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1.
Ophthalmologe ; 106(3): 242-51, 2009 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-18709375

RESUMO

BACKGROUND: Approximately 35,000 cases of neovascular age-related macular degeneration (AMD) occur annually in Germany. The neovascular form of AMD (NV-AMD) is responsible for severe vision loss associated with the disease in 90% of the cases. This study was conducted to assess the humanistic and economic burden of NV-AMD in the German population. METHODS: A cross-sectional, observational study of subject self-reported functional health, well-being, and disease burden among elderly subjects with (n=83) and without (n=93) NV-AMD in Germany was conducted. Patients participated in telephone surveys involving the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), the EuroQol (EQ-5D), the Hospital Anxiety and Depression Scale (HADS), and also reported history of falls, fractures, and healthcare resource utilization. Furthermore, the healthcare utilization and unit costs for the NV-AMD patients were calculated. RESULTS: The mean age of NV-AMD patients was 77.2 years and 64% were female. NV-AMD patients reported significantly worse vision-related function and overall well-being than controls (adjusted mean scores: NEI-VFQ-25 overall scale: 51.3 vs 96.3; p<0.0001) and significantly more depression symptoms than controls (HADS depression: 6.2 vs. 2.7; p<0.0001). NV-AMD patients also reported that the need for assistance with daily activities was more than 10 times greater compared to controls (26.5% vs. 2.2%; p<0.0001) and the prevalence of falls was 3 times that of the control group (13.3% vs 4.3%; p=0.031). Annual NV-AMD costs per patient were 9871, 6 times that of elderly patients without NV-AMD ( 1559). Of the NV-AMD costs one-half were direct non-medical-related costs (assistance of ADL or social benefit) and one-third were direct medical costs. CONCLUSIONS: NV-AMD is associated with decreased functional abilities and quality of life, which result in an increase in healthcare resource utilization. Consequently, costs were higher for NV-AMD patients compared to controls. These findings emphasize the need for new NV-AMD treatments that will prevent vision loss and progression to blindness, and lessen the ensuing economic burden. Sponsored by Pfizer Inc. New York, US.


Assuntos
Efeitos Psicossociais da Doença , Degeneração Macular/economia , Degeneração Macular/epidemiologia , Qualidade de Vida , Neovascularização Retiniana/economia , Neovascularização Retiniana/epidemiologia , Adolescente , Adulto , Criança , Feminino , Alemanha/epidemiologia , Humanos , Incidência , Masculino , Adulto Jovem
2.
J Hypertens ; 12(7): 803-7, 1994 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-7963509

RESUMO

OBJECTIVE: To evaluate the effects of an acute glucose load on circulating atrial natriuretic factor (ANF) levels. METHODS: We investigated plasma ANF, glucose and insulin levels before and after intravenous administration of 50% D-glucose (300 mg/kg body weight) in healthy, normal volunteers. RESULTS: In study group A (n = 30) plasma ANF was found to be increased significantly 30 min after the glucose load. In study group B (n = 55) the response of plasma ANF over time was assessed. A peak plasma ANF response was observed 10 min after intravenous glucose loading; thereafter, plasma ANF levels returned gradually to basal levels at 50 min after glucose injection. The latter produced in both study groups a similar acute hyperglycaemia, and in group B the expected concomitant hyperinsulinaemia. CONCLUSION: These observations demonstrate that, in normal humans, acute marked hyperglycaemia is accompanied by a rapid increase in circulating ANF levels. In this metabolic interaction, ANF might counteract the renal sodium-retaining effect of acute hyperglycaemia and hyperinsulinaemia.


Assuntos
Fator Natriurético Atrial/sangue , Glucose/farmacologia , Adulto , Glicemia/análise , Feminino , Humanos , Injeções Intravenosas , Insulina/sangue , Masculino , Radioimunoensaio , Valores de Referência , Fatores de Tempo
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