Published by Madridge Publishers Abstract Background: Diabetic Nephropathy (DN) is one of the complications in patients with prolonged diabetes. Among the genetic risk factors for DN, TNF-α, an anti-inflammatory cytokine is proposed to... more
Published by Madridge Publishers Abstract Background: Diabetic Nephropathy (DN) is one of the complications in patients with prolonged diabetes. Among the genetic risk factors for DN, TNF-α, an anti-inflammatory cytokine is proposed to act in a paracrine/autocrine manner and is hypothesized to be associated with insulin resistance. In the current study, the relationship of the G ↆC variant of the TNF-α gene in patients, associated with other biochemical parameters with DN was investigated.
Editorial "Vitamins Against Viruses: Implausible Pro-Vaccine Publications Contrasted Against Ignored Public Health Campaigns and Double-Blind Placebo-Controlled Clinical Trials" from Journal of Orthomolecular Medicine 2019 June
Dietary advanced glycation end products (AGE) formed during heating of food have gained interest as potential nutritional toxins with adverse effects on inflammation and glucose metabolism. In the present study, we investigated the... more
Dietary advanced glycation end products (AGE) formed during heating of food have gained interest as potential nutritional toxins with adverse effects on inflammation and glucose metabolism. In the present study, we investigated the short-term effects of high and low molecular weight (HMW and LMW) dietary AGE on insulin sensitivity, expression of the receptor for AGE (RAGE), the AGE receptor 1 (AGER1) andTNF-α, F2-isoprostaglandins, body composition and food intake. For 2 weeks, thirty-six Sprague–Dawley rats were fed a diet containing 20 % milk powder with different proportions of this being given as heated milk powder (0, 40 or 100 %), either native (HMW) or hydrolysed (LMW). Gene expression ofRAGEandAGER1in whole blood increased in the group receiving a high AGE LMW diet, which also had the highest urinary excretion of the AGE, methylglyoxal-derived hydroimidazolone 1 (MG-H1). Urinary excretion ofNε-carboxymethyl-lysine increased with increasing proportion of heat-treated milk pow...
Diabetes mellitus (DM) menjadi suatu masalah dalam kesehatan. Dalam penelitian global di tahun 2011 pasien DM sudah mencapai 366 juta jiwa dan sejumlah 13 jiwa tidak menyadarinya jika mereka telah terdiagnosis DM. Pola makan memiliki... more
Diabetes mellitus (DM) menjadi suatu masalah dalam kesehatan. Dalam penelitian global di tahun 2011 pasien DM sudah mencapai 366 juta jiwa dan sejumlah 13 jiwa tidak menyadarinya jika mereka telah terdiagnosis DM. Pola makan memiliki hubungan yang erat dengan penyakit degeneratif Diabetes Mellitus Tipe II. Rekomendasi asupan yang rendah dari karbohidrat dengan jenis yang sederhana dapat mempenggaruhi level gula dalam darah. Buah-buahan yang dianjurkan untuk dimakan adalah buah yang kurang manis yang sering digolongkan menjadi golongan buah B (pada umumnya memiliki indeks glikemiks sedang). Berdasarkan uraian diatas maka perlu adanya penelitian untuk mengidentifikasi perubahan kadar glukosa darah pada konsumsi buah dengan indeks glikemik medium yang sering tersedia di pasaran yaitu salah satunya adalah buah semangka. Tujuan penelitian ini adalah untuk mengetahui seberapa besar buah semangka meningkatkan gula darah. jenis penelitian ini adalah eksperimental dengan metode Pretest and P...
Breast cancer is the most common malignancy among women worldwide. There is extensive literature on the relationship between body weight and breast cancer risk but some doubts still remain about the role of adipokines per se, the role of... more
Breast cancer is the most common malignancy among women worldwide. There is extensive literature on the relationship between body weight and breast cancer risk but some doubts still remain about the role of adipokines per se, the role of insulin and glucose regardless of obesity, as well as the crosstalk between these players. Thus, in this study, we intend to determine the relation between body mass index (BMI), glycaemia, insulinemia, insulin-resistance, blood adipokine levels and tumour characteristics in a Portuguese group of pre- and postmenopausal overweight/obese women with breast cancer. We evaluated clinical and biochemical data in 154 participants, divided in 4 groups: (1) control with BMI <25 kg/m(2), n = 29 (CT); (2) control with BMI >25 kg/m(2), n = 48 (CTOb); (3) breast cancer with BMI <25 kg/m(2), n = 30 (BC); and (4) breast cancer with BMI >25 kg/m(2), n = 47 (BCOb). In women with breast cancer, we also performed tumour characterization. We found that BCO...
Defects in fatty acid (FA) utilization have been well described in group 1 pulmonary hypertension (PH) and in heart failure (HF), yet poorly studied in group 2 PH. This study was to assess whether the metabolomic profile of patients with... more
Defects in fatty acid (FA) utilization have been well described in group 1 pulmonary hypertension (PH) and in heart failure (HF), yet poorly studied in group 2 PH. This study was to assess whether the metabolomic profile of patients with pulmonary hypertension (PH) due HF, classified as group 2 PH, differs from those without PH. We conducted a proof-of-principle cross-sectional analysis of 60 patients with chronic HF with reduced ejection fraction and 72 healthy controls in which the circulating level of 71 energy-related metabolites was measured using various methods. Echocardiography was used to classify HF patients as noPH-HF (n = 27; mean pulmonary artery pressure [mPAP] 21 mmHg) and PH-HF (n = 33; mPAP 35 mmHg). The profile of circulating metabolites among groups was compared using principal component analysis (PCA), analysis of covariance (ANCOVA), and Pearson’s correlation tests. Patients with noPH-HF and PH-HF were aged 64 ± 11 and 68 ± 10 years, respectively, with baseline ...
Background Patients with liver cirrhosis experience a large variety of metabolic disorders associated with more hepatic decompensation. Hepatic encephalopathy (HE) is a significant complication in liver cirrhosis patients, presenting a... more
Background Patients with liver cirrhosis experience a large variety of metabolic disorders associated with more hepatic decompensation. Hepatic encephalopathy (HE) is a significant complication in liver cirrhosis patients, presenting a wide spectrum of neuropsychological symptoms. A deficiency of 25-hydroxy vitamin D (25-OHD) in the general population is associated with a loss of cognitive function, dementia, and Alzheimer's disease. Aim of the Study. Our study aims to check the relationship between low serum 25-OHD and HE in patients with HCV-related liver cirrhosis and assess its link with patient mortality. Patients and Methods. This study was observationally carried out on 100 patients with HCV-related liver cirrhosis. The patients were divided into 2 groups: Group A—included 50 HCV-related cirrhotic patients with HE, and Group B—included 50 HCV-related cirrhotic patients without HE. Assessment of disease severity using the end-stage liver disease (MELD) model and Child Turc...
ABSTRAK Penyakit jantung koroner merupakan penyakit arteri koroner yang ditandai adanya endapan lipid yang terkumpul di dalam sel yang melapisi dinding suatu arteri koroner dan menyumbat aliran darah. Tujuan penelitian mengkaji pengaruh... more
ABSTRAK Penyakit jantung koroner merupakan penyakit arteri koroner yang ditandai adanya endapan lipid yang terkumpul di dalam sel yang melapisi dinding suatu arteri koroner dan menyumbat aliran darah. Tujuan penelitian mengkaji pengaruh Lipid Profile Terhadap Penyakit Jantung Koroner. Disain penelitian adalah survey analitik. Sampel penelitian adalah sebagian pasien di Instalasi Rawat Jalan Penyakit Dalam RSUD Nganjuk dengan jumlah 32 orang. Variabel penelitian adalah lipid profile yang terdiri dari HDL, LDL, Trigliserida. Instrumen penelitian adalah observasi dan hasil pemeriksaan laboratorium lipid profile. Analisis data menggunakan uji Fisher Exact . Hasil penelitian menunjukkan sebagian memiliki kadar HDL yang normal, lebih dari sebagian memiliki kadar LDL dan trigliserida yang tinggi. Pasien Penyakit Jantung Koroner Di Instalasi Rawat Jalan Penyakit Dalam RSUD Nganjuk didapatkan terbanyak adalah NSTEMI dan terkecil adalah Asymtomatik. Hasil uji fisher exact menunjukkan terdapa...
At academic medical centers, attending rounds (AR) serve to coordinate patient care and educate trainees, yet variably involve patients. To determine the impact of standardized bedside AR on patient satisfaction with rounds. Cluster... more
At academic medical centers, attending rounds (AR) serve to coordinate patient care and educate trainees, yet variably involve patients. To determine the impact of standardized bedside AR on patient satisfaction with rounds. Cluster randomized controlled trial. 500-bed urban, quaternary care hospital. 1200 patients admitted to the medicine service. Teams in the intervention arm received training to adhere to 5 AR practices: 1) pre-rounds huddle; 2) bedside rounds; 3) nurse integration; 4) real-time order entry; 5) whiteboard updates. Control arm teams continued usual rounding practices. Trained observers audited rounds to assess adherence to recommended AR practices and surveyed patients following AR. The primary outcome was patient satisfaction with AR. Secondary outcomes were perceived and actual AR duration, and attending and trainee satisfaction. We observed 241 (70.1%) and 264 (76.7%) AR in the intervention and control arms, respectively, which included 1855 and 1903 patient ro...
We conducted a prospective trial randomizing 75 physicians to either a control or intervention arm to evaluate the impact of providing patient-reported information on anxiety and other mental health symptoms and disorders to primary care... more
We conducted a prospective trial randomizing 75 physicians to either a control or intervention arm to evaluate the impact of providing patient-reported information on anxiety and other mental health symptoms and disorders to primary care physicians. Five hundred seventy-three patients of the study physicians who met entry criteria were randomized to either usual care or usual care supplemented with feedback of patient-reported mental health information to physicians. This mental health information was derived from initial patient-reported questionnaires completed in waiting rooms of physicians contracted to a mixed-model health maintenance organization in Colorado. Main outcome measures included impact of intervention on rates of (1) chart notation of anxiety, depression, or other mental health diagnoses or symptoms; (2) referral to mental health specialists; (3) prescription of psychotropic medications; (4) hospitalization; and (5) office visits during a 5-month observation period....
The pharmacology of anti-SARS-CoV-2 drugs, Molnupiravir (M) and repurposed Ivermectin (IV) were compared. The IC 50 for the inhibition of viral replication were 0.3µM for M and 2.8µM for IV. Both drugs have good oral absorption, with M... more
The pharmacology of anti-SARS-CoV-2 drugs, Molnupiravir (M) and repurposed Ivermectin (IV) were compared. The IC 50 for the inhibition of viral replication were 0.3µM for M and 2.8µM for IV. Both drugs have good oral absorption, with M achieving peak plasma concentrations by 2 hours and IV by 5 hours. The plasma half life were 7 hours for M and 81-91 hours for IV. M inhibits viral replication inducing viral mutagenesis in RdRp, causing viral error catastrophe and viral extinction. IV affects viral cell entry, nuclear transport and inhibits replication via RdRp. IV has additional effect to suppress cytokine production through STAT-3 inhibition. M is a more potent antiviral drug and IV has a longer residence in the body. Their effects on RdRp and cytokine inhibition are potentially complimentary for anti-COVID-19 activity. Both IV and M should be compared in randomized controlled clinical trials, and the possibility of their combination for anti-SARS-CoV-2 antiviral actions, explored further.
Transitions of care pose significant risks for patients with complex medical histories. There are few experiential medical education curricula targeting this important aspect of care. We designed and tested an internal medicine... more
Transitions of care pose significant risks for patients with complex medical histories. There are few experiential medical education curricula targeting this important aspect of care. We designed and tested an internal medicine transitions of care experience integrated into interns' ambulatory curriculum. The program included 1-hour group didactics, a posthospitalization discharge visit in pairs with a home care nurse (cohort 1: 2011-2012; cohort 2: 2012-2013), and a half-day small-group visit to a skilled nursing facility led by a faculty member in geriatrics (cohort 2 only). Both visits had structured debriefings by faculty in geriatrics. For cohort 1, a quantitative follow-up survey was administered 18 to 20 months after the experience. For cohort 2, reflections were analyzed. Thirty-three of 42 second-year residents (79%) in cohort 1 who participated in didactics and a home visit completed the survey. Seventy-six percent (25 of 33) reported increased knowledge of interprofes...
Background Literature on difficult doctor-patient relationships has focused on the "difficult patient." Our objective was to determine physician and practice characteristics associated with greater physician-reported frustration with... more
Background Literature on difficult doctor-patient relationships has focused on the "difficult patient." Our objective was to determine physician and practice characteristics associated with greater physician-reported frustration with patients. Methods We conducted a secondary analysis of the Physicians Worklife Survey, which surveyed a random national sample of physicians. Participants were 1391 family medicine, general internal medicine, and medicine subspecialty physicians. The survey assessed physician and practice characteristics, including stress, depression and anxiety symptoms, practice setting, work hours, case-mix, and control over administrative and clinical practice. Physicians estimated the percentage of their patients who were "generally frustrating to deal with." We categorized physicians by quartile of reported frustrating patients and compared characteristics of physicians in the top quartile to those in the other three quartiles. We used logistic regression to model physician characteristics associated with greater frustration. Results In unadjusted analyses, physicians who reported high frustration with patients were younger (p 55 per week, higher stress, practice in a medicine subspeciality, and greater number of patients with psychosocial problems or substance abuse. Conclusion Personal and practice characteristics of physicians who report high frustration with patients differ from those of other physicians. Understanding factors contributing to physician frustration with patients may allow us to improve the quality of patient-physician relationships.
Skeletal muscle and adipose tissue play an important role in maintaining metabolic homeostasis and thermogenesis. We aimed to investigate the effects of single and repeated exposure to whole-body cryotherapy in volunteers with different... more
Skeletal muscle and adipose tissue play an important role in maintaining metabolic homeostasis and thermogenesis. We aimed to investigate the effects of single and repeated exposure to whole-body cryotherapy in volunteers with different physical fitness levels on 25-hydroxyvitamin D (25(OH)D) and myokines. The study included 22 healthy male volunteers (mean age: 21 ± 1.17 years), who underwent 10 consecutive sessions in a cryogenic chamber once daily (3 minutes, −110 °C). Blood samples were collected before and 30 minutes and 24 hours after the first and last cryotherapy sessions. Prior to treatment, body composition and physical fitness levels were measured. After 10 cryotherapy treatments, significant changes were found in myostatin concentrations in the low physical fitness level (LPhL) group. The 25(OH)D levels were increased in the high physical fitness level (HPhL) group and decreased in the LPhL group. The HPhL group had significant changes in the level of high-sensitivity in...
Chronic obstructive pulmonary disease (COPD) is usually associated with a variety of extra-pulmonary manifestations. Metabolic syndrome (MetS) is one such entity that has been scarcely studied in Indian patients. Availability of a good... more
Chronic obstructive pulmonary disease (COPD) is usually associated with a variety of extra-pulmonary manifestations. Metabolic syndrome (MetS) is one such entity that has been scarcely studied in Indian patients. Availability of a good screening marker may help in timely detection of this co morbidity in COPD patients. We conducted a cross sectional study to evaluate the prevalence of MetS among COPD patients and to evaluate the role of Interleukin-6 and insulin resistance (as measured by HOMA-IR) as screening markers for MetS in COPD. A total of 100 stable COPD patients were evaluated for MetS using US National Cholesterol Education Program Adult Treatment Panel III (2005) guidelines. Interleukin-6 and HOMA-IR (for insulin resistance) were measured and compared between COPD patients with and without MetS. ROC analysis was done to find the best cut-off value and sensitivity and specificity of both the molecules in detecting MetS. In the results, the mean age of the study cohort was ...