Comparison and assessment of thyroid morphology and function in inhabitants of Lower Silesia before and after administration of a single dose of iodine-containing contrast agent during cardiac intervention procedure

Wstęp: Wiadomym jest, że mieszkańcy terenów ubogich w jod rozwijają szereg niemych klinicznie patologii tarczycy. Celem badania była ocena morfologii i funkcji tarczycy w populacji dorosłych mieszkańców Dolnego Śląska oraz ocena wpływu na gruczoł tarczowy jednorazowo podanej dawki jodu w postaci kontrastu w trakcie kardiologicznych procedur interwencyjnych. Materiały i metody: Do pierwszej części badania, której celem była ocena morfologii i funkcji tarczycy u zdrowych mieszkańców Dolnego Śląska zakwalifikowano 120 osób (78 mężczyzn i 42 kobiety). Z tej grupy wyłoniono 60 osób (38 mężczyzn i 22 kobiety) które, z racji wskazań do inwazyjnych zabiegów kardiologicznych (koronarografii/PTCA), obciążono dużą dawką jodu oraz przeprowadzano u nich ocenę tyreologiczną po 1, 3 i 6 miesiącach od interwencji. Wyniki: 1) Patologiczne zmiany w morfologii tarczycy stwierdzono u 49,1%, zaburzenia dotyczące stężeń hormonów tarczycy i przeciwciał przeciwtarczycowych stwierdzono u 17,6%, które przekładały się na zaburzenia funkcji tarczycy u 9,3% zdrowych tyreologicznie mieszkańców Dolnego Śląska. 2) Największe zmiany: obniżenie stężenia TSH i wzrost stężenia fT3 były widoczne 4 tygodnie po obciążeniu jodem, prowadząc do rozpoznania nadczynności tarczycy u 15% pacjentów. Wnioski: 1) Z uwagi na dużą ilość klinicznie niemych zaburzeń morfologii i funkcji tarczycy ważna jest jej dokładna ocena przed obciążeniem chorego jodem. 2) Jest poparte dowodami i polecane monitorowanie stężenia TSH i fT3 przed i 4 tygodnie po obciążeniu chorego jodem. 3) Zaburzenia morfologii i funkcji tarczycy po podaniu pacjentowi jodu mają charakter przemijający, wymagają monitorowania, ale nie leczenia.Introduction: Inhabitants living in areas with endemic dietary iodine intake deficiency develop nodular goitre. The aim of our study was to evaluate thyroid morphology and function among adults residing in Lower Silesia and to assess the effect on the thyroid gland of an iodine-based contrasting agent administered during a cardiac intervention procedure. Materials and methods: The first part of the study (evaluation of thyroid gland) was carried out on 120 subjects (78 men and 42 women). From among this group, invasive cardiac procedures were performed on 60 subjects (38 men and 22 women) during the second part of the study. Endocrine tests were repeated one, three, and six months after the invasive procedure. Results: 1) Within the studied group, pathological changes in thyroid morphology were found in 49.1%, and thyroid function disturbances in 9.3%, of all subjects. 2) A decrease in TSH concentration with a corresponding increase in fT3 concentration was seen at the second visit (four weeks after iodine administration) leading to the diagnosis of hyperthyroidism in 15% of subjects. Conclusions: 1) Considering the multitude of silent thyroid pathologies, particular care is required before administering an iodine-based medium. 2) It is reasonable and advisable to monitor TSH and fT3 levels before and at four weeks after administration of an iodine-containing contrast agent. 3) Thyroid morphology and function disturbances after iodine administration do not necessitate treatment, as they are of transient character and only require monitoring

Wroclaw Epidemiological Trial on Diabetes - WET-Diab

WSTĘP. Aktywne poszukiwanie chorych z zaburzeniami gospodarki węglowodanowej stanowi najlepszą metodę zapobiegania późnym powikłaniom tego schorzenia. Celem pracy było określenie czynników ryzyka i częstości cukrzycy typu 2 - cukrzycy znanej i nieznanej w reprezentatywnej grupie mieszkańców Wrocławia. MATERIAŁY I METODY. Badaniu poddano grupę osób w wieku 55-75 lat dobraną drogą losowania warstwowego z bazy PESEL stałych mieszkańców Wrocławia. W pierwszym etapie przeprowadzono ankietę badawczą, analizując pomiary antropometryczne, ciśnienia tętniczego i glikemii we krwi włośniczkowej. Nieprawidłowy wynik glikemii stanowił podstawę zakwalifikowania do drugiego etapu badań, który obejmował glikemię na czczo i doustny test tolerancji glukozy (OGTT, oral glucose tolerance test) u osób z glikemią 5,5-6,7 mmol/l. WYNIKI. Spośród 1500 badanych do drugiego etapu z powodu glikemii powyżej 5,5 mmol/l zakwalifikowano 362 osoby: 216 kobiet i 146 mężczyzn. U 72 osób (19,8%) była to cukrzyca znana. U 10,34% osób potwierdzeniem cukrzycy było stężenie glikemii 2-krotnie przekraczające 7 mmol/l, natomiast na podstawie OGTT cukrzycę rozpoznano u 21,37% osób, nietolerancję glukozy u 37,24%, a nieprawidłową glikemię na czczo u 31,03%. Częstość cukrzycy nieznanej była wyższa niż częstość cukrzycy znanej u badanych w przedziale wiekowym 55–65 lat, natomiast u osób powyżej 65. roku życia większa była częstość cukrzycy znanej. WNIOSKI. Znamiennie częściej stwierdzano cukrzycę nieznaną u kobiet, z tym że wskaźnik masy ciała (BMI, body mass index) w cukrzycy znanej i nieznanej u kobiet nie różnił się istotnie statystycznie, natomiast u mężczyzn cukrzyca nieznana występowała znamiennie częściej, jeśli BMI wynosiło powyżej 30 kg/m2.INTRODUCTION. Active searching for patients with carbohydrate metabolism disorders is the best method for preventing of chronic complications of the disease. The aim of the study was to find risk factors and to estimate prevalence of type 2 diabetes (known and unknown) in Wrocław population. MATERIAL AND METHODS. The study was entered by subjects aged 55-75 years who were randomly chosen (the random number method) from the Wrocław population PESEL database. The first stage consisted of: age, profession, life-style questionnaire, family history, suffered diseases before and the anthropometrical evaluation, blood pressure and fasting capillary glucose level were performed. The patients with incorrect glucose level were included to second stage where fast glucose level and OGTT above 5.5-6.7 mmol/l evaluated. RESULTS. To second stage study 362 (216 women and 146 men) from 1500 subject were included with glycaemia higher than 5.5 mmol/l. The known diabetes was found in 72 persons (19.8%). The diagnosis of diabetes was confirmed because of two examination results higher than 7 mmol/l. Based on OGTT in 21.37% of patients diabetes and in 37.24% impaired glucose tolerance. CONCLUSIONS. Between 55-65 aged patients the prevalence of unknown diabetes was higher than known diabetes while known diabetes in patients older than 65 years was more common. Unknown diabetes was found significantly more often in females. In female with unknown and known diabetes BMI was not significantly different

The response of diabetic foot to a new type of dressing

<p>Abstract</p> <p>Background</p> <p>FlaxAid is a newly developed type of dressing enriched in particular flavonoids through genetic engineering of flax plants that exhibit health-promoting activities due to their strong antioxidant properties. The purpose of the current study was to assess the clinical efficacy of the FlaxAid bandage therapy for a patient affected with a diabetic foot ulcer which was unresponsive to previous treatments. The patient was treated with FlaxAid bandages for 12 weeks and the size and properties of the wound were routinely observed and recorded. Due to the the clinical picture of the wound study design was adopted whereby the comparative treatment was cotton gauze wetted with isotonic salt solution.</p> <p>Findings</p> <p>Following therapy, the foot ulcer decreased in size, despite the decompensation of advanced diabetes. It is believed that the beneficial nature of FlaxAid is derived from its high level and broad spectrum of antioxidants.</p> <p>Conclusions</p> <p>The FlaxAid dressing provides a novel and effective method for the treatment of diabetic foot ulcers. This study presents a preliminary pilot investigation and a larger number of subjects need to be included within the study in order to draw firm clinical conclusions. Efforts to this effect are currently under way.</p

Susceptibility to apoptosis of lymphocytes from patients with peripheral arterial disease

Purpose. To determine, in vitro, the susceptibility to apoptosis of lymphocytes from patients with peripheral arterial disease (PAD) in the presence of a low culture medium serum concentration, and to evaluate the correlation of the degree of apoptosis and the serum lipid levels. Methods. Lymphocytes were isolated from the venous blood of PAD patients with lower limb ischemia secondary to obliterative atherosclerosis of Fountain stage IIb. None of the patients had received hypo-lipemic therapy. The lymphocytes were incubated for 48 hr in media containing reduced concentrations of fetal calf serum. The study group consisted of 10 patients (7 men and 3 women), with a mean age of 67.0 ± 4.0 yr. The control group consisted of ten healthy volunteers, of the same mean age and sex proportion as the study group. Results. The percentage of non-apoptotic lymphocytes was lower (by 17%) and the percentage of late apoptotic lymphocytes was higher (by 33%) in the PAD patients than in the healthy donors when comparing the slopes of regression lines describing the relation between frequency of apoptotic lymphocytes in culture media containing reduced concentration of fetal calf serum The percentage of late apoptotic lymphocytes was correlated with the levels of total cholesterol (rs=0.93; P < 0.01) and LDL cholesterol (rs=0.80; P < 0.01) , and negatively correlated with the level of triglycerides (rs=-0.71; P < 0.05). Conclusion. The results of this study of lymphocyte apoptosis are important in understanding of the disease pathogenesis and should be taken into account in elaboration of treatment strategies

Influence of the Physical Training on Muscle Function and Walking Distance in Symptomatic Peripheral Arterial Disease in Elderly

Introduction. A typical symptom of chronic lower-limb ischaemia is lower-limb pain, which occurs during walking forcing the patient to stop, intermittent claudication (IC). Exercise rehabilitation is the basic form of treatment for these patients. Aim. The aim of this study was to compare the effectiveness of three types of physical training programmes conducted over a 12-week period in patients with chronic lower-limb arterial insufficiency. Materials and Methods. Ninety-five people qualified for the 3-month supervised motor rehabilitation programme, conducted three times a week. The respondents were assigned to three types of rehabilitation programmes using a pseudo-randomization method: Group I (TW), subjects undertaking treadmill walking training; Group II (NW), subjects undertaking Nordic walking training; Group III (RES+NW), subjects undertaking resistance and Nordic walking training. Treadmill test, 6 Minute Walk Test (6MWT), and isokinetic test were repeated after 3 months of rehabilitation, which 80 people completed. Results. Combined training (RES+NW) is more effective than Nordic walking alone and supervised treadmill training alone for improving ankle force-velocity parameters (p<0.05) in patients with intermittent claudication. Each of the proposed exercise rehabilitation programmes increased walking distance of patients with intermittent claudication (p<0.05), especially in 6MWT (p=0.001). Significant relationships of force-velocity parameters are observed in the maximum distance obtained in 6MWT, both in Group III (RES + NW) and in Group II (NW) at the level of moderate and strong correlation strength, which indicates that if the lower limbs are stronger the walking distance achieved in 6MWT is longer. Conclusions. Given both the force-velocity parameters and the covered distance, the training RES + NW gives the most beneficial changes compared to training TW alone and NW alone. All types of training increased walking distance, which is an important aspect of the everyday functioning of people with IC