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41.

Background

The aim of this study is to assess the relationship between cardiac autonomic dysfunction and increased platelet reactivity in patients with type 1 diabetes and whether alpha lipoic acid therapy (ALA) might improve both abnormalities in these patients.

Methods and materials

Cardiac autonomic function will be assessed by heart rate variability (HRV) analysis. Platelet reactivity will be investigated by both measuring the aggregation time on the PFA-100 method and flow cytometry. HRV and platelet reactivity will be re-assessed in the patients with depressed HRV after 4 weeks from randomization to ALA or placebo.

Discussion

The cardiovascular autonomic system might play a role in the modulation of platelet reactivity which is increased in diabetes. Within this framework, ALA might be found to exercise antithrombotic effects in addition to its known antioxidants properties.

Trial registration

Australian Clinical Trials Registry ACTRN 12610000291088.  相似文献   
42.
Journal of Thrombosis and Thrombolysis - Early assessment of thrombogenicity and antithrombotic drug effects may be important for therapeutic decision making in patients presenting with acute...  相似文献   
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Antiplatelet agents are the mainstay treatment in the prevention and management of atherothrombotic complications. However, a substantial interpatient variability in response to clopidogrel has been reported. Furthermore, patients with coronary artery disease and lesser platelet inhibition in response to clopidogrel are at increased risk for cardiovascular events. Clopidogrel after absorption requires two-step oxidation by the hepatic cytochrome P450 to generate its active metabolite. Polymorphisms of genes encoding the cytochrome enzymes and P-glycoprotein involved in clopidogrel absorption are regarded as major determinants of the interindividual variability in the clopidogrel-induced platelet inhibition. In our review we discuss the prevalence and clinical significance of various alleles of the genes: CYP2C19 and ABCB1 in the setting of coronary artery disease. Allele CYP2C19*2 is associated with excess of ischaemic events including myocardial infarction and stent thrombosis. On the other hand, CYP2C19*17 allele poses a serious threat of bleeding. Data concerning the prognostic value of genetic variant 3435C→T of ABCB1 remain inconclusive.  相似文献   
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The Brazilian Diabetes Society is starting an innovative project of quantitative assessment of medical arguments of and implementing a new way of elaborating SBD Position Statements. The final aim of this particular project is to propose a new Brazilian algorithm for the treatment of type 2 diabetes, based on the opinions of endocrinologists surveyed from a poll conducted on the Brazilian Diabetes Society website regarding the latest algorithm proposed by American Diabetes Association /European Association for the Study of Diabetes, published in January 2009.An additional source used, as a basis for the new algorithm, was to assess the acceptability of controversial arguments published in international literature, through a panel of renowned Brazilian specialists. Thirty controversial arguments in diabetes have been selected with their respective references, where each argument was assessed and scored according to its acceptability level and personal conviction of each member of the evaluation panel.This methodology was adapted using a similar approach to the one adopted in the recent position statement by the American College of Cardiology on coronary revascularization, of which not only cardiologists took part, but also specialists of other related areas.  相似文献   
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颞下颌紊乱的患者有咀嚼肌系统或颞下颌关节的功能障碍或二者兼有,典型症状为咀嚼肌疼痛,常伴有耳痛、头痛、面痛并向颈部或肩部放射,发病率约为5%左右。目前普遍认为心理压力是其主要原因,对该病的保守治疗方法主要包括对牙齿的治疗、理疗和抗炎治疗等。本研究目的是探讨医学催眠术对减轻颞下颌紊乱疼痛症状的作用。  相似文献   
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