Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 30.136
Filtrar
1.
J Med Virol ; 94(1): 99-109, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34570905

RESUMO

A severe pandemic of Coronavirus Disease (COVID-19) has been sweeping the globe since 2019, and this time, it did not stop, with frequent mutations transforming into virulent strains, for instance, B.1.1.7, B.1.351, and B.1.427. In recent months, a fungal infection, mucormycosis has emerged with more fatal responses and significantly increased mortality rate. To measure the severity and potential alternative approaches against black fungus coinfection in COVID-19 patients, PubMed, Google Scholar, World Health Organization (WHO) newsletters, and other online resources, based on the cases reported and retrospective observational analysis were searched from the years 2015-2021. The studies reporting mucormycosis with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) coinfection and/or demonstrating potential risk factors, such as a history of diabetes mellitus or suppressed immune system were included, and reports published in non-English language were excluded. More than 20 case reports and observational studies on black fungus coinfection in COVID-19 patients were eligible for inclusion. The results indicated that diabetes mellitus, hyperglycemic, and immunocompromised COVID-19 patients with mucormycosis were at a higher risk. We found that it was prudent to assess the potential risk factors and severity of invasive mycosis via standardized diagnostic and clinical settings. Large-scale studies need to be conducted to identify early biomarkers and optimization of diagnostic methods has to be established per population and geographical variation. This will not only help clinicians around the world to detect the coinfection in time but also will prepare them for future outbreaks of other potential pandemics.


Assuntos
COVID-19/epidemiologia , Coinfecção/epidemiologia , Mucormicose/epidemiologia , Mucormicose/mortalidade , SARS-CoV-2/isolamento & purificação , Diabetes Mellitus/patologia , Humanos , Hiperglicemia/patologia , Hospedeiro Imunocomprometido/fisiologia , Mucorales/crescimento & desenvolvimento , Mucorales/isolamento & purificação , Mucormicose/patologia , Estudos Retrospectivos , Fatores de Risco
2.
Arch. pediatr. Urug ; 92(2): e305, dic. 2021. tab
Artigo em Espanhol | LILACS, BNUY, UY-BNMED | ID: biblio-1278305

RESUMO

Las afecciones respiratorias agudas son la primera causa de consulta e ingreso hospitalario en los meses de invierno, y entre ellas el asma ocupa un lugar preponderante. El salbutamol es un broncodilatador con eficacia demostrada en las exacerbaciones y se utiliza de primera línea en el tratamiento. El objetivo de la presente comunicación es analizar dos casos clínicos de niños asmáticos que presentaron efectos adversos al salbutamol y requirieron el ingreso en la Unidad de Terapia Intensiva. Se propone revisar los efectos adversos del salbutamol empleado en crisis asmáticas y analizar las alternativas terapéuticas en esta enfermedad. Los síntomas de los efectos secundarios pueden confundirse con los causados por la propia enfermedad, por lo que puede usarse el fármaco de modo excesivo y es importante conocer el perfil posológico y caracterizar los posibles efectos secundarios en los pacientes para usar de manera racional y segura este medicamento.


Acute respiratory conditions are the first cause of consultation and hospital admission in the Winter months, being asthma the most important. Salbutamol is a bronchodilator with proven efficacy in exacerbations used first-line in treatment. The objective of this paper is to analyze two clinical cases of asthmatic children who presented adverse effects to salbutamol and required admission to the Intensive Care Unit. It is proposed to review the adverse effects of salbutamol used in asthmatic crises and to analyze therapeutic alternatives in this disease. Symptoms of side effects can be confused with those caused by the disease itself, determining the excessive use of this drug, thus, it is important to know the dosage profile and characterize the possible side effects to make rational and safe use of this drug.


As doenças respiratórias agudas são a primeira causa de consultas e internações nos meses de inverno e a asma ocupa é a mais importante. O salbutamol é um broncodilatador com eficácia comprovada nas exacerbações e é usado como tratamento de primeira linha. O objetivo desta comunicação é analisar dois casos clínicos de crianças asmáticas que apresentaram efeitos adversos ao salbutamol e necessitaram de internação em Unidade de Terapia Intensiva. Propõe-se revisar os efeitos adversos do salbutamol utilizado na crise asmática e analisar as alternativas terapêuticas nessa doença. Os sintomas de efeitos colaterais podem ser confundidos com os causados pela própria doença, determinando o uso excessivo desse medicamento, sendo importante conhecer o perfil posológico e caracterizar os possíveis efeitos colaterais nos pacientes para fazer um uso racional e seguro desse medicamento.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Acidose Láctica , Broncodilatadores/efeitos adversos , Albuterol/efeitos adversos , Hiperglicemia/induzido quimicamente , Hipopotassemia/induzido quimicamente , Agitação Psicomotora/etiologia , Recidiva , Asma/tratamento farmacológico , Taquicardia/induzido quimicamente , Tremor/induzido quimicamente , Alucinações/induzido quimicamente
3.
Arch Soc Esp Oftalmol (Engl Ed) ; 96(11): 598-601, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34756282

RESUMO

Ophthalmological diabetic complications are one of the main causes of blindness worldwide, so careful diagnostic and management is important. The screening plans implemented in our population made possible an early diagnosis and treatment, trying to reduce the consequences. Diabetic retinopathy is widely known, however we present the case of a rare retinal condition, acute panedothelial retinal leakage. It typically affects patients with type 1 DM and poor glycemic control. Its diagnosis is important since a strict metabolic control is sufficient for its resolution, avoiding aggressive therapies.


Assuntos
Diabetes Mellitus Tipo 1 , Retinopatia Diabética , Hiperglicemia , Cegueira , Diabetes Mellitus Tipo 1/complicações , Retinopatia Diabética/diagnóstico , Humanos , Retina
4.
Zhongguo Ying Yong Sheng Li Xue Za Zhi ; 37(5): 561-565, 2021 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-34816674

RESUMO

Objective: To investigate the effects of inhibition of lncRNA PVT1 on the proliferation, apoptosis and oxidative stress of vascular endothelial cells induced by hyperglycemic. Methods: Human umbilical vein endothelial cells (HUVECs) were cultured in vitro and divided into four groups: control group (5.5 mmol/L glucose), high glucose group (30 mmol/L glucose), high glucose + siNC group (30 mmol/L glucose +siNC, negative control group), HG + siPVT1 group (30 mmol/L glucose + siPVT1, lncRNA PVT1 silencing group). The expression of PVT1 after transfection was detected by quantitative real-time PCR. MTT assay was used to detect the effect of siPVT1 (small interfering RNA PVT1) on the proliferation of HUVECs cells induced by high glucose. Flow cytometry was used to detect ROS and apoptosis of HUVECs cells induced by siPVT1. Western blot was used to detect the expression levels of apoptotic proteins such as Bax, Bcl-2, and cleaved caspase-3 in HUVECs cells. Results: Compared with the control group, after transfection with siPVT1, the expression level of PVT1 was decreased significantly (P<0.05). MTT results showed that the proliferation activity of HUVECs cells in the high-glucose group was reduced significantly after 24 h and 48 h. Compared with the HG + siNC group, the proliferation activity of HUVECs cells in the HG + siPVT1 group was increased significantly (P<0.05) after 24 h and 48 h. Flow cytometry results showed that ROS and apoptosis rate of HUVECs cells in the high-glucose group were increased significantly compared with the control group. Compared with the HG + siNC (negative control) group, ROS and apoptosis rates of HUVECs cells in the HG + siPVT1 group were reduced significantly. Compared with the control group, the expression levels of cleaved-caspase-3 and Bax in the high-glucose group were significantly up-regulated, while the expression level of Bcl-2 was down-regulated. Compared with the HG + siNC group, the expression levels of cleaved-caspase-3 and Bax were down-regulated, and the expression level of Bcl-2 was up-regulated. The differences were statistically significant (P<0.05). Conclusion: Inhibition of lncRNA PVT1 can significantly increase the proliferation activity of HUVECs cells induced by hyperglycemia, reduce oxidative stress and inhibit cell apoptosis.


Assuntos
Hiperglicemia , RNA Longo não Codificante , Apoptose , Proliferação de Células , Células Cultivadas , Glucose , Células Endoteliais da Veia Umbilical Humana , Humanos , Estresse Oxidativo , RNA Longo não Codificante/genética
5.
Wiad Lek ; 74(9 cz 1): 2052-2059, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34725275

RESUMO

OBJECTIVE: The aim: To evaluate morphological changes in long tubular bones of mature rats under the influence of experimental hyperglycemia. PATIENTS AND METHODS: Materials and methods: The study was conducted on 140 nonlinear white male rats divided into two groups. The experimental group included rats that were introduced into a state of hyperglycemia by a single intraperitoneal injection of an alloxan dihydrate solution at a dose of 150 mg / kg body weight in 0.9% sodium chloride. The control group included rats that were injected with a similar volume of 0.9% sodium chloride one time intraperitoneally. The animals were taken out of the experiment on the 2nd, 30th, 60th, 90th, 120th, 150th and 180th day. Right and left femur and humerus were studied by morphometric and histological methods. RESULTS: Results: Under conditions of prolonged uncontrolled hyperglycemia in mature rats, there is a slowdown in the growth rate of length and thickness of femur and humerus. This is indicated by a significant decrease in the length of bone and its diaphyses, as well as by a decrease in the cross-sectional area of the diaphysis, the width of the proximal and distal epiphyses, starting from 120 and 90 days of the experiment, respectively. The relative area of trabecular tissue, thickness of trabeculae and epiphyseal cartilage decreases in comparison with animals of the control group. The diameter of osteons and their channels increases in cortical tissue. Changes in the microarchitecture of the trabecular and cortical compartments of femur and humerus under conditions of hyperglycemia are similar and are characterized by a reduced bone mass, bone disorder progression and remodeling disorders. CONCLUSION: Conclusions: Prolonged uncontrolled experimental hyperglycemia leads to slow growth of femur and humerus in mature rats, which is accompanied by an increase in microarchitecture disorder of the trabecular and cortical compartments, causing miniaturization of bones and, consequently, violation of their biomechanical properties and increased risk of fractures.


Assuntos
Fraturas Ósseas , Hiperglicemia , Animais , Densidade Óssea , Osso e Ossos , Fêmur , Masculino
6.
Pan Afr Med J ; 39: 274, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34754351

RESUMO

Introduction: hyperglycemic emergencies (diabetic ketoacidosis and hyperglycemic hyperosmolar state) are the most common serious acute metabolic complications of diabetes which result in significant morbidity and mortality. There is paucity of data on hyperglycemic emergencies in Cameroon. The objective of this study was to investigate the precipitants and outcomes of patients admitted for hyperglycemic emergencies in the Buea Regional Hospital in the South West Region of Cameroon. Methods: in this retrospective study the medical records of patients admitted for hyperglycemic emergencies between 2013 and 2016 in the medical unit of the Buea Regional Hospital were reviewed. We extracted data on demographic characteristics, admission clinical characteristics, precipitants, and treatment outcomes. Logistic regression was used to determine predictors of mortality. Results: data were available for 60 patients (51.7% females) admitted for hyperglycemic emergencies. The mean age was 55.2±16.3 (range 18-86). Overall there were 51 (85%) cases of hyperosmolar hyperglycemic state. Twenty six (43.3%) of the patients had hypertension. The most common precipitants of hyperglycemic emergencies were infections (41.7%), newly diagnosed diabetes (33.3%) and non-adherence to medications (33.3%). Mean admission blood glucose was 574mg/dl±70.0mg/dl. The median length of hospital stay was 6 days. Overall case fatality rate was 21.7%. Six (46.2%) deaths were related to infections. Predictors of mortality were a Glasgow coma score <13(p<0.001), a diastolic blood pressure <60 mmHg (p=0.034) and a heart rate >90(0.057) on admission. Conclusion: admission for hyperglycemic emergencies in this semi-urban hospital is associated with abnormally high case fatality. Infections, newly diagnosed diabetes and non-adherence to medications are the commonest precipitants of hyperglycemic emergencies. Public health measures to reduce morbidity and mortality from hyperglycemic crisis are urgently needed.


Assuntos
Cetoacidose Diabética/diagnóstico , Hiperglicemia/diagnóstico , Coma Hiperglicêmico Hiperosmolar não Cetótico/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Glicemia/metabolismo , Camarões , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Cetoacidose Diabética/epidemiologia , Cetoacidose Diabética/terapia , Emergências , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Hiperglicemia/mortalidade , Hiperglicemia/terapia , Coma Hiperglicêmico Hiperosmolar não Cetótico/epidemiologia , Coma Hiperglicêmico Hiperosmolar não Cetótico/terapia , Tempo de Internação/estatística & dados numéricos , Masculino , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
7.
J Nutr Sci Vitaminol (Tokyo) ; 67(5): 283-291, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34719613

RESUMO

Zeolite, an abundant mineral in the Earth's crust, is utilized in a wide range of fields because of its well-known adsorption properties. Its application as a functional food ingredient resembling dietary fiber is expected, but it has not yet been investigated in the context of prevention of lifestyle-related diseases. The present study was designed to evaluate the availability and safety of a natural zeolite preparation for this purpose. Acute oral toxicity testing showed that the lowest lethal dose of zeolite was more than 2,000 mg/kg body weight for both male and female mice. In a prolonged feeding test for 18 wk using model mice with high-fat-induced obesity and type 2 diabetes mellitus, intake of a 10% zeolite-containing diet suppressed body weight gain, as well as liver and visceral fat weights, without any changes in food and energy intake. Moreover, plasma lipid (triacylglycerol, total cholesterol and high-density-lipoprotein cholesterol) levels and fasting blood glucose levels decreased in parallel with zeolite intake. No changes in the glycated hemoglobin level were found. However, in an oral glucose tolerance test at week 12, increased postprandial blood glucose levels were suppressed in accordance with zeolite intake, and then insulin secretion was also decreased. On the other hand, a decrease of plasma amylase activity and increases in total bilirubin and urea nitrogen suggested the need for further investigation of safety.


Assuntos
Diabetes Mellitus Tipo 2 , Hiperglicemia , Hiperlipidemias , Zeolitas , Animais , Glicemia , Diabetes Mellitus Tipo 2/prevenção & controle , Dieta Hiperlipídica/efeitos adversos , Feminino , Hiperlipidemias/etiologia , Hiperlipidemias/prevenção & controle , Insulina , Masculino , Camundongos , Obesidade/etiologia , Obesidade/prevenção & controle
8.
Ann Palliat Med ; 10(9): 9685-9691, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34628894

RESUMO

BACKGROUND: It is well known that diabetes mellitus is one of the high-risk factors for periodontitis and also for the failure of implant restorations. Usually, the success of an implant restoration depends on both the good osseointegration and the stable soft tissue interface on the implant neck. A good gingival interface of the implant neck is the barrier that enables implant to resist oral microorganisms and the site of initiation of peri-implantitis. This study sought to investigate the effects of hyperglycemia on the attachment and proliferation of human gingival fibroblasts (HGFs) on pure titanium surfaces. METHODS: HGFs were cultured in cell culture mediums with different glucose concentrations (i.e., 5.5, 8. 8, 10, and 15 mmol/L) for 7 d and seeded on pure titanium surfaces. The cells that were seeded on the titanium surfaces had been cultured in cell culture mediums with different glucose concentrations for 3 and 7 d. The attached HGFs on the titanium surfaces were counted for all groups using a blood cell counting plate, and the results were statistically analyzed. The morphologies of the attached HGFs on the titanium surfaces were observed for all the groups using a scanning electronic microscope. RESULTS: As the glucose concentrations increased, the number of attached HGFs on the titanium surfaces decreased. The numbers of attached cells in Groups A and B 7 d after being seeded on the titanium surfaces were more than those 3 d after being seeded (P<0.05). The numbers of attached cells in Groups C and D 3 d after being seeded on the titanium were more than those 7 d after being seeded (P<0.05). The scanning electronic microscope showed that the attached cells in Groups A and B proliferated well, and most cells grew one on top of another. Conversely, the attached cells in Groups C and D proliferated sparsely and the cell morphologies were not good. CONCLUSIONS: The attachment and proliferation of HGFs on pure titanium surfaces were inhibited by increases in glucose concentrations, and the inhibition was further enhanced by the passage of time.


Assuntos
Hiperglicemia , Titânio , Adesão Celular , Células Cultivadas , Fibroblastos , Humanos , Propriedades de Superfície
9.
Int J Mol Sci ; 22(19)2021 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-34639136

RESUMO

BACKGROUND: α-cyclodextrin (α-CD) is one of the dietary fibers that may have a beneficial effect on cholesterol and/or glucose metabolism, but its efficacy and mode of action remain unclear. METHODS: In the present study, we examined the anti-hyperglycemic effect of α-CD after oral loading of glucose and liquid meal in mice. RESULTS: Administration of 2 g/kg α-CD suppressed hyperglycemia after glucose loading, which was associated with increased glucagon-like peptide 1 (GLP-1) secretion and enhanced hepatic glucose sequestration. By contrast, 1 g/kg α-CD similarly suppressed hyperglycemia, but without increasing secretions of GLP-1 and insulin. Furthermore, oral α-CD administration disrupts lipid micelle formation through its inclusion of lecithin in the gut luminal fluid. Importantly, prior inclusion of α-CD with lecithin in vitro nullified the anti-hyperglycemic effect of α-CD in vivo, which was associated with increased intestinal mRNA expressions of SREBP2-target genes (Ldlr, Hmgcr, Pcsk9, and Srebp2). CONCLUSIONS: α-CD elicits its anti-hyperglycemic effect after glucose loading by inducing lecithin inclusion in the gut lumen and activating SREBP2, which is known to induce cholecystokinin secretion to suppress hepatic glucose production via a gut/brain/liver axis.


Assuntos
Trato Gastrointestinal/metabolismo , Hiperglicemia/prevenção & controle , Lecitinas/metabolismo , Período Pós-Prandial , Canais de Potássio Corretores do Fluxo de Internalização/fisiologia , Proteína de Ligação a Elemento Regulador de Esterol 2/metabolismo , alfa-Ciclodextrinas/farmacologia , Animais , Trato Gastrointestinal/efeitos dos fármacos , Hiperglicemia/etiologia , Hiperglicemia/metabolismo , Hiperglicemia/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Proteína de Ligação a Elemento Regulador de Esterol 2/genética
10.
Int J Mol Sci ; 22(19)2021 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-34639069

RESUMO

The prevalence of type 2 diabetes (T2D) is rapidly increasing across the globe. Fetal exposure to maternal diabetes was correlated with higher prevalence of impaired glucose tolerance and T2D later in life. Previous studies showed aberrant DNA methylation patterns in pancreas of T2D patients. However, the underlying mechanisms remained largely unknown. We utilized human embryonic stem cells (hESC) as the in vitro model for studying the effects of hyperglycemia on DNA methylome and early pancreatic differentiation. Culture in hyperglycemic conditions disturbed the pancreatic lineage potential of hESC, leading to the downregulation of expression of pancreatic markers PDX1, NKX6-1 and NKX6-2 after in vitro differentiation. Genome-wide DNA methylome profiling revealed over 2000 differentially methylated CpG sites in hESC cultured in hyperglycemic condition when compared with those in control glucose condition. Gene ontology analysis also revealed that the hypermethylated genes were enriched in cell fate commitment. Among them, NKX6-2 was validated and its hypermethylation status was maintained upon differentiation into pancreatic progenitor cells. We also established mouse ESC lines at both physiological glucose level (PG-mESC) and conventional hyperglycemia glucose level (HG-mESC). Concordantly, DNA methylome analysis revealed the enrichment of hypermethylated genes related to cell differentiation in HG-mESC, including Nkx6-1. Our results suggested that hyperglycemia dysregulated the epigenome at early fetal development, possibly leading to impaired pancreatic development.


Assuntos
Diferenciação Celular/genética , Metilação de DNA , Células-Tronco Embrionárias/metabolismo , Hiperglicemia/genética , Hiperglicemia/metabolismo , Pâncreas/citologia , Pâncreas/metabolismo , Linhagem Celular , Células Cultivadas , Biologia Computacional/métodos , Diabetes Mellitus Tipo 2 , Células-Tronco Embrionárias/citologia , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Glucose/metabolismo , Células-Tronco Embrionárias Humanas/citologia , Células-Tronco Embrionárias Humanas/metabolismo , Humanos , Células Secretoras de Insulina/citologia , Células Secretoras de Insulina/metabolismo
11.
Medicina (Kaunas) ; 57(10)2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34684109

RESUMO

Diabetes mellitus is an increasingly prevalent chronic metabolic disease characterized by prolonged hyperglycemia that leads to long-term health consequences. It is estimated that impaired healing of diabetic wounds affects approximately 25% of all patients with diabetes mellitus, often resulting in lower limb amputation, with subsequent high economic and psychosocial costs. The hyperglycemic environment promotes the formation of biofilms and makes diabetic wounds difficult to treat. In this review, we present updates regarding recent advances in our understanding of the pathophysiology of diabetic wounds focusing on impaired angiogenesis, neuropathy, sub-optimal chronic inflammatory response, barrier disruption, and subsequent polymicrobial infection, followed by current and future treatment strategies designed to tackle the various pathologies associated with diabetic wounds. Given the alarming increase in the prevalence of diabetes, and subsequently diabetic wounds, it is imperative that future treatment strategies target multiple causes of impaired healing in diabetic wounds.


Assuntos
Diabetes Mellitus , Pé Diabético , Hiperglicemia , Amputação , Doença Crônica , Pé Diabético/terapia , Humanos , Cicatrização
12.
Int J Mol Sci ; 22(19)2021 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-34639164

RESUMO

Hyperglycemia is a condition with high glucose levels that may result in dyslipidemia. In severe cases, this alteration may lead to diabetic retinopathy. Numerous drugs have been approved by officials to treat these conditions, but usage of any synthetic drugs in the long term will result in unavoidable side effects such as kidney failure. Therefore, more emphasis is being placed on natural ingredients due to their bioavailability and absence of side effects. In regards to this claim, promising results have been witnessed in the usage of Ipomoea batatas (I. batatas) in treating the hyperglycemic and dyslipidemic condition. Thus, the aim of this paper is to conduct an overview of the reported effects of I. batatas focusing on in vitro and in vivo trials in reducing high glucose levels and regulating the dyslipidemic condition. A comprehensive literature search was performed using Scopus, Web of Science, Springer Nature, and PubMed databases to identify the potential articles on particular topics. The search query was accomplished based on the Boolean operators involving keywords such as (1) Beneficial effect OR healing OR intervention AND (2) sweet potato OR Ipomoea batatas OR traditional herb AND (3) blood glucose OR LDL OR lipid OR cholesterol OR dyslipidemia. Only articles published from 2011 onwards were selected for further analysis. This review includes the (1) method of intervention and the outcome (2) signaling mechanism involved (3) underlying mechanism of action, and the possible side effects observed based on the phytoconstiuents isolated. The comprehensive literature search retrieved a total of 2491 articles using the appropriate keywords. However, on the basis of the inclusion and exclusion criteria, only 23 articles were chosen for further review. The results from these articles indicate that I. batatas has proven to be effective in treating the hyperglycemic condition and is able to regulate dyslipidemia. Therefore, this systematic review summarizes the signaling mechanism, mechanism of action, and phytoconstituents responsible for those activities of I. batatas in treating hyperglycemic based on the in vitro and in vivo study.


Assuntos
Retinopatia Diabética/prevenção & controle , Dislipidemias/tratamento farmacológico , Hiperglicemia/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Ipomoea batatas/química , Extratos Vegetais/uso terapêutico , Animais , Retinopatia Diabética/etiologia , Dislipidemias/complicações , Humanos , Hiperglicemia/complicações
13.
Int J Mol Sci ; 22(19)2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34639171

RESUMO

Diabetes is a major risk factor for cardiovascular diseases, especially cardiomyopathy, a condition in which the smooth muscles of the heart become thick and rigid, affecting the functioning of cardiomyocytes, the contractile cells of the heart. Uncontrolled elevated glucose levels over time can result in oxidative stress, which could lead to inflammation and altered epigenetic mechanisms. In the current study, we investigated whether hyperglycemia can modify cardiac function by directly affecting these changes in cardiomyocytes. To evaluate the adverse effect of high glucose, we measured the levels of gap junction protein, connexin 43, which is responsible for modulating cardiac electric activities and Troponin I, a part of the troponin complex in the heart muscles, commonly used as cardiac markers of ischemic heart disease. AC16 human cardiomyocyte cells were used in this study. Under hyperglycemic conditions, these cells demonstrated altered levels of connexin 43 and Troponin-I after 24 h of exposure. We also examined hyperglycemia induced changes in epigenetic markers: H3K9me1, Sirtuin-1 (SIRT1), and histone deacetylase (HDAC)-2 as well as in inflammatory and stress-related mediators, such as heat shock protein (HSP)-60, receptor for advanced glycation end products (RAGE), toll-like receptor (TLR)-4, high mobility group box (HMGB)-1 and CXC chemokine receptor (CXCR)-4. Cardiomyocytes exposed to 25mM glucose resulted in the downregulation of HSP60 and SIRT1 after 48 h. We further examined that hyperglycemia mediated the decrease in the gap junction protein CX43, as well as CXC chemokine receptor CXCR4 which may affect the physiological functions of the cardiomyocytes when exposed to high glucose for 24 and 48 h. Upregulated expression of DNA-binding nuclear protein HMGB1, along with changes in histone methylation marker H3K9me1 have demonstrated hyperglycemia-induced damage to cardiomyocyte at 24 h of exposure. Our study established that 24 to 48 h of hyperglycemic exposure could stimulate stress-mediated inflammatory mediators in cardiomyocytes in vitro. These stress-related changes in hyperglycemia-induced cardiomyocytes may further initiate an increase in injury markers which eventually could alter the epigenetic processes. Therefore, epigenetic and inflammatory mechanisms in conjunction with alterations in a downstream signaling pathway could have a direct effect on the functionality of the cardiomyocytes exposed to high glucose during short and long-term exposures.


Assuntos
Biomarcadores/metabolismo , Epigênese Genética , Hiperglicemia/fisiopatologia , Mediadores da Inflamação/metabolismo , Miócitos Cardíacos/patologia , Estresse Fisiológico , Chaperonina 60/genética , Chaperonina 60/metabolismo , Conexina 43/genética , Conexina 43/metabolismo , Proteína HMGB1/genética , Proteína HMGB1/metabolismo , Histona Desacetilase 2/genética , Histona Desacetilase 2/metabolismo , Humanos , Proteínas Mitocondriais/genética , Proteínas Mitocondriais/metabolismo , Miócitos Cardíacos/metabolismo , Receptores CXCR4/genética , Receptores CXCR4/metabolismo , Sirtuína 1/genética , Sirtuína 1/metabolismo
14.
Int J Mol Sci ; 22(19)2021 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-34638531

RESUMO

Cardiovascular disease (CVD) is the primary cause of higher and earlier morbidity and mortality in people with type 1 diabetes (T1D) compared to people without diabetes. In addition, women with T1D are at an even higher relative risk for CVD than men. However, the underlying pathophysiology is not well understood. Atherosclerotic changes are known to progress early in life among people with T1D, yet it is less clear when excess CVD risk begins in females with T1D. This review explores the prevalence of classical CVD risk factors (such as glycemic control, hypertension, dyslipidemia, obesity, albuminuria, smoking, diet, physical inactivity), as well as of novel biomarkers (such as chronic inflammation), in children and adolescents with T1D with particular regard to sex-related differences in risk profile. We also summarize gaps where further research and clearer clinical guidance are needed to better address this issue. Considering that girls with T1D might have a more adverse CVD risk profile than boys, the early identification of and sex-specific intervention in T1D would have the potential to reduce later CVD morbidity and excess mortality in females with T1D. To conclude, based on an extensive review of the existing literature, we found a clear difference between boys and girls with T1D in the presence of individual CVD risk factors as well as in overall CVD risk profiles; the girls were on the whole more impacted.


Assuntos
Aterosclerose/complicações , Doença da Artéria Coronariana/complicações , Diabetes Mellitus Tipo 1/etiologia , Fatores de Risco de Doenças Cardíacas , Hipertensão/complicações , Adolescente , Pressão Sanguínea/fisiologia , Criança , Dislipidemias/patologia , Feminino , Humanos , Hiperglicemia/patologia , Masculino , Obesidade/patologia , Comportamento Sedentário , Fatores Sexuais
15.
J Coll Physicians Surg Pak ; 31(10): 1228-1230, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34601847

RESUMO

Hemichorea-hemiballismus, secondary to hyperglycemia, is a rare but easily treatable condition that is usually associated with type II diabetes mellitus. This is a case of a 68- year lady, with long-standing, poorly controlled diabetes mellitus, who presented with disabling right-sided hemichorea-hemiballismus. The T1-weighted magnetic resonance imaging revealed hyperintensity in the basal ganglia. The abnormal movements subsided within a few days after achieving euglycaemia with insulin therapy. This case highlights the importance of treatment of hyperglycaemia in a diabetic patient presenting with acute or sub-acute abnormal movement disorder. Key Words: Hemichorea, Hemiballismus, Hyperglycemia, T-1 hyperintensity.


Assuntos
Diabetes Mellitus Tipo 2 , Discinesias , Hiperglicemia , Encéfalo/diagnóstico por imagem , Diabetes Mellitus Tipo 2/complicações , Discinesias/tratamento farmacológico , Discinesias/etiologia , Humanos , Hiperglicemia/complicações , Hiperglicemia/tratamento farmacológico , Imageamento por Ressonância Magnética
16.
Arthritis Res Ther ; 23(1): 253, 2021 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-34620223

RESUMO

BACKGROUND: The objective of this study was to determine if mechanistic target of rapamycin (mTOR) inhibition with or without AMP-activated protein kinase (AMPK) activation can protect against primary, age-related OA. DESIGN: Dunkin-Hartley guinea pigs develop mild primary OA pathology by 5 months of age that progresses to moderate OA by 8 months of age. At 5 months, guinea pigs served as young control (n = 3) or were fed either a control diet (n = 8), a diet enriched with the mTOR-inhibitor rapamycin (Rap, 14 ppm, n = 8), or Rap with the AMPK-activator metformin (Rap+Met, 1000 ppm, n = 8) for 12 weeks. Knee joints were evaluated by OARSI scoring, micro-computed tomography, and immunohistochemistry. Glenohumeral articular cartilage was collected for western blotting. RESULTS: Rap- and Rap+Met-treated guinea pigs displayed lower body weight than control. Rap and Rap+Met inhibited articular cartilage mTORC1 but not mTORC2 signaling. Rap+Met, but not Rap alone, stimulated AMPK. Despite lower body weight and articular cartilage mTORC1 inhibition, Rap- and Rap+Met-treated guinea pigs had greater OA severity in the medial tibial plateau due to articular cartilage structural damage and/or proteoglycan loss. Rap and Rap+Met increased plasma glucose compared to control. Plasma glucose concentration was positively correlated with proteoglycan loss, suggesting hyperglycemic stress after Rap treatment was related to worsened OA. CONCLUSIONS: This is the first study to show that Rap induced increase in plasma glucose was associated with greater OA severity. Further, articular cartilage mTORC1 inhibition and bodyweight reduction by dietary Rap and Rap+Met did not appear to protect against primary OA during the prevailing hyperglycemia.


Assuntos
Cartilagem Articular , Hiperglicemia , Osteoartrite , Animais , Cobaias , Hiperglicemia/induzido quimicamente , Osteoartrite/induzido quimicamente , Sirolimo/toxicidade , Microtomografia por Raio-X
17.
Aquat Toxicol ; 241: 106000, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34715482

RESUMO

Bisphenol AF (BPAF), one of the main alternatives to bisphenol A, has been frequently detected in various environmental media, including the human body, and is an emerging contaminant. Epidemiological investigations have recently shown the implications of exposure to BPAF in the incidence of diabetes mellitus in humans, indicating that BPAF may be a potential diabetogenic endocrine disruptor. However, the effects of BPAF exposure on glucose homeostasis and their underlying mechanisms in animals remain largely unknown, which may limit our understanding of the health risks of BPAF. To this end, zebrafish (Danio rerio), an emerging and valuable model in studying animal glycometabolism and diabetes, were exposed to environmentally relevant concentrations (5 and 50 µg/L) and 500 µg/L BPAF for 28 d. Several key toxicity endpoints of blood glucose metabolism were detected in our study, and the results showed significantly increased fasting blood glucose levels, hepatic glycogen contents and hepatosomatic indexes and decreased muscular glycogen contents in the BPAF-exposed zebrafish. The results of quantitative real-time PCR showed the abnormal expression of genes involved in glycometabolic networks, which might promote hepatic gluconeogenesis and inhibit glycogenesis and glycolysis in the muscle and/or liver. Furthermore, the failure of insulin regulation, including plasma insulin deficiency and impaired insulin signaling pathways in target tissues, may be a potential mechanism underlying BPAF-induced dysfunctional glycometabolism. In summary, our results provide novel in vivo evidence that BPAF can cause fasting hyperglycemia by interfering with glycometabolic networks, which emphasizes the potential health risks of environmental exposure to BPAF in inducing diabetes mellitus.


Assuntos
Hiperglicemia , Poluentes Químicos da Água , Animais , Compostos Benzidrílicos/toxicidade , Jejum , Humanos , Hiperglicemia/induzido quimicamente , Fenóis , Poluentes Químicos da Água/toxicidade , Peixe-Zebra
18.
Can J Surg ; 64(5): E491-E509, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34598927

RESUMO

Preoperative optimization has not been explored comprehensively in the surgical literature, as this responsibility has often been divided among surgery, anesthesia and medicine. We developed an evidence-based clinical practice guideline to summarize existing evidence and present diagnostic and treatment algorithms for use by surgeons caring for patients scheduled to undergo major elective surgery. We focus on 3 common comorbid conditions seen across surgical specialties - anemia, hyperglycemia and smoking - as these conditions increase complication rates in patients undergoing major surgery and can be optimized successfully as soon as 6-8 weeks before surgery. With the ability to address these conditions earlier in the patient journey, surgeons can positively affect patient outcomes. The aim of this guideline is to bring optimization in the preoperative period under the existing umbrella of evidence-based surgical care.


Assuntos
Algoritmos , Anemia/terapia , Medicina Baseada em Evidências/normas , Hiperglicemia/terapia , Complicações Pós-Operatórias/prevenção & controle , Guias de Prática Clínica como Assunto/normas , Cuidados Pré-Operatórios/normas , Fumar/terapia , Anemia/diagnóstico , Humanos , Hiperglicemia/diagnóstico
19.
Eur J Radiol ; 144: 109997, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34634534

RESUMO

PURPOSE: To determine chest CT changes 6 months and 12 months after the onset of coronavirus disease 2019 (COVID-19) in patients with diabetes or hyperglycemia and the risk factors for these residual lung abnormalities. METHODS: In total, 141 COVID-19 patients were assigned to group 1 (diabetes), group 2 (secondary hyperglycemia) or group 3 (controls). Initial and six- and twelve-month follow-up computed tomography (CT) scans were performed 16 days, 175 days and 351 days after symptom onset, respectively. CT findings and clinical and peak laboratory parameters were collected and compared. Univariable and multivariable logistic regression analyses were performed to identify the independent predictors for the presence of residual lung abnormalities at the 6-month follow-up exam. Seven variables (age; the presence of acute respiratory distress syndrome; the duration of hospitalization; the peak levels of lactate dehydrogenase (LDH) and C-reactive protein; and the initial total CT score) were chosen in the final multivariable models. RESULTS: At the six-month follow-up, abnormalities were still observed on chest CT in 77/141 (54.6%) patients. Reticular patterns (40/141, 28.4%) and ground-glass opacities (GGOs) (29/141, 20.6%) were the most common CT abnormalities on the follow-up CT scans. Patients in Groups 1 and 2 had significantly higher incidences of residual lung abnormalities than those in Group 3 (65.4% and 58.3%, respectively vs. 36.6%; p < 0.05). Twelve months after disease onset, the chest CT changes persisted in 13/25 (52.0%) patients. A duration of hospitalization > 20 days (OR: 5.630, 95% CI: 1.394-22.744, p = 0.015), an LDH level ≥ 317 U/L (OR: 7.020, 95% CI: 1.032-47.743, p = 0.046) and a total CT score > 15 (OR: 9.919, 95% CI: 1.378-71.415, p = 0.023) were independent predictors of residual pulmonary abnormalities in patients with diabetes or secondary hyperglycemia. CONCLUSIONS: A considerable proportion of surviving COVID-19 patients with diabetes or secondary hyperglycemia had residual pulmonary abnormalities six months after disease onset, and we found evidence of persistent chest CT changes at the one-year follow-up. Residual lung abnormalities were associated with longer hospital stays, higher peak LDH levels and higher initial total CT scores.


Assuntos
COVID-19 , Diabetes Mellitus , Hiperglicemia , Seguimentos , Humanos , Hiperglicemia/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Alta do Paciente , Estudos Retrospectivos , SARS-CoV-2
20.
PLoS One ; 16(10): e0258894, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34673829

RESUMO

INTRODUCTION: Little is known about the influence of hyperglycemia first detected in pregnancy (HFDP) on weight outcomes in exposed offspring in Africa. We investigated the influence of maternal blood glucose concentrations during pregnancy on offspring weight outcomes at birth and preschool age, in offspring exposed to HFDP, in South Africa. RESEARCH DESIGN AND METHODS: Women diagnosed with HFDP had data routinely collected during the pregnancy and at delivery, at a referral hospital, and the offspring followed up at preschool age. Maternal fasting, oral glucose tolerance test 1 and 2-hour blood glucose were measured at diagnosis of HFDP and 2-hour postprandial blood glucose during the third trimester. Offspring were classified as either those exposed to diabetes first recognized in pregnancy (DIP) or gestational diabetes (GDM). At birth, neonates were classified into macrosomia, low birth weight (LBW), large for gestational age (LGA), appropriate (AGA) and small for gestational age (SGA)groups. At preschool age, offspring had height and weight measured and Z-scores for weight, height and BMI calculated. RESULTS: Four hundred and forty-three neonates were included in the study at birth, with 165 exposed to DIP and 278 exposed to GDM. At birth, the prevalence of LGA, macrosomia and LBW were 29.6%, 12.2% and 7.5%, respectively, with a higher prevalence of LGA and macrosomia in neonates exposed to DIP. At pre-school age, the combined prevalence of overweight and obesity was 26.5%. Maternal third trimester 2-hour postprandial blood glucose was significantly associated with z-scores for weight at birth and preschool age, and both SGA and LGA at birth. CONCLUSION: In offspring exposed to HFDP, there is a high prevalence of LGA and macrosomia at birth, and overweight and obesity at preschool age, with higher prevalence in those exposed to DIP, compared to GDM. Maternal blood glucose control during the pregnancy influences offspring weight at birth and preschool age.


Assuntos
Peso ao Nascer/fisiologia , Glicemia , Peso Corporal/fisiologia , Hiperglicemia/fisiopatologia , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Adulto , Pré-Escolar , Feminino , Teste de Tolerância a Glucose , Humanos , Hiperglicemia/sangue , Recém-Nascido , Masculino , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/fisiopatologia , África do Sul , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...