Purpose. Physical activity is an integral part of the treatment of diabetes. The aim of the study was to assess aerobic capacity and cardiovascular-respiratory reactions to a single physical exercise with gradually increasing intensity in normobaric hypoxia in patients with Type 1 diabetes. Methods. The study was conducted on a sample of adults with Type 1 diabetes (GT1D, n = 13) and a randomly chosen healthy control (GK, n = 15). The study participants performed a progressive exercise test to exhaustion in normoxia (FiO2 ~ 20.90%) and 7 days later in normobaric hypoxia (FiO2 ~ 15.14%). At rest, during exercise, and after completion of the test blood was drawn and physiological indicators were monitored. Results. Two-way ANOVA revealed a significant effect of hypoxia and physical exercise on blood glucose concentrations (F = 6.1 p < 0.01). In GT1D , lower glucose levels were observed in normobaric hypoxia compared with baseline and post-exercise levels in normoxia (p < 0.05). A tendency to increased maximal oxygen uptake and significantly higher minute pulmonary ventilation was observed in both groups in response to exercise and hypoxia. Conclusions. Physical activity and hypoxia may effectively control glucose homeostasis and increase cardiorespiratory adaptation to exercise in Type 1 diabetics.
Benign symmetrical lipomatosis (BSL) is known as Madelung’s disease or the Launois-Bensaude syndrome (LBS) and Multiple symmetrical lipomatosis (MSL) as well. It is a rare metabolic disorder, whose etiology remains unknown. The condition mainly aff ects 30–60 year-old people, 15–30 times more males than females. Typically BSL progression occurs during the period of a few months to a few years in patients who have or have had a history of alcohol abuse. The patient’s appearance is characterized by symmetrical, multiple, nonencapsulated masses of lipomata mainly around the head and neck but also in other regions excluding the face, forearms and legs. Neurological disturbances in the form of polyneuropathy in BSL are accompanied by hepatopathy, nephropathy, glucose intolerance or diabetes. The molecular genetic examinations of patients with BSL showed numerous deletions of mitochondrial DNA in muscle and tissue cells due to alcohol abuse as well. The diagnosis of BSL confi rms the unique appearence of the patients and anamnesis. No laboratory parameters specifi c to the condition exist. USG with biopsy, cross-sectional imaging with CT or MR imaging confi rm the diagnosis. The main indications for the treatment of BSL are shortness of breath, swallowing disorders, restriction of head and neck motion and aesthetic considerations. The standard treatment is surgical excision of the pathological tissues. The disease is progressive and relapses after removal are often observed.
PL
Łagodna symetryczna tłuszczakowatość (benign symmetrical lipomatosis – BSL) jest znana również pod nazwami: choroba Madelunga, zespół Launois- Bensaude (Launois-Bensaude syndrome – LBS) czy też liczna symetryczna tłuszczakowatość (multiple symmetrical lipomatosis – MSL). Jest to rzadka choroba metaboliczna o nieznanej etiologii. Najczęściej ujawnia się między 30. a 60. rokiem życia, rozwija się w okresie od kilku miesięcy do kilku lat, 15–30 razy częściej u mężczyzn niż u kobiet. Głównie dotyczy osób długotrwale nadużywających alkoholu. Chrakteryzuje się symetrycznym gromadzeniem nieotorebkowanych mas tłuszczakowych głównie w okolicy głowy i szyi, ale także w innych okolicach, z wyjątkiem przedramion, podudzi i twarzy. Obok zaburzeń neurologicznych o charakterze polineuropatii, w chorobie występują marskość stłuszczeniowa wątroby oraz uszkodzenie kanalików nerkowych, a także nietolerancja glukozy lub cukrzyca. Molekularne badania genetyczne chorych na BSL potwierdzają liczne delecje mitochondrialnego DNA w komórkach mięśniowych i tłuszczowych, które są także wywołane wpływem alkoholu. Rozpoznanie ustala się głównie na podstawie badania podmiotowego i przedmiotowego. Nie ma żadnego specyficznego parametru laboratoryjnego charakteryzującego BSL. Pomocnymi metodami diagnostycznymi są USG z możliwością BAC, TK oraz MRI. Głównymi wskazaniami do leczenia BSL są duszność, zaburzenia połykania, trudności w poruszaniu głową i szyją, względy estetyczne. Podstawową metodą leczenia jest chirurgiczne usunięcie patologicznych tkanek. Choroba ma charakter postępujący, po usunięciu tkanek często obserwuje się nawroty.
Any new method of treatment is associated with high expectations for its success, particularly if the therapy is based not only on the premise of achieving a symptomatic effect, but also improving functional quality and repairing structurally damaged tissues. Platelet Rich Plasma (PRP) application was shown to be a successful catalyst in the healing process for a wide variety of conditions in animal and human models. However, its use has been controversial due to many types of the PRP definition, optimal concentration, and modalities of implementation. In the qualification of patients for PRP treatment, not only should medical indications be considered, but also the role of participation in therapy with a physiotherapist supervising physical parameters and techniques used during recovery time. Further study is required in order to define optimal handling procedures of PRP injection. Long-term follow up will reveal if the promise of this substance can be realized and implemented to maximize its potential as a therapeutic remedy.
Wound healing is a complex pathophysiological process, in which platelets play a crucial role. Platelet alpha-granules release growth factors to the wound bed; the factors are necessary in the healing process. In chronic wounds, such as poorly healing lower-leg ulcers of venous origin, there is decreased activity of multiple growth factors, so the concept of exogenous delivery of such factors seems a logical strategy. Platelet-rich plasma therapy in patients with lower-leg ulcers of venous origin combined with conventional treatment methods (previously ineffective in these patients) seems, based on our observation, an important adjunct leading to recovery. The aim of the study was to present an original method of autologous platelet-rich plasma application through the creation of a sort of “biological chamber” containing a concentrate of growth factors. Material and methods. The described therapy was implemented in 10 patients, who had been ineffectively treated for more than one year in the outpatient setting. Patients with exacerbation of inflammatory process, signs of wound infection and ankle brachial pressure index < 0.8 were excluded from the study. After the application of platelet-rich plasma, further treatment was continued with the use of moist therapy and compression therapy according to a uniform regimen. Results. Complete healing was achieved within 4-10 weeks from the beginning of the product administration in all patients. Conclusion. The presented method seems technically simple, effective and relatively inexpensive
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