Plasma levels of matrix metalloproteinase-2, -3, -10, and tissue inhibitor of metalloproteinase-1 are associated with vascular complications in patients with type 1 diabetes: The EURODIAB Prospective Complications Study

Impaired regulation of extracellular matrix remodeling by matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinase (TIMP) may contribute to vascular complications in patients with type 1 diabetes. We investigated associations between plasma MMP-1, -2, -3, -9, -10 and TIMP-1, and cardiovascular disease (CVD) or microvascular complications in type 1 diabetic patients. We also evaluated to which extent these associations could be explained by low-grade inflammation (LGI) or endothelial dysfunction (ED). Methods: 493 type 1 diabetes patients (39.5 ± 9.9 years old, 51% men) from the EURODIAB Prospective Complications Study were included. Linear regression analysis was applied to investigate differences in plasma levels of MMP-1, -2, -3, -9, -10, and TIMP-1 between patients with and without CVD, albuminuria or retinopathy. All analyses were adjusted for age, sex, duration of diabetes, Hba1c and additionally for other cardiovascular risk factors including LGI and ED. Results: Patients with CVD (n = 118) showed significantly higher levels of TIMP-1 [β = 0.32 SD (95%CI: 0.12; 0.52)], but not of MMPs, than patients without CVD (n = 375). Higher plasma levels of MMP-2, MMP-3, MMP-10 and TIMP-1 were associated with higher levels of albuminuria (p-trends were 0.028, 0.004, 0.005 and 0.001, respectively). Severity of retinopathy was significantly associated with higher levels of MMP-2 (p-trend = 0.017). These associations remained significant after further adjustment for markers of LGI and ED. Conclusions: These data support the hypothesis that impaired regulation of matrix remodeling by actions of MMP-2, -3 and-10 and TIMP-1 contributes to the pathogenesis of vascular complications in type 1 diabetes

Relationship Between Risk Factors and Mortality in Type 1 Diabetic Patients in Europe: The EURODIAB Prospective Complications Study (PCS)

OBJECTIVE—The purpose of this study was to examine risk factors for mortality in patients with type 1 diabetes

Gestational diabetes: influence of food intake on birth weight, HBA1, and maternal weight gain

International audienc

ANSO study: Evaluation in an indoor environment of a mobile assistance robotic grasping arm

International audienceObjectiveTo evaluate the reliability and functional acceptability of the “Synthetic Autonomous Majordomo” (SAM) robotic aid system (a mobile Neobotix base equipped with a semi-automatic vision interface and a Manus robotic arm).Materials and methodsAn open, multicentre, controlled study. We included 29 tetraplegic patients (23 patients with spinal cord injuries, 3 with locked-in syndrome and 4 with other disorders; mean ± SD age: 37.83 ± 13.3) and 34 control participants (mean ± SD age: 32.44 ± 11.2). The reliability of the user interface was evaluated in three multi-step scenarios: selection of the room in which the object to be retrieved was located (in the presence or absence of visual control by the user), selection of the object to be retrieved, the grasping of the object itself and the robot's return to the user with the object. A questionnaire was used to assess the robot's user acceptability.ResultsThe SAM system was stable and reliable: both patients and control participants experienced few failures when completing the various stages of the scenarios. The graphic interface was effective for selecting and grasping the object – even in the absence of visual control. Users and carers were generally satisfied with SAM, although only a quarter of patients said that they would consider using the robot in their activities of daily living.ObjectifÉvaluation de la fiabilité et de l’acceptabilité de l’usage d’un robot mobile d’assistance, Synthetic Autonomous Majordomo (SAM) composé d’une base mobile Néobotix avec bras télémanipulateur Manus, doté d’une interface de saisie automatique d’objet.Patients et méthodesÉtude multicentrique ouverte contrôlée sous l’égide de l’association APPROCHE. Vingt-neuf patients tétraplégiques d’âge moyen 37,83 ± 13,3 : 23 blessés médullaires, 2 Locked In Syndrome, 4 autres pathologies. Trente-quatre sujets témoins d’âge moyen 32,44 ± 11,2. La fiabilité de l’interface graphique du système de commande a été évaluée à travers 3 scénarii comportant différentes étapes : désignation de la pièce où se trouve l’objet, déplacement de SAM vers l’objet, désignation de l’objet à saisir avec ou sans contrôle visuel, saisie automatique de l’objet, déclenchement du retour de SAM. L’usage du robot et son acceptabilité ont été évalués par un questionnaire.RésultatsLe système est stable et fiable : il y a peu d’échec dans la réalisation des différentes étapes des scénarii aussi bien pour les patients que pour les témoins. L’interface graphique est efficace pour la désignation et la saisie de l’objet. SAM a été bien accueilli par tous les utilisateurs patients et thérapeutes. Mais seuls les patients envisageraient un transfert de l’utilisation du robot en vie quotidienne