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1.
Texto & contexto enferm ; 29: e20180105, Jan.-Dec. 2020. tab
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1094551

RESUMEN

ABSTRACT Objective: to investigate the association between resilience and self-care in people with diabetes mellitus treated in Primary Health Care. Method: Cross-sectional study, sample consisting of 362 people, aged 18 years or older, diagnosed with diabetes for at least one year. Descriptive analyzes and comparison of means were performed, assuming statistical significance with a value of p <0.05. The Resilience Scale and Questionnaire on Diabetes Self-Care Activities were applied, containing six dimensions: general food, specific food, physical activity, blood glucose monitoring, foot care, medication use, plus three items on smoking. Data collection took place between December and May 2016, in ten Health Centers in a city in the south of the country. Results: among the 15 self-care activities, four showed a statistically significant association when compared to the average resilience, highlighting: healthy eating and professional guidance, desirable sweet consumption, blood sugar assessment as recommended. Conclusion: the results obtained highlight the relationship between high averages of resilience and adequate performance in the care of diabetes mellitus.


RESUMEN Objetivo: investigar la asociación entre resiliencia y autocuidado en personas con diabetes mellitus tratadas en Atención Primaria de Salud. Método: estudio transversal, muestra compuesta por 362 personas, mayores de 18 años, diagnosticadas con diabetes durante al menos un año. Se realizaron análisis descriptivos y comparación de promedios, asumiendo significación estadística con un valor de p <0,05. Se aplicó la Escala de Resiliencia y el Cuestionario sobre las actividades de autocuidado de la diabetes, que contiene seis dimensiones: alimentación general, alimentación específica, actividad física, monitoreo de glucosa en sangre, cuidado de los pies, uso de medicamentos, más tres artículos sobre fumar. La recopilación de datos tuvo lugar entre diciembre y mayo de 2016, en diez centros de salud en una capital en el sur del país. Resultados: de las 15 actividades de autocuidado, cuatro han mostrado una asociación estadísticamente significativa en comparación con el promedio de resiliencia, destacando:alimentación saludable y orientación profesional, consumo de dulces, evaluación de azúcar en la sangre según lo recomendado. Conclusión: los resultados obtenidos apuntan a la relación entre altos promedios de resiliencia y desempeño adecuado en el cuidado de la diabetes mellitus.


RESUMO Objetivo: investigar a associação entre resiliência e autocuidado em pessoas com diabetes mellitus atendidas na Atenção Primária à Saúde. Método: Estudo transversal, amostra composta por 362 pessoas, com idade igual ou superior a 18 anos, com diagnóstico de diabetes há pelo menos um ano. Foram realizadas análises descritivas e de comparação de médias, assumindo significância estatística com valor de p <0,05. Aplicou-se Escala de Resiliência e Questionário de Atividades de Autocuidado com Diabetes, contendo seis dimensões: alimentação geral, alimentação específica, atividade física, monitorização da glicemia, cuidados com pés, uso de medicamento, acrescidos de três itens sobre tabagismo. A coleta de dados ocorreu entre dezembro a maio de 2016, em dez Centros de Saúde de uma capital do sul do país. Resultados: das 15 atividades de autocuidado, quatro apresentaram associação estatisticamente significativa quando comparadas à média de resiliência, destacando-se: alimentação saudável e orientação profissional, consumo de doces desejável, avaliação do açúcar no sangue conforme recomendado. Conclusão: os resultados obtidos apontam a relação entre médias altas de resiliência e o desempenho adequado nos cuidados do diabetes mellitus.


Asunto(s)
Humanos , Adulto , Atención Primaria de Salud , Autocuidado , Enfermería , Diabetes Mellitus , Resiliencia Psicológica
2.
Texto & contexto enferm ; 29: e20180508, Jan.-Dec. 2020. tab
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1094548

RESUMEN

ABSTRACT Objective: to evaluate sensorimotor alterations in the extremities of the lower limbs and associated factors in Diabetes Mellitus patients. Method: this was a cross-sectional and analytical study, conducted in a Basic Health Unit, in Teresina (Brazil) with a sample of 102 participants between April and July 2018, by means of a semi-structured form. For the statistical analyses, the Pearson's chi-square and Fisher's exact tests were performed. Results: among the study participants, 99 (97.1%) presented alterations, 73 (71.6%) on the skin and 40 (39.2%) on nails. The sensorimotor examination identified 40 (39.22%) individuals with tactile sensitivity alterations and 13 (12.7%) with reduced vibratory sensitivity, using the 128 Hz tuning fork. The factors associated with sensorimotor alterations detected by the 10 gram monofilament were the following: time of disease over ten years; absence of periodic foot evaluation (p=0.003); impaired visual acuity (p=0.001); presence of pain or discomfort (p=0.003); pain worsening at night (p=0.008); moderate pain intensity (p=0.012) and relief at rest (p=0.015). Conclusion: sensory alterations in the lower limbs showed their relationship with some of the research variables, such as time of disease, foot evaluation, glycemic value, presence of pain or discomfort (worsening and relief shifts, and intensity), skin coloring and vibratory sensitivity evaluation with a tuning fork.


RESUMEN Objetivo: evaluar las alteraciones sensoriomotoras de las extremidades de los miembros inferiores y los factores asociados en pacientes con diabetes mellitus. Método: estudio transversal y analítico realizado en una Unidad Básica de Salud, en Teresina (Brasil) con una muestra de 102 participantes, entre los meses de abril y julio de 2018 por medio de un formulario semiestructurado. Para los análisis estadísticos se efectuaron las pruebas de chi-cuadrado de Pearson y exacta de Fisher. Resultados: de los participantes del estudio, 99 (97,1%) presentaron alteraciones: 73 (71,6%) en la piel y 40 (39,2%) en las uñas. Al realizarse el examen sensoriomotor se identificaron 40 (39,22%) personas con alteraciones de sensibilidad táctil y 13 (12,7%), con sensibilidad vibratoria reducida, utilizando un diapasón de 128 Hz. Los factores asociados a las alteraciones sensoriomotoras detectadas por el monofilamento de 10 gramos fueron las siguientes: tiempo de la enfermedad superior a diez años, ausencia de una evaluación periódica de los pies (P=0,003), agudeza visual afectada (p=0,001), presencia de dolor o malestar (p=0,003); empeoramiento del dolor durante la noche (p=0,008), intensidad de dolor moderada (p=0,012) y alivio del dolor en reposo (p=0,015). Conclusión: las alteraciones sensoriales en los miembros inferiores demostraron su relación con algunas de las variables de la investigación, como el tiempo de la enfermedad, la evaluación de los pies, el valor glicémico, la presencia de dolor o malestar (turnos de empeoramiento y mejora del dolor, e intensidad del dolor), coloración de la piel y la evaluación de la sensibilidad vibratoria con un diapasón.


RESUMO Objetivo: avaliar as alterações sensório-motoras das extremidades dos membros inferiores e fatores associados em pacientes com diabetes mellitus. Método: estudo transversal e analítico, realizado em uma Unidade Básica de Saúde, em Teresina (Brasil) com amostra de 102 participantes, entre os meses de abril a julho de 2018, por meio de formulário semiestruturado. Para as análises estatísticas, realizaram-se os testes qui-quadrado de Pearson e o exato de Fisher. Resultados: dentre os participantes do estudo, 99 (97,1%) apresentaram alterações, sendo 73 (71,6%) na pele e 40 (39,2%) em unhas. A realização do exame sensório-motor identificou 40 (39,22%) pessoas com alterações de sensibilidade tátil e 13 (12,7%), com sensibilidade vibratória reduzida, utilizando o diapasão 128 Hz. Os fatores associados às alterações sensório-motoras detectadas pelo monofilamento de 10 gramas foram: tempo de doença acima de dez anos; ausência de avaliação dos pés periodicamente (0,003); acuidade visual prejudicada (p=0,001); presença de dor ou desconforto (p=0,003); piora da dor no período noturno (p=0,008); intensidade da dor moderada (p=0,012) e aliviada ao repouso (p=0,015). Conclusão: as alterações sensoriais nos membros inferiores demonstraram sua relação com algumas das variáveis da pesquisa, como o tempo de doença, a avaliação dos pés, valor glicêmico, presença de dor ou desconforto (turno de piora, alívio e intensidade da mesma), coloração da pele e da avaliação de sensibilidade vibratória com diapasão.


Asunto(s)
Humanos , Adulto , Atención Primaria de Salud , Enfermería Primaria , Pie Diabético , Diabetes Mellitus , Neuropatías Diabéticas
3.
Recurso de Internet en Inglés, Español, Portugués | LIS - Localizador de Información en Salud | ID: lis-47967

RESUMEN

Às vésperas do Dia Mundial da Diabetes, em 14 de novembro, a Organização Pan-Americana da Saúde (OPAS) pede um melhor controle da doença para prevenir tanto suas complicações e quanto aquelas associadas à infecção por COVID-19. O organismos internacional também pede que pessoas que vivem com diabetes continuem tendo acesso a serviços de atenção primária à saúde e tratamento em meio à pandemia de COVID-19.


Asunto(s)
Infecciones por Coronavirus , Diabetes Mellitus , Control/prevención & control
4.
Kardiologiia ; 60(9): 110-121, 2020 Oct 14.
Artículo en Ruso | MEDLINE | ID: mdl-33131482

RESUMEN

Cardiovascular (CVD) and oncological diseases (OD) are the main causes of death worldwide and account for a heavy burden on economy, disability and mortality in many countries. Clear understanding of the mechanisms shared by CVD and cancer is important for increasing the life span and quality of life in cancer survivors as well as for preventing comorbidities and correct instructing the patients about risk factors and lifestyle modifications. Both groups of diseases share risk factors, including smoking, obesity, diabetes mellitus, alcohol consumption, unhealthy diet, etc. Along with these factors, inflammation may play a key role as it promotes both types of diseases and accompanies obesity, diabetes mellitus, arterial hypertension, and dyslipidemia. Better understanding of the interaction between CVD and cancer will allow creating common effective diagnostic and preventive strategies and safe approaches to the treatment.


Asunto(s)
Enfermedades Cardiovasculares , Diabetes Mellitus , Hipertensión , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Humanos , Calidad de Vida , Factores de Riesgo
5.
Kardiologiia ; 60(9): 30-37, 2020 Oct 14.
Artículo en Ruso | MEDLINE | ID: mdl-33131472

RESUMEN

Aim        To analyze results of changing the management tactics in patients with acute coronary syndrome (ACS) in clinical practice from 2004 through 2018 expressed as improvement in prognosis.Material and methods        Results of two observational studies were analyzed: ORACLE I (2004-2007), which included 1193 patients with ACS (mean age, 61.1±11.69 years; men, 63.3 %) and ORACLE II (2014-2017), which included 1652 patients from 4 vascular centers (mean age, 64.61±12.67 years; men, 62.3 %).Results   Patients included into the ORACLE II study in 2014 were significantly older and the proportion of patients with diabetes mellitus was greater than in the ORACLE I study (14.7 and 22.6 %, respectively). After matching the groups by major clinical characteristics, it was found that introducing the invasive management tactics for ACS patients was associated with a reduced rate of all-cause death (from 8.2 to 6.1 % for one year), a tendency towards decreased number of coronary death cases (from 5.6 to 4.0 %), and a decrease in risk of recurrent coronary complications (from 17.4  to 7.7 %).Conclusion            Implementing the vascular program statistically significantly decreased the total death rate for at least one-year observation in comparable patient groups.


Asunto(s)
Síndrome Coronario Agudo , Diabetes Mellitus , Síndrome Coronario Agudo/terapia , Anciano , Complicaciones de la Diabetes , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Factores de Riesgo
6.
Washington; D.C.; OPS; 2020-11-16. (OPS/PHE/HEO/20-0044).
No convencional | PAHO-IRIS | ID: phr-53028

RESUMEN

La finalidad de este documento de información es presentar información actualizada sobre la respuesta que ha brindado la Oficina Sanitaria Panamericana (la Oficina) desde noviembre del 2016 hasta julio del 2020 a fin de mantener una agenda eficaz de cooperación técnica en la República Bolivariana de Venezuela y en los Estados Miembros vecinos.


Asunto(s)
Infecciones por Coronavirus , Coronavirus , Infecciones por Coronavirus , Transmisión de Enfermedad Infecciosa , Pandemias , Enfermedades Transmisibles , Enfermedades no Transmisibles , Enfermedad Crónica , Salud Mental , Factores de Riesgo , Acceso a Medicamentos Esenciales y Tecnologías Sanitarias , Cooperación Técnica , Hipertensión , Diabetes Mellitus , Creación de Capacidad , Urgencias Médicas , Venezuela
7.
Washington, D.F.; OPS; 2020-11-10. (OPS-W/NMH/NV/20-0043).
en Español | PAHO-IRIS | ID: phr-53007

RESUMEN

El presente módulo sobre diagnóstico y manejo de la diabetes de tipo 2 se basa en la orientación de la Organización Mundial de la Salud (OMS) relativa al diagnóstico, la clasificación y el tratamiento de la diabetes. Está en consonancia con el conjunto de intervenciones esenciales contra las enfermedades no transmisibles definido por la OMS, y puede usarse de manera independiente o en conjunto con el paquete técnico HEARTS elaborado para mejorar la salud cardiovascular. Los destinatarios pueden variar en función del contexto, los sistemas de salud existentes y las prioridades nacionales.


Asunto(s)
Diabetes Mellitus Tipo 2 , Diabetes Mellitus , Enfermedades no Transmisibles , Epidemiología , Factores de Riesgo , Glucemia
8.
Washington, D.C.; OPS; 2020-11-02. (PAHO/PHE/HEO/20-0044).
No convencional en Inglés | PAHO-IRIS | ID: phr-52969

RESUMEN

This information document provides an update on the Pan American Sanitary Bureau’s response to maintaining an effective technical cooperation agenda in the Bolivarian Republic of Venezuela and neighboring Member States, from November 2016 to July 2020. The Bolivarian Republic of Venezuela has been facing a sociopolitical and economic situation that has negatively impacted social and health indicators. There have been intensified population movements both within the country and to other countries, particularly to Argentina, Brazil, Chile, Colombia, Costa Rica, Curaçao, Dominican Republic, Ecuador, Guyana, Mexico, Panama, Paraguay, Peru, Trinidad and Tobago, and Uruguay. Since 2017, an estimated 5.2 million Venezuelans have migrated to other countries, including an estimated 4.3 million who have gone to countries in Latin America and the Caribbean.


Asunto(s)
Infecciones por Coronavirus , Coronavirus , Transmisión de Enfermedad Infecciosa , Pandemias , Enfermedades no Transmisibles , Enfermedad Crónica , Salud Mental , Factores de Riesgo , Acceso a Medicamentos Esenciales y Tecnologías Sanitarias , Cooperación Técnica , Hipertensión , Diabetes Mellitus , Creación de Capacidad , Urgencias Médicas , Venezuela
9.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(11): 1283-1288, 2020 Nov 06.
Artículo en Chino | MEDLINE | ID: mdl-33147930

RESUMEN

Objective: To investigate the comprehensive control situation and related factors of diabetes mellitus. Methods: From August to December of 2017, 13 259 residents aged 18 to 79 years old were randomly selected as the subjects by stratified multi-stage cluster sampling method. Questionnaire, physical examination and laboratory tests were conducted. The effective sample size was 13 240. A total of 1 592 diabetes patients were found. In this study, 917 diabetes patients who had been diagnosed before the investigation were selected as subjects. The comprehensive control of diabetes patients was analyzed. The situation of diabetes patients with hypertension, dyslipidemia, overweight and obesity, coronary heart diseases was analyzed. Logistic regression analysis of complex sampling was used to analyze the related factors of diabetes comprehensive control. Results: The average age of 917 patients with diabetes was (58.5±0.7) years old. The proportion of people who participated in diabetes follow-up management was 29.0%. There were 89.5% diabetes patients with one or more chronic diseases. The comprehensive control rate of diabetes mellitus was 2.0%, men and women were 1.8% and 2.3%, respectively (P>0.05). The rate of comprehensive control among those diabetes patients with chronic diseases was 0.4%, lower than that of those without chronic diseases (15.6%, P<0.05). The comprehensive control rate of people who participated in diabetes follow-up management was 1.4%. The control rate of blood glucose, blood pressure, blood lipid and weight of diabetes mellitus was 30.9%, 30.2%, 17.4% and 27.7%, respectively. Logistic regression analysis of complex sampling showed that excessive intake of red meat, with chronic diseases and qualified core knowledge were all related with comprehensive control of diabetes mellitus, OR value was 31.41, 39.98 and 0.29, P<0.05. Conclusion: The comprehensive control rate of diabetes mellitus was low. Excessive intake of red meat, with chronic diseases and qualified core knowledge were all related with comprehensive control of diabetes mellitus.


Asunto(s)
Diabetes Mellitus , Dislipidemias , Hipertensión , Adolescente , Adulto , Anciano , Beijing , China , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Adulto Joven
10.
Clin Sci (Lond) ; 134(21): 2791-2805, 2020 11 13.
Artículo en Inglés | MEDLINE | ID: mdl-33135725

RESUMEN

Angiotensin-converting enzyme II (ACE2) is a homologue of angiotensin-converting enzyme discovered in 2000. From the initial discovery, it was recognized that the kidneys were organs very rich on ACE2. Subsequent studies demonstrated the precise localization of ACE2 within the kidney and the importance of this enzyme in the metabolism of Angiotensin II and the formation of Angiotensin 1-7. With the recognition early in 2020 of ACE2 being the main receptor of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2), the interest in this protein has dramatically increased. In this review, we will focus on kidney ACE2; its localization, its alterations in hypertension, diabetes, the effect of ACE inhibitors and angiotensin type 1 receptor blockers (ARBs) on ACE2 and the potential use of ACE2 recombinant proteins therapeutically for kidney disease. We also describe the emerging kidney manifestations of COVID-19, namely the frequent development of acute kidney injury. The possibility that binding of SARS-CoV-2 to kidney ACE2 plays a role in the kidney manifestations is also briefly discussed.


Asunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus/enzimología , Enfermedades Renales/enzimología , Riñón/enzimología , Peptidil-Dipeptidasa A/metabolismo , Neumonía Viral/enzimología , Receptores Virales/metabolismo , Lesión Renal Aguda/enzimología , Lesión Renal Aguda/virología , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Animales , Antivirales/uso terapéutico , Betacoronavirus/efectos de los fármacos , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/virología , Diabetes Mellitus/enzimología , Diabetes Mellitus/fisiopatología , Historia del Siglo XXI , Interacciones Huésped-Patógeno , Humanos , Hipertensión/enzimología , Hipertensión/fisiopatología , Riñón/fisiopatología , Enfermedades Renales/tratamiento farmacológico , Enfermedades Renales/fisiopatología , Pandemias , Peptidil-Dipeptidasa A/historia , Peptidil-Dipeptidasa A/uso terapéutico , Neumonía Viral/virología , Receptores Virales/historia
11.
Kardiologiia ; 60(7): 108-114, 2020 Aug 11.
Artículo en Ruso | MEDLINE | ID: mdl-33155949

RESUMEN

Atrial fibrillation is one of the most common concomitant diseases in patients with diabetes mellitus (DM). Meta-analyses of multiple studies have shown that the risk of AF is higher for diabetic patients with impaired glucose homeostasis than for patients without DM. Patients with AF and DM were younger, more frequently had arterial hypertension, chronic kidney disease, heart failure, and ischemic heart disease, and stroke and were characterized with a more severe course of AF. The article discusses possible mechanisms of the mutually aggravating effects of DM and AF, scales for evaluating the risk of bleeding (CHADS2, CHA2DS2­VASc, HAS-BLED), and the role of anticoagulants. A meta-analysis of 16 randomized clinical studies, including 9 874 patients, has demonstrated the efficacy of oral anticoagulants in prevention of stroke with an overall decrease in the relative risk by 62 % compared to placebo (95% confidence interval, from 48 to 72 ). For prevention of complications in patients with AF and DM, current antithrombotic therapies can be used, specifically the oral factor Xa inhibitor, rivaroxaban, which is the best studied in patients with AF and DM and represents a possible alternative to warfarin in such patients.


Asunto(s)
Fibrilación Atrial , Diabetes Mellitus , Accidente Cerebrovascular , Administración Oral , Anticoagulantes/uso terapéutico , Fibrilación Atrial/complicaciones , Fibrilación Atrial/tratamiento farmacológico , Fibrilación Atrial/epidemiología , Diabetes Mellitus/tratamiento farmacológico , Humanos , Factores de Riesgo , Rivaroxabán/uso terapéutico , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/etiología , Accidente Cerebrovascular/prevención & control , Warfarina/uso terapéutico
12.
Zhongguo Zhong Yao Za Zhi ; 45(19): 4677-4685, 2020 Oct.
Artículo en Chino | MEDLINE | ID: mdl-33164432

RESUMEN

To evaluate the quality differences of four mainstream species of Berberidis Cortex,~1H-NMR metabolomics was applied to detect its primary and secondary metabolites, and the partial least squares discriminant analysis and analysis of variance were integrated to screen differential metabolites between species. Furthermore, diabetic rat model was established by high fat diet and streptozotocin to assess differences in antidiabetic activities among the four species. Sixteen compounds were simultaneously detected and identified, including alkaloids, organic acids, carbohydrates and amino acids. Interspecific difference markers were revealed as magnoflorine, jateorhi-zine, bufotenidine and saccharose for the first time. Berberis vernae and B. kansuensis presented superior activities on reducing blood glucose level, improving insulin resistance, increasing insulin sensibility and anti-inflammation. B. dictyophylla showed moderate antidiabe-tic effect, while B. diaphana rendered inferior antidiabetic capacity. Based on the contents of four differential markers and the results of antidiabetic activity evaluation, the quality of four Berberidis Cortex species was ranked as B.vernae≈B.kansuensis>B. dictyophylla>B. diaphana. These results provided references for species collation, quality standard establishment and exploitation of Berberidis Cortex. The antidiabetic activities of B. vernae and B. kansuensis as well as their mechanisms of action merit further study in the future.


Asunto(s)
Berberis , Diabetes Mellitus , Animales , Hipoglucemiantes/farmacología , Metabolómica , Espectroscopía de Protones por Resonancia Magnética , Ratas
13.
J Assoc Physicians India ; 68(11): 46-50, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33187037

RESUMEN

Diabetes Mellitus (DM) is a global heath burden and the leading cause for cardiovascular (CV) disease. The differential presentation of CV disease in DM is related to the metabolic derangements leading to deterioration of myocardial cell function and its serious consequences. Therefore, there is a need for early and effective treatment intervention for this myocardial cell metabolic dysfunction. DM and myocardial ischemia (MI) share a common metabolic dysregulation mediated via increased fatty acid oxidation that makes the diabetic heart susceptible to myocardial ischemia and reduced myocardial performance during ischemia compared to non-diabetic heart. Modulation of myocardial free fatty acid metabolism should be the key target for metabolic interventions in patients with Diabetic CV complications. Trimetazidine, a fatty acid metabolic modulator, has shown to improve CV outcomes in diabetes. The present review summarizes the clinical evidence and relevance of trimetazidine as an anti-anginal and antiischemic agent in patients with DM. Evidence suggested that trimetazidine could significantly improve clinical outcomes in patients with angina or heart failure and diabetes. Administering trimetazidine in patients with diabetes undergoing re-vascularization could also provide significant clinical benefits. Current clinical practice guidelines also recommend trimetazidine as a first-line agent for selected patients or as a second-line treatment option for angina patients.


Asunto(s)
Enfermedad de la Arteria Coronaria , Diabetes Mellitus , Isquemia Miocárdica , Trimetazidina , Diabetes Mellitus/tratamiento farmacológico , Humanos , Isquemia Miocárdica/tratamiento farmacológico , Trimetazidina/uso terapéutico , Vasodilatadores/uso terapéutico
14.
MMWR Morb Mortal Wkly Rep ; 69(45): 1665-1670, 2020 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-33180755

RESUMEN

Diabetes increases the risk for developing cardiovascular, neurologic, kidney, eye, and other complications. Diabetes and related complications also pose a huge economic cost to society: in 2017, the estimated total economic cost of diagnosed diabetes was $327 billion in the United States (1). Diabetes complications can be prevented or delayed through the management of blood glucose (measured by hemoglobin A1C), blood pressure (BP), and non-high-density lipoprotein cholesterol (non-HDL-C) levels, and by avoiding smoking; these are collectively known as the ABCS goals (hemoglobin A1C, Blood pressure, Cholesterol, Smoking) (2-5). Assessments of achieving ABCS goals among adults with diabetes are available at the national level (4,6); however, studies that assess state-level prevalence of meeting ABCS goals have been lacking. This report provides imputed state-level proportions of adults with self-reported diabetes meeting ABCS goals in each of the 50 U.S. states and the District of Columbia (DC). State-level estimates were created by raking and multiple imputation methods (7,8) using data from the 2009-2018 National Health and Nutrition Examination Survey (NHANES), 2017-2018 American Community Survey (ACS), and 2017-2018 Behavioral Risk Factor Surveillance System (BRFSS). Among U.S. adults with diabetes, an estimated 26.4% met combined ABCS goals, and 75.4%, 70.4%, 55.8%, and 86.0% met A1C <8%, BP <140/90 mmHg, non-HDL-C <130 mg/dL and nonsmoking goals, respectively. Public health departments could use these data in their planning efforts to achieve ABCS goal levels and reduce diabetes-related complications at the state level.


Asunto(s)
Complicaciones de la Diabetes/epidemiología , Complicaciones de la Diabetes/prevención & control , Diabetes Mellitus/epidemiología , Adulto , Femenino , Objetivos , Humanos , Masculino , Prevalencia , Autoinforme , Estados Unidos/epidemiología
15.
Front Endocrinol (Lausanne) ; 11: 582936, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33133024

RESUMEN

Covid-19 is a recently-emerged infectious disease caused by the novel severe acute respiratory syndrome coronavirus SARS-CoV2. SARS-CoV2 differs from previous coronavirus infections (SARS and MERS) due to its high infectivity (reproduction value, R0, typically 2-4) and pre- or asymptomatic transmission, properties that have contributed to the current global Covid-19 pandemic. Identified risk factors for disease severity and death from SARS-Cov2 infection include older age, male sex, diabetes, obesity and hypertension. The reasons for these associations are still largely obscure. Evidence is also emerging that SARS-CoV2 infection exacerbates the underlying pathophysiology of hyperglycemia in people with diabetes. Here, we discuss potential mechanisms through which diabetes may affect the risk of more severe outcomes in Covid-19 and, additionally, how diabetic emergencies and longer term pathology may be aggravated by infection with the virus. We consider roles for the immune system, the observed phenomenon of microangiopathy in severe Covid-19 infection and the potential for direct viral toxicity on metabolically-relevant tissues including pancreatic beta cells and targets of insulin action.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/complicaciones , Complicaciones de la Diabetes , Diabetes Mellitus/epidemiología , Diabetes Mellitus/virología , Neumonía Viral/complicaciones , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Humanos , Pandemias , Neumonía Viral/transmisión , Neumonía Viral/virología , Factores de Riesgo
18.
Med Hypotheses ; 143: 110185, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33017914

RESUMEN

COVID-19 pandemic is spreading rapidly worldwide, and drug selection can affect the morbidity and mortality of the disease positively or negatively. Alpha-lipoic acid (ALA) is a potent antioxidant and reduces oxidative stress and inhibits activation of nuclear factor-kappa B (NF-kB). ALA reduces ADAM17 activity and ACE2 upregulation. ALA is known to have antiviral effects against some viruses. ALA may show antiviral effect by reducing NF-kB activation and alleviating redox reactions. ALA increases the intracellular glutathione strengthens the human host defense. ALA activates ATP dependent K+ channels (Na+, K+-ATPase). Increased K+ in the cell raises the intracellular pH. As the intracellular pH increases, the entry of the virus into the cell decreases. ALA can increase human host defense against SARS-CoV-2 by increasing intracellular pH. ALA treatment increases antioxidant levels and reduces oxidative stress. Thus, ALA may strengthen the human host defense against SARS-CoV-2 and can play a vital role in the treatment of patients with critically ill COVID-19. It can prevent cell damage by decreasing lactate production in patients with COVID-19. Using ALA with insulin in patients with diabetes can show a synergistic effect against SARS-CoV-2. We think ALA treatment will be beneficial against COVID-19 in patients with diabetes.


Asunto(s)
Proteína ADAM17/metabolismo , Infecciones por Coronavirus/prevención & control , Complicaciones de la Diabetes/prevención & control , FN-kappa B/metabolismo , Pandemias/prevención & control , Peptidil-Dipeptidasa A/metabolismo , Neumonía Viral/prevención & control , Ácido Tióctico/uso terapéutico , Antioxidantes/uso terapéutico , Betacoronavirus , Infecciones por Coronavirus/complicaciones , Complicaciones de la Diabetes/virología , Diabetes Mellitus/tratamiento farmacológico , Humanos , Concentración de Iones de Hidrógeno , Insulina/metabolismo , Oxidación-Reducción , Estrés Oxidativo , Neumonía Viral/complicaciones
19.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1560-1563, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-33018290

RESUMEN

The characteristics of diabetic retinopathy (DR) fundus images generally consist of multiple types of lesions which provided strong evidence for the ophthalmologists to make diagnosis. It is particularly significant to figure out an efficient method to not only accurately classify DR fundus images but also recognize all kinds of lesions on them. In this paper, a deep learning-based multi-label classification model with Gradient-weighted Class Activation Mapping (Grad-CAM) was proposed, which can both make DR classification and automatically locate the regions of different lesions. To reducing laborious annotation work and improve the efficiency of labeling, this paper innovatively considered different types of lesions as different labels for a fundus image so that this paper changed the task of lesion detection into that of image classification. A total of five labels were pre-defined and 3228 fundus images were collected for developing our model. The architecture of deep learning model was designed by ourselves based on ResNet. Through experiments on the test images, this method acquired a sensitive of 93.9% and a specificity of 94.4% on DR classification. Moreover, the corresponding regions of lesions were reasonably outlined on the DR fundus images.


Asunto(s)
Aprendizaje Profundo , Diabetes Mellitus , Retinopatía Diabética , Retinopatía Diabética/diagnóstico por imagen , Fondo de Ojo , Humanos , Sensibilidad y Especificidad
20.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(8): 929-934, 2020 Aug 28.
Artículo en Inglés, Chino | MEDLINE | ID: mdl-33053534

RESUMEN

OBJECTIVES: Diabetic foot ulcer (DFU), with a high rate of amputation and mortality, is a serious complication of diabetes. However, the therapeutic effect of diabetic foot is poor. This study aimed to investigate the effect of CD147 on epithelial-mesenchymal transition (EMT) process in DFU and molecular mechanisms. METHODS: Immunohistochemistry was used to reveal the expression of several proteins, such as CD147, E-cadherin, N-cadherin, Slug, and Phospho-RSK2 in DFU, non-diabetic refractory tissues, and wound margin tissues (normal blood glucose). Western blotting was used to analyze the expression of CD147 and Slug in HaCaT cells in the high-glucose environment. HaCaT cells with CD147 or RSK2 knockdown was constructed. Wound healing assay was used to test the migration capability of HaCaT cells with knockdown of CD147. Western blotting was used to detect the protein level of Slug in HaCaT cells with CD147 or RSK2 knockdown to investigate the effects of CD147 or RSK2 on EMT. Immunoprecipitation (IP) assay was used to detect the interaction between CD147 and RSK2. RESULTS: The expression levels of CD147 and Slug in the epithelial cells of marginal DFU tissues were significantly lower than those in non-diabetic refractory tissues and wound margin tissues (all P<0.05). CD147 and Slug expressions were down-regulated in HaCaT cells cultured with high glucose (all P<0.05). The migration ability of HaCaT cells with CD147 knockdown was decreased. Knockdown of CD147 or RSK2 significantly inhibited the expression of Slug. The direct interaction between RSK2 and CD147 was found via IP assay. CONCLUSIONS: CD147 could cause DFU re-epithelialization obstacle via affecting RSK2-mediated Slug/EMT process, which might be an underlying mechanism for the slow healing of DFU.


Asunto(s)
Basigina , Diabetes Mellitus , Pie Diabético , Canales de Potasio de Pequeña Conductancia Activados por el Calcio , Basigina/fisiología , Pie Diabético/genética , Transición Epitelial-Mesenquimal , Humanos , Proteínas de Transporte de Catión Orgánico , Transducción de Señal , Factores de Transcripción de la Familia Snail/genética , Cicatrización de Heridas
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