Nephropathy is considered a foremost cause of morbidity and mortality in patients with type 1 or type 2 diabetes mellitus. Hyperglycemia causes renal injury directly or via hemodynamic alterations. These alterations induce glomerular hyperfiltration, microalbuminuria, mesangial expansion, and GBM thickening and arteriolar hyalinosis. Risk determination has potential importance in the management of Diabetic Neuropathy advancement. In addition to the traditional approaches through albuminuria and glomerular filtration rate for the prediction and monitoring of the rate of damage among diabetic patients, various studies are enduring to identify biomarkers. Recent approaches to treat this disorder emphasize on increased control of glycemia and blood pressure using therapies based on renin-angiotensinaldosterone system blockade. Renal and pancreatic transplantation is considered the best modality. This review of literature focuses on pathogenic factors, risk factors, diagnosis and treatment of diabetic nephropathy.
Comparison of results DEXA and Ultrasonography of densitometry at patients in different groups. Comparative analysis x-ray densitometry of spine and ultrasound densitometry of the calcaneus were provided in 2 different clinical groups: postmenopausal osteoporosis(n=26), and type 2 diabetes mellitus (n=66). T-scores correlated poorly between the methods. No correlation was found between the results of ultrasound and X-ray densitometry in any of the examined groups of patients. It was determine that in postmenopausal women and in patients with diabetes mellitus should be determined bone density by X-ray densitometry. Ultrasound examination of the calcaneus in these groups of patients is uninformative. The most pronounced changes in postmenopausal osteoporosis are found in the vertebrae, but in senile osteoporosis and diabetes mellitus at the femoral neck. The ultrasound diagnostic method often determines the category of less severe violations than the X-ray densitometry of the axial skeleton. Only in senile osteoporosis determining hardness of the calcaneus can be used for screening the state of the skeleton.
The aim of the study was to evaluate the population mortality seasonal dynamics in the settings of emergency medical care availability. The study was conducted in Sumgait based on the medical certificates of death data analysis for 2013. The average daily number of deaths from all causes and from circulatory system diseases, the monthly number of death cases proportion in the structure of annual death cases, the proportion of deaths from circulatory system diseases among the total number of deaths were calculated. The average daily number of deaths from all causes was 4.42, including 2.72 cases - from circulatory system diseases. The average daily number of death cases from all causes below the annual average rate was observed in June, July, August and September, and when performing the seasonal analysis - in summer and autumn from circulatory system diseases - in January, June, September and December. The winter and spring increase in all-cause mortality rate was registered, whereas the mortality rate peak was characteristic for February and March. In the seasonality analysis the largest proportion of death cases number from circulatory system diseases in the structure of total annual mortality rate was in the spring. The proportion of deaths from circulatory diseases among the death causes of Sumgait population was 61.5±1.2%. In winter, the proportion of deaths from circulatory system diseases in the structure of causes of death from all causes was minimal (53.3±2.3%), and in the summer - the maximum (68.9±2.4%). The regularity of mortality seasonal dynamics in Sumgait is the winter-spring increase and summer decrease in all-cause mortality rate; distinctive feature of the mortality seasonal dynamics in Sumgait is associated with mortality risk increase in spring due to circulatory system diseases.
Unique gut microbial colonisation patterns are associated with the onset of allergic disease in infants; however, there is insufficient evidence to determine if aberrant microbial composition patterns persist in adult allergic rhinitis (AR) sufferers. To compare the gut microbiome composition between adult AR sufferers and controls. Gut microbial composition in stool samples was compared between 57 adult AR sufferers (39.06 ± 13.29 years) and 23 controls (CG; 36.55 ± 10.51 years) via next-generation sequencing of the V3–V4 hypervariable regions of the 16S rRNA gene. Taxonomic classification and identity assignment was performed using a reference-based approach with the NCBI database of 16S rRNA gene sequences. Species richness determined via the Shannon index was significantly reduced in the AR cohort compared to the CG (4.35 ± 0.59 in AR vs. 4.65 ± 0.55 in CG, p = 0.037); trends for reductions in operational taxonomic unit (OTU) counts, inverse Simpson, and CHAO1 diversity indices were also noted. Bacteroidetes (p = 0.014) was significantly more abundant in the AR group than in the CG. In contrast, the Firmicutes phylum was significantly less abundant in the AR group than in the CG (p = 0.006). An increased abundance of Parabacteroides (p = 0.008) and a reduced abundance of Oxalobacter (p = 0.001) and Clostridiales (p = 0.005) were also observed in the AR cohort compared to the CG. Adult AR sufferers have a distinct gut microbiome profile, marked by a reduced microbial diversity and altered abundance of certain microbes compared to controls. The results of this study provide evidence that unique gut microbial patterns occur in AR sufferers in adulthood and warrant further examination in the form of mechanistic studies.
Total knee arthroplasty (TKA) is gaining acceptance among patients worldwide, knowing who benefits from surgery and who does not is detrimental. Comorbid conditions are detrimental for joint replacement surgery, and patient medical optimization is critical and sometimes challenging. TKA surgery was first performed in 1968. Since then, improvement in many aspects of the procedure is reported. This study aimed to retrospectively evaluate the predictive factors for outcome in TKA done at Aseer central hospital. Retrospective study of TKA cases done at a tertiary care hospital in the Abha region, Saudi Arabia from January 2006 to January 2012 was included in the study. We evaluated Knee function using Knee Society scoring system, and the percentage of each comorbidity in our patient study group was recorded. Female were more than males (83.33% vs. 16.67% males). comorbidities in the study group and their frequencies were: psychosocial factors (28.4%); severe joint disease (67%); additional joint disease (other knee, 59.4%; hips, 35.4%; spine, 34.2%); depression and anxiety (49.8%); hypertension (25%); asthma (14%); sleep apnea (8.4%); diabetes: HbA1c < 7 (82%); HbA1c > 7 (18%); obesity BMI < 30 (96.6%); BMI > 30 (3.4%); peripheral vascular disease (0.20%); and comparative pre- and postoperative knee scores with observed correlation showed significant improvement. Isolating the predictive factors of unfavored outcome may help total knee results.