Abstract

To assess the effects of each traditional cardiovascular risk factor (hypertension, diabetes mellitus, dyslipidemia, and smoking), including the presence of coronary artery disease (CAD), on carotid intima-media thickness (CIMT) and to assess the degree of carotid plaque occurrence. A total of 553 outpatients (216 men and 337 women, mean age 67.06 ± 12.44 years) who underwent a carotid artery ultrasound were screened for carotid plaque and CIMT measurements. The CIMT medians were higher in males (P < .001) and in patients with hypertension (P < .001). A linear increase occurred in mean CIMT of 0.0059 mm for each year of increase in age. The presence of plaque indicated a tendency to correlate with CIMT (P = .067). The presence of hypertension associated with diabetes (P = .0061, estimated difference 0.0494 mm) or dyslipidemia (P = .0016, estimated difference 0.0472 mm) or CAD (P = .0043, estimated difference 0.0527 mm) increased the mean CIMT measurements. The probability of plaque occurrence in carotid arteries is influenced by the age (P < .001) and is higher in patients with dyslipidemia (P = .008) and CAD (P < .001). Hypertension is the strongest cardiovascular risk factor that increases CIMT, followed by age and male sex. Age and dyslipidemia increase the probability of carotid plaque. Increased CIMT and plaque could be present in the same patient caused by different risk factors and with independent effects on the artery wall and different clinical prognoses.

Abstract

Erectile dysfunction (ED) is one of the most common complications of diabetes, being oxidative stress an important feature of diabetic ED. Deleterious events induced by oxidative stress lead to crucial cellular and tissue alterations targeted by oxidative lesions. However, the noxious effects of oxidative stress mechanisms in penile tissue with the progression of diabetes, remains unclear. We intended to evaluate systemic and penile oxidative stress in an early and late stage of diabetes. Male Wistar rats were divided in groups: 2 and 8‐weeks of streptozotocin‐induced type 1 diabetes, and age‐matched controls. Systemic oxidative stress was evaluated in urine by hydrogen peroxide (H2 O2 ) quantification and in plasma by reduced/oxidized glutathione (GSH/GSSG) ratio. Penile oxidative status was assessed by H2 O2 production and by the evaluation of protein nitration through the detection of 3‐nitrotyrosine (3‐NT). 3‐NT was quantified by Western blotting analysis and immunohistochemistry allowed to identify its cavernosal cellular location. Systemic evaluation revealed a significant increase in urinary H2 O2 levels in both diabetic groups. A significant decrease of circulating GSH/GSSG ratio was observed in animals with late stage diabetes. In cavernosal tissue, H2 O2 production was significantly increased at 8‐weeks diabetes. Regarding 3‐NT cavernosal formation, data revealed a significant increment in advanced diabetes and a predominant location in cavernosal smooth muscle cells. We observed that systemic and cavernosal noxious effects induced by oxidative stress are predominant in advanced diabetes. Increased penile protein oxidative modifications in late‐staged diabetes may be responsible for structural/functional deregulations in cellular/molecular systems, contributing to the development of diabeticassociated ED.

Abstract

Diabetes is one of the most challenging long-term diseases (LTD) nowadays. Diabetes is associated with dietary restrictions, medical treatments and a strict life style, and has important emotional implications. The aim of this study is to analyze the impact of participating in online support groups (OSG) and participants’ emotional well-being, social support, self-esteem and motivation. An online survey was disseminated in online forums about diabetes, in Spanish (N = 344). Results show that participating in OSGs has a significant influence on the four variables analyzed. However, the direction of this influence depends on participants’ type of diabetes. Participating in OSG is associated with an increase in self-reported social support and motivation for type 2 patients with diabetes, while it is associated with a decrease of both variables for type 1 patients. No differences were observed for emotional well-being and self-esteem. These results have direct implications for both people with type 1 and 2 diabetes and medical professionals in managing online communications more effectively.

Abstract

In order to contribute to the treatment of diabetes, which is one of the main causes of death in Ecuador and in the world, a research project is being developed to create equipment that allows the effective control and treatment of this disease. The electronic equipment created for nutrition control, allows the diabetic patient to have information about the amount of calories they should ingest in consideration of their activities and their medical treatment. The mechatronic equipment for the physical exercise of people with diabetic foot, allows the application of therapies according to the severity of the affection. Considering that this is a delicate and complex treatment, the equipment helps the patients to alleviate its discomfort, to decrease the time of recovery and in some cases even to avoid amputation. The construction of the biomedical equipment for the control of nutrition is completed. While the equipment for the treatment of diabetic foot is in a stage of development of prototypes and tests. Both equipment has been conceived and developed with rigorous engineering methods and under quality standards, making an important contribution to research, development of science, technology, and innovation.

Abstract

To retrospectively review our experience of managing patients with emphysematous pyelonephritis (EPN). Case notes of patients with EPN were reviewed. The patients' demographic data, clinical presentation, investigation findings, treatment, and outcome were studied. Twelve patients were diagnosed with EPN. Majority (66.7%) of them had diabetes mellitus. All patients had been evaluated by computed tomography (CT). Using the classification proposed by Wan et al, five patients had type 1 EPN, whereas six, two, and four patients had Huang and Tseng CT class 2, 3a, and 3b EPN, respectively. Immediate nephrectomy was performed in six patients, whereas conservative treatment was adopted in the other six. In the nephrectomy group, one patient died of disseminated sepsis after a protracted course. Conservative treatment failed in three patients, who succumbed despite salvage nephrectomy in two of them. Analysis revealed that severe hyperglycemia and radiological CT class (both Wan and Huang systems) were significant predictors of mortality from EPN. Severe hyperglycemia and CT class of EPN are significant risk factors for death. CT is the investigation of choice for correct diagnosis of EPN. Additional intervention should be offered to EPN patients with Wan type 1 and Huang and Tseng class 3 CT features.