Dysglycemia, in this survey defined as impaired glucose tolerance (IGT) or type 2 diabetes, is common in patients with coronary artery disease (CAD) and associated with an unfavorable prognosis. This European survey investigated dysglycemia screening and risk factor management of patients with CAD in relation to standards of European guidelines for cardiovascular subjects. RESEARCH DESIGN AND METHODS The European Society of Cardiology's European Observational Research Programme (ESC EORP) European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V (2016-2017) included 8,261 CAD patients, aged 18-80 years, from 27 countries. If the glycemic state was unknown, patients underwent an oral glucose tolerance test (OGTT) and measurement of glycated hemoglobin A 1c. Lifestyle, risk factors, and pharmacological management were investigated. RESULTS A total of 2,452 patients (29.7%) had known diabetes. OGTT was performed in 4,440 patients with unknown glycemic state, of whom 41.1% were dysglycemic. Without the OGTT, 30% of patients with type 2 diabetes and 70% of those with IGT would not have been detected. The presence of dysglycemia almost doubled from that selfreported to the true proportion after screening. Only approximately one-third of all coronary patients had completely normal glucose metabolism. Of patients with known diabetes, 31% had been advised to attend a diabetes clinic, and only 24% attended. Only 58% of dysglycemic patients were prescribed all cardioprotective drugs, and use of sodium-glucose cotransporter 2 inhibitors (3%) or glucagon-like peptide 1 receptor agonists (1%) was small. CONCLUSIONS Urgent action is required for both screening and management of patients with CAD and dysglycemia, in the expectation of a substantial reduction in risk of further cardiovascular events and in complications of diabetes, as well as longer life expectancy.
Background: Hyaluronic acid is widely used in the medical field. However, there is a lack of research about its effect on patients with certain risks, such as compromised wound healing commonly found in patients with poorly controlled type 2 diabetes. The aim of this study is to investigate the efficacy of hyaluronic acid on the post-extraction wound healing and pain in patients with poorly controlled type 2 diabetes. Material and Methods: The randomized controlled split-mouth study was designed, which included 30 patients with poorly controlled type 2 diabetes with a bilaterally same teeth in the lower jaw for extraction. The sockets treated with 0.8% hyaluronic acid represented the study group, while the sockets where hyaluronic acid was not applied represented the control group. Wound closure rate (WCR), clinical scores in wound healing scale (WHS) and pain intensity in Visual analogue scale (VAS) were recorded. Patients were followed up on 5 th , 10 th , 15 th , 20 th , 25 th day after tooth extraction.
Maintenance hemodialysis (HD) patients often experience fluctuations of volume status. Although hypervolemia possibly induces systemic inflammation, the relationship between volume status and leptin has not yet been well defined. The aims of this study were to determine the levels of leptin, C-reactive protein (CRP), and ferritin in relation to volume status and to assess the relationship between leptin and volume and inflammatory status in chronic HD patients. This prospective study included 93 HD patients divided, based on evaluation using the body composition monitor, into normovolemic and hypervolemic groups (overhydration/extracellular water [OH/ECW] ≤ 15% and OH/ECW > 15%, respectively). The levels of leptin and inflammatory markers (CRP, ferritin) were determined during a mid-week dialysis session in all patients. There were more hypervolemic patients after 12 months of follow up than at baseline (41% vs. 38%). Hypervolemic patients had significantly lower leptin levels (11.42 ± 19.24 ng/mL vs. 34.53 ± 40.32 ng/mL at baseline and 13.41 ± 22.04 ng/mL vs. 41.54 ± 21.78 ng/mL at 12 months), longer time on dialysis, and poorer nutritional status than normovolemic patients. Inflammation was present regardless of the volume status, but hypervolemic patients had significantly higher CRP and ferritin than normovolemic patients. A statistically significant reverse correlation was found between leptin level, hyperhydration index, and OH/ECW. No significant correlation was found between leptin and inflammatory markers CRP and ferritin.
Introduction:Prevalence of the kidney stones (renal calculi) increase in several countries in parallel with the increase of overweight, diabetes (type 2 diabetes) and hypertension.Goal:The goal of our research was to evaluate the connection between the calcium nephrolithiasis and overweight, as quantified using the Body Mass Index (BMI) of the adult population, with a particular reflection on the age groups within it.Material and methods:The research was prospective and it was implemented at the Clinical Center of Banja Luka, at the Urology Clinic in the period from 1st April 2012 to 1st January 2013. The trial encompassed 120 patients with calcium nephrolithiasis of the upper part of the urinary tract and 120 patients without nephrolithiasis. A group of patients with the calcium nephrolithiasis presented a working group, while a group of patients without nephrolithiasis presented a control group. The BMI obtained on the basis of bodily weight and height of the patient, where the age and sex of specific reference values of the BMI were developed by the Center for Disease Control and Prevention (CDC) were not used in the calculation of the BMI.Results:Analyzing the values of the BMI in relation to age groups, where there was a statistically significant difference in the working group, whereas in the control group there was a statistically high significant difference, testing of statistical significance of the average value of the BMI was done by observed age groups of working and control group, as well as to the total sample of work and control group using the Chi-Square test and T-test for independent samples. Having observed the age group of 20-40 years, statistically significant differences have been noted at the level of risk of 10%, which confirms that there is a connection between the categories of the BMI and the group, which the patient comes from (Chi-Square test p-0.05), that is, T-test has shown that the values are different at the level of 10%, i.e. p<0.1 (p=0.073). Having observed the age group 40-60, there was no dependency between the category of the BMI and the group, that is, the differences are not statistically significant, p>0.05 (t-test p=0.314). In addition to this, the average BMI values are not significantly different, p>0.05 (t-test p=0.871). Having observed the age group of the older than 60, there was no dependency between the category of the BMI and the group, that is, the differences are not statistically significant, p>0.05 (Chi-square test p=0.167). Having observed the total sample of the working and control group, there was no dependency of the category of the BMI and the group (or urolithiasis), p>0.05 (Chi-Square test p=1.208), whereas the results of the T-test showed that there was no statistically significant difference of the arithmetic mean values of the BMI working group and control group, p>0.05 (t-test p=0.620).Conclusion:Overweight in younger age groups of adult population may be connected to the occurrence of calcium nephrolithiasis, thus we suggest that urolithia...
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