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Diabetic foot: A real challenge 糖尿病足:一个真正的挑战
Pub Date : 2018-01-01 DOI: 10.4172/2161-1017-C1-022
R. Kant
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引用次数: 0
An overview on sleep apnoea in Polycystic ovary syndrome 多囊卵巢综合征睡眠呼吸暂停的研究综述
Pub Date : 2018-01-01 DOI: 10.4172/2161-1017-C3-029
pSahar Mansour Ibrahim Yossria Ahmed Elsayed Hanan Fahmy Azzam, Reda Esmail Reyadp
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引用次数: 0
Newly Discovered Physiological Effects of Oxytocin 新发现的催产素生理作用
Pub Date : 2018-01-01 DOI: 10.4172/2161-1017.1000288
E. Hughes
New physiological effects of oxytocin (OT) have been discovered as potentially impacting a variety of diseases, including mood and emotional disorders, autism spectrum disorder, inflammatory conditions, cardiac abnormalities, bone health and sexual behavior. OT has been dubbed “the love hormone” due to its positive effects on a number of social behaviors, including interpersonal trust, empathy, bonding and the ability to recognize emotions.
催产素(OT)的新生理效应已被发现可能影响多种疾病,包括情绪和情绪障碍、自闭症谱系障碍、炎症、心脏异常、骨骼健康和性行为。OT被称为“爱情荷尔蒙”,因为它对许多社会行为有积极影响,包括人际信任、同理心、联系和识别情绪的能力。
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引用次数: 1
The Triumvirate of Adiposopathy: A Literature Review and Proposal of the Claros Pathophysiological Model 脂肪病三巨头:文献综述及Claros病理生理模型的提出
Pub Date : 2018-01-01 DOI: 10.4172/2161-1017.1000293
Rosero Rj, Polanco Jp, A. Jaramillo, Á. Gómez, I. Cossío, D. Cortés, A. Uribe, P. Ji, B. Geloneze
Obesity is currently considered as the 21st century epidemic. The accelerated increase in prevalence and mortality due to cardiovascular diseases establishes a historical precedent as a global public health problem. The increased incidence of obesity and obesity-associated chronic diseases (coronary heart disease, cancer, diabetes), together with the frequent finding of these conditions in the clinic, urgently call for studies aiming to identify possible pathophysiologic connections among these conditions. Obesity is often seen only as an imbalance between caloric intake and energy expenditure. On the other hand, numerous neuroendocrine factors are responsible for the regulation of energy metabolism. In addition, body metabolism is also affected by the autocrine, paracrine, and endocrine activity of organokines. Thus, the understanding signaling pathways, action and regulation of organokines could lead to a comprehensive approach to obesity, which in turn may unravel new indicators of adiposopathy, that are not necessarily associated solely to body weight or evident excess of fatty tissue. Herein we propose a pathophysiological model, which we refer to as the triumvirate of adiposopathy, involving the alteration of organokine balance (myokines, hepatokines, and adipokines) and that takes into account signaling pathways that are common to pro-inflammatory states such as insulin resistance and endothelial damage, emphasizing in adiposopathy and obesity, aiming to achieve the early identification of cardiometabolic risk, and thus positively impact the risk of morbimortality associated with adiposity.
肥胖目前被认为是21世纪的流行病。心血管疾病发病率和死亡率的加速上升开创了作为全球公共卫生问题的历史先例。肥胖和与肥胖相关的慢性疾病(冠心病、癌症、糖尿病)发病率的增加,以及这些疾病在临床中的频繁发现,迫切需要研究这些疾病之间可能的病理生理联系。肥胖通常只被视为热量摄入和能量消耗之间的不平衡。另一方面,许多神经内分泌因子负责调节能量代谢。此外,机体代谢还受有机因子的自分泌、旁分泌和内分泌活性的影响。因此,了解信号通路、器官因子的作用和调节可能会导致肥胖症的综合方法,进而可能揭示脂肪病的新指标,这些指标不一定仅仅与体重或脂肪组织的明显过剩有关。在此,我们提出了一个病理生理模型,我们称之为脂肪病的三要素,涉及器官因子平衡的改变(肌肉因子、肝因子和脂肪因子),并考虑到促炎状态(如胰岛素抵抗和内皮损伤)中常见的信号通路,强调脂肪病和肥胖,旨在实现心脏代谢风险的早期识别。从而积极影响与肥胖相关的死亡风险。
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引用次数: 0
Newborn Thyroid Stimulating Hormone Levels in Heel Prick Blood at the Yaounde Gyneco-Obstetric and Paediatric Hospital Cameroon 喀麦隆雅温得妇产科和儿科医院新生儿足跟刺血中促甲状腺激素水平
Pub Date : 2018-01-01 DOI: 10.4172/2161-1017.1000287
Bodieu Chetcha Adele, Mah Evelyn Mungyeh, Ngo Um Sap Suzanne, Y. S. Alkali, Chizo Agwu, Chetcha Bernard, T. Ekoe, A. Oduwole, C. Andreas
Background: Thyroid hormone is necessary for normal brain growth, myelination, normal neuronal connections and physical growth. The most critical period for the effect of thyroid hormone on brain development is the first few months of life. No data from Cameroon that described the iodine status and thyroid function of the Cameroonian pregnant women and neonates is available. This study determined the newborn Thyroid Stimulating Hormone levels at the Yaounde Gyneco-Obstetric and Paediatric Hospital-Cameroon and demonstrated the association between perinatal factors and newborn TSH levels. Subjects and method: A descriptive cross-sectional study was done from the 10th January to 10th March 2017. On the third day of life, the heel prick blood obtained and dropped on a filter paper was analyzed for TSH using the commercial Human Neonatal TSH ELISA Kit (Catalog number EL10012N from Anogen, Yes Biotech Laboratories Ltd. Canada). The mean Thyroid Stimulating Hormone levels of the newborns were determined and, considering the perinatal factors and one-way analysis of variance were used to determine any correlation between the Thyroid Stimulating Hormone values and perinatal factors. Results: 180 newborns were recruited during the study period. The Thyroid Stimulating Hormone values were normally distributed, within the range of [1.17-2.57 μIU/ml]. The mean Thyroid Stimulating Hormone value for the subjects was 1.59 ± 0.22 μIU/ml. 96.11% were within [-2SD and + 2SD]. Only high birth weights have been found to be associated with the high Thyroid Stimulating Hormone levels. Conclusion: This study presented the normal reference values for Thyroid Stimulating Hormone in Cameroonian newborns at the Yaounde Gyneco-Obstetric and Pediatric Hospital Cameroon. Using this result, no neonates in the study had values pointing to a Congenital Hypothyroidism diagnosis.
背景:甲状腺激素是正常大脑发育、髓鞘形成、正常神经元连接和身体发育所必需的。甲状腺激素对大脑发育的影响最关键的时期是出生后的头几个月。喀麦隆没有描述喀麦隆孕妇和新生儿碘状况和甲状腺功能的数据。本研究测定了喀麦隆雅温得妇产科和儿科医院新生儿促甲状腺激素水平,并证明围产期因素与新生儿TSH水平之间的关系。研究对象和方法:于2017年1月10日至3月10日进行描述性横断面研究。出生第三天,取足跟刺血滴在滤纸上,使用商用人类新生儿TSH酶联免疫吸附测定试剂盒(目录号EL10012N, Anogen, Yes Biotech Laboratories Ltd.)分析TSH。加拿大)。测定新生儿平均促甲状腺激素水平,考虑围产期因素,采用单因素方差分析确定促甲状腺激素水平与围产期因素的相关性。结果:研究期间共招募了180名新生儿。促甲状腺激素值呈正态分布,在[1.17 ~ 2.57 μIU/ml]范围内。受试者的平均促甲状腺激素值为1.59±0.22 μIU/ml。96.11%在[-2SD和+ 2SD]范围内。只有高出生体重被发现与高促甲状腺激素水平有关。结论:本研究提出了喀麦隆雅温得妇产科和儿科医院新生儿促甲状腺激素的正常参考值。利用这一结果,研究中没有新生儿具有指向先天性甲状腺功能减退诊断的价值。
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引用次数: 0
Efficacy of Maximum and Optimum Doses of Hydroxychloroquine Added to Patients with Poorly Controlled Type 2 Diabetes on Stable Insulin Therapy along with Glimepiride And Metformin: Association of High-Sensitive C-Reactive Protein (Hs-CRP) and Glycosylated Haemoglobin (Hba1c) 控制不佳的2型糖尿病患者联合格列美脲和二甲双胍稳定胰岛素治疗时羟氯喹最大和最佳剂量的疗效:高敏c反应蛋白(Hs-CRP)和糖化血红蛋白(Hba1c)的相关性
Pub Date : 2018-01-01 DOI: 10.4172/2161-1017.1000283
A. Baidya, H. N. Chakravarti, R. Saraogi, Amit S. Gupta, Rishad Ahmed, A. Banerjee, Satpathy Sc
Aim: To determine the efficacy of maximum and optimum dosages of hydroxychloroquine (400 and 200 mg once daily) treatment combined with insulin along with metformin and Glimepiride in Type 2 diabetes patients who are poorly controlled and relationship to be evaluate between high-sensitive C-reactive protein (hs-CRP) and glycosylated haemoglobin (HbA1c) levels in such patients.Methods: In a multicentre,open-labelled comparative observational study, randomised 240 patients [mean age 56.44 years and mean body mass index (BMI) 33.20 kg/m2, mean glycosylated haemoglobin (HbA1C) 8.58% ; mean duration of diabetes 13.7 years] with type 2 diabetes who were poorly controlled with a high stable insulin dose (≥ 30 Units/day for ≥ 30 days), glimepiride (2 mg/day) and metformin (1000 mg/day) were randomly allocated to either hydroxychloroquine 200 or 400 mg once daily for 6 months (24 weeks).Results: At completion of 6 months (24 weeks), statistically significant, dose-dependent mean decreases from baseline were seen in both the hydroxychloroquine 200 and 400 mg groups for HbA1C (-0. and -1.3%, respectively) (p<0.0001), fasting plasma glucose (FPG) (-29.5 mg/dl and -33.2 mg/dl, respectively) (p<0.0001) and postprandial plasma glucose (PPG) (-39.6 mg/dl and -49.8 mg/dl, respectively) (p<0.0001) . Insulin dosage also decreased significantly in both the groups (-5.6 and -9.8 IU/day, respectively; p ≤ 0.05) from baseline. Insulin dose has reduced in significant number of patients. In the present study of type 2 diabetes patients, we found that hs-CRP levels correlated with HbA1c levels.Conclusions: In type 2 diabetes patients who are poorly controlled, addition of hydroxychloroquine (HCQ) to insulin along with Glimepiride and Metformin significantly improved glycemic control in a dose-dependent manner and was generally well tolerated. In type 2 diabetes patients who are poorly controlled by oral antidiabetic or insulin or in combination, reduction in hs-CRP highly influence HbA1c reduction.
目的:确定羟氯喹(400和200mg,每日一次)联合胰岛素、二甲双胍和格列美脲治疗控制不良的2型糖尿病患者的最大和最佳剂量的疗效,并评估这类患者中高敏c反应蛋白(hs-CRP)和糖化血红蛋白(HbA1c)水平之间的关系。方法:在一项多中心、开放标记的比较观察性研究中,随机选择240例患者[平均年龄56.44岁,平均体重指数(BMI) 33.20 kg/m2,平均糖化血红蛋白(HbA1C) 8.58%;2型糖尿病患者控制不良,胰岛素稳定剂量高(≥30单位/天,持续≥30天)、格列美脲(2 mg/天)和二甲双胍(1000 mg/天),随机分配至羟氯喹200或400 mg组,每日1次,持续6个月(24周)。结果:在6个月(24周)结束时,羟氯喹200和400 mg组的HbA1C(-0。空腹血糖(FPG)(分别为-29.5 mg/dl和-33.2 mg/dl) (p<0.0001)和餐后血糖(PPG)(分别为-39.6 mg/dl和-49.8 mg/dl) (p<0.0001)。两组的胰岛素剂量也显著降低(分别为-5.6和-9.8 IU/天);P≤0.05)。大量患者胰岛素剂量减少。在目前对2型糖尿病患者的研究中,我们发现hs-CRP水平与HbA1c水平相关。结论:在控制不良的2型糖尿病患者中,在胰岛素中加入羟氯喹(HCQ)与格列美脲和二甲双胍可显著改善血糖控制,且具有剂量依赖性,且通常耐受性良好。在口服降糖药或胰岛素或联合使用控制不良的2型糖尿病患者中,hs-CRP的降低高度影响HbA1c的降低。
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引用次数: 13
Combination Levothyroxine and Levotriiodothyronine Therapy for Hypothyroidism Treatment-Is it Worth the Risks? 左旋甲状腺素和左旋三碘甲状腺原氨酸联合治疗甲状腺功能减退——值得冒险吗?
Pub Date : 2018-01-01 DOI: 10.4172/2161-1017.1000E127
R. Kant, V. Verma
About 4.6% of the U.S. population ages 12 and older and 3.05% of European population has hypothyroidism [1,2]. Thyroid produces thyroxine (T4) and triiodothyronine (T3) but T3 is more active at the cellular level because of its higher affinity for the nuclear thyroid hormone receptors. In humans, approximately 80% of the T3 produced daily derives from monodeiodination of T4 in extrathyroidal tissues [3]. Current guidelines consistently recommend Levothyroxine (LT4) monotherapy as treatment of choice for hypothyroidism management [4,5]. The goal of therapy is to restore physical and psychological wellbeing and normalize serum TSH. Although LT4 monotherapy is effective, up to 5-10% of hypothyroid patients with normal TSH on LT4 does not feel entirely well and reports persistent symptoms [5]. Given the high prevalence of patients who are not satisfied with LT4 monotherapy, a review of the literature evaluating efficacy and safety of combination levothyroxine and levotriiodothyronine therapy (LT4/ LT3) is worthwhile.
约4.6%的美国12岁及以上人群和3.05%的欧洲人群患有甲状腺功能减退症[1,2]。甲状腺产生甲状腺素(T4)和三碘甲状腺原氨酸(T3),但T3在细胞水平上更活跃,因为它对核甲状腺激素受体有更高的亲和力。在人类中,每天大约80%的T3来源于甲状腺外组织中T4的单脱碘[3]。目前的指南一致推荐左旋甲状腺素(LT4)单一疗法作为治疗甲状腺功能减退症的选择[4,5]。治疗的目标是恢复身体和心理健康,使血清TSH正常化。虽然LT4单药治疗是有效的,但高达5-10%的TSH正常的甲状腺功能减退患者在LT4治疗后感觉不完全好,并报告持续症状[5]。鉴于对LT4单药治疗不满意的患者比例较高,对评价左旋甲状腺素和左旋三碘甲状腺原氨酸联合治疗(LT4/ LT3)的疗效和安全性的文献进行回顾是值得的。
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引用次数: 1
Diagnosis and Management of Subclinical Hypothyroidism in Pregnancy: A Retrospective Review Study 妊娠期亚临床甲状腺功能减退症的诊断和治疗:一项回顾性研究
Pub Date : 2018-01-01 DOI: 10.4172/2161-1017.1000291
A. Mortadha
Back ground: The hormones of thyroid organ play an important role for a normal pregnancy without maternal or fetal complexities. However, using different methods and thyrotropin (TSR) ranges for diagnosis subclinical hypothyroidism (SCH) in different population are challenging. The aim of this study is to clarify the world wide variation in prevalence of SCH, the accurate methods been used for diagnosing (SCH) in pregnant women, main adverse pregnancy outcomes related to (SCH) and the clinical impact of levothyroxine on gestational SCH related complications. Methods: Meta-analysis of the results of all studies that were investigated the screening methods, adverse pregnancy outcomes and the treatment of SCH during pregnancy which was published in English language during the last two decade including the popular guidelines in this regard. Results: The studies revealed a strong linear association between preterm delivery, miscarriage and TSH level with more events, if combined with positive thyroid antibodies. The difference in TSH (TSR) ranges among different ethnicity and countries should be considered for diagnosis and treatment. Conclusion: Early diagnosis and treatment of SCH during pregnancy is cost effective in reducing the preterm labour, miscarriage and its complications. Using specific TSH cut off level for each population is essential for accurate diagnosis and screening should include not only high risk cases but patients in countries with high prevalence of SCH.
背景:甲状腺激素对正常妊娠无母胎并发症起重要作用。然而,在不同人群中使用不同的方法和促甲状腺素(TSR)范围诊断亚临床甲状腺功能减退(SCH)具有挑战性。本研究的目的是阐明世界范围内SCH患病率的变化、诊断孕妇SCH的准确方法、与SCH相关的主要不良妊娠结局以及左旋甲状腺素对妊娠期SCH相关并发症的临床影响。方法:荟萃分析近二十年来发表的所有关于妊娠期SCH的筛查方法、不良妊娠结局和治疗的研究结果,包括这方面的流行指南。结果:研究显示,如果合并甲状腺抗体阳性,早产、流产和TSH水平与更多事件之间存在很强的线性关联。在诊断和治疗时应考虑不同种族和国家之间TSH (TSR)范围的差异。结论:妊娠期早期诊断和治疗妊高征对减少早产、流产及其并发症具有成本效益。为每个人群使用特定的TSH切断水平对于准确诊断至关重要,筛查不仅应包括高风险病例,还应包括SCH高流行国家的患者。
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引用次数: 0
An exploratory survey to estimate prevalence, and perceived knowledge of Polycystic ovary syndrome (PCOS) in young adults 一项探索性调查,以估计患病率,和认知知识的多囊卵巢综合征(PCOS)在年轻的成年人
Pub Date : 2018-01-01 DOI: 10.4172/2161-1017-C3-030
Manisha Rao, S. Broughton
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引用次数: 1
Trends on Prevalence of Diabetes Mellitus at Nedjo General Hospital, Western Ethiopia: Cross-Sectional Study 埃塞俄比亚西部nejo总医院糖尿病流行趋势:横断面研究
Pub Date : 2018-01-01 DOI: 10.4172/2161-1017.1000296
Ginenus Fekadu, Said Adem, F. Bekele
Background and Objective: Diabetes mellitus (DM) is the commonest of all metabolic diseases all over the world. It is estimated that between 5-10% of the population suffer from this disease. Ethiopia is one of the top five countries with the highest number of people affected by DM in sub Saharan Africa (SSA). Hence the study aimed to assess the trend in the prevalence of DM in Nedjo General Hospital (NGH). Methods: A hospital-based cross-sectional study from patients’ records was reviewed by using structured data extraction tool. Data were obtained from medical records of all registered diabetic patients in the Diabetic Follow up Clinic between 2012 and 2016. A Chi square was used as test of significance at 95% of confidence interval. A P value of 0.05 or less than 0.05 was used as the cut-of level for statistical significance. Result: From the total of 299 diabetic patients, 175 (58.5%) were type-1 DM (T1DM) and 124 (41.5%) were type-2 DM (T2DM). The study revealed that trend of DM was increasing over the consecutive five years of the study period. Majority of the patients were males comprising 64.9% with female to male ratio of 1:1.8. DM was significantly associated with age of the patients (χ2=11.28, P=0.003) at 95% of confidence interval. Hypertension was the most common co morbid recorded in 61 (20.4%) of the total patients. About 169 (96.6%) of T1DM patients who were on insulin and 88 (71.0%) T2DM patients were on oral hypoglycemic agents (OHA). Conclusion and Recommendation: The overall prevalence of diabetes mellitus was steadily increasing in patients who were attending at NGH over last five consecutive years. Adopting a healthy life style, balanced diet, and avoiding other risk factor from their life style is mandatory.
背景与目的:糖尿病(DM)是世界上最常见的代谢性疾病。据估计,有5-10%的人口患有这种疾病。埃塞俄比亚是撒哈拉以南非洲(SSA)受DM影响人数最多的五个国家之一。因此,本研究旨在评估内德霍总医院(NGH)糖尿病患病率的趋势。方法:采用结构化数据提取工具,对以医院为基础的患者病历横断面研究进行回顾。数据来源于2012 - 2016年在糖尿病随访诊所登记的所有糖尿病患者的病历。在95%的置信区间使用卡方作为显著性检验。以0.05或小于0.05的P值作为有统计学意义的截断水平。结果:299例糖尿病患者中,1型糖尿病(T1DM) 175例(58.5%),2型糖尿病(T2DM) 124例(41.5%)。研究发现,在连续5年的研究期间,糖尿病的发病率呈上升趋势。患者以男性居多,占64.9%,男女比例为1:8 .8。DM与患者年龄有显著相关性(χ2=11.28, P=0.003), 95%可信区间。高血压是最常见的合并症,61例(20.4%)。约169例(96.6%)T1DM患者使用胰岛素,88例(71.0%)T2DM患者使用口服降糖药(OHA)。结论和建议:在过去的5年里,在NGH就诊的患者中,糖尿病的总体患病率稳步上升。采取健康的生活方式,均衡的饮食,避免其他危险因素的生活方式是强制性的。
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引用次数: 1
期刊
Endocrinology and Metabolic Syndrome
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