RESUMO
The aim of this narrative non-systematic review was to investigate the potential interplay among frailty syndrome, sarcopenia and diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM) patients. Data derived from a limited number of studies underline that DKD is a significant risk factor for frailty. On the other hand, frailty syndrome poses a higher risk for end-stage renal disease (ESRD) in subjects with DKD. In addition, frailty seems to affect the cognitive function and social life of DKD individuals, whilst as DKD deteriorates, there is a higher prevalence of sarcopenia which is a fundamental frailty factor. As a result, it is shown that a bidirectional relation is established between these entities, as diabetes mellitus (DM) affects the components of frailty and sarcopenia and vice versa. This vicious cycle is created through multiple pathophysiologic mechanisms, including the anabolic role of insulin, low-grade inflammation, cytokines and endothelial function, prompting further investigation in this area. Specific nutritional and exercise interventions are imperative to be established in order to ameliorate potential adverse outcomes, concerning these entities.
Assuntos
Diabetes Mellitus Tipo 2 , Nefropatias Diabéticas , Fragilidade , Sarcopenia , Humanos , Idoso , Nefropatias Diabéticas/terapia , Diabetes Mellitus Tipo 2/complicações , Fragilidade/complicações , Idoso Fragilizado , Sarcopenia/etiologiaAssuntos
Valva Aórtica/cirurgia , Terapia Combinada/métodos , Doenças das Valvas Cardíacas/cirurgia , Próteses Valvulares Cardíacas/efeitos adversos , Trombose/diagnóstico por imagem , Acenocumarol/administração & dosagem , Acenocumarol/uso terapêutico , Adulto , Assistência ao Convalescente , Anticoagulantes/uso terapêutico , Valva Aórtica/patologia , Aspirina/administração & dosagem , Aspirina/uso terapêutico , Ecocardiografia/métodos , Ecocardiografia Transesofagiana/métodos , Enoxaparina/administração & dosagem , Enoxaparina/uso terapêutico , Fibrinolíticos/uso terapêutico , Doenças das Valvas Cardíacas/complicações , Doenças das Valvas Cardíacas/patologia , Heparina de Baixo Peso Molecular/administração & dosagem , Heparina de Baixo Peso Molecular/uso terapêutico , Humanos , Injeções Subcutâneas , Masculino , Trombose/tratamento farmacológico , Trombose/patologia , Resultado do TratamentoRESUMO
Kounis syndrome is the concurrence of coronary spasm, acute myocardial infarction or stent thrombosis, with allergic reactions in the setting of mast-cell and platelet activation. In this report Kounis syndrome manifesting as stent thrombosis with left ventricular thrombus formation was triggered by a food-induced allergic reaction. The allergic reaction to food was confirmed by oral rice pudding ingredients challenge test while skin tests were inconclusive. To our knowledge, this is first report of early stent thrombosis secondary to food allergic reaction in a 70-year-old man patient who was found to have left ventricular thrombus and undiagnosed hypertrophic cardiomyopathy.