Advanced glycation end-products, a pathophysiological pathway in the cardiorenal syndrome

The prevalence of heart failure (HF) is increasing. A distinction is made between diastolic HF (preserved left ventricular ejection fraction (LVEF)) and systolic HF (reduced LVEF). Advanced glycation end-products (AGEs) are crystallized proteins that accumulate during ageing, but are particularly increased in patients with diabetes mellitus and in patients with renal failure. Through the formation of collagen crosslinks, and by interaction with the AGE-receptor, which impairs calcium handling and increases fibrosis, AGE-accumulation has pathophysiologically been associated with the development of diastolic and renal dysfunction. Interestingly, diastolic dysfunction is a frequent finding in elderly patients, diabetic patients and in patients with renal failure. Taken together, this suggests that AGEs are related to the development and progression of diastolic HF and renal failure. In this review, the role of AGEs as a possible pathophysiological factor that link the development and progression of heart and renal failure, is discussed. Finally, the role of AGE intervention as a possible treatment in HF patients will be discussed

Gekast naar de konst : fragmenten uit P.C. Hoofts Nederlandsche Historiën /

Bibliography: p. 13-15.Van Elslander, Antoni

Parent-reported problem behavior among children with sensory disabilities attending elementary regular schools

Parent-reported problem behaviors of 94 children with visual and auditory disabilities, attending elementary regular schools, were compared with problems reported in a general population sample of nondisabled children. Both samples were matched by means of a pairwise matching procedure, taking into account age and sex. Problem behavior was measured by Achenbach's (1991) CBCL (Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4-18 and 1991 Profile, University of Vermont, Department of Psychiatry, Burlington, VT). No significant main effects of type, degree, and nature of disability were found on the CBCL Total Problems scale, nor on the syndrome scales. In general, children with sensory disabilities attending elementary regular schools did not show more problems in comparison to nondisabled children. Merely on the Social Problems scale there was a significant difference between both samples, the children with sensory disabilities getting higher scores than their nondisabled peers. Further, children with sensory disabilities ran considerable risks of developing deviant scores on the Social Problems and the Thought Problems syndromes, the odds being respectively 3.2 and 5.2 times higher than in the general population sample. To optimize the benefits from placement in integrated classrooms for children with sensory disabilities, school counselors and teachers should not only focus on the academic achievements of these children, but also on their social skills and peer sociometric status