PubMed Health⌕ Search

Biomedical subjects

O Ziegler

Publications and source records attributed to O Ziegler.

85 records · Page 5Linked to original sources
PubMed1987

[The flow-volume curve. Expression of emptying as a function of venous distensibility].

Mercury strain gauge venous occlusion plethysmography is a non invasive exploration of the lower limb venous hemodynamic. Classically, venous distensibility (delta V/V %) is expressed in terms of time during venous inflow (venous occlusion) and venous outflow (after cuff deflation). The authors proposed to express the total flow Q of the limb (obtained by a differentiator of the electric signal of the strain gauge) in terms of the venous distensibility (delta V/V %) whatever recording a top each second. This new representation Q = f(delta V/V) permit a more acute visualisation of the initial part of the venous emptying: more differentiation between venous drainage and systolic arterial waves, acceleration then deceleration of the venous emptying, return of the venous wall to its initial position later than venous emptying, active venous constriction. Some parameters are proposed to described this curve and the values obtained in 50 patients without and 10 patients with deep venous thrombosis are reported.

Adult↗
PubMedDate not supplied

Hemobiological properties of gliclazide.

Non-insulin-dependent diabetes mellitus (NIDDM) is associated with an increased risk of macro- and microvascular degenerative complications. Gliclazide is a second generation sulfonylurea that is widely used in the treatment of type II diabetes mellitus. Its hypoglycemic activity is well documented. In addition to its metabolic effects, gliclazide has beneficial effects on the hemobiological abnormalities of NIDDM. These effects are mediated by the azabicyclo-octyl ring grafted on to its aulfonylurea core. Numerous studies have demonstrated that gliclazide reduces platelet hyperadhesion and platelet hyperaggregability. These actions have been extensively confirmed in diabetic patients over periods of up to 3 years. With regard to platelet functions, several groups have demonstrated a significant reduction in serum and intraplatelet beta thromboglobulin and thromboxane B2. In animal models, in-vitro and in-vivo gliclazide stimulates endothelial prostacyclin synthesis. The beneficial effects of the compound on thromboxane/prostacyclin balance have been recently confirmed in type II diabetic patients after a 3-month treatment period. Concerning fibrinolysis, gliclazide restores low plasminogen activity to normal in NIDDM patients previously treated with first-generation sulfonyl-ureas. Gliclazide increases fibrinolytic potential by increasing endothelial cell tissue plasminogen activator and pre-kallikrein activity. More recent studies suggest that gliclazide may have effects on fibrin network structure, rendering the fibrin more amenable to fibrinolysis. Finally, it has been shown that gliclazide has a potent free-radical-scavenging activity in vitro. This property has been recently confirmed in vivo in type II diabetic patients and may suggest that platelet reactivity and oxidative stress are related in these patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

[Obesity and type 2 diabetes].

Obesity is an epidemic disease associated with numerous cardiovascular risk factors as diabetes mellitus, dyslipidemia, hypertension. Insulin resistance seems to be an important promoter for the development of most of these abnormalities. Besides genetic background, obesity, especially abdominal adiposity, is by far the most important factor for the development of type 2 diabetes. The treatment of a diabetic obese subject begins with diet and regular physical activity, eventually with a psychological support. In case of failure of such lifestyle approach alone, addition of drug therapy should be considered. It may include pharmacological agents able to promote weight loss (orlistat, sibutramine, possibly rimonabant) and/or antihyperglycaemic compounds capable of reducing insulin resistance (metformin, glitazones, acarbose). In case of severe/morbid obesity complicated with type 2 diabetes not well controlled with medical means, bariatric surgery is the only treatment that can induce an important and sustained weight loss, associated with marked improvement of metabolic control and amelioration of overall prognosis.

Abdomen↗
PubMedDate not supplied

[Psychological aspects of remission induced by intensive insulin therapy in type I diabetes. A retrospective study of 44 patients].

The psychological consequences of induced remission of type 1 diabetes, have not yet been investigated thoroughly. We studied the psychological status of 44 patients (16 women, 28 men), age 21 years +/- 8 months (mean +/- SD), whose remission lasted 12 +/- 9 months. Patients' psychological reactions were analyzed retrospectively, using a 20 items standardized questionnaire, investigating 3 successive periods: 1) initial intensive insulin therapy; 2) remission; 3) permanent insulin therapy. 8% of the subjects only considered the remission phase useless, whereas 49% expressed a positive appraisal. Hope was predominant feeling, 25% of the patients believing in a completed recovery of diabetes. Perceived therapeutic constraints were, in decreasing order: regimen, way of life's regularity, self monitoring of blood glucose. When starting permanent insulin therapy, opposite answers were given: 49% negative feelings, 33% positive feelings and 18% ambivalent feelings. During this period, insulin injections represented the major therapeutic constraint, followed by self monitoring of blood glucose. To summarize, induced remission does not appear to be psychologically harmful and is considered useful by a large majority of patients. Effective psychological support has to be offered to help those patients to cope with their irrational hopes of healing and to dampen their deception at the end of the remission period.

Adult↗
PubMedDate not supplied

Depletion in choline containing phospholipids of LpB particles in adequately controlled type I insulin-dependent diabetes mellitus.

The aim of the present study was to evaluate the serum and lipoprotein levels of choline--containing phospholipids (lecithin, lysolecithin and sphingomyelin) in a group of type I diabetic patients in fair metabolic control. Forty-eight male adult diabetic patients without macroproteinuria were compared with 48 healthy controls matched for age and body weight. Total cholesterol and phospholipids were assessed in plasma and in apolipoprotein B (apoB) and non apoB containing lipoprotein particles (Lp B and Lp non B particles) separated using precipitation with Concanavalin A. When compared to the control group, diabetic patients have significantly lower serum phospholipids and phospholipids and cholesterol content of LpB particles. All the other parameters studied were similar in the two groups. The phospholipids/cholesterol ratio, calculated in LpB particles is also significantly reduced in the diabetic group. These results strongly suggest a depletion in the choline containing phospholipid content of LpB particles and therefore an alteration of the surface components of atherogenic particles in type I diabetes mellitus.

Adult↗
PubMedDate not supplied

Lack of relationship between Lp(a) particle levels and albumin excretion rate in type 1 diabetic patients.

The excess risk of cardiovascular disease in Type 1 diabetes mellitus compared to non diabetic subjects is only partially explained by standard risk factors. Several studies suggest that Lp(a) concentrations are increased in Type 1 diabetes mellitus, but data are still controversial. Moreover, a high cardiovascular risk has been reported in diabetic patients with persistent proteinuria. Therefore, the aim of this study was to compare the Lp(a) particle levels in insulin-dependent diabetic patients with or without increased urinary albumin excretion. Cross-sectional study of Lp(a) plasma levels in a population of 140 insulin-dependent diabetic patients: 83 without increased proteinuria, 14 with borderline elevation of urinary albumin excretion, 27 with micro- and 16 with macro-proteinuria. Simultaneous determination of plasma lipids, fasting blood glucose and HbA1c was performed. The mean plasma Lp(a) concentrations and the distribution of the levels were comparable in all of the diabetic patient groups. No relationship existed between Lp(a) and HbA1c, fasting blood glucose or any lipid plasma levels. No influence of albumin excretion rate on Lp(a) levels was observed. These data provide no evidence of a specific contribution of Lp(a) particles to the increased morbidity and mortality from cardiovascular disease observed among patients with nephropathy.

Adult↗
PubMedDate not supplied

Lower-extremity arterial disease in diabetes mellitus due to chronic pancreatitis.

OBJECTIVE: To determine the prevalence of lower-extremity arterial disease and the sites of arterial obstruction in patients with pancreatic diabetes. PATIENTS AND METHODS: The retrospective study included 83 patients with diabetes due to chronic pancreatitis (age [m +/- SD] 54.5 +/- 9.5 yr, diabetes duration 9.7 +/- 7.4 yr) and 83 patients with idiopathic diabetes were carefully matched for sex, age, diabetes duration and treatment. They were screened for arteriopathy by segmental blood pressures and Doppler ultrasound, and for cardiovascular risk factors. The arterial lesions were classified as proximal (above-knee), distal (below-knee), and combined (both above- and below-knee). RESULTS: Lower extremity arterial disease occurred in 25.3% of pancreatitis patients and in 14.5% of idiopathic diabetes patients (p = 0.08). The sites of obstruction in both groups were similar; proximal obstruction: 4 vs 4 cases; distal: 10 vs 5 cases, combined: 7 vs 3 cases. The prevalence of arteriopathy increased with age and diabetes duration in both groups (p < 0.01). Total cholesterol, LDL cholesterol and apolipoprotein B were lower in the pancreatitis patients (p < 0.01); 92% of these were smokers vs 62% of idiopathic diabetes patients (p < 0.001). CONCLUSIONS: Arteriopathy, assessed by non-invasive tests, has the same prevalence and distribution in chronic pancreatitis and idiopathic diabetes patients, despite their different vascular risk factor profiles. This emphasizes the role of chronic hyperglycaemia and its duration in the pathogenesis of macroangiopathy in diabetic patients.

Aged↗
PubMedDate not supplied

[Optic neuropathy in diabetic subjects].

Four clinical forms of optic neuropathy can occur in diabetes: 1. Axial neuropathy is a classical optic neuropathy. 2. Anterior ischemic optic neuropathy is an acute optic disc ischaemia and the visual loss depends on the number of fibers destroyed. 3. Acute disc swelling occurs in young patients with a type 1 diabetes. It can be asymptomatic, but can also simulate optic disc new-vessels. It seems not to be a ciliary but rather an epipapillary and peripapillary capillaropathy. 4. Optic atrophy can constitute the final out come of forms one and too. In the child, the Wolfram ou DIDMOAD syndrome associates diabetes insipidus, diabetes mellitus, optic atrophy and deafness.

Adult↗