Search results for "65"
showing 10 items of 1111 documents
Size and subclasses of low-density lipoproteins in patients with obstructive sleep apnea.
2012
Patients with obstructive sleep apnea (OSA) have proatherogenic dyslipidemia. We analyzed predictors of low-density lipoproteins' (LDLs) size in patients with OSA. In a cross-sectional study including 58 participants with OSA (30 without the metabolic syndrome [MetS] and 28 with MetS), we evaluated the size of LDL by gradient gel electrophoresis. Compared with patients without the MetS, those with MetS showed lower LDL size ( P = .007), due to a reduction in large LDL-I particles ( P = .002) and an increase in small, dense LDL-IIIA ( P = .048) and LDL-IIIB ( P = .037). The size of LDL correlated inversely with age ( r = −.268, P = .042) and serum triglycerides ( r = −.364, P = .005), and p…
Dual-release hydrocortisone vs conventional glucocorticoids in adrenal insufficiency
2019
Background Dual-release hydrocortisone (DR-HC) improves metabolism in patients with adrenal insufficiency. The aims of this study were to compare the cardiovascular and metabolic effects of conventional glucocorticoids (GCs) vs. DR-HC and of high vs. low doses of GCs, after 48 months of observation. Methods We selected 27 patients on hydrocortisone (mean dose 17.5 ± 4.2 mg/day) and 20 patients on cortisone acetate (mean dose 37.5 ± 12.1 mg/day) who maintained this treatment (group A) and 53 patients switched to DR-HC (mean dose 22 ± 4.8 mg/day) (group B). At baseline and after 48 months, clinical and metabolic parameters and Framingham Risk Score (FRS) were obtained. Results After 48 month…
SGLT2 inhibitors in T2D and associated comorbidities - differentiating within the class
2019
Abstract Background For patients with type 2 diabetes (T2D), cardiovascular disease (CVD) is the single most common cause of mortality. In 2008 and 2012, the Federal Drug Administration (FDA) and the European Medicines Agency (EMA) respectively mandated cardiovascular outcomes trials (CVOTs) on all new anti-diabetic agents, as prospective trials statistically powered to rule out excess cardiovascular risk in patients with T2D. Unexpectedly, some of these CVOTs have demonstrated not only cardiovascular safety, but also cardioprotective effects, as was first shown for the SGLT2 inhibitor empagliflozin in EMPA-REG OUTCOME. Expert opinion To debate newly available CVOT data and to put them into…
Diabetes mellitus secondary to Cushing's disease
2018
Associated with important comorbidities that significantly reduce patients’ overall wellbeing and life expectancy, Cushing’s disease (CD) is the most common cause of endogenous hypercortisolism. Glucocorticoid excess can lead to diabetes, and although its prevalence is probably underestimated, up to 50% of patients with CD have varying degrees of altered glucose metabolism. Fasting glycemia may nevertheless be normal in some patients in whom glucocorticoid excess leads primarily to higher postprandial glucose levels. An oral glucose tolerance test should thus be performed in all CD patients to identify glucose metabolism abnormalities. Since diabetes mellitus (DM) is a consequence of cortis…
Diabetes Secondary to Acromegaly: Physiopathology, Clinical Features and Effects of Treatment.
2018
Acromegaly is a rare disease due to chronic GH excess and to the consequent increase in IGF-1 levels. Both GH and IGF-1 play a role in intermediate metabolism affecting glucose homeostasis. Indeed, chronic GH excess impairs insulin sensitivity, increases gluconeogenesis, reduces the glucose uptake in adipose tissue and muscle and alters pancreatic β cells function. As a consequence, glucose metabolism alterations are a very frequent complication in acromegaly patients, further contributing to the increased cardiovascular risk and mortality. Treatment modalities of acromegaly differently impact on glucose tolerance. Successful surgical treatment of acromegaly ameliorates glucose metabolism a…
Effect of the Alterations in Contractility and Morphology Produced by Atrial Fibrillation on the Thrombosis Potential of the Left Atrial Appendage
2021
Atrial fibrillation (AF) is a common arrhythmia mainly affecting the elderly population, which can lead to serious complications such as stroke, ischaemic attack and vascular dementia. These problems are caused by thrombi which mostly originate in the left atrial appendage (LAA), a small muscular sac protruding from left atrium. The abnormal heart rhythm associated with AF results in alterations in the heart muscle contractions and in some reshaping of the cardiac chambers. This study aims to verify if and how these physiological changes can establish hemodynamic conditions in the LAA promoting thrombus formation, by means of computational fluid dynamic (CFD) analyses. In particular, sinus …
Intravenöse Eisensubstitution bei chronischer Erkrankung – bei wem, wann und wie?
2019
ZusammenfassungIn den letzten Jahren konnten wesentliche Fortschritte in der Erkennung und Behandlung des Eisenmangels erzielt werden, deren Ergebnisse auch für viele Fachgebiete und insbesondere mit Patienten mit chronisch-entzündlichen Erkrankungen relevant sind. Allerdings wird in der täglichen Praxis ein Eisenmangel vielfach nicht identifiziert und konsequent therapiert.Ein Eisenmangel kann – auch bevor eine Anämie auftritt – die Lebensqualität einschränken und den Verlauf der Grunderkrankung beeinflussen. Bei Patienten mit chronischen Erkrankungen sollte der Eisenstatus regelmäßig erfasst werden. Gerade bei Patienten mit chronisch-entzündlichen Erkrankungen sind die derzeit verfügbaren…
Conceptual changes in lease accounting: Regulatory and academic challenges
2019
El objetivo principal de este trabajo es demostrar que el posicionamiento de los emisores de normas contables y el de los grupos de presión es coherente con la Teoría de la Ideología de la regulación y la Teoría Positiva de la Contabilidad de los efectos económicos, respectivamente. Sin embargo, contrariamente a la literatura previa de lobbying, argumentamos que en un contexto internacional y tras a˜nos de experiencia con las Normas Internacionales de Información Financiera (NIIF), todos los agentes, y no solo los emisores de las normas, utilizan aspectos conceptuales y técnicos, ya que los grupos de interés, fundamentalmente los preparadores, prevén hacer más efectiva su actividad de lobby…
Descriptive Epidemiology of Human Thyroid Cancer: Experience From a Regional Registry and The “Volcanic Factor”
2013
Thyroid cancer (TC), the most common endocrine tumor, has steadily increased worldwide due to the increase of the papillary histotype. The reasons for this spread have not been established. In addition to more sensitive thyroid nodule screening, the effect of environmental factors cannot be excluded. Because high incidences of TC were found in volcanic areas (Hawaii and Iceland), a volcanic environment may play a role in the pathogenesis of TC.In January 2002, the Regional Register for Thyroid Cancer was instituted in Sicily. With a population of approximately 5 million inhabitants with similar genetic and lifestyle features, the coexistence in Sicily of rural, urban, industrial, moderate-t…
Dual-release hydrocortisone improves hepatic steatosis in patients with secondary adrenal insufficiency: A real-life study
2019
Background:Conventional glucocorticoid treatment has a significant impact on liver in patients with adrenal insufficiency. Dual-release hydrocortisone (DR-HC) provides physiological cortisol exposure, leading to an improvement in anthropometric and metabolic parameters. We aimed to evaluate the effects of 12-month DR-HC treatment on the hepatic steatosis index (HSI), a validated surrogate index of hepatic steatosis, in patients with secondary adrenal insufficiency (SAI).Methods:A total of 45 patients with hypopituitarism, 22 with hypogonadism, hypothyroidism, ACTH, and GH deficiencies, and 23 with hypogonadism, hypothyroidism, and ACTH deficiency, on replacement therapy for all the pituitar…