ABSTRACT
BACKGROUND: Type 1 diabetes (T1DM) often coexists with other autoimmune diseases, most commonly with hypothyroidism. To date, the influence of coexisting autoimmune hypothyroidism (AHT) on the course of chronic neurovascular complications of autoimmune diabetes has not been established. The aim of the study was to assess the relationship between AHT and the occurrence of chronic T1DM complications. METHODS: The study group comprised 332 European Caucasian participants with T1DM [165 (49.7%) men]. AHT was recognized in subclinical and overt hypothyroidism and confirmed by the presence of anti-thyroid autoantibodies: anti-peroxidase (ATPO) and/or anti-thyroglobulin (ATg) and ultrasonography (hypoechogenicity, parenchymal heterogeneity, lymph nodes assessment). RESULTS: In the analyzed group, 48.5% of patients were diagnosed with at least one neurovascular complication. At the time of enrollment, 16.3% of participants were diagnosed with AHT. Patients with AHT, compared to those without AHT, were characterized by a higher prevalence of neurovascular complications (64.8 vs. 45.3%; P = 0.009) and retinopathy (55.6 vs. 38.9%; P = 0.02). There were significant differences between groups with and without neurovascular complications, with regard to classic risk factors for chronic diabetes complications: age, T1DM duration, SBP, DBP, HbA1c, TG, eGFR and hypertension prevalence. In the multivariate logistic regression analysis, AHT was an independent predictor of neurovascular complications after adjusting for age, DBP, HbA1c and TG (odds ratio, 2.40; 95% confidence interval, 1.17-4.92; P = 0.02). CONCLUSIONS: AHT coexisting with T1DM was associated with a higher incidence of neurovascular complications.
Subject(s)
Diabetes Mellitus, Type 1/epidemiology , Hashimoto Disease/epidemiology , Nervous System Diseases/epidemiology , Thyroiditis, Autoimmune/epidemiology , Vascular Diseases/epidemiology , Adult , Diabetes Mellitus, Type 1/diagnosis , Diabetic Neuropathies/diagnosis , Diabetic Neuropathies/epidemiology , Diabetic Retinopathy/diagnosis , Diabetic Retinopathy/epidemiology , Female , Hashimoto Disease/diagnosis , Humans , Male , Middle Aged , Nervous System Diseases/diagnosis , Risk Factors , Thyroiditis, Autoimmune/diagnosis , Vascular Diseases/diagnosisABSTRACT
Plasma fibronectin concentration, AT III, PAI-1 and platelet count in 115 patients with gestosis, chronic hypertension and in physiological pregnancy were estimated. The obtained results indicate the significant fibronectin increase in gestosis patients. The positive correlation between fibronectin concentration and gestosis index was found. PAI-1 activity appeared to be the only haemostatic parameter which significantly increased in toxaemia. Prophylaxis with acetylosalicylic acid did not affect the fibronectin concentration. Fibronectin determination allows to differentiate toxaemic patients from the chronic hypertension cases. The high specificity and sensitivity of the test implies its important clinical role.
Subject(s)
Endothelium, Vascular/chemistry , Fibronectins/blood , Pre-Eclampsia/diagnosis , Pregnancy Complications/diagnosis , Adult , Female , Humans , Pre-Eclampsia/blood , Pregnancy , Pregnancy Complications/blood , Retrospective StudiesABSTRACT
A case of 68 years old patient with neurosarcoma of the radial nerve is presented. After total resection of the tumour and the suture of the sheath of the nerve its function has returned. Eight years later the recurrence took place and 2 years later the limb has been amputated.
Subject(s)
Neurofibrosarcoma/surgery , Peripheral Nervous System Neoplasms/surgery , Radial Nerve/physiopathology , Aged , Amputation, Surgical , Humans , Male , Neoplasm Recurrence, Local/surgery , Neurofibrosarcoma/complications , Peripheral Nervous System Neoplasms/complicationsABSTRACT
In 50 patients operated on from various gynaecological indications the haemostasis system was monitored determining its parameters before and 2 hours after the operation and again after 5 days. Besides routine tests of platelet-related haemostasis, clotting system and fibrinolysis the fibrinolytic activity was assessed in dynamic tests after venous stasis. The obtained results confirmed the presence of a tendency for development of the disseminated intravascular clotting syndrome with associated fibrinolysis activation immediately after the operation. On the fifth day a tendency was noted for thromboembolic complications which was prevented by increased synthesis of plasminogen activator in the vascular wall. The study confirmed the usefulness of prophylactic doses of heparin in patients with presence of risk factors. In the light of own investigations and a survey of the pertinent literature the authors suggest that simultaneous administration of small subcutaneous doses of heparin and application of intermittent compression would be the most adequate method of thrombosis prevention after operations in the small pelvis.
