19 research outputs found
EFFECTS OF OMEGA-3 POLYUNSATURATED FATTY ACIDS ON THE CIRCADIAN RHYTHM OF HEART RATE VARIABILITY PARAMETERS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND CARDIOVASCULAR AUTONOMIC NEUROPATHY
Aim. The aim of the study was to analyze the effect of a-3 polyunsaturated fatty acids (a-3 PUFAs) on the heart rate variability (HRV) parameters in patients with type 2 diabetes mellitus (T2DM) and advanced stage of cardiovascular autonomic neuropathy (CAN).Material and methods. We have examined 36 patients with T2DM and advanced stage of CAN, aged between 50-59 years with disease duration 1-6 years and median glycated hemoglobin A1c 71%±0,12%. Patients with T2DM and advanced stage of CAN were divided into 2 groups. The first group received traditional antihyperglycemic therapy (n=15, control) for three mo; patients in group 2 (n=21) received in addition 1 g/day of the a-3 PUFAs for three months.Results. Prescription of the a-3 PUFAs to the patients with T2DM and advanced stage of CAN was accompanied by a statistically significant increase of the timedomain HRV parameters; the spectral HRV parameters during the active and passive periods compared to the control group.Conclusion. Obtained results suggest that the efficacy of a-3 PUFAs is the result of a direct effect of the a-3 PUFAs on the investigated indexes
Association of arterial stiffness, N-terminal pro-brain natriuretic peptide, insulin resistance, and left ventricular diastolic dysfunction with diabetic cardiac autonomic neuropathy
Aim: To investigate the changes of insulin resistance (IR), parameters of arterial stiffness, concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP), and echocardiographic parameters in patients with cardiac autonomic neuropathy (CAN) and type 2 diabetes mellitus (T2D).Methods: This study recruited 44 patients with T2D (19 patients without CAN and 25 patients with CAN) and 15 healthy volunteers. Arterial stiffness, immunoreactive insulin, homeostasis model assessment IR, NT-proBNP parameters, and echocardiographic examination were assessed.Results: Development of CAN is associated with increase in NT-proBNP levels, IR parameters, and arterial stiffening. Among patients with CAN, arterial stiffness parameters were considered as high. We found out that among patients of this group, the value of brachial augmentation index was normal in 52%, elevated in 40%, and pathological in 8%; pulse wave velocity was normal in 16%, elevated in 52%, and pathological in 32% of cases. Obtained results showed that development of CAN is accompanied by more pronounced left ventricular diastolic dysfunction and by formation of left ventricular hypertrophy (LVH), mostly by concentric type. Among patients of this group concentric LVH was diagnosed among 76 % and eccentric LVH among 16% of persons. Multiple regression analysis, after controlling for age, sex, diabetes duration, blood pressure, HbA1c, and left ventricular mass index, showed an independent association of heart rate response to deep breathing with pulse wave velocity (P < 0.001).Conclusion: Development of CAN is associated with increased IR parameters, increased levels of NT-proBNP, arterial stiffening, left ventricular diastolic dysfunction, and formation of LVH, mostly by concentric type
Effects of benfotiamine on the insulin resistance state, some pro- and anti-inflammatory factors content in patients with type 2 diabetes mellitus and cardiac autonomic neuropathy
Aim. The aim of the study was to analyze the effect of benfotiamine (BFT) on the insulin resistance state, the content of some pro- and anti-inflammatory factors in patients with type 2 diabetes mellitus (T2DM) and advanced stage of cardiac autonomic neuropathy (CAN).Material and methods. 40 patients with T2DM and advanced stage of CAN, aged between 50-59 yrs with disease term 1-6 yrs and average glycated hemoglobin A1c (HbA1c) 7,16%±0,19% were examined. Patients were divided into 2 groups. The patients from first group received standard hypoglycemic treatment (n=19, control) for three mo. To patients from the second (n=21, treatment group) was prescribed 300 mg/q.d. of the BFT in addition for three mo. The levels of blood glucose, HbA1c, immunoreactive insulin (IRI), high sensitivity C-reactive protein (hs-CRP), leptin, tumor necrosis factor-alpha (TNF-alpha), interleukins (IL)-6, IL-8 and IL-10 were determined. The Homeostasis Model Assessment (HOMA) insulin resistance (IR) index (HOMA-IR) parameters, TNF-alpha/IL-10 ratio were calculated.Results. Treatment with BFT led to significant decrease in the concentration of IRI [Î=-12,74%±1,42% (p<0,05)]; hs-CRP [Î=-13,62%±1,96% (p<0,05)], TNF-alpha [Î=-10,24%±1,54% (p<0,05)] and IL-6 [Î=-15,41%±2,03% (p<0,05)] compared to the control group. At the same time, prescription of BFT does not affect the concentration of glucose, leptin, IL-8, IL-10; HOMA-IR and TNF-alpha/IL-10 ratio parameters (p>0,05).Conclusion. Obtained data may indicate a decrease in the activity of the proinflammatory link of the immune response and allow us to consider BFT as a promising pharmacological agent in the complex treatment of the advanced stage of CAN
Older fallers attended to by an ambulance but not transported to hospital: A vulnerable population at high risk of future falls
Abstract Objective : This prospective cohort study describes older nonâtransported fallers seen by the Ambulance Service of New South Wales (ASNSW), quantifies the level of risk and identifies predictors of future falls and ambulance use. Methods : Participants were 262 people aged 70 years or older with a fallârelated ASNSW attendance who were not transported to an emergency department. They completed a questionnaire about health, medical and physical factors previously associated with falling. Falls were monitored for six months after ambulance attendance with monthly fall calendars. Results : Participants had a high prevalence of chronic medical conditions, functional limitations and past falls. During followâup, 145 participants (58%) experienced 488 falls. Significant predictors of falls during followâup were three or more falls in the past year, being unable to walk more than 10 minutes without resting, and requiring assistance for personalâcare activities of daily living (ADLs). Sixtyâtwo participants (25%) required repeat, fallârelated ambulance attendance during the study. Predictors of repeat ambulance use were: 3+ falls in past year, requiring assistance for personalâcare ADLs and having disabling pain in past month. Conclusions : Older, nonâtransported fallers seen by the ASNSW are a vulnerable population with high rates of chronic health conditions. Implications : Onward referral for preventive interventions may reduce future falls and ambulance service calls
Studierende als Lehrende in der studentischen notfallmedizinischen Ausbildung. Ein neues Wahlpflichtfach zur strukturierten Beurteilung von Notfallpatienten nach dem AMLS Konzept
Roll 770a. Basketball Publicity Pix. (Pictures) Image 5 of 35. (25 October 1961) [PHO 1.770a.5]The Boleslaus Lukaszewski (Father Luke) Photographs contain more than 28,000 images of Saint Louis University people, activities, and events between 1951 and 1970. The photographs were taken by Boleslaus Lukaszewski (Father Luke), a Jesuit priest and member of the University's Philosophy Department faculty