Impact of diabetes mellitus on functional exercise capacity and pulmonary functions in patients with diabetes and healthy persons.

BACKGROUND: Chronic diabetic complications may afflict all organ tissues, including those of the respiratory system. The six-minute walk test (6MWT) is an alternative and widely used method of assessing functional capacity and is simple to perform. However, to our knowledge, the impact of diabetes mellitus on 6MWT performance has not been investigated previously. This research aimed to compare the functional exercise capacity and pulmonary functions in patients with diabetes and in healthy persons. METHODS: The study included 131 participants: 64 patients with type 1 and 2 diabetes mellitus (DM) and 67 healthy participants (CG). All of the participants were nonsmoking and did not have pulmonary disorders that affected the pulmonary function tests or 6MWT. Metabolic parameters and biochemical markers of inflammation were assessed. Full lung function tests and a 6MWT were performed. RESULTS: In the DM group, the walking distance was 109 m shorter than that in the CG (P < 0.001). Moreover, compared to the CG, the DM group showed lower values of forced expiratory volume in one second (FEV1 (l) 3.6 vs. 2.8, P < 0.001) and total lung capacity (TLC (l) 6.6 vs. 5.6, P < 0.001), as well as a decrease in diffusion capacity (DLCO (mmol/min/kPa), 10.0 vs. 8.6, P < 0.001). CONCLUSIONS: The 6MWT is a valuable test that complements the assessment of daily physical capacity in patients with diabetes, irrespective of type. Pulmonary function and the capacity for physical exertion varied between patients with diabetes mellitus and the healthy participants in the CG.

Pulmonary capillary permeability and pulmonary microangiopathy in diabetes mellitus.

Significant increase in permeability surface (PS) in patients with diabetes confirms pulmonary microcirculation damage in these patients.

Orthodontic characteristics of maxillary arch deficiency in 5-year-old patients undergoing unilateral cleft lip and palate repair with and without early gingivoplasty.

The purpose of this study was to compare the maxillary arch morphology in 5-year-old children treated for unilateral cleft lip and palate (UCLP) with early gingivoplasty (EGP) and without this procedure (non-EGP). Three-dimensional (3-D) imaging was used to verify which measurements and to what degree specific orthodontic parameters differ in both groups. The study included 120 non-syndromic 4.5-5.5-year-old children treated surgically at the age of 6-18 months. Fifty-six children underwent EGP utilising a Skoog-type of technique. The (non-EGP) group consisted of 64 patients. Patients in both groups were treated without nasoalveolar moulding prior to cleft lip repair. The maxillary arch models were obtained and subjected to the 3-D computer-aided imaging procedure and metric analysis. Ten selected orthodontic measurements were calculated based on imaging landmarks. The computed data derived from models in both (EGP and non-EGP) groups were compared. The differences between groups were statistically analysed using Student's test. Five orthodontic measurements: the angle of the lesser segment inclination, dental arch radius of this segment, anterior palatal depth, palatal surface and length of dental arch demonstrate more severe maxillary underdevelopment in patients with previous EGP. The results reaffirm the negative impact of EGP with wide undermining of periosteal flaps on maxillary development and suggest that these five parameters may be the most sensitive early indicators of growth alteration.

[Accuracy of spirometry performed by general practitioners and pulmonologists in Pomeranian Region in the "Prevention of COPD" NHS program]. / Ocena poprawnosci wykonania badania spirometrycznego przez lekarzy podstawowej opieki zdrowotnej oraz pneumonologów w ramach ogólnopolskiego programu Narodowego Funduszu Zdrowia: "Profilaktyka POChP".

INTRODUCTION: Spirometry is the key test in diagnosing and severity assessment of chronic obstructive pulmonary disease (COPD). Despite the simplicity of the test, the discrepancy between results obtained by general practitioners and specialists is noted, what may lead to under- or overestimating of COPD prevalence. The aim of the study was to evaluate the quality of spirometry testing and interpretation performed by general practitioners and pulmonologists. MATERIAL AND METHODS: Physicians from 56 healthcare units in the region of Pomerania were included. The participants (both GPs and pulmonologists) were trained in methodology and interpretation of spirometry tests. Then they were asked to choose 10 spirograms and send them for evaluation. Presence of patients' personal details and signature of staff member, contents of graphs and tables, accuracy of the test and correctness of interpretation were evaluated. In statistical analysis c-square test was used. RESULTS: The response from 14 healthcare units was received including 142 spirograms from GPs and 80 from pulmonologists. All spirograms contained personal details, gender, age, body weight and height as well as results of spirometry in form of tables and diagrams with predicted and measured values. Pulmonologists signed the spirograms more often than GPs (91% v. 77%, p<0.001) and more often presented results of properly performed tests (75% v. 45%, p<0.0001). However, in their group there were more interpretation errors (73% v. 91%, p<0.05). Methodological mistakes revealed during the study were usually: too short and not enough dynamic inspiration and expiration. In some cases spirograms with expiration lasting 1.3 sec were considered normal. The most common interpretation mistakes included: diagnosis of mixed-type ventilatory defects, wrong classification of obstruction level and lack of interpretation. In two cases result was found to be normal despite the lack of forced expiratory volume in one second value. CONCLUSION: The results indicate the necessity of continuous training in spirometry testing and interpretation by both general practitioners and specialists and nurses.