37,254 research outputs found

    Diabetes mellitus in dogs: therapy, monitoring and prognostic factors

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    Il diabete mellito (DM) √® una delle malattie endocrine pi√Ļ comuni nel cane. Una volta raggiunta la diagnosi di DM, √® necessario iniziare un trattamento insulinico nonch√© una dieta specifica, al fine di controllare i livelli di glucosio nel sangue e di conseguenza i segni clinici. Inoltre, al fine di ottenere un buon controllo glicemico, √® essenziale garantire uno stretto monitoraggio terapeutico. Nella presente tesi sono riportati numerosi studi relativi a trattamento, monitoraggio e prognosi dei cani con DM. Il capitolo 2 √® una review che illustra i principali aspetti terapeutici e di monitoraggio del DM. Il capitolo 3 riporta uno studio che confronta l'efficacia e la sicurezza dell'insulina Lenta e dell'insulina Neutra Protamine Hagedorn (NPH). I metodi di monitoraggio per cani con DM possono essere classificati in diretti od indiretti. I metodi di monitoraggio diretto includono misurazioni serali della glicemia o monitoraggio continuo del glucosio interstiziale tramite appositi dispositivi (Continuous Glucose Monitoring System, CGMS). Le modalit√† indirette comprendono la valutazione dell'assunzione di acqua e del peso corporeo, la quantificazione del glucosio/chetoni nelle urine e la misurazione delle concentrazioni di proteine glicate. Il capitolo 4 mostra uno studio volto a valutare l'accuratezza e la precisione di un glucometro e un glucometro/chetometro nel cane. Il Flash Glucose Monitoring system √® un CGMS recentemente validato per l'uso nel cane; la sua utilit√† clinica nel monitoraggio del DM canino √® esaminata nel capitolo 5. Il capitolo 6 descrive uno studio in cui si validano 2 metodi analitici per la misurazione delle fruttosamine sieriche e dell'emoglobina glicata nel cane e confronta l‚Äôutilit√† delle due proteine glicate nel definire il controllo glicemico. Infine, il capitolo 7 riporta uno studio finalizzato a determinare il tempo di sopravvivenza e ad identificare il valore prognostico di diverse variabili cliniche e clinico-patologiche nei cani con DM.Diabetes mellitus (DM) is one of the most common endocrine diseases in dogs. After diagnosis, it is necessary to start an insulin treatment and an appropriate dietetic management, in order to control blood glucose (BG) levels and consequently the clinical signs. Moreover, in order to achieve a good glycemic control, monitoring of diabetic dogs (DD) is essential. In the present thesis are illustrated several studies concerning treatment, monitoring and prognosis of dogs with DM. Chapter 2 is a review illustrating the main therapeutic aspects and monitoring methods of canine DM. Chapter 3 reports a study that compare the efficacy and safety of Lente insulin and Neutral Protamine Hagedorn (NPH) insulin in DD. Monitoring methods for dogs with DM can be classified as direct or indirect. Direct monitoring methods include serial BG measurements (BG curve) or continuous BG monitoring via a Continuous Glucose Monitoring System (CGMS). Indirect ways of monitoring include assessment of water intake and body weight, quantification of urine glucose/ ketones and measurements of glycosylated protein concentrations. Chapter 4 shows a study aimed at assessing the accuracy and precision of one glucometer (Gluco Calea, WellionVet) and one glucometer/ketometer (Belua, Wellion Vet) in the canine species. Flash glucose monitoring system is a CGMS recently validated for use in DD. The clinical usefulness of FGMS in monitoring DD is investigated in chapter 5. Chapter 6 investigates the performance of 2 assays for the measurement of serum fructosamine (SF) and glycated hemoglobin (HbA1c) in dogs and compares the use of SF and HbA1c to assess glycemic control in DD. Despite DM is one of the most common endocrine disorders in dogs, prognostic factors are still largely unknown. Chapter 7 reports a study to determine overall survival time and identify the prognostic value of several clinical and clinicopathological variables in newly diagnosed DD

    –źmelioration by phytoadaptogene of effects of balneofactors of Truskavets‚Äô Spa on patients with post-radiation encephalopathy

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    Background.¬†We have previously explored effects of Ukrainian¬†phytocomposition ‚ÄúBalm Truskavets‚Äô‚Ä̬†on parameters of neuro-endocrine-immune complex and biophotonics in humans with maladaptation.¬†It is known that in patients with post-radiation encephalopathy the reaction to some stimuli is significantly changed, therefore it needs correction.¬†The purpose of this study is to test the ability of this phytocomposition to amelioration the effects of standard balneotherapeutic complex in patients with post-radiation encephalopathy.¬†Material and methods. The research was carried out through a retrospective analysis of the database of the Truskavetsian Scientific School of Balneology, which remained unpublished. The object of observation in 1997 were 19 men and 3 women with urate¬†urolithiasis and chronic pyelonephritis¬†who were exposed to pathogenic factors of the accident at the Ch–ĺrnobylian nuclear power plant during the liquidation of its consequences in 1986-87. The survey was conducted twice: on admission and after two weeks of rehabilitation in sanatorium ‚ÄúPerlyna Prykarpattya‚Ä̬†(Truskavets‚Äô Spa). 11 patients received standard balneotherapy¬†while¬†the other 11 patients additionally received the phytocomposition¬†‚ÄúBalm Truskavets‚Äô‚ÄĚ. According to the protocol, blood pressure,¬†routine hematological and biochemical blood parameters were determined. In addition, physical working capacity (PWC150)¬†as well as EEG, heart rate variability (HRV) and immunity parameters were determined.¬†Results. Standard balneotherapy increases the decreased level of T-helper lymphocytes, but further decreases the level of B-lymphocytes, glomerular filtration rate and PWC150, in combination with increased normal levels of blood creatinine and urea, as well as decreased levels of diastolic BP and heart rate.¬†This is accompanied by a further increase in the sympathetic tone and the leveling of the increased of ULF band HRV as marker of level in the plasma of catecholamines and glucocorticoids.¬†Additional use of phytocomposition limits the adverse effects of standard balneotherapy by modulating EEG and HRV parameters. Conclusion. Phytocomposition¬†"Balm¬†Truskavets'" by¬†modulating¬†the¬†parameters¬†of¬†the¬†nervous¬†system¬†limits¬†the¬†adverse¬†effects¬†of¬†standard¬†balneotherapy¬†at¬†the¬†Truskavets‚Äô¬†Spa¬†in¬†patients¬†with¬†post-radiation¬†encephalopathy

    Serum creatinine and urea assays on Atellica¬ģ CH and Architect¬ģ ci4100: method comparison

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    Serum creatinine and urea are markers of renal function usually measured in conjunction. This study aims to evaluate the comparability of a new analyzer incorporated to our laboratory, Atellica¬ģ with the established analyzer, Architect ¬ģ ci 4100 in serum creatinine and urea assays. We ran 110 tests for creatinine and 107 for urea. In both analyzers, serum creatinine assay is based on the Jaffe reaction while urea measurement is based on the Roch-Ramel enzymatic reaction. Linear association between methods was evaluated using Pearson's correlation coefficient. Methods comparability was assessed using Passing-Bablok and Deming linear regression. Differences between analyzers were evaluated using Bland-Altman plot. For serum creatinine, regression equations are Atellica = 0.9721 x Architect - 2.7282 (Passing & Bablok) and Atellica = 0.8884 x Architect + 1.3456 (Deming). The mean difference between the two methods is -11.7 ¬Ķmol/L as indicated by Bland-Altman plot. For urea, regression lines are expressed as Atellica = 1.0252 x Architect ‚Äď 0.1609 (Passing-Bablok) and Atellica = 1.1424 x Architect ‚Äď 0.9532 (Deming). Bland-Altman plot presented a mean difference of -0.1 mmol/L. These results could be described as a very good agreement between the two methods, the two analyzers could be used interchangeably. DOI: http://dx.doi.org/10.5281/zenodo.754215

    Potential of cell-free hemoglobin and haptoglobin as prognostic markers in patients with ARDS and treatment with veno-venous ECMO

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    Abstract Background Hemolysis is associated with increased mortality in patients with sepsis, ARDS, or therapy with extracorporeal membrane oxygenation (ECMO). To quantify a critical threshold of hemolysis in patients with ARDS and treatment with veno-venous ECMO, we aimed to identify cutoff values for cell-free hemoglobin (CFH) and haptoglobin (Hp) plasma concentrations associated with a significant increase in ICU mortality. Methods Patients with ARDS admitted to a tertiary ARDS referral center between 01/2007 and 12/2018 and treatment with veno-venous ECMO were included. Cutoff values for mean CFH (mCFH) and mean Hp (mHp) plasma concentrations dividing the cohort into groups with significantly different ICU mortalities were calculated and patient characteristics were compared. A multiple logistic regression model with stepwise backward variable selection was included. In addition, cutoff values for vulnerable relative timespans for the respective CFH and Hp concentrations were calculated. Results A quantitative cutoff value of 11¬†mg/dl for mCFH separated the cohort (n‚ÄČ=‚ÄČ442) regarding ICU mortality (mCFH‚ÄȂȧ‚ÄČ11¬†mg/dl: 38%, [95%-CI: 32.22‚Äď43.93] (n‚ÄČ=‚ÄČ277) vs. mCFH‚ÄČ>‚ÄČ11¬†mg/dl: 70%, [61.99‚Äď76.47] (n‚ÄČ=‚ÄČ165), p‚ÄČ‚ÄČ0.39¬†g/l: 38.7%, [33.01‚Äď44.72] (n‚ÄČ=‚ÄČ279), p‚ÄČ‚ÄČ11¬†mg/dl: 33%; [26.81‚Äď40.54] (n‚ÄČ=‚ÄČ192) vs.‚ÄČ>‚ÄČ13.3% of days with CFH‚ÄČ>‚ÄČ11¬†mg/dl: 62%; [56.05‚Äď68.36] (n‚ÄČ=‚ÄČ250), p‚ÄČ‚ÄČ18.2% of therapy days (‚ȧ‚ÄČ18.2% days with Hp‚ÄȂȧ‚ÄČ0.39¬†g/l: 27%; [19.80‚Äď35.14] (n‚ÄČ=‚ÄČ138) vs.‚ÄČ>‚ÄČ18.2% days with Hp‚ÄȂȧ‚ÄČ0.39¬†g/l: 60%; [54.43‚Äď65.70] (n‚ÄČ=‚ÄČ304), p‚ÄČ‚ÄČ11¬†mg/dl. In addition, also Hp plasma concentrations need consideration when the injurious effect of elevated CFH is evaluated

    Associations between TyG-BMI and normal-high blood pressure values and hypertension: cross-sectional evidence from a non-diabetic population

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    ObjectiveTriglyceride glucose body mass index (TyG-BMI) has been shown to be strongly associated with a variety of chronic diseases. However, little is known about the associations between TyG-BMI and normal-high blood pressure (BP) values and hypertension (HTN).MethodThe current study was cross-sectional in design and included 15,464 non-diabetic participants recruited between 1994 and 2016 in the NAGALA (NAfld in the Gifu Area, Longitudinal Analysis) study. Associations between TyG-BMI and normal-high BP values and HTN were assessed using multivariate logistic regression. The ability of the TyG index, BMI, and their combined index TyG-BMI to identify normal-high BP values and HTN was compared by receiver operating characteristic (ROC) curves.ResultsAmong the 15,464 eligible non-diabetic participants, 28.56% (4,416/15,464) and 6.23% (964/15,464) had normal-high BP values and HTN, respectively. Multivariate logistic regression analysis showed positive correlations between BMI, TyG index, TyG-BMI and normal-high BP values/HTN; after standardized regression coefficients, TyG-BMI had the strongest association with normal-high BP values and HTN compared to BMI and TyG index. In the fully adjusted model, the odds ratio (OR) value corresponding to the relationship between TyG-BMI and HTN/normal-high BP values was 2.35; when TyG-BMI was used as a categorical variable, compared with the lowest quartile of TyG-BMI the regression coefficient for the association of the highest quartile of TyG-BMI with normal-high BP values increased by 426%, while the regression coefficient for the association with HTN increased by 527%. In further spline regression analysis, we also found that there was a linearly positive correlation between TyG-BMI and systolic BP/diastolic BP (SBP/DBP), which supported the linear trend between TyG-BMI and HTN/normal-high BP values (P-trend <0.0001). In addition, ROC analysis showed that TyG-BMI had good diagnostic values for both normal-high BP values and HTN, and TyG index combined with BMI can significantly improve the ability of a single index to identify normal-high BP values and HTN.ConclusionIn the non-diabetic population, TyG-BMI showed a significant positive correlation with both normal-high BP values and HTN, and TyG-BMI was of higher value for the identification of both normal-high BP values and HTN compared to BMI and TyG index alone

    Impact of Population Based Indoor Residual Spraying with and without Mass Drug Administration with Dihydroartemisinin-Piperaquine on Malaria Prevalence in a High Transmission Setting: A Quasi-Experimental Controlled Before-and-After Trial in Northeastern Uganda

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    Background: Declines in malaria burden in Uganda have slowed. Modelling predicts that indoor residual spraying (IRS) and mass drug administration (MDA), when co-timed, have synergistic impact. This study investigated additional protective impact of population-based MDA on malaria prevalence, if any, when added to IRS, as compared with IRS alone and with standard of care (SOC). Methods: The 32-month quasi-experimental controlled before-and-after trial enrolled an open cohort of residents (46,765 individuals, 1st enumeration and 52,133, 4th enumeration) of Katakwi District in northeastern Uganda. Consented participants were assigned to three arms based on residential subcounty at study start: MDA+IRS, IRS, SOC. IRS with pirimiphos methyl and MDA with dihydroartemisinin- piperaquine were delivered in 4 co-timed campaign-style rounds 8‚ÄČmonths apart. The primary endpoint was population prevalence of malaria, estimated by 6 cross-sectional surveys, starting at baseline and preceding each subsequent round. Results: Comparing malaria prevalence in MDA+IRS and IRS only arms over all 6 surveys (intention-to-treat analysis), roughly every 6‚ÄČmonths post-interventions, a geostatistical model found a significant additional 15.5% (95% confidence interval (CI): [13.7%, 17.5%], Z‚ÄČ=‚ÄČ9.6, p‚ÄČ=‚ÄČ5e‚ąí20) decrease in the adjusted odds ratio (aOR) due to MDA for all ages, a 13.3% reduction in under 5‚Äôs (95% CI: [10.5%, 16.8%], Z‚ÄČ=‚ÄČ4.02, p‚ÄČ=‚ÄČ5e‚ąí5), and a 10.1% reduction in children 5‚Äď15 (95% CI: [8.5%, 11.8%], Z‚ÄČ=‚ÄČ4.7, p‚ÄČ=‚ÄČ2e‚ąí5). All ages residents of the MDA + IRS arm enjoyed an overall 80.1% reduction (95% CI: [80.0%, 83.0%], p = 0.0001) in odds of qPCR confirmed malaria compared with SOC residents. Secondary difference-in-difference analyses comparing surveys at different timepoints to baseline showed aOR (MDA + IRS vs IRS) of qPCR positivity between 0.28 and 0.66 (p \u3c 0.001). Of three serious adverse events, one (nonfatal) was considered related to study medications. Limitations include the initial non-random assignment of study arms, the single large cluster per arm, and the lack of an MDA-only arm, considered to violate equipoise. Conclusions: Despite being assessed at long time points 5‚Äď7‚ÄČmonths post-round, MDA plus IRS provided significant additional protection from malaria infection over IRS alone. Randomized trials of MDA in large areas undergoing IRS recommended as well as cohort studies of impact on incidence

    Association of type 2 diabetes mellitus with lung cancer in patients with chronic obstructive pulmonary disease

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    BackgroundPatients with chronic obstructive pulmonary disease (COPD) have an increased risk of developing lung cancer. Some studies have also suggested that diabetes mellitus (DM) may increase the risk of developing lung cancer. This study aimed to investigate whether type 2 DM (T2DM) is associated with an increased risk of lung cancer in patients with COPD.Materials and methodsWe conducted a retrospective analysis on two cohorts: the National Health Insurance Service-National Sample Cohort (NHIS-NSC) of Korea and the Common Data Model (CDM) database of a university hospital. Among patients newly diagnosed with COPD in each cohort, those with a lung cancer diagnosis were included, and a control group was selected through propensity score matching. We used the Kaplan‚ÄďMeier analysis and Cox proportional hazard models to compare lung cancer incidence between patients with COPD and T2DM and those without T2DM.ResultsIn the NHIS-NSC and CDM cohorts, we enrolled 3,474 and 858 patients with COPD, respectively. In both cohorts, T2DM was associated with an increased risk of lung cancer [NHIS-NSC: adjusted hazard ratio (aHR), 1.20; 95% confidence interval (CI), 1.02‚Äď1.41; and CDM: aHR, 1.45; 95% CI, 1.02‚Äď2.07). Furthermore, in the NHIS-NSC, among patients with COPD and T2DM, the risk of lung cancer was higher in current smokers than in never-smokers (aHR, 1.45; 95% CI, 1.09‚Äď1.91); in smokers with ‚Č•30 pack-years than in never-smokers (aHR, 1.82; 95% CI, 1.49‚Äď2.25); and in rural residents than in metropolitan residents (aHR, 1.33; 95% CI, 1.06‚Äď1.68).ConclusionOur findings suggest that patients with COPD and T2DM may have an increased risk of developing lung cancer compared to those without T2DM

    Multiple functions and regulatory network of miR-150 in B lymphocyte-related diseases

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    MicroRNAs (miRNAs) play vital roles in the post-transcriptional regulation of gene expression. Previous studies have shown that miR-150 is a crucial regulator of B cell proliferation, differentiation, metabolism, and apoptosis. miR-150 regulates the immune homeostasis during the development of obesity and is aberrantly expressed in multiple B-cell-related malignant tumors. Additionally, the altered expression of MIR-150 is a diagnostic biomarker of various autoimmune diseases. Furthermore, exosome-derived miR-150 is considered as prognostic tool in B cell lymphoma, autoimmune diseases and immune-mediated disorders, suggesting miR-150 plays a vital role in disease onset and progression. In this review, we summarized the miR-150-dependent regulation of B cell function in B cell-related immune diseases
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