the intima layer). It was also remarkable that an arterial incomprensibility was always associated with arterial calcifications.

  15. An audit of cushioned diabetic footwear: relation to patient compliance.

    Science.gov (United States)

    Chantelau, E; Haage, P

    1994-01-01

    The recurrence rate of neuropathic foot ulcers is reported in 51 diabetic patients regularly attending a diabetic foot clinic. All of the patients were provided with protective footwear reducing peak plantar pressure at the forefoot area by 50% (versus normal shoes), and were followed up for up to 4 years. Compliance with this footwear was recorded by assessing the daily time of wearing protective or normal shoes, and compliance with foot care was recorded from the entries in the patients charts. The results of this observational study demonstrate that wearing protective shoes for > 60% of the daytime significantly (p = 0.0002) reduced the ulcer relapse rate by > 50% in comparison with shorter wearing times for these shoes. In addition, patients without ulcer relapses had foot care significantly more frequently than patients with relapse (p < 0.05). It is concluded that cushioned protective footwear in association with frequent foot care is essential in the prevention of neuropathic diabetic foot ulcer recurrence.

  16. Noninvasive Detection of Endothelial Function in Normal Subjects,Asymptomatic Patients at Risk of Atherosclerosis and Patients with Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    F. Rajabzadeh

    2005-06-01

    Full Text Available Background/Objective: The endothelial dysfunction is associated with atherosclerosis. The dilatory reaction of atherosclerotic vessels in response to occlusion is reduced. This reduction could be of value in atherosclerosis determination. This study aimed at comparing brachial artery response to occlusion and administration of nitroglycerine in three groups: coronary artery disease patients, individuals with corona ry disease risk factors but no coronary disease,and normal subjects. Patients and Methods: The participants included 23 healthy individuals, 22 subjects with cardiovascular risk factors (diabetes mellitus, smoking, hyperte nsion or hypercholesterolemia ,and 57 angiographically proven coronary pati ents. The brachial artery diameter was measured by color Doppler ultrasound at rest, 5 min utes after inflation of the cuff, and 5 minutes after sublingual administration of nitroglycerine pearl. Results: The vessel’s diameter increased the least in the coronary artery disease and coronary risk factor groups in comparison to nor mal subjects (p=0.003 and 0.048, respectively. Vessel dilatation in response to nitroglycerine did not differ in healthy individuals from the coronary patients or the risk factor group (p=0.96 and 0.77, respectively. Conclusion: Doppler ultrasound may be used as a noninvasive method to identify subjects with endothelial dysfunction at high risk of coronary artery disease who need intervention or more invasive procedures.

  17. Left ventricular systolic dysfunction in asymptomatic Marfan syndrome patients is related to the severity of gene mutation: insights from the novel three dimensional speckle tracking echocardiography.

    Directory of Open Access Journals (Sweden)

    Mohamed Abd El Rahman

    Full Text Available In asymptomatic Marfan syndrome (MFS patients we evaluated the relationship between the types of fibrillin-1 (FBN1 gene mutation and possible altered left ventricular (LV function as assessed by three-dimensional speckle tracking echocardiography (3D-STE.Forty-five MFS patients (mean age 24 ± 15 years and 40 age-matched healthy controls were studied. Genetic evaluation for the FBN1 gene was carried on 32 MFS patients. Gene mutation (n = 15, 47% was classified as mild when the mutation resulted in nearly normally functioning protein, while mutations resulting in abnormally function protein were considered to be severe (n = 17, 53%. All patients and controls underwent 3D-STE for evaluation of LV function by an echocardiographer blinded to the results of the genetic testing. Compared to controls, MFS patients had significantly lower 3D-STE derived LV ejection fraction (EF, 57.43 ± 7.51 vs. 62.69 ± 4.76%, p = 0.0001, global LV longitudinal strain (LS, 14.85 ± 2.89 vs. 17.90 ± 2.01%, p = 0.0001, global LV circumferential strain (CS, 13.93 ± 2.81 vs. 16.82 ± 2.17%, p = 0.0001 and global LV area strain (AS, 25.76 ± 4.43 vs. 30.51 ± 2.61%, p = 0.0001. Apart from the global LV LS all these parameters were significantly lower in patients with severe gene mutation than in those with mild mutation (p < 0.05. In the multivariate linear regression analysis only the type of mutation had a significant influence on the 3D-STE derived LVEF (p = 0.017, global CS (p = 0.005 and global AS (p = 0.03.In asymptomatic MFS patients latent LV dysfunction can be detected using 3D STE. The LV dysfunction is mainly related to the severity of gene mutation, suggesting possible primary cardiomyopathy in MFS patients.

  18. Periodontal disease in diabetic patients - clinical and histopathological aspects.

    Science.gov (United States)

    Corlan Puşcu, Dorina; Ciuluvică, Radu Constantin; Anghel, Andreea; Mălăescu, Gheorghe Dan; Ciursaş, Adina Nicoleta; Popa, Gabriel Valeriu; Agop Forna, Doriana; Busuioc, Cristina Jana; Siloşi, Izabela

    2016-01-01

    Periodontal disease is one of the most frequent diseases affecting people all over the world. The relation between periodontal disease and diabetes mellitus raised the interest both of dentists and doctors treating metabolic diseases, as the two conditions influence one another. In our study, we analyzed a number of 75 patients with diabetes mellitus and periodontal disease that presented to the medical consultory for conditions of the dental maxillary system. The clinical study showed that periodontal disease and diabetes may affect young adults as well, still this pathological association more frequently appears after the age of 50. The disease was identified especially in the women living in urban area. The clinical examination of the dental maxillary system identified the presence of gingival ulcerations, dental calculus, gingival bleeding, radicular leftovers with anfractuous margins, fixed prostheses with an inappropriate cervical adjustment. Of the systemic diseases associated to periodontal disease and diabetes mellitus, there was observed that 66.66% of the patients also suffered from cardiovascular diseases (high blood pressure, ischemic cardiopathy, heart failure), and 37.33% suffered from obesity. The histopathological and immunohistochemical tests highlighted the presence of an inflammatory chronic, intense reaction, mainly formed of lymphocytes, plasmocytes, macrophages and granulocytes, heterogeneously disseminated and alteration of the structure of marginal and superficial periodontium. The inflammatory reaction in the patients with periodontal disease and diabetes was more intense than in the patients with periodontal disease without diabetes.

  19. Increase in overall mortality risk in patients with type 2 diabetes receiving different oral diabetes drugs

    Directory of Open Access Journals (Sweden)

    E A Pigarova

    2012-12-01

    Full Text Available Реферат по статье: Pantalone KM, Kattan MW, Yu C, Wells BJ, Arrigain S, Jain A, Atreja A, Zimmerman RS. Increase in overall mortality risk in patients with type 2 diabetes receiving glipizide, glyburide or glimepiride monotherapy versus metformin: a retrospective analysis. Diabetes Obes Metab. 2012 Sep;14(9:803-809.

  20. Alteration of melatonin secretion in patients with type 2 diabetes and proliferative diabetic retinopathy

    OpenAIRE

    Hikichi T; Tateda N; Miura T

    2011-01-01

    Taiichi Hikichi1, Naohiro Tateda2, Toshiaki Miura31Department of Ophthalmology, Ohtsuka Eye Hospital, Sapporo; 2Asahikawa National College of Technology, Asahikawa; 3Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, JapanBackground: The purpose of this study was to evaluate the dynamics of plasma melatonin secretion in patients with type 2 diabetes mellitus and diabetic retinopathy.Methods: Plasma melatonin levels were measured by high-performance liquid chromatography in 56 p...

  1. PREVALENCE OF DIABETIC RETINOPATHY IN TYPE - 2 DIABETES MELLITUS PATIENTS IN TRIPURA

    Directory of Open Access Journals (Sweden)

    Arindam

    2014-01-01

    Full Text Available OBJECTIVE : To study the prevalence of diabetic retinopathy and its relationship with the various risks factors in type 2 diabetes mellitus patients. PATIENTS AND METHODS : One hundred type 2 diabetes mellitus patients attending the departments of Medicine and Ophthalmology of TMC &Dr. BRAM Teaching Hospital comprised the material of this study. Detaile d history , clinical examination and thorough ophthalmological examination including fundus photography of all the diabetic patients under study were done. The glycaemic control was evaluated for all the subjects by estimation of blood glucose and HbA1c , presence of microalbuminuria and lipid profiles. RESULTS: There were 61 (61% females and 39 (39% males in the study of which 42 (42% patients , 15(35.7% males and 27(64.3% females had diabetic retinopathy. Among 42 retinopathy patients NPDR , PDR and AD R were 15(35.7% , 17 (40.48% and 10 (23.81% respectively. Duration of diabetes was found the most significant contributory factor in the causation of DR (Chi - square – 43.66; p<0.01& F - 78.037 , p=0.00. Other factors which were significantly associated wi th diabetic retinopathy are age (p=0.00 , glycaemic control as assessed by HbA1c (p=0.00 , blood glucose - fasting (p=0. 00 & postprandial (p=0.00 and MAU (p=0.00. Factors like blood pressure - Systolic (p=0.655 & diastolic (p=0.964 , hypercholesterolemi a (p=0.140 , and BMI (p=0.513 did not show any significant correlation.

  2. Are diabetic patients being screened for sleep related breathing disorder?

    Institute of Scientific and Technical Information of China (English)

    Salim; Surani

    2013-01-01

    Prevalence of both diabetes mellitus and obstructive sleep apnea(OSA)is high among general population.Both of these conditions are associated with significant morbidity.OSA affects approximately 25%of men and 9%of women,and its prevalence is even higher among obese,Hispanics,African American and diabetic patients.Diabetes on the other hand besides having high prevalence in general population has even higher prevalence among ethnic populations as Hispanics and African American.Despite the availability of several simple screening tools for OSA,as Berlin questionnaire,STOP-BANG questionnaire,NAMES Criteria,the utility for screening of OSA among the diabetic population remains marginal.This in turn can lead to significant morbidity and complications related to OSA as well as worsening of diabetes mellitus and increase in diabetic complications due to untreated sleep related breathing disorder.It is therefore imperative for the primary care giver to screen for OSA among the diabetic population as a part of their routine evaluation to prevent worsening of diabetes,and its cardiovascular,renal,ophthalmologic and neurological complications.

  3. A low-fat diet improves peripheral insulin sensitivity in patients with Type 1 diabetes

    DEFF Research Database (Denmark)

    Rosenfalck, A M; Almdal, T; Viggers, L;

    2006-01-01

    To compare the effects on insulin sensitivity, body composition and glycaemic control of the recommended standard weight-maintaining diabetes diet and an isocaloric low-fat diabetes diet during two, 3-month periods in patients with Type 1 diabetes.......To compare the effects on insulin sensitivity, body composition and glycaemic control of the recommended standard weight-maintaining diabetes diet and an isocaloric low-fat diabetes diet during two, 3-month periods in patients with Type 1 diabetes....

  4. Identifying diabetic patients with cardiac autonomic neuropathy by heart rate complexity analysis

    Directory of Open Access Journals (Sweden)

    Palaniswami Marimuthu

    2009-01-01

    Full Text Available Abstract Background Cardiac autonomic neuropathy (CAN in diabetes has been called a "silent killer", because so few patients realize that they suffer from it, and yet its effect can be lethal. Early sub clinical detection of CAN and intervention are of prime importance for risk stratification in preventing sudden death due to silent myocardial infarction. This study presents the usefulness of heart rate variability (HRV and complexity analyses from short term ECG recordings as a screening tool for CAN. Methods A total of 17 sets of ECG recordings during supine rest were acquired from diabetic subjects with CAN (CAN+ and without CAN (CAN- and analyzed. Poincaré plot indexes as well as traditional time and frequency, and the sample entropy (SampEn measure were used for analyzing variability (short and long term and complexity of HRV respectively. Results Reduced (p > 0.05_Poincaré plot patterns and lower (p Conclusion Our results demonstrate the potential utility of SampEn (a complexity based estimator of HRV in identifying asymptomatic CAN.

  5. Painful Diabetic Neuropathy in Japanese Diabetic Patients Is Common but Underrecognized

    Directory of Open Access Journals (Sweden)

    Mayumi Tsuji

    2013-01-01

    Full Text Available Although chronic pain due to diabetic neuropathy, defined as painful diabetic neuropathy (PDN, is a debilitating and distressing complication of diabetes, epidemiological data on PDN has been scarce, especially in Asia. We evaluated the prevalence of Japanese PDN and its impact on their quality of life (QOL and metnal state. In addition, we examined to which extent physicians are aware of patients’ PDN. A total of 298 patients with diabetes were found to be eligible for the study. We revealed that substantial percentage (22.1% of Japanese diabetic patients had PDN and that PDN had negative effect on patients’ QOL and mental state. However, physicians were aware of PDN in only 36.4% of patients with the condition. To the best of our knowledge, this is the first report showing the extent of physicians’ awareness of patients’ PDN. In conclusion, physicians treating diabetes need to be more aware of patients’ PDN in everyday clinical practice to prevent the progression of PDN and improve the patients’ QOL and mental state.

  6. Different Pathophysiological Phenotypes among Newly Diagnosed Type 2 Diabetes Patients

    DEFF Research Database (Denmark)

    Stidsen, Jacob

    2013-01-01

    Type 2 diabetes (T2D) can be considered a syndrome with several different pathophysiological mechanisms leading to hyperglycemia. Nonetheless, T2D is treated according to algorithms as if it was one disease entity. Methods: We investigated the prevalence of different pathophysiological phenotypes...... among newly diagnosed T2D patients in Denmark. Based on baseline data from a Danish national cohort study we investigated 1048 incident diagnosed T2D patients. The diagnosis T2D was made by general practitioners based on clinical judgement. Phenotypes were classified in the following groups: latent...... autoimmune diabetes (LADA) (GAD antibody titer >= 20 IE/ml and not T1D), secondary diabetes (recent history of pancreatitis, pancreatectomy or pancreas amylase > 65U/l, and GAD negativity), steroid-induced diabetes (oral glucocorticoid-treated subjects), insulinopenic (f-P-C-peptide

  7. Euglycemic Diabetic Ketoacidosis in a Patient with Cocaine Intoxication.

    Science.gov (United States)

    Abu-Abed Abdin, Asma; Hamza, Muhammad; Khan, Muhammad S; Ahmed, Awab

    2016-01-01

    Diabetic ketoacidosis (DKA) is characterized by elevated anion gap metabolic acidosis, hyperglycemia, and elevated ketones in urine and blood. Hyperglycemia is a key component of DKA; however, a subset of DKA patients can present with near-normal blood glucose, an entity described as "euglycemic DKA." This rare phenomenon is thought to be due to starvation and food restriction in insulin dependent diabetic patients. Cocaine abuse is considered a trigger for development of DKA. Cocaine also has anorexic effects. We describe an interesting case of euglycemic DKA in a middle-aged diabetic female presenting with elevated anion gap metabolic acidosis, with near-normal blood glucose, in the settings of noncompliance to insulin and cocaine abuse. We have postulated that cocaine abuse was implicated in the pathophysiology of euglycemic DKA in this case. This case highlights complex physiological interplay between type-1 diabetes, noncompliance to insulin, and cocaine abuse leading to DKA, with starvation physiology causing development of euglycemic DKA.

  8. Morganella morganii-associated arthritis in a diabetic patient.

    Science.gov (United States)

    Cetin, Meryem; Ocak, Sabahattin; Kuvandik, Guven; Aslan, Bahadir; Temiz, Muhyittin; Aslan, Ahmet

    2008-03-01

    This case report involves a 60-year-old diabetic man who developed septic arthritis as a result of the pathogen Morganella morganii. The patient had complaints of elevated body temperature, malaise, rigors and pain in the left knee, despite no history of trauma. On examination of the knee, erythema, warmth, tenderness and swelling was observed. Arthrocentesis performed on his left knee indicated the presence of straw-coloured, cloudy fluid without crystals. Bacterial identification based on biochemical and automated methods indicated the growth of M morganii. M morganii was also isolated sedimentafrom the exudate of a diabetic ulcer in the left foot, with antibiotic susceptibilities identical to those from the knee effusion. This case indicates that M morganii may be considered as a possible cause of septic arthritis in diabetic patients, especially those with diabetic foot infections.

  9. Odontogenic infection involving the secondary fascial space in diabetic and non-diabetic patients: a clinical comparative study

    OpenAIRE

    Chang, Je-Shin; Yoo, Kil-Hwa; Yoon, Sung Hwan; Ha, Jiwon; JUNG, Seunggon; Kook, Min-Suk; Park, Hong-Ju; Ryu, Sun-Youl; Oh, Hee-Kyun

    2013-01-01

    Objectives This retrospective study was performed to evaluate the clinical impact of diabetes mellitus on the prognosis in secondary space infection. Materials and Methods Medical records, radiographic images, computed tomography, and microbial studies of 51 patients (25 diabetic patients and 26 non-diabetic patients) were reviewed. Patients were diagnosed as secondary fascial space infections with odontogenic origin and underwent treatment at Chonnam National University Hospital, in Departme...

  10. Thyroid Cancer Risk Is Not Increased in Diabetic Patients

    Science.gov (United States)

    Tseng, Chin-Hsiao

    2012-01-01

    Objective This study evaluated thyroid cancer risk with regards to diabetes status and diabetes duration, and with the use of anti-diabetic drugs including sulfonylurea, metformin, insulin, acarbose, pioglitazone and rosiglitazone, by using a population-based reimbursement database in Taiwan. Methods A random sample of 1,000,000 subjects covered by the National Health Insurance was recruited. After excluding patients with type 1 diabetes, 999730 subjects (495673 men and 504057 women) were recruited into the analyses. Logistic regression estimated the odds ratios (OR) and their 95% confidence intervals (CI) for independent variables including age, sex, diabetes status/duration, anti-diabetic drugs, other medications, comorbidities, living regions, occupation and examinations that might potentially lead to the diagnosis of thyroid cancer in various models. Results The diabetic patients had a significantly higher probability of receiving potential detection examinations (6.38% vs. 5.83%, Pdiabetes status was 0.816 (0.652–1.021); and for diabetes duration diabetes was 0.071 (0.010–0.507), 0.450 (0.250–0.813), 0.374 (0.203–0.689) and 1.159 (0.914–1.470), respectively. Among the anti-diabetic agents, only sulfonylurea was significantly associated with thyroid cancer, OR (95% CI): 1.882 (1.202–2.947). The OR (95% CI) for insulin, metformin, acarbose, pioglitazone and rosiglitazone was 1.701 (0.860–3.364), 0.696 (0.419–1.155), 0.581 (0.202–1.674), 0.522 (0.069–3.926) and 0.669 (0.230–1.948), respectively. Furthermore, patients with benign thyroid disease or other cancer, living in Kao-Ping/Eastern regions, or receiving potential detection examinations might have a significantly higher risk; and male sex, hypertension, dyslipidemia, chronic obstructive pulmonary disease, vascular complications or use of statin, aspirin or non-steroidal anti-inflammatory drugs might be associated with a significantly lower risk. Conclusions There is a lack of an overall

  11. Brain changes in diabetes mellitus patients with gastrointestinal symptoms

    DEFF Research Database (Denmark)

    Drewes, Anne M; Søfteland, Eirik; Dimcevski, Georg;

    2016-01-01

    neuropathy of the central nervous system (CNS) may play a major role. This systematic review provides an overview of the neurodegenerative changes that occur as a consequence of diabetes with a focus on the CNS changes and gastrointestinal (GI) dysfunction. Animal models where diabetes was induced......Diabetes mellitus is a common disease and its prevalence is increasing worldwide. In various studies up to 30%-70% of patients present dysfunction and complications related to the gut. To date several clinical studies have demonstrated that autonomic nervous system neuropathy and generalized...

  12. Diabetic Cardiovascular Autonomic Neuropathy Predicts Recurrent Cardiovascular Diseases in Patients with Type 2 Diabetes

    Science.gov (United States)

    Cha, Seon-Ah; Yun, Jae-Seung; Lim, Tae-Seok; Min, Kyoungil; Song, Ki-Ho; Yoo, Ki-Dong; Park, Yong-Moon; Ahn, Yu-Bae

    2016-01-01

    Cardiovascular autonomic neuropathy (CAN) is a risk factor for cardiovascular disease (CVD) and mortality in patients with type 2 diabetes. This study evaluated the relationship between CAN and recurrent CVD in type 2 diabetes. A total of 206 patients with type 2 diabetes who had a history of CVD within 3 years of enrollment were consecutively recruited from January 2001 to December 2009 and followed-up until December 2015. Cardiovascular autonomic function tests were performed using the following heart rate variability parameters: expiration-to-inspiration ratio, response to Valsalva maneuver and standing. We estimated the recurrence of CVD events during the follow-up period. A total of 159 (77.2%) of the 206 patients enrolled completed the follow up, and 78 (49.1%) patients had recurrent episodes of CVD, with an incidence rate of 75.6 per 1,000 patient-years. The mean age and diabetes duration were 62.5 ± 8.7 and 9.2 ± 6.9 years, respectively. Patients who developed recurrent CVD also exhibited hypertension (P = 0.004), diabetic nephropathy (P = 0.012), higher mean systolic blood pressure (P = 0.006), urinary albumin excretion (P = 0.015), and mean triglyceride level (P = 0.035) than did patients without recurrent CVD. Multivariable Cox hazard regression analysis revealed that definite CAN was significantly associated with an increased risk of recurrent CVD (hazard ratio [HR] 3.03; 95% confidence interval [CI] 1.39−6.60; P = 0.005). Definite CAN was an independent predictor for recurrent CVD in patients with type 2 diabetes who had a known prior CVD event. PMID:27741306

  13. Patient involvement in diabetes care: experiences in nine diabetes care groups

    Directory of Open Access Journals (Sweden)

    Lidwien Lemmens

    2015-12-01

    Full Text Available Introduction: Despite the expected beneficial effects on quality of care, patient involvement in diabetes care groups, which deliver a bundled paid integrated care programme for diabetes type 2, seems to be limited. The aim of this study was to gain insight into levels and methods of patient involvement, into facilitators and barriers, and into the future preferences of care groups and patient representatives.Theory and methods: Semi-structured interviews were held with 10 representatives of care groups and 11 representatives of patient advocacy groups. An adapted version of Arnstein's ladder of citizen participation was used to define five levels of patient involvement.Results: Patient involvement in care groups was mostly limited to informing and consulting patients. Higher levels, i.e., advising, co-producing and decision-making, were less frequently observed. Care groups and patient representatives perceived largely the same barriers and facilitators and had similar preferences regarding future themes and design of patient involvement.Conclusion: Constructive collaboration between diabetes care groups and patient representatives to enhance patient involvement in the future seems viable. Several issues such as the lack of evidence for effectiveness of patient involvement, differences in viewpoints on the role and responsibilities of care groups and perceived barriers need to be addressed.

  14. Urinary 6-sulfatoxymelatonin level in diabetic retinopathy patients with type 2 diabetes.

    Science.gov (United States)

    Chen, Wei; Cao, Hui; Lu, Qian-Yi; Wang, Na; Zhao, Shu-Zhi; Xu, Xun; Zheng, Zhi

    2014-01-01

    Melatonin is a powerful antioxidant. Decreased melatonin excretion has been reported to be associated with several oxidative stress-related diseases. The urinary metabolite of melatonin, 6-sulfatoxymelatonin (aMT6s), has proved to be a very reliable index of melatonin production. The present study aims to evaluate the level of urinary aMT6s in patients with type 2 diabetes mellitus and diabetic retinopathy. Urine samples were collected from 10 patients with diabetes and no diabetic retinopathy (NDR), 19 patients with nonproliferative diabetic retinopathy (NPDR), 38 patients with proliferative diabetic retinopathy (PDR), and 16 subjects without diabetes mellitus, who served as controls. The level of aMT6s in specimens was assayed by a commercial aMT6s ELISA kit, creatinine levels were also measured for each sample to get urinary aMT6s/creatinine ratio. Creatinine-adjusted urinary aMT6s values were compared among four groups. The urinary aMT6s (mean ± SD) levels were 9.95 ± 2.42, 9.90 ± 2.28, 8.40 ± 1.84 and 5.58 ± 1.33 ng/mg creatinine in the controls and in patients with NDR, NPDR, or PDR, respectively. The urinary aMT6s level of the PDR group was significantly lower than that of the control, NDR and DR groups. No significant difference was found among the control, NDR and DR groups. After adjustment for various factors (age, smoking, cancer, and coronary heart disease) that may influence the aMT6s level, the odds-ratio of urinary aMT6s comparing PDR patients to controls was 0.246 (95% confidence interval = 0.108-0.558, P = 0.001). Therefore, the urinary aMT6s level is significantly decreased in diabetic patients with PDR but not in diabetic patients without PDR, which indicates that decreased urinary aMT6s level may be associated with the pathogenesis of PDR.

  15. Illness Beliefs Predict Mortality in Patients with Diabetic Foot Ulcers

    Science.gov (United States)

    Vedhara, Kavita; Dawe, Karen; Miles, Jeremy N. V.; Wetherell, Mark A.; Cullum, Nicky; Dayan, Colin; Drake, Nicola; Price, Patricia; Tarlton, John; Weinman, John; Day, Andrew; Campbell, Rona; Reps, Jenna; Soria, Daniele

    2016-01-01

    Background Patients’ illness beliefs have been associated with glycaemic control in diabetes and survival in other conditions. Objective We examined whether illness beliefs independently predicted survival in patients with diabetes and foot ulceration. Methods Patients (n = 169) were recruited between 2002 and 2007. Data on illness beliefs were collected at baseline. Data on survival were extracted on 1st November 2011. Number of days survived reflected the number of days from date of recruitment to 1st November 2011. Results Cox regressions examined the predictors of time to death and identified ischemia and identity beliefs (beliefs regarding symptoms associated with foot ulceration) as significant predictors of time to death. Conclusions Our data indicate that illness beliefs have a significant independent effect on survival in patients with diabetes and foot ulceration. These findings suggest that illness beliefs could improve our understanding of mortality risk in this patient group and could also be the basis for future therapeutic interventions to improve survival. PMID:27096609

  16. [Characteristics of aphakic eye in patients with diabetes].

    Science.gov (United States)

    Kartasheva, E A; Abramov, M V; Evdokimova, M I

    1998-01-01

    Ninety patients with aphakia and diabetes were examined. Intraocular pressure was normal in 30 patients, in 30 aphakia was concomitant with primary glaucoma, and 30 presented with aphakic glaucoma. Fundus oculi was examined with a slit lamp and +60 D lens, gonioscopy and cycloscopy were carried out using a contact prism proposed by the authors. Aphakic glaucoma developed as a result of changes in the anterior chamber corner: coarse postoperative cicatrices and vitreo-corneal adhesions. Diabetic retinopathy was equally incident in all three groups of patients. Changes in the ciliary vessels can anticipate diabetic retinopathy. New vessels on ciliary body processes is an unfavorable prognostic sign as regards visual functions in patients with aphakia and increased intraocular pressure.

  17. Plasma concentration of asymmetric dimethylarginine (ADMA) predicts cardiovascular morbidity and mortality in type 1 diabetic patients with diabetic nephropathy

    DEFF Research Database (Denmark)

    Lajer, M.; Tarnow, L.; Jorsal, A.

    2008-01-01

    performed a prospective observational follow-up study including 397 type 1 diabetic patients with overt diabetic nephropathy (243 men aged 42.1 +/- 10.5 years, GFR 76 +/- 34 ml/min per 1.73 m(2)) and a control group of 175 patients with longstanding type 1 diabetes and persistent normoalbuminuria (104 men...... aged 42.7 +/- 9.7 years, duration of diabetes 27.7 +/- 8.3 years). Patients were followed for a median 11.3 years (range 0.0-12.9) with yearly measurements of GFR ((51)Cr-EDTA plasma clearance) in patients with diabetic nephropathy. Endpoints were fatal and nonfatal cardiovascular disease (CVD......), decline in GFR, ESRD, and all-cause mortality. RESULTS: Among patients with diabetic nephropathy, 37 patients (19.4%) with ADMA levels below the median, compared with 79 patients (43.4%) above the median, suffered a major cardiovascular event during the follow-up period (P

  18. Asymptomatic infection with Borrelia burgdorferi.

    Science.gov (United States)

    Steere, Allen C; Sikand, Vijay K; Schoen, Robert T; Nowakowski, John

    2003-08-15

    The natural history of asymptomatic seroconversion to Borrelia burgdorferi has been unclear. We report here, on the basis of a post hoc assessment, the frequency and outcome of asymptomatic seroconversion to B. burgdorferi in participants of a large Lyme disease vaccine trial. We show that infection with B. burgdorferi may be asymptomatic but that asymptomatic infection is unusual in the United States.

  19. Therapeutic efficacy of ozone in patients with diabetic foot.

    Science.gov (United States)

    Martínez-Sánchez, Gregorio; Al-Dalain, Saied M; Menéndez, Silvia; Re, Lamberto; Giuliani, Attilia; Candelario-Jalil, Eduardo; Alvarez, Hector; Fernández-Montequín, José Ignacio; León, Olga Sonia

    2005-10-31

    Oxidative stress is suggested to have an important role in the development of complications in diabetes. Because ozone therapy can activate the antioxidant system, influencing the level of glycemia and some markers of endothelial cell damage, the aim of this study was to investigate the therapeutic efficacy of ozone in the treatment of patients with type 2 diabetes and diabetic feet and to compare ozone with antibiotic therapy. A randomized controlled clinical trial was performed with 101 patients divided into two groups: one (n = 52) treated with ozone (local and rectal insufflation of the gas) and the other (n = 49) treated with topical and systemic antibiotics. The efficacy of the treatments was evaluated by comparing the glycemic index, the area and perimeter of the lesions and biochemical markers of oxidative stress and endothelial damage in both groups after 20 days of treatment. Ozone treatment improved glycemic control, prevented oxidative stress, normalized levels of organic peroxides, and activated superoxide dismutase. The pharmacodynamic effect of ozone in the treatment of patients with neuroinfectious diabetic foot can be ascribed to the possibility of it being a superoxide scavenger. Superoxide is considered a link between the four metabolic routes associated with diabetes pathology and its complications. Furthermore, the healing of the lesions improved, resulting in fewer amputations than in control group. There were no side effects. These results show that medical ozone treatment could be an alternative therapy in the treatment of diabetes and its complications.

  20. Body Mass Index and Retinopathy in Type 1 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Snježana Kaštelan

    2014-01-01

    Full Text Available Aim. To investigate whether body mass index (BMI independently or in correlation with other risk factors is associated with diabetic retinopathy (DR progression. Methods. The study included 176 patients with type 1 diabetes divided into three groups according to DR status: group 1 (no retinopathy; n=86, group 2 (mild/moderate nonproliferative DR; n=33, and group 3 (severe/very severe NPDR or proliferative DR; n=57. Results. A significant deterioration of HbA1c, an increase in total cholesterol, systolic, diastolic blood pressure, and diabetic nephropathy with the progression of retinopathy were found. DR progression was correlated with diabetes duration, HbA1c, hypertension, total cholesterol, and the presence of nephropathy. In patients without nephropathy, statistical analyses showed that progression of retinopathy increased significantly with higher BMI (gr. 1: 24.03 ± 3.52, gr. 2: 25.36 ± 3.44, gr. 3: 26.93 ± 3.24; P<0.01. A positive correlation between BMI and a significant deterioration of HbA1c, an increase in cholesterol, triglycerides, and hypertension was observed. Conclusion. BMI in correlation with HbA1c, cholesterol, and hypertension appears to be associated with the progression of DR in type 1 diabetic patients without nephropathy. However, additional studies are required to investigate the pathogenic role of obesity and weight loss in retinal diabetic complications particularly relating to nephropathy.

  1. Body Mass Index and Retinopathy in Type 1 Diabetic Patients

    Science.gov (United States)

    Kaštelan, Snježana; Salopek Rabatić, Jasminka; Tomić, Martina; Gverović Antunica, Antonela; Ljubić, Spomenka; Kaštelan, Helena; Orešković, Darko

    2014-01-01

    Aim. To investigate whether body mass index (BMI) independently or in correlation with other risk factors is associated with diabetic retinopathy (DR) progression. Methods. The study included 176 patients with type 1 diabetes divided into three groups according to DR status: group 1 (no retinopathy; n = 86), group 2 (mild/moderate nonproliferative DR; n = 33), and group 3 (severe/very severe NPDR or proliferative DR; n = 57). Results. A significant deterioration of HbA1c, an increase in total cholesterol, systolic, diastolic blood pressure, and diabetic nephropathy with the progression of retinopathy were found. DR progression was correlated with diabetes duration, HbA1c, hypertension, total cholesterol, and the presence of nephropathy. In patients without nephropathy, statistical analyses showed that progression of retinopathy increased significantly with higher BMI (gr. 1: 24.03 ± 3.52, gr. 2: 25.36 ± 3.44, gr. 3: 26.93 ± 3.24; P < 0.01). A positive correlation between BMI and a significant deterioration of HbA1c, an increase in cholesterol, triglycerides, and hypertension was observed. Conclusion. BMI in correlation with HbA1c, cholesterol, and hypertension appears to be associated with the progression of DR in type 1 diabetic patients without nephropathy. However, additional studies are required to investigate the pathogenic role of obesity and weight loss in retinal diabetic complications particularly relating to nephropathy. PMID:24696683

  2. Diabetic peripheral neuropathy and prevalence of erectile dysfunction in Japanese patients aged diabetes mellitus: The Dogo Study.

    Science.gov (United States)

    Furukawa, S; Sakai, T; Niiya, T; Miyaoka, H; Miyake, T; Yamamoto, S; Maruyama, K; Ueda, T; Senba, H; Todo, Y; Torisu, M; Minami, H; Onji, M; Tanigawa, T; Matsuura, B; Hiasa, Y; Miyake, Y

    2017-01-01

    Only limited epidemiological evidence exists regarding the relationship between diabetic neuropathy and erectile dysfunction (ED) among Japanese patients with type 2 diabetes mellitus. To investigate the relationship between diabetic neuropathy and ED among Japanese patients with type 2 diabetes mellitus, a multicenter cross-sectional study was conducted in 287 male Japanese patients with type 2 diabetes mellitus, age (19-65 years). Diabetic neuropathy was diagnosed if the patients showed two or more of the following three characteristics: neuropathic symptoms, decreased or disappeared Achilles tendon reflex and/or abnormal vibration perception. ED, moderate to severe ED, and severe ED were defined as present when a subject had a Sexual Health Inventory for Men score diabetic neuropathy and severe ED were 47.0 and 39.0%, respectively. Diabetic neuropathy was independently positively associated with severe ED, but not ED and moderate ED: the adjusted odds ratio was 1.90 (95% confidence interval: 1.08-3.38). No relationships were found between diabetic retinopathy or diabetic nephropathy and ED. Diabetic neuropathy is positively associated with severe erectile dysfunction among Japanese type 2 diabetes mellitus patients aged <65 years.

  3. Patients' Outcome Expectations Matter in Psychological Interventions for Patients with Diabetes and Comorbid Depressive Symptoms

    NARCIS (Netherlands)

    Snippe, Evelien; Schroevers, Maya J.; Tovote, Annika; Sanderman, Robbert; Emmelkamp, Paul M. G.; Fleer, Joke

    2015-01-01

    This study examined whether patients' expectations of treatment outcome predict treatment completion, homework compliance, and depressive symptom improvement in cognitive behavior therapy (CBT) and mindfulness-based cognitive therapy (MBCT). Study participants were patients with diabetes and comorbi

  4. How To Prevent Foot Ulcers In Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Ghada Morshed

    2012-03-01

    Full Text Available The prevalence of development of foot ulcers in diabetic patients is 4% to 10%, these ulcers may be infected, cause morbidity and may lead to lower extremity amputation.Objective: Prevention of diabetic foot ulcers in patients known to be diabetics by fasting blood sugar (FBS, HbA1C tests.Material and Methods: The study was done on 120 patients between March 2010 and July 2011 diagnosed as diabetics and they performed simple screening tests for peripheral neuropathy (Semmes-Weinstein monofilament examination (SWME, superficial pain, vibration testing by the on-off method, the timed method. Nerve conduction studies (NCS were used as standard criterion for detection of neuropathy, they also underwent Doppler ultrasound and ankle-brachial pressure index (ABPI measurement to assess the vascularity of their lower limbs. All patients were given proper education to prevent foot ulcers, including optimising glycemic control, cessation of smoking, debridement of calluses, appropriate foot wear and foot care with periodic foot examination.Results: In our study we succeeded in increasing the prevention of foot ulceration in our diabetic patients by 95%, compared to results achieved with the previous measures.Conclusion: Screening tests are effective for all diabetic patients to identify patients at risk of foot ulceration. They may benefit from prophylactic interventions including, optimising glycemic control, cessation of smoking, debridement of calluses, appropriate foot wear and intensive foot care.Also, we take care of patients with low risk of foot ulceration by adequate foot care and periodic foot examination to prevent foot ulceration.

  5. Retinal Capillary Rarefaction in Patients with Type 2 Diabetes Mellitus

    Science.gov (United States)

    Jumar, Agnes; Harazny, Joanna M.; Ott, Christian; Friedrich, Stefanie; Kistner, Iris; Striepe, Kristina

    2016-01-01

    Purpose In diabetes mellitus type 2, capillary rarefaction plays a pivotal role in the pathogenesis of end-organ damage. We investigated retinal capillary density in patients with early disease. Methods This cross-sectional study compares retinal capillary rarefaction determined by intercapillary distance (ICD) and capillary area (CapA), measured non-invasively and in vivo by scanning laser Doppler flowmetry, in 73 patients with type 2 diabetes, 55 healthy controls and 134 individuals with hypertension stage 1 or 2. Results In diabetic patients, ICD was greater (23.2±5.5 vs 20.2±4.2, p = 0.013) and CapA smaller (1592±595 vs 1821±652, p = 0.019) than in healthy controls after adjustment for differences in cardiovascular risk factors between the groups. Compared to hypertensive patients, diabetic individuals showed no difference in ICD (23.1±5.8, p = 0.781) and CapA (1556±649, p = 0.768). Conclusion In the early stage of diabetes type 2, patients showed capillary rarefaction compared to healthy individuals. PMID:27935938

  6. Is tetrahydrobiopterin a therapeutic option in diabetic hypertensive patients?

    Directory of Open Access Journals (Sweden)

    Alberto Francisco Rubio-Guerra

    2010-09-01

    Full Text Available Alberto Francisco Rubio-Guerra1, Hilda Vargas-Robles2, Luz Maria Ramos-Brizuela1, Bruno Alfonso Escalante-Acosta21Metabolic Clinic, Hospital General de Ticomán SS DF, Mexico; 2Department of Molecular Biomedicine, Centro de Investigacion y de Estudios Avanzados del IPN, MexicoAbstract: Nitric oxide (NO is an important regulator of vascular tone, and is also an antithrombotic, anti-inflammatory, antiproliferative, and antiatherogenic factor. Endothelial function is altered in patients with coronary artery disease, stroke, and peripheral artery disease, and endothelial dysfunction correlates with the risk factor profile for a patient. Hypertension and type 2 diabetes are risk factors for vascular disease, and are both pathologies characterized by loss of NO activity. Indeed, endothelial dysfunction is usually present in diabetic and/or hypertensive patients. Tetrahydrobiopterin is an essential cofactor for the NO synthase enzyme, and insufficiency of this cofactor leads to uncoupling of the enzyme, release of superoxide, endothelial dysfunction, progression of hypertension, and finally, proatherogenic effects. Tetrahydrobiopterin is also an important mediator of NO synthase regulation in type 2 diabetes and hypertension, and may be a rational therapeutic target to restore endothelial function and prevent vascular disease in these patients. The aim of this paper is to review the rationale for therapeutic strategies directed to biopterins as a target for vascular disease in type 2 diabetic hypertensive patients.Keywords: tetrahydrobiopterin, endothelial dysfunction, diabetes, hypertension, oxidative stress, nitric oxide, eNOS synthase uncoupling

  7. Effect of amiodarone therapy on mortality in patients with left ventricular dysfunction and asymptomatic complex ventricular arrhythmias: Argentine Pilot Study of Sudden Death and Amiodarone (EPAMSA).

    Science.gov (United States)

    Garguichevich, J J; Ramos, J L; Gambarte, A; Gentile, A; Hauad, S; Scapin, O; Sirena, J; Tibaldi, M; Toplikar, J

    1995-09-01

    The efficiency of prophylactic antiarrhythmic treatment with amiodarone in reducing 1-year mortality in patients with reduced left ventricular ejection fraction ( < 35%) and asymptomatic ventricular arrhythmias (Lown classes 2 and 4) was investigated in a prospective, multicenter, randomized, controlled study. Among 127 patients who entered the study, 61 were assigned to no antiarrhythmic therapy (control group [CG] and 66 to amiodarone treatment (amiodarone group [AG]). Amiodarone was administered at a dosage of 800 mg/day for 2 weeks followed by 400 mg/day thereafter. A 12-month follow-up was completed for 106 patients (57 in the AG and 49 in the CG). Amiodarone reduced the overall mortality rate, which was 10.5% in the AG versus 28.6% in the CG (odds ratio [OR] 0.29; 95% confidence interval [CI] 0.10 to 0.84; log-rank test 0.02) and sudden death rate, which was 7.0% in the AG versus 20.4% in the CG (OR 0.29; 95% CI 0.08 to 1.00; log-rank test 0.04). Side effects were rare, and in only three patients did amiodarone treatment have to be discontinued.

  8. Cost-effectiveness of telemonitoring of diabetic foot ulcer patients

    DEFF Research Database (Denmark)

    Fasterholdt, Iben; Gerstrøm, Marie; Rasmussen, Benjamin Schnack Brandt

    2017-01-01

    This study compared the cost-effectiveness of telemonitoring with standard monitoring for patients with diabetic foot ulcers. The economic evaluation was nested within a pragmatic randomised controlled trial. A total of 374 patients were randomised to either telemonitoring or standard monitoring...

  9. Neurohormonal profile of patients with heart failure and diabetes

    NARCIS (Netherlands)

    van der Horst, I. C. C.; de Boer, R. A.; Hillege, H. L.; Boomsma, F.; Voors, A. A.; van Veldhuisen, D. J.

    2010-01-01

    Background. Neurohormonal activation is generally recognised to play an important role in the pathophysiology, prognosis and treatment of chronic heart failure (HF). While the number of patients with diabetes increases, little if anything is known about neurohormonal activation in HF patients with d

  10. Plasma follistatin is elevated in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Hansen, J; Rinnov, Anders Rasmussen; Krogh-Madsen, Rikke

    2013-01-01

    Plasma follistatin is elevated in patients with low-grade inflammation and insulin resistance as observed with polycystic ovary syndrome. In the present study, we evaluated plasma follistatin in patients with type 2 diabetes characterised by low-grade inflammation and assessed the acute effects o...

  11. Plasma and Saliva Irisin Levels of Patients with Diabetic Nephropathy and Non-Diabetic Proteinuria

    Directory of Open Access Journals (Sweden)

    Ali GÜREL

    2015-12-01

    Full Text Available OBJECTIVE: Primary glomerular diseases or some systemic disorders such as diabetes (DM may cause proteinuria. Irisin (IRI is a hormone secreted as a response to physical exercise by the skeleton muscle and thought to be protective against many metabolic disorders such as DM, obesity. Decreased levels of irisin were observed in chronic kidney disease (CKD, type 2 DM and obesity. The aim of this study was to determine IRI levels in blood and saliva of proteinuric patients with and without diabetes. MATERIAL and METHODS: Sampling was from 15 diabetic, 15 non-diabetic proteinuria and 13 healthy control subjects. IRI concentrations were measured by using commercial ELISA kits. Statistical analysis was performed using SPSS 12. Groups were compared by the Kruskal-Wallis test and then Mann–Whitney post hoc test was performed. RESULTS: Plasma and saliva IRI levels of non- diabetic group were higher than the diabetic group. There was a significant positive correlation between plasma IRI concentrations and HDL, albumin levels but a negative correlation between plasma IRI and LDL levels. CONCLUSION: IRI levels were low both in plasma and saliva in diabetic subjects. IRI may be an important marker and/or therapeutic agent for disorders associated with energy expenditure and kidney diseases in the future.

  12. Navigating care for Bedouin patients with diabetes.

    Science.gov (United States)

    Dunton, Shauna; Higgins, Alison; Amkraut, Jonathan; Abu-Rabia, Yones

    2016-03-04

    The Bedouin Arab population in the southern Negev region of Israel has faced health problems as a result of transitioning rapidly from a nomadic agricultural lifestyle to a more modern urban lifestyle. Like many populations around the world, the Bedouins have changed their diets and become more sedentary and this has led to a high rate of diabetes. In this case report, we examine how diabetes has affected the life of an influential man in the Bedouin community and the significance this case has in the greater context of a global rise in chronic disease.

  13. Clinical features of asymptomatic pulmonary carcinoma: An analysis of 91 patients%91例无症状肺癌的临床特点分析

    Institute of Scientific and Technical Information of China (English)

    高俊珍; 李国华; 付秀华; 王立红; 徐长丽

    2012-01-01

    目的 分析无症状肺癌患者的临床特点,评价体检对肺癌早期诊断的临床意义,探讨早期诊断肺癌的策略.方法 对近6年在本院发现的91例无症状肺癌患者的临床资料进行回顾性分析.结果 无症状肺癌中男性好发,男女比例2∶1,平均年龄(56.63±0.67)岁,在老年与非老年中的分布相近;腺癌最多见,以周围型为主,好发于右肺上叶;主要确诊方法首先是手术,其次是支气管镜检查;非小细胞肺癌早期48例(60.0%)多于晚期的32例(40.0%);12例发生2个部位以上的转移.结论 无症状肺癌起病隐匿,被发现时并非完全是早期,应提倡定期体检和早期及时手术.%Objective To analyze the clinical features of patients with asymptomatic pulmonary carcinoma, evaluate the clinical significance of health check- up in early discovery of pulmonary carcinoma and investigate the way to discover the pulmonary carcinoma in its early stages. Methods The clinical data of 91 cases with asymptomatic pulmonary carcinoma in recent 6 years were retrospectively analyzed. Results The majority was men in asymptomatic lung'cancer, and male/female ratio was 2:1. Average age was (56.63±0.67) years. The distribution in the elderly and non -elderly was similar. Adenocarcinoma with peripheral type of lung cancer was most common. Furthermore, the diseased were mainly located in superior lobe of right lung. The major diagnosis method was surgery while the secondary method was bronchoscopy. There were 48 (60.0% ) non - small cell lung cancer patients in early stages and 32 (40.0%) in advanced stages. There was a significant difference between two groups. Twelve cases had more than two metastatic sites. Conclusion The outbreak of asymptomatic pulmonary carcinoma is insidious of its onset. It will not be in its early stage once it is confirmed. Accordingly, regular health check - up and timely surgical treatment should be recommended.

  14. Fluorescence lifetime imaging ophthalmoscopy in type 2 diabetic patients who have no signs of diabetic retinopathy

    Science.gov (United States)

    Schweitzer, Dietrich; Deutsch, Lydia; Klemm, Matthias; Jentsch, Susanne; Hammer, Martin; Peters, Sven; Haueisen, Jens; Müller, Ulrich A.; Dawczynski, Jens

    2015-06-01

    The time-resolved autofluorescence of the eye is used for the detection of metabolic alteration in diabetic patients who have no signs of diabetic retinopathy. One eye from 37 phakic and 11 pseudophakic patients with type 2 diabetes, and one eye from 25 phakic and 23 pseudophakic healthy subjects were included in the study. After a three-exponential fit of the decay of autofluorescence, histograms of lifetimes τi, amplitudes αi, and relative contributions Qi were statistically compared between corresponding groups in two spectral channels (490diabetic patients and age-matched controls (p450 ps, and the shift of τ3 from ˜3000 to 3700 ps in ch1 of diabetic patients when compared with healthy subjects indicate an increased production of free flavin adenine dinucleotide, accumulation of advanced glycation end products (AGE), and, probably, a change from free to protein-bound reduced nicotinamide adenine dinucleotide at the fundus. AGE also accumulated in the crystalline lens.

  15. A STUDY OF PATTERN OF DIABETIC RETINOPATHY AND ASSOCIATED RISK FACTORS IN DIABETIC PATIENTS : A HOSPITAL BASED STUDY

    Directory of Open Access Journals (Sweden)

    Manoj

    2015-11-01

    Full Text Available BACKGROUND: Diabetes mellitus has protean manifestations in an individual and affects virtually every organ of the body. Diabetic retinopathy remains a leading cause of vision loss and blindness in people of working age- group. The present study was a hospital- based study designed to study the pattern of diabetic retinopathy and associated risk factors in diabetic individuals. MATERIAL AND METHODS: Our study was a prospective, hospital- based study of 200 cases of diabetes mellitus attending the Eye OPD at R.D. Gardi Medical College, Ujjain. All patients suffering from diabetes, irrespective of the duration of the disease, were included in the study. Each patient was subjected to a comprehensive ocular examination and the results were recorded and analyzed in detail. RESULTS: Our study included 200 diabetic patients. Out of these 111 (55.5% were males and 89 (44.5% were females. 108 (54% patients were in the age group between 41- 60 years. 109 (54.5% patients in the study group had duration of diabetes > 5years. We found that 114 (28.5% eyes had mild non- proliferative diabetic retinopathy (NPDR, 36 (9% eyes had moderate non- proliferative diabetic retinopathy, and 14 (3.5% eyes showed proliferative diabetic retinopathy (PDR. 61 (30.5% patients had raised blood pressure in the study group which suggests hypertension as a significant risk factor for diabetic retinopathy. We found that 101 (50.5% patients in the study group had HbA1c levels > 8gm% and 55 (27.5% patients had dyslipidemia. 21 (10.5% patients had hemoglobin levels < 8gm%. The prevalence of blindness in our study group was found to be 10.3%. CONCLUSION: The results of our study show that pattern of diabetic retinopathy in an individual is directly associated with risk factors such as duration of diabetes, hypertension, poor glycemic control, dyslipidemia and anaemia.

  16. Improving long-term outcomes of coronary intervention in patients with diabetes

    Institute of Scientific and Technical Information of China (English)

    SHEN Wei-feng

    2009-01-01

    @@ In China, the prevalence of type 2 diabetes mellitus is increasing due to the aging of the population, increased frequency of obesity, and suboptimal nutritional habits1The current number of diabetic patients in China is around 40 million. Patients with diabetes even without prior cardiovascular disease have the same event rates as individuals without diabetes but with nrior myocardial infarction.2

  17. Vision related quality of life in patients with type 2 diabetes in the EUROCONDOR trial

    DEFF Research Database (Denmark)

    Trento, Marina; Durando, Olga; Lavecchia, Sonia;