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61.
Giorgio Gragnoli Italo Tanganelli Anna Maria Signorini Paolo Tarli Carlo Paoli 《Acta diabetologica》1982,19(2):161-166
Summary In 44 diabetic patients treated either with insulin or with oral antidiabetic agents, non-enzymatic glycosylation of serum
proteins (GSP), expressed as nmol of 5-hydroxymethylfurfural/mg protein, showed higher values than those found in control
subjects. In the diabetics GSP was more closely correlated to the degree of glycometabolic control during the 15 days preceding
the assay, than to the glycosylated hemoglobin (HbAl). However, GSP values did not correlate significantly with fasting blood
glucose levels. It may be concluded that GSP can be used as an index of the medium-term control of diabetes mellitus. 相似文献
62.
Cibele Dal-Fabbro Silvério Garbuio Vânia D’Almeida Fátima D. Cintra Sergio Tufik Lia Bittencourt 《Sleep & breathing》2014,18(4):749-759
Purpose
This study aims to compare the effects of a mandibular advancement device (MAD) with continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA) on blood pressure (BP), oxidative stress, and heart rate variability (HRV) in a randomized, crossed-over, single-blind, and controlled trial.Methods
Twenty-nine moderate-to-severe adult OSA patients underwent MAD, CPAP, and placebo oral appliance treatment. Polysomnography, Epworth sleepiness scale, 24-h ambulatory BP monitoring, oxidative stress parameters (malondialdehyde, catalase, superoxide dismutase, vitamins C, E, B6, B12, folate, homocysteine, uric acid), and HRV were assessed at baseline and after 1 month of each treatment. Diaries were used to evaluate compliance for devices and a pressure–time meter for CPAP.Results
Both active treatments resulted in decreases in apnea and hypopnea index and Epworth sleepiness scale; CPAP showed a greater effect. Frequency of diastolic BP dipping was higher in the MAD group compared with the CPAP group. A significant drop from baseline levels for catalase activity was observed after MAD. For HRV, there was a significant decrease in total power at night with CPAP and MAD compared with POA, and a decrease in index of sleep autonomic variation with MAD compared with baseline levels. Compliance rates were higher with MAD rather than CPAP.Conclusions
Even though CPAP proved to be more effective at attenuating OSA, better compliance with MAD favored the reduction of one of the enzymes which participates in oxidative stress and better autonomic modulation during sleep. 相似文献63.
64.
Marjolein H. J. van de Pol MD Joep Lagro MD PhD Lia R. M. G. Fluit MD PhD Toine L. M. Lagro‐Janssen MD PhD Marcel G. M. Olde Rikkert MD PhD 《Journal of the American Geriatrics Society》2014,62(10):1943-1949
Given the increasingly aging population, nearly every doctor will encounter elderly adults who present with multiple complex comorbidities that can challenge even experienced physicians. This may explain why many medical students do not have a positive attitude toward elderly adults and find the complexity of their problems overwhelming. It was hypothesized that a recently developed medical school geriatrics course, based on the game GeriatriX and designed specifically to address the complexities associated with decision‐making in geriatrics, can have a positive effect on attitudes toward geriatrics and on perceived knowledge of geriatrics. The effects of this game‐based course were evaluated as a proof of concept. The assessment was based on the Aging Semantic Differential (ASD) and a validated self‐perceived knowledge scale of geriatric topics. The usability of (and satisfaction with) GeriatriX was also assessed using a 5‐point Likert scale. After completion of the course, the ASD changed significantly in the geriatrics course group (n = 29; P = .02) but not in a control group that took a neuroscience course (n = 24; P = .30). Moreover, the geriatrics course group had a significant increase in self‐perceived knowledge for 12 of the 18 topics (P = .002), whereas in the control group self‐perceived knowledge increased significantly for one topic only (sensory impairment) (P = .04). Finally, the geriatrics students reported enjoying GeriatriX. This proof‐of‐concept study clearly supports the hypothesis that a 4‐week course using a modern educational approach such as GeriatriX can improve students' self‐perceived knowledge of geriatrics and their attitudes toward elderly adults. 相似文献
65.
Fatima Dumas Cintra Renata Pimentel Leite Luciana Julio Storti Lia Azeredo Bittencourt Dalva Poyares Laura de Siqueira Castro Sergio Tufik Angelo de Paola 《Arquivos brasileiros de cardiologia》2014,103(5):368-374
Background
The mechanisms associated with the cardiovascular consequences of obstructive sleep apnea include abrupt changes in autonomic tone, which can trigger cardiac arrhythmias. The authors hypothesized that nocturnal cardiac arrhythmia occurs more frequently in patients with obstructive sleep apnea.Objective
To analyze the relationship between obstructive sleep apnea and abnormal heart rhythm during sleep in a population sample.Methods
Cross-sectional study with 1,101 volunteers, who form a representative sample of the city of São Paulo. The overnight polysomnography was performed using an EMBLA® S7000 digital system during the regular sleep schedule of the individual. The electrocardiogram channel was extracted, duplicated, and then analyzed using a Holter (Cardio Smart®) system.Results
A total of 767 participants (461 men) with a mean age of 42.00 ± 0.53 years, were included in the analysis. At least one type of nocturnal cardiac rhythm disturbance (atrial/ventricular arrhythmia or beat) was observed in 62.7% of the sample. The occurrence of nocturnal cardiac arrhythmias was more frequent with increased disease severity. Rhythm disturbance was observed in 53.3% of the sample without breathing sleep disorders, whereas 92.3% of patients with severe obstructive sleep apnea showed cardiac arrhythmia. Isolated atrial and ventricular ectopy was more frequent in patients with moderate/severe obstructive sleep apnea when compared to controls (p < 0.001). After controlling for potential confounding factors, age, sex and apnea-hypopnea index were associated with nocturnal cardiac arrhythmia.Conclusion
Nocturnal cardiac arrhythmia occurs more frequently in patients with obstructive sleep apnea and the prevalence increases with disease severity. Age, sex, and the Apnea-hypopnea index were predictors of arrhythmia in this sample. 相似文献66.
67.
68.
Micrographia (MG), an acquired impairment of writing characterized by diminution of letter size, coupled with slowing and loss of accuracy, is most frequently observed in the course of degenerative disease of basal ganglia, such as Parkinson’s Disease. Only a few cases of MG without concomitant extrapyramidal signs have been described, mostly following vascular lesion of the left basal ganglia. In this article we report an isolated pattern of MG following an extensive traumatic cerebral lesion centered in the left basal ganglia. The nature of this impairment is analyzed according to a cognitive model of writing and interpreted as a specific example of peripheral dysgraphia. 相似文献
69.
Teresa Cristina Barros Schütz Thays Crosara Abrah?o Cunha Thais Moura-Guimaraes Gabriela Pontes Luz Carolina Ackel-D'Elia Eduardo da Silva Alves Gilberto Pantiga Junior Marco Tulio de Mello Sergio Tufik Lia Bittencourt 《Clinics (S?o Paulo, Brazil)》2013,68(8):1168-1174