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Macrovascular disease

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https://www.readbyqxmd.com/read/27932229/regorafenib-for-patients-with-hepatocellular-carcinoma-who-progressed-on-sorafenib-treatment-resorce-a-randomised-double-blind-placebo-controlled-phase-3-trial
#1
Jordi Bruix, Shukui Qin, Philippe Merle, Alessandro Granito, Yi-Hsiang Huang, György Bodoky, Marc Pracht, Osamu Yokosuka, Olivier Rosmorduc, Valeriy Breder, René Gerolami, Gianluca Masi, Paul J Ross, Tianqiang Song, Jean-Pierre Bronowicki, Isabelle Ollivier-Hourmand, Masatoshi Kudo, Ann-Lii Cheng, Josep M Llovet, Richard S Finn, Marie-Aude LeBerre, Annette Baumhauer, Gerold Meinhardt, Guohong Han
BACKGROUND: There are no systemic treatments for patients with hepatocellular carcinoma (HCC) whose disease progresses during sorafenib treatment. We aimed to assess the efficacy and safety of regorafenib in patients with HCC who have progressed during sorafenib treatment. METHODS: In this randomised, double-blind, parallel-group, phase 3 trial done at 152 sites in 21 countries, adults with HCC who tolerated sorafenib (≥400 mg/day for ≥20 of last 28 days of treatment), progressed on sorafenib, and had Child-Pugh A liver function were enrolled...
December 5, 2016: Lancet
https://www.readbyqxmd.com/read/27929441/aortic-stiffness-as-a-surrogate-endpoint-to-micro-and-macrovascular-complications-in-patients-with-type-2-diabetes
#2
REVIEW
Claudia R L Cardoso, Gil F Salles
Increased aortic stiffness has been recognized as a predictor of adverse cardiovascular outcomes in some clinical conditions, such as in patients with arterial hypertension and end-stage renal disease, in population-based samples and, more recently, in type 2 diabetic patients. Patients with type 2 diabetes have higher aortic stiffness than non-diabetic individuals, and increased aortic stiffness has been correlated to the presence of micro- and macrovascular chronic diabetic complications. We aimed to review the current knowledge on the relationships between aortic stiffness and diabetic complications, their possible underlying physiopathological mechanisms, and their potential applications to clinical type 2 diabetes management...
December 6, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27928947/oral-glucose-lowering-drugs-and-cardiovascular-outcomes-from-the-negative-record-and-accord-to-neutral-tecos-and-promising-empa-reg
#3
C Tsioufis, E Andrikou, C Thomopoulos, N Papanas, D Tousoulis
Cardiovascular (CV) morbidity and mortality are higher among patients with diabetes mellitus type 2 (T2DM), particularly those with concomitant CV diseases, compared with other populations. In patients with T2DM, intensive glucose lowering reduces microvascular disease, but has a smaller and debated effect on CV events or mortality. In this setting, the US Food and Drug Administration (FDA) required in 2008 that all new agents for the treatment of T2DM should be evaluated in terms of CV safety. Metformin has long been established as first-line pharmacological therapy in patients with T2DM, due to its proven beneficial CV effects...
December 8, 2016: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/27927187/the-importance-of-proteinuria-and-prior-cardiovascular-disease-in-all-major-clinical-outcomes-of-atherosclerotic-renovascular-disease-a-single-center-observational-study
#4
Diana Vassallo, James Ritchie, Darren Green, Constantina Chrysochou, Joseph Blunt, Philip A Kalra
BACKGROUND: Identification of patients at risk of developing adverse events would enable aggressive medical therapy and possibly targeted revascularization. The aim of this study is to characterize the determinants of long-term outcomes in atherosclerotic renovascular disease (ARVD). METHODS: Patients with a radiological diagnosis of ARVD were recruited into this single-center prospective cohort study between 1986 and 2014. Data collected included baseline co-morbid conditions, annualized prescribed medications and laboratory data (serum creatinine [υmol/L], proteinuria [g/24 h])...
December 7, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27923453/circulating-micrornas-as-biomarkers-for-metabolic-disease
#5
REVIEW
Marcelina Párrizas, Anna Novials
Incidence of diabetes and other metabolic disorders is increasing worldwide, with almost half the cases remaining undiagnosed. This is cause for concern as poor management of glucose or lipid levels causes tissue damage that may result in micro- or macrovascular complications. Current methods of diagnosing metabolic disorders do not provide any clues on disease aetiology or their posterior evolution and incidence of complications, which are the main cause of disease-associated morbidity. Circulating microRNAs found in blood change with the physiological condition of the organism and may help to: (1) identify people at risk of developing metabolic disease, (2) diagnose diabetes or other metabolic disorders on the basis of their aetiology, (3) predict the development of complications, and (4) monitor response to treatment...
October 2016: Best Practice & Research. Clinical Endocrinology & Metabolism
https://www.readbyqxmd.com/read/27916650/cardiac-oxidative-stress-in-diabetes-mechanisms-and-therapeutic-potential
#6
REVIEW
Alyssa Faria, Shanta J Persaud
Macrovascular complications of diabetes, including diabetic cardiovascular disease (CVD), occur through a number of hyperglycaemia-induced mechanisms that include generation of oxidative stress, accumulation of advanced glycation end-products (AGE) and activation of protein kinase C (PKC). Cardiac oxidative stress is associated with increased cardiac fibrosis and hypertrophy, and reduced cardiac performance and contractility, leading to severe cardiac dysfunction and potentially fatal cardiac events. It occurs under conditions of excessive synthesis of reactive oxygen species (ROS)...
December 1, 2016: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27904032/coronary-microvascular-dysfunction%C3%A3-epidemiology-pathogenesis-prognosis-diagnosis-risk-factors-and-therapy
#7
Cheng Chen, Janet Wei, Ahmed AlBadri, Parham Zarrini, C Noel Bairey Merz
Angina has traditionally been thought to be caused by obstructive coronary artery disease (CAD). However, a substantial number of patients with angina are found to not have obstructive CAD when undergoing coronary angiography. A significant proportion of these patients have coronary microvascular dysfunction (CMD), characterized by heightened sensitivity to vasoconstrictor stimuli and limited microvascular vasodilator capacity. With the advent of non-invasive and invasive techniques, the coronary microvasculature has been more extensively studied in the past 2 decades...
November 29, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27903991/role-of-oxidative-stress-and-inflammatory-factors-in-diabetic-kidney-disease
#8
Esmat Aghadavod, Samaneh Khodadadi, Azar Baradaran, Parto Nasri, Mahmood Bahmani, Mahmoud Rafieian-Kopaei
Diabetic nephropathy (DN) is a serious complication of diabetes mellitus, and its prevalence has been increasing in developed countries. Diabetic nephropathy has become the most common single cause of end-stage renal disease worldwide. Oxidative stress and inflammation factors are hypothesized to play a role in the development of late diabetes complications. Chronic hyperglycemia increases oxidative stress, significantly modifies the structure and function of proteins and lipids, and induces glycoxidation and peroxidation...
November 2016: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/27884679/risk-stratified-staging-in-paediatric-hepatoblastoma-a-unified-analysis-from-the-children-s-hepatic-tumors-international-collaboration
#9
Rebecka L Meyers, Rudolf Maibach, Eiso Hiyama, Beate Häberle, Mark Krailo, Arun Rangaswami, Daniel C Aronson, Marcio H Malogolowkin, Giorgio Perilongo, Dietrich von Schweinitz, Marc Ansari, Dolores Lopez-Terrada, Yukichi Tanaka, Rita Alaggio, Ivo Leuschner, Tomoro Hishiki, Irene Schmid, Kenichiro Watanabe, Kenichi Yoshimura, Yurong Feng, Eugenia Rinaldi, Davide Saraceno, Marisa Derosa, Piotr Czauderna
BACKGROUND: Comparative assessment of treatment results in paediatric hepatoblastoma trials has been hampered by small patient numbers and the use of multiple disparate staging systems by the four major trial groups. To address this challenge, we formed a global coalition, the Children's Hepatic tumors International Collaboration (CHIC), with the aim of creating a common approach to staging and risk stratification in this rare cancer. METHODS: The CHIC steering committee-consisting of leadership from the four major cooperative trial groups (the International Childhood Liver Tumours Strategy Group, Children's Oncology Group, the German Society for Paediatric Oncology and Haematology, and the Japanese Study Group for Paediatric Liver Tumours)-created a shared international database that includes comprehensive data from 1605 children treated in eight multicentre hepatoblastoma trials over 25 years...
November 21, 2016: Lancet Oncology
https://www.readbyqxmd.com/read/27874160/microvascular-and-macrovascular-complications-of-type-2-diabetic-mellitus-in-central-kingdom-of-saudi-arabia
#10
Aboud F Alaboud, Ayla M Tourkmani, Turki J Alharbi, Aljoharah H Alobikan, Osama Abdelhay, Saad M Al Batal, Hesham I Alkashan, Umar Y Mohammed
To determine the prevalence of macrovascular and microvascular complications of type 2 diabetes mellitus and its associated determinants.  Methods: We evaluated the online medical records of patients with type 2 diabetes mellitus who have been seen in chronic disease unit between April and June 2014. Seven hundred and forty-eight participants satisfied the inclusion criteria. Of these, 317 (42.4%) were males with a mean age of 57.9 years, 681 (64.3%) were obese with body mass index (BMI) of greater than 30, while only 9...
December 2016: Saudi Medical Journal
https://www.readbyqxmd.com/read/27846250/reduced-microvascular-density-in-omental-biopsies-of-children-with-chronic-kidney-disease
#11
Dorothea Burkhardt, Maria Bartosova, Betti Schaefer, Niels Grabe, Bernd Lahrmann, Hamoud Nasser, Christian Freise, Axel Schneider, Anja Lingnau, Petra Degenhardt, Bruno Ranchin, Peter Sallay, Rimante Cerkauskiene, Michal Malina, Gema Ariceta, Claus Peter Schmitt, Uwe Querfeld
BACKGROUND: Endothelial dysfunction is an early manifestation of cardiovascular disease (CVD) and consistently observed in patients with chronic kidney disease (CKD). We hypothesized that CKD is associated with systemic damage to the microcirculation, preceding macrovascular pathology. To assess the degree of "uremic microangiopathy", we have measured microvascular density in biopsies of the omentum of children with CKD. PATIENTS AND METHODS: Omental tissue was collected from 32 healthy children (0-18 years) undergoing elective abdominal surgery and from 23 age-matched cases with stage 5 CKD at the time of catheter insertion for initiation of peritoneal dialysis...
2016: PloS One
https://www.readbyqxmd.com/read/27834062/comparison-of-urine-albumin-to-creatinine-ratio-acr-between-acr-strip-test-and-quantitative-test-in-prediabetes-and-diabetes
#12
Eun Hee Nah, Seon Cho, Suyoung Kim, Han Ik Cho
BACKGROUND: Albuminuria is generally known as a sensitive marker of renal and cardiovascular dysfunction. It can be used to help predict the occurrence of nephropathy and cardiovascular disorders in diabetes. Individuals with prediabetes have a tendency to develop macrovascular and microvascular pathology, resulting in an increased risk of retinopathy, cardiovascular diseases, and chronic renal diseases. We evaluated the clinical value of a strip test for measuring the urinary albumin-to-creatinine ratio (ACR) in prediabetes and diabetes...
January 2017: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/27825607/linguistic-and-psychometric-validation-of-the-malaysian-version-of-diabetes-quality-of-life-brief-clinical-inventory-dqol-bci
#13
Syamimi Samah, Chin Fen Neoh, Yuet Yen Wong, Mohamed Azmi Hassali, Asrul Akmal Shafie, Siong Meng Lim, Kalavathy Ramasamy, Nafiza Mat Nasir, Yung Wen Han, Thomas Burroughs
BACKGROUND: Quality of life (QoL) assessment provides valuable outcome to support clinical decision-making, particularly for patients with chronic diseases that are incurable. A brief, 15-item diabetes-specific tool [i.e. Diabetes Quality of Life-Brief Clinical Inventory (DQoL-BCI)] is known to be developed in English and validated for use in clinical practice. This simplified tool, however, is not readily available for use in the Malaysian setting. OBJECTIVE: To translate the DQoL-BCI into a Malaysian version and to assess its construct validity (factorial validity, convergent validity and discriminant validity), reliability (internal consistency) and floor and ceiling effects among the Malaysian diabetic population...
October 24, 2016: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/27824243/hypertriglyceridemic-waist-in-type-1-diabetes-patients-prevalence-and-related-factors
#14
Mercè Fernández-Miró, Juan J Chillarón, Mercè Albareda, Sara Fontserè, Cristina Colom, Lluís Vila, Juan Pedro-Botet, Juana A Flores LE-Roux
BACKGROUND: The hypertriglyceridemic waist has been linked to a higher number of cardiovascular risk factors and a greater probability of developing diabetes and cardiovascular disease. Around 50% of individuals with type 1 diabetes (T1D) are overweight or obese and triglyceridemia is associated with the onset of micro- and macrovascular complications. METHODS: A cross-sectional study was conducted in men with T1D to assess the association between the prevalence of hypertriglyceridemic waist and cardiovascular risk factors and hypogonadism...
November 8, 2016: Minerva Endocrinologica
https://www.readbyqxmd.com/read/27823603/prediabetes-a-worldwide-epidemic
#15
REVIEW
Catherine M Edwards, Kenneth Cusi
Prediabetes, defined by blood glucose levels between normal and diabetic levels, is increasing rapidly worldwide. This abnormal physiologic state reflects the rapidly changing access to high-calorie food and decreasing levels of physical activity occurring worldwide, with resultant obesity and metabolic consequences. This is particularly marked in developing countries. Prediabetes poses several threats; there is increased risk of developing type 2 diabetes mellitus (T2DM), and there are risks inherent to the prediabetes state, including microvascular and macrovascular disease...
December 2016: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/27821407/role-of-type-2-diabetes-in-determining-retinal-renal-and-cardiovascular-outcomes-in-women-with-previous-gestational-diabetes-mellitus
#16
Ravi Retnakaran, Baiju R Shah
OBJECTIVE: Women who have gestational diabetes mellitus (GDM) have elevated lifetime risks for the development of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), compared with their peers. However, it is not known whether their risk of CVD is dependent upon the development of T2DM. Thus, we sought to evaluate the role of T2DM in determining vascular outcomes in women with previous GDM. RESEARCH DESIGN AND METHODS: All women in Ontario, Canada, with a live-birth pregnancy between April 1994 and March 2014 (n = 1,515,079) were stratified into the following four groups: women with GDM in whom T2DM subsequently developed (n = 15,585, median age 32 years); those with GDM in whom T2DM did not develop (n = 41,299; median age 32 years); women who did not have GDM but in whom T2DM developed (n = 49,397; median age 31 years); and those with neither GDM nor T2DM (n = 1,408,798; median age 30 years)...
November 7, 2016: Diabetes Care
https://www.readbyqxmd.com/read/27814624/micrornas-in-control-of-gene-regulatory-programs-in-diabetic-vasculopathy
#17
Chongzhe Pei, Xiaoping Zhang, Shu Meng, Yigang Li
Diabetes is generally associated with vasculopathy, which contains both microvascular and macrovascular complications, associated with high morbidity and mortality. Currently, despite interventional therapy, the overall prognosis for patients with diabetic vasculopathy remains unsatisfactory. Angiogenesis and vascular injury and repair are associated with a variety of cells. However, the molecular mechanisms of the cells that are involved in pathogenesis of diabetic vasculopathy remain largely unknown. As novel molecules, microRNAs (miRs) take part in regulating protein-coding gene expression at the post-transcriptional level, and contribute to the pathogenesis of various types of chronic metabolism disease, especially diabetic vasculopathy...
January 1, 2017: Frontiers in Bioscience (Landmark Edition)
https://www.readbyqxmd.com/read/27809453/long-term-study-of-the-association-of-adipokines-and-glucose-variability-with-diabetic-complications
#18
Jin Joo Cha, Hye Sook Min, Kitae Kim, Mi Jin Lee, Mi Hwa Lee, Jung Eun Kim, Hye Kyoung Song, Dae Ryong Cha, Young Sun Kang
Background/Aims: Recent studies have suggested an important role of adipokines in the development of insulin resistance and diabetes mellitus. The clinical relevance of adipokines on long-term outcomes in patients with diabetes and chronic kidney disease is uncertain. The purpose of this study was to identify a predictable factor in patients with long-term diabetic complications. Methods: A total of 161 diabetic individuals were followed-up from 2002 to 2013. Circulating plasma levels of adiponectin, glypican-4, irisin, visfatin, and visit-to-visit glucose variability were measured in diabetic patients...
November 4, 2016: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/27803933/endothelial-microparticles-act-as-novel-diagnostic-and-therapeutic-biomarkers-of-diabetes-and-its-complications-a-literature-review
#19
REVIEW
Fan Deng, Shuang Wang, Liangqing Zhang
Diabetes mellitus- (DM-) related vascular diseases attract increased attention due to their high morbidity and mortality. The incidence of obesity, atherosclerosis, coronary heart disease, hypertension, and dyslipidemia is significantly higher in DM patients, with an earlier onset and faster progression compared with non-DM patients. DM-related vascular diseases including macrovascular and microvascular complications are characterized by endothelial dysfunction. Therefore, a better understanding of the etiology and mechanisms of endothelial dysfunction is important for the diagnosis and treatment of DM...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27796904/strategies-for-diabetes-management-using-newer-oral-combination-therapies-early-in-the-disease
#20
REVIEW
Joel Zonszein, Per-Henrik Groop
INTRODUCTION: The duration of uncontrolled type 2 diabetes mellitus (T2DM) can adversely impact small and large vessels, eventually leading to microvascular and macrovascular complications. Failure of therapeutic lifestyle changes, monotherapy, and clinical inertia contribute to persistent hyperglycemia and disease progression. The aim was to review the complex pathophysiology of type 2 diabetes and how different oral agents can be used effectively as first-line therapy in combination with metformin, as well as in patients not achieving glycemic goals with metformin therapy...
December 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
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