[INSULIN RESISTANCE: FOCUS ON THE ADIPOSE TISSUE]
URICH Elemér
MARCH 20, 2004
Lege Artis Medicinae - 2004;14(03)
URICH Elemér
MARCH 20, 2004
Lege Artis Medicinae - 2004;14(03)
[Insulin resistance is defined as a state of subnormal biological response to normal quantity of insulin. This phenomenon was first described by Hinsworth and Kerr in 1939, however it has come to the centre of interest only in the last two decades. It is the central pathogenetic factor of type 2 diabetes and the more complex clinical entity of metabolic syndrome, consequently also referred to as insulin resistance syndrome. In the background of insulin resistance alterations of the adipose tissue can be observed which clinically means obesity in most of the cases, however, this issue cannot be simplified to obesity only as increase in adipose tissue growth may be beneficial in certain cases. Current article discusses the explanation of this paradox and the pathophysiologic link between adipose tissue and insulin resistance. It also reviews the therapeutic aspects of insulin resistance emphasizing the role of thiazolidinedione type drugs having recently joined the therapeutic palette.]
Lege Artis Medicinae
Lege Artis Medicinae
Lege Artis Medicinae
[Smoking causes a health catastrophy all over the world. Its importance is increasing in the less developed countries. More and more young people (especially women) have started smoking recently. Its devastating effect on women carries on to the next generations. Prevention should already begin in childhood. In Hungary, there is a wide network to assist for those who want to give up smoking - especially in the national network of lung health care clinics. Peer supporters have a prominent role in helping these patients. The market-strategy and publicity campaign of major tobacco producers also deserves intensive attention.]
Lege Artis Medicinae
[In this review we summarise the current results of the genomic investigation of allergic diseases. From the genetic point of view allergy is multifactorial, which means that the susceptibility to the disease is determined by the effect of one or more genes or the interactions between multiple genes and involves important nongenetic factors such as the environment for their expression. Among allergic diseases the genomic background of asthma was studied most thoroughly. Until now, using hundreds of DNA markers, located across all of the human chromosomes, 16 genome-wide screens for susceptibility genes for asthma or asthma related intermediate phenotypes in 12 different populations have been published and 20 chromosomal regions have been highlighted for further analysis. In genetic association studies more than 500 genes were identified as candidate genes for asthma. In this review, we selected those results which were consistently reported by several independent studies or appeared particularly important or interesting. According to the results of the human genome programs and association studies we discuss the possible roles of candidate genes found in these loci in the pathomechanism of allergy and atopy.]
Clinical Neuroscience
[Epilepsy is one of the most common chronic neurological disease in childhood. Patients with epilepsy – even with so-called benign epilepsy – need medication for years. During this time, children go through a very big change, not only gaining weight and height, but also changing hormonal and metabolic processes. Maturation processes in different brain areas also take place at different rates depending on age. All of these should be considered when preparing a therapeutic plan. In everyday practice after the diagnosis of epilepsy, the applied drug is most often selected based on the shape and type of seizure. However, a number of other factors need to be considered when designing a therapeutic strategy: 1. efficacy (form of epilepsy, type of seizure), 2. age, gender, 3. pharmacological properties of the drug, 4. adverse drug reaction profile, 5. lifestyle (community), figure (skinny, corpulent, obese), 6. other comorbidities (nutrition, behavioral and learning problems, circulatory disorders, kidney or liver disease), 7. expected interactions with other drugs already used, 8. genetics, 9. other aspects (drug registration and prescription rules). The purpose of this article is to help to decide which antiepileptic drugs are expected to have the least side effects in a particular child with different comorbidities and which medications should be avoided if possible.]
Hypertension and nephrology
[Summary – Considering the pathomechanism, the risk factors, as well as the environmental and toxic effects, some associated illnesses, unhealthy life-style habits in the background of hypertension and infertility, significant overlapping can be found. The question arises; does play any role the hypertension in the development of infertility? In this article the author review the connection between the hypertension and infertility. ]
Lege Artis Medicinae
[Commemorating the 30th anniversary of foundation the journal Lege Artis Medicinae, the author endeavours to review the main developments of diabetology in the same period and arranges their reflections on the journal’s pages. He points out that similar to many other disciplines, the history of development has extremely been rich in the past three decades, thus he focused only on a few issues. The author analyses the changes in the treatment of type 2 diabetes and highlights specific aspects like the importance of early metabolic control, individualized treatment choices, a risk-oriented approach instead of a glucocentric direction, and the role of patient education and a health-conscious lifestyle, which have resulted in the holistic approach of our therapeutic strategy. While using relevant quotes, the author shows that the readers of the journal were also able to keep pace with all events and they were always provided with relevant information by authentic specialists of diabetology. ]
Clinical Neuroscience
The relationship among obstructive sleep apnea syndrome (OSAS), type 2 diabetes mellitus (DM2) and obesity is very complex and multi-directional. Obesity and increased visceral fat are important perpetuating factors for DM2 in patients with OSAS. On the other hand, OSAS itself leads to obesity by causing both leptin and insulin resistance as a consequence of activation of the sympathetic nervous system. Risk for developing DM2 further increases in patients with OSAS and obesity. Data regarding effects of positive airway pressure (PAP) therapy, gold standard treatment for OSAS, on glycemic control were inconsistent due to variability in duration of and adherence to PAP therapy. In our cohort study we investigated effects of PAP treatment on glucose metabolism in normal-weighted non-diabetic OSAS patients, in obese non-diabetic OSAS patients, and in OSAS patients with DM2. We prospectively analyzed 67 patients diagnosed with OSAS and documented to be effectively treated with PAP therapy for three months. Apnea-hypopnea index was highest in the diabetic group, being significantly higher than in the normal-weighted group (p=0.021). Mean HOMA values were significantly higher in obese (p=0.002) and diabetic group (p=0.001) than normal-weighted group; the differences were still significant after PAP therapy. HbA1c levels were significantly higher in diabetic group compared to those in normal-weighted (p=0.012) and obese (p=0.001) groups. After PAP treatment, decrease in HbA1c levels were significant in normal-weighted (p=0.008), obese (p=0.034), and diabetic (p=0.011) groups. There was no correlation with the change in HbA1c levels and age (p=0.212), BMI (p=0.322), AHI (p=0.098) or oxygen levels (p=0.122). Our study showed that treatment of OSAS by PAP therapy offers beneficial effect on glucose metabolism, not only in diabetic patients, but also in obese and normal-weighted OSAS patients. Although data regarding overall effects of PAP therapy on glycemic control present contradictory results in the literature, it should be emphasized that duration and adherence to PAP therapy were main determinants for beneficial outcome of treatment.
1.
2.
3.
4.
Journal of Nursing Theory and Practice
[Correlations Between Burnout and Socio-demographic and Workplace Related Factors Among Health-care Workers During The Covid-19 Pandemics]5.
Journal of Nursing Theory and Practice
[Operational Efficiency Investigation from APN Perioperative Perspective]1.
Journal of Nursing Theory and Practice
[Burnout and depression among healthcare nursing staff]2.
Journal of Nursing Theory and Practice
[Evaluation of clinical practices among academic nursing students]3.
Journal of Nursing Theory and Practice
[Identifying osteoporosis in a primary care setting with quantitative ultrasound]4.
Journal of Nursing Theory and Practice
[The Effect of Asthma Bronchiale on Everyday life Activities Among Adolescents]5.
COMMENTS
0 comments