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Observational Case-Control Study on The Risk Factors of Fetal Macrosomia and Fetal-Maternal Associated Pathology

Abstract

Background and aims: The purpose of this study was to evaluate the frequency of demographic and clinical risk factors for fetal macrosomia, maternal pregestational, gestational and intra partum pathology associated with macrosomia, and to investigate the dynamic of these parameters in a decade.

Material and method: We conducted two studies, a case-control study of 261 mothers who delivered macrosomic babies and 241 mothers who delivered normal weight babies in 2016, and then we compared the parameters obtained from the study group of 261women who delivered in 2016 macrosomic babies with those of a study group of 220 women who delivered macrosomic babies in 2006 at Gynecology I County Hospital of Cluj-Napoca. The data was stored and analyzed using Microsoft Excel.

Results and conclusions: Overweight before pregnancy, the excessive weight gain during pregnancy, and the delivery of a macrosomic baby increase the risk to deliver in the future a macrosomic baby. Mothers who delivered macrosomic babies had a higher incidence of thyroid gland pathology (hypofunction) and gestational diabetes than those who delivered normal weight babies.

Open access
Oral Supplementation Effect of Iron and its Complex Form With Quercetin on Oxidant Status and on Redistribution of Essential Metals in Organs of Streptozotocin Diabetic Rats

Abstract

Background and aims: Quercetin, is a polyphenolic antioxidant compound. It is able to form complex with metal ions such as iron and exerts a broad range of biological activities like improving metabolic disorders. This research aims at investigating the effect of oral supplementation of iron (2.5mg Fe/Kg/day) and its complex form (molar ratio 1:5; 2.5mg/25mg/Kg/day) with quercetin (25mg/Kg/day) on lipid metabolism, oxidant status and trace elements contents in organs of Wistar diabetic rats (45 mg/kg/rat.ip of streptozotocin) during eight weeks of experimentation.

Material and method: To achieve this, liver and adipose tissue enzymes activities, NO, O2−•, TBARs, carbonyl protein levels in plasma were analysed. Metals (Cu, Fe, Mg, Zn) analysis of organs were determined by inductively coupled plasma atomic emission spectroscopy.

Results: Iron supplemented alone induced a noticeable disorder in lipid, lipoprotein, lipases and oxidant status. Yet, it caused an imbalance in the redistribution of metals in the organs of diabetic and non diabetic rats. Iron-quercetin complex was shown as less harmful and more beneficial than iron supplemented alone.

Conclusions: This complex could reverse oxidative stress and iron deficiency mostly caused by the diabetic disease but at the same time it induces an imbalance in redistribution of other essential metals.

Open access
Prevalence of Hypoglycemia, Treatment Satisfaction, Adherence and Their Associations with Glycemic Goals in Patients with Type 2 Diabetes Mellitus Treated with Sulfonylureas: Findings from the Real-Life Effectiveness and Care Patterns of Diabetes Management (RECAP-DM) in Romania

Abstract

Background and aims: The aim of this study was to assess the prevalence and evaluate the impact on several treatment and quality of life parameters of hypoglycemia in type 2 diabetes mellitus patients treated with sulfonylureas (SU) in Romania. Secondary objective was to determine the proportion of patients attaining haemoglobin A1c (HbA1c) target of <7%.

Material and method: This was a multi-center, observational study using retrospective clinical chart and laboratory parameters review, and a cross-sectional survey in Romania. The sample in this study consisted of 385 patients. Socio-demographic and clinical variables were compared between patients with inadequate and adequate control.

Results: The mean age of all enrolled subjects was 65.37 (33-87) years. The average BMI was 30.44 kg/m2. Mean diabetes duration was 7.76 (6 months -32) years with the mean age of diabetes at diagnosis of 57.75 (31-85) years. HbA1c was recorded for 238 subjects with mean value of 7.12 (4.8-10.97) %.

Conclusions: The prevalence of hypoglycaemia in SU treated patients was 42.2%. Highest prevalence was in the 50-60 age category, at 49.2% and lowest among the eldest subjects (>70 years), at 38.6%. Prevalence of patients at the goal of HbA1c<7% was 50.8 %. Patients with adequate glycaemic control had more acceptable BMI than those with inadequate glycaemic control. In patients not achieving a goal of HbA1c < 7%, higher level of plasma glucose and total cholesterol was determined compared to those with adequate glycaemic control. There were no significant differences in the HDL-C, triglycerides or albumin:creatinine ratios in patients with both adequate and inadequate glycaemic control.

Open access
Pulmonary Tuberculosis Characteristics in a Patient with Type 2 Diabetes Mellitus

Abstract

Tuberculosis (TB) and diabetes mellitus (DM) are two chronic diseases with major impact on worldwide morbidity and mortality. DM significantly increases the risk of death, therapeutic failure and relapse of TB, requiring a much more careful monitoring of these patients. In this article we present the case of a patient with type 2 DM in the stage of major chronic complications, with numerous risk factors for TB and atypical symptomatology, pulmonary X-ray showing active TB lesions. The patient did not follow the diabetologist's recommendations, discontinuing the antidiabetic treatment on his own initiative. The glycemic imbalance and chronic alcoholism caused the failure of the anti TB therapy.

Open access
The Relation Between Type 2 Diabetes Mellitus and Parkinson Disease Up to Date

Abstract

Parkinson’s disease is defined nowadays as a neurodegenerative disease with prominent motor symptoms accompanied by a wide range of comorbidities, some of them, like type 2 diabetes mellitus, probably implicated in the pathogenesis and progression of the disease. In order to achieve this article, which aimed to realize an up to date synthesis of published dedicated papers, a PubMed search was performed; it revealed increasing evidence that these two morbid conditions share many pathogenic pathways and current studies are trying to finally transform the accumulated knowledge into curative therapy or effective prevention for these frequent and complex diseases.

Open access
Association of Vitamin D Status with Body Mass Index in Adolescents in Ukraine

Abstract

Background and aims: Vitamin D status in many health managements have been researched extensively, but its dependence with obesity still remains controversial. This article is devoted to examination of blood cholecalciferol levels in Ukrainian population with establishment the association of cholecalciferol levels and body mass index (BMI). Materials and methods: For this observed investigation, data were collected during the summer 2017, over a period of one week from three township areas in Carpathian region, Ukraine from 304 adults aged 19-78 years. Measured variables contained 25(OH)D level, weight and weight applied to check BMI degree. The average level of vitamin D among adolescents presented 23.1 ± 8.2 ng/ml. Female gender was associated with lower vitamin D concentrations (22.9 ± 9.3 ng/ml vs. 26.2 ± 8.5 ng/ml for men). Among the participants, 74.4% had a BMNI of 25 kg/m2 and over, and in 27.3% of them the number was 30 kg/m2 and over. Results: Violation of vitamin D status was detected in 90.5% persons. 1.8% people had been identified as severe 25(OH)D deficiency. Measurement of cholecalciferol demonstrated meaningful connection between its level and BMI only in persons with BMI 25-29.9 kg/m2. Average vitamin D concentrations in persons with BMI over30 kg/m2 did not vary to a significant range from data in persons with normal body weight. Conclusions: Vitamin D status among the adolescents in Ukraine is far from optimum. Our results confirm reliable association between cholecalciferol level and BMI in persons with overweight. Interchange between conservation of vitamin D and BMI needs additional surveys.

Open access
Clinical and Therapeutic Characteristics of Patients with Type 2 Diabetes Mellitus in Romania – Mentor Study

Abstract

Background and aims: PREDATORR Study estimated diabetes mellitus (DM) prevalence in Romania at 11.7%. MENTOR is the first national major study trying to determine the quality of the metabolic control in patients with type 2 diabetes (T2DM), the therapeutic options used, and the microvascular and macrovascular complications prevalence in order to achieve a better management for Romanian patients with T2DM. Material and methods: The study was designed as an observational analytical, multicenter, prospective study. Study population was selected from T2DM patients stratified by: age, diabetes duration and gender. Data was collected in an eCRF: demographics, physical examination, cardiovascular evaluation, blood tests, known pathology, treatment. Results: There were 54.80% women, mean age was 60.53±7.39 years. The average BMI is over 30 kg/m2 with a decreasing trend over the age. 60% had their HbA1c over the threshold of 7%. Average blood pressure was less than 140/80 mmHg. 76,66% of T2DM subjects have at least one chronic complication. On oral therapy we have 55.44% of patients, on insulin only therapy 12.99% and on a combination of oral and insulin therapy 22.51%. Conclusions: This study showed a high prevalence of diabetes complications and metabolic alterations (obesity, hypertension, dyslipidemia, etc.). Age, male gender and diabetes duration were associated with a higher risk for poor metabolic control and complications. Further data will be collected over a 3 years period to obtain a better image over T2DM evolution in Romanian population.

Open access
Comparative Study of the Effect of Various Forms of Quercetin on Experimental Diabetes

Abstract

Background and aims: Diabetes mellitus (DM) is a multifactorial metabolic disorder characterized by hyperglycaemia caused by insulin deficiency or insulin resistance. It is a global public health problem. This study aimed to determine specific pharmacological effect of quercetin in water soluble and liposomal preparations in experimental diabetes mellitus. Material and methods: We examined the effect of Corvitin and Lipoflavone (at the dose of 10 mg / kg body weight) in a comparative study in white rats with type 1 diabetes and type 2 diabetes coupled with obesity. To simulate the forms of diabetes mellitus most analogous to those in humans we used Streptozotocin at the doses of 30 mg / kg and 50 mg / kg. We tested the levels of glucose, glycosylated hemoglobin, C-reactive protein, and interleukins 6 and 4 in the blood. Results: In animals with type 1 and type 2 diabetes Lipoflavone significantly reduces glucose and glycosylated hemoglobin levels compared to the rats treated with Corvitin. When administered to animals with diabetes, the effect of quercetin in liposomal form on the concentrations of IL-6, IL-4 and Creactive protein is also larger compared to the water-soluble form. Conclusions: Water soluble quercetin preparation Corvitin and to a larger extent liposomal preparation of this flavonoid, Lipoflavone, show anti-inflammatory effect and restore key parameters of carbohydrate metabolism in experimental type 1 diabetes mellitus and type 2 diabetes coupled with obesity, reducing blood glucose and glycosylated hemoglobin levels.

Open access
Effect of Fiber-Rich Snacks on C-Reactive Protein and Atherogenic Index in Type 2 Diabetes Patients

Abstract

Background and aims: High levels of non-HDL and atherogenic cholesterol can induce inflammation, and as risk factor for cardiovascular diseases. This study was to evaluate the effects of fiber-rich snacks on non-HDL cholesterol, atherogenic index, and Creactive protein (CRP) levels in type 2 diabetes patients (T2DM). Material and Methods: Twenty T2DM patients, were recruited from the Policlinic of Endocrine, Dr. Sardjito General Hospital, Yogyakarta, Indonesia. The subjects received daily 32g fiber-rich snacks made of Dioscorea esculenta, arrowroot, cassava and pumpkin for 4 weeks. Fasting non-HDL cholesterol, atherogenic index, CRP and HbA1c levels were measured before and after intervention. Paired t-test was used to evaluate the results. Results: The fiber-rich snack intervention in T2DM patients significantly reduced levels of non-HDL cholesterol and CRP levels (p<0.05), but the decreased the atherogenic index was not significant (p>0.05). The intervention also significantly reduced the CRP levels (p<0.05) but did not affect HbA1c levels. Body weight, body mass index (BMI), waist circumference decreased significantly after consuming the snacks (p<0.05). Conclusions: This study showed fiber-rich snack has a positive effect in improving non-HDL cholesterol, atherogenic index and CRP levels but does not affect HbA1c levels in T2DM patients.

Open access