1,721,189 research outputs found
Hyperprolactinemias
No full textProlactin is a protein hormone secreated from the anterior pituitary that is under the supressive effect of a hypothalamic prolactin inhibitor factor, dopamin. Hyperprolactinemia in which prolactin level is detected above 20 ng/ml in adults may be due to physiologic, pharmacologic or pathologic causes. The most frequent pathologic cause of symptomatic hyperprolactinemia is prolactinoma. The differential diagnosis of the etiologic factors is important in both the treatment and follow-up of hyperprolactinemic cases admitted with the clinical symptoms and signs of hypogonadism
Hyperprolactinemias
No full textProlactin is a protein hormone secreated from the anterior pituitary that is under the supressive effect of a hypothalamic prolactin inhibitor factor, dopamin. Hyperprolactinemia in which prolactin level is detected above 20 ng/ml in adults may be due to physiologic, pharmacologic or pathologic causes. The most frequent pathologic cause of symptomatic hyperprolactinemia is prolactinoma. The differential diagnosis of the etiologic factors is important in both the treatment and follow-up of hyperprolactinemic cases admitted with the clinical symptoms and signs of hypogonadism
Diabetes mellitus and the gastrointestinal system
No full textDiabetes mellitus is an important health care problem worldwide, with an increasing number of patients. According to International Diabetes Federation 2021 data, approximately 537 million adults have diabetes worldwide, and the number is projected to rise significantly every decade. Diabetes mellitus can lead to chronic complications affecting different organ systems. Chronic microvascular and macrovascular complications may occur in the same patient, influencing each other's progression and the patient's life, causing morbidities and mortality. Diabetes mellitus and the gastrointestinal tract can impact each other through different mechanisms. The gut microbiota may play an essential role in the emergence of metabolic syndrome, type 2 diabetes, and chronic diabetes-related complications. Although diabetes is primarily a disease of the endocrine pancreas, it has some detrimental effects on the exocrine pancreas and digestive enzymes. Infections, functional and organic dysfunctions due to poorly controlled diabetes, coexistences of some autoimmune gastrointestinal disorders, and tumors are the other main topics to be concerned about in the gastrointestinal complications of diabetes mellitus. Besides, antidiabetic medications used in treating diabetes mellitus can also have some unfavorable effects on the gastrointestinal system. Diabetic gastroenteropathy or gastroparesis is a common complication in prolonged diabetic patients with poor glycemic control that can markedly impair the quality of life. The gastroenterological complaints in diabetes mellitus include abdominal pain, nausea, flatulence, vomiting, heartburn, constipation, diarrhea, and fecal incontinence. The type and the duration of diabetes, the success of the metabolic control, antidiabetic agents used, and accompanying diseases can affect the extent of the gastrointestinal system involvement in diabetic patients. This chapter will discuss the effect of diabetes mellitus and its treatment on the gastrointestinal system
Evaluating a physicians' perspective on the use of probiotics and vitamins against coronavirus disease
No full textObjective: To evaluate the perspective of family physicians on probiotics and vitamins against coronavirus disease-2019.Methods: The cross-sectional study was conducted from June 1 to 30, 2021, after approval from the ethics review committee of Bursa Uludag University, Bursa, Turkey, and comprised family physicians of either gender working at family health centres in the country. Data was collected using an online questionnaire to measure the sociodemographic characteristics, habits, health status related to coronavirus disease-2019, and their knowledge, awareness and behaviour towards the use of probiotics and vitamins during the pandemic. Data was analysed using SPSS 25.Results: Of the 218 family physicians, 130(59.6%) were male and 88(40.4%) were female. The overall mean age was 46.82 +/- 5.85 years, mean professional experience was 22.32 +/- 8.75 years, and mean experience in family medicine was 10.14 +/- 3.51 years. The knowledge and awareness level about coronavirus disease-2019 was high 4.18 +/- 0.58, exposure to the disease 3.36 +/- 0.83 and their inclination towards the use of vitamins and probiotics 1.68 +/- 0.75 was low. Among the participants, 90(41.3%) used probiotic products and 120(55%) used drugs, such as vitamins and minerals. Vitamin C 99(45.4%) was the most commonly used supplement.Conclusion: Physicians' knowledge and awareness and a realistic scientific approach are important when recommending supplements, such as probiotics, vitamins and minerals, to individuals during the pandemic
Weight gain in kidney transplant recipients: Risks, cardiovascular outcome and management
No full textKidney transplantation (KT), which is by far the most frequently carried out transplantation globally, is generally accepted as the best treatment both for quality of life and cost effectiveness in end stage renal disease patients although other renal replacement therapies are present. In spite of considerable progress in immunosuppressive and supportive treatments, a number of factors still interfere with the complete success of KT. Cardiovascular (CV) disease is the leading cause of death in renal transplant recipients (RTR). They are at an increased CV risk because of advanced age and adverse effects such as weight gain, hypertension, glucose intolerance, diabetes and dyslipidemia. The determinants that lead to atherosclerosis in RTRs are similar to those in the general population. Excessive weight gain that leads to obesity is quite common after KT. This is often attributed to corticosteroids and other immunosuppressive drugs. Average weight gain in 1year posttransplant period have been reported to be 8-14 kgs. Risk factors for weight gain are feeling of well-being, unrestricted diet, increased appetite, ethnicity, age at the time of transplant, sex, pre-existing obesity, dialysis modality, socioeconomic status and donor type. Obesity has long been associated with an increased risk for coronary heart disease. The risk is compounded by the common coexistence of other risk factors associated with obesity. It is uncertain how much of the risk is due to obesity alone. Furthermore, the mechanisms by which obesity, particularly abdominal obesity, cause or accelerate coronary atherogenesis are also uncertain. Abdominal fat is a strong predictor of mortality after adjustment for total-body fat, and waist circumference correlates highly with abdominal fat. Body mass index (BMI) apart, anthropometric measures of abdominal obesity and body fat distribution like waist circumference and waist/hip ratio appear directly, rather than inversely, associated with all-cause and CV mortality in the general population. In a recent study of RTRs, waist-to-hip ratio but not BMI correlated with CV risk factors, suggesting that central adiposity has a major role in determining CV risk. This shows the importance of identifying ideal measures of adiposity in the evaluation of RTRs because most centers rely solely on BMI. Using only BMI as a cut off value for transplant might not be ideal. In the general population, obesity is widely recognized as a major risk factor for the development of kidney disease. Glomerular hyperfiltration and hypertrophy have long been proposed as possible pathogenic mechanisms in obesity related kidney disease. Many important risk factors for chronic allograft nephropathy, shortened graft function and lower recipient life expectancy have a higher incidence in obese patients, including hypertension, dyslipidemia and type 2 diabetes, although there are conflicting reports in the literature. In addition, posttransplant complications, especially new-onset transplant diabetes mellitus, wound complications and weight gain, are more common in obese RTRs (BMI ≥35kg/m2) in early period. The management of obesity is an important factor necessary to ensure long-term patient and graft survival. Nutritional counseling and exercise should be available immediately after KT for all RTRs. In this article, we review the impact of increased BMI on patient and graft survival, risk factors for the development of post-transplant obesity and available intervention options. © 2012 by Nova Science Publishers, Inc. All rights reserved
The evaluation of the role of bmi and insulin resistance on inflammatory markers, PAL-1 levels and arterial stiffness in newly diagnosed type 2 diabetes mellitus patients
No full textBACKGROUND: Increased cardiovascular risk, represented by endothelial inflammation, probably starts with the very first course of type-2 diabetes (T2DM). Almost 85.2% of all T2DM patients are overweight or obese. Thrombosis accounts 80% of all deaths in patients with diabetes. The thrombotic-fibrinolytic equilibrium shifts in favor of thrombosis by plasminogen activator inhibitor-1 (PAI-1). PAI-1 secretion is induced primarily by CRP. PAI-1 overexpression predisposes unstable plaque development. The contribution of obesity and diabetes to this process is not clearly understood. In this study, we aimed to investigate comparison of inflammatory markers, PAI-1 levels and arterial stiffness according to BMI and impaired glucose metabolism in patient with newly diagnosed T2DM.METHODS: Newly diagnosed 60 T2DM patients were enrolled. Demographics and measurements were noted. Liver (AST, ALT), kidney (urea, creatinine, albumin/creatinine ratio), metabolic (fasting blood glucose, post-prandial blood glucose, insulin, c-peptide, HbA1c, total cholesterol, low-density lipoprotein [LDL], high-density lipoprotein [HDL], triglyceride) parameters, inflammatory markers [hsCRP, fibrinogen]), PAI-1 levels and pulse wave velocity was measured from all participants. The results were compared.RESULTS: Inflammatory markers and PAI-1 levels were significantly elevated in obese group compared to overweight participants. The correlation analysis showed that waist and hip circumferences, high-sensitive CRP, fibrinogen and PAI-1 levels were positively correlated with BMI but not with HbA1c levels.CONCLUSIONS: The results of our study showed that lipid levels, glycemic and blood pressure values of the obese and overweight patients were similar. BMI affects inflammatory markers and PAI-1 levels independent of glucose regulation and insulin resistance in newly diagnosed T2DM. According to the current study BMI is found to be more prominent in terms of inflammatory markers and PAI-1 levels compared to insulin resistance and impaired glucose metabolism in newly diagnosed T2DM
Knowledge, attitude, and practice towards COVID-19: Research to develop a measuring instrument
No full textOBJECTIVE: To evaluate the knowledge, attitudes, and behaviors of individuals about COVID-19 and to develop a valid and reliable scale that can measure these items about COVID-19 and other similar pandemic processes. DESIGN: Methodological scale study with a quantitative approach. SITE: Carried out at the Uludağ University Family Health Center in Bursa, Turkey. PARTICIPANTS: 415 individuals in the first phase and 367 in the retest phase. INTERVENTIONS: Carried out between March 1, 2021, and April 30, 2021. MAIN MEASUREMENTS: Reliability and factor analyses were performed and validity was evaluated. In factor analysis, a scale with 4 factors and 30 questions was obtained. Confirmatory factor analysis (CFA) was applied to the factor scores of the scale. Factors were named A-General Culture, B-Mask, Distance and Cleanliness, C-Mental Status, and D-Way of Information. A 3-point Likert-type scoring system was created for the responses. RESULTS: Cronbach's alpha value was 0.894. In factor modeling, 3 of the confirmatory factor analysis fit indices were good and 4 of them were acceptable, so our model was found to be appropriate. The scale was highly reliable, according to internal and external consistency coefficients. The scale was named the Turkey COVID-19 Attitude Scale. p values < 0.05 were considered statistically significant. CONCLUSIONS: The valid and reliable Turkey COVID-19 Attitude Scale, which we developed to evaluate the knowledge, attitudes, and behaviors of individuals about COVID-19, can be used to guide research during COVID-19 and future pandemics
Anthropometric outcomes in type 2 diabetic patients with new dapagliflozin treatment; actual clinical experience data of six months retrospective glycemic control from single center
No full textIntroduction: Dapagliflozin is an antidiabetic drug that has been used as a member of the new antidiabetic drug group that acts by inhibiting SGLT-2 and increasing urinary glucose excretion. With numerous controlled experimental studies of dapagliflozin, evaluation of real-life data after entry into clinical practice is an important condition. In our study, the effects of dapagliflozin on glycemic control and anthropometric measurements were investigated retrospectively.Methods: A-total of thirty-one type 2 diabetics were enrolled in the study. Data of before dapagliflozin and three and six months of treatment were recorded.Results: Dapagliflozin reduced HbA1c levels by 0,9% at 3 months and 0,79% at 6 months. Fasting plasma glucose decreased 41,1 mg/dl in the 3rd and 42 mg/dl in the 6th, postprandiyal glucose decreased 86,3 mg/dl in the 3rd and 74,2 mg/dl in the 6th. In the 3rd and 6th, body weights decreased by 3,3 kg and 4,2 kg, BMI decreased by 1,3 kg/m(2) and 1,6 kg/m(2) respectively. Similarly, it was observed that the waist circumference decreased by 1,3 cmat the end of 6th.Conclusion: Our data show that SGLT-2 inhibitors provide glycemic control with reduce HbA1c levels by 0.8-0.9%, and reduce fasting and postprandial plasma glucose levels without increasing the risk of hypoglycemia and causing weight lose around 5% at the six mounths. SGLT-2 inhibitors were found to be more effective in reduce postprandiyal plasma glucose in patients who did not use insulin and fasting plasma glucose in patients with diabetes mellitus less than 10 years. (c) 2018 Published by Elsevier Ltd on behalf of Diabetes India
Efficacy and safety of three-times-daily versus twice-daily biphasic insulin aspart 30 in patients with type 2 diabetes mellitus inadequately controlled with basal insulin combined with oral antidiabetic drugs
No full textAims: To compare the efficacy and safety of biphasic insulin aspart 30 (BIAsp 30) administered three times daily (TID) vs. twice daily (BID), plus metformin, in patients with type 2 diabetes mellitus (T2DM) inadequately controlled on basal insulin +/- 1 oral antidiabetic drug (OAD).Methods: Randomised, multinational, open-label, treat-to-target trial. Subjects inadequately controlled (HbA1c 7.5-10.0%) on basal insulin and metformin +/- 1 OAD were randomised to BIAsp 30 TID (n = 220) or BIAsp 30 BID (n = 217). Primary endpoint was change from baseline in HbA1c after 24 weeks of treatment.Results: Most (400/437, 91.5%) subjects completed the trial. The majority (276/400 [69.0%]) were from the China region. After 24 weeks, HbA1c decreased comparably in both BIAsp 30 groups (-1.7% vs. -1.6% [-19 vs. -18 mmol/mol], for TID and BID dosing, respectively; estimated treatment difference: -0.09% [-0.23; 0.06] 95% CI, -1 mmol/mol [-3; 1], p = 0.26). Safety profiles, including number of subjects experiencing hypoglycaemia, were similar.Conclusions: BIAsp 30 administered either TID or BID with metformin was a safe and effective option when intensifying treatment after failure of basal insulin and OADs in patients with T2DM. Adding a third injection at lunchtime may be preferable if HbA1c remains above target, if the lunchtime meal is the largest meal of the day, or if persistent postprandial hyperglycaemia after lunch is observed.Novo Nordis
Re-training of type 2 diabetic patients for better adherence to diabetes care plan in oral anti-diabetics and plus insulin treatment groups
No full textPurpose: This prospective observational single-centre study was designed to evaluate the effect of patient re-training for better adherence to regular self-monitoring of blood glucose (SMBG), standard diabetic diet and exercise program in ambulatory patients with type 2 diabetes mellitus (T2DM) receiving oral anti-diabetic (OAD) and OAD plus insulin treatments.Material and Method: In this study, we enrolled a total of 61 patients with T2DM in whom ongoing therapy with OAD (n=34) and OAD+insulin (n=27) failed to achieve adequate glycemic control. The patients were educated for lifestyle behavior, adherence to diet and exercise therapy, close monitoring with SMBG without change in their ongoing drugs and dosing. Changes in glycemic parameters, serum lipids and anthropometrics at the end of 3rd month were compared between the treatment groups.Results: During the course of the study, a significant decrease in the body weight and fat were observed in OAD (p<0.001 and p=0.002) and OAD+insulin groups (p=0.044 and p=0.008, respectively). A significant decrease in the HbA1c % (6.1%; 8.2% to 7.6%) was observed in the overall population (p<0.001) as well as in OAD (p=0.011) and OAD+ insulin (p=0.001) groups. A significant decrease was noted in the post-prandial capillary blood glucose levels in only OAD+insulin group.Discussion: Re-training approach with close follow-up and frequent SMBG seems to be important factors for the maintenance of achieved glycemic control. In our study, the effect of diabetes education on postprandial capillary blood glucose levels was more pronounced in OAD+ insulin group
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