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1.
Rev. Odontol. Araçatuba (Impr.) ; 42(2): 35-41, maio-ago. 2021.
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1252912

RESUMO

O objetivo deste estudo é realizar uma revisão da literatura para identificar os principais fatores que levam às complicações em implantodontia. Os implantes osseointegráveis e sua aplicação na odontologia revolucionaram a reabilitação oral de pacientes sejam eles edêntulos totais ou parciais em busca de recuperação funcional e satisfação estética. A pesquisa científica em uma busca constante pela magnificação deste tratamento, possibilitaram o uso de reabilitações implantossuportadas como um método de tratamento previsível com um índice elevado de sucesso. No entanto, como qualquer modo de tratamento, complicações e falhas também podem ocorrer na implantodontia. Após a revisão de literatura pode-se concluir que as condições médicas do paciente, hábitos sociais e parafuncionais, inexatidão do planejamento cirúrgico e protético, conhecimento técnico e científico do cirurgião-dentista, a falta de relacionamento interdisciplinar e deficiente cooperação do paciente no pós-operatório, podem estar relacionadas às complicações no tratamento reabilitador com implantes dentários(AU)


The objective of this study is to carry out a complete literature review to elucidate and evaluate the factors that lead to complications in implantology. The osseointegrated implantsimplants and their application in dentistry have revolutionized the oral rehabilitation of patients who need this treatment, be they total or partial edentulous in search of functional recovery and aesthetic satisfaction. Scientific research and a constant search for the magnification of this treatment, allowed the use of implant-enhanced rehabilitation as a predictable treatment method with a high success rate. However, like any treatment mode, complications and failures can also occur in implantology. the patient's medical conditions, social and parafunctional habits, inaccuracy of surgical and prosthetic planning, technical and scientific knowledge of the dental surgeon, lack of interdisciplinary relationship and poor patient cooperation in the postoperative, may be related to complications in rehabilitating treatment with dental implants(AU)


Assuntos
Implantes Dentários , Implantes Dentários/efeitos adversos , Implantação Dentária Endo-Óssea , Tabagismo , Prótese Dentária Fixada por Implante , Diabetes Mellitus , Difosfonatos , Peri-Implantite , Reabilitação Bucal
2.
Ned Tijdschr Tandheelkd ; 128(6): 317-322, 2021 Jun.
Artigo em Holandês | MEDLINE | ID: mdl-34096931

RESUMO

Periodontitis has been considered the sixth complication of diabetes. The aim of this study was to assess the impact of periodontal treatment on diabetes-related healthcare costs in patients with diabetes. Data on 41,598 adults (45.7% female) with at least 1 insurance claim in 2012 for diabetes-related treatment were included in the analysis. The impact of periodontal treatment on diabetes-related healthcare costs was analysed by means of fixed effect models for panel data. The median diabetes-related healthcare costs per patient in 2012, including costs for diagnosis, treatment, medication, and hospitalisation, were €38.45 per quarter (interquartile range €11.52 - €263.14). The fixed effects models showed a reduced expenditure on diabetes-related costs of €12.03 [95%CI €-15.77; €-8.29] per quarter following periodontal treatment. These results support the relevance and necessity of good periodontal care for patients with diabetes.


Assuntos
Diabetes Mellitus , Custos de Cuidados de Saúde , Adulto , Assistência Odontológica , Diabetes Mellitus/terapia , Feminino , Gastos em Saúde , Humanos , Masculino , Estudos Retrospectivos
3.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(6): 507-509, 2021 Jun 09.
Artigo em Chinês | MEDLINE | ID: mdl-34098664

RESUMO

The common chronic disorders in the world, such as cardiovascular diseases, diabetes mellitus, cancers, etc., are all the multi-factorial diseases. They are caused by the interactions of various risk factors among which inflammation plays an important role in the pathogenesis of all these chronic disorders. Any factor which contributes or enhances systemic inflammatory burdens may serve as the risk factors of these diseases. During periodontitis, the bacteremia and subsequent systemic dispersal of periodontal pathogens and bacterial components may elicit production of pro-inflammatory immune mediators, and the pro-inflammatory immune mediators produced locally at the periodontal lesion may also enter the systemic circulation. Behaving as a potential source for increased chronic systemic inflammatory challenge, periodontitis contributes as the risk factor of these systemic inflammation associated chronic diseases.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus , Periodontite , Humanos , Inflamação , Fatores de Risco
4.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(6): 557-564, 2021 Jun 09.
Artigo em Chinês | MEDLINE | ID: mdl-34098671

RESUMO

Objective: To investigate the effect of antibiotics application in perioperative period on carotid artery and serum interluekin-6 (IL-6) in chronic periodontitis (CP) rats with hyperlipidemia (HL) or diabetes mellitus (DM). Methods: The models of CP rats with HL or DM were established in different batches. The rats were divided into groups as follows: A and A' were normal control groups, n=7 in each group; B(HL) and B'(DM) were groups of HL and DM, n=7 in each; C(HL+CP) and C'(DM+CP) were groups of CP with HL and CP with DM, n=21 in each. After the establishment of the models, groups C and C' were divided into C1 and C1' non-intervention group, C2 and C2' simple tooth extraction group and C3 and C3' antibiotic-assisted tooth extraction, with 7 rats in each of the groups. Two time interventions were performed to extract experimental teeth (bilateral maxillary first and second molars) in groups C2, C2', C3 and C3'. Serum samples were collected at 5 time points before and after tooth extraction (T1: before the first tooth extraction; T2: one week after the first tooth extraction; T3, T4, T5: the first, third and fifth week after the second tooth extraction), respectively. The absolute content of IL-6 in serum was detected by enzyme-linked immunosorbent assay (ELISA). Ratio of the absolute content in the experimental groups and control groups were calculated as the relative content of IL-6. At the end of the experiments, all rats were euthanasia and the bifurcation vascular tissues of carotid artery were collected for the observation of the carotid artery pathology and plaque formation and the measurement of the thickness of carotid intimal-medial layer (IMT). Results: Carotid artery pathology observation showed the IMT in group C was significantly thickened and the group C2 was the most thickened one (compared with group A, P<0.01). Elastic fibers in groups C1 and C2 were disordered or even broken and disappeared, presenting typical atherosclerotic plaques, which were diffuse calcium salt deposits in the intimal-medial layers and protrude into the lumen. Elastic fibers in group C3 were ranged in ordered relatively without obvious fracture and the number of plaques was significantly reduced. The vascular walls in rats of groups B' and C' were incomplete, the IMTs had no obvious changes, elastic fibers were ranged disorderly and broken and the smooth muscle cells had vacuolar changes. In group C2', the vascular wall was significantly thinned and calcified plaques appeared in the artery, which showed multiple calcification lesions penetrating through the intimal-medial layer or even the whole layer. The vascular wall of group C3' was integrity and the elastic fibers arranged relatively clutter-free, the number of plaques was reduced. Results of detections of IL-6 showed the relative contents of IL-6 in groups B, B', C1, and C1' increased with time. At T3 time point, the relative contents of IL-6 in groups C2 and C3 reached the peak, C2 was 10.4 times of group A and C3 was 9.5 times of group A, and then decreased to different low levels. At T5 point, comparisons of the relative contents of IL-6 showed C3 < C2 < C1 (3.2 times, 5.4 times, 9.6 times of group A, respectively). The relative contents of IL-6 in groups C2' and C3' reached the peak at T2 point (4.9 times and 4.5 times of group A, respectively), and then decline with time. At T5 point, comparisons of the relative contents of IL-6 showed C3'< C2'< C1' (1.2 times, 1.4 times and 3.1 times of group A, respectively). Conclusions: Blood vessels were observed more obvious thickened in the tooth extraction without antibiotic of HL+CP rats with calcifications increase. Blood vessels of DM+CP rats became thin and fragile and even the integrity was damaged. Perioperative use of antibiotics might reduce the carotid artery lesions and decrease serum levels of inflammatory cytokines.


Assuntos
Diabetes Mellitus , Hiperlipidemias , Animais , Antibacterianos , Artérias Carótidas , Humanos , Interleucina-6 , Período Perioperatório , Ratos , Ratos Sprague-Dawley
5.
Zhonghua Yan Ke Za Zhi ; 57(6): 440-446, 2021 Jun 11.
Artigo em Chinês | MEDLINE | ID: mdl-34098693

RESUMO

Objective: To report the efficacy and safety of minimally invasive vitrectomy for the treatment of severe proliferative diabetic retinopathy (PDR) and the effect of preoperative retinal photocoagulation on prognosis. Methods: Case-series study and cohort study. This study included 48 severe PDR patients (53 eyes). There are 28 males and 20 females. The average age was 53.5 (range, 40.0 to 59.0) years old. Patients were divided into two groups according to whether preoperative retinal photocoagulation was performed. Under the guidance of the concept of minimally invasive vitrectomy, all patients received intravitreal injection of conbercept 3 days before standard pars plana vitrectomy with a 27G+ vitrectomy system. To relieve traction, the proliferative fibrovascular membrane was divided into islands as small as possible. It was not necessary to pursue a complete removal of the proliferative membrane. The 27G+ vitrector was flexibly applied as a multifunctional tool for membrane removal by reducing frequencies at which the device entered and left the eye. Intraocular retinal photocoagulation was performed in the main area. The primary outcome measures were best corrected visual acuity (BCVA) and retinal reattachment rate, and the secondary outcome measures were intraoperative and postoperative complications. Statistical analysis was performed using t test, rank sum test and χ² test. Results: All patients tolerated intravitreal conbercept, with no serious intraoperative or postoperative adverse events. Postoperative BCVA values were improved significantly compared with preoperative values (χ²=125.11, P<0.01). The mean logMAR BCVA improved from 1.90 (1.30, 2.30) preoperatively to 1.00 (0.70, 1.90) at 1 week postoperatively, 0.8 (0.5, 1.3) at 1 month postoperatively, 0.7 (0.40, 1.20) at 3 months postoperatively, and 0.70 (0.40, 1.20) at 6 months postoperatively. The visual function increased progressively with time. Postoperatively, the primary and final reattachment rates were 92.5% (50/53) and 96.2% (51/53), respectively. Abnormal intraocular pressure lasted for more than one week occurred in 2 eyes; Vitreous hemorrhage recurred in 5 eyes; Retinal detachment occurred in 4 eyes (7.5%); No postoperative endophthalmitis, choroidal detachment or incision related retinal hole occurred. The intraoperative and postoperative parameters in the preoperative retinal photocoagulation group were better than the preoperative non-photocoagulation group, but the difference was not significant (P>0.05). Conclusions: Minimally invasive vitrectomy is fully qualified for the management of severe PDR, with maximized benefits. (Chin J Ophthalmol, 2021, 57:440-446).


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Descolamento Retiniano , Adulto , Estudos de Coortes , Retinopatia Diabética/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Descolamento Retiniano/cirurgia , Resultado do Tratamento , Acuidade Visual , Vitrectomia , Hemorragia Vítrea/cirurgia
6.
Mater Sci Eng C Mater Biol Appl ; 126: 112169, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34082970

RESUMO

Injectable hydrogels with multifunctional tunable properties comprising biocompatibility, anti-oxidative, anti-bacterial, and/or anti-infection are highly preferred to efficiently promote diabetic wound repair and its development remains a challenge. In this study, we report chondroitin sulphate (CS) and sodium alginate (SA)-based injectable hydrogel using solvent casting method loaded with curcumin that could potentiate reepithelization, increase angiogenesis, and collagen deposition at wound microenvironment to endorse healing cascade. The physical interaction and self-assembly of chondroitin sulfate grafted alginate (CS-Alg-g-PF127) hydrogel were confirmed using nuclear magnetic resonance (1H NMR) and Fourier transformed infrared spectroscopy (FT-IR), and cytocompatibility was confirmed by fibroblast viability assay. The Masson's trichrome (MT) and hematoxylin and eosin (H&E) results revealed that blank chondroitin sulfate grafted alginate (CS-Alg-g-PF127) and CUR loaded CS-Alg-g-PF127 hydrogel had promising tissue regenerative ability, and showing enhanced wound healing compared to other treatment groups. The controlled release of CUR from injectable hydrogel was evaluated by drug release studies and pharmacokinetic profile (PK) using high-performance liquid chromatography (HPLC) that exhibited the mean residence time (MRT) and area under the curve (AUC) was increased up to 16.18 h and 203.64 ± 30.1 µg/mL*h, respectively. Cytotoxicity analysis of the injectable hydrogels using 3 T3-L1 fibroblasts cells and in vivo toxicity evaluated by subcutaneous injection for 24 h followed by histological examination, confirmed good biocompatibility of CUR loaded CS-Alg-g-PF127 hydrogel. Interestingly, the results of in vivo wound healing by injectable hydrogel showed the upregulation of fibroblasts-like cells, collagen deposition, and differentiated keratinocytes stimulating dermo-epidermal junction, which might endorse that they are potential candidates for excisional wound healing models.


Assuntos
Diabetes Mellitus , Hidrogéis , Alginatos , Sulfatos de Condroitina , Humanos , Espectroscopia de Infravermelho com Transformada de Fourier , Cicatrização
7.
Zhongguo Zhen Jiu ; 41(6): 659-62, 2021 Jun 12.
Artigo em Chinês | MEDLINE | ID: mdl-34085484

RESUMO

ZHANG Ren, the chief physician, believes that diabetic retinopathy is located at eye and closely related to qi and yin. He proposes the treatment principle of this disease, i.e. combination of the primary and the secondary, in which, taking the eye as the treatment target and focusing on the symptoms. Acupuncture is provided for activating blood circulation and resolving stasis at the extra points, e.g. Xinming and Shangjianming, and also meridian points, e.g. Cuanzhu (BL 2) and Tongziliao (GB 1). The comprehensive application is emphasized with filiform needle, dermal needle and acupoint injection. Moreover, the mental and physical conditions are treated simultaneously to regulate emotions and the preventive idea is suggested on early treatment and persistent treatment.


Assuntos
Terapia por Acupuntura , Acupuntura , Diabetes Mellitus , Retinopatia Diabética , Meridianos , Pontos de Acupuntura , Retinopatia Diabética/terapia , Emoções , Humanos , Masculino
8.
J Pak Med Assoc ; 71(5): 1503-1505, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34091646

RESUMO

The muscle is an important organ-system of the body, which contributes to, and is impacted by, viscerometabolic health. This brief communication presents a structured discussion of the role of skeletal muscle in the pathophysiology, clinical presentation, and management of diabetes.


Assuntos
Diabetes Mellitus , Diabetes Mellitus/epidemiologia , Humanos , Músculo Esquelético
9.
J Pak Med Assoc ; 71(5): 1506-1507, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34091647

RESUMO

Diabetes care involves a rational understanding of the complex clinical and pharmacological interactions. If we have clarity of thought in our goals and aims, it becomes much easier to plan treatment strategies. The hierarchal model of metabolic modulation and optimization represents an effort to achieve simplicity and straightforwardness in deciding aims of diabetes care, planning approaches, and choosing the right arsenal for intervention. This model lists the targets of therapy as symptomatic, glucometabolic, vasculometabolic, barometabolic and viscerometabolic optimization.


Assuntos
Diabetes Mellitus , Diabetes Mellitus/terapia , Humanos
12.
BMC Infect Dis ; 21(1): 524, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34088268

RESUMO

BACKGROUND: With pandemic of coronavirus disease 2019 (COVID-19), human coronaviruses (HCoVs) have recently attached worldwide attention as essential pathogens in respiratory infection. HCoV-229E has been described as a rare cause of lower respiratory infection in immunocompetent adults. CASE PRESENTATION: We reported a 72-year-old man infected by HCoV-229E with rapid progression to acute respiratory distress syndrome, in conjunction with new onset atrial fibrillation, intensive care unit acquired weakness, and recurrent hospital acquired pneumonia. Clinical and radiological data were continuously collected. The absolute number of peripheral T cells and the level of complement components diminished initially and recovered after 2 months. The patient was successfully treated under intensive support care and discharged from the hospital after 3 months and followed. CONCLUSION: HCoV-229E might an essential causative agent of pulmonary inflammation and extensive lung damage. Supportive treatment was essential to HCoVs infection on account of a long duration of immunological recovery in critical HCoV-229E infection.


Assuntos
Resfriado Comum/diagnóstico , Coronavirus Humano 229E , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Idoso , Antibacterianos/uso terapêutico , Líquido da Lavagem Broncoalveolar/virologia , Resfriado Comum/complicações , Resfriado Comum/virologia , Infecções por Coronavirus/complicações , Diabetes Mellitus , Pneumonia Associada a Assistência à Saúde/complicações , Pneumonia Associada a Assistência à Saúde/tratamento farmacológico , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Pneumonia Viral/tratamento farmacológico
13.
BMC Ophthalmol ; 21(1): 252, 2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34098891

RESUMO

BACKGROUND: To describe the longitudinal changes in retinal neovascularization elsewhere (NVE) as observed on optical coherence tomography angiography (OCTA) in proliferative diabetic retinopathy (PDR) treated by panretinal photocoagulation (PRP). METHODS: Each patient included in this prospective clinical study was newly diagnosed with PDR and NVE confirmed by both fundus fluorescein angiography (FFA) and OCTA. They received four sessions of PRP using a multiwavelength laser. Best-corrected visual acuity (BCVA) and OCTA images of the NVE were obtained before each PRP session and at 1 month, 3 months, and 6 months after the PRP treatment. Generalized estimating equations (GEE) was used to investigate the differences between the BCVA and NVE areas before and after PRP. RESULTS: Thirty-two eyes of 32 patients with a mean age of 50.56 ± 7.05 years were included. We found a statistically significant reduction in the NVE area at all time points compared with the baseline except at 6 months (all P < 0.05). Further analysis demonstrated no statistically significant change in the NVE area between two adjacent timepoints except from baseline to post-1st PRP (P < 0.05). BCVA at 3 months showed a statistically significant improvement compared with baseline (P < 0.05), but no significant changes in BCVA were observed during the other visits. CONCLUSIONS: We found an overall regression in the NVE area following PRP starting as early as 1 week after the 1st session and lasting up to 3 months. OCTA provides quantitative information on vascular changes and could be a practical method for the longitudinal evaluation of neovascularization.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Neovascularização Retiniana , Adulto , Retinopatia Diabética/diagnóstico por imagem , Retinopatia Diabética/cirurgia , Angiofluoresceinografia , Humanos , Fotocoagulação a Laser , Pessoa de Meia-Idade , Estudos Prospectivos , Neovascularização Retiniana/diagnóstico , Neovascularização Retiniana/cirurgia , Tomografia de Coerência Óptica , Acuidade Visual
14.
BMC Med Inform Decis Mak ; 21(1): 182, 2021 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-34098959

RESUMO

BACKGROUND: Early diagnosis for the diabetes complications is clinically demanding with great significancy. Regarding the complexity of diabetes complications, we applied a multi-label classification (MLC) model to predict four diabetic complications simultaneously using data in the modern electronic health records (EHRs), and leveraged the correlations between the complications to further improve the prediction accuracy. METHODS: We obtained the demographic characteristics and laboratory data from the EHRs for patients admitted to Changzhou No. 2 People's Hospital, the affiliated hospital of Nanjing Medical University in China from May 2013 to June 2020. The data included 93 biochemical indicators and 9,765 patients. We used the Pearson correlation coefficient (PCC) to analyze the correlations between different diabetic complications from a statistical perspective. We used an MLC model, based on the Random Forest (RF) technique, to leverage these correlations and predict four complications simultaneously. We explored four different MLC models; a Label Power Set (LP), Classifier Chains (CC), Ensemble Classifier Chains (ECC), and Calibrated Label Ranking (CLR). We used traditional Binary Relevance (BR) as a comparison. We used 11 different performance metrics and the area under the receiver operating characteristic curve (AUROC) to evaluate these models. We analyzed the weights of the learned model and illustrated (1) the top 10 key indicators of different complications and (2) the correlations between different diabetic complications. RESULTS: The MLC models including CC, ECC and CLR outperformed the traditional BR method in most performance metrics; the ECC models performed the best in Hamming loss (0.1760), Accuracy (0.7020), F1_Score (0.7855), Precision (0.8649), F1_micro (0.8078), F1_macro (0.7773), Recall_micro (0.8631), Recall_macro (0.8009), and AUROC (0.8231). The two diabetic complication correlation matrices drawn from the PCC analysis and the MLC models were consistent with each other and indicated that the complications correlated to different extents. The top 10 key indicators given by the model are valuable in medical application. CONCLUSIONS: Our MLC model can effectively utilize the potential correlation between different diabetic complications to further improve the prediction accuracy. This model should be explored further in other complex diseases with multiple complications.


Assuntos
Complicações do Diabetes , Diabetes Mellitus , China , Atenção à Saúde , Complicações do Diabetes/diagnóstico , Diabetes Mellitus/diagnóstico , Registros Eletrônicos de Saúde , Humanos , Curva ROC
15.
Med Clin North Am ; 105(4): 663-679, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34059244

RESUMO

Lower extremity ulcerations contribute to significant morbidity and economic burden globally. Chronic wounds, or those that do not progress through healing in a timely manner, are estimated to affect 6.5 million people in the United States alone causing, significant morbidity and economic burden of at least an estimated $25 billion annually. Owing to the aging population and increasing rates of obesity and diabetes mellitus globally, chronic lower extremity ulcers are predicted to increase. Here, we explore the pathophysiology, diagnosis, and management of the most (and least) commonly seen lower extremity ulcers.


Assuntos
Úlcera da Perna/diagnóstico , Úlcera da Perna/economia , Úlcera da Perna/terapia , Extremidade Inferior/patologia , Adulto , Idoso , Envelhecimento/fisiologia , Aterosclerose/complicações , Doença Crônica , Comorbidade , Efeitos Psicossociais da Doença , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Úlcera da Perna/fisiopatologia , Extremidade Inferior/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Fatores de Risco , Estados Unidos/epidemiologia , Cicatrização/fisiologia
16.
Med Clin North Am ; 105(4): 681-697, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34059245

RESUMO

Diabetes mellitus is a significant worldwide health concern and cutaneous manifestations are common. This review describes characteristic skin findings of diabetes, general skin findings related to diabetes, and findings related to diabetes treatment with a focus on clinical presentation, diagnosis, pathophysiology, epidemiology, and treatment. As the prevalence of diabetes continues to rise, cutaneous manifestations of diabetes mellitus likely will be encountered more frequently by physicians in all disciplines including dermatologists and primary care physicians. Accordingly, knowledge regarding the prevention, diagnosis, and management of cutaneous manifestations is an important aspect in the care of patients with diabetes.


Assuntos
Complicações do Diabetes/patologia , Diabetes Mellitus/epidemiologia , Dermatopatias/diagnóstico , Dermatopatias/prevenção & controle , Dermatopatias/fisiopatologia , Acantose Nigricans/etiologia , Acantose Nigricans/patologia , Acantose Nigricans/terapia , Dermatologistas/estatística & dados numéricos , Pé Diabético/etiologia , Pé Diabético/patologia , Pé Diabético/terapia , Saúde Global/estatística & dados numéricos , Humanos , Conhecimento , Lipodistrofia/etiologia , Lipodistrofia/patologia , Lipodistrofia/terapia , Pessoa de Meia-Idade , Necrobiose Lipoídica/etiologia , Necrobiose Lipoídica/patologia , Necrobiose Lipoídica/terapia , Médicos de Atenção Primária/estatística & dados numéricos , Prevalência , Escleredema do Adulto/etiologia , Escleredema do Adulto/patologia , Escleredema do Adulto/terapia , Dermatopatias/epidemiologia
17.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 50(2): 239-244, 2021 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-34137229

RESUMO

To investigate the postoperative serum triglyceride (TG) levels in predicting the risk of new-onset diabetes mellitus (NODM) in patients following allogeneic liver transplantation. One hundred and forty three patients undergoing allogeneic liver transplantation in Shanghai General Hospital from July 2007 to July 2014 were enrolled in this study. The NODM developed in 33 patients after liver transplantation. The curve of dynamic TG levels in the early period after liver transplantation was generated. Independent risk factors of NODM were determined by univariate and multivariant logistic regression analyses. The clinical value of TG in predicting NODM was analyzed by area under the ROC curve (AUC). Serum TG levels were gradually rising in the first week and then reached the plateau phase (stable TG, sTG) in patients after surgery. The sTG in NODM group were significantly higher than that in non-NODM group (=-2.31, <0.05). Glucocorticoid therapy (=4.054, <0.01), FK506 drug concentration in the first week after operation (=3.482, <0.05) and sTG (=3.156, <0.05) were independent risk factors of NODM. ROC curve analysis showed that the AUC of sTG in predicting NODM was 0.72. TG shows a gradual recovery process in the early period after liver transplantation, and the higher TG level in stable phase may significantly increase the risk of NODM in patients.


Assuntos
Diabetes Mellitus , Transplante de Fígado , China/epidemiologia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/etiologia , Humanos , Transplante de Fígado/efeitos adversos , Fatores de Risco , Tacrolimo/efeitos adversos , Triglicerídeos
18.
BMC Bioinformatics ; 22(1): 318, 2021 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-34116627

RESUMO

BACKGROUND: Drug-drug interaction (DDI) is a serious public health issue. The L1000 database of the LINCS project has collected millions of genome-wide expressions induced by 20,000 small molecular compounds on 72 cell lines. Whether this unified and comprehensive transcriptome data resource can be used to build a better DDI prediction model is still unclear. Therefore, we developed and validated a novel deep learning model for predicting DDI using 89,970 known DDIs extracted from the DrugBank database (version 5.1.4). RESULTS: The proposed model consists of a graph convolutional autoencoder network (GCAN) for embedding drug-induced transcriptome data from the L1000 database of the LINCS project; and a long short-term memory (LSTM) for DDI prediction. Comparative evaluation of various machine learning methods demonstrated the superior performance of our proposed model for DDI prediction. Many of our predicted DDIs were revealed in the latest DrugBank database (version 5.1.7). In the case study, we predicted drugs interacting with sulfonylureas to cause hypoglycemia and drugs interacting with metformin to cause lactic acidosis, and showed both to induce effects on the proteins involved in the metabolic mechanism in vivo. CONCLUSIONS: The proposed deep learning model can accelerate the discovery of new DDIs. It can support future clinical research for safer and more effective drug co-prescription.


Assuntos
Aprendizado Profundo , Diabetes Mellitus , Preparações Farmacêuticas , Análise de Dados , Interações Medicamentosas , Humanos , Transcriptoma
19.
Endocr Pract ; 27(6): 505-537, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34116789

RESUMO

OBJECTIVE: To provide evidence-based recommendations regarding the use of advanced technology in the management of persons with diabetes mellitus to clinicians, diabetes-care teams, health care professionals, and other stakeholders. METHODS: The American Association of Clinical Endocrinology (AACE) conducted literature searches for relevant articles published from 2012 to 2021. A task force of medical experts developed evidence-based guideline recommendations based on a review of clinical evidence, expertise, and informal consensus, according to established AACE protocol for guideline development. MAIN OUTCOME MEASURES: Primary outcomes of interest included hemoglobin A1C, rates and severity of hypoglycemia, time in range, time above range, and time below range. RESULTS: This guideline includes 37 evidence-based clinical practice recommendations for advanced diabetes technology and contains 357 citations that inform the evidence base. RECOMMENDATIONS: Evidence-based recommendations were developed regarding the efficacy and safety of devices for the management of persons with diabetes mellitus, metrics used to aide with the assessment of advanced diabetes technology, and standards for the implementation of this technology. CONCLUSIONS: Advanced diabetes technology can assist persons with diabetes to safely and effectively achieve glycemic targets, improve quality of life, add greater convenience, potentially reduce burden of care, and offer a personalized approach to self-management. Furthermore, diabetes technology can improve the efficiency and effectiveness of clinical decision-making. Successful integration of these technologies into care requires knowledge about the functionality of devices in this rapidly changing field. This information will allow health care professionals to provide necessary education and training to persons accessing these treatments and have the required expertise to interpret data and make appropriate treatment adjustments.


Assuntos
Diabetes Mellitus Tipo 1 , Diabetes Mellitus , Glicemia , Automonitorização da Glicemia , Diabetes Mellitus/terapia , Diabetes Mellitus Tipo 1/tratamento farmacológico , Humanos , Insulina/uso terapêutico , Sistemas de Infusão de Insulina , Qualidade de Vida , Tecnologia , Estados Unidos
20.
N Engl J Med ; 384(23): 2219-2228, 2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34107181

RESUMO

BACKGROUND: Documenting current trends in diabetes treatment and risk-factor control may inform public health policy and planning. METHODS: We conducted a cross-sectional analysis of data from adults with diabetes in the United States participating in the National Health and Nutrition Examination Survey (NHANES) to assess national trends in diabetes treatment and risk-factor control from 1999 through 2018. RESULTS: Diabetes control improved from 1999 to the early 2010s among the participants but subsequently stalled and declined. Between the 2007-2010 period and the 2015-2018 period, the percentage of adult NHANES participants with diabetes in whom glycemic control (glycated hemoglobin level, <7%) was achieved declined from 57.4% (95% confidence interval [CI], 52.9 to 61.8) to 50.5% (95% CI, 45.8 to 55.3). After major improvements in lipid control (non-high-density lipoprotein cholesterol level, <130 mg per deciliter) in the early 2000s, minimal improvement was seen from 2007-2010 (52.3%; 95% CI, 49.2 to 55.3) to 2015-2018 (55.7%; 95% CI, 50.8 to 60.5). From 2011-2014 to 2015-2018, the percentage of participants in whom blood-pressure control (<140/90 mm Hg) was achieved decreased from 74.2% (95% CI, 70.7 to 77.4) to 70.4% (95% CI, 66.7 to 73.8). The percentage of participants in whom all three targets were simultaneously achieved plateaued after 2010 and was 22.2% (95% CI, 17.9 to 27.3) in 2015-2018. The percentages of participants who used any glucose-lowering medication or any blood-pressure-lowering medication were unchanged after 2010, and the percentage who used statins plateaued after 2014. After 2010, the use of combination therapy declined in participants with uncontrolled blood pressure and plateaued for those with poor glycemic control. CONCLUSIONS: After more than a decade of progress from 1999 to the early 2010s, glycemic and blood-pressure control declined in adult NHANES participants with diabetes, while lipid control leveled off. (Funded by the National Heart, Lung, and Blood Institute.).


Assuntos
Anti-Hipertensivos/uso terapêutico , Diabetes Mellitus/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipoglicemiantes/uso terapêutico , Adulto , Fatores Etários , Idoso , Peso Corporal , Colesterol/sangue , Estudos Transversais , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Quimioterapia Combinada/tendências , Uso de Medicamentos/tendências , Feminino , Hemoglobina A Glicada/análise , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto Jovem
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