Medicine (General)
Steroid Use, Adrenal Suppression, and Emergency Department Visits in COPD Patients: A Cross-Sectional Study
This study aims to investigate the relationship between steroid use adrenal suppression and frequent emergency department (ED) visits in patients with Chronic Obstructive Pulmonary Disease (COPD).
Systemic glucocorticoids are commonly prescribed in the management of COPD exacerbations; however prolonged or repeated steroid use may lead to adrenal suppression. Although the standard steroid regimen for COPD exacerbations is short-term frequent ED visits may result in cumulative steroid exposure raising concerns about adrenal insufficiency and its clinical consequences.
This study investigates the potential association between steroid-induced adrenal suppression and frequent ED visits among COPD patients. It further examines the impact of steroid administration on cortisol and Adrenocorticotropic hormone (ACTH) levels.
This prospective cross-sectional observational study was conducted in a university-based ED. Patients with COPD with dyspnea and who presented to the ED between 06:00-08:00 were included. Demographics previous presentations to the ED medications used hormone levels and other laboratory results were recorded.
Fifty patients (82% were male) included. Sputum symptoms along with incidences of heart failure were higher in patients who received steroids in the ED. Ronchi was higher crackles and pretibial edema were lower in the patients who received steroids in the ED. Among the patients with low cortisol levels the frequency of patients who received steroids in the ED was higher than those who did not.
Primary healthcare clinicians should monitor COPD patients for potential adrenal insufficiency. Careful regulation of steroid dosages during exacerbation treatment and minimizing polypharmacy are essential to mitigate the long-term effects of prolonged steroid use.
A Rare Case of Ischial Tubercle Pressure Sore with Secondary Periperineal Necrotizing Fasciitis
Perineal necrotizing fasciitis or Fournier's gangrene is a rare but rapidly progressing condition characterized by fascial necrosis. It is a severe potentially life-threatening infection requiring prompt diagnosis and standardized treatment to optimize patient outcomes.
A 48-year-old woman with poorly controlled type 2 diabetes developed necrotizing fasciitis of the right perineum secondary to an ischial tuberosity pressure ulcer. She had a prior spinal cord injury resulting in sensory dysfunction in the lower limbs which masked significant pain. Management included surgical debridement open wound care antimicrobial therapy and a free skin graft for wound closure.
Effective treatment of necrotizing fasciitis relies on aggressive debridement and appropriate antimicrobial therapy. This case highlights the importance of early recognition and intervention to improve clinical diagnostic and management strategies.
Prognostic Value and Immune Characterization of Genes Associated with Childhood Acute Leukemia applying Single-Cell RNA Sequencing
Childhood acute lymphoblastic leukemia (cALL) the most common pediatric hematologic malignancy arises primarily from B-cell origin and is strongly associated with immune dysfunction. This article integrated single-cell and bulk transcriptomic data to identify key B-cell subsets and cALL-related molecules as biomarkers.
Single-cell RNA sequencing (scRNA-seq) Data from 2 pre-B high hyperdiploid (HHD) ALL patients and 3 healthy pediatric bone marrow samples (GSE132509) were utilized for cell clustering using the Seurat package. Functional enrichment pseudo-time trajectory and cell-cell communication analyses were performed using clusterProfiler Monocle2 and CellChat R packages respectively. Bulk RNA-seq data of 511 cALL samples in the TARGET-ALL-P2 cohort were used to construct a prognostic model via Cox and LASSO regression. Immune infiltration differences between different risk groups were analyzed using ESTIMATE MCP-counter and CIBERSORT algorithms.
The scRNA-seq analysis identified five cell subpopulations with B cells demonstrating significant enrichment in cALL samples. Notably the C2 subset was associated with cell proliferation. Ligand-receptor analysis revealed key interactions involving B cell C2. Four marker genes (CENPF IGLL1 ANP32E and PSMA2) were identified to build a risk model. Low-risk patients showed better survival while high-risk patients had higher ESTIMATE scores.
This study examined the key role of B cells in cALL constructed a risk model with strong prognostic predictive ability applying multi-omics analysis and primarily explored its potential mechanism in immune regulation.
This study revealed the critical role of B cells in cALL and the prognostic model showed a high prediction accuracy providing a potential target for individualized treatment of cALL.
Esketamine Reduces Lung Injury Caused by Limb Ischemia-Reperfusion by Regulating Oxidative Stress via the TLR4/NF-κB/NLRP3 Pathway
Esketamine has shown promise in mitigating tissue damage caused by ischemia-reperfusion injury making it a potential therapeutic candidate for acute lung injury (ALI) induced by limb ischemia-reperfusion (LIR-ALI).
This study sought to explore the role and mechanism of esketamine in the LIR-ALI rat model.
The effects of esketamine on the LIR-ALI rats model were evaluated through histopathological examination assessment of pulmonary edema measurement of MDA and SOD levels and analysis of inflammatory cytokine levels (IL-1β etc.) in the bronchoalveolar fluid (BALF) and serum. Western blot analysis was used to assess the expressions of TLR4 NF-κB and NLRP3. TLR4 agonist LPS was used to validate the role of NF-κB/NLRP3 pathway in LIR-ALI.
Esketamine significantly alleviated LIR-induced ALI by reducing pulmonary edema inflammatory cell infiltration and oxidative stress. Elevated MDA content and suppressed SOD activity were significantly reversed by esketamine along with inactivity of the TLR4/NF-κB/NLRP3 pathway. Esketamine treatment reduced inflammatory response in BALF and serum. TLR4 activation by LPS reversed the ameliorative effects of esketamine on LIR-ALI.
Esketamine protected against LIR-induced ALI by mitigating oxidative stress and suppressing the TLR4/NF-κB/NLRP3 axis. These findings highlight the potential therapeutic value of esketamine for ALI.
Single-cell RNA Sequencing Analysis Reveals the Regulatory Functions of Copines Family Genes in Testicular Cancer Progression
The aim of this study is to investigate the expression patterns and regulatory functions of Copines family genes in different cellular subpopulations in testicular cancer based on single-cell data and to analyze the regulatory mechanism of Copines family genes in cancer.
Testicular cancer is a frequently diagnosed male tumor. Emerging evidence suggests that Copines family genes are implicated in a variety of cancer phenotypes and cancer progression. Analyzing the expression pattern of Copines family genes in testicular cancer may help improve the treatment efficacy of the cancer.
This study sought to characterize the expression profiles of Copines family genes in the cellular subpopulations of testicular cancer and to identify key signaling pathways through which they regulate cancer progression.
Based on single-cell transcriptomic data of testicular cancer we classified testicular cancer cell subpopulations and analyzed the expressions of Copines family genes in each subpopulation. Cell subpopulations were grouped according to the expression levels of Copines family genes and differentially expressed Copines family genes between the groups were screened by differential expression analysis. Functional enrichment analysis on the differentially expressed genes (DEGs) was performed with a clusterprofiler package. Functional pathways enriched by the Copines family genes were calculated by AUCell enrichment score. Copy number variation (CNV) analysis was performed using inferCNV to analyze gene mutation patterns across cellular subpopulations and pseudotime analysis was conducted using Monocle to infer cellular differentiation pathways of cellular subpopulations.
Single-cell clustering identified four major cell subpopulations namely NK/T cells tumor cells B cells and macrophages. Notably the control samples had a relatively small proportion of tumor cells. Further clustering of the tumor cells identified six cell subpopulations among which multiple Copines genes especially CPNE1 and CPNE3 showed a high expression. The testicular cancer samples were grouped by the expression patterns of Copines genes and the DEGs between groups included GNLY MGP1 CFD2 CCL21 SPARCL13 as well as some other genes involved in the malignant progression of cancer. Pseudotime analysis showed that the upregulated genes were enriched in cell migration and PI3K-Akt pathway while the downregulated genes were related to immunity. This indicated that the Copines genes regulated the cellular heterogeneity and malignant transformation in testicular cancer.
This study revealed the potential molecular mechanism through which Copines family genes drove the progression of testicular cancer through regulating PI3K-Akt signaling pathway and cell cycle providing a new target for the development of precision treatment targeting Copines family genes and prognostic assessment of the cancer.
Sterile Inflammation and Cell Death Pathways in Liver Ischemia-Reperfusion Injury: A Review and Perspective
Hepatic Ischemia-Reperfusion Injury (IRI) is a critical complication in liver transplantation and resection driven by oxidative stress and sterile inflammation mediated by damage-associated molecular patterns (DAMPs). Current therapeutic challenges arise from interconnected cell death pathways and redundant inflammatory mechanisms.
This review synthesizes mechanistic insights into DAMP signaling and regulated cell death modalities in IRI aiming to identify translational gaps and propose precision-targeted therapies.
A literature search in PubMed using keywords “IRI” “DAMPs” and cell death modes was conducted without date restrictions. Peer-reviewed studies on human/animal models were included with qualitative synthesis of DAMP-cell death interactions.
During ischemia mitochondrial dysfunction releases HMGB1 ATP and mtDNA activating Kupffer cell TLR4/RAGE and cGAS-STING pathways triggering NLRP3 inflammasome- driven cytokine storms. Reperfusion amplifies ROS bursts lipid peroxidation and iron overload creating a self-sustaining cycle of damage. Cell death modalities exhibit spatiotemporal specificity: hepatocyte ferroptosis dominates early injury while macrophage pyroptosis and necroptosis predominate in steatotic livers during late phases. HMGB1 lactylation and mtDNA-cGAS signaling emerge as key regulators. Machine perfusion (e.g. hypothermic oxygenated perfusion) reduces biliary complications via mitochondrial resuscitation outperforming conventional drug-based therapies.
Current single-pathway targeting shows limited efficacy due to IRI’s complexity. Future strategies should integrate temporal targeting (ferroptosis inhibitors pre-reperfusion; pyroptosis blockers post-reperfusion) DAMP-neutralizing agents (anti-HMGB1 antibodies) and precision preservation combining multi-omics biomarkers with ex vivo pharmacological preconditioning. Addressing metabolic vulnerabilities in fatty livers and refining cell death-specific interventions are critical for bridging translational gaps.
Yipishen Xiezhuo Jiedu Decoction in Ameliorating Kidney Damage Through miR-223/NLRP3/Caspase-1 Pathway
Hyperuricemia Nephropathy (HN) is an emerging metabolic disorder that predisposes individuals to Chronic Kidney Disease (CKD) yet effective treatments remain limited. Inflammation plays a pivotal role in HN-induced kidney injury with the NLRP3 inflammasome serving as a central mediator of this process. This study investigates the therapeutic effects of Yipishen Xiezhuo Jiedu Decoction (YPSXZJDD) a traditional Chinese medicine on HN-induced kidney injury through the miR-223/NLRP3/Caspase-1 pathway.
The key active components of YPSXZJDD were screened using UHPLC-Q Exactive Orbitrap-MS and a Protein-Protein Interaction (PPI) network diagram was constructed to explore potential mechanisms of action. The identified components were then utilized to intervene in both cellular and animal models of hyperuricemic nephropathy evaluating their therapeutic effects and underlying mechanisms.
Catalpol and Tanshinone IIA were identified as the key active components of YPSXZJDD. These compounds significantly mitigated renal epithelial cell apoptosis and inflammation by upregulating miR-223 which in turn inhibited the NLRP3/Caspase-1 pathway. The upregulation of miR-223 led to a marked reduction in NLRP3 activity and inflammatory responses thereby alleviating HN-induced kidney damage.
The findings of this study underscore the critical role of miR-223 in regulating the NLRP3 inflammasome and highlight its potential as a therapeutic target for HN. The inhibition of the NLRP3/Caspase-1 pathway by miR-223 significantly reduces inflammation and renal injury demonstrating the therapeutic efficacy of YPSXZJDD. These results offer a novel perspective on the application of traditional Chinese medicine in treating HN highlighting the importance of miR-223 in regulating inflammation.
This study demonstrates that YPSXZJDD alleviates HN-induced kidney injury by upregulating miR-223 and inhibiting the NLRP3/Caspase-1 pathway. The therapeutic potential of YPSXZJDD is supported by its ability to mitigate inflammation and renal damage offering a promising approach for HN treatment. Further research into the broader role of miR-223 in kidney disease and related conditions is warranted to expand the understanding of its therapeutic applications.
Immunocytes Play a Crucial Role as Mediators in the Protective Effects of D-β-Hydroxybutyrate Dehydrogenase 1 against Type 2 Diabetes Mellitus: A Mendelian Randomization Study
Observational studies suggest an association between the immune system and type 2 diabetes. The present study sought to ascertain the causal relationship between BDH1 and type 2 diabetes and investigate whether immunocytes mediate this relationship.
Appropriate single nucleotide polymorphisms (SNPs) were carefully selected from publicly available GWAS databases based on rigorous criteria to ensure the validity of the Mendelian randomization (MR) analysis. Inverse variance weighting (IVW) was employed as the primary approach for assessing effect sizes supplemented by four sensitivity analysis techniques: weighted median simple mode weighted mode and MR-Egger regression tests all aimed at ensuring the robustness and reliability of the IVW results. Reverse MR was conducted to confirm the feasibility of the mediation analysis. Lastly Cochran’s Q test MR Egger intercept regression and MR-PRESSO analysis were utilized to examine heterogeneity and horizontal pleiotropy.
The expression of BDH1 is inversely associated with the risk of type 2 diabetes with an odds ratio of 0.97 (95% CI: 0.95-0.99). IgD+ CD38+ B cell absolute count (20.7%) HLA DR on dendritic cell (18.7%) BAFF-R on CD20- CD38- B cell (9.5%) CD25 on IgD+ CD24+ B cell (4.1%) and BAFF-R on IgD+ B cell (3.4%) all exhibit certain mediating effects whereas IgD+ CD38+ B cell absolute count activated and resting CD4 regulatory T cell % CD4+ T cell transitional B cell absolute count CD28- CD8 dim T cell absolute count CD45 on HLA DR+ CD8+ T cell FSC-A on HLA DR+ natural killer and SSC-A on plasmacytoid dendritic cell exert masking effects.
The findings indicate that immunocytes could serve as a crucial mediating mechanism through which BDH1 exerts its protective effect against type 2 diabetes offering novel insights for the prevention and therapeutic management of the disease.
Diagnostic Biomarkers and Targeted Drug Prediction for Acute Kidney Injury: A Computational Approach
Acute Kidney Injury (AKI) is a clinical syndrome with rapid onset and poor prognosis and existing diagnostic methods suffer from low sensitivity and delay. To achieve early identification and precise intervention there is an urgent need to discover new precise biomarkers.
AKI samples were acquired from Gene Expression Omnibus (GEO) database. AKI-related module genes were identified using the “WGCNA” package. The “Limma” package was used to filter Differentially Expressed Genes (DEGs). Protein interaction networks were constructed by intersecting key modular genes with DEGs and six algorithms (MCC MNC Degree EPC Closeness and Radiality) in the cytoHubba plug-in were combined to screen candidate genes. Diagnostic biomarkers were cross-screened using LASSO regression with Support Vector Machine–Recursive Feature Elimination (SVM-RFE) machine learning algorithm and their predictive performance was verified by Receiver Operating Characteristic (ROC) analysis. Transcription Factors (TFs) regulatory network was constructed applying Cytoscape 3.8.0. Finally the prediction and molecular docking analysis of potential target drugs were performed using the DSigDB database and AutoDockTools.
A total of 498 key modular genes significantly associated with AKI were screened and 88 AKI-related DEGs and 18 candidate genes were further identified. Importantly four biomarkers with high diagnostic value (DDX17 FUBP1 PABPN1 and SF3B1) were screened and validated using dual machine learning algorithms including LASSO regression and SVM-RFE. The area under the ROC curve (AUC) values for these biomarkers were greater than 0.8 indicating good predictive performance. Moreover 19 TFs and 17 miRNA of SF3B1 10 TFs and 58 miRNA of PABPN1 15 TFs and 60 miRNA of FUBP1 together with 13 TFs and 109 miRNA of DDX17 were screened. Drug prediction and molecular docking analysis revealed that Demecolcine and Testosterone Enanthate stably bind to certain markers.
Four potential biomarkers closely related to AKI were identified which may be involved in the occurrence and progression of AKI by regulating key processes such as transcription. The predicted Demecolcine and Testosterone Enanthate may also be involved in the repair of renal injury by regulating key target genes. Although further experimental validation is still needed these may still provide new intervention strategies for the treatment of AKI.
To conclude four AKI biomarkers with high diagnostic value were screened by integrating multiple computational methods revealing a new perspective on the molecular mechanism of AKI. The results provided a new theoretical basis for achieving early precision diagnosis and individualized treatment of AKI.
Association of Anti-TPO Antibody and Inflammatory Markers with Thyroid Ultrasound Findings
The objective of this study was to evaluate the demographic clinical laboratory and ultrasonographic characteristics of patients diagnosed with subclinical hypothyroidism with a particular emphasis on the anti-thyroid peroxidase (anti-TPO) antibody and inflammatory biomarkers.
The study included 157 patients diagnosed with subclinical hypothyroidism categorised into anti-TPO-positive and anti-TPO-negative groups. A retrospective comprehensive evaluation comprising demographic data thyroid medication status ultrasonographic characteristics and laboratory parameters was conducted and statistically analysed between the groups.
Of 157 patients 48.4% were anti-TPO positive. This group was significantly associated with increased levothyroxine (LT4) use and sonographic parenchymal heterogeneity. However there were no significant differences in nodule presence number size or structure. A positive correlation was found between anti-TPO and ferritin levels. In addition a positive correlation was observed between the thyroid-stimulating hormone (TSH)/free T4 ratio and the solidity of nodules as well as between TSH and the neutrophil-to-lymphocyte ratio (NLR). Surprisingly a negative correlation was found between anti-TPO levels and the number of nodules as well as the cystic characterisation of the nodules.
In our study higher levels of anti-TPO and TSH were associated with inflammatory markers such as ferritin and NLR suggesting a possible link with systemic inflammation. Furthermore anti-TPO and the TSH/T4 ratio also showed associations with specific sonographic features of the thyroid gland.
TSH and anti-TPO levels might be associated with systemic inflammation and thyroid sonographic findings in patients with subclinical hypothyroidism. More studies on larger patient populations should confirm the same results to suggest their clinical significance.
Diabetes Mellitus: Exploring Biomarkers, Complications, and Therapeutic Strategies with a Spotlight on Cyanobacterial Bioactive Compounds - A Comprehensive Review
Diabetes regarded as a prevalent metabolic disorder with multifactorial origins contributes to a myriad of global complications. These cumulate an elevated susceptibility to kidney failure nerve impairment blindness atherosclerosis heart ailments and even strokes. Recent investigations underscore the diverse roles of associated biomarkers in diabetes progression. Among these are biomarkers for diabetes mellitus such as DPP-4 PPAR-ϒ SGLT-2 α-amylase and α-glucosidase which are linked to the onset of diabetes and its related problems. As a result of undesirable adverse consequences linked to extant synthetic antidiabetic medications research attention is increasingly directed towards formulating natural antidiabetic drugs aiming for enhanced efficacy and reduced complications. Cyanobacteria stand out as a pivotal repository of natural bioactive metabolites extensively harnessed for pharmaceutical and nutraceutical development. The potent bioactive compounds sourced from cyanobacteria hold substantial promise kindling high expectations in scientific research and presenting vast prospects for drug discovery and advancement. Some of these bioactive compounds have demonstrated impressive effectiveness displaying successful applications across various phases of clinical trials. This review strives to provide a more precise understanding of diabetes mellitus encompassing its clinical manifestation epidemiological data complications and prevailing treatment modalities. The objective of this review is to contribute researchers and readers an enhanced and accurate understanding of diabetes mellitus by covering its clinical manifestation epidemiological evidence difficulties and prevailing therapeutics possibilities.
Herbal Insights: Exploring the Therapeutic Potential of Indian Dietary Herbs in Diabetic Cardiomyopathy Management
Diabetic Cardiomyopathy (DCM) poses a substantial healthcare challenge necessitating innovative therapeutic strategies. This review delves into the evolving role of traditional Indian dietary herbs in managing DCM aiming to shed light on their potential contributions.
A comprehensive examination of the existing body of literature was conducted synthesizing data from studies exploring the effects of various Indian dietary herbs on DCM. Molecular mechanisms clinical outcomes and safety profiles were scrutinized to establish a holistic perspective on their therapeutic potential.
The review illuminates the multifaceted benefits of Indian dietary herbs in DCM management. These herbs have demonstrated efficacy in mitigating cardiac dysfunction reducing oxidative stress and modulating inflammatory responses. Molecular insights highlight their role in the intricate signaling pathways underlying DCM. Furthermore their safety profiles render them promising candidates for adjunct therapy.
Indian dietary herbs emerge as promising allies in the battle against DCM offering a holistic approach to the management of this intricate condition. Their cardioprotective effects coupled with their ability to address the underlying molecular mechanisms herald a new era in DCM therapy. This review underscores the need for further research to harness the potential of these herbs fully and provides a beacon of hope for individuals affected by DCM.
Phloridzin's Diabetic Wound Healing Potential through DPP-4 Enzyme Inhibition: A Review Article
Diabetic wound healing is a dynamic medical process that takes place in an environment within the body that is complex and contains elevated sugar levels oxygen deprivation and cellular oxidative stress. Phloridzin (Phlorizin) is one of the most well-known polyphenols found in apples because of its anti-inflammatory antioxidant antibacterial antidiabetic and antiseptic properties; it can also play a significant part in the healing of diabetic wounds.
The study aimed to investigate the role of phloridzin as an efficient DPP-4 inhibitor with additional therapeutic effects in diabetic wound healing as Dipeptidyl Peptidase-4 (DPP-4) expression increases in response to increases in glucose Reactive Oxygen Species (ROS) and inflammation. Phloridzin inhibiting DPP-4 preserves Stromal cell-derived Factor-1α (SDF-1α) Insulin-like Growth Factor (IGF) and Glucagon-like Peptide-1 (GLP-1) which are possible DPP-4 substrates involved in wound healing.
The accessible material from systemic searches in PubMed Scopus and published articles was reviewed with no period of limitation.
The in silico study showed strong binding of phloridzin with DPP-4 protein (2P8S); also in vitro DPP-4 inhibition assay has shown better inhibition by phloridzin. This study offers new research directions for examining phloridzin’s capacity to withstand oxidative stress as well as for redefining its tactical function as a powerful DPP-4 inhibitor to regulate the process involved in the healing of diabetic wounds.
Evidence of a Bi-Directional Relationship between Arterial Stiffness and Diabetes: A Systematic Review and Meta-Analysis of Cohort Studies
There are numerous cross-sectional studies showing an association between arterial stiffness and diabetes but the temporality of the association is unclear.
To investigate the temporal relationship between arterial stiffness and diabetes.
We searched MEDLINE and Embase from inception to 31 August 2023 to identify cohort studies that assessed whether arterial stiffness as measured by pulse wave velocity (PWV) was predictive of the development of diabetes and vice versa. We summarised study data and where possible undertook meta-analysis.
We identified 19 studies that included people with type 1 type 2 and gestational diabetes. All 11 studies investigating arterial stiffness as a predictor of diabetes found a significant relationship. Six of those studies were suitable for meta-analysis. The risk of developing diabetes was greater in people with higher PWV at baseline than lower PWV (RR = 2.14 95%CI 1.65 to 2.79 p < 0.00001) and the mean difference in baseline PWV was higher in people who developed diabetes than those who did not (mean difference: 0.77 m/s 95%CI 0.47 to 1.06 p < 0.00001). Of 8 studies investigating diabetes as a predictor of arterial stiffness 7 found a significant relationship.
There is evidence of a bidirectional relationship between arterial stiffness and diabetes. Arterial stiffness may provide a causal link between diabetes and future cardiovascular disease.
CRD42019129563.
The Effect of COVID-19 Lockdown Among Adolescents with Type 1 Diabetes: A Systematic Review and Meta-Analysis
The aim of this study was to assess how the lockdown of the COVID-19 pandemic had affected the glycaemic control of adolescents aged 10-19 with type 1 diabetes.
A comprehensive search of literature was performed in PubMed Scopus Web of Science and ProQuest. Published articles up to September 2022 were included. The Glucose Monitoring Index (GMI) and HbA1c level were defined as outcome variables. Average glucose level was found to be a common variable in both HbA1c levels and GMI; therefore HbA1c and GMI were converted to average glucose (mg/dL) using appropriate formulas. Studies reported the outcomes in two or three periods (pre-lockdown lockdown and post-lockdown) were included in the analysis. A paired wise meta-analysis was performed among the studies that reported all three periods. Homogeneity across studies was assessed using I2 statistic.
Fourteen studies were included in the study. The pooled average glucose during the lockdown decreased to 166.9 mg/dL (95% CI 153.78 180.02) from 205.793 mg/dL (95% CI 188.412 223.173) during the pre-lockdown period then it increased to 204.23 mg/dL (95% CI 186.17 222.29) during the post-lockdown period. A paired wise meta-analysis indicated a reduction in average glucose levels. However it was not statistically significant possibly due to the small number of studies that reported data from all three periods.
Although the descriptive analysis of our study showed that the lockdown had affected (decreased) the average glucose level among adolescents with type 1 diabetes this was not statistically significant in the pooled analysis.
The Impact of Low-Volume High-Intensity Interval Training (LV-HIIT) on Fatty Liver Index (FLI) and Estimated Glomerular Filtration Rate (eGFR) in Patients with Type 2 Diabetes Mellitus (T2DM)
Prevention and reduction of liver fat accumulation and maintenance of Glomerular Filtration Rate (GFR) have been proposed as important therapeutic goals in patients with Type 2 Diabetes Mellitus (T2DM).
This study aimed to determine the effect of Low-Volume High-Intensity Interval Training (LV-HIIT) on fatty liver index (FLI) and GFR estimation in patients with T2DM.
This randomized controlled trial included 80 patients with T2DM and a sedentary lifestyle randomly divided into HIIT (n=40) and a control group (n=40). Patients with a history of T2DM for at least one year and HbA1C levels between 6.4% and 10% were selected. The intervention group underwent a 4-week LV-HIIT course comprising 3 sessions per week while the control group did not receive any intervention. FLI eGFR anthropometric measurements and laboratory variables were assessed in all participants before and after the intervention.
FLI (62.0 at baseline 53.0 at follow-up) significantly decreased in the LV-HIIT group after the intervention while eGFR (71.0 at baseline 73.6 at follow-up) significantly increased (P<0.001). However the control group showed a significant reduction only in Fasting Blood Sugar (FBS) (P<0.05). After the intervention the LV-HIIT group had significantly lower FBS (129.0 at baseline 121.0 at follow-up) Alanine Aminotransferase (ALT) (24.0 at baseline 18.0 at follow-up) and Gamma-Glutamyl Transferase (GGT) (22.0 at baseline 19.0 at follow-up) as well as higher eGFR compared to the control group (P<0.05).
LV-HIIT exercise appears to be a promising and effective training method for improving FLI and eGFR in patients diagnosed with T2DM.
IRCT 20200 729048246N1.
Prevalence and Predictors of Albuminuria in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study from the United Arab Emirates
Albuminuria in Diabetes mellitus (DM) patients may lead to nephropathy and end-stage renal disease. Our study aimed to assess the prevalence of albuminuria and its associated predictors among type 2 DM patients in the United Arab Emirates.
A retrospective cross-sectional study was conducted among type 2 DM patients in the diabetic clinic at Fujairah Hospital from 1st January 2016 to 30th January 2020 after getting the ethical clearance. Data were collected electronically from the health information system and analyzed using SPSS version 26. Regression analysis and ANOVA were used for inferential analysis. A P-value of ≤0.05 was considered significant.
Among the 200 patients included in the study the mean age of the study population was 56 years and the majority of them were females (71%). The prevalence of albuminuria was found to be 44%. By using regression analysis glycated hemoglobin (HbA1c; P=0.038) and systolic blood pressure (SBP; P=0.003) were found to be predictors of albuminuria. One way ANOVA revealed that there were significant associations between the albumin levels and HbA1c (P=0.004) SBP (P= 0.002) diastolic blood pressure (DBP; P=0.028) serum creatinine (Scr) (P=0.039) and glomerular filtration rate (GFR; P=0.013).
To the best of our knowledge this is the first study from Fujairah emirate that explored the prevalence and predictors of albuminuria in type 2 DM patients. We found a high prevalence of albuminuria among type 2 DM patients. HbA1c and SBP directly contributed to albuminuria. To improve glycemic control patients need to improve physical activity reduce overweight and adherence to medications that improve overall therapeutic outcomes.
Design of a Low-Complexity Deep Learning Model for Diagnosis of Type 2 Diabetes
Recent research demonstrates that diabetes can lead to heart problems neurological damage and other illnesses.
In this paper we design a low-complexity Deep Learning (DL)-based model for the diagnosis of type 2 diabetes. In our experiments we use the publicly available PIMA Indian Diabetes Dataset (PIDD). To obtain a low-complexity and accurate DL architecture we perform an accuracy-versus-complexity study on several DL models.
The results show that the proposed DL structure including Convolutional Neural Networks and Multi-Layer Perceptron models (i.e. CNN+MLP model) outperforms other models with an accuracy of 93.89%.
With these features the proposed hybrid model can be used in wearable devices and IoT-based health monitoring applications.
Ultrasound Evaluations of Ankle and Foot Muscles in Diabetic Peripheral Neuropathy Systematic Review with Meta-Analysis
Diabetic peripheral neuropathy (DPN) is the prevalent microvascular complication of diabetes mellitus (DM). 30-50% of diabetics are likely to be affected by DPN. It significantly impacts the skeletal muscles resulting in an accelerated loss of muscle mass. The objective of this systematic review was to evaluate the ankle and foot muscle changes in diabetic peripheral neuropathy using ultrasound.
A comprehensive search was conducted in Scopus Embase and PubMed databases which yielded 64 studies out of which 5 studies are included in this meta-analysis.
The meta-analysis shows that the thickness and cross-section area of the extensor digitorum brevis muscle are reduced in DPN as compared to the control group with p-value<0.004 and p-value<0.001 respectively. The thickness of MIL muscle was also smaller in DPN p-value=0.02. Similarly the thickness and CSA of AH muscle are also reduced in DPN patients compared to the control group with p-values of 0.21 and 0.14.
Meta-analysis reveals that diabetic peripheral neuropathy (DPN) patients have reduced foot muscle thickness and cross-sectional area (CSA) compared to controls without neuropathy. This highlights the importance of ultrasound in detecting muscle atrophy early in diabetic patients since it provides objective measures beyond traditional screening with its real-time and non-invasive nature.