The incidence of risk factors of type 2 diabetes mellitus in relatives of the patients

WSTĘP. Celem niniejszej pracy była ocena występowania zaburzeń gospodarki węglowodanowej u krewnych I stopnia chorych na cukrzycę typu 2 zależnie od obecności innych czynników ryzyka tej choroby. MATERIAŁ I METODY. Ocenianą grupę tworzyło 42 krewnych I stopnia chorych leczonych w Przyklinicznej Poradni Diabetologicznej Szpitala Uniwersyteckiego w Bydgoszczy. Przeprowadzano badanie podmiotowe, przedmiotowe oraz test doustnego obciążenia 75 g glukozy. WYNIKI. U 13 osób (31%) rozpoznano zaburzenia gospodarki węglowodanowej (grupa ZGW), zaś u 29 ich nie stwierdzono (grupa BZGW). Badani z grupy ZGW byli istotnie statystycznie starsi od osób z grupy BZGW (59,8 &#177; 14,6 vs. 37,8 &#177; 15,5 roku; p < 0,001), cechowały ich znamiennie większe rodzinne obciążenie cukrzycą typu 2 (2,0 &#177; 1,1 vs. 1,1 &#177; 0,4; p < 0,001 - liczba krewnych w rodzinie) i istotnie wyższa liczba czynników ryzyka choroby (2,9 &#177; 1,2 vs. 2,0 &#177; 1,2; p < 0,01). Najczęstsze, istotne statystycznie okazało się występowanie w wywiadzie nieprawidłowego stężenia glukozy we krwi - 61,5% (BZGW - 6,9%). Obie grupy nie różniły się pod względem liczby chorych rodziców, natomiast rodzeństwo chore na cukrzycę miało 92,3% osób z grupy ZGW i tylko 13,8% z grupy BZGW. Przynajmniej jedno dziecko chore na cukrzycę miało 23% osób z grupy ZGW, natomiast nikt z BZGW. Nie wykazano istotnych różnic między grupami odnośnie wskaźnika masy ciała (28,3 &#177; &#177; 4,5 kg/m2 vs. 25,9 &#177; 4,9 kg/m2) oraz wskaźnika talia- biodro (0,86 &#177; 0,08 vs. 0,83 &#177; 0,07, odpowiednio). Cukrzyca ciążowa wystąpiła u 7,7% vs. 6,9% badanych, urodzenie dziecka z masą ciała powyżej 4000 g dotyczyło 7,7% versus 11,9%, a zespół policystycznych jajników stwierdzono u 7,7% versus 3,4%. WNIOSKI. U krewnych I stopnia chorych na cukrzycę typu 2 wystąpienie zaburzeń gospodarki węglowodanowej zależało od: wieku, sumy czynników ryzyka cukrzycy, a zwłaszcza stwierdzenia nieprawidłowych wartości glikemii w wywiadzie, liczby krewnych chorych na cukrzycę typu 2, w szczególności chorego rodzeństwa i dzieci.INTRODUCTION. The aim of the study was the evaluation of glucose metabolism disturbances in I° relatives of the patients with type 2 diabetes, depending on the other present risk factors. MATERIAL AND METHODS. The evaluated group consisted of 42 I° relatives of the patients treated in Outpatient Diabetology Clinic of the University Hospital in Bydgoszcz. A subjective, objective examination and the oral glucose tolerance test were carried out. RESULTS. In 13 patients (31%) glucose metabolism disturbances (ZGW group) were identified, in 29 they were not stated (BZGW group). The examined ZGW group patients were considerably statistically older than the BZGW (59.8 &#177; 14.6 vs. 37.8 &#177; 15.5 years; p < 0.001), had a remarkably greater inherited susceptibility to type 2 diabetes (2.0 &#177; 1.1 vs. 1.1 &#177; &#177; 0.4; p < 0.001 of the number of relatives in the family) and were characterized by a significantly higher number of the diabetes risk factors (2.9 &#177; 1.2 vs. 2.0 &#177; 1.2; p < 0.01). The occurrence of the abnormal glycaemia - 61.5% (BZGW - 6.9%) in the anamnesis turned out to be the most common and statistically important. Both groups did not differ in the number of parents with diabetes, whereas 92.3% patients of the ZGW and only 13.8% of the BZGW had siblings with diabetes. 23% people with ZGW had at least one child with diabetes while no-one thase with BZGW. No significant differences between the groups, regarding BMI were stated: 28.3 &#177; 4.5 kg/m2 versus 25.9 &#177; 4.9 kg/m2 and WHR: 0.86 &#177; 0.08 versus 0.83 &#177; &#177; 0.07 respectively. Gestational diabetes mellitus occurred in 7.7% versus 6.9%, giving birth to a newborn with birth weight above 4000 g: 7.7% versus 11.9%, polycystic ovary syndrome: 7.7% versus 3.4%. CONCLUSIONS. In the I° relatives of the patients with type 2 diabetes the occurrence of glucose metabolism disturbances depended on: age, the amount of diabetes risk factors, especially stating abnormal glycaemia values in the anamnesis, the number of relatives with type 2 diabetes, siblings and children in particular

Telemedicine in Cardiology: Modern Technologies to Improve Cardiovascular Patients’ Outcomes—A Narrative Review

The registration of physical signals has long been an important part of cardiological diagnostics. Current technology makes it possible to send large amounts of data to remote locations. Solutions that enable diagnosis and treatment without direct contact with patients are of enormous value, especially during the COVID-19 outbreak, as the elderly require special protection. The most important examples of telemonitoring in cardiology include the use of implanted devices such as pacemakers and defibrillators, as well as wearable sensors and data processing units. The arrythmia detection and monitoring patients with heart failure are the best studied in the clinical setting, although in many instances we still lack clear evidence of benefits of remote approaches vs. standard care. Monitoring for ischemia is less well studied. It is clear however that the economic and organizational gains of telemonitoring for healthcare systems are substantial. Both patients and healthcare professionals have expressed an enormous demand for the further development of such technologies. In addition to these subjects, in this paper we also describe the safety concerns associated with transmitting and storing potentially sensitive personal data

Sex-related differences in patients undergoing radiofrequency ablation of atrioventricular nodal reentrant tachycardia

Background: Atrioventricular nodal reentry tachycardia (AVNRT) is the most common paroxysmal supraventricular tachycardia. The relatively ineffective antiarrhythmic drugs and the predominant young age makes the catheter ablation the therapy of choice in many patients. This results in predominance of this arrhythmia in electrophysiological labs. The aim of the study was to analyze the gender-related differences among patients undergoing the radiofrequency catheter ablation of slow pathway entrance to the atrioventricular node. Material and methods: The study group comprised of 147 consecutive patients with diagnosed atrioventricular nodal reentry tachycardia, who underwent the radiofrequency catheter ablation (RFCA) of slow pathway. Patients have been divided into 2 groups, based on sex. Results: The overall 97.3% of effectiveness of RFCA was observed. Women were significantly younger than men (53.7+/-17.2 vs 57.7+/-9.8 years) with lower radiation dose (2383.5+/-1993.2 vs 2891.6+/-2377.1 cGyxcm2). Conclusions: Younger age of women in comparison to men during RFCA of AVNRT reflects earlier onset of symptoms in women. Gender does not affect the time of fluoroscopy, but the higher rate of inducible tachycardia after RFCA in women may suggest the existence of anatomical difficulties or the operator’s apprehensions. Sex-related difference in radiation dose that we have observed may result from the greater volume of the men’s chest

Charakterystyka elektokardiograficzna załamka P u pacjentów z niepełnym blokiem pęczka Bachmanna i migotaniem przedsionków

Introduction: The structural and functional changes in atrial myocardium create a substrate for atrial fibrillation. The pathophysiology include enlargement of the cavities and replacing the cardiomyocytes with connective tissue. That slows down the conduction velocity and creates focal conduction block zones and slow conduction areas promoting the re-entrant circuits. The described changes influence the duration and amplitude of the P wave in the ECG. Materials and methods: The study group consisted of 54 patients diagnosed with atrial fibrillation. There were 19 women and 35 men, aged 65.8+/-10.0 years. 22 patients had paroxysmal AF, in sinus rhythm during the examination and 32 had persistent AF, in whom the direct current cardioversion was performed in order to achieve sinus rhythm. In patients with persistent atrial fibrillation the P wave duration after the restoration the sinus rhythm was significantly longer in comparison to patients with paroxysmal atrial fibrillation (159.2+/-14.3 vs 171.2+/-16.6 ms, p=0.006). Results: The patients with persistent AF showed higher positive amplitude in lead V1 as well as higher negative amplitude than patients with paroxysmal AF: positive amplitude (0.053+/-0.023 vs 0.084+/-0.040 mV, p=0.002), negative amplitude (0.045+/-0.018vs 0.075+/-0.037 mV, p=0.001). Discusion: In conclusions: In patients with incomplete Bachmann’s bundle block and atrial fibrillation the duration of the P wave is prolonged, more in the persistent arrhythmia group. The P wave duration and morphology correlate with the interatrial conduction disturbances. The P wave morphology changes indicate the causal relationship of AF rather with interatrial conduction delay than with left atrial hypertrophy.Introduction: The structural and functional changes in atrial myocardium create a substrate for atrial fibrillation. The pathophysiology include enlargement of the cavities and replacing the cardiomyocytes with connective tissue. That slows down the conduction velocity and creates focal conduction block zones and slow conduction areas promoting the re-entrant circuits. The described changes influence the duration and amplitude of the P wave in the ECG. Materials and methods: The study group consisted of 54 patients diagnosed with atrial fibrillation. There were 19 women and 35 men, aged 65.8+/-10.0 years. 22 patients had paroxysmal AF, in sinus rhythm during the examination and 32 had persistent AF, in whom the direct current cardioversion was performed in order to achieve sinus rhythm. In patients with persistent atrial fibrillation the P wave duration after the restoration the sinus rhythm was significantly longer in comparison to patients with paroxysmal atrial fibrillation (159.2+/-14.3 vs 171.2+/-16.6 ms, p=0.006). Results: The patients with persistent AF showed higher positive amplitude in lead V1 as well as higher negative amplitude than patients with paroxysmal AF: positive amplitude (0.053+/-0.023 vs 0.084+/-0.040 mV, p=0.002), negative amplitude (0.045+/-0.018vs 0.075+/-0.037 mV, p=0.001). Discusion: In conclusions: In patients with incomplete Bachmann’s bundle block and atrial fibrillation the duration of the P wave is prolonged, more in the persistent arrhythmia group. The P wave duration and morphology correlate with the interatrial conduction disturbances. The P wave morphology changes indicate the causal relationship of AF rather with interatrial conduction delay than with left atrial hypertrophy