Current Issue : January - March Volume : 2016 Issue Number : 1 Articles : 7 Articles
The syndrome of inappropriate antidiuretic hormone (SIADH) is a disease characterized by hyponatremia and hyperosmolarity\nof urine where vasopressin and angiotensin II are implicated in the alteration of salt water balance and cardiovascular and blood\npressure regulation. The aim of this study is to analyse the expression of substances related with cardiovascular and salt water\nregulation in the subfornical organ in a case of SIADH. Two brains, one taken from a 66-year-old man with SIADH and the other\nfrom a 63-year-old man without SIADH, were used. Immunohistochemical study was performed using anti-angiotensin II, antivasopressin,\nand anti-collagen-VI as primary antibodies. Angiotensin and vasopressin immunoreaction were found in neurons, in\nperivascular spaces, and in the ependymal layer in the subfornical organ in both cases.However, in the SIADH case, the angiotensin\nII and collagen-IV expression in the SFO were different suggesting this organ�s possible participation in the physiopathology of\nSIADH....
Type 1 diabetes (T1D) is autoimmune disease with chronic hyperglycaemic state. Besides diabetic retinopathy, nephropathy, and\nneuropathy, T1D is characterized by poor bone health.Thereduced bone mineralization and quality/strength, due to hyperglycemia,\nhypoinsulinemia, autoimmune inflammation, low levels of insulin growth factor-1 (IGF-1), and vitamin D, lead to vertebral/hip\nfractures. Young age of T1D manifestation, chronic poor glycemic control, high daily insulin dose, low BMI, reduced renal function,\nand the presence of complications can be helpful in identifying T1D patients at risk of reduced bone mineral density. Although risk\nfactors for fracture risk are still unknown, chronic poor glycemic control and presence of diabetic complications might raise the\nsuspicion of elevated fracture risk in T1D. In the presence of the risk factors, the assessment of bone mineral density by dual-energy\nX-ray absorptiometry and the search of asymptomatic vertebral fracture by lateral X-ray radiography of thorax-lumbar spine should\nbe recommended. The improvement of glycemic control may have a beneficial effect on bone in T1D. Several experiments showed\npromising results on using anabolic pharmacological agents (recombinant IGF-1 and parathyroid hormone) in diabetic rodents\nwith bone disorder. Randomized clinical trials are needed in order to test the possible use of bone anabolic therapies in humans\nwith T1D...
Diabetes mellitus is the commonest cause of CKD. It is the leading cause of new patients requiring renal replacement therapy,\naccounting for 40%, 34%, and 30% of cases in United States, Germany, and Australia, respectively. Recent studies have shown that\na low-molecular weight protein, cystatin C, freely filtered by the kidneys is a novel biomarker that may be used for detection of\nearly renal dysfunction in patients with type 1 or type 2 diabetes. Cystatin C has also been shown to detect cardiovascular disease in\npatients with diabetes and it may also be linked with incident type 2 diabetes in obese patients.We aim to review current evidence\nbased literature on use of cystatin C for early detection of diabetic nephropathy due to type 1 and type 2 diabetes in comparison to\nconventional methods and explore its association with other comorbidities....
Diabetic kidney disease in patients with type 2 diabetes strongly correlates with the incidence of major cardiovascular events and\nall-causemortality. Pharmacological and lifestyle based management focusing on glycaemic, lipid, and blood pressure control is the\nmainstay of treatment but efficacy remains limited. Roux en Y gastric bypass is an efficacious intervention in diabetes. Emerging\nevidence also supports a role for bypass as an intervention for early diabetic kidney disease. This paper firstly presents level 1\nevidence of the effects of bypass on hyperglycaemia and hypertension and then summarises emerging data on its effects on diabetic\nkidney disease. Glucagon-like peptide-1 is implicated as a central mediator of diabetes resolution following bypass through the\nincretin effect. It has been ascribed vasodilatory, pronatriuretic, and antioxidant properties and its exogenous administration or\noptimisation of its endogenous levels via dipeptidyl peptidase IV inhibition results in antioxidant and antiproteinuric effects in\npreclinical models of DKD. Some evidence is emerging of translation of coherent effects in the clinical setting. These findings raise\nthe question of whether pharmacotherapy targeted at optimising circulating hormone levels may be capable of recapitulating some\nof the effects of bypass surgery on renal injury....
Diabetes mellitus is a metabolic disease possible to treat via several different therapeutic approaches. Since the advent of\ninsulin in 1922, type 1 diabetes mellitus has become a chronic treatable disease. Nonetheless, type 1 diabetes mellitus can be a\ndevastating disease when the macro- and microangiopathic complications take place after several years of illness. Starting from\nthe eighties, pancreas/islet transplantation has become a potential innovative treatment of diabetes mellitus. The major advantage\nof pancreas/islet transplantation is the restoration of c-peptide cosecretion along with insulin; the major disadvantage is the\nneed to administer immunosuppressive drugs which are diabetogenic themselves. Islet transplantation is the progenitor of more\nrecent forms of cellular and stem cell therapies which will be reviewed herein. Cellular therapies for diabetes mellitus are still an\nexperimental procedure. Herein we present the actual current achievements and an outlook of close future possible advancements\nin the area of cellular transplantation for the cure of diabetes mellitus....
The past decade produced important advances in molecular genetic techniques potentially supplanting the traditional cytogenetic\ndiagnosis of Turner syndrome (TS). Rapidly evolving genomic technology is used to screen 1st trimester pregnancies for sex\nchromosomal anomalies including TS, and genomic approaches are suggested for the postnatal diagnosis of TS. Understanding the\ninterpretation and limitations of new molecular tests is essential for clinicians to provide effective counseling to parents or patients\nimpacted by these tests. Recent studies have advanced the concept that X chromosome genomic imprinting influences expression\nof the Turner phenotype and contributes to gender differences in brain size and coronary disease. Progress in cardiovascular MRI\nover the past decade has dramatically changed our view of the scope and criticality of congenital heart disease in TS. Cardiac MRI\nis far more effective than transthoracic echocardiography in detecting aortic valve abnormalities, descending aortic aneurysm, and\npartial anomalous pulmonary venous return; recent technical advances allow adequate imaging in girls as young as seven without\nbreath holding or sedation. Finally, important developments in the area of gynecological management of girls and young women\nwith TS are reviewed, including prognostic factors that predict spontaneous puberty and potential fertility and recent practice\nguidelines aimed at reducing cardiovascular risk for oocyte donation pregnancies in TS....
The aim of this study is to evaluate the additional costs associated with calcium monitoring and treatment as well as evaluate\nthe incidence and predictors of post thyroidectomy hypocalcemia. Methods. This case-control study involved thyroidectomy and\ncompletion thyroidectomy patients operated on between January 2012 and August 2013. Cases were defined as requiring calcitriol\nsupplementation, and controls did not require supplementation. Patient (age, sex), nodule (cytology, pathology), surgical data (neck\ndissection, parathyroid identification, and reimplantation), and hospital stay (days hospitalized in total and after drain removal)\nwere compared. Comparisons were made using ...
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