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microvascular complications

Fukashi Ishibashi, Mitra Tavakoli
Aims: Hyperglycemia is associated with an increased risk of microvascular complications in patients with type 2 diabetes. The aim of the present study was to investigate whether the reduction of the levels of HbA1c by tight glycemic control (GC) decreases the rate of microvascular complications and improves the neurological measures in patients with type 2 diabetes. Methods: Detailed clinical and neurological examinations including corneal confocal microscopy (CCM) were performed in 141 Japanese patients with type 2 diabetes and 60 age-matched control subjects at baseline and follow-up with GC for 4 years...
2018: Frontiers in Endocrinology
Piotr Chudzik, Somshubra Majumdar, Francesco Calivá, Bashir Al-Diri, Andrew Hunter
BACKROUND AND OBJECTIVES: Diabetic retinopathy is a microvascular complication of diabetes that can lead to sight loss if treated not early enough. Microaneurysms are the earliest clinical signs of diabetic retinopathy. This paper presents an automatic method for detecting microaneurysms in fundus photographies. METHODS: A novel patch-based fully convolutional neural network with batch normalization layers and Dice loss function is proposed. Compared to other methods that require up to five processing stages, it requires only three...
May 2018: Computer Methods and Programs in Biomedicine
Erika Gucciardo, Sirpa Loukovaara, Ani Korhonen, Pauliina Repo, Beatriz Martins, Helena Vihinen, Eija Jokitalo, Kaisa Lehti
Proliferative diabetic retinopathy (PDR) is a major diabetic microvascular complication characterized by pathological angiogenesis. Several retinopathy animal models have been developed to study the disease mechanisms and putative targets. However, knowledge on the human proliferative disease remains incomplete, relying on steady-state results from thin histological neovascular tissue sections and vitreous samples. New translational models are thus required to comprehensively understand the disease pathophysiology and develop improved therapeutic interventions...
March 13, 2018: Journal of Pathology
Masaki Kobayashi, Douglas W Zochodne
Diabetic polyneuropathy (DPN) continues to be generally considered as a "microvascular" complication of diabetes mellitus alongside nephropathy and retinopathy. The microvascular hypothesis, however, may be tempered by the concept that diabetes directly targets dorsal root ganglion sensory neurons. This neuron specific concept, supported by accumulating evidence, might account for important features of DPN, such as its early sensory neuron degeneration. Diabetic sensory neurons develop neuronal atrophy alongside a series of mRNA changes related to declines in structural proteins, increases in heat shock protein (HSP), increases in the receptor for advanced glycation endproducts (RAGE), declines in growth factor signaling and other changes...
March 13, 2018: Journal of Diabetes Investigation
Esteban Gonzalez Ballerga, Mario Omar Pozo, Paolo Nahuel Rubatto Birri, Vanina Siham Kanoore Edul, Juan Antonio Sorda, Jorge Daruich, Arnaldo Dubin
OBJECTIVE: To assess sublingual microcirculation in cirrhotic patients and its relationship to spider angiomas, complications, and outcome. METHODS: Thirty-one cirrhotic patients were prospectively compared to 31 matched controls. Sublingual microcirculation was evaluated by videomicroscopy. We specifically looked for capillaries with increased red blood cell velocity, which was defined as a velocity higher than the percentile 100th of controls. RESULTS: Compared to controls, cirrhotic patients showed decreased total and perfused vascular density (14...
March 12, 2018: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
Francesco Saverio Sorrentino, Silvia Matteini, Claudio Bonifazzi, Adolfo Sebastiani, Francesco Parmeggiani
In the face of the global epidemic of diabetes, it is critical that we update our knowledge about the pathogenesis of diabetes and the related micro alterations on the vascular network in the body. This may ultimately lead to early diagnosis and novel treatment options for delaying the progression of diabetic complications. Research has recently revealed the pivotal role of endothelin in the pathogenesis of diabetic complications, particularly in the regulation of the capillary flow, which is affected in the course of retinopathy...
March 9, 2018: Eye
Kyriakos Ioannou
Diabetic nephropathy is defined as a microvascular complication of the kidneys induced by diabetes mellitus and is characterized by albuminuria and progressive loss of kidney function. However, neither albuminuria nor glomerular filtration rate decline are diabetic nephropathy-specific markers, thus the diagnosis of diabetic nephropathy greatly depends on assumptions. Several factors should be taken into account when urinary albumin levels are assessed before establishing the diagnosis of diabetic nephropathy, while newer more specific markers for diabetic nephropathy are urgently needed...
October 2017: Hormones: International Journal of Endocrinology and Metabolism
Matej Završnik, Jernej Letonja, Jana Makuc, Maja Šeruga, Ines Cilenšek, Daniel Petrovič
Diabetic nephropathy (DN) is a microvascular complication that affects up to 40% of diabetic patients and can lead to end-stage kidney disease. Inflammatory cytokines such as interleukin 1 (IL-1), IL-6, IL-18 and tumor necrosis factor-α have been linked to the development and progression of DN. The aim of our study was to examine the relationship between rs2243250 polymorphism of the interleukin 4 gene (IL4) and DN in patients with type 2 diabetes mellitus (T2DM). This study is a continuation of our previous research on the association between angiotensinogen (AGT) gene polymorphisms and DN in patients with T2DM...
March 7, 2018: Bosnian Journal of Basic Medical Sciences
Jing Han, Yue Li, Xiuli Liu, Tongrong Zhou, Haijing Sun, Paul Edwards, Hua Gao, Fu-Shin Yu, Xiaoxi Qiao
The oral anti-diabetic drug metformin has been found to reduce cardiovascular complications independent of glycemic control in diabetic patients. However, its role in diabetic retinal microvascular complications is not clear. This study is to investigate the effects of metformin on retinal vascular endothelium and its possible mechanisms, regarding two major pathogenic features of diabetic retinopathy: angiogenesis and inflammation. In human retinal vascular endothelial cell culture, metformin inhibited various steps of angiogenesis including endothelial cell proliferation, migration, and tube formation in a dose-dependent manner...
2018: PloS One
Min Wu, Xianming Fu, Ying Ji, Wanhai Ding, Dali Deng, Yehan Wang, Xiaofeng Jiang, Chaoshi Niu
BACKGROUND: Microvascular decompression (MVD) of the trigeminal nerve is the most effective treatment for trigeminal neuralgia (TN). However, when encountering with classical trigeminal neuralgia caused by venous compression, the procedure becomes much more difficult, and failure or recurrence due to incomplete decompression may become frequent. This study aimed to investigate the anatomical variation of the culprit veins, and discuss the surgical strategy for different types respectively...
March 3, 2018: World Neurosurgery
Kotb Abbass Metwalley, Sherifa Ahmed Hamed, Hekma Saad Farghaly
Cardiovascular autonomic neuropathy (CAN) is a major complication of type 1 diabetes (T1D). This study aimed to evaluate cardiac autonomic nervous system (ANS) function in children with T1D and its relation to different demographic, clinical and laboratory variable. This cross-sectional study included 60 children with T1D (mean age = 15.1 ± 3.3 years; duration of diabetes = 7.95 ± 3.83 years). The following 8 non-invasive autonomic testing were used for evaluation: heart rate at rest and in response to active standing (30:15 ratio), deep breathing and Valsalva maneuver (indicating parasympathetic function); blood pressure response to standing (orthostatic hypotension or OH), sustained handgrip and cold; and heart rate response to standing or positional orthostatic tachycardia syndrome or POTs (indicating sympathetic function)...
March 2, 2018: European Journal of Pediatrics
Pedro Castro, Elsa Azevedo, Isabel Rocha, Farzaneh Sorond, Jorge M Serrador
BACKGROUND: Chronic kidney disease increases stroke incidence and severity but the mechanisms behind this cerebro-renal interaction are mostly unexplored. Since both vascular beds share similar features, microvascular dysfunction could be the possible missing link. Therefore, we examined the relationship between renal function and cerebral autoregulation in the early hours post ischemia and its impact on outcome. METHODS: We enrolled 46 ischemic strokes (middle cerebral artery)...
March 2, 2018: BMC Neurology
David Karásek, Helena Vaverková
Diabetic dyslipidemia is one of the main risk factors for atherosclerosis. Although its participation in diabetic microvascular complications is not that dominant, dyslipidemia may play an important role in formation and progression of these complications. Pathophysiological mechanisms by which diabetic dyslipidemia affects the etiopathogenesis of diabetic nephropathy, retinopathy, neuropathy and diabetic foot are presented. The data from clinical studies and treatment possibilities for particular microvascular complications using lipid-lowering therapy are discussed...
2018: Vnitr̆ní Lékar̆ství
Craig A Bollig, Claire S Spradling, Laura M Dooley, Tabitha L Galloway, Jeffrey B Jorgensen
BACKGROUND: The effects of perioperative hyperglycemia on complications and outcomes in microvascular reconstruction have not been reported in the literature. METHODS: A retrospective cohort of 203 patients undergoing microvascular reconstruction was generated. Perioperative glucose levels and clinical factors were tested for associations with complications using simple and multivariate analyses. RESULTS: Hyperglycemia (blood glucose ≥ 180 mg/dL) occurred in 91 patients (44...
March 1, 2018: Head & Neck
XingMei Liu, YingYing Zhang, MingJun Shi, YuanYuan Wang, Fan Zhang, Rui Yan, LingLing Liu, Ying Xiao, Bing Guo
Diabetic nephropathy (DN) is a serious clinical microvascular complication of diabetes mellitus. DN is characterized by the accumulation of extracellular matrix, resulting in progressive fibrosis leading to the loss of renal function. Notch1 and phosphatase and tensin homolog deleted on chromosome ten (PTEN) signaling have been associated with fibrosis. Autophagy serves as an essential regulator of tubular cellular homeostasis. However, how these molecules control the balance between fibrosis and autophagy, the main homeostatic mechanism regulating fibrosis, is not well understood...
February 26, 2018: Biochemical and Biophysical Research Communications
Saeed Mehrzadi, Manijeh Motevalian, Mozhgan Rezaei Kanavi, Iman Fatemi, Habib Ghaznavi, Mansoor Shahriari
Diabetic retinopathy (DR) is one of the most common and serious microvascular complications of diabetes. The aim of the present study was to evaluate the effects of melatonin (MEL) on retinal injury in diabetic rats. In this study, 21 rats were randomly divided into three groups: control, diabetic, diabetic + MEL. Streptozotocin (STZ) was used to induce diabetes at a dose of 50 mg/kg, i.p. and blood glucose was measured to choose the diabetic rats for the study. MEL (20 mg/kg) was given orally for 7 weeks in diabetic rats starting one week after induction of diabetes...
March 1, 2018: Fundamental & Clinical Pharmacology
Francesco Pichi, K Bailey Freund, Antonio Ciardella, Mariachiara Morara, Emad B Abboud, Nicola Ghazi, Christine Dackiw, Netan Choudhry, Eduardo Cunha Souza, Leonardo Provetti Cunha, J Fernando Arevalo, T Y Alvin Liu, Adam Wenick, Lingmin He, Guadalupe Villarreal, Piergiorgio Neri, David Sarraf
Importance: Congenital retinal macrovessel (CRM) is a rarely reported venous malformation of the retina that is associated with venous anomalies of the brain. Objective: To study the multimodal imaging findings of a series of eyes with congenital retinal macrovessel and describe the systemic associations. Design, Setting, and Participants: In this cross-sectional multicenter study, medical records were retrospectively reviewed from 7 different retina clinics worldwide over a 10-year period (2007-2017)...
March 1, 2018: JAMA Ophthalmology
Evan M Graboyes, Travis P Schrank, Mitchell L Worley, Suhael R Momin, Terry A Day, Andrew T Huang
BACKGROUND: Characteristics of 30-day unplanned readmissions after head and neck microvascular reconstruction remain poorly understood. METHODS: We conducted a retrospective cohort of patients who underwent head and neck microvascular reconstruction between 2010 and 2015. RESULTS: The 30-day unplanned readmission rate was 13.0% (64/493). The most common readmission diagnoses were dehiscence, surgical site infection, or fistula (45.3%; n = 29)...
March 1, 2018: Head & Neck
Eoin P Brennan, Muthukumar Mohan, Aaron McClelland, Christos Tikellis, Mark Ziemann, Antony Kaspi, Stephen P Gray, Raelene Pickering, Sih Min Tan, Syed Tasadaque Ali-Shah, Patrick J Guiry, Assam El-Osta, Karin Jandeleit-Dahm, Mark E Cooper, Catherine Godson, Phillip Kantharidis
Background The failure of spontaneous resolution underlies chronic inflammatory conditions, including microvascular complications of diabetes such as diabetic kidney disease. The identification of endogenously generated molecules that promote the physiologic resolution of inflammation suggests that these bioactions may have therapeutic potential in the context of chronic inflammation. Lipoxins (LXs) are lipid mediators that promote the resolution of inflammation. Methods We investigated the potential of LXA4 and a synthetic LX analog (Benzo-LXA4 ) as therapeutics in a murine model of diabetic kidney disease, ApoE-/- mice treated with streptozotocin...
February 28, 2018: Journal of the American Society of Nephrology: JASN
Wensheng Liu, Kaizhong Liu, Shu Zhang, Lihong Shan, Jiangfeng Tang
BACKGROUND Acute lung injury (ALI) is a life-threatening complication of sepsis. Tetramethylpyrazine (TMP) has been used in the clinical treatment of vascular diseases. The aim of this study was to investigate the therapeutic effects and possible involved mechanisms on ALI. MATERIAL AND METHODS Cecal ligation and puncture (CLP) was used to establish a sepsis model in rats. TMP at various dosages were administrated to rats using a intragastric method. Animal survival rate was calculated. The lung functions were evaluated by lung weight/dry weight ratio (W/D), PaO2, dynamic compliance (DC), and airway resistance index (ARI)...
February 28, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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