Background: An increasing number of studies support the hypothesis that endothelial dysfunction due to reduced availability of nitric oxide plays a key role in initiation, development and progression ...of essential hypertension. The aim of our study was to determine whether the ingestion of L-arginine actually improves microvascular function in normotensive subjects with a family history of hypertension.Methods: 30 normotensive healthy men, aged 20–30 years, were divided into two groups according to the family history of hypertension. We measured ECG, heart rate, systolic and diastolic arterial pressure, cardiac output, stroke volume, total peripheral resistance (Task Force Monitor) and laser Doppler (LD) flux in the microvessels of the skin on the forearm at rest, before and after the administration of 0.9 g L-arginine. The endothelium-dependent vasodilation was assessed by iontophoresis of acetylcholine and the endothelium-independent vasodilation by iontophoresis of sodium nitroprusside.Results: After the ingestion of L-arginine the heart rate and the cardiac output statistically significantly decreased in both groups (paired t-test, p < 0.05). Arterial pressure did not change significantly. Stroke volume decreased and total peripheral resistance increased only in the group of subjects with a family history of hypertension (paired t-test, p < 0.05) The ingestion of L-arginine in predisposed normotensive subjects acutely improved the endothelium-dependent vasodilation (Dunnett’s test, p < 0.05), which is consistent with the assumption that endothelial dysfunction is already present in these subjects.Conclusions: In subjects with a family history of hypertension L-arginine improved endothelial function. This justifies L-arginine as a potential agent for the prevention and/or treatment of arterial hypertension.
Managing type 2 diabetes (T2D) effectively is a considerable challenge. The Appraisal of Diabetes Scale (ADS) has proven valuable in understanding how individuals perceive and cope with their ...condition. This study aimed to evaluate the psychometric properties of the Slovenian version of ADS (ADS-S). We recruited a sample of 400 adult individuals with T2D from three primary healthcare centers in Slovenia, ensuring an average of 57 cases per individual item. The psychometric evaluation included internal consistency, test-retest reliability, construct validity, and discriminant validity. Confirmatory factor analysis (CFA) was additionally performed to evaluate the fit of one- and two-factor models. After excluding incomplete questionnaires, 389 individuals participated, averaging 72.0±7.5 years, with 196 men and 193 women. ADS-S exhibited acceptable internal consistency (Cronbach's alpha = 0.70) and strong test-retest reliability (interclass correlation = 0.88, p <0.001). Criterion validity was established through significant correlations between ADS-S score and EQ-5D utility score (r = -0.34, p <0.001), EQ-VAS score (r = -0.38, p 7.5% (r = 0.22, p = 0.019). Discriminant validity assessment found no significant correlation between ADS-S score and age, but a significant correlation with female gender (r = 0.17, p = 0.001). CFA results supported a two-factor structure (psychological impact of diabetes and sense of self-control) over a one-factor structure, as indicated by model fit indicators. ADS-S stands as a valid and reliable tool for assessing psychological impact and self-control in Slovenian T2D patients. Future research should explore adding items for capturing secondary appraisal of diabetes and studying the influence of female gender on ADS scores.
V zadnjih letih smo priča hitremu razvoju informacijskih in komunikacijskih tehnologij, ki se uporabljajo v zdravstvenih sistemih. Obdobje pandemije Covid-19 in s tem povezano socialno distanciranje ...je digitalizacijo zdravstva še dodatno pospešilo. Preko projekta eZdravje je slovenski zdravstveni sistem pridobil številne sodobne in večstransko uporabne informacijske rešitve, ki jih v vsakodnevni praksi uporabljamo tudi v družinski medicini. Ob upoštevanju pravil komuniciranja in določenih omejitev je telemedicinska oblika svetovanja in zdravljenja lahko klinično strokovna, varna, enostavna, dostopna in pomeni prihranek časa in stroškov. Telemedicinske storitve lahko pripomorejo k boljšemu življenju prebivalstva, zato je njihova vloga pri obravnavi pacientov tudi v prihodnosti nepogrešljiva. Za kakovostno in varno obravnavo pacientov je potrebno poskrbeti za ustrezno tehnološko podporo, dodatno izobraževanje in usposabljanje zdravstvenih delavcev, izdelavo poenotenih protokolov in standardov obravnave ter razrešitev problema varovanja osebnih podatkov.
Introduction: Good metabolic control of a patient with type 2 diabetes (T2D) and arterial hypertension (AH) requires continuous monitoring of patient's health and associated diseases, where lifelong ...education and support represent key factors in patient empowerment and successful self-management. This is a task beyond the capabilities of healthcare professionals in Slovenia, which could be solved with engagement and cooperation of partners outside the healthcare system. Therefore, appropriate organisation, training and functioning of lay persons, who will provide peer support, can significantly contribute to improved integrated care in patients with T2D and AH. In this way trained peer supporters will voluntarily share their knowledge, experiences and support to other patients with the same chronic disease without linguistic nor cultural barriers.
Aim: The aim of our pilot study was to determine the acceptability, effectiveness and feasibility of educational training in disease management for persons providing peer support to patients with T2D and AH at the primary healthcare level in Slovenia.
Methods: This study is a part of an ongoing international research project SCUBY (SCale Up diaBetes and hYpertension care). Our pilot study started with recruitment of 36 patients with T2D and/or AH. Participants were educated in a total of 15 hours of group and individual training by nurses with special skills. Before and after completing the training, participants filled out questionnaires including sociodemographic and clinical data, knowledge about T2D and AH, Appraisal of Diabetes Scale and Theoretical Framework of Acceptability.
Results: 31 patients (21 women and 10 men) successfully completed structured educational training in management of their T2D and AH and became trained peer supporters. Their average age was 63,9 ± 8,9 years, they were treated for T2D on average of 14,3 ± 11,7 years and for AH on average of 7,9 ± 8,1 years. Compared to the knowledge at the time of entering the research, their knowledge about T2D (p<0,001) as well as about AH (p=0,022) increased significantly. The impact on the quality of life with T2D was insignificantly better (p=0,146). The participants rated training as highly acceptable in all 7 domains of acceptability; the total mean score on a 5-point scale was 4,44 ± 0,52.
Conclusions: Educational training in disease management for peer supporters proved to be highly acceptable, effective and feasible, which indicates a great potential for successful implementation of peer support for patients with T2D and AH at the primary healthcare level in Slovenia. Active role of trained peer supporters will lead to the development of a new form of cooperation and collaboration between patients, their family members, informal caregivers in local community and healthcare professionals.
Reduced availability of nitric oxide leads to dysfunction of endothelium which plays an important role in the development of cardiovascular diseases.
The aim of the present study was to determine ...whether the dietary supplement L-arginine improves the endothelial function of microvessels by increasing nitric oxide production.
We undertook experiments on 51 healthy male volunteers, divided into 4 groups based on their age and physical activity since regular physical activity itself increases endothelium-dependent vasodilation. The skin laser Doppler flux was measured in the microvessels before and after the ingestion of L-arginine (0.9 g). The endothelium-dependent vasodilation was assessed by acetylcholine iontophoresis and the endothelium-independent vasodilation by sodium nitroprusside iontophoresis. In addition, we measured endothelium-dependent and endothelium-independent vasodilation in 81 healthy subjects divided into four age groups.
After the ingestion of L-arginine, the endothelium-dependent vasodilation in the young trained subjects increased (paired t-test, p < 0.05), while in the other groups it remained the same. There were no differences in the endothelium-independent vasodilation after ingestion of L-arginine. With aging endothelium-independent vasodilation decreased while endothelium-dependent vasodilation remained mainly unchanged.
Obtained results demonstrated that a single dose of L-arginine influences endothelium-dependent vasodilation predominantly in young, trained individuals.
