Hyper-reactive platelets and type 2 diabetes / 中南大学学报(医学版)

Type 2 diabetes mellitus is a progressive process. With the course of the disease progress, microvascular and macrovascular complications always happen. Thrombotic events caused by macrovascular complications, including coronary heart diseases and cerebrovascular diseases, are the main fatal factor for the patients with type 2 diabetes. Endothelial dysfunction, coagulative activation, impaired fibrinolysis, together with hyper-reactive platelets contribute to the diabetic prothrombotic state, which is strongly related to the macrovascular complications. In particular, the hyper-reactive platelets play a fundamental role among them. Type 2 diabetes is characterized by several metabolic dysfunctions such as hyperglycemia, insulin resistance and shortage, oxidative stress, systemic inflammation, obesity, and dyslipidemia. These metabolic dysfunctions work together to promote the formation of hyper-reactive platelets, which are distinctive in type 2 diabetes. The regular antiplatelet drugs, like aspirin, show limited inhibitory effect on them. Hence, studying the mechanism behind the hyper-reactive platelets could provide a brand-new view on the prevention of macrovascular complications and cardiovascular events in type 2 diabetes.

Effect of Cold Pressor Test (CPT) on Pulse Rate and Blood Pressure amongst Individuals with and without Family History of Hypertension.

It is an established fact that primary and secondary hypertension and related cardiovascular disorders have a familial predisposition. We also know that essential hypertension is the most common amongst hypertensives. The aim of our study was to find out effect of cold pressor test (CPT) on heart rate and blood pressure amongst individuals with and without family history of hypertension. MethodsPresent study was undertaken using within group design consisting of measurements at basal and CPT and the parameters studied were pulse rate and Blood pressure. ResultsIn our study we found that in males with family history of HT (n=15), the mean basal pulse rate was 78.33 beats/min and following CPT it increased to 85.73. Similarly, in males without family history of HT (n=18) mean basal pulse rate was 77.28 beats/min and following CPT it increased to 86.72 beats/min. In both cases it was statistically significant. But it is observed that in case of females with family history of HT (n= 20) mean basal pulse rate was 80.9 beats/min and following CPT it increased to 89.1. Similarly, in Females without family history of HT (n=26) mean basal pulse rate was 77.15 beats/min and following CPT it increased to 84.73 beats/min and in both these cases, it was statistically significant. In males with family history of HT (n=15), mean basal SBP was 115.13 mmHg and following CPT increased to 123.93 and this was statistically significant and the mean DBP was 74.67 mmHg and following CPT it increased to 79.82 mmHg and it was not statistically significant. In males without family history of HT (n=18) mean basal SBP was 114.67 mmHg and following CPT it was increased to 122.89 mmHg and increase was statistically significant and mean DBP was 74.44 mmHg and following CPT it increased to 76.33 mmHg and this increase was not statistically significant. In females with family with family history of HT (n=20) the mean SBP was 114.2 mmHg and following CPT it increased to 121.9 mmHg and it was statistically significant and the mean DBP was 73.75 mmHg and following CPT it increased to 78.80 mmHg and it was not statistically significant. In females without family history of HT (n= 26) the mean basal SBP was 108.23 mmHg and following CPT it increased to 117.08 mmHg and the mean basal DBP was 69.92 mmHg and following CPT it was increased to 76.69 mmHg this increase in both the cases was statistically significant (table 1,2). In both the groups, none of the subjects was found to be hyperreactive to either systolic or diastolic blood pressure when they were subjected to CPT. ConclusionsIn both the groups, subjects were found to be hyporeactive or normoreactive to either systolic or diastolic blood pressure when they were subjected to CPT. But increase in basal blood pressure response is known to be due to CPT.

Exertional‑induced bronchoconstriction: Comparison between cardiopulmonary exercise test and methacholine challenging test.

Introduction: Exertional‑induced bronchoconstriction is a condition in which the physical activity causes constriction of airways in patients with airway hyper‑ responsiveness. In this study, we tried to study and evaluate any relationship between the findings of cardiopulmonary exercise testing (CPET) and the response to methacholine challenge test (MCT) in patients with dyspnea after activity. Materials and Methods: Thirty patients with complaints of dyspnea following activity referred to “Lung Clinic” of Baqiyatallah Hospital but not suffering from asthma were entered into the study. The subjects were excluded from the study if: Suffering from any other pulmonary diseases, smoking more than 1 cigarette a week in the last year, having a history of smoking more than 10 packets of cigarettes/year, having respiratory infection in the past 4 weeks, having abnormal chest X‑ray or electrocardiogram, and cannot discontinue the use of medicines interfering with bronchial provocation. Baseline spirometry was performed for all the patients, and the values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV/FVC were recorded. The MCT and then the CPET were performed on all patients. Results: The mean VO2 (volume oxygen) in patients with positive methacholine test (20.45 mL/kg/min) was significantly lower than patients with negative MCT (28.69 mL/kg/min) (P = 0.000). Respiratory rates per minute (RR) and minute ventilation in the group with positive MCT (38.85 and 1.636 L) were significantly lower than the group with negative methacholine test (46.78 and 2.114 L) (P < 0.05). Also, the O2 pulse rate in the group with negative methacholine test (116.27 mL/beat) was significantly higher than the group with positive methacholine test (84.26 mL/beat) (P < 0.001). Conclusion: Pulmonary response to exercise in patients with positive methacholine test is insufficient. The dead space ventilation in these patients has increased. Also, dynamic hyperinflation in patients with positive methacholine test causes the reduced stroke volume and O2 pulse in these patients.

Sensitive skin: An overview.

Sensitive skin is less tolerant to frequent and prolonged use of cosmetics and toiletries. It is self-diagnosed and typically unaccompanied by any obvious physical signs of irritation. With the change in lifestyle and also with increased opportunity to use many new brands of cosmetics and toiletries, there has been an increase in females complaining of unique sensation in their facial skin. Sensitive skin presents as smarting, burning, stinging, itching, and/or tight sensation in their facial skin. The condition is found in more than 50% of women and 40% of men, creating a sizable demand for products designed to minimize skin sensitivity. Good numbers of invasive and non-invasive tests are designed to evaluate and predict the sensitive skin. Management includes guidelines for selecting suitable cosmetics and toiletries in sensitive skin individuals.

Avaliação da pressão arterial em indivíduos normais e hiper-reatores. Um estudo comparativo dos métodos de medidas casual e da MAPA / Blood Pressure Response in Normorreactive and Hyperreactive Patients. A Comparative Study Between Casual and Ambulatory Blood Pressure Monitoring

PURPOSE: To evaluate the levels of blood pressure when measured by casual and ambulatory blood pressure monitoring. METHODS: We studied 16 sedentary and normotensive subjects (mean 43 +/- 3 years old) showing an exaggerated blood pressure response (SBP > 220 mmHg) during a cycloergometric test, hyperreactive group (HG). This group was compared to 15 others with SBP < or = 220 mmHg during exercise, normoreactive group (NG). Casual blood pressure was obtained by the conventional method and the ambulatory blood pressure monitoring (ABPM) was obtained with SpaceLabs 90207 monitor. This procedure (test 1) was repeated after four months (test 2). RESULTS: Both groups showed statistically higher levels of blood pressure when measured by ABPM device, compared to casual measurements. Systolic blood pressure was significantly higher in HG in casual measurement, in test 1 but not in test 2. Diastolic blood pressure was significantly higher in HG only through the ABPM device. The ambulatory blood pressure average values for two or 24 hours was similar in both groups. No significant differences were observed in left ventricular morphology at the echocardiogram. CONCLUSION: These findings indicate that hyperreactive subjects have an exaggerated stress-induced cardiovascular response during the installation of the device.

Objetivo - Avaliar a pressão arterial de indivíduos normais e hiper-reatores antes e após a colocação do aperelho de monitorização ambulatorial da pressão arterial (MAPA), bem como as médias de 2h, 24h e subperíodos de monitorização. Métodos - Estudaram-se 16 indivíduos (43±3 anos), sedentários, assintomáticos, normotensos e que apresentaram elevação exagerada da pressão sistólica (PAS >220mmHg) durante o teste ergométrico, constituindo o grupo hiper-reator (GH). Este grupo foi comparado com outros 15 indivíduos normotensos em repouso e que apresentaram durante o esforço PAS <220mmHg (GN). A pressão casual foi determinada pelo método auscultatório convencional e os valores de monitorização foram obtidos com o monitor SpaceLabs 90207. Este procedimento (teste 1) foi repetido após período de quatro meses (teste 2). Resultados - Em ambos os grupos observou-se elevação estatisticamente significante das cifras pressóricas após a instalação do monitor, em relação à medida casual. A PAS casual e a pressão diastólica da 1ª medida da MAPA foram maiores (p<0,05) em GH, cujas significâncias desapareceram após quatro meses. A média das duas primeiras horas de monitorização e dos valores da MAPA de 24h foram semelhantes em ambos os grupos. O estudo ecocardiográfico não apresentou diferenças estruturais cardíacas entre GN e GH. Conclusão - Esses dados indicam que indivíduos hiper-reatores podem apresentar resposta cardiovascular exagerada estresse-induzida durante a instalação do monitor