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1.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud, LIS-bvsms | ID: lis-LISBR1.1-46917

RESUMEN

Cerca de 250 milhões de pessoas no mundo têm diabetes. Os números assustam e ajudam a avaliar o tamanho do desafio para combater essa doença. E para reforçar a conscientização a respeito desse mal, principalmente em relação a sua prevenção e as dificuldades enfrentadas pelos pacientes, foi instituída pela Federação Internacional de Diabetes (IDF) e pela Organização Mundial da Saúde (OMS), no dia 14 de novembro, o Dia Mundial do Diabetes.


Asunto(s)
Diabetes Mellitus
2.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud, LIS-bvsms | ID: lis-LISBR1.1-46873

RESUMEN

Doença de pele caracterizada por manchas escuras resultantes de uma hiperceratose.


Asunto(s)
Acantosis Nigricans , Resistencia a la Insulina , Diabetes Mellitus
3.
MMWR Morb Mortal Wkly Rep ; 68(43): 961-966, 2019 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-31671084

RESUMEN

Diabetes affects approximately 12% of the U.S. adult population and approximately 25% of adults aged ≥65 years. From 2009 to 2017, there was no significant change in diabetes prevalence overall or among persons aged 65-79 years (1). However, these estimates were based on survey data with <5,000 older adults. Medicare administrative data sets, which contain claims for millions of older adults, afford an opportunity to explore both trends over time and heterogeneity within an older population. Previous studies have shown that claims data can be used to identify persons with diagnosed diabetes (2). This study estimated annual prevalence and incidence of diabetes during 2001-2015 using Medicare claims data for beneficiaries aged ≥68 years and found that prevalence plateaued after 2012 and incidence decreased after 2006. In 2015 (the most recent year estimated) prevalence was 31.6%, and incidence was 3.0%. Medicare claims can serve as an important source of data for diabetes surveillance for the older population, which can inform prevention and treatment strategies.


Asunto(s)
Diabetes Mellitus/epidemiología , Medicare/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Incidencia , Masculino , Prevalencia , Estados Unidos/epidemiología
4.
Undersea Hyperb Med ; 46(5): 719-722, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31683373

RESUMEN

Introduction: Stingray spine injuries are among the most common marine animal injuries in humans. While most resolve with immersion in warm water, a few become infected and require antibiotics. We present a case report of a presumptive stingray injury that evolved to a major slough and which required prolonged healing in a patient with diabetes mellitus. Our literature review was unable to find a similarly reported case. Materials: A co-author was asked to evaluate and manage an ominous-appearing wound on the right foot of a diabetic. The problem developed after the individual had been wading in shallow ocean beach water. The patient's diabetic sensory neuropathy obscured the immediate association of the problem with a stingray injury, but this became the presumptive diagnosis when pain developed and necessitated that he seek medical care. Findings/Clinical Course: After an initial urgent care visit, increasing pain and worsening appearance of the patient's foot necessitated a visit to our emergency department. The patient was admitted the next day due to symptoms of systemic sepsis. On the fourth hospital day, a large bulla on the lateral side of the right foot was excised. This unroofed a full-thickness slough to the periosteum level of the underlying bones. Not until the 16th hospital day had enough improvement occurred to discharge the patient. Over the next 16 weeks, the wound improved, developed a vascular base and epithelialized. Conclusion: With a dearth of literature about stingray injuries in patients with diabetes mellitus reported, our case is unique: The patient's wound course more closely resembled a toxic inoculation than the typical puncture wound-cellulitis presentations associated with stingray injuries.


Asunto(s)
Mordeduras y Picaduras/complicaciones , Traumatismos de los Pies/terapia , Rayas , Heridas Penetrantes/terapia , Adulto , Animales , Antibacterianos/uso terapéutico , Mordeduras y Picaduras/terapia , Vesícula/etiología , Vesícula/terapia , Complicaciones de la Diabetes/terapia , Diabetes Mellitus , Traumatismos de los Pies/etiología , Humanos , Masculino , Necrosis , Infecciones Estreptocócicas/diagnóstico , Infecciones Estreptocócicas/tratamiento farmacológico , Combinación Trimetoprim y Sulfametoxazol/uso terapéutico , Cicatrización de Heridas , Heridas Penetrantes/etiología
5.
Orv Hetil ; 160(47): 1872-1880, 2019 Nov.
Artículo en Húngaro | MEDLINE | ID: mdl-31736343

RESUMEN

Introduction: The problem of diabetes worldwide raises increasingly serious public health issues in Hungary. In recent years, the emphasis on obesity as a primary cause of diabetes has been driven by a complex understanding of the causes of civilization: the role of sleep problems and stress in the development of the disease and the aggravation of the condition has been proven and supported. Aim: The aim of the study was to investigate the relationship between stress, sleep problems and diabetes in the representative Hungarostudy 2013 survey. Method: In the cross-sectional questionnaire study, 2000 adults participated. Mean of age was 46.9 (SD = 18.24) years. The average BMI was 26.0 (SD = 4.97) kg/m2. Measures: socio-demographic data, question about the presence of treated diabetes, symptomatic list, Perceived Stress Scale. Results: The frequency of diabetes treated one year before the date of the survey was 8.2%. The levels of stress experienced by diabetic patients were significantly higher than those experienced by participants not treated with diabetes (t(1944) = -2.586, p = 0.010). After adjusting potential background variables, perceived stress shows a marginally significant relationship with diabetes (OR = 1.03, p = 0.052). 26.0% of the respondents reported sleep problems last month, while 40.2% of them reported fatigue and energy shortages. The presence of sleep problems (χ2(2) = 61.108, p<0.001) and feeling of fatigue or lack of energy (χ2(2) = 51.061, p<0.001) are significantly more frequent among people with diabetes. Treated diabetes also predicts the presence of sleep problems (OR = 1.77, p = 0.003) as well as fatigue and lack of energy (OR = 1.88, p = 0.004) under the control of potential background variables. Conclusion: Our results show that, according to trends in other parts of the world, both sleep problems and stress play a significant role in the development of diabetes in Hungary. This draws attention to the need for effective screening and treatment of these factors in the prevention and treatment of diabetes in accordance with international protocols. Orv Hetil. 2019; 160(47): 1872-1880.


Asunto(s)
Diabetes Mellitus/psicología , Fatiga/complicaciones , Trastornos del Sueño-Vigilia/complicaciones , Estrés Psicológico/etiología , Adulto , Estudios Transversales , Diabetes Mellitus/epidemiología , Fatiga/epidemiología , Femenino , Humanos , Hungría/epidemiología , Masculino , Trastornos del Sueño-Vigilia/epidemiología , Estrés Psicológico/epidemiología , Encuestas y Cuestionarios
6.
Pan Afr Med J ; 33: 309, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31692777

RESUMEN

Introduction: Adherence to insulin therapy is a critical factor for adequate control of diabetes mellitus. Despite the multiple well-known benefits of adherence to insulin therapy, poor adherence remains to be a common cause of diabetes mellitus-related complications. A better management of diabetes mellitus requires determining the level of patient adherence and identifying why non-adherence to insulin therapy occurs. Therefore, this study was designed to assess the level of adherence to insulin therapy and associated factors among diabetes mellitus patients. Methods: The study was conducted from May 1 to July 1, 2018, using a cross-sectional study design. Interviewer-administered questionnaire was employed for data collection and systematic random sampling technique was used to select study participants. The collected data were entered using Epi data version 3.1.1 and exported to SPSS version 22 for analysis. Logistic analysis was carried out to check the level of association between adherence to insulin therapy and the independent variables with significance level of 0.05 at 95% confidence interval. Results: 273 respondents were selected with a 100% response rate. Near to one-fourth (24.2%) of the respondents were adherent to their insulin therapy. The study revealed that good knowledge of diabetes mellitus [AOR=6.51; 95% CI [1.58, 26.71], age [>30 years] [AOR=2.63; 95% CI [1.27, 5.42], knowledge regarding insulin self-injection [AOR=4.21; 95%CI [1.06,16.65], favorable attitude towards insulin injection [AOR=2.14; 95% CI [1.04,4.41], free-of-cost insulin therapy [AOR= 4.62, 95% CI [1.06,16.65], having of glucometer at home [AOR= 2.82, 95% CI [1.12,7.09], and being a member of Ethiopian diabetic association [AOR= 5.41, 95% CI [2.31,12.64] were found to significantly affect adherence to insulin therapy. Conclusion: Nearly one-fourth of the study participants were adherent to their insulin therapy. Good knowledge and favorable attitude towards insulin injection, good knowledge regarding diabetes mellitus, being a member of the Ethiopian Diabetes Association, age greater than thirty years old, free-of-cost insulin therapy and having glucometer at home were found to be significant predictors of adherence to insulin therapy.


Asunto(s)
Diabetes Mellitus/tratamiento farmacológico , Hipoglucemiantes/administración & dosificación , Insulina/administración & dosificación , Cumplimiento de la Medicación/estadística & datos numéricos , Adolescente , Adulto , Estudios Transversales , Etiopía , Femenino , Conocimientos, Actitudes y Práctica en Salud , Hospitales Públicos , Humanos , Inyecciones , Masculino , Persona de Mediana Edad , Autoadministración , Encuestas y Cuestionarios , Adulto Joven
7.
Pan Afr Med J ; 33: 260, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31692826

RESUMEN

Introduction: Dietary management is considered to be one of the cornerstones of diabetes care. Improvement of dietary practice alone can reduce glycosylated hemoglobin (HbA1c) by an absolute 1 to 2% with the greatest impact at the initial stages of diabetes. Methods: Data from Hospital based cross sectional study were used to assess the level of dietary adherence and its determinants among diabetic patients. The morisky 8 item medication adherence scale was used to develop 10 item tool for evaluation of dietary adherence. Multiple logistic regression was conducted to identify factors which affect dietary adherence and variables with P vale < 0.05 were considered statistically significant. Results: More than half of 303 participants (55.7%) were found to be non-adherent to the recommended dietary approach. Gathering with family and friends and eating out were the major reasons for not being compliant with the recommended regimen. Attending diabetic nutrition education (AOR=2.8 95% C 1.97, 5.61) and having the disease for more than 10 years (AOR 2.9 95% CI 1.32, 5.84) were statistically significant with adherence to dietary recommendation. Conclusion: Non-adherence to recommended dietary practice was observed in more than fifty percent of patients; it is therefore a major public health problem. Attending diabetic nutrition education and length of diabetes greater than 10 years were the factors associated with adherence to dietary recommendation. This findings indicate that it is important to design strategies to help patients understand their dietary regimens and improve their adherence.


Asunto(s)
Diabetes Mellitus/dietoterapia , Cooperación del Paciente/estadística & datos numéricos , Educación del Paciente como Asunto/métodos , Adulto , Estudios Transversales , Etiopía , Femenino , Hospitales de Enseñanza , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo
8.
MMWR Morb Mortal Wkly Rep ; 68(45): 1020-1023, 2019 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-31725705

RESUMEN

Approximately 30 million persons in the United States have diabetes.* Persons with diabetes are at risk for vision loss from diabetic retinopathy and other eye diseases (1). Diabetic retinopathy, the most common diabetes-related eye disease, affects 29% of U.S. adults aged ≥40 years with diabetes (2) and is the leading cause of incident blindness among working-age adults (1). It is caused by chronically high blood glucose damaging blood vessels in the retina.† Annual dilated eye exams are recommended for persons with diabetes because early detection and timely treatment of diabetic eye diseases can prevent irreversible vision loss§,¶ (3,4). Studies have documented prevalence of annual eye exams among U.S. adults with diabetes (5,6); however, a lack of recent state-level data limits identification of geographic disparities in adherence to this recommendation. Medicare claims from the 50 states, the District of Columbia (DC), Puerto Rico, and U.S. Virgin Islands (USVI) were examined to assess the prevalence of eye exams in 2017 among beneficiaries with diabetes who were continuously enrolled in Part B fee-for-service insurance, which covers annual eye exams for beneficiaries with diabetes.** This report also examines disparities, by state and race/ethnicity, in receipt of eye exams. Nationally, 54.1% of beneficiaries with diabetes had an eye exam in 2017. Prevalence ranged from 43.9% in Puerto Rico to 64.8% in Rhode Island. Fewer than 50% of beneficiaries received an eye exam in seven states (Alabama, Alaska, Kentucky, Louisiana, Nevada, West Virginia, and Wyoming) and Puerto Rico. Non-Hispanic white (white) beneficiaries had a higher prevalence of receiving an eye exam (55.6%) than did non-Hispanic blacks (blacks) (48.9%) and Hispanics (48.2%). Barriers to receiving eye care (e.g., suboptimal clinical care coordination and referral, low health literacy, and lack of perceived need for care) might limit Medicare beneficiaries' ability to follow this preventive care recommendation. Understanding and addressing these barriers might prevent irreversible vision loss among persons with diabetes.


Asunto(s)
Diabetes Mellitus/epidemiología , Planes de Aranceles por Servicios/estadística & datos numéricos , Disparidades en Atención de Salud , Medicare Part B/economía , Selección Visual , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Disparidades en Atención de Salud/etnología , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos/epidemiología , Adulto Joven
10.
Rev. Ciênc. Plur ; 5(2): 68-93, ago. 2019. ilus
Artículo en Portugués | LILACS, BBO - Odontología | ID: biblio-1021761

RESUMEN

Introdução:A Educação Popular em Saúde (EPS) remete indivíduos e grupos à troca de saberes e experiências, permitindo-lhes associar a saúde ao resultado das suas condições de vida levando a uma emancipação do sujeito. Objetivo:Promover ações educativas com portadores de Diabetes Mellitus (DM);realizar oficinas de capacitação em EPS com trabalhadores de saúde; e avaliar os resultados das ações realizadas para os trabalhadores e usuários, em uma Unidade de Saúde da Família em Natal/RN. Método:Trata-se de uma pesquisa-ação com o referencial teórico da Teoria da Educação Libertadora, centrada na pedagogia problematizadora. Participaram da pesquisa trinta trabalhadores de saúde e trinta e seis usuários diabéticos. As ações foram organizadas através de rodas de conversa, dinâmicas de grupo, narrativas de vida, relatos de experiências, e explicitação de saberes, desejos, limitações, crenças e valores socialmente construídos. A coleta dos dados foi realizada através da Técnica de Associação Livre de Palavras, entrevista semiestruturada e grupo focal. O material empírico foi submetido à análise de ocorrência com auxílio do programa IRAMUTEQ. Resultados:Foram geradas palavras, expressões e categorias, a partir dos temas abordados e de situações criativas mostrando que a EPS vem sendo incorporada timidamente no processo educativo dos sujeitos deste estudo e bem distante dos princípios de participação, organização de um trabalho político, ampliação dos espaços de diálogo, respeito, de solidariedade e tolerância entre os diversos atores envolvidos no enfrentamento dos problemas de saúde, fundamentais para o aperfeiçoamento na construção de práticas saudáveis da atenção básica. Conclusões:A utilização de práticas ativas de ensino-aprendizagem, centradas na ampliação da escuta e em capacitações sobre EPS, poderá possibilitar mudanças no cenário onde os usuários e trabalhadores de saúde atuam com a diabetes mellitus (AU).


Introduction:Popular Health Education (EPS) refers to individuals and groups to exchange knowledge and experiences, allowing them to associate health to the outcomes of their living conditions.Objective:To know and promote educational actions with patients with diabetes Mellitus (DM); Perform training workshops in EPS with health workers; To know and develop participatory educative actions with diabetic groups; and evaluate the results of theactions performed for workers and users, in a family health unit in Natal/RN.Methods:This is an action research with the theoretical framework of liberating education theory, centered on problematizing pedagogy. Thirty health workers and 36 diabetic users participated in the study. The actions were organized through conversation wheels, group dynamics, life narratives, reports of experiences, and explication of knowledge, desires, limitations, beliefs and socially constructed values. Data collection was performed through the free word association technique, semi-structured interview and focal group. The empirical material was subjected to occurrence analysis (Bardin) with the aid of the Iramuteq program (Ratinaud; Marchand).Results:The data analyses originated words, expressions, categories, themes and creative situations showing that EPS is in process of construction, but still very incipient in primary care. words, expressions and categories were generated from the themes addressedand creative situations showing that the EPS has been incorporated timidly in the educational process of the subjects of this study and far from the principles of participation, organization of a political work, expansion of the spaces of dialogue, respect, solidarity and tolerance among the various actors involved in coping with health problems, fundamental for the improvement in the construction of Healthy practices of primary care.Conclusions:The use of active teaching-learning practices, centered on the amplification of listening and in training on EPS, may enable changes in the scenario where users and health workers act with diabetes mellitus (AU).


Asunto(s)
Humanos , Masculino , Femenino , Salud de la Familia , Salud del Anciano , Educación en Salud , Grupos Focales/métodos , Investigación Cualitativa , Brasil , Diabetes Mellitus , Aprendizaje
11.
Am Surg ; 85(10): 1184-1188, 2019 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-31657321

RESUMEN

Guidelines suggest targeting a preoperative international normalized ratio (INR) < 1.5. We examined and compared the predictive value of INR relative to the Model for End-Stage Liver Disease (MELD). We reviewed the American College of Surgeons NSQIP from 2005 to 2016 for adult patients undergoing open or laparoscopic cholecystectomy. Patients with a preoperative INR were stratified into groups: ≤1, >1 to ≤1.5, >1.5 to ≤2, and >2. Thirty day postoperative mortality was the primary outcome. Multivariable logistic regressions controlled for baseline differences. Of 58,177 cholecystectomy patients, 15.2 per cent had INR ≤ 1, 80.4 per cent had INR > 1 to ≤1.5, 3.7 per cent had INR > 1.5 to ≤2, and 0.7 per cent had INR > 2. Patients with INR > 2 were older and more likely to have diabetes and hypertension (P < 0.001). Multivariable regression demonstrated a stepwise increase in mortality for INR > 1 to ≤1.5 (odds ratio (OR) = 1.50 [1.10-2.05]), INR > 1.5 to ≤2 (OR = 2.96 [1.97-4.45]), and INR > 2 (OR = 3.21 [1.64-6.31]) relative to INR ≤ 1. C-statistic for INR (0.910) and MELD (0.906) models indicated a similar value in predicting mortality. INR groups also faced an incremental, increased risk of bleeding. Although unable to track preoperative correction of INR, this analysis identifies that INR remains an excellent predictor of postoperative mortality and bleeding after both open and laparoscopic cholecystectomies and is comparable to MELD.


Asunto(s)
Colecistectomía/mortalidad , Enfermedad Hepática en Estado Terminal/sangre , Enfermedad Hepática en Estado Terminal/mortalidad , Relación Normalizada Internacional/mortalidad , Adulto , Factores de Edad , Análisis de Varianza , Colecistectomía Laparoscópica/mortalidad , Diabetes Mellitus/tratamiento farmacológico , Enfermedad Hepática en Estado Terminal/diagnóstico , Enfermedad Hepática en Estado Terminal/cirugía , Femenino , Humanos , Hipertensión/tratamiento farmacológico , Relación Normalizada Internacional/estadística & datos numéricos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Hemorragia Posoperatoria/mortalidad , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Medición de Riesgo
12.
Wei Sheng Yan Jiu ; 48(5): 723-727, 2019 Sep.
Artículo en Chino | MEDLINE | ID: mdl-31601311

RESUMEN

OBJECTIVE: To investigate the prevalence and relevant factors of type 2 diabetes mellitus among urban and rural residents over 18 years old in Guizhou Province in 2010-2012. METHODS: A total of 3073 residents over 18 years old were sampled by multi-stage and stratified random cluster sampling in Guizhou Province from"2010-2012 Chinese nutrition and health surveillance", including 1576 people in urban areas and 1497 people in rural areas, 1362 males and 1711 females. The participants were investigated for their basic conditions, lifestyle and behavior, and physical indicators, blood pressure, blood glucose, TC, and TG were also measured, and then the prevalence was calculated. Multivariate analysis was performed using an unconditional logistic regression model. RESULTS: Among the 3073 residents aged 18 years and over in Guizhou Province, 151 were diagnosed with type 2 diabetes mellitus, with a prevalence of4. 9%, among which 80 were urban residents and 71 were rural residents, with a prevalence of 5. 1% and 4. 7%, respectively. There was no statistically significant difference between urban and rural areas( χ~2= 0. 183, P = 0. 669). Age was associated with type 2 diabetes mellitus, and the prevalence increased with age( χ_()~2= 55. 478, P =0. 001). The result of multivariate Logistic regression analysis showed that family history, abdominal obesity, hypertension, abnormal TC and abnormal TG all had statistically significant influences on the prevalence of type 2 diabetes mellitus( OR values were2. 377, 1. 721, 1. 666, 1. 619 and 1. 982, respectively, all P <0. 05). CONCLUSION: The prevalence of type 2 diabetes mellitus in residents aged 18 and over in Guizhou Province was lower than the national average level. The prevention of type 2 diabetes in Guizhou residents should be targeted at middle-aged and elderly people, people with family history, people with abdominal obesity, people with hypertension and dyslipidemia.


Asunto(s)
Diabetes Mellitus Tipo 2/epidemiología , Adolescente , Adulto , Anciano , China/epidemiología , Diabetes Mellitus , Femenino , Humanos , Hipertensión , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Población Rural , Encuestas y Cuestionarios
13.
Rev Saude Publica ; 53: 94, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31644724

RESUMEN

OBJECTIVE: To evaluate trends in the use of generic and non-generic medicines to treat hypertension and diabetes under the Farmácia Popular Program (FP) and its impact on generic medicines sales volume and market share in the Brazilian pharmaceutical market. METHODS: This longitudinal, retrospective study used interrupted time series design to analyze changes in monthly sales volume and proportion of medicines sales (market share) for oral antidiabetic and antihypertensive medicines for generic versus non-generic products. Analyses were conducted in a combined dataset that aggregate monthly sales volumes from the Farmácia Popular program and from the QuintilesIMS™ (IQVIA) national market sales data from January 2007 to December 2012. The Farmácia Popular program phases analyzed included: a) 2009 reductions in medicines reference prices (AFP-II) and b) 2011 implementation of free medicines program for hypertension and diabetes, the Saúde não tem preço (SNTP - Health has no price). RESULTS: Patterns of use for FP-covered antidiabetic and antihypertensive medicines were similar to their use in the market in general. After one year of the decreases in government subsidies in April 2010, market share of antidiabetic and antihypertensive medicines experienced relative declines of -54.5% and -59.9%, respectively. However, when FP-covered medicines were made free to patients, overall market volume for antidiabetic and antihypertensive generics increased dramatically, with 242.6% and 277.0% relative increases by February 2012, as well as non-generics with relative increase of 209.7% and 279% for antidiabetic and antihypertensive medicines, respectively. CONCLUSIONS: Ministry of Health policies on the amount of patient cost sharing and on the choice of medicines on coverage lists have substantial impacts on overall generic sales volume in retail pharmacies.


Asunto(s)
Antihipertensivos/uso terapéutico , Comercio/tendencias , Servicios Comunitarios de Farmacia/tendencias , Medicamentos Genéricos/uso terapéutico , Hipoglucemiantes/uso terapéutico , Programas Nacionales de Salud/tendencias , Brasil , Comercio/estadística & datos numéricos , Servicios Comunitarios de Farmacia/estadística & datos numéricos , Diabetes Mellitus/tratamiento farmacológico , Política de Salud , Humanos , Hipertensión/tratamiento farmacológico , Análisis de Series de Tiempo Interrumpido , Estudios Longitudinales , Programas Nacionales de Salud/estadística & datos numéricos , Farmacias/estadística & datos numéricos , Farmacias/tendencias , Evaluación de Programas y Proyectos de Salud , Valores de Referencia , Estudios Retrospectivos , Factores de Tiempo
14.
Medicine (Baltimore) ; 98(40): e17414, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31577754

RESUMEN

BACKGROUND: MicroRNAs (miRNAs) are small noncoding single-stranded RNAs with a length of ∼21 nucleotides. Single nucleotide polymorphisms (SNPs) may affect the function of miRNAs, resulting in a variety of disorders in vivo. Recently, diabetes mellitus (DM) has become a global healthcare problem, and several studies have reported that 2 common polymorphisms (miRNA 146a rs2910164 and miRNA 27a rs895819) are related to susceptibility to diabetes. Given that no consensus had been reached regarding the association of the 2 polymorphisms with diabetes, we conducted this meta-analysis. METHODS: Four databases (PubMed, EMBASE, Cochrane, and Web of Science) were searched up to January 9, 2019. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the association strength. Subgroup and sensitivity analyses were also performed. RESULTS: Six studies involving 2585 cases and 2435 controls for miR146a rs2910164 and 5 studies involving 2922 cases and 2781 controls for miR27a rs895819 were ultimately analyzed in our meta-analysis. Based on pooled results, no statistical significance in association between rs2910164 and diabetes in Caucasians, Asians, or type 2 diabetes was observed in any genetic models. Nevertheless, we found a significant correlation between miRNA27a rs895819 and diabetes in the homozygote model (CC vs TT: OR = 0.58, 95%CI [0.35,0.98]) and recessive model (CC vs CT + TT: OR = 0.59, 95%CI [0.36,0.97]). By performing subgroup analysis, we also observed that C allele conveyed a significant protective effect against diabetes development in Caucasians (C vs T: OR = 0.67, 95%CI [0.52,0.85]). CONCLUSION: In conclusion, this meta-analysis indicated that miRNA27a rs895819 might play a protective role in diabetes, and miRNA146a rs2910164 likely had no association with diabetes.


Asunto(s)
Diabetes Mellitus/genética , MicroARNs/genética , Grupo de Ascendencia Continental Asiática , Diabetes Mellitus Tipo 2/genética , Grupo de Ascendencia Continental Europea , Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Humanos , Oportunidad Relativa , Polimorfismo de Nucleótido Simple , Factores de Riesgo
15.
Exp Suppl ; 111: 385-416, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31588541

RESUMEN

In addition to the common types of diabetes mellitus, two major monogenic diabetes forms exist. Maturity-onset diabetes of the young (MODY) represents a heterogenous group of monogenic, autosomal dominant diseases. MODY accounts for 1-2% of all diabetes cases, and it is not just underdiagnosed but often misdiagnosed to type 1 or type 2 diabetes. More than a dozen MODY genes have been identified to date, and their molecular classification is of great importance in the correct treatment decision and in the judgment of the prognosis. The most prevalent subtypes are HNF1A, GCK, and HNF4A. Genetic testing for MODY has changed recently due to the technological advancements, as contrary to the sequential testing performed in the past, nowadays all MODY genes can be tested simultaneously by next-generation sequencing. The other major group of monogenic diabetes is neonatal diabetes mellitus which can be transient or permanent, and often the diabetes is a part of a syndrome. It is a severe monogenic disease appearing in the first 6 months of life. The hyperglycemia usually requires insulin. There are two forms, permanent neonatal diabetes mellitus (PNDM) and transient neonatal diabetes mellitus (TNDM). In TNDM, the diabetes usually reverts within several months but might relapse later in life. The incidence of NDM is 1:100,000-1:400,000 live births, and PNDM accounts for half of the cases. Most commonly, neonatal diabetes is caused by mutations in KCNJ11 and ABCC8 genes encoding the ATP-dependent potassium channel of the ß cell. Neonatal diabetes has experienced a quick and successful transition into the clinical practice since the discovery of the molecular background. In case of both genetic diabetes groups, recent guidelines recommend genetic testing.


Asunto(s)
Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus/genética , Enfermedades del Recién Nacido/genética , Pruebas Genéticas , Factor Nuclear 1-alfa del Hepatocito/genética , Factor Nuclear 4 del Hepatocito/genética , Humanos , Recién Nacido , Mutación , Canales de Potasio de Rectificación Interna/genética , Proteínas Serina-Treonina Quinasas/genética , Receptores de Sulfonilurea/genética
16.
Vestn Oftalmol ; 135(4): 33-40, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31573555

RESUMEN

INTRODUCTION: In 1994, academician S.N. Fyodorov directed the development of laser cataract extraction (LCE) technique, which does not require manual or ultrasonic lens fragmentation. PURPOSE: To determine the effectiveness and safety of Russian LCE technology in patients with diabetes mellitus using comparative analysis, and to develop practical guidelines. MATERIAL AND METHODS: The study analyzed the results of 154 operations in patients with complicated cataract and diabetes mellitus (DM). 80 LCE operations and 74 ultrasonic cataract phacoemulsification (PhEC) surgeries including implantation of intraocular lens were performed. The duration of DM was 12.5±7.1 years in the LCE group and 11.9±7.3 years in the PhEC group. The energy of neodymium Nd:YAG laser endo-dissector with original wavelength of 1.44 µm together with low-intensity He-Ne laser radiation of 0.63 µm were delivered simultaneously to the eye cavity. RESULTS: Corneal endothelial cells loss was significantly lower (by 1.8 times) after LCE, in the early postop period, in 1 year, and 2 years after the surgery; the incidence of intraocular pressure increase and ciliary body edema were lower as well. Moreover, there is no negative influence on the posterior segment of the eye because the radiation of laser endo-dissector during the duty cycle of cataract removal does not extend beyond the lens capsule, and does not affect other tissues of the eye. CONCLUSION: In comparison to ultrasound cataract surgery, LCE is a more safe and effective method of removing complicated cataracts in diabetic patients with any degree of lens density.


Asunto(s)
Extracción de Catarata , Catarata , Diabetes Mellitus , Catarata/complicaciones , Complicaciones de la Diabetes , Células Endoteliales , Humanos , Federación de Rusia
17.
JAMA ; 322(15): 1518-1519, 2019 10 15.
Artículo en Inglés | MEDLINE | ID: mdl-31613341
19.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(10): 1000-1006, 2019 Oct 06.
Artículo en Chino | MEDLINE | ID: mdl-31607045

RESUMEN

Objective: To evaluate the cost-effectiveness of potential government fully-funded influenza vaccination for diabetics in our country. Methods: From the societal perspective, a decision tree model was developed to compare outcomes (including impact on the influenza-related outpatient consultation, hospitalization and excess mortality, and quality-adjusted life years (QALY), as well as incremental cost-effectiveness ratio (ICER)) of a national fully-funded vaccination programme in the population with diabetes and status quo (i.e., vaccinated with out-of-pocket payment, with a uptake rate of zero), using the published data with regarding to influenza related ILI (influenza-like illness) consultation rate, hospitalization rate and excess mortality rate, health-related quality of life and economic burden, diabetes prevalence, population size, health seeking behaviour, vaccine uptake rate, vaccine efficacy/effectiveness, etc. A time horizon of 1 year was used in the present analysis, and all costs were expressed in CNY in 2016 using the consumer price index. All results are presented in M (P(25), P(75)). Results: In the scenario of 40% vaccination coverage in the population with diabetes, government fully-funded vaccination programme was estimated to cost 1.71 (1.67, 1.75) billions CNY, and expected to prevent 110 000 (81 000, 143 000) influenza-related ILI consultations, 36 000 (28 000, 44 000) influenza-related SARI hospitalizations and 12 000 (9 000, 16 000) influenza-related deaths due to respiratory and cardiovascular diseases. A total of 108 000 (82 000, 142 000) QALY were estimated to be gained. The ICER was 10 088 (7 365, 14 046) CNY per QALY gained. The probability of cost-effectiveness of the fully-funded vaccination programme was 99.1% at a threshold of 53 680 CNY per QALY gained (GDP per capita in 2016). Conclusion: Government fully-funded influenza vaccination in population with diabetes is cost-effective, and thus is recommended as the key strategy of diabetes prevention and control.


Asunto(s)
Diabetes Mellitus , Vacunas contra la Influenza/economía , Gripe Humana , Vacunación/economía , China , Análisis Costo-Beneficio , Gobierno , Humanos , Calidad de Vida , Años de Vida Ajustados por Calidad de Vida
20.
Wiad Lek ; 72(9 cz 2): 1723-1726, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31622254

RESUMEN

OBJECTIVE: Introduction: Chronic hyperglycemia as the main link in DM pathogenesis leads to systemic vessels and nerves lesion with chronic bone complications development consequently. The aim: To evaluate influence of hyperglycemia on reparative osteogenesis after perforated tibial fracture in rats. PATIENTS AND METHODS: Materials and methods: A total of 30 white adult rats were subdivided into two groups: 15 healthy rats in Group 1 (control) and 15 rats with alloxan induced hyperglycemia in Group 2 (investigated) and were carried out of experiment on the 10th, 20th and 30th day after the fracture. Hyperglycemia in rats was verificated as the postprandial glycemic rate ≥ 8,0 mmol/l. Tibia diaphysis fracture was modeled by a cylindrical defect with a diameter of 2 mm with portable frezer. Morphological evaluation. A complex morphological studies included histological, morphometric and immunohistochemical examination. RESULTS: Results: This is confirmed by an increase in MMP-9 expression in connective tissue, a decrease in TGF-ß expression in all phases, an increase in the expression of CD3 and CD20 and a marked decrease in the expression of all vascular markers. During hyperglycemia, incomplete blood supply to the tissues occurs, necrosis of bone and soft tissues develop in the area of the fracture, the reparative reaction slows down considerably and manifests itself in the development of fibrous and, less commonly, cartilage tissue. CONCLUSION: Conclusions: In hyperglycemia rats, there was a delay in the callus formation, a decrease in proliferation and ossification, and a slowdown in the processes of angiogenesis.


Asunto(s)
Diabetes Mellitus/fisiopatología , Osteogénesis , Fracturas de la Tibia/complicaciones , Animales , Antígenos CD20/metabolismo , Huesos , Callo Óseo , Complejo CD3/metabolismo , Modelos Animales de Enfermedad , Metaloproteinasa 9 de la Matriz/metabolismo , Neovascularización Fisiológica , Ratas , Factor de Crecimiento Transformador beta/metabolismo
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