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https://www.readbyqxmd.com/read/29909238/autophagy-as-an-emerging-target-in-cardiorenal-metabolic-disease-from-pathophysiology-to-management
#1
REVIEW
Yingmei Zhang, Adam T Whaley-Connell, James R Sowers, Jun Ren
Although advances in medical technology and health care have improved the early diagnosis and management for cardiorenal metabolic disorders, the prevalence of obesity, insulin resistance, diabetes, hypertension, dyslipidemia, and kidney disease remains high. Findings from numerous population-based studies, clinical trials, and experimental evidence have consolidated a number of theories for the pathogenesis of cardiorenal metabolic anomalies including resistance to the metabolic action of insulin, abnormal glucose and lipid metabolism, oxidative and nitrosative stress, endoplasmic reticulum (ER) stress, apoptosis, mitochondrial damage, and inflammation...
June 15, 2018: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29907172/-nursing-care-of-a-patient-admitted-to-a-hyperbaric-chamber-for-a-chronic-wound
#2
Stéphanie Chevallier, Simon Le Nabat, Arnaud Druelle, Hugues Lefort, Jean-Éric Blatteau
The hyperbaric chamber is a particularly relevant therapy for the healing of chronic wounds such as radiation-induced wounds, ulcers, diabetic foot or osteomyelitis. This article describes the pathway of a patient with a chronic wound from the perspective of a hyperbaric medicine nurse.
June 2018: Revue de L'infirmière
https://www.readbyqxmd.com/read/29898968/association-between-diabetes-and-subsequent-parkinson-disease-a-record-linkage-cohort-study
#3
Eduardo De Pablo-Fernandez, Raph Goldacre, Julia Pakpoor, Alastair J Noyce, Thomas T Warner
OBJECTIVE: To investigate the association between type 2 diabetes mellitus (T2DM) and subsequent Parkinson disease (PD). METHODS: Linked English national Hospital Episode Statistics and mortality data (1999-2011) were used to conduct a retrospective cohort study. A cohort of individuals admitted for hospital care with a coded diagnosis of T2DM was constructed, and compared to a reference cohort. Subsequent PD risk was estimated using Cox regression models. Individuals with a coded diagnosis of cerebrovascular disease, vascular parkinsonism, drug-induced parkinsonism, and normal pressure hydrocephalus were excluded from the analysis...
June 13, 2018: Neurology
https://www.readbyqxmd.com/read/29871814/potential-of-memory-t-cells-in-bridging-preoperative-chemoradiation-and-immunotherapy-in-rectal-cancer
#4
REVIEW
Sven de Mey, Heng Jiang, Hui Wang, Benedikt Engels, Thierry Gevaert, Inès Dufait, Olivier Feron, Joeri Aerts, Valeri Verovski, Mark De Ridder
The management of locally advanced rectal cancer has passed a long way of developments, where total mesorectal excision and preoperative radiotherapy are crucial to secure clinical outcome. These and other aspects of multidisciplinary strategies are in-depth summarized in the literature, while our mini-review pursues a different goal. From an ethical and medical standpoint, we witness a delayed implementation of novel therapies given the cost/time consuming process of organizing randomized trials that would bridge an already excellent local control in cT3-4 node-positive disease with long-term survival...
June 2, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29844947/surgical-technical-evidence-review-of-hip-fracture-surgery-conducted-for-the-ahrq-safety-program-for-improving-surgical-care-and-recovery
#5
REVIEW
Anaar Siletz, Christopher P Childers, Claire Faltermeier, Emily S Singer, Q Lina Hu, Clifford Y Ko, Stephen L Kates, Melinda Maggard-Gibbons, Elizabeth Wick
Background: Enhanced recovery pathways (ERPs) have been shown to improve patient outcomes in a variety of contexts. This review summarizes the evidence and defines a protocol for perioperative care of patients with hip fracture and was conducted for the Agency for Healthcare Research and Quality safety program for improving surgical care and recovery. Study Design: Perioperative care was divided into components or "bins." For each bin, a semisystematic review of the literature was conducted using MEDLINE with priority given to systematic reviews, meta-analyses, and randomized controlled trials...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29808091/risk-of-microvascular-complications-and-macrovascular-risk-factors-in-early-onset-type-1-diabetes-after-at-least-10-years-duration-an-analysis-of-three-population-based-cross-sectional-surveys-in-germany-between-2009-and-2016
#6
Thaddäus Tönnies, Anna Stahl-Pehe, Christina Baechle, Katty Castillo, Oliver Kuss, Rhuphine Yossa, Lena M E Lindner, Reinhard W Holl, Joachim Rosenbauer
Aims: To estimate the risk of microvascular complications and macrovascular risk factors among persons with early-onset (diagnosed at ages 0 to <5 years) and long-duration type 1 diabetes and determine temporal trends and associations with potential predictors. Methods: We conducted three population-based cross-sectional surveys in Germany ( N = 1789) to obtain information on exposures and five outcomes (retinopathy, nephropathy, dyslipidemia, hypertension, and a composite endpoint combining all four outcomes)...
2018: International Journal of Endocrinology
https://www.readbyqxmd.com/read/29806747/for-debate-personalized-health-care-as-exemplified-by-home-sodium-measurements-in-a-child-with-central-diabetes-insipidus-and-impaired-thirst-perception
#7
EDITORIAL
A A A van der Linde, A E van Herwaarden, J D Oosting, H L Claahsen-van der Grinten, E P L M de Grouw
BACKGROUND: We describe a 6-year old boy with central diabetes insipidus (CDI) caused by destruction of the pituitary gland due to treatment of an optical pathway glioma. He has been treated with chemotherapy and has had several debulking operations over the past years and consequently developed central hypocortisolism, hypothyroidism and CDI. The treatment of CDI was gravely complicated by an impaired thirst perception and compulsive drinking behavior. He was frequently seen at the ER or admitted due to dysregulation of fluid balance...
April 2018: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/29772673/reducing-amputations-in-people-with-diabetes-rapid-evaluation-of-a-new-care-pathway
#8
Sandra MacRury, Kate Stephen, Fiona Main, Jane Gorman, Sandra Jones, David Macfarlane
People with diabetes are at increased risk of foot ulcers, which, if left untreated, can lead to infection, gangrene, and subsequent amputation. Management by a multidisciplinary diabetes foot team has been shown to reduce amputation rates; however, accessing specialist treatment is made particularly difficult when living in remote and rural locations, such as many individuals cared for within NHS Highland. The RAPID project was made up of two phases: firstly, to evaluate the technical feasibility of a new integrated care pathway using innovative technology, and secondly, to establish process enhancement of the pathway to justify a larger-scale study...
May 16, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29766565/a-retrospective-observational-study-of-people-with-type-1-diabetes-with-self-reported-severe-hypoglycaemia-reveals-high-level-of-ambulance-attendance-but-low-levels-of-therapy-change-and-specialist-intervention
#9
B C T Field, R Nayar, A Kilvert, M Baxter, J Hickey, M Cummings, S C Bain
AIM: To evaluate the impact of severe hypoglycaemia on NHS resources and overall glycaemic control in adults with Type 1 diabetes. METHODS: An observational, retrospective study of adults (aged ≥ 18 years) with Type 1 diabetes reporting one or more episodes of severe hypoglycaemia during the preceding 24 months in 10 NHS hospital diabetes centres in England and Wales. The primary outcome was healthcare resource utilization associated with severe hypoglycaemia...
May 15, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29696678/barriers-to-foot-care-in-patients-with-diabetes-as-identified-by-healthcare-professionals
#10
C J W Pankhurst, M E Edmonds
AIMS: To seek the views of healthcare professionals as to the barriers to foot care that they perceive as having an impact on clinical outcomes and contributing to the number of amputations. METHODS: The study involved healthcare professionals from the UK attending our 2015 and 2016 Masterclass diabetic foot conferences. Admission to these conferences was open to all members of the multidisciplinary spectrum who provide care of people with diabetes and foot problems...
April 26, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29671082/sex-differences-in-the-burden-and-complications-of-diabetes
#11
REVIEW
Sanne A E Peters, Mark Woodward
PURPOSE OF THE REVIEW: To review the latest evidence on sex differences in the burden and complications of diabetes and discuss the potential explanations for the sex differences described. RECENT FINDINGS: Diabetes is a strong risk factor for vascular disease, with compelling evidence that the relative risks of vascular diseases conferred by diabetes are considerably greater in women than men. The mechanisms underpinning women's excess relative risk of vascular disease from diabetes are unknown...
April 18, 2018: Current Diabetes Reports
https://www.readbyqxmd.com/read/29617999/the-association-between-diabetes-and-depressive-symptoms-varies-by-quality-of-diabetes-care-across-europe
#12
Eva A Graham, Katie H Thomson, Clare L Bambra
Background: Depressive symptoms are more common in adults with diabetes and may arise from the physical and psychosocial burden of disease. Better quality of diabetes care may be associated with a reduced disease burden and fewer depressive symptoms. Methods: This cross-sectional study included 34 420 participants from 19 countries in the European Social Survey Round 7 (2014-2015). Countries were grouped into quartiles based on their quality of diabetes care as measured in the Euro Diabetes Index 2014...
April 3, 2018: European Journal of Public Health
https://www.readbyqxmd.com/read/29602992/updated-panel-report-best-practices-for-the-surgical-treatment-of-obesity
#13
Dana A Telem, Daniel B Jones, Philip R Schauer, Stacy A Brethauer, Raul J Rosenthal, David Provost, Stephanie B Jones
BACKGROUND: During the 2004 annual meeting of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), a panel of experts convened to provide updated information on best practices in bariatric surgery. The rapid evolution of endoluminal technologies, surgical indications, and training in bariatric surgery since 2004 has led to new questions and concerns about optimal treatment algorithms, patient selection, and the preparation of our current and future bariatric workforce...
March 30, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29584734/comorbidity-health-pathways-in-heart-failure-patients-a-sequences-of-regressions-analysis-using-cross-sectional-data-from-10-575-patients-in-the-swedish-heart-failure-registry
#14
Claire A Lawson, Ivonne Solis-Trapala, Ulf Dahlstrom, Mamas Mamas, Tiny Jaarsma, Umesh T Kadam, Anna Stromberg
BACKGROUND: Optimally treated heart failure (HF) patients often have persisting symptoms and poor health-related quality of life. Comorbidities are common, but little is known about their impact on these factors, and guideline-driven HF care remains focused on cardiovascular status. The following hypotheses were tested: (i) comorbidities are associated with more severe symptoms and functional limitations and subsequently worse patient-rated health in HF, and (ii) these patterns of association differ among selected comorbidities...
March 2018: PLoS Medicine
https://www.readbyqxmd.com/read/29575134/glucose-alert-system-improves-health-professional-responses-to-adverse-glycaemia-and-reduces-the-number-of-hyperglycaemic-episodes-in-non-critical-care-inpatients
#15
M Kyi, P R Wraight, L M Rowan, K A Marley, P G Colman, S Fourlanos
AIM: To investigate the effect of a novel glucose alert system, comprising the Melbourne Glucose Alert Pathway and glucose-alert-capable networked blood glucose meters, on nursing and hospital medical officer responses to adverse glycaemia. METHODS: A prospective, pre- and post-observational study was undertaken in non-critical care wards of a tertiary hospital over 4 months (n=148 or 660 patient-days). The intervention consisted of two components designed to promote a consistent staff response to blood glucose measurements: (1) a clinical escalation pathway, the Melbourne Glucose Alert Pathway, and (2) networked blood glucose meters, which provide a visual alert for out-of-range blood glucose measurement...
June 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29573523/presenting-predictors-and-temporal-trends-of-treatment-related-outcomes-in-diabetic-ketoacidosis
#16
Christopher M Horvat, Heba M Ismail, Alicia K Au, Luigi Garibaldi, Nalyn Siripong, Sajel Kantawala, Rajesh K Aneja, Diane S Hupp, Patrick M Kochanek, Robert Sb Clark
OBJECTIVE: This study examines temporal trends in treatment-related outcomes surrounding a diabetic ketoacidosis (DKA) performance improvement intervention consisting of mandated intensive care unit admission and implementation of a standardized management pathway, and identifies physical and biochemical characteristics associated with outcomes in this population. METHODS: A retrospective cohort of 1225 children with DKA were identified in the electronic health record by international classification of diseases codes and a minimum pH less than 7...
March 24, 2018: Pediatric Diabetes
https://www.readbyqxmd.com/read/29559450/current-challenges-and-opportunities-in-the-prevention-and-management-of-diabetic-foot-ulcers
#17
William J Jeffcoate, Loretta Vileikyte, Edward J Boyko, David G Armstrong, Andrew J M Boulton
Diabetic foot ulcers remain a major health care problem. They are common, result in considerable suffering, frequently recur, and are associated with high mortality, as well as considerable health care costs. While national and international guidance exists, the evidence base for much of routine clinical care is thin. It follows that many aspects of the structure and delivery of care are susceptible to the beliefs and opinion of individuals. It is probable that this contributes to the geographic variation in outcome that has been documented in a number of countries...
April 2018: Diabetes Care
https://www.readbyqxmd.com/read/29559205/a-clinical-evaluation-of-placental-growth-factor-in-routine-practice-in-high-risk-women-presenting-with-suspected-pre-eclampsia-and-or-fetal-growth-restriction
#18
L Ormesher, E D Johnstone, E Shawkat, A Dempsey, C Chmiel, E Ingram, L E Higgins, J E Myers
OBJECTIVE: To evaluate the use of plasma Placental Growth Factor (PlGF), recommended by the recent NICE guidance, in women with suspected pre-eclampsia (PE) and/or fetal growth restriction (FGR). STUDY DESIGN: Non-randomised prospective clinical evaluation study in high-risk antenatal clinics in a tertiary maternity unit. METHODS: PlGF testing was performed in addition to routine clinical assessment in 260 women >20 weeks' gestation with chronic disease (hypertension, renal disease ± diabetes) with a change in maternal condition or in women with suspected FGR to determine the impact on clinical management...
March 13, 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29522974/genetics-of-hba1c-a-case-study-in-clinical-translation
#19
REVIEW
Aaron Leong, Eleanor Wheeler
Glycated hemoglobin (HbA1c) measures the amount of glucose in the blood in the previous 2-3 months and is used to test whether an individual has diabetes (HbA1c≥6.5%), or how well they are managing their diabetes. Genome-wide association studies have successfully identified multiple genomic loci influencing HbA1c, through both glycemic (factors that affect the amount blood glucose levels) and erythrocytic (factors that affect the red blood cell) pathways. Inaccuracies in HbA1c, due to non-glycemic variants, could lead to suboptimal care or adverse health consequences...
March 6, 2018: Current Opinion in Genetics & Development
https://www.readbyqxmd.com/read/29518765/from-treating-childhood-malnutrition-to-public-health-nutrition
#20
W Philip T James
BACKGROUND: This analysis sets out an overview of an IUNS presentation of a European clinician's assessment of the challenges of coping with immediate critical clinical problems and how to use metabolic and a mechanistic understanding of disease when developing nutritional policies. SUMMARY: Critically ill malnourished children prove very sensitive to both mineral and general nutritional overload, but after careful metabolic control they can cope with a high-quality, energy-rich diet provided their initial lactase deficiency and intestinal atrophy are taken into account...
2018: Annals of Nutrition & Metabolism
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