The increasing prevalence of diabetic kidney disease (DKD), a common complication of type 1 and type 2 diabetes, is becoming a leading risk factor of developing end stage renal disease (ESRD). The multiple mechanisms involved in renal tissue damage are a challenge for effective targeted therapy. Urolithins are metabolites generated by gut microbiota upon dietary intake of plant-derived elagitannins. Multidirectional effects of these compounds include their anti-inflammatory, antioxidant, anti-proliferatory, anti-migratory and antiglycative properties that are mediated by modulation of signaling pathways and gene expression. Biochemical properties of urolithins indicate their capacity to regulate numerous mechanisms responsible for developing the hyperglycemia-induced tissue injury. The potentially beneficial effects of urolithins on podocytes, the most vulnerable renal cells should be particularly considered. The purpose of this review is to provide the evidence from the in vivo and in vitro studies showing that urolithin-based therapy could be a useful tool for protecting the kidneys from damage in diabetes.
Introduction: Hospitalization costs of diabetic patients are estimated to be higher than non-diabetic. Literature on the topic is however limited. The aim of this study was to compare the costs of elective and emergency cholecystectomy of diabetic and non-diabetic patients. Material and methods: A retrospective analysis involved diabetic versus non-diabetic age- and sex-matched patients who underwent emergency and elective cholecystectomy at a single center in Poland between 2016-2019. Results: The total costs of an elective cholecystectomy were 739.31 ± 423.07 USD for diabetic patients and 797.14 ± 772.24 USD for non-diabetic patients (p = 0.51). Whereas emergency cholecystectomy total costs were 3950.72 ± 2856.83 USD (diabetic patients) and 2464.31 ± 1718.21 USD (non-diabetic patients) (p = 0.04). The difference in total costs between elective cholecystectomy vs emergency cholecystectomy in both groups (diabetic vs non-diabetic patients) was statistically significant (p < 0.01 vs p < 0.05 respectively). Conclusions: In this study we demonstrated that emergency cholecystectomy is associated with a significant increase in hospitalization costs, particularly in diabetic patients. This suggests that early qualification of diabetic patients for an elective cholecystectomy could be beneficial for both diabetic patients and public health insurers.
The material presented in this paper is an attempt to lay down requirements for the planned design of an insulin pump. An insulin pump is a device for continuous dosage of insulin at a selected rate, which facilitates treatment and improves the lives of diabetic patients. This paper is a compilation of medical requirements and user suggestions of presently offered insulin pumps.It seems important to establish proper requirements for a device before starting developing any design for an insulin pump.
Diabetes is a disease affecting people of all races in the world, it can appear at any age. It is considered to be social disease due to the incidence and complications. It is a disease of complex etiology, classified as a metabolic disease with chronic hyperglycemia. It requires intensive hypoglicemizing therapy. There are two types of diabetes: type I and type II with different etiologies and varied clinical picture.In the case of prolonged illness serious complications develop, from which, however, the sick may be saved, on condition of the patient's absolute submission to the rigors of treatment. It is possible to live an active life and even practice sports. Extremely important in this case is the correct blood glucose, providing for adjusted glucose homeostasis, which is promoted by physical activity. Physical exercise can be an important therapeutic agent in treating diabetes, provided the criteria of its physiological tolerance are determined. It is vital that an individual approach to the patient is made, associated with the duration of the disease and existing complications. Patient education in monitoring patients' glucose levels is important, i.e. the efficiency in the implementation of individual insulin therapy and hyperglycemia or hypoglycemia self-prevention during and after physical exercise. Patients who decide to practice sport should find the optimal way to control exercise, and diet during and after exercise, then the sporting success is possible.
Resistance training (RT) can provide several benefits for individuals with Type 2 diabetes. The aim of this study was to investigate the effects of resistance training on the strength levels and uric acid (UA) concentration in individuals with Type 2 diabetes. The study included 68 patients (57.7±9.0 years) that participated in an organized program of RT for 12 weeks. The volunteers were divided into two groups: an experimental group (EG; n=34) that performed the resistance training program consisting of seven exercises executed in an alternating order based on segments; and a control group (CG; n=34) that maintained their normal daily life activities. Muscle strength and uric acid were measured both pre- and post-experiment. The results showed a significant increase in strength of the subjects in the EG for all exercises included in the study (p<0.001). Comparing the strength levels of the post-test, intergroup differences were found in supine sitting (p<0.001), leg extension (p<0.001), shoulder press (p<0.001), leg curl (p=0.001), seated row (p<0.001), leg press (p=0.001) and high pulley (p<0.001). The measured uric acid was significantly increased in both experimental and control groups (p<0.001 and p=0.001, respectively). The intergroup comparison showed a significant increase for the EG (p=0.024). We conclude that the training program was effective for strength gains despite an increase in uric acid in Type 2 diabetics.
Based on overlapping structural requirements for both efficient aldose reductase inhibitors and PPAR ligands, [5-(benzyloxy)-1H-indol-1-yl]acetic acid (compound 1) was assessed for inhibition of aldose reductase and ability to interfere with PPARγ. Aldose reductase inhibition by 1 was characterized by IC50 in submicromolar and low micromolar range, for rat and human enzyme, respectively. Selectivity in relation to the closely related rat kidney aldehyde reductase was characterized by approx. factor 50. At organ level in isolated rat lenses, compound 1 significantly inhibited accumulation of sorbitol in a concentration-dependent manner. To identify crucial interactions within the enzyme binding site, molecular docking simulations were performed. Based on luciferase reporter assays, compound 1 was found to act as a ligand for PPARγ, yet with rather low activity. On balance, compound 1 is suggested as a promising lead-like scaffold for agents with the potential to interfere with multiple targets in diabetes.
Muscle denervation atrophy is a result of lower motor neuron injury, thus an early restitution of muscle stimulation is essential in prevention of atrophic changes. The aim of the study was to evaluate the new application of naturally occurring epineural sheath conduit in repair of the peripheral nerve gap to prevent development of muscle denervation atrophy. Material and methods. We used the model of 20 mm sciatic nerve gap, resulting in denervation atrophy of the gastrocnemius muscle in the diabetic rats (DM type 2, n=42, Zucker Diabetic Fatty strain). We applied the epineural sheath conduit created from the autologous sciatic nerve for gap repair. Muscle atrophy was assessed with the Gastrocnemius Muscle Index (GMI) and microscopic muscle morphometry (mean fiber area) at 6 and 12 postoperative week. Muscle regeneration in the experimental group was compared to the gold-standard technique of autologous nerve grafting for the repair of created nerve gap. Results. The GMI evaluation revealed comparable muscle mass restoration in groups with nerve repair using both epineural sheath and standard autologous nerve grafting (reaching 28 and 35% of contralateral muscle mass at 12 postoperative week, respectively, p=0.1), and significantly better restoration when compared to the negative control group (no repair, 20%, p<0.01). Micromorphometry confirmed significantly larger area of the regenerated muscle fibers in groups with both nerve grafting and epineural sheath conduit repair (reaching for both ca. 42% of the non-operated side), when compared to severe atrophic outcome when no nerve repair was performed (14% of the control fiber area, p<0.0001). The effectiveness of epineural conduit technique in muscle mass restoration was observed between 6 and 12 weeks after nerve repair - when gastrocnemius muscle mass increased by 12%. Conclusions. Peripheral nerve gap repair with naturally occurring epineural sheath conduit is effective in prevention of muscle denervation atrophy. This method is applicable in diabetic model conditions, showing results of regeneration which are comparable to the autologous nerve graft repair
One of significant challenges faced by diabetologists, surgeons and orthopedists who care for patients with diabetic foot syndrome is early diagnosis and differentiation of bone structure abnormalities typical of these patients, i.e. osteitis and Charcot arthropathy. In addition to clinical examination, the patient’s medical history and laboratory tests, imaging plays a significant role. The evaluation usually begins with conventional radiographs. In the case of osteomyelitis, radiography shows osteopenia, lytic lesions, cortical destruction, periosteal reactions as well as, in the chronic phase, osteosclerosis and sequestra. Neurogenic arthropathy, however, presents an image resembling rapidly progressing osteoarthritis combined with aseptic necrosis or inflammation. The image includes: bone destruction with subluxations and dislocations as well as pathological fractures that lead to the presence of bone debris, osteopenia and, in the later phase, osteosclerosis, joint space narrowing, periosteal reactions, grotesque osteophytes and bone ankylosis. In the case of an unfavorable course of the disease and improper or delayed treatment, progression of these changes may lead to significant foot deformity that might resemble a “bag of bones”. Unfortunately, radiography is non-specific and frequently does not warrant an unambiguous diagnosis, particularly in the initial phase preceding bone destruction. For these reasons, alternative imaging methods, such as magnetic resonance tomography, scintigraphy, computed tomography and ultrasonography, are also indicated.
PL
Jednym z istotnych problemów, z jakimi borykają się diabetolodzy, chirurdzy i ortopedzi zajmujący się leczeniem pacjentów z zespołem stopy cukrzycowej, jest możliwie wczesne rozpoznanie oraz zróżnicowanie zmian w strukturach kostnych typowych dla tej grupy chorych – zapalenia kości i neuroosteoartropatii Charcota. W procesie diagnostycznym obok badania podmiotowego, przedmiotowego i wyników badań laboratoryjnych istotną rolę odgrywa diagnostyka obrazowa. Metodą pierwszego rzutu jest klasyczna radiografia. W przypadku zapalenia kości na radiogramach można stwierdzić: obszary rozrzedzenia struktury kostnej, przerwanie zarysów warstwy korowej, odczyny okostnowe, a w fazie przewlekłej również zagęszczenie utkania kostnego i obecność martwaków. W przebiegu neuroosteoartropatii Charcota rozwija się natomiast obraz przypominający szybko postępujące zmiany zwyrodnieniowe, połączone z martwicą aseptyczną lub zmianami zapalnymi, na który składają się: destrukcja kostna z podwichnięciami i zwichnięciami oraz patologicznymi złamaniami prowadzącymi do pojawienia się licznych fragmentów kostnych, rozrzedzenie struktury kostnej, a w fazie późniejszej sklerotyzacja, zwężenie szpar stawowych oraz powstawanie odczynów okostnowych, groteskowych osteofitów, jak również ankyloza kostna. Przy niekorzystnym przebiegu i niewłaściwym leczeniu progresja zmian może doprowadzić do nasilonego zniekształcenia stopy i powstania tzw. rumowiska kostnego. Niestety obraz radiologiczny bywa nieswoisty i niejednokrotnie nie pozwala na postawienie jednoznacznego rozpoznania, zwłaszcza w fazie początkowej, zanim dojdzie do destrukcji kostnej. Z tego względu w niejednoznacznych przypadkach wskazane jest wykorzystanie również innych metod diagnostyki obrazowej, takich jak tomografia rezonansu magnetycznego, badania scyntygraficzne, tomografia komputerowa i ultrasonografia. Artykuł w wersji polskojęzycznej jest dostępny na stronie http://jultrason.pl/index.php/issues/volume-18-no-72
In The present study, the aims was to investigate and compare the effect of insulin and embryonic stem cells (ESC) loaded nanoparticle formulations (NPs) on pancreatic-beta-TC-cell regeneration. Characterization studies of NPs were performed. Permeability of insulin and the effect of ESC on pancreatic beta cells were investigated. by the determination of Insulin or glucose levels were determined and histologic investigations were also performed. ESC encapsulation efficiency was calculated by western blot analysis. The particle sizes of insulin and ESC-loaded-NPs were determined as 0.665±0.202 µm and 0.650 ±0.310 µm. The mean zeta potentials of insulin and ESC-loaded-NPs nanoparticles were found as 6.88±0.729 mV, 5.13±0.631 mV. The polydispersity index of insulin and ESC nanoparticles were 0.660±0.175, 0.620±0.205 respectively. Encapsulation efficiency of insulin and ESC-loaded-NPs were found to be 50±1.53% and 51%. Insulin release from nanoparticles was found to be 72.8% over 48h. The gGlucose concentrations wasere decreased to 201 and 202.7 mg/dl from 250 mg/dl in streptozocin (STZ) induced diabetic mice group after insulin and ESC-loaded-NPs administration. Insulin and ESC-loaded-NPs improved the blood insulin levels in all experimental groups. These NPs may be used for repairing of pancreatic cells. Healing or some degree of regeneration was observed when insulin and ESC-loaded-NPs were administered to the mice ip. ESC-loaded-NPs can be a potential source for cell replacement therapy in the treatment of diabetes.
Cushing’s disease is a rare endocrine disorder caused by ACTH-secreting pituitary adenoma. The treatment of choice is a transsphenoidal surgery performed by an experienced neurosurgeon. However, in some patients adjuvant treatment is required due to ineffective surgery or disease recurrence. This article discusses new aspects of pharmacological treatment of ACTH-dependent hypercortisolism in light of a recent publication reporting the efficacy and safety of once a month pasireotide LAR injections in Cushing’s disease.
Inflammation and oxidative stress have been reported in patients with chronic hepatitis C (CHC) infection, but their influence on ischemia-modified albumin (IMA) levels and diabetes prevalence remains unknown. Sixty-three CHC patients, 28 with diabetes, and 40 healthy controls were enrolled in the study. Circulating levels of oxidative stress markers [Nε-(carboxymethyl)lysine- advanced glycation end products (CML-AGEs) and advanced oxidation protein products-(AOPPs)], pro-inflammatory cytokines (interleukin-6, and tumor necrosis factor α), and high-sensitivity C-reactive protein (hsCRP) were assessed. Compared with the controls, the CHC patients with diabetes showed a significant increase in plasma concentrations of IMA, AOPPs, interleukin-6 and hsCRP (P < 0.05). The values of IMA and hsCRP were more elevated in patients with diabetes than without diabetes (both P < 0.01). The positive relationships were found between hsCRP and presence of diabetes, IMA (both P < 0.01) and AOPP levels (P < 0.05). CML-AGEs did not show any significant correlation with IMA, markers of inflammation and presence of diabetes. In conclusion, we have documented significant elevation in plasma levels of IMA and AOPPs in CHC patients. In addition, circulating IMA was associated with inflammation markers and diabetes prevalence. This observation suggests a relationship between IMA and inflammation in CHC patients with diabetes, which may represent one of the mechanisms involved in the accelerated atherosclerosis in this population.
This study was conducted for investigating the effects of chronically administered vitamin D3 and resveratrol, which has antioxidant properties, on memory and learning impairment caused by streptozotocin-induced diabetes. Saline was administered to the mice in the first group. Streptozotocin (60 mg/kg, i.p.) was given to the mice in the second group for 3 consecutive days and no treatment was performed. Vitamin D3 (800 IU/kg, i.p.) was given to the streptozotocin-induced hyperglycemic mice in the third group for 4 weeks. Resveratrol (40 mg/kg, i.p.) was given to the streptozotocin-induced hyperglycemic mice in the fourth group for 4 weeks. Then, passive avoidance test was applied to the mice. A significant difference was found between DM+Vit D3 group (21.6±1.7, n=7) and diabetic control group (28±2.6, n=7) in the acquisition test (p<0.001). A similar result was observed between diabetic-resveratrol group (23.7±2.5, n=7) and the untreated diabetic mice group (28±2.6, n=7). There was a significant difference. 4-week vitamin D3 (400 IU/day, i.p.) and 4-week resveratrol (40 mg/kg, i.p.) treatments given to streptozotocin-induced diabetic mice were observed to significantly improved the passive avoidance acquisition and retention times. These results show the positive effects of vitamin D3 on memory.
Vanadium belongs to the group of transition metals and is present in the air and soil contaminants in large urban agglomerations due to combustion of fossil fuels. It forms numerous inorganic compounds (vanadyl sulfate, sodium metavanadate, sodium orthovanadate, vanadium pentoxide) as well as complexes with organic compounds (BMOV, BEOV, METVAN). Depending on the research model, vanadium compounds exhibit antitumor or carcinogenic properties. Vanadium compounds generate ROS as a result of Fenton's reaction or of the reaction with atmospheric oxygen. They inactivate the Cdc25B2 phosphatase and lead to degradation of Cdc25C, which induces G2/M phase arrest. In cells, vanadium compounds activate numerous signaling pathways and transcription factors, including PI3K-PKB/Akt-mTOR, NF-κB, MEK1/2-ERK, that cause cell survival or increased expression and release of VEGF. Vanadium compounds inhibit p53-dependent apoptosis and promote entry into the S phase of cells containing functional p53 protein. In addition, vanadium compounds, in particular organic derivatives, have insulin-mimetic and antidiabetic properties. Vanadium compounds lower blood glucose levels in animals and in clinical trials. They also inhibit the activity of protein tyrosine phosphatase 1B. By activating the PI3K-PKB/Akt pathway, vanadium compaunds increase the cellular uptake of glucose by the GLUT4 transporter. The PKB/Akt pathway is also used to inactivate glycogen synthase kinase-3. The impact of vanadium compounds on inflammatory reactions has not been fully studied. Vanadium pentoxide causes expression of COX-2 and the release of proinflammatory cytokines in a human lung fibroblast model. Other vanadium compounds activate NF-κB in macrophages by activating IKKβ.
Adipose tissue is at a point of high interest in medical research, not only as an energy depot, but also because it secretes nearly more than 600 cytokines. These are termed‚ adipokines’. Human adipokines are involved in numerous metabolic processes, including the regulation of appetite, energy expenditure, insulin sensitivity, inflammation and cardiovascular activity. Thus, these could be clinically important as a markers of adipose tissue function and increased metabolic risk. The search for novel adipokines linking obesity to related co-morbidities has become a major topic in obesity research. In such work, there is an increasing need to define their function, their molecular targets and their potential clinical relevance as biomarkers or in the treatment of obesity and other metabolic diseases. Omentin (34 kDa) is a recently identified fat deposition-specific adipokine with multiple interactions. Concentrations of omentin have been shown to be decreased in patients with obesity and impaired glucose regulation, in patients afflicted with diabetes type 1 and 2, and in patients with polycystic ovary syndrome. These are all diseases commonly associated with insulin resistance and obesity. The aim of this study was to show and compare the latest information about omentin and its relationships with obesity, diabetes mellitus (DM), metabolic syndrome (MetS), inflammation, cardiac problems, sex hormone imbalances and cancer. The association of omentin with particular metabolic indexes may suggest that an elevation in omentin level may be seen as being a marker for leanness, while a decreased level will underline possible situations of overweight and obesity along with their comorbidities (diabetes, cardiovascular disease, metabolic syndrome, inflammation and even cancer). However, a challenge for the future is to fully understand the multiple role played by omentin. Thus, more studies in these matter are required.
Treating diabetes is a complex process covering proper diet, regular and moderate physical activity and medication. The basis of diet planning is to determine the energy requirements, considering the age, sex, physical activity, physiological condition, concomitant diseases and body mass of the patient. The aim of the study was to evaluate the energy value of meals consumed by patients with type 2 diabetes considering their age, sex and body mass. MATERIAL AND METHODS The study was performed three times on 100 patients, including 52 men and 48 women. It consisted in a 24-hour diet recall and performing anthropometric measures. To evaluate the energy value of meals, the Dieta 2 computer program was used, whereas the Statistica 7.1 program was used for statistical analyses purposes. RESULTS Among the men and women of all the age groups, the daily energy requirements were lower comparing to the dietary recommendations. Moreover, the energy value of individual meals was lower in comparison to the recommendations, excluding dinner which for all the age and weight groups (excluding men aged 31–50 of 90–99kg body mass and women over 75 years of age of 60–69 kg body mass) provided more energy comparing to the recommended value. The energy value of individual meals consumed by the studied patients regardless of their age, weight and body mass was lower comparing to the dietary recommendations. An improper distribution of energy in daily rations and its inadequate division in meals was noted, regardless of the age and sex of the studied subjects. CONCLUSIONS A 24-hour diet recall is an element enabling possible health risks assessment, including undernutrition, overweight or obesity in patients with type 2 diabetes.
PL
Leczenie cukrzycy jest procesem kompleksowym i obejmuje stosowanie odpowiedniej diety, regularnej i umiarkowanej aktywności fizycznej oraz przyjmowanie leków. Podstawą planowania diety jest ustalenie zapotrzebowania energetycznego, które powinno uwzględniać wiek, płeć, aktywność fizyczną, stan fizjologiczny, współistnienie chorób oraz masę ciała pacjenta. Celem pracy była ocena wartości energetycznej posiłków spożywanych przez pacjentów z cukrzycą typu 2, z uwzględnieniem ich płci, wieku i masy ciała. MATERIAŁ I METODY Badanie zostało przeprowadzone trzykrotnie. Uczestniczyło w nim 100 pacjentów, w tym 52 mężczyzn i 48 kobiet. Składały się na nie 24-godzinny wywiad żywieniowy oraz pomiary antropometryczne. Do oceny wartości energetycznej posiłków posłużono się programem komputerowym Dieta 2, do analiz statystycznych wykorzystano program Statistica 7.1. WYNIKI Dla mężczyzn i kobiet we wszystkich grupach wiekowych dobowa podaż energii była niższa od wskazywanej w zalecaniach żywieniowych. Także wartość energetyczna poszczególnych posiłków była niższa od zalecanej, z wyjątkiem posiłku obiadowego, który we wszystkich grupach wiekowych i wagowych (poza mężczyznami w wieku 31–50 lat i masie ciała 90–99 kg oraz kobietami powyżej 75 lat i masie ciała 60–69 kg) dostarczał więcej energii od ilości rekomendowanej. Wartość energetyczna poszczególnych posiłków spożywanych przez badanych pacjentów niezależnie od ich płci, wieku i masy ciała była niższa od zaleceń żywieniowych. Stwierdzono nieprawidłowy rozkład energii zawartej w dziennej racji pokarmowej i podział jej na posiłki, niezależnie od płci i wieku badanych osób. WNIOSEK 24-godzinny wywiad żywieniowy jest elementem umożliwiającym ocenę możliwości wystąpienia zagrożeń zdrowia, w tym niedożywienia, nadwagi lub otyłości, u pacjentów z cukrzycą typu 2.
WSTĘP: Zakażenia występują u wszystkich pacjentów, w tym także u chorych na cukrzycę (diabetes mellitus – DM), której współwystąpienie może jednak determinować przebieg zakażenia. Celem pracy było porównanie przebiegu i leczenia infekcji u chorych z DM i bez DM. MATERIAŁ I METODY: Analizie poddano dokumentację medyczną 180 pacjentów hospitalizowanych w 2021 r. w Klinice Chorób Wewnętrznych, Autoimmunologicznych i Metabolicznych w Katowicach z powodu infekcji. W analizie uwzględniono wiek, płeć, rozpoznanie kliniczne, metodę leczenia DM, antybiotykoterapię i parametry laboratoryjne. Do analizy statystycznej wykorzystano program Statistica. WYNIKI: Najczęstszymi przyczynami hospitalizacji w obu grupach były: zapalenie płuc w przebiegu COVID-19 (35,5% DM vs 33,7% bez DM) oraz infekcje dróg moczowych (26,3% DM vs 19,2% bez DM). Istotnie więcej pacjentów bez DM wymagało leczenia z użyciem wielu antybiotyków (69,7% DM vs 89,4% bez DM). Najczę-ściej stosowanymi antybiotykami były β-laktamy (59,2% DM vs 57,7% bez DM). Śmiertelność wewnątrzszpitalna wyniosła 20% (21% DM vs 19,2% bez DM). Czas hospitalizacji wynosił 1–35 dni, mediana w całej grupie wyniosła 9 dni (10 dni w przypadku DM vs 8 dni bez DM). Analizowano zarówno początkowe, jak i końcowe stężenie CRP. Mediana wartości początkowej wyniosła 71,6 (72,3 DM vs 66,2 bez DM), a mediana wartości końcowej 17,15 (17,9 DM vs 15,3 bez DM). Mediana stężenia glukozy przy przyjęciu wynosiła 123,5 mg/dL (156 mg/dL DM vs 107 mg/dL bez DM). WNIOSKI: Wiele powikłań DM jest dobrze znanych, jednak przebieg i leczenie infekcji nie różnią się istotnie u pacjentów z DM i bez DM. Mimo to do każdego pacjenta należy podchodzić indywidualnie, tak aby wybrane leczenie stanowiło zoptymalizowaną terapię.
EN
INTRODUCTION: Infections affect all patients, including those with diabetes mellitus (DM), which can determine the course of infection. The aim of the study was to compare the course and treatment of infection in patients with DM and without DM. MATERIAL AND METHODS: 180 medical records of patients hospitalized in 2021 at the Department of Internal Medicine, Autoimmune and Metabolic Diseases in Katowice, with infections were analyzed. The analysis included age, sex, clinical diagnosis, DM treatment, antibiotic therapy, and laboratory parameters. The Statistica program was used for statistical analysis. RESULTS: The most prevalent reasons for hospitalization in both groups were: pneumonia in the course of COVID-19 (35.5% DM vs 33.7% non-DM) and urinary tract infections (26.3% DM vs 19.2% non-DM). Significantly more non-DM patients required polyantibiotic treatment (69.7% DM vs 89.4% non-DM). The most frequently used antibiotics were β-lactams (59.2% DM vs 57.7% non-DM). In-hospital mortality was 20% (21% DM vs 19.2% non-DM). The length of hospitalization was 1–35 days, the median in the whole group was 9 days (10 days DM vs 8 days non-DM). Both the initial and terminal CRP concentrations were analyzed. The median of the initial value was 71.6 (72.3 DM vs 66.2 non-DM) and the median of the terminal value was 17.15 (17.9 DM vs 15.3 non-DM). The glucose concentration on admission was assessed with the median 123.5 mg/dL (156 mg/dL DM vs 107 mg/dL non-DM). CONCLUSIONS: Many DM complications are well known, yet the course and treatment of infection do not differ significantly in patients with DM and without DM. Despite that, each patient should be considered individually, so the chosen treatment constitutes an optimized therapy.
A properly selected nutritional strategy is of key importance for training optimization and exercise capacity improvement. The diet with low carbohydrate content and high fat content is a controversial issue since its efficacy is questionable. It affects body mass, glycaemia control and the risk factors for cardiovascular conditions. The main reasons for using this diet include body ability to acquire energy from fats which allows weight and body fat content control. Increased fat consumption leads to the production of ketone bodies (KBs) in the liver, such as acetoacetic acid, acetone and β-hydrobutyric acid, which are alternative sources of energy for tissues, including the brain, the heart and the skeletal muscles. These compounds are used during exercise and their concentration is higher during the period of post-exercise regeneration. The increased speed of fat oxidation and the decreased use of glycogen can improve physical capacity. It is suggested that this strategy alters body metabolic response to exercise and improves exercise efficacy. The paper describes the effect of low carbohydrate and high fat diet on the human body and physical capacity, translated into athletic performance.
PL
Odpowiednio dobrana strategia żywieniowa ma kluczowe znaczenie w optymalizacji treningu i poprawie zdolności wysiłkowych. Dieta o niskiej zwartości węglowodanów i wysokiej zawartości tłuszczu stanowi kontrowersyjne zagadnienie, gdyż skuteczność jej stosowania jest niejednoznaczna. Ma ona wpływ na masę ciała, kontrolę glikemii i czynniki ryzyka rozwoju choroby sercowo-naczyniowej. Jednym z głównych powodów jej stosowania jest zdolność organizmu do wykorzystania tłuszczów jako źródła energii, co pozwala na kontrolę wagi i poziomu tkanki tłuszczowej. Zwiększenie spożycia tłuszczów prowadzi do wytwarzania w wątrobie związków ketonowych, takich jak acetooctan, aceton i β-hydroksymaślan, które służą jako alternatywne źródło energii dla tkanek, w tym mózgu, serca i mięśni szkieletowych. Związki te wykorzystywane są podczas ćwiczeń, a ich stężenie jest podwyższone podczas okresu regeneracji powysiłkowej. Podwyższona szybkość utleniania tłuszczu i zmniejszone wykorzystanie glikogenu może poprawiać wydajność. Sugeruje się, że strategia ta zmienia odpowiedź metaboliczną organizmu na ćwiczenia i poprawia ich efektywność. W obecnej publikacji zajmiemy się zagadnieniem wpływu diety o niskiej zawartości węglowodanów i wysokiej zawartości tłuszczu na organizm oraz na wydolność fizyczną w przełożeniu na wyniki u sportowców.
We studied the influence of low doses of γ radiation (from 0.04 to 1.8 mGy) on the stability of human red blood cells (RBC) from healthy donors and diabetic patients using absorption spectroscopy. Because of the alteration of many enzymatic pathways in diabetic RBCs resulting in strong modification of the lipid and protein membrane components one could expect that the ionizing γ-radiation should influence the stability of the healthy and diabetic cells in a different way. Indeed, distinct discontinuities and monotonic changes of hemolysis detected in the healthy and diabetic RBCs suggest that various enzymatic and chemical processes are activated in these membranes by γ radiation. Mössbauer measurements showed that only the highest applied dose of γ radiation caused modification of hemoglobin in both types of RBCs.
INTRODUCTION: Infections affect all patients, including those with diabetes mellitus (DM), which can determine the course of infection. The aim of the study was to compare the course and treatment of infection in patients with DM and without DM. MATERIAL AND METHODS: 180 medical records of patients hospitalized in 2021 at the Department of Internal Medicine, Autoimmune and Metabolic Diseases in Katowice, with infections were analyzed. The analysis included age, sex, clinical diagnosis, DM treatment, antibiotic therapy, and laboratory parameters. The Statistica program was used for statistical analysis. RESULTS: The most prevalent reasons for hospitalization in both groups were: pneumonia in the course of COVID-19 (35.5% DM vs 33.7% non-DM) and urinary tract infections (26.3% DM vs 19.2% non-DM). Significantly more non-DM patients required polyantibiotic treatment (69.7% DM vs 89.4% non-DM). The most frequently used antibiotics were β-lactams (59.2% DM vs 57.7% non-DM). In-hospital mortality was 20% (21% DM vs 19.2% non-DM). The length of hospitalization was 1–35 days, the median in the whole group was 9 days (10 days DM vs 8 days non-DM). Both the initial and terminal CRP concentrations were analyzed. The median of the initial value was 71.6 (72.3 DM vs 66.2 non-DM) and the median of the terminal value was 17.15 (17.9 DM vs 15.3 non-DM). The glucose concentration on admission was assessed with the median 123.5 mg/dL (156 mg/dL DM vs 107 mg/dL non-DM). CONCLUSIONS: Many DM complications are well known, yet the course and treatment of infection do not differ significantly in patients with DM and without DM. Despite that, each patient should be considered individually, so the chosen treatment constitutes an optimized therapy.
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WSTĘP: Zakażenia występują u wszystkich pacjentów, w tym także u chorych na cukrzycę (diabetes mellitus – DM), której współwystąpienie może jednak determinować przebieg zakażenia. Celem pracy było porównanie przebiegu i leczenia infekcji u chorych z DM i bez DM. MATERIAŁ I METODY: Analizie poddano dokumentację medyczną 180 pacjentów hospitalizowanych w 2021 r. w Klinice Chorób Wewnętrznych, Autoimmunologicznych i Metabolicznych w Katowicach z powodu infekcji. W analizie uwzględniono wiek, płeć, rozpoznanie kliniczne, metodę leczenia DM, antybiotykoterapię i parametry laboratoryjne. Do analizy statystycznej wykorzystano program Statistica. WYNIKI: Najczęstszymi przyczynami hospitalizacji w obu grupach były: zapalenie płuc w przebiegu COVID-19 (35,5% DM vs 33,7% bez DM) oraz infekcje dróg moczowych (26,3% DM vs 19,2% bez DM). Istotnie więcej pacjentów bez DM wymagało leczenia z użyciem wielu antybiotyków (69,7% DM vs 89,4% bez DM). Najczę-ściej stosowanymi antybiotykami były β-laktamy (59,2% DM vs 57,7% bez DM). Śmiertelność wewnątrzszpi-talna wyniosła 20% (21% DM vs 19,2% bez DM). Czas hospitalizacji wynosił 1–35 dni, mediana w całej grupie wyniosła 9 dni (10 dni w przypadku DM vs 8 dni bez DM). Analizowano zarówno początkowe, jak i końcowe stężenie CRP. Mediana wartości początkowej wyniosła 71,6 (72,3 DM vs 66,2 bez DM), a mediana wartości końcowej 17,15 (17,9 DM vs 15,3 bez DM). Mediana stężenia glukozy przy przyjęciu wynosiła 123,5 mg/dL (156 mg/dL DM vs 107 mg/dL bez DM). WNIOSKI: Wiele powikłań DM jest dobrze znanych, jednak przebieg i leczenie infekcji nie różnią się istotnie u pacjentów z DM i bez DM. Mimo to do każdego pacjenta należy podchodzić indywidualnie, tak aby wybrane leczenie stanowiło zoptymalizowaną terapię.
INTRODUCTION: Carpal tunnel syndrome (CTS) is an upper limb neuropathy that occurs as a result of compression of the median nerve in the carpal tunnel and is the most common mononeuropathy in the general population. The aim of the study was to assess the electrophysiological parameters of the median nerve before and 6 months after surgical treatment of CTS in patients with a history of smoking and comorbidities. MATERIAL AND METHODS: 84 patients with CTS who were eligible for surgery were enrolled in this prospective study. Electrophysiological tests were performed in the patients before and 6 months after surgery for CTS. RESULTS: The results of the study prove that smoking and diabetes significantly worsen the electrophysiological parameters in patients undergoing surgical treatment of CTS. CONCLUSIONS: Smoking and diabetes cause a significantly worse prognosis in patients after surgery for CTS.
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WSTĘP: Zespół cieśni nadgarstka (ZCN) jest neuropatią kończyny górnej, pojawiającą się w wyniku ucisku nerwu pośrodkowego w kanale nadgarstka. Celem badania była ocena parametrów elektrofizjologicznych nerwu pośrodkowego przed leczeniem i 6 miesięcy po leczeniu operacyjnym ZCN u pacjentów obciążonych nikotynizmem oraz chorobami współistniejącymi. MATERIAŁ I METODY: Do prospektywnego badania włączono 84 pacjentów z rozpoznanym klinicznie i elektrofizjologicznie ZCN kwalifikowanych do leczenia operacyjnego. U każdego pacjenta przed leczeniem oraz 6 miesięcy po leczeniu operacyjnym ZCN przeprowadzono badanie elektrofizjologiczne. WYNIKI: Uzyskane wyniki dowodzą, że nikotynizm i cukrzyca istotnie pogarszają parametry elektrofizjologicz-ne u pacjentów poddanych leczeniu operacyjnemu ZCN. WNIOSKI: Nikotynizm i cukrzyca są niekorzystnymi rokowniczo czynnikami u osób operowanych z powodu ZCN.
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