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1.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 48(3): 282-288, 2019 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-31496160

RESUMO

OBJECTIVE: To determine the effect of trimetazidine on cardiac function and exercise tolerance in primary hypertension patients with type 2 diabetic. METHODS: In this randomized, double-blind, placebo-controlled prospective study, 60 primary hypertensive patients with diabetic were equally assigned into two groups, patients received trimetazidine (20 mg, 3 times a day) or placebo for 1 year. Echocardiography, cardiopulmonary exercise testing were performed; and the plasma N terminal pro B type natriuretic peptide (NT-ProBNP), hr-CRP, TNF-α, angiotensin Ⅱ and endothelin concentration were determined before and after treatment. RESULTS: In trimetazidine group, the left ventricular mass index, the mitral flow velocity E wave to A wave ratio (E/A), the peak early diastolic velocity (VE) to late diastolic velocity (VA) ratio (VE/VA) and the peak systolic velocity (Vs) were significantly improved, the plasma NT-ProBNP level was significantly decreased, and the exercise time, metabolic equivalent, maximal oxygen uptake and anaerobic threshold were significantly increased (all P<0.05); plasma concentration of hr-CRP, TNF-α, angiotensin Ⅱ and endothelin were significantly reduced after trimetazidine treatment, compared with baseline (all P<0.05) and with placebo (all P<0.05). There were no significant differences in any of above parameters after treatment in placebo group (all P>0.05). No severe adverse reaction was observed in both groups. CONCLUSIONS: For patients with both hypertension and diabetes, trimetazidine can improve cardiac function and increase exercise tolerance.


Assuntos
Complicações do Diabetes , Diabetes Mellitus , Tolerância ao Exercício , Coração , Hipertensão , Trimetazidina , Complicações do Diabetes/complicações , Diabetes Mellitus/tratamento farmacológico , Método Duplo-Cego , Tolerância ao Exercício/efeitos dos fármacos , Coração/efeitos dos fármacos , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Peptídeo Natriurético Encefálico/sangue , Estudos Prospectivos , Resultado do Tratamento , Trimetazidina/farmacologia , Trimetazidina/uso terapêutico , Vasodilatadores/farmacologia , Vasodilatadores/uso terapêutico
2.
J Microbiol Immunol Infect ; 52(4): 654-662, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31446929

RESUMO

BACKGROUND/PURPOSE: Diabetes is associated with increased mortality in Acinetobacter baumannii (AB) complex infection. This study investigated the risk factors and relationship of diabetic status and glycemic indices to mortality in patients with carbapenem-resistant (CR) AB complex bacteremia. METHODS: Relationship of glycemic indices to mortality were compared in adult diabetes (DM) and nondiabetes (non-DM) patients with CRAB complex bacteremia hospitalized from January 2010 to December 2015 in MacKay Memorial Hospital, Taiwan. RESULTS: Of 317 patients with CRAB complex bacteremia, 146 (46.06%) had diabetes. DM patients were elderly (mean age of 69.23 years) and the mortality rate was higher (64.38% vs. 52.05%, p = 0.036) than in non-DM patients. By multivariate analysis, septic shock was associated with increased mortality in DM patients. Hypoglycemia was associated with increased mortality in non-DM patients only (100% vs. 50.33%, p = 0.006). The lowest mortality was for the blood glucose range 70-100 mg/dL in non-DM patients (43.24%) and 100-140 mg/dL for DM patients (56.52%). Increased glycemic variability (coefficient of variation (CV) > 40% compared to < 20%) was associated with increased mortality in non-DM patients (86.36% vs. 47.12%, p = 0.003). CONCLUSION: Effects of dysglycemia on mortality due to CRAB complex bacteremia differ according to diabetic status. Mortality was higher in DM patients. In non-DM patients, hypoglycemia and increased CV were associated with increased mortality. The lowest mortality was for the blood glucose range 70-100 mg/dL in non-DM patients and 100-140 mg/dL for DM patients.


Assuntos
Infecções por Acinetobacter/mortalidade , Bacteriemia/mortalidade , Glicemia/análise , Carbapenêmicos/farmacologia , Complicações do Diabetes/microbiologia , Complicações do Diabetes/mortalidade , Farmacorresistência Bacteriana , Infecções por Acinetobacter/sangue , Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/efeitos dos fármacos , Acinetobacter baumannii/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/farmacologia , Bacteriemia/sangue , Bacteriemia/microbiologia , Complicações do Diabetes/sangue , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Taiwan/epidemiologia
4.
Rev. chil. endocrinol. diabetes ; 12(3): 170-174, jul. 2019. tab
Artigo em Espanhol | LILACS | ID: biblio-1006512

RESUMO

Objetivo: El objetivo del estudio fue describir las características y evolución de los pacientes que acudieron a las urgencias de nuestro hospital y fueron diagnosticados de cetoacidosis diabética (CAD) utilizando la novedosa herramienta de Big Data Savana. Método: Estudio retrospectivo descriptivo de los pacientes atendidos en urgencias del Hospital Universitario Infanta Leonor durante los años 2011 al 2016 con diagnóstico de CAD. La búsqueda se realizó con Savana Manager. Resultados: Se diagnosticaron 95 episodios de CAD en 68 pacientes. Del total de episodios de CAD, 57 fueron en diabéticos tipo 1 (de ellos 4 LADA), 25 en diabéticos tipo 2, 2 en diabéticos postpancreatectomía y 12 fueron debuts diabéticos. Del total, 61 (64,2%) requirieron ingreso hospitalario, de ellos 23 (24,2%) ingresaron en UCI. La media de HbA1c fue de 10,6 ± 2,1%. Tres pacientes requirieron reingreso tras el alta. La mortalidad fue muy baja con el fallecimiento en 1 paciente diagnosticado simultáneamente de cáncer pulmonar. Los desencadenantes de la CAD fueron: 35 casos (36,8%) falta de adherencia al tratamiento, 31 (32,6%) infecciones, 12 (12,6%) debuts, 8 (8,4%) varias causas y 9 (9,5%) no se pudo determinar la causa. Se clasificaron como CAD de gravedad leve un 28%, un 38% como de gravedad moderada y 34% como graves. La duración del ingreso no se relacionó con la severidad de la cetoacidosis. Conclusiones: La CAD es una complicación grave que afecta tanto a diabéticos tipo 1 como a tipo 2 con elevado porcentaje de ingresos hospitalarios y en UCI, aunque con baja mortalidad en nuestro medio. La duración de los ingresos no se relaciona con la severidad del cuadro.


Objective: the study was designed to describe the clinical features and evolution of the diabetic patients attended in our hospital emergency department with diabetic ketoacidosis (DKA) using the novel Big Data tool Savana. Method: Retrospective descriptive study of the patients attended in the emergency room of the Infanta Leonor University Hospital during the years 2011 to 2016 with diagnosis of CAD. The search was made with Savana. Results: 95 episodes of DKA were diagnosed in 68 patients. Of the total episodes of CAD 57 were in type 1 diabetics (of which 4 were LADA), 25 in type 2 diabetics, 2 in diabetics postpancreatectomy and 12 were new onset of diabetes. Of the total, 61 (64.2%) required hospital admission, of which 23 (24.2%) were admitted to the intensive care unit (ICU). The mean HbA1c was 10.6 ± 2.1%. Three patients required readmission after discharge. Mortality was very low with death in 1 patient simultaneously diagnosed of lung cancer. The triggers of CAD were: 35 cases (36,8%) lack of adherence to treatment, 31 (32.6%) infections, 12 (12.6%) new onset, 8 (8,4%) various causes and 9 (9.5%) the cause could not be determined. They were classified as mild DKA 28%, 38% as moderate and 34% as severe. The duration of admission was not related to the severity of ketoacidosis. Conclusions: DKA is a serious complication that affects both, type 1 and type 2 diabetics patients, with a high percentage of hospital and ICU admissions, although with low mortality in our environment. The lenght of the stay in hospital is not related to the severity of the DKA.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Cetoacidose Diabética/epidemiologia , Complicações do Diabetes/epidemiologia , Espanha/epidemiologia , Informática Médica , Epidemiologia Descritiva , Estudos Retrospectivos , Cetoacidose Diabética/etiologia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Serviço Hospitalar de Emergência , Hiperglicemia/complicações , Hiperglicemia/epidemiologia
6.
J Assoc Physicians India ; 67(4): 83, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31309808

RESUMO

Introduction: Cataract represents one of the most frequent eye complications in type 1 DM and type 2 DM patients; contrarily, acute cataract in young diabetic patients occurs very rarely. Only few cases with acute bilateral cataract - all relatively shortly after the diagnosis of type 1 DM have been reported. It can affect visual acuity from slight visual impairment to complete blindness. Although usually associated with chronic hyperglycaemia, it may also occur on rapid restoration of euglycaemia.1 Early detection of diabetes and adequate glycaemic control, particularly in female adolescents, may prevent this debilitating complication of diabetes.


Assuntos
Catarata/complicações , Complicações do Diabetes/diagnóstico , Diabetes Mellitus Tipo 1/complicações , Adolescente , Cegueira , Glicemia , Feminino , Humanos , Prevalência
7.
BMC Infect Dis ; 19(1): 603, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291896

RESUMO

BACKGROUND: This study aims to investigate the pathogen distribution and drug resistance in patients with acute cerebral infarction complicated with diabetes mellitus and nosocomial pulmonary infection. METHODS: From August 2015 to December 2017, 172 pathogenic bacterial strains from patients with acute cerebral infarction complicated with diabetes mellitus and nosocomial pulmonary infection in our hospital were identified, and the drug sensitivity was analyzed. RESULTS: Among these 172 strains of pathogenic bacteria, gram negative bacteria was the main cause of pulmonary infection in hospitalized patients with acute cerebral infarction, accounting for 75.6% of all pathogens. Furthermore, 80% of diabetic patients with cerebral infarction had lung infection induced by gram negative bacteria, which was significantly higher than that in non-diabetic patients (72.2%). Moreover, the drug resistance rate in the diabetic group (68.3%) was significantly higher than that in the non-diabetic group (54.3%). Gram positive bacteria accounted for 19.1% of all pathogenic bacteria. The infection rate of gram-positive bacteria in diabetic patients with cerebral infarction was 14.7%, which was lower than that in the non-diabetic group (22.6%). The drug-resistance rate was higher in the diabetic group (45.5%) than in the non-diabetic group (28.2%). Furthermore, the fungal infection rate in patients with lung infection in these two groups was 5.3 and 5.2%, respectively, and fungi presented with high sensitivity to commonly used antifungal agents. CONCLUSION: In patients with acute cerebral infarction complicated with diabetes mellitus and nosocomial pulmonary infection, the majority of pathogens are multidrug-resistant gram negative bacilli. Pathogen culture should be conducted as soon as possible before using antibiotics, and antimicrobial agents should be reasonably used according to drug sensitivity test results.


Assuntos
Infarto Cerebral/complicações , Infecção Hospitalar/microbiologia , Complicações do Diabetes/microbiologia , Resistência Microbiana a Medicamentos , Pneumonia/microbiologia , Doença Aguda , Anti-Infecciosos/farmacologia , Anti-Infecciosos/uso terapêutico , Bactérias/classificação , Bactérias/efeitos dos fármacos , Bactérias/isolamento & purificação , Infarto Cerebral/tratamento farmacológico , Infarto Cerebral/microbiologia , Infecção Hospitalar/tratamento farmacológico , Complicações do Diabetes/tratamento farmacológico , Feminino , Fungos/classificação , Fungos/efeitos dos fármacos , Fungos/isolamento & purificação , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pneumonia/tratamento farmacológico
8.
Rev Med Suisse ; 15(657): 1350-1353, 2019 Jul 10.
Artigo em Francês | MEDLINE | ID: mdl-31290631

RESUMO

Does inappropriate treatment contribute to the risk of falls and fractures in older diabetic patients ? Among 2205 diabetics hospitalized in a geriatric ward, this retrospective study analyses the follow-up of the group with a fracture (12 %) according to the glycated hemoglobin (HbA1c) and the recommended targets. In our collective where only 4 % are healthy (50 % are vulnerable, 46 % are frail), the average value of HbA1c is 6.9 %. When we compare HbA1c, we find that more than 79.3 % of patients have HbA1c at least 0.5 % below the recommended target for their category. This suggests overtreatment that may have contributed to falls.


Assuntos
Complicações do Diabetes , Diabetes Mellitus , Fraturas Ósseas , Acidentes por Quedas , Idoso , Fraturas Ósseas/complicações , Fraturas Ósseas/terapia , Hemoglobina A Glicada , Humanos , Estudos Retrospectivos
9.
Medicine (Baltimore) ; 98(29): e16559, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31335740

RESUMO

Although the optimal treatment for femur shaft fracture is intramedullary nailing fixation, nonunion still occurs. We determined the oligotrophic nonunion rate among femur fractures managed operatively and identified risk factors for reoperation. This was a retrospective clinical study. The data of the patients between 40 and 70 years old with diaphyseal femur fracture who have received reamed and interlocked intramedullary nailing fixation in our hospital from February 2014 to April 2018 were collected. They were followed at regular intervals for at least 1 year after the operation. The primary outcome was nonunion of the fracture site that required reoperation in accordance with the radiographic union scale for tibial shaft fracture (RUST), which is a reasonable score system for lower limb diaphyseal fracture. Three of them were hypertrophic nonunion (1.9%) and the other 13 cases were oligotrophic nonunion (8.6%) at postoperative 12 months follow-up. All of the postoperative plain films showed adequate reduction quality. The three hypertrophic nonunion cases were all obese male with fracture site comminution. Fracture at the proximal third junction, hypertension (HTN) and diabetes mellitus (DM) was significantly associated with oligotrophic nonunion of the fracture site from logistic regression analysis. The mean RUST score 3 months after the operation was not significantly different between the union group and nonunion group but was significantly lower 6 months after the operation in the nonunion group. In conclusion, intramedullary nailing of the femur shaft fractures was associated with a low risk of nonunion at the 1-year follow-up in the middle age group. Those with comorbidity such as obese, HTN, and DM, with fracture site at the proximal third junction or comminution should be followed up closely and rehabilitation with cause aggressively. Radiographic scale as the RUST score at postoperative 6 months could be used to predict this complication.


Assuntos
Fraturas do Fêmur/cirurgia , Fixação Intramedular de Fraturas , Fraturas não Consolidadas/diagnóstico por imagem , Adulto , Idoso , Redução Fechada , Complicações do Diabetes , Feminino , Fraturas do Fêmur/complicações , Fraturas do Fêmur/diagnóstico por imagem , Seguimentos , Fraturas não Consolidadas/cirurgia , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Radiografia , Reoperação , Estudos Retrospectivos , Fatores de Risco
10.
Zhonghua Yan Ke Za Zhi ; 55(7): 481-484, 2019 Jul 11.
Artigo em Chinês | MEDLINE | ID: mdl-31288350

RESUMO

Cataract is one of the common cause of vision decrease in diabetic patients, which occurs earlier and develops faster than in common patients, and often requires surgery for treatment. However, diabetic patients are more likely to have fundus lesions, and are more prone to have complications, such as infection, posterior capsular opacity, cystoid macular edema, etc. Diabetic patients have a higher risk of cataract surgery than ordinary cataract patients. Therefore, clinicians should be conscious about the particularity of diabetic cataract surgery, develop an appropriate and individual diagnosis and treatment plan according to its characteristics, and regulate the overall management to prevent possible risks and ensure the safety of patients.(Chin J Ophthalmol, 2019, 55: 481-484).


Assuntos
Extração de Catarata , Catarata , Complicações do Diabetes , Edema Macular , Humanos
11.
Rev Med Suisse ; 15(653): 1127-1130, 2019 May 29.
Artigo em Francês | MEDLINE | ID: mdl-31148424

RESUMO

Diabetes mellitus (DM) affects an increasing proportion of workers, a trend that will compound with the ageing of the workforce. It is therefore important to consider DM in the workplace context. There is an interrelationship between DM and work. Indeed dysglycemia is associated with a greater risk of work accidents and long-term DM complications. On the other side work conditions can affect DM's stability. The consequences are absenteeism, presenteeism, early retirement or even disability with significant socio-economic costs. To keep patients with DM into the workforce, the evaluation of their working conditions is mandatory and ideally in collaboration with the general practitioner, diabetologist and occupational physician (OP). This article outlines some practical guidelines for the evaluation of diabetic's worker.


Assuntos
Absenteísmo , Diabetes Mellitus , Pessoas com Deficiência , Aposentadoria , Complicações do Diabetes , Humanos , Local de Trabalho
12.
Rev Med Suisse ; 15(653): 1132-1139, 2019 May 29.
Artigo em Francês | MEDLINE | ID: mdl-31148425

RESUMO

Hemodialysis (HD) centers are facing an increasing number of patients with diabetes. These cases require an intensive multidisciplinary approach of the consequences of renal failure, glycemic control and nutrition and the management of frequent co-morbidities, in particular the diabetic foot. A major challenge is to decrease glycemic variability and the risk of hypoglycemia. Because of increased risk of hypoglycemia-associated mortality, the HbA1C target is loosened in the majority of HD patients. Continuous glucose monitoring technology has identified important glycemic fluctuations during and after dialysis. However, their reliability in HD needs to be improved. New therapeutic pathways that decrease glucose excursions and hypoglycemia, such as GLP1 receptor agonists and sensor-coupled insulin pumps, have yet to be validated in HD.


Assuntos
Complicações do Diabetes , Falência Renal Crônica , Diálise Renal , Glicemia , Automonitorização da Glicemia , Complicações do Diabetes/terapia , Diabetes Mellitus/tratamento farmacológico , Hemoglobina A Glicada , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Reprodutibilidade dos Testes
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(6): 654-659, 2019 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-31238614

RESUMO

Objective: To study the prevalence and correlates of diabetes among HIV/AIDS who were on antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefectures (Dehong), Yunnan province. Methods: The database of HIV/AIDS receiving ART in Dehong was downloaded by using the basic information system of AIDS prevention and control in China. In this cross-sectional study, HIV/AIDS patients who were currently on ART and aged 18 years or above, were consecutively recruited, between July 2017 and June 2018, in Dehong. All the subjects underwent hemoglobin A1c (HbA1c) testing. Patient with diabetes was defined as meeting any of these indicators (HbA1c ≥6.5%, baseline FPG ≥7.0 mmol/L, FPG ≥7.0 mmol/L in the most recent visit). Both univariate and multivariate logistic regression analysis were carried on to evaluate the correlates of diabetes among the HIV/AIDS patients. Results: In total of 4 376 HIV/AIDS patients were included for analysis, with the average age as (43.7±10.1) years, proportion of males as 53.8% (2 356/4 376) and the HCV positive rate as 24.1% (1 055/4 376). The mean years was (8.9±3.8) years after the HIV diagnosis was made, and the mean duration on treatment was (6.8±2.9) years. The prevalence of diabetes was 11.4% (500/4 376). Through multivariate logistic regression analysis, data showed that the risk factors of diabetes of HIV/AIDS on ART were: aged 40 years or above, being male, HCV positive, baseline body mass index ≥24.0 kg/m(2), elevated TG ≥1.70 mmol/L in the most recent visit and baseline antiretroviral regimens under Efavirenz (EFV). Conclusions: Prevalence rate of diabetes appeared higher in HIV/AIDS patients who were on ART in Dehong. Prevention and control measures should be targeted on HIV/AIDS patients who were with risk factors of diabetes as being elderly, male, HCV positive, overweight and higher TG. Further esearch is needed to evaluate the association between the use of EFV and diabetes.


Assuntos
Terapia Antirretroviral de Alta Atividade , Diabetes Mellitus/epidemiologia , Infecções por HIV/tratamento farmacológico , Adolescente , Adulto , Idoso , China/epidemiologia , Estudos Transversais , Complicações do Diabetes/epidemiologia , HIV , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência
14.
Life Sci ; 230: 169-177, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31150685

RESUMO

AIMS: Hippocampal oxidative stress and apoptosis of CA1 neurons play significant roles in the pathophysiology of diabetes-associated cognitive decline (DACD). The present study was aimed to elucidate the putative effects of sesamin, a major lignan of sesame seed, against DACD, and possible involvement of anti-oxidative and anti-apoptotic mechanisms. MAIN METHODS: Fifty adult male Wistar rats were randomly divided into control, control-sesamin (30 mg/kg/day), diabetic, diabetic-sesamin (30 mg/kg/day), and diabetic-insulin (6 IU/rat/day) groups. Diabetic rats were treated with sesamin (P.O.) or insulin (S.C.) for eight consecutive weeks. Cognitive performance was evaluated in a Morris Water Maze (MWM) test; in addition, superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and malondialdehyde (MDA) concentrations were assayed in the hippocampus using assay kits. Moreover, hematoxylin-eosin (HE), TUNEL, and immunohistochemistry (IHC) stainings were conducted to evaluate histological changes, the apoptosis status and expression of pro- and anti-apoptotic proteins in the hippocampal CA1 neurons, respectively. KEY FINDINGS: The results showed that diabetes reduced the spatial cognitive ability in MWM, which was accompanied by decrease in SOD, CAT, and GPx activities and increase in MDA level in the hippocampus. Additionally, diabetes resulted in neuronal loss, enhanced apoptotic index, elevated the expression of pro-apoptotic Bax protein, and decreased the expression of anti-apoptotic Bcl-2 protein in the hippocampal CA1 neurons. Interestingly, sesamin treatment improved all the above-mentioned deficits of diabetes at a comparable level with insulin therapy. SIGNIFICANCE: The results suggest that sesamin could be a promising potential therapeutic agent against DACD, possibly through its intertwined anti-hyperglycemic, anti-oxidative, and anti-apoptotic properties.


Assuntos
Disfunção Cognitiva/tratamento farmacológico , Complicações do Diabetes/tratamento farmacológico , Dioxóis/farmacologia , Lignanas/farmacologia , Animais , Antioxidantes/farmacologia , Apoptose/efeitos dos fármacos , Diabetes Mellitus Experimental/metabolismo , Dioxóis/metabolismo , Glutationa Peroxidase/metabolismo , Hipocampo/metabolismo , Insulina/farmacologia , Lignanas/metabolismo , Masculino , Malondialdeído/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Substâncias Protetoras/farmacologia , Ratos , Ratos Wistar , Espécies Reativas de Oxigênio/metabolismo , Superóxido Dismutase/metabolismo
15.
Managua; s.n; jun. 2019. 81 p. ilus, tab, graf.
Tese em Espanhol | LILACS | ID: biblio-1015445

RESUMO

OBJETIVO: Determinar los conocimientos, actitudes y prácticas, con respecto a la RD, de los pacientes diabéticos, que acuden a la consulta oftalmológica en el CENAO, Managua, Nicaragua, Febrero 2019. METODOLOGÍA: Estudio descriptivo transversal a través de una encuesta CAP. Esta se basaba en las siguientes agrupaciones de datos: características sociodemográficas, características clínicas, conocimientos, actitudes y prácticas. Participaron 47 pacientes diabéticos mayores de 18 años que asistieron a la consulta oftalmológica en el CENAO durante el tiempo de investigación. RESULTADOS: El 76,6% (36) de los pacientes eran mayores de 50 años, El 47% (22) no sabían el tipo de diabetes que padecían y el 70,2% (33) aún no tenían RD. El 94% (44) de los pacientes tenían buenas actitudes, el 63% (30) tenían buenas prácticas y solamente el 5% (3) tenían buenos conocimientos sobre la RD. CONCLUSIONES: La mayoría de los pacientes diabéticos no solamente tenían buenas actitudes con respecto al chequeo ocular anual y a la importancia de visitar a un oftalmólogo en caso de que sea necesario, sino que también tenían buenas prácticas con respecto a este tema. No obstante, la gran mayoría de los pacientes diabéticos tenían un nivel de conocimientos, sobre la RD, que se considera deficiente. Esto permitió la existencia de una discrepancia significativa entre el nivel de conocimientos, las actitudes y las prácticas, con respecto a la RD, de los pacientes diabéticos


Assuntos
Humanos , Oftalmologia , Complicações do Diabetes , Diabetes Mellitus , Retinopatia Diabética , Epidemiologia Descritiva , Administração em Saúde
16.
Rev Assoc Med Bras (1992) ; 65(5): 678-681, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31166445

RESUMO

OBJECTIVE: We describe the case of a diabetic patient who developed vertebral osteomyelitis and bilateral psoas abscess with gas formation due to klebsiella pneumoniae. METHODS: A 64-year-old woman with a 4-year history of type-2 diabetes mellitus was admitted to the Emergency Department. The subject had a 2-day history of high-grade fever associated with chills and a 5-hour history of consciousness. She received empirical treatment with febrifuge, after which her fever decreased. RESULTS: Her fever recurred after an interval of three hours. A computed tomography scan of the abdomen revealed vertebral osteomyelitis and bilateral psoas muscle abscess with gas formation. Blood culture and purulent fluid described the growth of the Klebsiella pneumoniae. The patient received antibiotic therapy and bilateral drainage therapy after the drainage catheter was placed into the abscess cavity by CT-guidance. Due to the serious damage to the vertebral column and permanent pain, the patient underwent minimally invasive internal spinal fixation and recovered successfully. CONCLUSION: A case of vertebral osteomyelitis and bilateral psoas abscess with gas formation caused by Klebsiella pneumoniae in a diabetic patient. Antibiotic therapy, drainage, and minimally invasive internal spinal fixation were performed, which enabled a good outcome.


Assuntos
Complicações do Diabetes/cirurgia , Infecções por Klebsiella/cirurgia , Klebsiella pneumoniae/patogenicidade , Osteomielite/cirurgia , Abscesso do Psoas/cirurgia , Doenças da Coluna Vertebral/cirurgia , Complicações do Diabetes/microbiologia , Drenagem/métodos , Feminino , Gases/metabolismo , Humanos , Infecções por Klebsiella/microbiologia , Pessoa de Meia-Idade , Osteomielite/microbiologia , Abscesso do Psoas/microbiologia , Reprodutibilidade dos Testes , Doenças da Coluna Vertebral/microbiologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
17.
Gene ; 710: 170-177, 2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31153886

RESUMO

Covalently closed, single-stranded circular RNAs (circRNAs) are a class of newly discovered endogenous RNAs involved in the pathological process of various types of diseases through sponging microRNAs (miRNAs). However, the role of circRNAs in diabetic cataract (DC) is unclear. Our previous studies have demonstrated that miR-204-5p was expressed more lowly in DC than the normal controls, but whether it relates to the sponge function of circRNAs remains unknown. This study aimed to identify differentially expressed circRNAs in DC tissues and investigate the interaction between circRNAs and miR-204-5p in the development of cataract. RNA-sequencing based circRNA expression profiling was determined in DC lens tissues as well as transparent lens tissues, and 1063 circRNAs were significantly differentially expressed in the DC group compared to the normal control group (p ≤ 0.05, fold change ≥ 2.0). Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were applied to predict the function of these differentially expressed circRNAs, and the top ten enriched GO entries and KEGG pathways were annotated. Expression levels of the two candidate circRNAs having conserved interaction with miR-204-5p were validated by qRT-PCR, showing that the change direction of these circRNAs was consistent with the RNA-sequencing data. Moreover, circKMT2E was up-regulated more than two folds in DC lens tissues compared with normal tissues, exhibiting an expression trend opposite to miR-204-5p. Bio-informatics analysis showed that there were totally four seed sequences of circKMT2E on hsa-miR-204-5p. Thus, we speculated that circKMT2E may function as a sponge molecule of miR-204-5p and play a role in the pathogenesis of DC. Although the exact mechanisms need further validation, our study found that the differentially expressed circRNAs was involved in the pathogenesis of DC, which can provide a new target for non-surgical treatment of DC.


Assuntos
Catarata/genética , Complicações do Diabetes/genética , MicroRNAs/genética , RNA/genética , Regulação para Cima , Idoso , Regulação para Baixo , Feminino , Perfilação da Expressão Gênica , Humanos , Cristalino/química , Cristalino/patologia , Masculino , Pessoa de Meia-Idade , Análise de Sequência de RNA
18.
Medicine (Baltimore) ; 98(23): e15935, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31169714

RESUMO

BACKGROUND: Patients requiring posterior lumbar surgery have increased annually. Incision infection after lumbar surgery has serious consequences for patients. However, data on the related factors of incision infection after lumbar surgery in diabetic patients are limited. Therefore, this study aimed to analyze diabetic patients who underwent lumbar surgery and to explore the risk factors of perioperative incision infection to provide a scientific basis for perioperative intervention of lumbar spine surgery and reduce risk of incision infection in such patients. METHODS: We retrospectively reviewed data of diabetic patients who underwent posterior lumbar surgery from 2011 to 2016. A total of 523 diabetic patients undergoing posterior lumbar surgery were analyzed for the influence of various risk factors on postoperative incision infection. Univariate and multivariate logistic regression was performed. The test level was α=.05, and P < .05 was considered statistically significant. RESULTS: In the past 6 years, among the 523 diabetic patients, the incidence of incision infection after posterior lumbar surgery was approximately 7.1%, of which the shallow incision infection rate was 4.2% and the deep incision infection rate was 2.9%. Incision infection of posterior lumbar surgery in diabetic patients is related to smoking, preoperative glycosylated hemoglobin A1c, postoperative albumin (Alb), surgical segment, operation time, and intraoperative blood loss, especially on postoperative fasting blood glucose, postoperative postprandial blood glucose, local subcutaneous fat thickness, and operation sequence (odds ratio >5.00). Meanwhile, sex, age, body mass index (BMI), preoperative Alb, and newly diagnosed diabetes were not highly correlated with incision infection after posterior lumbar surgery. CONCLUSION: Local subcutaneous fat thickness is a better indicator for predicting incision infection compared with BMI. In diabetic patients undergoing lumbar surgery, actively controlling blood glucose fluctuations, restoring normal diet early after surgery, and optimizing surgical procedures to reduce trauma and operative time can effectively reduce the risk of infection after posterior lumbar surgery.


Assuntos
Complicações do Diabetes/cirurgia , Diabetes Mellitus/cirurgia , Vértebras Lombares/cirurgia , Procedimentos Neurocirúrgicos/efeitos adversos , Infecção da Ferida Cirúrgica/etiologia , Idoso , Glicemia , Índice de Massa Corporal , Complicações do Diabetes/sangue , Complicações do Diabetes/patologia , Diabetes Mellitus/sangue , Diabetes Mellitus/patologia , Feminino , Hemoglobina A Glicada/análise , Humanos , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Procedimentos Neurocirúrgicos/métodos , Estudos Retrospectivos , Fatores de Risco , Gordura Subcutânea/patologia , Infecção da Ferida Cirúrgica/sangue , Infecção da Ferida Cirúrgica/epidemiologia
19.
Artigo em Chinês | MEDLINE | ID: mdl-31245952

RESUMO

OBJECTIVE: To study the effects of Zuogui Jiangtang Jieyu Formula (ZGJTJYF, the Chinese Medicine) on hippocampal neuron apoptosis in diabetes mellitus complicated with depression (DD). METHODS: The primary cultured hippocampal neurons were treated with high glucose (150 mmol/L) and corticosterone (200 micromol/L) to establish the cell model of DD in vitro. The cultured hippocampal neurons were randomly divided into five groups: blank serum group, normal group, Zuogui Jiangtang Jieyu recipe drug-containing serum group, positive drug (metformin + fluoxetine) drug-containing serum group and model group (three compound holes in each group). The model group and the normal group were given the same amount of culture medium, and the other groups were given the corresponding serum with 10% volume fraction for 18 hours. Hoechst staining, high content cell imaging and RT-PCR were used to detect the apoptosis of hippocampal neurons and the expressions of apoptosis-related ETS-like 1 transcription factor(ELK-1), C-Jun N-terminal kinase(JNK) and c-Fos proteins and genes. RESULTS: Compared with the blank group, the apoptotic number of hippocampal neurons in the model group was increased significantly, and the expression levels of ELK-1, JNK and c-Fos were increased significantly (P<0.05). Compared with the model group, the local bright spots of hippocampal neurons in the Zuogui Jiangtang Jieyu recipe-containing serum group and the positive drug-containing serum group were decreased significantly, and the number of apoptotic cells was decreased significantly. The expressions of JNK, c-fos protein and mRNA were down-regulated significantly (P< 0.05), and the neural network and dendritic junction were improved significantly. CONCLUSION: Zuo Gui Jiang Tang Jie Yu Formula can reverse the expressions of ELK-1, JNK and c-Fos signals in hippocampal neurons under DD environment and play an anti-apoptotic effect.


Assuntos
Depressão , Complicações do Diabetes , Diabetes Mellitus , Medicamentos de Ervas Chinesas , Hipocampo , Animais , Apoptose/efeitos dos fármacos , Depressão/tratamento farmacológico , Complicações do Diabetes/tratamento farmacológico , Medicamentos de Ervas Chinesas/farmacologia , Hipocampo/efeitos dos fármacos , MAP Quinase Quinase 4/efeitos dos fármacos , Neurônios , Proteínas Proto-Oncogênicas c-fos/efeitos dos fármacos , Distribuição Aleatória , Ratos , Proteínas Elk-1 do Domínio ets/efeitos dos fármacos
20.
Wiad Lek ; 72(5 cz 2): 1092-1097, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31175751

RESUMO

OBJECTIVE: Introduction: Worldwide, there is a tendency to an increase in the number of patients with diabetes mellitus. After cardiovascular disease and oncology, this disease takes the third place, being ahead of HIV and tuberculosis. The aim of the research was to study and analyze the dynamics of the prevalence, incidence and disability of diabetes mellitus among children aged 0-17 years in the Poltava region over the period of 2008-2017. PATIENTS AND METHODS: Materials and methods: The data of statistical reports of medical institutions and the Center of Medical Statistics of the Ministry of Health of Ukraine over the period of 2008-2017 was analyzed. The obtained data was processed using using the MS Office 2010 software package. RESULTS: Review: We have found that the prevalence of diabetes mellitus among children under the age of 17 in the Poltava region is constantly growing. In 2008, the prevalence of diabetes among children aged 0-17 years was 1.11. In 2017, the index was 1.32. Regarding the incidence, the indicator also gradually increased, in 2017 it was 0.21 versus 0.12 in 2008. Having analyzed the disability of diabetes among children, it is evident that the total disability is gradually increasing. If in 2008 there were 185children with diabetes mellitus, then in 2017 there were 256 people (disability index 0.72 and 1.09, respectively). The primary disability among children in 2017 was 0.19, in 2008 it was 0.09, respectively. CONCLUSION: Conclusions: The presented research allowed to study and analyze the incidence, prevalence and disability of diabetes mellitus among children from 0 to 17 years old in the Poltava region over the period of 2008-2017.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus , Adolescente , Criança , Pré-Escolar , Complicações do Diabetes , Diabetes Mellitus/epidemiologia , Humanos , Incidência , Lactente , Recém-Nascido , Prevalência , Ucrânia
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