Our study provides interesting but preliminary results about the potential role of inositol stereoisomers supplementation in the treatment of GDM on insulin resistance levels and several maternal-fetal outcomes. Further studies are required to examine the optimal and effective dosages of different inositol supplements. CLINICAL TRIAL REG. NO.: NCT02097069, ClinicalTrial.gov.
Objectives
The aim of this study was to evaluate the circulating levels of CD40 ligand (CD40 L), Dickkopf‐1 (DKK‐1) and P‐selectin, their relationships and their contributions to cardiovascular risk in subjects with HIV infection.
Methods
The study population included 80 HIV‐infected patients, 14 (17.5%) of whom had diabetes mellitus (DM) and 32 (40.0%) of whom had arterial hypertension (AH). The HIV‐infected patients were compared with a control group with similar demographic and clinical features. CD40L, DKK‐1 and P‐selectin levels were measured using an enzyme‐linked immunosorbent assay.
Results
The HIV‐infected patients showed higher levels of all the cardiovascular disease (CVD) markers. Both serum CD40L and DKK‐1 were significantly higher in HIV‐infected patients than in the HIV‐negative controls (P < 0.001), while soluble P‐selectin showed no significant between‐group difference (P = 0.133), reflecting the role of HIV infection in CVD. In the HIV‐infected group, patients with DM showed lower levels of CD40L and DKK‐1 in comparison with the nondiabetic patients and patients with AH (P < 0.05, with Bonferroni correction). In contrast, patients with AH showed higher levels of CD40L and DKK‐1 in comparison to patients without DM or AH (P < 0.05, with Bonferroni correction). Patients with AH showed higher levels of CD40L and DKK‐1 than patients with DM (P < 0.05, with Bonferroni correction).
Conclusions
In this study, we found that HIV‐infected patients displayed significantly higher circulating levels of both CD40L and DKK‐1, which were linearly and directly correlated, when compared to HIV‐negative patients. The presence of diabetes was associated with lower levels of both CD40L and DKK‐1, whereas the presence of hypertension was associated with higher levels of CD40L.
Aim: Increased life expectancy causes a higher prevalence of chronic and degenerative diseases, and greater frailty among older people. Hip fracture is a common event for older people, and 1-year mortality after hip fracture is high. The present study was carried out in the Abruzzo region, Italy, over the years from 2006 to 2015, entailing as its main objectives the assessment of age and sex-specific trends in the incidence of hip fractures, with the subsequent hospital mortality. Causes of 30-day hospital readmissions were assessed.Methods: Data were collected from all hospital discharge records. Information on all 30-day readmissions was also retrieved.Results: Overall, 23 075 patients were admitted to hospital for hip fracture (mean age 81.0 AE 11.7 years,72.6% women). The overall hip fracture incidence remained constant over the study period, varying from 175.9 cases in 2006 to 179.3 cases per 100 000 in 2015. However, the incidence progressively increased from 40.0 to 51.0 among men, and from 61.6 to 80.9 among patients aged >85 years. The in-hospital mortality rate was 3.8%. Within 30 days from the hip fracture discharge, 10 526 patients (45.6%) had a second hospitalization, related to the condition of interest in >80% of the patients. Additionally, 414 (3.9%) patients died during the second hospitalization.Conclusions: Although women aged >65 years remain the category of patients at highest risk of hip fracture, an increasing trend is observed among men and patients aged >85 years. Hip fracture is frequently associated with early hospital readmission and is responsible for elevated in-hospital mortality.
In our study, neoadjuvant chemoradiotherapy was associated with good results in terms of sphincter function, late toxicities, and QoL indexes. A routine use of assessment scales could contribute to a better selection of patients with increased risk of developing functional disorders who could benefit from neoadjuvant therapy.
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