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Neuropatia auton?mica cardiovascular diabética: fatores de risco, impacto clínico e diagnóstico precoce
Rolim, Luiz Clemente de Souza Pereira;Sá, Jo?o Roberto de;Chacra, Antonio Roberto;Dib, Sérgio Atala;
Arquivos Brasileiros de Cardiologia , 2008, DOI: 10.1590/S0066-782X2008000400014
Abstract: cardiovascular autonomic neuropathy (can) is one of the most clinically significant complications of diabetes mellitus (dm), but one of the least frequently diagnosed. in this review, we discuss the major risk factors for the development and progression of can in patients with dm, the natural history of autonomic neuropathy and its impact on cardiovascular disease in dm, as well as the tests for the early diagnosis and staging of can in the clinical practice. the bibliographic research was based on two databases: medline and tripdatabase, with the following descriptors: diabetic cardiovascular autonomic neuropathy and cardiovascular autonomic neuropathy and diabetes. we selected english and german articles, written between 1998 and 2007. in its initial stages (early and intermediate), can may be diagnosed and reversed. however, in advanced cases (severe stage), the only treatment that remains is a symptomatic one. can is associated with higher cardiovascular morbidity and mortality rates and poor quality of life in diabetic individuals.
Diabetes mellitus tipo 1 na ausência de neuropatia auton?mica n?o altera a taxa de sudorese no exercício
Rocha, Cristiane Martins;Madeira, Luciana Gon?alves;Sá, Kátia Regina;Lopes, Luciana Napole?o;Albuquerque, Daniel Peixoto de;Diniz, Leonardo Maurício;Rodrigues, Luiz Oswaldo Carneiro;
Revista Brasileira de Medicina do Esporte , 2009, DOI: 10.1590/S1517-86922009000100005
Abstract: sudoresis is the main autonomic human thermoregulatory mechanism. it can be influenced by several factors, including diseases, among them diabetes mellitus type 1 (dm1), whose patients are potential victims of thermoregulatory disturbances. regular physical exercises are recommended to diabetic people and some of them even become athletes. however, up to now, the sweat rate (sr) of diabetic patients during graded exercise until exhaustion (gxt) has not been compared to the sr of healthy individuals with similar physical characteristics. the present study measured global (srglobal) and local (srlocal) sweat rates during gxt in 14 diabetic (dm) and control subjects (cg), similar in age, gender, body composition and aerobic capacity. urine specific gravity (gu), body mass and blood glucose (gblood) were measured before and after gxt. besides that, srlocal (forearm and leg) was measured by iontophoresis with pilocarpine (0.5%) in the dm group. heart rate (hr), skin temperature (tsk) and environmental thermal conditions were measured during the experiment. both initial and final gblood were higher in the dm, as expected. the gu were similar between groups. exercise induced similar srglobal and srlocal in both groups, whereas the rest hr and rest and exercise tsk were higher in the dm. forearm and leg sr were not different in the dm. it was concluded that the sweating response was not different between young diabetic patients and control group during gxt in a temperate environment.
Neuropatia sensitiva e auton mica herditátia tipo II: a propósito de dois casos
Sanvito Wilson Luiz,Cataldo Berenice Oliveira V,Costa Agnaldo Rodrigues
Arquivos de Neuro-Psiquiatria , 2003,
Abstract: Dois casos de neuropatia sensitiva e auton mica hereditária do tipo 2 s o descritos. Este tipo de neuropatia faz parte de um grupo constituído por cinco entidades diferentes. A sistematiza o destas neuropatias depende de múltiplos critérios como idade de início, aspectos genéticos, manifesta es clínicas, aspectos eletroneuromiográficos e patológicos. Neste relato descrevemos dois irm os com 27 e 35 anos de idade que foram acompanhados em nosso Servi o, com quadro de insensibilidade à dor e conseqüentes deformidades de membros e distúrbios sensitivo-tróficos. Para estes pacientes foi definido o diagnóstico de neuropatia sensitiva e auton mica hereditária do tipo 2, com modalidade de transmiss o hereditária autoss mica recessiva. A idade de início do quadro, os aspectos hereditários, as manifesta es clínicas e os aspectos eletroneuromiográficos s o analisados. O diagnóstico diferencial com outras neuropatias sensitivas hereditárias e adquiridas é considerado.
Asociación de la neuropatía autonómica cardiovascular y el intervalo QT prolongado con la morbimortalidad cardiovascular en pacientes con diabetes mellitus tipo 2 Association of cardiovascular autonomic neuropathy and prolonged QT interval with cardiovascular morbidity and mortality in patients with type 2 diabetes mellitus  [cached]
Ray Ticse Aguirre,Jaime E. Villena
Revista Peruana de Medicina Experimental y Salud Pública , 2011,
Abstract: Con el objetivo de evaluar la relación entre la neuropatía autonómica cardiovascular (NACV) y el intervalo QT corregido (QTc) con la morbimortalidad cardiovascular en pacientes con diabetes mellitus tipo 2, se realizó el seguimiento a 5 a os de 67 pacientes que acudieron a consulta externa del Servicio de Endocrinología. Se presentaron eventos cardiovasculares en 16 pacientes; el 82% completó el seguimiento y se encontró que el intervalo QTc prolongado fue la única variable que se asoció de forma significativa a morbimortalidad cardiovascular en el análisis de regresión logística múltiple (RR: 13,56; IC 95%: 2,01-91,36) (p=0,0074). In order to evaluate the relationship between cardiovascular autonomic neuropathy and corrected QT interval (QTc) with cardiovascular morbidity and mortality in patients with type 2 diabetes mellitus, we followed up for 5 years 67 patients attending the outpatient Endocrinology Service. 82% completed follow-up and cardiovascular events occurred in 16 patients. We found that long QTc interval was the only variable significantly associated with cardiovascular morbidity and mortality in the multiple logistic regression analysis (RR: 13.56, 95% CI: 2.01-91.36) (p = 0.0074).
Asociación de la neuropatía autonómica cardiovascular y el intervalo QT prolongado con la morbimortalidad cardiovascular en pacientes con diabetes mellitus tipo 2
Ticse Aguirre,Ray; Villena,Jaime E.;
Revista Peruana de Medicina Experimental y Salud Pública , 2011, DOI: 10.1590/S1726-46342011000100013
Abstract: in order to evaluate the relationship between cardiovascular autonomic neuropathy and corrected qt interval (qtc) with cardiovascular morbidity and mortality in patients with type 2 diabetes mellitus, we followed up for 5 years 67 patients attending the outpatient endocrinology service. 82% completed follow-up and cardiovascular events occurred in 16 patients. we found that long qtc interval was the only variable significantly associated with cardiovascular morbidity and mortality in the multiple logistic regression analysis (rr: 13.56, 95% ci: 2.01-91.36) (p = 0.0074).
Disfun??o auton?mica cardiovascular no diabetes mellitus experimental
De Angelis, Katia;Schaan, Beatriz D'Agord;Rodrigues, Bruno;Malfitano, Christiane;Irigoyen, Maria Cláudia;
Arquivos Brasileiros de Endocrinologia & Metabologia , 2007, DOI: 10.1590/S0004-27302007000200007
Abstract: much new information has been published in the last few years regarding pathophysiology of cardiovascular autonomic dysfunction in diabetic rats and mice. our group has been studying the time-course cardiovascular changes associated with experimental diabetes in the last years, and obtained consistent evidences of severe dysautonomia in diabetes animal models. the aim of this manuscript is to review the contribution that studies involving different animal models of insulin deficiency or resistance have given to understand, treat and prevent diabetic cardiovascular autonomic dysfunction.
Epidemiologia e qualidade de vida em indivíduos com neuropatia diabética dolorosa: uma revis o bibliográfica  [PDF]
Layz Alves Ferreira Souza,Ana Paula da Costa Pessoa,Letícia Cunha Franco,Lílian Varanda Pereira
Revista Eletr?nica de Enfermagem , 2010,
Abstract: A neuropatia diabética dolorosa (NDD) é conceituada como dor iniciada ou causada por les o primária ou disfun o ou perturba o transitória no sistema nervoso periférico ou central. O objetivo do estudo foi analisar a produ o bibliográfica acerca da epidemiologia e do impacto da NDD na qualidade de vida dos indivíduos. Pesquisa bibliográfica de estudos indexados em cinco fontes de dados, utilizando-se os descritores diabetes, diabetes mellitus, neuropatia dolorosa, dor neuropática, qualidade de vida, SF-36, epidemiologia e similares em inglês e espanhol, no período de 1998 a 2010. Foram selecionadas 28 publica es. A prevalência de NDD variou de 26,4 a 65,3%; descrita como dor em “queima o”, “formigamento”, agulhada” e contínua”, com intensidade variando de leve à intensa; capaz de gerar depress o em 35% dos casos e prejudicar principalmente a energia, capacidade de caminhar e o sono. A NDD é frequente entre as pessoas com diabetes mellitus e gera efeitos negativos na qualidade de vida dessa popula o.
Obesity and the risk of cardiovascular disease and diabetes mellitus

Matthew J Sorrentino,

老年心脏病学杂志(英文版) , 2006,
Abstract: The increasing prevalence of obesity worldwide has many experts concerned about the worsening health of a large proportion of the population. It is well recognized that obe-sity is associated with a higher mortality, an increased risk of hypertension and hyperlipidemia, cardiovascular disease, dia-betes mellitus, osteoarthritis, gall bladder disease and possibly some cancers. Currently it is estimated that over two thirds of adults in the United States are overweight and nearly one third are clinically obese.' Of special concern is the rapid increase in obesity among children. Other countries both developed and developing are experiencing similar trends.
Previous Gestational Diabetes Mellitus and Markers of Cardiovascular Risk  [PDF]
Nikolaos Vrachnis,Areti Augoulea,Zoe Iliodromiti,Irene Lambrinoudaki,Stavros Sifakis,George Creatsas
International Journal of Endocrinology , 2012, DOI: 10.1155/2012/458610
Abstract: The prevalence of gestational diabetes mellitus (GDM) in the developed world has increased at an alarming rate over the last few decades. GDM has been shown to be associated with postpartum diabetes, insulin resistance, hypertension, and dyslipidemia. A history of previous GDM (pGDM), associated or not with any of these metabolic abnormalities, can increase the risk of developing not only type 2 diabetes mellitus but also cardiovascular disease (CVD) independent of a diagnosis of type 2 diabetes later in life. In this paper we discuss the relationship among inflammatory markers, metabolic abnormalities, and vascular dysfunction in women with pGDM. We also review the current knowledge on metabolic modifications occurring in normal pregnancy and the link between alterations of a normal metabolic state with the long-term maternal complications that may result in increased CVD risk. Our review of studies on pGDM prompts us to recommend that these women be considered a population at risk for later CVD events, which however could be avoided via the use of specially designed follow-up programs in the future. 1. Introduction Gestational diabetes mellitus (GDM) is any degree of glucose intolerance with onset or first recognition during pregnancy [1, 2]. In early gestation fasting blood glucose is lower and insulin sensitivity decreases slightly. This is followed by progressively increasing insulin resistance in the second and third trimesters with a borderline increase of insulin production or hyperinsulinemia. Furthermore, insulin resistance occurs as a result of placental hormones that antagonize insulin, estrogen, progesterone, human placental lactogen (HPL), human placental growth hormone, cortisol, prolactin, and tumor necrosis factor-alpha (TNF-α) [3]. The above different pathophysiologic mechanisms accompanying pregnancy result in metabolic changes that allow for higher postprandial maternal glucose. Pregnancy is a hyperinsulinemic state which may develop into impaired glucose tolerance if insulin secretion is unable to compensate for pregnancy-associated insulin resistance [3–5]. The condition of GDM is a state of chronic low-grade subclinical inflammation characterized by abnormal production of cytokine and mediators and activation of a network of inflammatory signaling pathways. Although the characteristic of GDM is insulin resistance, the exact mechanism involved in this process is still unknown. The increased insulin resistance during pregnancy has been, as just described, attributed to cortisol and gestational hormones, but more recent data have
Neuropatia óptica isquêmica anterior e poliarterite nodosa: relato de caso  [cached]
Graf Christie Michelle,Skare Thelma Larocca,Moreira Carlos Augusto
Arquivos Brasileiros de Oftalmologia , 2006,
Abstract: Descreve-se uma paciente com diagnóstico de poliarterite nodosa, em tratamento com citostáticos e corticosteróides que desenvolveu neuropatia óptica isquêmica anterior, uma manifesta o considerada bastante rara para esta doen a.
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