老年糖尿病患者急诊行胆道手术后心律失常的分析

目的通过对老年糖尿病患者急诊行胆道手术后心律失常的分析,找出老年糖尿病患者急诊行胆道手术后心律失常的原因,从而有效地避免心律失常的 .发生.方法443例老年糖尿病患者急诊行胆道手术,心律失常的统计时间范围是从手术结束到手术后24h内.电解质、血红蛋白的数据为急诊入院时或急诊入院后术前3h内所采集的数据,采集的数据经统计学处理.结果本组443例中发生心律失常113例(25.5%),其中有心血管病史发生心律失常为92例,高血钾或低血钾发生心律失常为73例,手术时间大于2h为58例,低血红蛋白发生心律失常为57例,连续硬膜外94例.经过统计学处理发生心律失常分别与有无心血管病史、血钾和血红蛋白值、麻醉方式密切相关.有心血管病史、血钾不正常、血红蛋白偏低、手术时间大于2h、连续硬膜外是引起老年人急诊行胆道手术后致心律失常的主要因素.结论发现主要与原有心血管疾病、高血钾或低血钾、低血红蛋白、手术时间、麻醉方式关系密切.     

Modeling low birth weights using threshold regression: results for U. S. birth data

Babies born live under 2,500 g or with a gestational age under 37 weeks are often inadequately developed and have elevated risks of infant mortality, congenital malformations, mental retardation, and other physical and neurological impairments. In this paper, we model birth weight as a first hitting time (FHT) of a birthing boundary in a Wiener process representing fetal development. We associate the parameters of the process and boundary with covariates describing maternal characteristics and the birthing environment using a relatively new regression methodology called threshold regression. Two FHT models for birth weight are developed. One is a mixture model and the other a competing risks model. These models are tested in a case demonstration using a 4%-systematic sample of the more than four million live births in the United States in 2002. An extensive data set for these births was provided by the National Center for Health Statistics. The focus of this paper is on the conceptual framework, models and methodology. A full empirical study is deferred to a later occasion.     

Self-management of gestational diabetes among Chinese migrants: A qualitative study

Background

Gestational diabetes mellitus is one of the most common complications of pregnancy. Women with Gestational diabetes are at increased risk of serious health outcomes, such as pre-eclampsia, obstructed labor, and the development of Type 2 diabetes later in life. Chinese migrants, the third largest cultural group in Australia, are more likely to develop Gestational diabetes than Australian-born women. However, to date, Gestational diabetes self-management has not been investigated in this population.

An integrative review of interventions for limiting gestational weight gain in pregnant women who are overweight or obese

ProblemExcessive gestational weight gain in women who are overweight or obese puts them at risk of poor short- and long-term outcomes for maternal and neonatal health. Several interventions have been trialled to encourage women who are overweight or obese to limit gestational weight gain during pregnancy.AimThe aim of this review was to analyse the evidence on interventions to limit gestational weight gain in pregnant women who are overweight or obese.MethodAn integrative review guided by the Joanna Briggs Institute approach was conducted. An unlabeled search query of pregnancy, weight, and obesity was conducted in Medline, Scopus and CINAHL, limited to English language, 2010–2020 publications, and primary research on humans. Unlabeled search query of “((pregnancy outcome) OR (prenatal care) OR (pregnancy complications)) AND ((weight loss) OR (weight gain) OR (weight management)) AND (obesity) was used. Additional 9 records were identified through reference lists. Following a critical appraisal, 21 primary research articles were included in this review. A thematic synthesis was undertaken.FindingsFour major themes were identified. These are (1) mixed findings of lifestyle interventions for weight management, (2) ineffectiveness of probiotics or metformin for weight management, (3) psycho-behavioural interventions for weight management, and (4) midwifery role as an integral component in multidisciplinary intervention for weight management.ConclusionThe literature suggests a need for longer duration of behavioural lifestyle intervention sessions led by the same midwife trained in motivational interviewing to limit weight gain in pregnant women who are overweight or obese.     

Strength in Process: Using Concept Mapping to Inform Community Coalition Development

This study reports on the use of Concept Mapping to delineate a conceptual framework germane to the planning and initial formation of tri-county rural diabetes coalition in a southeast US community. The focus of the tricounty coalition is to reduce diabetes-related inequalities in vulnerable populations. After a review of pertinent literature on community coalitions, this article explicates Concept Mapping processes utilized to plan and organize the formation of a coalition, offers analyses of the results, and discusses implications for current and future practices pertaining to community coalition work.     

文化程度对糖尿病患者健康教育需求的影响与分析

目的:了解不同文化程度的糖尿病患者对健康教育需求的差别,并提出改进教育方式提高教育效果的建议.方法:对南京地区5家三甲医院的502例患者进行问卷调查.结果:不同文化层次的患者对注射胰岛素技术和注意事项、药物治疗的效果及不良反应等10项内容需求的差别有统计学意义.其中,药物治疗的效果及不良反应、定期复查的项目和时间,文化程度高者需求较高.不同文化程度的患者,对集体讲座、发放健康资料、个体咨询和订阅报纸杂志需求的差异有统计学意义.其中,健康资料、订报纸杂志,文化程度高者需求较高.结论:健康教育的内容要因人施教;要注重运用现代化手段,如电话和互联网;要结合糖尿病患者的家属进行指导和心理疏导.     

Relationship between vitamin D receptor BsmI and FokI polymorphisms and anthropometric and biochemical parameters describing metabolic syndrome

Introduction.?It was found that vitamin D may have a direct effect on adipocyte differentiation and metabolism and might be involved in the glucose regulation of insulin secretion, as suggested from the discovery of a nuclear localization of 1,25-(OH)₂D₃ in pancreatic islets. In recent years, several polymorphisms in the VDR gene which are able to alter the activity of VDR protein have been described. The BsmI and FokI polymorphisms were described in relation to obesity and type 2 diabetes.

The aim of the study was to find whether there are associations between BsmI and FokI polymorphisms and anthropometric (BMI, WHR, BP) and biochemical parameters describing metabolic syndrome.

Materials and methods.?Studied were 176 randomly selected men aged 25–65 years (mean: 51.99 years) with a mean BMI of 28.06 kg/m². Two polymorphisms of the VDR gene (FokI and BsmI) were explored using the PCR-RFLP method. Serum glucose, insulin, total cholesterol, LDL, HDL, and TG were measured using commercially available kits.

Results.?It was found that BB carriers tend to have higher BMI (29.00 ± 3.74 versus 26.81 ± 3.76, p = 0.024) and waist circumference (101.79 ± 10.59 versus 96.23 ± 10.35, p = 0.014) compared with the bb genotypes. Similarly, FF and Ff carriers had higher fasting insulin levels than the ff genotypes (12.30 ± 10.26 versus 9.76 ± 5.88, p = 0.001 and 9.76 ± 5.88 vs. 6.35 ± 2.64, p = 0.008), and lover cHDL levels in comparison to ff genotypes (52.28 ± 10.02 versus 60.63 ± 16.58, p = 0.015 and 53.70 ± 12.03 versus 60.63 ± 16.58, p = 0.032. Besides these, no significant differences were found.

Conclusions.?The BsmI VDR polymorphism seems to influence BMI, while the FokI VDR polymorphism appears to affect insulin sensitivity and serum cHDL level.     

Effect of body image on gestational weight gain in overweight and obese women

Problem or backgroundThere is little information available describing how women who are overweight or obese in pregnancy perceive their bodies, and in particular the effect of body image dissatisfaction on gestational weight gain.QuestionTo describe how women who are overweight or obese in pregnancy perceive their body, and the effect of body image on gestational weight gain.MethodsThis prospective nested cohort study evaluated self estimation of body weight, preferred body shape, dieting behavior, satisfaction with body weight and shape, and gestational weight gain in pregnant women who were overweight or obese, through self-completed questionnaire in early pregnancy in South Australia from October 2010 to February 2012.FindingsOf the 442 women who completed the questionnaire, 25.8% correctly identified their BMI, with 70.1% under-estimating and 4.1% over-estimating their BMI. Women who were obese were significantly less likely to correctly identify their BMI, as were younger women. Women who incorrectly identified their BMI were significantly more likely to have higher gestational weight gain (P < 0.001). Approximately 45% of women indicated dissatisfaction with their weight or body shape, with this being more common in women of higher parity and higher BMI. Dissatisfaction was significantly related to gestational weight gain.ConclusionWomen who report increasing dissatisfaction with their body size and shape are more likely to gain excessive weight during pregnancy. Further research should explore insights about maternal body image and diet related behaviors.     

冠心病合并糖尿病与单纯冠心病危险因素及临床特点比较研究

目的:探讨冠心病合并糖尿病与单纯冠心病的危险因素和临床特点的差异?方法:1 926例行冠状动脉造影(coronary angiography,CAG)检查的个体确诊为冠心病的患者1 277例,分为冠心病无糖尿病组和冠心病合并糖尿病组,同时确诊非冠心病个体649例作为对照组?收集相关危险因素和临床资料?结果:3组总体比较,性别?年龄?体质指数(body mass index,BMI)?空腹血糖?载脂蛋白A?脂蛋白a?高血压?本次入院发病心脏彩超左心室射血分数?吸烟?每天吸烟量?饮酒及工作活动强度和平时锻炼频率在3组人群中的分布差异有统计学意义(P < 0.05);冠心病无糖尿病组和冠心病合并糖尿病组相比,BMI?空腹血糖?载脂蛋白A和每天吸烟量差异有统计学意义(P < 0.05);多因素Logistic回归分析结果表明,与阴性对照组相比,男性?年龄> 60岁?高血压?吸烟等因素可增加单纯冠心病发病风险,同时年龄> 60岁?BMI≥24?高水平总胆固醇和吸烟是冠心病合并糖尿病发生的高危因素;与单纯冠心病组相比,女性?BMI≥24?高水平甘油三酯可增加冠心病合并糖尿病的发生风险?结论:女性?BMI≥24?血脂水平异常和冠脉多支病变等因素可增加冠心病合并糖尿病的发生风险?应开展针对性的人群预防,加强冠心病合并糖尿病危险因素的综合防治,对提高冠心病合并糖尿病的生活质量和改善预后有着重要意义?     

西洛他唑联合丁咯地尔治疗2型糖尿病合并下肢动脉病变早期疗效观察

目的观察西洛他唑联合丁咯地尔治疗2型糖尿病并下肢动脉病变（PAD）早期疗效及不良反应。方法90例2型糖尿病并PAD早期（无伴下肢溃疡发生）患者随机分为治疗组50例和对照组40例。对照组在降糖治疗的基础上口服阿司匹林联合丁咯地尔;治疗组在降糖治疗的基础上口服西洛他唑联合丁咯地尔。疗程均为3个月。治疗前后分别检测主观症状及体征、间歇性跛行距离、踝肱指数（ABI）、脉搏波传播速度（PWV）等变化。结果治疗组与对照组ABI、PWV治疗后与治疗前比较,以及两组间治疗后比较,差异有显著意义（P〈0.01或P〈0.05）。治疗组PAD的总有效率与对照组比较,差异有显著意义（P〈0.05）。结论西洛他唑联合丁咯地尔治疗2型糖尿病并PAD早期效果显著,安全性好。