Amaç: Ciddi morbidite ve mortalitelere neden olabilen küresel bir sağlık sorunu olan diabetes mellitusun öz yönetiminde hastaların diyabet ile ilgili sahip oldukları bilgi ve tutumlar hayati öneme ...sahiptir. Bu çalışmada; tip 2 diyabetli hastaların diyabetle ilgili bilgi ve tutum düzeylerinin belirlenmesi ve ilişkili faktörlerin değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Tanımlayıcı ve kesitsel nitelikteki bu çalışma 9 Nisan–9 Haziran 2019 tarihleri arasında, T.C. Sağlık Bakanlığı, Sakarya Üniversitesi Eğitim ve Araştırma Hastanesi, iç hastalıkları kliniği, diyabet polikliniğine ayaktan başvuran, 149 tip 2 diyabet hastası üzerinde yapıldı. Hastalara, araştırmacılar tarafından hazırlanmış kişisel bilgi formu ve diyabet bilgi düzeyi anket formu yanı sıra Diyabet Tutum Ölçeği, araştırmacı gözetiminde kendi kendine doldurma yöntemiyle uygulandı. Elde edilen veriler istatistiksel olarak değerlendirildi. Bulgular: Hastaların yaş ortalaması 54,82 yıl±10,74 SS ve ortalama hastalık süresi 9,51 yıl±6,86 SS olarak bulundu. Hastaların diyabet bilgi düzeyi anketinden aldıkları ortalama puan 100 üzerinden 74,39±11,40 SS olarak ve Diyabet Tutum Ölçeğinden aldıkları toplam tutum puanı ortalaması ise 3,99±0,30 SS olarak hesaplandı. Hastalık süresi (p=0,006), eğitim düzeyi (p lt;0,001) ve alkol kullanım durumu (p=0,010) açısından diyabet bilgi düzeyleri arasında anlamlı fark saptandı. Sigara kullanım durumu (p=0,015) açısından ise diyabet tutum düzeyleri arasında anlamlı fark görüldü. Diyabet bilgi düzeyi anketinden alınan puanlar ile Diyabet Tutum Ölçeğinden alınan puanlar arasında istatistiksel olarak anlamlı ilişki olduğu gözlendi (p=0,002; r=0,249). Sonuç: Hastaların diyabetle ilgili bilgi düzeylerinin arttırılması ve olumlu tutumlar geliştirmelerinin sağlanması açısından eksikliklerin saptandığı konular ve dezavantajlı gruplar göz önünde bulundurularak güncellenmiş daha etkin ve kapsamlı eğitim programlarına ihtiyaç vardır.
It is well known that patients with diabetes mellitus are more prone to infection. In patients with diabetes mellitus, chronic infections are frequent and severe, due to the impairment of their ...immune status. The aim of this study was to determine the association between Helicobacter pylori infection and type 2 diabetes mellitus in the United Arab Emirates population. This is a case and control study comparison of type 2 diabetes mellitus and non-diabetic groups. The study was conducted at the primary health care clinics in United Arab Emirates during the period from June 2002 to August 2003. The study included 210 type 2 diabetes mellitus patients and 210 non-diabetic subjects.
Helicobacter pylori was assessed by histopathological examination by measuring antibody profiles (IgG and IgA) among type 2 diabetes mellitus patients and the non-diabetic group.
The mean age of type 2 diabetes mellitus patients infected with Helicobacter pylori was 48.1 +/- 7.9 years compared to 46.7 +/- 5.4 years in the non-diabetic infected subjects. A positive antibody titer for Helicobacter pylori infection (IgA >or=300) was found in 76.7% of the diabetic subjects compared to 64.8% of the non-diabetic subjects (p<0.009). There was higher prevalence of Helicobacter pylori infection in diabetic obese patients than the non-diabetic subjects (23.6% vs 11.8%, p<0.001). Muscular (47.2%), gastrointestinal (29.8%), chronic bronchitis (22.4%), nausea (19.9%), anemia (18%), abdominal pain (12.4%), diarrhea (10.6%) and vomiting (7.5%) were more common in diabetic patients infected with Helicobacter pylori.
The present study suggests that there is a significant association between Helicobacter pylori infection and type 2 diabetes mellitus. Helicobacter pylori infection was significantly higher in diabetic obese patients than non-diabetic subjects.
Elevated asymmetric dimethylarginine (ADMA) levels, an endogenous inhibitor of nitric oxide synthase, are an important cardiovascular risk factor. In patients with diabetes, increased ADMA levels ...have been reported, which may be associated with endothelial dysfunction. In this study, effect of nebivolol on serum ADMA levels in hypertensive patients with type 2 diabetes have been compared with metoprolol, an another beta-blocker.
A total of 54 patients (27 female, 27 male; mean age: 53.0+/-8.7 years) with type 2 diabetes and hypertension were included in this randomized, open-label, prospective study. Patients were randomized to receive either nebivolol 5 mg/day (n=28) or metoprolol 100 mg/day (n=26) for 12 weeks. When the patients could not reach target blood pressure levels at the end of week 4, indapamide (2.5 mg/day) was added. Enzyme Linked Immunosorbent Assay was used for serum ADMA measurements.
Similar reductions in blood pressure values were observed in both groups (p>0.05). In nebivolol group, there were no significant changes in serum ADMA levels compared to baseline (0.6+/-0.2 micromol/l vs 0.6+/-0.1 micromol/l, p>0.05), whereas in metoprolol group a 35.6% increase in serum ADMA levels was observed (0.6+/-0.1 micromol/l vs 0.7+/-0.2 micromol/l, p<0.01).
We observed a significant increase in ADMA levels, a marker of endothelial dysfunction, during metoprolol treatment, whereas nebivolol had neutral effects on ADMA levels in patients with type 2 diabetes mellitus and hypertension.
Cilj ove studije je bio ispitati povezanost diabetes mellitusa tip 2 (T2DM), antidijabetičke terapije, hipotireoze i karcinoma
štitnjače. Analizirani su podaci od 320 pacijenata koji su operirani ...zbog sumnje na karcinom štitnjače. Dijagnoza karcinoma
štitnjače je potvrđena patohistološkom analizom kod 95 pacijenata. Nije nađena značajna razlika u prisutnosti dijagnoze
T2DM i hipotireoze u odnosu na prisutnost karcinoma štitnjače (p=0.13; p=0.85), kao niti u spolu ispitanika s T2DM i
hipotireozom s obzirom na tip karcinoma štitnjače (p=0.19; p=0.25). Pacijenti s T2DM (Odds ratio OR 1.89; 95% CI,
0.856–4.163) i pacijenti s hipotireozom (OR, 1.05; 95% CI, 0.530–2.164) su imali veću vjerojatnost od karcinoma štitnjače,
kao i ispitanici koji su imali obje dijagnoze u kombinaciji (p=0.37; OR, 2.39; 95% CI, 0.333–17.278), u odnosu na pacijente
koji nemaju te dijagnoze. Muškarci s T2DM (OR, 6.19; 95% CI, 1.180-32.513) su imali veću vjerojatnost od karcinoma
štitnjače od žena. Veću vjerojatnost od karcinoma štitnjače imali su pacijenti koji uzimaju peroralne antidijabetike (OR, 1.91;
95% CI, 0.804–4.512) u odnosu na one koji uzimaju inzulin. Prema rezultatima ove studije možemo zaključiti da postoji
povezanost T2DM, hipotireoze, peroralnih antidijabetika i karcinoma štitnjače.
The significance of T-wave negativity in lead V1 in adults and its relationship with cardiovascular risk factors have not been clarified. This study was designed to determine the prevalence of ...negative T waves in chest lead V1 in an adult cohort.
The study included 508 adults (278 males, mean age 51.5+/-9.7 years; 230 females, mean age 51.2+/-10.0 years) enrolled in the longitudinal Turkish Adult Risk Factor survey from all geographical regions of Turkey, whose prospective data on the prevalence of coronary heart disease and its risk factors were available for comparative assessment of T-wave groups. Associations of negative T waves were sought in relation to age, sex, cardiovascular risk factors, and coronary heart disease.
The prevalence of T-wave negativity in women was significantly higher than that of men (38.3% vs 7.2%; p<0.001). No age-related differences were found between the two sexes with respect to the presence or absence of negative T waves (p>0.05). Cardiovascular risk factors and cardiometabolic conditions did not differ among men with respect to the T-wave pattern. However, women presenting negative T waves in lead V1 had significantly lower systolic blood pressure (p=0.007) and HDL-cholesterol (p=0.034) values, and a higher incidence of type 2 diabetes (p=0.048) than women with positive T waves.
No convincing explanation could be offered for the significantly higher female predilection for the presence of negative T-waves in lead V1. Negative T waves in lead V1 were not associated with adverse cardiometabolic risks.
Giriş: Dermatoglifiklerle ilgili bilgilerin medikal ve genetik tanı alanına girişi yakın geçmişe dayanır.
Amaç: Normal ve insülinden bağımsız diyabeti olan kişilerin dermatoglifik özelliklerinin ...araştırılması amaçlandı.
Yöntem ve Gereç: İnsülin bağımsız diyabeti olan 112(49K) hasta ve 142(77K) normal sağlıklı kontrole ait veriler karşılaştırıldı. Modifiye Purvis-Smith mürekkep yöntemi kullanılarak baskılar elde edildi ve veriler t-test ve ki-kare testleri kullanılarak karşılaştırıldı.
Bulgular: Kontrollerin daha dar açılarına karşın, diyabeti olan hastalarda cinsiyete bakılmaksızın 'atd' açısında istatistiksel olarak anlamlı bir artış olduğu gözlendi. Diyabetik hastalarda ilave aksiyel triradii(t'/t") varlığı da
anlamlı idi.
Sonuç: Diğer parametreler anlamlı olarak bulunmasa da daha geniş 'atd' açısı ve ilave aksiyel triradii gibi veriler özellikle diyabete eğilimi olan kişilerin taramasında güvenilir göstergeler olarak bulunmuştur.
Background: It is only recently that the knowledge of dermatoglyphics has been applied to the field of medical and genetic diagnosis. Aim: The aim of the present study was to compare and evaluate the dermatoglyphic pattern in individuals with non-insulin dependent diabetes mellitus (NIDDM) with a normal adult population. Materials and Methods: Both quantitative as well as qualitative parameters were analyzed in 112 (63 male and 49 female) subjects and compared with the data from 142 (65 male and 77 female) healthy controls. Modified Purvis-Smith ink method was used for obtaining the prints, and statistical analyses were done using Student's unpaired t test and chi-square test. Results: A statistically significant increase in the 'atd' angle was noted on both hands of both sexes in diabetics when compared to the controls, who showed narrower angles. The presence of an additional axial triradii (t'/t") in diabetic patients was also significant. Conclusions: With the available data, although other parameters were not statistically significant, the current work emphasizes that a wider 'atd' angle and the additional axial triradii were seen as reliable indicators helpful in scientific screening of populations prone to diabetes mellitus.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Due to the close anatomical position between the endocrine system cells and the exocrine system cells in the pancreas, some interactions could be expected in these two different types of cells. This ...possible exocrine dysfunction may cause difficulties in the management of blood glucose level because of secondary malabsorption which may have resulted from the exocrine dysfunction. Taking this possibility into account, we aimed to investigate the exocrine function of the pancreas in 32 diabetic patients and in 12 healthy control subjects in this study.
Fecal pancreatic elastase-1 (PE1), which has a high sensitivity and specificity, was measured in serum samples by ELISA specifically for this purpose.
It was found that the exocrine function declined in 28% of type 2 diabetic patients, while there was no decrease in the control subjects. However, there were no significant correlations between pancreatic elastase levels and the duration of diabetes, glycemic control, or consumption of alcohol.
These findings suggest that evaluation of the exocrine function in diabetic patients might be useful for better management of diabetic patients.
Charles Bonnet Sendromu: İki olgu sunumu VELET, Selvinaz; ÖZMEN, Mine; ÜNSALVER, Barış Önen
Türk psikiyatri dergisi,
09/2007, Letnik:
18, Številka:
3
Journal Article
Odprti dostop
Görme yeteneğinin yitirilmesini takiben, görsel varsanılarla ortaya çıkan Charles-Bonnet Sendromu'nda (CBS), içgörü ve bilişsel yetiler korunmuştur. Yazıda, biri görme yeteneğini hipofiz ...makroadenomuna, diğeri diyabetik retinopatiye bağlı olarak yitiren ve CBS gelişen iki olgunun tanı ve tedavi süreçleri tartışılmıştır.
Birinci olgu, 35 yaşında, erkek bir hastaydı. Hipofiz adenomu nedeniyle uygulanan operasyonlar sonrasında, optik atrofi nedeniyle, görme yetisini kaybetmiş, ardından görsel varsanılar gelişmişti. 80 mg/gün ziprasidonla görsel varsanılar beşinci günde geriledi, ancak ortaya çıkan şiddetli baş ağrısı nedeniyle ilaç kesildi. 5mg/gün olanzapin başlandı, ancak yanıt alınamadı. Kendi isteğiyle, antipsikotik kullanılmaksızın izlendiği 7 ay sonuna doğru görüntüler değişerek ışık parlamaları ve basit şekillere dönüştü.
İkinci olgu, 20 senedir tip-II Diabetes Mellitus tanısı olan, 54 yaşında, bir kadın hastaydı. 4 sene önce, diyabetik retinopatiye bağlı bilateral görme kaybının hemen ardından görsel varsanılar gelişmişti. Ketiyapin 100 mg/gün ve paroksetin 20 mg/gün ile varsanılar tamamen geriledi.
Olgulardan hiçbiri yakınmalarından hekimlerine söz etmemişti; ikinci olguda tanı 4 yıl sonra hekimin aktif sorgulaması ile konmuştu. Her iki olguda da nöroanatomik lezyonlar mevcuttu, bilişsel yetiler tamdı ve içgörü korunmuştu. Tanı konusunda ilgili branş hekimlerinin eğitilmesi ve görme yetisini yitiren hastalarda CBS'nun aktif olarak taranması gerekmektedir. Tedavide yeni kuşak antipsikotiklerden ziprasidon ve ketiyapin etkili gözükmektedir.
Charles-Bonnet syndrome (CBS) occurs after the loss of vision or a decrease in visual ability and is characterized by visual hallucinations with insight and preserved cognitive status. In this paper, 2 cases in which vision was lost (in one patient due to hypophyseal macroadenoma and in the other due to diabetic retinopathy) are presented.
The first case is a 35-year-old male referred to the psychiatry department for depressive complaints. He lost his vision due to optic atrophy following multiple surgeries for hypophyseal macroadenoma and visual hallucinations developed afterwards. Ziprasidone 80 mg/day was started and the hallucinations disappeared on the fifth day, but the medication had to be withdrawn because of severe vascular type headaches. Olanzapine 5 mg/day was subsequently used without benefit. He refused further medication and the visions gradually changed into sparkling lights and simple figures at the 7-month follow-up.
The second case was a 54-year-old woman with a 20-year history of type-II diabetes mellitus. Visual hallucinations developed after bilateral visual loss due to diabetic retinopathy 4 years earlier. She responded well to treatment with quetiapine 100 mg/day and paroxetine 20 mg/day.
Neither of the cases had reported their visual symptoms to their physicians; the second case was diagnosed after 4 years by active screening. Both of the cases had neuroanatomic lesions. CBS symptoms should be screened actively in patients with visual loss and physicians should be educated about diagnosing CBS. Novel antipsychotics, such as ziprasidone and quetiapine, seem to be effective alternatives for the treatment of CBS.
Atherosclerosis is a complex and multifactorial disorder that involves many
cell types and organs as well as many physiological processes. It is believed
that the oxidative stress plays a critical ...role in the initiation and
progression of atherosclerosis. Cardiovascular diseases (CVD) are the leading
cause of death in Serbia and discovering oxidative stress markers, including
gene variants, would contribute to reducing the number of patients. A
association study, comprised 140 patients with diabetes mellitus type 2 and
cardiovascular complications (DM+A), 60 patients with clinical manifestations
of atherosclerosis (A) and 100 healthy individuals (K), has been undertaken
in order to estimate the relevance of polymorphisms in genes related to
oxidative stress, lipid metabolism, and detoxification as oxidative stress
markers and disease risk factors. Polymorphisms in genes whose products exert
an antioxidative role in the plasma (pon1 Q192R, L55M i C(-107)T), in both
plasma and cells (apoE 112/158 polymorphisms) and antioxidative and
detoxication role in cells (GSTM1*0, GSTT1*0 i GSTP1 Ile105Val) have been
selected for the study. Genomic DNA was isolated from peripheral blood cells
or from buccal epithelial cells. The genotyping was performed using
restriction digestion of PCR products and by analysis of restriction fragment
length (PCR-RFLP) on agarose or polyacrilamide gel electrophoresis and the
real-time PCR method. Chi-square and Fisher exact test were used for
determination of differences in the analyzed genotype and allele distribution
frequencies, and logistic regression analysis was used for disease risk
assessment. Hypertension, hyperlipidemia and positive family history of CVD
are risk factors for atherosclerosis-based cardiovascular complications in
both patient groups and positive family history of CVD is a risk factor for
atherosclerosis in T2DM patients. Allele and genotype frequencies for Q192R
polymorphism of pon1 gene showed significant difference between patients with
T2DM and controls (p<0.0001) and between patients with T2DM and the group
without T2DM (with atherosclerosis) (p<0.0001). The results of logistic
regression analysis showed a significant increase of risk for atherosclerosis
development in diabetics that carry R allele and genotypes QR and RR compared
with controls (for R allele :OR=2,22, p<0,0001; for QR genotype: OR=3,36,
p<0,0001; for RR genotype: OR=4,29, p=0,0012) and compared with group A (for
R allele : OR=2,28, p<0,001; for QR genotype: OR=3,7, p<0,0001; for RR
genotype: OR=4,27, p=0,006). A significant difference in GSTM1 null genotype
and GSTT1 null genotype frequencies between patients with atherosclerosis
without T2DM and control group were observed and logistic regression analysis
showed a 2 fold increase in the risk for disease in patients with the GSTM1
null genotype (OR= 2.0, p<0.03) and more than 2 fold increase of the risk in
patients with GSTT1 null genotype (OR=2.26, p<0.03). GSTM1 and GSTT1 combined
deletion frequencies were significantly different between groups. In the
group of diabetics, carriers of double null genotypes had an approximately
4.5 fold increase of the risk for atherosclerosis in patients with T2DM
(OR=4.4, p=0.05) and 15 fold increase in risk in patients without T2DM
(OR=15.05, p<0.0001) compared with control group. Also, we observed a
significant increase of the risk for atherosclerosis in double null carriers
in patients without T2DM compared with diabetics (for DM+A group: OR=0.29,
p=0.001). No statistically significant difference was found after comparing
allele and genotype frequencies between groups for the L55M and C(-107)T
polymorphisms in pon1 gene and 112/158 polymorphism in apoE gene. No
association with disease risk could be observed for any of the alleles or
genotypes of these three polymorphisms. In conclusion, Q192R polymorphism of
pon1 gene and combined deletion of GSTM1 and GSTT1 genes are genetic markers
of oxidative stress in patients with diabetes mellitus type 2 with clinical
manifestations of atherosclerosis and that GSTM1 null and GSTT1 null
genotypes, alone or in combination are susceptibility factors for the
development of atherosclerosis in patients without T2DM.
Ateroskleroza je kompleksno i multifaktorsko oboljenje koje obuhvata veliki
broj tipova ćelija kao i brojne fiziološke procese. Veruje se da oksidativni
stres igra važnu ulogu u inicijaciji i progresiji ateroskleroze.
Kardiovaskularne bolesti (CVD) predstavljaju vodeći uzrok smrtnosti u Srbiji
i pronalaženje markera oksidativnog stresa, uključujući i genske varijante,
doprinelo bi smanjenju broja obolelih. Studija asocijacije, koja je
obuhvatala 140 obolelih od diabetes mellitus tip 2 sa kardiovaskularnim
komplikacijama (DM+A), 60 obolelih od neke od kliničkih manifestacija
ateroskleroze (A) i 100 zdravih kontrola (K) je sprovedena da bi se utvrdila
značajnost polimorfizama gena koji su povezani sa oksidativnim stresom,
metabolizmom lipida i detoksifikacijom kao markera oksidativnog stresa i
faktora rizika za nastanak oboljenja. Za studiju su odabrani polimorfizmi
gena čiji produkti imaju antioksidativnu ulogu u plazmi (pon1 Q192R, L55M i
C(-107)T), antioksidativnu ulogu i ulogu u metabolizmu lipida u plazmi i
ćeliji (apoE 112/158 polimorfizam) i antioksidativnu i detoksifikujuću ulogu
u ćeliji (GSTM1*0, GSTT1*0 i GSTP1 Ile105Val). Genomska DNK je izolovana ili
iz ćelija periferne krvi ili iz epitelnih ćelija bukalne sluzokože.
Genotipizacija je rađena restrikcionom digestijom PCR produkata i analizom
dužine restrikcionih fragmenata (PCR-RFLP) na agaroznom ili poliakrilamidnom
gelu i real-time PCR metodom. Hi-kvadrat i Fišerov egzaktni test su
upotrebljeni za utvrđivanje razlika u distribuciji učestalosti ispitivanih
genotipova i alela, a logističkom regresionom analizom utvrđivan je rizik za
oboljevanje. Hipertenzija, hiperlipidemija i pozitivna porodična istorija za
KVB su faktori rizika za kardiovaskularne komplikacije u čijoj osnovi je
ateroskleroza kod obe grupe pacijenata, a pozitivna porodična istorija za KVB
je faktor rizika za aterosklerozu kod obolelih od T2DM. Učestalosti alela i
genotipova Q192 polimorfizma pon1 gena pokazale su značajnu razliku izmenu
pacijenata sa T2DM i kontrola (p<0.0001) i između pacijenata sa T2DM i grupe
bez T2DM (sa aterosklerozom) (p<0.0001). Rezultati logističke regresione
analize su pokazali značajno povećanje rizika za razvoj kliničkih
manifestacija ateroskleroze kod dijabetičara koji nose R alel i genotipove QR
i RR u poređenju sa kontrolama (za R alel:OR=2,22, p<0,0001; za QR genotip:
OR=3,36, p<0,0001; za RR genotip: OR=4,29, p=0,0012) i u poređenju sa grupom
A (za R alel: OR=2,28, p<0,001; za QR genotip: OR=3,7, p<0,0001; za RR
genotip: OR=4,27, p=0,006). Uočena je i značajna razlika u učestalostima
GSTM1 nultog genotipa i GSTT1 nultog genotipa između obolelih bez T2DM i
kontrolne grupe, a logistička regresiona analiza je pokazala 2 puta veći
rizik za oboljenje kod osoba sa GSTM1 nultim genotipom (OR= 2.0, p<0.03) i
više od 2 puta povećan rizik kod pacijenata sa GSTT1 nultim genotipom
(OR=2.26, p<0.03). Učestalost kombinovane delecije GSTM1 i GSTT1 se značajno
razlikovala među grupama. Dijabetičari, nosioci dvostrukog nultog genotipa su
imali približno 4,5 puta uvećan rizik za razvoj ateroskleroze (OR=4,4,
p=0,05) a rizik od ateroskleroze bio je čak 15 puta veći kod nosilaca nultih
genotipova bez T2DM (OR=15,05, p<0,0001) u poređenju sa kontrolnom grupom.
Takođe, uočili smo i značajno povećanje rizika za aterosklerozu kod nosilaca
dvostruke delecije kod pacijenata bez T2DM u poređenju sa dijabetičarima (za
DM+A grupu: OR=0,29, p=0,001). Nije nađena statistički značajna razlika u
učestalosti alela i genotipova poređenjem grupa za L55M i C(-107)T
polimorfizme pon1 gena i 112/158 polimorfizam apoE gena. Nije uočena
povezanost sa rizikom od bolesti ni za jedan od alela i genotipova ova tri
polimorfizma. Možemo zaključiti da su polimorfizam Q192R pon1 gena kao i
kombinovana delecija GSTM1 i GSTT1 gena genetički markeri oksidativnog stresa
kod obolelih od diabetes mellitus tip 2 sa kliničkim manifestacijama
ateroskleroze, a da su GSTM1 nulti genotip i GSTT1 nulti genotip, pojedinačno
ili udruženo, faktori podložnosti za razvoj ateroskleroze kod pacijenata bez
T2DM.
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