Chronic complications of spinal cord injury

Spinal cord injury(SCI) is a serious medical condition that causes functional, psychological and socioeconomic disorder. Therefore, patients with SCI experience significant impairments in various aspects of their life. The goals of rehabilitation and other treatment approaches in SCI are to improve functional level, decrease secondary morbidity and enhance health-relatedquality of life. Acute and long-term secondary medical complications are common in patients with SCI. However, chronic complications especially further negatively impact on patients' functional independence and quality of life. Therefore, prevention, early diagnosis and treatment of chronic secondary complications in patients with SCI is critical for limiting these complications, improving survival, community participation and health-related quality of life. The management of secondary chronic complications of SCI is also important for SCI specialists, families and caregivers as well as patients. In this paper, we review data about common secondary longterm complications after SCI, including respiratory complications, cardiovascular complications, urinary and bowel complications, spasticity, pain syndromes, pressure ulcers, osteoporosis and bone fractures. The purpose of this review is to provide an overview of risk factors, signs, symptoms, prevention and treatment approaches for secondary long-term complications in patients with SCI.

Development of diabetic complications and influencing factors among 32653 type 2 diabetes patients:retrospective cohort study using a multi-state Markov

Background:Patients with type 2 diabetes are at high risk for developing multiple chronic complications.However,there is a lack of studies of the cumulative number of diabetic complications in China.Methods:A retrospective cohort study was performed from 2009 to 2021.Type 2 diabetes patients who were first diagnosed after the age of 35 years between January 1,2009,and December 31,2017,were included.Five states were defined according to the number of chronic complications:no(S0),one(S1),two(S2),three(S3),and four or more complications(S4).A multi-state Markov model was constructed to estimate transition probability,transition intensity,mean sojourn time,and the possible factors for each state.Results:The study included 32653 type 2 diabetes patients(mean age,59.59 years;15929(48.8%)male),and mean follow-up time of 7.75 years.In all,4375 transitions were observed.The 12-year transition probability of from state S0 to S1 was the lowest at 16.4%,while that from S2 to S3 was the highest,at 45.6%.Higher fasting blood glucose,lower high-density lipoprotein cholesterol,higher total cholesterol,and an unhealthy diet were associated with higher risk of progression from S0 to S1.Being female,less than 60 years old,weekly physical activity,and vegetarian diet decreased this risk.Being female and less than 60 years old reduced the likelihood of transition from S1 to S2,whereas lower high-density lipoprotein cholesterol increased this likelihood.Conclusions:Following the occurrence of two complications in type 2 diabetes patients,the risk for accumulating a third complication within a short time is significantly increased.It is important to take advantage of the stable window period when patients have fewer than two complications,strengthen the monitoring of blood glucose and blood lipids,and encourage patients to maintain good living habits to prevent further deterioration.

Health Management of Patients with Type II Diabetes and its Influence on Chronic Complication

Objectives:To explore the application of health management in patients with type II diabetes and to analyze and compare the incidence of chronic complications.Methods:the relevant research work was carried out in our hospital.During September 2018 to September 2019,100 patients with type II diabetes were randomly divided into two groups:one group was given routine nursing intervention,the other group was given health management,and they were named control group and experimental group respectively.Each group had 50 patients,the influence of different nursing methods on the incidence of chronic complications in patients was explored.Results:In the one-year followup results,the corresponding complications of patients mainly include cardiovascular disease,kidney disease,cerebrovascular disease,fundus disease and peripheral neuropathy.The incidence of complications in the experimental group is 10.00%,while that in the control group is 32.00%.in comparison,the incidence in the experimental group is lower,and the data difference between the two group is small(P<0.05),which exists significance.Conclusion:The application of health management method in type II diabetes has significant effect,which can reduce the incidence of chronic complications,improve the quality of life of patients,and has positive significance for clinical development.

Sitagliptin in treatment of diabetes complicated by chronic hepatitis C

To the Editor: A high prevalence of glucose intolerance in patients with chronic hepatitis C has been reported, [1] and there is a significant association of chronic hepatitis C with diabetes mellitus (DM). [2] But DM has been suggested to be associated with the onset of hepatocellular carcinoma

Hypoglycaemiac Medicinal Plants Used by Diabetics at CNHU-HKM

Introduction: Diabetes is a major public health problem. Medicinal plants are frequently used either combine with industrial treatment or exclusively, in Africa and particularly in Benin. Our study aims to identify the different medicinal plants used by diabetic patients at the CNHU-HKM. Method: we carried out a descriptive and analytical cross-sectional study. It took place at the University Clinic of Endocrinology, Metabolism and Nutrition of CNHU-HKM over a of 3 months period from 20th of June to 16th of September, 2022, over diabetic followed-up. Results: One hundred and seventy-three (173) patients were gathered using an anonymous inquiry form. In the study population, the age of the patients varied between 31 and 75 years with an average age of 59 +/− 1.43 years, women represented 59% with a sex ratio (male/female) of 0.69. Sixty-five (65) or 37.6% of the population had used medicinal plants. Among given reasons for using medicinal plants were, mainly the positiveness on a third party. Data analysis outcome twenty-nine species of plants belonging to twenty (20) botanical families, the most represented being the Annonaceae and Fabaceae. The most used species are Phyllanthus amarus (hlenwé in fon), Mangifera indica (mangatin in fon), Momordica charantia (gninsikin in fon), Combretum micranthum (kinkéliba in fon), and Picralima nitida (ayorkpè in fon). Most used parts of the plants are the leaves. The recipes are prepared mainly by infusion and are administered exclusively by mouth. Most of the patients who used the hypoglycaemic medicinal plants were satisfied and no adverse effects were reported by them. Conclusion: Hypoglycaemic medicinal plants could be subjected to pharmacognosy and marketed due to their richness in active components, after further toxicological studies.

2型糖尿病患者慢性并发症的患病率及相关因素分析

糖尿病是一组呈全球流行趋势的慢性代谢性疾病。随着经济的发展和人民生活方式的改变以及人口老龄化,糖尿病患病率逐年增加是全球范围内的共同趋势。

Validity and reliability of the Polish version of the Michigan Neuropathy Screening Instrument

BACKGROUND Diabetic sensorimotor polyneuropathy is an important risk factor for foot ulceration and amputation.Thus,patients with diabetes should be screened for this disorder according to local guidelines.An obstacle to the diagnosis of this disease may be the lack of unified diagnostic criteria due to the lack of properly validated scales used for assessment.AIM To validate both sections(A and B)of the Michigan Neuropathy Screening Instrument(MNSI)in Polish(PL)patients with diabetes.METHODS A cross-sectional study using a test(A1,B1)and re-test(A2,B2)formula was performed in 80 patients with diabetes.The gold standard used for neuropathy detection was a nerve conduction study(NCS)which was performed in all participants.Reliability of the MNSI-PL was assessed using the Cronbach’s alpha,Kuder-Richardson formula 20(KR-20),split-half reliability,the Gottman split-half tests,and correlation between first and second half was accessed.Stability was assessed using an intraclass correlation coefficient(ICC).For external validation,we used simple linear correlation,binomial regression,and agreement between two different tools using a Bland-Altman plot analysis.RESULTS The scale was internally consistent(Cronbach’s alpha for the full scale:0.81 for A and 0.87 for B).MNSI-PL scores in test/retest showed high stability(ICC=0.73 for A and ICC=0.97 for B).The statistically important correlations between MNSI-PL and NCS were found for B1,B2,and A1(P<0.005).The cut-off points of≥3 for section A(sensitivity of 90%-100%;specificity of 33%-40%)and≥2 for section B(sensitivity of 81%-84%;specificity of 60%-70%)were obtained during neuropathy detection.CONCLUSION The MNSI-PL is a reliable and valid instrument in screening for diabetic neuropathy.

Epidemiological Aspects of Cerebrovascular Accidents in the Diabetic:Experience of the Medical Clinic II of the Hospital Center Abass Ndao of Dakar

Introduction: The objective of our study was to describe the socio-demographic characteristics and cardiovascular risk factors (RVFs) of diabetic patients admitted for stroke in a department other than neurology. Methods: Retrospective cross-sectional study over a period of six (6) years (January 2010 and December 2016), performed at the Internal Medicine Department of the Abass Ndao Hospital Center in Dakar. Results: 79 adults with a mean age of 64.67 years, a female predominance (51.89%). The major risk factors found were arterial hypertension in 74.68% of cases, dyslipidemia in 32.35% of cases, smoking in 6.32% of cases. The reasons for consultation were a disorder of consciousness in 27.4% of cases, hemiplegia in 43.3% of cases, headache in 18.98% of cases, vertigo in 8.86% and dysarthria in 10.12% of the cases. Mean systolic blood pressure was 150 mmHg, mean diastolic blood pressure was 86 mmHg. The average blood glucose was 3 g/l. Strokes were associated with left ventricular hypertrophy in 30.55% of cases. Ischemic stroke accounted for 74.68%. The evolution was marked by a death in 20.25% (16) cases. Conclusion: Stroke is a major public health problem. Despite its predominance of women, they (stroke) affected 48.10% of men in our study when we know that in Africa the social activity is based on men. They remain a serious pathology in the diabetic by the high lethality.

Effects of Lipoprotein(a) on Elderly Diabetes Mellitus

In order to explore clinical relationship between Lipoprotein(a) and elderly diabetes, the level of plasma Lp(a) in 78 elderly patients with diabetes mellitus and 60 healthy controls was assayed. The results showed that there was significant difference in the percentage of high Lp(a) level between diabetis and healthy subjects (P<0.01); that the percentages of high Lp(a) level with fasting Lp(a)200 mg/L, 300 mg/L in complication group were all significantly higher than those in noncomplication group (P<0.02); that there was significant difference in the percentage of high Lp(a) level with fasting and postprandial 2 hours Lp(a)200 mg/L in 30 patients without complication, the former was also significantly higher as compared with controls. These suggested that fasting blood sample was better for measurement of plasma Lp(a) level, and that fasting plasma Lp(a)200 mg/L might be useful for diabetes epidemiological investigation; that there was high plasma Lp(a) level in diabetics, especially in diabet

ORIGINAL ARTl CLESSilybin Decreases Erythrocytic Sorbitol Level and ImprovesPeripheral Nerve Conduction Velocity in Patients with Non-lnsulin Dependent Diabetes Mellitus

The effects of silybin on erythrocytic sorbitol level and peripheral nerve conduction veloci-ty were studied in 14 cases of noninsulin dependent diabetes mellitus (NIDDM) . Atter oral administrationof silybin 231 mglday for 4 weeks, no blood glucose change was observed in patients with NIDDM, whilethe erythrocytic sorbitol level was significantly decreased from 72. 55 21. 61 to 39. 53 14. 94 nmol/g .Hb (P<0. 01) . At the same time, peripheral nerve conduction vefocity was also improved. These resultsindicate that silybin is an effective aldose reductase inhibitor which can improve the disorder of polyolpathway in NIDDM patients and prevent chronic complications of diabetes.