Cerebral Ventricular Enlargement in Chronic Schizophrenia: Consistencies and Contradictions

1987 ◽  
Vol 150 (3) ◽  
pp. 324-330 ◽  
Author(s):  
A. Farmer ◽  
R. Jackson ◽  
P. McGuffin ◽  
P. Storey
Keyword(s):  
Chronic Schizophrenia ◽  
Ventricular Enlargement ◽  
Chronic Schizophrenics ◽  
Significant Difference ◽  
History Of ◽  
Paranoid Symptoms ◽  
Operational Criteria ◽  
First Rank Symptoms

A study of cerebral ventricular size measured as ventricle to brain ratio (VBR) using computerised tomographic brain scan in chronic schizophrenics provided no support for suggestions that there are significant differences between patients who fall into different clinical subtypes. We found no significant difference in VBR between patients with and without a family history of schizophrenia or between those with or without paranoid symptoms. Applying Crow's classification, contrary to expectations, Type 1 patients had significantly larger ventricles than those with ‘mixed’ symptomatology (both Type 1 and Type 2 features). We also applied a variety of operational criteria which attempt to define schizophrenia as a whole: of these only Schneider's first-rank symptoms (FRS) yielded conclusive results - FRS-positive patients had significantly larger mean VBR than those without such symptoms. Previously, it has been suggested that ventricular enlargement is more closely associated with ‘negative’ than with ‘positive’ symptoms.

scholarly journals Effect of COVID-19 on the clinical course of diabetic ketoacidosis (DKA) in people with type 1 and type 2 diabetes

2021 ◽  
Vol 10 (4) ◽  
pp. 371-377
Author(s):  
Punith Kempegowda ◽  
Eka Melson ◽  
Agnes Johnson ◽  
Lucy Wallett ◽  
Lucretia Thomas ◽  
...  
Keyword(s):  
Natural History ◽  
Clinical Course ◽  
External Control ◽  
Multi Centre Study ◽  
Significant Difference ◽  
History Of ◽  
Using Data ◽  
Worse Prognosis

Objective COVID-19 in people with diabetes is associated with a disproportionately worse prognosis. DKA is an acute complication of diabetes with a mortality rate of approximately 0.67%. Little is known about the natural history of DKA in the presence of COVID-19. This study aimed to explore the effects of COVID-19 on presentation, clinical course and outcome in patients presenting with DKA. Design Retrospective cohort study. Methods All patients treated for DKA between 1 March 2020 and 30 May 2020 were included. Patients were categorised as COVID-positive or COVID-negative based on the swab test. A pre-COVID group was established using data from 01 March 2019 to 30 May 2019 as external control. Data regarding demographics, diabetes type, pH, bicarbonate, lactate, glucose, DKA duration, complications and outcome were collected. Results A total of 88 DKA episodes were included in this study. There was no significant difference in the severity or duration of DKA between the three groups. COVID-positive T1DM were more hyperglycaemic on admission compared to COVID-negative and pre-COVID patients. There was an over representation of T2DM in COVID-positive patients with DKA than in pre-COVID or COVID-negative groups. Conclusion COVID-19 appears to influence the natural history of DKA differently in T1DM and T2DM. Patients with T1DM and COVID-19 presented with more hyperglycaemia (60 mmol/L (35.9–60.0) vs 31.4 mmol/L (28.0–39.1) vs 24 mmol/L (20.2–33.75), respectively). Patients with T2DM were unusually presenting in DKA when infected with COVID-19 with greater ICU need and higher mortality rates. A collaborative, multi-centre study is needed to provide more definitive results.

scholarly journals EXPRESS: Pulmonary Hypertension Associated With Neurofibromatosis Type 2

2021 ◽  
pp. 204589402110295
Author(s):  
Hirohisa Taniguchi ◽  
Tomoya Takashima ◽  
Ly Tu ◽  
Raphaël Thuillet ◽  
Asuka Furukawa ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Neurofibromatosis Type ◽  
Pulmonary Vascular Remodeling ◽  
Life Threatening ◽  
History Of ◽  
Pulmonary Arterial ◽  
First Time

Although precapillary pulmonary hypertension (PH) is a rare but severe complication of patients with neurofibromatosis type 1 (NF1), its association with NF2 remains unknown. Herein, we report a case of a 44-year-old woman who was initially diagnosed with idiopathic pulmonary arterial hypertension (IPAH) and treated with PAH-specific combination therapy. However, a careful assessment for a relevant family history of the disease and genetic testing reveal that this patient had a mutation in the NF2 gene. Using immunofluorescence and Western blotting, we demonstrated a decrease in endothelial NF2 protein in lungs from IPAH patients compared to control lungs, suggesting a potential role of NF2 in PAH development. To our knowledge, this is the first time that precapillary PH has been described in a patient with NF2. The altered endothelial NF2 expression pattern in PAH lungs should stimulate work to better understand how NF2 is contributing to the pulmonary vascular remodeling associated to these severe life-threatening conditions.

Maternal history of type 2 diabetes is associated with diabetic nephropathy in type 1 diabetic patients

2007 ◽  
Vol 33 (1) ◽  
pp. 37-43 ◽  
Author(s):  
S. Hadjadj ◽  
F. Duengler ◽  
F. Torremocha ◽  
G. Faure-Gerard ◽  
F. Bridoux ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Nephropathy ◽  
Diabetic Patients ◽  
Maternal History ◽  
History Of ◽  
Type 1 Diabetic Patients

scholarly journals Cannabinoids in health and disease: pharmacological potential in metabolic syndrome and neuroinflammation

2018 ◽  
Vol 36 (2) ◽  
Author(s):  
Andrea Mastinu ◽  
Marika Premoli ◽  
Giulia Ferrari-Toninelli ◽  
Simone Tambaro ◽  
Giuseppina Maccarinelli ◽  
...  
Keyword(s):  
Cannabis Sativa ◽  
Cannabinoid Receptor ◽  
Receptor Type ◽  
History Of ◽  
Health And Disease ◽  
Pharmacological Potential ◽  
The Brain ◽  
Synthesis And Degradation

Abstract The use of different natural and/or synthetic preparations of Cannabis sativa is associated with therapeutic strategies for many diseases. Indeed, thanks to the widespread diffusion of the cannabinoidergic system in the brain and in the peripheral districts, its stimulation, or inhibition, regulates many pathophysiological phenomena. In particular, central activation of the cannabinoidergic system modulates the limbic and mesolimbic response which leads to food craving. Moreover, cannabinoid agonists are able to reduce inflammatory response. In this review a brief history of cannabinoids and the protagonists of the endocannabinoidergic system, i.e. synthesis and degradation enzymes and main receptors, will be described. Furthermore, the pharmacological effects of cannabinoids will be outlined. An overview of the involvement of the endocannabinoidergic system in neuroinflammatory and metabolic pathologies will be made. Finally, particular attention will also be given to the new pharmacological entities acting on the two main receptors, cannabinoid receptor type 1 (CB1) and cannabinoid receptor type 2 (CB2), with particular focus on the neuroinflammatory and metabolic mechanisms involved.

scholarly journals CNNM2-Related Disorders: Phenotype and Its Severity Were Associated With the Mode of Inheritance

2021 ◽  
Vol 9 ◽  
Author(s):  
Han Zhang ◽  
Ye Wu ◽  
Yuwu Jiang
Keyword(s):  
De Novo ◽  
Serum Magnesium ◽  
Brain Magnetic Resonance Imaging ◽  
Functional Studies ◽  
Pathogenic Variants ◽  
Significant Difference ◽  
Domain Variations ◽  
Type 3

CNNM2 (Cystathionine-β-synthase-pair Domain Divalent Metal Cation Transport Mediator 2) pathogenic variants have been reported to cause hypomagnesemia, epilepsy, and intellectual disability/developmental delay (ID/DD). We identified two new cases with CNNM2 novel de novo pathogenic variants, c.814T>C and c.976G>C. They both presented with infantile-onset epilepsy with DD and hypomagnesemia refractory to magnesium supplementation. To date, 21 cases with CNNM2-related disorders have been reported. We combined all 23 cases to analyze the features of CNNM2-related disorders. The phenotypes can be classified into three types: type 1, autosomal dominant (AD) inherited simple hypomagnesemia; type 2, AD inherited hypomagnesemia with epilepsy and ID/DD; and type 3, autosomal recessive (AR) inherited hypomagnesemia with epilepsy and ID/DD. All five type 1 cases had no epilepsy or ID/DD; they all had hypomagnesemia, and three of them presented with symptoms secondary to hypomagnesemia. Fifteen type 2 patients could have ID/DD and seizures, which can be controlled with antiseizure medications (ASMs); their variations clustered in the DUF21 domain of CNNM2. All three type 3 patients had seizures from 1 to 6 days after birth; the seizures were refractory, and 1/3 had status epilepticus; ID/DD in these AR-inherited cases was more severe than that of AD-inherited cases; they all had abnormalities of brain magnetic resonance imaging (MRI). Except for one patient whose serum magnesium was the lower limit of normal, others had definite hypomagnesemia. Hypomagnesemia could be improved after magnesium supplement but could not return to the normal level. Variations in the CBS2 domain may be related to lower serum magnesium. However, there was no significant difference in the level of serum magnesium among the patients with three different types of CNNM2-related disorders. The severity of different phenotypes was therefore not explained by decreased serum magnesium. We expanded the spectrum of CNNM2 variants and classified the phenotypes of CNNM2-related disorders into three types. We found that DUF21 domain variations were most associated with CNNM2-related central nervous system phenotypes, whereas hypomagnesemia was more pronounced in patients with CBS2 domain variations, and AR-inherited CNNM2-related disorders had the most severe phenotype. These results provide important clues for further functional studies of CNNM2 and provide basic foundations for more accurate genetic counseling.

scholarly journals Clinical significance of intramammary arterial calcifications in diabetic women

2004 ◽  
Vol 61 (2) ◽  
pp. 163-167 ◽  
Author(s):  
Zorica Milosevic ◽  
Jelica Bjekic ◽  
Stanko Radulovic ◽  
Branislav Goldner
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Control Group ◽  
Duration Of Diabetes ◽  
Diabetic Macroangiopathy ◽  
Indirect Sign ◽  
Significant Difference

Background. It is well known that intramammary arterial calcifications diagnosed by mammography as a part of generalized diabetic macroangiopathy may be an indirect sign of diabetes mellitus. Hence, the aim of this study was to determine the incidence of intramammary arterial calcifications, the patient?s age when the calcifications occur, as well as to observe the influence of diabetic polineuropathy, type, and the duration of diabetes on the onset of calcifications, in comparison with nondiabetic women. Methods. Mammographic findings of 113 diabetic female patients (21 with type 1 diabetes and 92 with type 2), as well as of 208 nondiabetic women (the control group) were analyzed in the prospective study. The data about the type of diabetes, its duration, and polineuropathy were obtained using the questionnaire. Statistical differences were determined by Mann-Whitney test. Results. Intramammary arterial calcifications were identified in 33.3% of the women with type 1 diabetes, in 40.2% with type 2, and in 8.2% of the women from the control group, respectively. The differences comparing the women with type 1, as well as type 2 diabetes and the controls were statistically significant (p=0.0001). Women with intramammary arterial calcifications and type 1 diabetes were younger comparing to the control group (median age 52 years, comparing to 67 years of age, p=0.001), while there was no statistically significant difference in age between the women with calcifications and type 2 diabetes (61 years of age) in relation to the control group (p=0.176). The incidence of polineuropathy in diabetic women was higher in the group with intramammary arterial calcifications (52.3%) in comparison to the group without calcifications (26.1%), (p=0.005). The association between intramammary arterial calcifications and the duration of diabetes was not found. Conclusion. The obtained results supported the theory that intramammary arterial calcifications, detected by mammography could serve as markers of co-existing diabetes mellitus and therefore should be specified in radiologic report in case of their early development.

scholarly journals Aggregation activity of blood formed elements in patients with type 1 and type 2 diabetes mellitus

2012 ◽  
Vol 15 (2) ◽  
pp. 49-53
Author(s):  
Boris Il'ich Kuznik ◽  
Yury Antonovich Vitkovskiy ◽  
Marina Yur'evna Zakharova ◽  
Natalya Nikolaevna Klyuchereva ◽  
Olga Sergeevna Rodnina ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Platelet Aggregation ◽  
Blood Samples ◽  
Significant Difference ◽  
Erythrocyte Adhesion ◽  
T1 And T2 ◽  
Aggregation Activity ◽  
Spontaneous Platelet Aggregation

Aims. To assess differences in blood formed elements aggregation activity in patients with type 1 (T1) and type 2 (T2) diabetes mellitus(DM). Materials and methods. We studied blood samples from 88 patients with T1 and T2 DM. Platelet aggregation activity was assessed bymeans of ?Biola? aggregometer; we also determined platelet-lymphocyte and leucocyte-erythrocyte adhesion intensity. Results. We show that spontaneous platelet aggregation is markedly increased in patients with T1DM but remains normal or slightlyelevated in case of T2DM. In blood from patients with T2DM platelet aggregation in response to ADP, epinephrine, ristomycineand contact with collagen was generally increased, whereas in T1DM we often observed its secondary reduction. Data on plateletlymphocyteadhesion in T1DM is controversial, but in T2DM this process seems to be significantly suppressed. Quantity of leucocyteerythrocyteaggregates was sharply increased in both T1DM and T2DM. Conclusion. We've determined significant difference in blood formed elements aggregation activity between patients with T1 and T2 DM.

Fluid flow and faulting history of the Iano tectonic window (Southern Tuscany, Italy).

2021 ◽  
Author(s):  
Paolo Fulignati ◽  
Martina Zucchi ◽  
Andrea Brogi ◽  
Enrico Capezzuoli ◽  
Domenico Liotta ◽  
...  
Keyword(s):  
Fluid Inclusions ◽  
Hydrothermal Fluids ◽  
Normal Faults ◽  
High Angle ◽  
Quartz Veins ◽  
History Of ◽  
Tectonic Window ◽  
Liquid Vapor

<p>In the Iano area (Southern Tuscany) a small tectonic window of Tuscan metamorphic units is observed. This belongs to the northernmost part of the so-called Mid-Tuscan ridge and, during Pliocene, formed a submarine high, now defining the easternmost shoulder of the Volterra Pliocene basin. The area gives the opportunity to investigate the complete cycle of negative inversion from crustal thickening to crustal thinning, which characterizes Southern Tuscany. Our new data focus on the western margin of the Iano ridge, and in particular on a system of high angle normal faults that represents the youngest structures of the investigated area. These structures, deformed low angle regional detachments locally juxtaposing the uppermost units of contractional nappe stack (the ophiolite-bearing Ligurian units), with the Tuscan metamorphic units, with an almost complete excision of at least 3.5 Km thick Mesozoic to Tertiary Tuscan nappe succession. The high angle normal faults show variable Plio-Quaternary vertical displacements from few meters to about 500 meters, and acted as pathways for the upwelling of hydrothermal fluids, as revealed by Pleistocene travertine deposits, hydrothermal alteration and occurrence of different generations of fluid inclusions in hydrothermal veins associated with these fault systems. Fluid inclusions were studied in quartz veins hosted in the Verrucano metasediments forming the top of the Tuscan metamorphic unit, as well as in some carbonate lithotypes (Cretaceous to Tertiary in age) of the overlying Tuscan Nappe. Two different kinds of fluid inclusions were documented. The Type 1 are multiphase (liquid + vapor + 1 daughter mineral) liquid-rich fluid inclusions whereas the Type 2 are two-phase (liquid + vapor) liquid-rich fluid inclusions. Type 1 fluid inclusions are primary in origin and were found only in quartz veins present in Verrucano metarudites, whereas Type 2 fluid inclusions occur in quartz veins present in both Verrucano phyllites and quartzites and in the carbonate units of the Tuscan Nappe. These are secondary and can be furthermore distinguished in two sub-populations (Type 2a and Type 2b) on the basis of petrographic observation and microthermometric data. Fluid inclusion investigation evidenced an evolution of the hydrothermal fluids from relatively high-T (~265°C) and hypersaline (35 wt.% NaCl<sub>equiv.</sub>) fluids trapped at about 100 MPa, to lower temperature (~195°C) and salinity (~9.5 wt.% NaCl<sub>equiv.</sub>) fluids, having circulated in the high-angle fault system. Based on the new data and a revision of the local tectonic setting a fluid-rock interaction history has been reconstructed with new hints and constraints for the Plio-Quaternary extensional history of the Volterra basin.</p>

ORGANIZATION OF AMBULATORY CARE FOR TYPE 2 DIABETES MELLITUS

Vestnik ◽  
2021 ◽  
pp. 187-193
Author(s):  
З.К. Манатбекова ◽  
А. Озат ◽  
А.Е. Бектур ◽  
А.Р. Шаймерден ◽  
Д.А. Ахат ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Outpatient Care ◽  
Best Practice ◽  
Self Management ◽  
Order Sets ◽  
History Of ◽  
Insulin Use ◽  
Quality Assurance Standards

Качественная амбулаторная помощь при диабете требует как стандартов оказания амбулаторной помощи, часто обеспечиваемой структурированными наборами заказов, так и стандартов обеспечения качества для улучшения процессов. Протоколы, обзоры и руководства «передовой практики» непоследовательно применяются в больницах. Чтобы исправить это, в больницах установлены протоколы для структурированного ухода за пациентами и структурированные наборы заказов, которые включают компьютеризированный ввод заказов врача (CPOE). В первоначальных заказах должен быть указан тип диабета (например, диабет 1 или 2 типа) или отсутствие диабета в анамнезе. Поскольку стационарное использование инсулина и приказы о выписке могут быть более эффективными, если основаны на уровне A1C при поступлении, выполните тест A1C у всех пациентов с диабетом или гипергликемией, госпитализированных в больницу, если тест не был проведен. выполнено за предыдущие 3 месяца. Целью данной работы является рассмотрение стандартов амбулаторного лечения пациентов с диабетом 2 типа, составление рекомендации по поведению и формировании навыков в отношении самоконтроля при диабете. Quality ambulatory diabetes care requires both outpatient care standards, often provided by structured ordering, and quality assurance standards to improve processes. “Best practice” protocols, reviews and guidelines are inconsistently applied in hospitals. To remedy this, hospitals have established protocols for structured patient care and structured order sets that include computerized entry of physician orders (CPOE). Initial orders must indicate the type of diabetes (such as type 1 or 2 diabetes) or no history of diabetes. Because inpatient insulin use and discharge orders may be more effective if based on admission A1C levels, perform an A1C test on all diabetic or hyperglycemic patients admitted to the hospital if the test has not been performed. completed in the previous 3 months. The aim of this work is to review the standards of outpatient treatment of patients with type 2 diabetes, to draw up recommendations on behavior and skills formation in relation to self-management in diabetes.

Abstract P267: Burden of Disease Among Older Adults With Type 1 and Type 2 Diabetes: Results From the Study of Longevity in Diabetes (SOLID)

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Mary E Lacy ◽  
Paola Gilsanz ◽  
Chloe Eng ◽  
Michal S Beeri ◽  
Andrew J Karter ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Emergency Department ◽  
Functional Impairment ◽  
Coronary Bypass ◽  
Emergency Department Utilization ◽  
Geriatric Syndromes ◽  
History Of

Introduction: Increasing incidence of type 1 diabetes (T1D) coupled with increasing life expectancy have resulted in an unprecedented number of older adults living with T1D. However, little is known about the burden of aging and diabetes-related complications in this unique group. We hypothesized that older adults with T1D would have greater diabetes and aging-related burden compared to an age, sex, race/ethnicity, and education-matched group of older adults with type 2 diabetes (T2D). Methods: We compared the following characteristics by diabetes type among older adults (aged ≥60) with T1D (n=805) and T2D (n=249) from the Study of Longevity in Diabetes (SOLID) using chi-squared tests: diabetes history (age of onset, diabetes duration); diabetes-related complications (retinopathy, neuropathy, nephropathy, severe hypo- and hyperglycemia resulting in hospitalization/emergency department utilization), cardiovascular disease (stroke, MI, coronary bypass), and geriatric syndromes (depression, incontinence, memory problems and functional impairment). Results: Average age at diagnosis and duration of diabetes, respectively, were 28 years old and 40 years duration for T1D and 56 years old and 13 years duration for T2D (Table 1). Compared to T2D, participants with T1D were more likely to report history of retinopathy, neuropathy, nephropathy, lifetime hypo- and hyperglycemic events resulting in hospitalization/emergency department utilization, and history of a coronary bypass. By contrast, those with T2D were more likely to be incontinent and have functional impairment. Conclusions: Our results show that diabetes-related complications are more prevalent in those with T1D than in comparable adults with T2D, while certain geriatric syndromes were more prevalent in those with T2D. Older adults with T1D are a growing population with unique diabetes-specific and aging-related considerations. Additional research is needed to understand the interplay of aging and diabetes in this group to inform patient care .

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