Predictors of cardiovascular risk factors in Tehranian adults: diet and lifestyle

We carried out a dietary intake assessment in 486 adults 20 from the Tehran Lipid and Glucose Study. There was a strong positive association between body mass index [BMI] and serum triglycerides [beta = 1.6, P < 0.05] and carbohydrate intake and triglycerides [beta = 2.4, P < 0.05]. There was also an association between low-density lipoprotein cholesterol and weight [beta = 1.1, P < 0.05], age [beta = 1.6, P < 0.05] and cholesterol intake [beta = 0.7, P < 0.01]. For 1 unit increase in either BMI, waist to hip ratio or saturated fatty acid intake, diastolic blood pressure increased 0.6, 0.9 and 0.1 mmHg, respectively [P < 0.05]. Dietary and non-dietary factors have an association with, and play a role as predictors of, CVD risk factors

Barriers to podiatric care among diabetic patients in the San Francisco Bay area.

This study investigates the provision of general medical and foot care, the barriers to access for foot care, and the awareness of foot risks in an urban diabetic population. A survey composed of 26 questions was mailed to 2375 diabetic patients in the San Francisco Bay area who are members of the American Diabetes Association (ADA). Three hundred ninety-two surveys were returned for a response rate of 16%. Of the 392 respondents, 7 (1.8%) indicated that they were not receiving any medial care for their diabetes, with another 15 (3.8%) receiving general medical care from an alternative health care provider. Among the respondents, 87 (22%) did not have their feet examined by any health care provider. The remainder of the patients were receiving foot care from a health care provider with 191 (48.7%) under the care of a provider other than a podiatrist. Of those not receiving any foot care, 53 (61%) reported that they did not seek any pedal care because they do not have any apparent foot or leg problems. Another 12 (13.8%) indicated that they did not know whom to see for their lower extremity problems. Lack of insurance or inability to afford medical care was the main reason that prevented 7 (8%) of the patients from receiving routine foot care. With respect to the patient's knowledge of diabetes-associated foot disorders, the majority (72%-79%) knew that poor circulation, neuropathy, ulcers, painful leg and foot conditions, infection, and amputation were associated with diabetes. From all the surveyors, 106 (27%) reported that they were not advised or educated on the potential lower extremity complications of diabetes by their health care provider. The results of this study indicate that in an urban population of diabetic patients, all of whom were members of ADA, a significant number are not adequately educated on the importance of routine foot care.

The role of dynamic plantar pressures in diabetic foot ulcers.

OBJECTIVE: The significance of plantar pressure studies in detecting sites of plantar ulceration in diabetic patients was investigated. RESEARCH DESIGN AND METHODS: A total of 97 diabetic patients participated in this study. History and physical data, such as history of smoking, type of diabetes, ankle/brachial indexes, and the presence of protective sensory threshold, were collected. Using the EMED-SF plantar pressure analyzer, dynamic pressure variables, such as normalized peak pressure of maximum pressure picture (MPP), pressure-time integral (PTI), and force-time integral (FTI), were measured in each foot. Statistical analysis included descriptive statistics and analyses of variance. RESULTS: Out of 97 patients, 34 patients had no history of neuropathy and plantar ulceration (the diabetic control [DC] group). Another 14 patients had neuropathy with no previous history of plantar ulcers (the DN group), whereas the remainder of the patients had a history of peripheral neuropathy with plantar ulceration (the DU group). There were significant increases in MPP (P < 0.004) and PTI (P < 0.0004) levels in the DU group when compared with the DC group with the highest pressure present under the 4th and 5th metatarsal heads. No statistical significance existed among groups when comparing FTI levels. CONCLUSIONS: Neuropathic patients have an increase in dynamic plantar foot pressures placing them at risk for plantar ulceration. Instruments such as the EMED-SF system can be helpful in detecting possible sites of plantar ulcerations by locating the areas of maximum pressure.

Time dependence of Na-nitroprusside administration in the prevention of neutrophil infiltration in the rat ischemic kidney.

The aim of this study was to determine the ideal time of administration of Na-nitroprusside to prevent neutrophil infiltration in ischemically damaged kidneys. Sprague-Dawley rats were subjected to 75 min of renal warm ischemia and contralateral nephrectomy. The animals were divided into 7 groups: the ischemic control (IC), which received normal saline, the sham group without warm ischemia and the experimental groups, which received intravenous Na-nitroprusside (NP) (5 mg/kg) at 75, 30, 15, and 5 min prior to reperfusion. Another experimental group was given verapamil (V) (5 mg/kg) as a NO-independent vasodilator 5 min prior to reperfusion. The final evaluation included survival at seven days, serum creatinine (SCr) and blood urea nitrogen (BUN) daily for 3 days, and neutrophil infiltration determined by the presence of myeloperoxidase (MPO) in renal tissue at 2 hr after reperfusion. Histological damage was assessed at 24 hr. There were significant improvements in all parameters when the Na-NP was administered at 75, 30, and 15 min prior to reperfusion when compared with the control group (p < 0.05). There were no differences either in survival or renal function when the 5 min group was compared with the IC or V groups. It is concluded then, that Na-NP can be administered as late as 15 min before reperfusion and still have a protective effect. It appears that the mechanism of protection of Na-NP is due to blocking of one of the steps of the interaction between leukocytes and endothelium--migration. Furthermore, the verapamil (a NO-independent vasodilator) and Na-NP5 (a NO-dependent vasodilator) groups did not show a beneficial effect in these severely ischemically damaged kidneys, which might be one more reason to believe that Na-NP could be interacting at the level of leukocyte-endothelial cell interaction.

Protective effect of combined allopurinol and verapamil given at reperfusion in severe renal ischemia.

This study investigates the role of verapamil, a calcium channel blocker, combined with allopurinol, a xanthine-oxidase inhibitor, when given at reperfusion after severe renal ischemia injury in the rat. Male Sprague-Dawley rats were subjected to 60 minutes of warm ischemia by cross clamping the whole left renal pedicle (artery and vein). At the end of ischemia, the clamps were removed and a contralateral nephrectomy was performed. The animals (n = 40 per group) were divided into five groups; Group 1, ischemic control (IC) receiving lactated Ringer's; Group 2, allopurinol (A) 100 mg/kg; Group 3, verapamil (V) 1.25 mg/kg; Group 4, receiving a combination of A + V at the same concentrations; and Group 5, sham group. Each drug was given intravenously at the end of the ischemic period at reperfusion. Survival was evaluated at 7 days. Renal damage was assessed by kidney function tests (serum creatinine and blood urea nitrogen, or BUN), light histology. Lipid peroxidation was measured in renal tissue using the TBA (thiobarbituric acid) assay. The best survival rate was seen in the combination group of A + V (70% at 7 days; p < .01 vs. control). Single drugs were not as effective as the combination when compared to the IC. Serum creatinine at 24 and 48 hours showed a significant difference between the IC and treatment groups. At 72 hours there were no differences among the treated groups. Histological damage was more pronounced in the IC (Grade 4.0) than in the allopurinol (3.4 +/- 0.8), verapamil (3.0), or A + V (2.2 +/- 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)