Takotsubo cardiomyopathy (also referred to as transient apical ballooning syndrome, broken heart syndrome or stress cardiomyopathy) is an increasingly recognized entity in the western world typically characterized by ...Takotsubo cardiomyopathy (also referred to as transient apical ballooning syndrome, broken heart syndrome or stress cardiomyopathy) is an increasingly recognized entity in the western world typically characterized by reversible left ventricular dysfunction that develops in the setting of acute severe emotional or physical stress. Increased catecholamine levels have been proposed to play a central role in the pathogenesis of the disease, although the specific pathophysiology of this condition remains elusive at the present moment. In recent times, there have been reports of takotsubo cardiomyopathy (TC) following medical interventions such as invasive or surgical procedures or specific medical regimens. In the current report, we present a patient with multiple recurrences of TC triggered by the same medical therapeutic intervention; in our particular case, repetitive exposure to inhaled beta-2-adrenoceptor agonist.展开更多
Beta-2-microglobulin (B2M) is a low molecular weight polypeptide (11,800 Da) that exists in a free form and a form bound to cell membranes (light chains of HLA class I molecules). Their dosage is used in the explorati...Beta-2-microglobulin (B2M) is a low molecular weight polypeptide (11,800 Da) that exists in a free form and a form bound to cell membranes (light chains of HLA class I molecules). Their dosage is used in the exploration and monitoring of renal function in haemodialysis patients, hence the interest of this study, the objective of which is to study the different players involved in the increase of beta-2-microglobulin. <strong>Materials and Methods:</strong> This was a prospective and descriptive study from January 1<sup>st</sup>, 2017 to August 31, 2017 (08 months). All patients with chronic hemodialysis for 3 years or more were included. We analyzed sociodemographic, clinical and paraclinical data. <strong>Results:</strong> We collected 50 patients. The mean age was 50 ± 4.6 years with extremes of 30 and 82 years. The female sex predominated (52%). Chronic end-stage renal failure was hypertensive (86%), diabetic (4%). All patients benefited from intermittent hemodialysis for 8 hours per week using a low permeability membrane (cuprophane). The average duration of hemodialysis was 68 ± 6.4 months with extremes of 36 and 204 months. Twenty percent (20%) and four percent (4%) of chronic dialysis patients had joint pain and sensory deficit. Phalen’s sign was positive in 2% (1 case), Tinel’s sign in 2% (1 case) and carpal tunnel syndrome in 2% (1 case). The mean serum beta-2-microglobulin level was 58.34 ng/l with extremes of 16.99 and 112.24 ng/l. There was a correlation between hypertensive nephropathies and beta-2-microglobulin levels above 50 ng/l (P < 0.001). The mortality rate was 6%. <strong>Conclusion:</strong> Our study has objectified factors such as inadequate dialysis (8 hours/week), use of low permeability membrane in the increase of beta-2-microglobulin. The increase in serum beta-2-microglobulin levels in our patients is evidence of poor purification of medium molecules. Its reduction can be established by improving the quality of dialysis, in particular by using a high-permeability membrane.展开更多
目的:分析格列吡嗪与二甲双胍联用治疗新发初诊2型糖尿病患者的应用价值。方法:研究对象选取2024年4月至2025年4月在本院收治的102例初诊2型糖尿病患者,以信封法随机分为联合组和二甲双胍组,两组均51例,二甲双胍组予以二甲双胍治疗,联...目的:分析格列吡嗪与二甲双胍联用治疗新发初诊2型糖尿病患者的应用价值。方法:研究对象选取2024年4月至2025年4月在本院收治的102例初诊2型糖尿病患者,以信封法随机分为联合组和二甲双胍组,两组均51例,二甲双胍组予以二甲双胍治疗,联合组予以格列吡嗪联合二甲双胍治疗,两组患者均干预3 m。比较两组血糖水平、空腹C肽、餐后2 h C肽、胰岛β细胞功能指数(Homeostasis model assessment-β,HOMA-β)、胰岛抵抗指数(Homeostasis model assessment-IR,HOMA-IR),统计不良反应。结果:治疗后,联合组在降低糖化血红蛋白、空腹血糖、餐后2 h血糖方面均优于二甲双胍组(P<0.05),两组空腹及餐后2 h C肽均较治疗前有显著升高(P<0.05),且联合组空腹及餐后2 h C肽均高于二甲双胍组(P<0.05),联合组HOMA-β高于二甲双胍组(P<0.05),HOMA-IR低于二甲双胍组(P<0.05),两组不良反应比较无明显差异(P>0.05)。结论:格列吡嗪与二甲双胍联合治疗新发2型糖尿病具有协同降糖效果,能有效改善胰岛β细胞功能,安全性良好。展开更多
文摘Takotsubo cardiomyopathy (also referred to as transient apical ballooning syndrome, broken heart syndrome or stress cardiomyopathy) is an increasingly recognized entity in the western world typically characterized by reversible left ventricular dysfunction that develops in the setting of acute severe emotional or physical stress. Increased catecholamine levels have been proposed to play a central role in the pathogenesis of the disease, although the specific pathophysiology of this condition remains elusive at the present moment. In recent times, there have been reports of takotsubo cardiomyopathy (TC) following medical interventions such as invasive or surgical procedures or specific medical regimens. In the current report, we present a patient with multiple recurrences of TC triggered by the same medical therapeutic intervention; in our particular case, repetitive exposure to inhaled beta-2-adrenoceptor agonist.
文摘Beta-2-microglobulin (B2M) is a low molecular weight polypeptide (11,800 Da) that exists in a free form and a form bound to cell membranes (light chains of HLA class I molecules). Their dosage is used in the exploration and monitoring of renal function in haemodialysis patients, hence the interest of this study, the objective of which is to study the different players involved in the increase of beta-2-microglobulin. <strong>Materials and Methods:</strong> This was a prospective and descriptive study from January 1<sup>st</sup>, 2017 to August 31, 2017 (08 months). All patients with chronic hemodialysis for 3 years or more were included. We analyzed sociodemographic, clinical and paraclinical data. <strong>Results:</strong> We collected 50 patients. The mean age was 50 ± 4.6 years with extremes of 30 and 82 years. The female sex predominated (52%). Chronic end-stage renal failure was hypertensive (86%), diabetic (4%). All patients benefited from intermittent hemodialysis for 8 hours per week using a low permeability membrane (cuprophane). The average duration of hemodialysis was 68 ± 6.4 months with extremes of 36 and 204 months. Twenty percent (20%) and four percent (4%) of chronic dialysis patients had joint pain and sensory deficit. Phalen’s sign was positive in 2% (1 case), Tinel’s sign in 2% (1 case) and carpal tunnel syndrome in 2% (1 case). The mean serum beta-2-microglobulin level was 58.34 ng/l with extremes of 16.99 and 112.24 ng/l. There was a correlation between hypertensive nephropathies and beta-2-microglobulin levels above 50 ng/l (P < 0.001). The mortality rate was 6%. <strong>Conclusion:</strong> Our study has objectified factors such as inadequate dialysis (8 hours/week), use of low permeability membrane in the increase of beta-2-microglobulin. The increase in serum beta-2-microglobulin levels in our patients is evidence of poor purification of medium molecules. Its reduction can be established by improving the quality of dialysis, in particular by using a high-permeability membrane.
文摘目的:分析格列吡嗪与二甲双胍联用治疗新发初诊2型糖尿病患者的应用价值。方法:研究对象选取2024年4月至2025年4月在本院收治的102例初诊2型糖尿病患者,以信封法随机分为联合组和二甲双胍组,两组均51例,二甲双胍组予以二甲双胍治疗,联合组予以格列吡嗪联合二甲双胍治疗,两组患者均干预3 m。比较两组血糖水平、空腹C肽、餐后2 h C肽、胰岛β细胞功能指数(Homeostasis model assessment-β,HOMA-β)、胰岛抵抗指数(Homeostasis model assessment-IR,HOMA-IR),统计不良反应。结果:治疗后,联合组在降低糖化血红蛋白、空腹血糖、餐后2 h血糖方面均优于二甲双胍组(P<0.05),两组空腹及餐后2 h C肽均较治疗前有显著升高(P<0.05),且联合组空腹及餐后2 h C肽均高于二甲双胍组(P<0.05),联合组HOMA-β高于二甲双胍组(P<0.05),HOMA-IR低于二甲双胍组(P<0.05),两组不良反应比较无明显差异(P>0.05)。结论:格列吡嗪与二甲双胍联合治疗新发2型糖尿病具有协同降糖效果,能有效改善胰岛β细胞功能,安全性良好。
