ABSTRACT
OBJECTIVE: Waveform analysis has been used to assess vascular resistance and predict cardiovascular events. We aimed to identify microvascular abnormalities in patients with IGT using ocular waveform analysis. The effects of pioglitazone were also assessed. METHODS: Forty patients with IGT and 24 controls were studied. Doppler velocity recordings were obtained from the central retinal, ophthalmic, and common carotid arteries, and sampled at 200 Hz. A discrete wavelet-based analysis method was employed to quantify waveforms. The RI was also determined. Patients with IGT were randomized to pioglitazone or placebo, and measurements were repeated after 12-week treatment. RESULTS: In the ocular waveforms, significant differences in power spectra were observed in frequency band 4 (corresponding to frequencies between 6.25 and 12.50 Hz) between groups (p < 0.05). No differences in RI occurred. No association was observed between waveform parameters and fasting glucose or insulin resistance. Pioglitazone had no effect on waveform structure, despite significantly reducing insulin resistance, fasting glucose, and triglycerides (p < 0.05). CONCLUSIONS: Analysis of ocular Doppler flow waveforms using the discrete wavelet transform identified microvascular abnormalities that were not apparent using RI. Pioglitazone improved glucose, insulin sensitivity, and triglycerides without influencing the contour of the waveforms.
Subject(s)
Eye , Hypoglycemic Agents/administration & dosage , Insulin Resistance , Microcirculation/drug effects , Microvessels/abnormalities , Microvessels/physiopathology , Thiazolidinediones/administration & dosage , Adult , Aged , Blood Glucose/metabolism , Eye/blood supply , Eye/physiopathology , Fasting , Female , Humans , Male , Middle Aged , PioglitazoneSubject(s)
Antibodies, Monoclonal, Humanized/adverse effects , Antirheumatic Agents/adverse effects , Arthritis, Rheumatoid/drug therapy , Immunoglobulin Fab Fragments/adverse effects , Immunosuppressive Agents/adverse effects , Lung Diseases, Interstitial/chemically induced , Polyethylene Glycols/adverse effects , Female , HumansABSTRACT
We describe a 21-year-old woman with chronic diffuse sclerosing osteomyelitis (CDSO) of the left femur. The patient presented with shortening of the left leg and intractable pain that was unrelieved with conventional analgesia. Radiological imaging and open bone biopsy confirmed the diagnosis of chronic diffuse sclerosing osteomyelitis. Treatment with risedronate was commenced and a dramatic response in the patient's symptoms and biochemical markers of bone turnover was observed. To our knowledge this is the first case of CDSO treated successfully with risedronate.