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Purpose
The accumulation of advanced glycation end products (AGEs) in local tissue is an important cause of low-grade inflammation and oxidative stress and is linked to late diabetic complications. Physical activity has various beneficial cardiometabolic effects in type 1 diabetes (T1D) and is associated with lower frequency of chronic complications of diabetes, although the specific mechanisms still remain unclear. The present study determines the association between self-reported physical activity and skin autofluorescence (AF), a marker of tissue accumulation of AGEs in adults with T1D.Methods
We enrolled 119 patients (63 women), aged 34 years (interquartile range [IQR], 26–41 years), with T1D duration of 17 years (IQR, 12–25 years), glycosylated hemoglobin (HbA1c) of 7.9% (IQR, 7.1%–8.9%) referred to an outpatient diabetes clinic. Patients with diabetes duration of <5 years, age >65 years, concomitant diabetic ketoacidosis, and severe complications that restrict physical activity (eg, diabetic foot, diabetic proliferative retinopathy, blindness) were excluded. Physical activity was measured with the short version of the International Physical Activity Questionnaire (IPAQ-SF), and raw scores were then log-transformed because of non-normality. The accumulation of AGEs in the skin was assessed on the basis of skin AF. Correlations between AF and various laboratory and clinical findings were assessed, and multivariate linear regression analysis was used to examine factors that influenced AGEs.Findings
Skin AF correlated positively with age (Spearman’s coefficient [Rs] = 0.47; P < 0.0001), HbA1c (Rs = 0.30; P = 0.001), waist-to-hip ratio (WHR; Rs = 0.23; P = 0.02), and negatively with logIPAQ-SF (Rs = –0.28; P = 0.002). A stepwise multivariable linear regression analysis indicated age (β = 0.46; P < 0.0001), HbA1c (β = 0.21; P = 0.01), and logIPAQ-SF score (β = –0.17; P = 0.04) as predictors of the skin AF after adjustment for sex and WHR (R2 = 0.36; P < 0.0001).Implications
Higher physical activity is related to lower accumulation of AGEs in patients with T1D. Our study provides new insight into the beneficial effects of physical activity in T1D according to tissue accumulation of AGEs. 相似文献- Key Points
Creating a positive patient safety culture is assumed to be a prerequisite for quality and safety. We found that:
??healthcare providers in Dutch GP cooperatives perceive patient safety culture positively;
??triage nurses scored higher than GPs, and older and more experienced healthcare professionals scored higher than younger and less experienced professionals – on several patient safety culture factors; and
??within the GP cooperatives, safety climate and openness of communication had the largest potential for improvement.
Introduction
The aim of the study was to investigate the role of the proteolytic fraction from Vasconcellea cundinamarcensis, designated as P1G10, on the healing of chronic foot ulcers in neuropathic patients with diabetes 2.Methods
Fifty patients were enrolled in a prospective, randomized, double-blind trial, to verify the efficacy and safety of a topical dressing formulated with 0.1% P1G10, intended for wound healing, versus a hydrogel (control) protocol. Upon completion of the intervention, the outcome evaluated the number of patients attaining full epithelization (100%), or at least 80% healing. Statistical analysis compared the data on each group for the significance of the differences.Results
Collection of data was finished in week 16, and the results were analyzed by intention to treat. The results showed that, in the control group, 5 patients attained 100% ulcer healing, 3 patients?≥?80% healing and 11 experienced ulcer changes?≤?80%, and the remainder showed no changes or their wounds became worse. Meanwhile, in the P1G10 group, 11 patients experienced full healing, 4 had healing?≥?80% and 5 had ulcer changes?≤?lower than 80%, and the remainder showed no changes or their wounds became worse. The healing incidence for the first endpoint (100% healing) showed that the P1G10 group was 2.95-fold more efficacious than the control group (CI 95%) and 2.52-fold (CI, 95%) higher than its control for the second endpoint (80% healing).Conclusions
These data support the hypothesis that topical application of the proteolytic fraction identified as P1G10 significantly enhances foot ulcer healing compared to hydrogel treatment.Material and methods
We included 30 patients with HE classified by “Haven Criteria for Hepatic Encephalopathy”. They were randomized into two groups: 1) Mannitol Group (MG) with mannitol 20% administered into the intestine by an enema, 2) conventional group (CG) with lactulose 40?g enema both substances were diluted in 800?mL of double distilled solution every 6?h; all patients received neomycin. We evaluated ammonia concentration, plasma oxidative stress, HE severity, intestinal discomfort and adverse effects.Results
Hyperammonemia (171?±?104 vs 79?±?49?μmol ammonia/L, p?<?0.01), and oxidative stress (MDA 29 vs 27%, formazan 15 vs 11%, carbonyls 16 vs 9% and dityrosines 10 vs 5%) were reduced in MG and CG respectively. The HE severity decreased by two degrees compared to baseline values in both groups. Intestinal discomfort and electrolyte plasma alterations were less frequent (p?<?0.05) in MG than CG.Conclusions
Intestinal mannitol is as effective and safe as conventional treatment for reducing hyperammonemia, oxidative stress, and hepatic encephalopathy of CLD patients in the emergency room. Likewise, mannitol is better tolerated than conventional treatment. 相似文献Methods: The clinical records of patients who underwent orbital decompression for the treatment of spontaneous globe luxations between 2010 and 2013 were reviewed. Data collected were age, gender, predisposing factors, preoperative and postoperative exophthalmometry, duration of follow-up, presence of diplopia before and after surgery and intra- and postoperative complications.
Results: Seven patients underwent orbital decompression after spontaneous globe luxation during the study period. Six patients underwent bilateral decompression. Two patients underwent a three-wall decompression, four of them medial and lateral decompression and one patient medial decompression. The predisposing factors for globe luxation were Graves’ orbitopathy, malar hypoplasia, high myopia, floppy eyelid syndrome and orbital fat hypertrophy in the context of obesity. After orbital decompression, none of the patients reported new globe luxations. No intraoperative complications were observed. None of the patients developed de novo diplopia.
Discussion: Orbital decompression is an effective method for the prevention of new episodes in patients with spontaneous globe luxations. It has good aesthetic and functional results and addresses the exophthalmos present in most cases. 相似文献