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1. Effects of structured versus usual care on renal endpoint in type 2 diabetes: the SURE study: a randomized multicenter translational study

Author

Juliana C, Chan, Wing-Yee, So, Chun-Yip, Yeung, Gary T, Ko, Ip-Tim, Lau, Man-Wo, Tsang, Kam-Piu, Lau, Sing-Chung, Siu, June K, Li, Vincent T, Yeung, Wilson Y, Leung, Peter C, Tong, and Tai-Pan, Ip

Subjects
Adult, Risk, medicine.medical_specialty, Time Factors, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Type 2 diabetes, law.invention, Randomized controlled trial, law, Internal medicine, Diabetes mellitus, Internal Medicine, Clinical endpoint, medicine, Humans, Hypoglycemic Agents, Diabetic Nephropathies, Renal replacement therapy, Triglycerides, Original Research, Aged, Monitoring, Physiologic, Advanced and Specialized Nursing, Glycated Hemoglobin, Patient Care Team, business.industry, Clinical Care/Education/Nutrition/Psychosocial Research, Editorials, Cholesterol, LDL, Middle Aged, medicine.disease, Genetic translation, Surgery, Renal Replacement Therapy, Blood pressure, Treatment Outcome, Editorial, Diabetes Mellitus, Type 2, Relative risk, Creatinine, Kidney Failure, Chronic, business
Abstract

OBJECTIVE Multifaceted care has been shown to reduce mortality and complications in type 2 diabetes. We hypothesized that structured care would reduce renal complications in type 2 diabetes. RESEARCH DESIGN AND METHODS A total of 205 Chinese type 2 diabetic patients from nine public hospitals who had plasma creatinine levels of 150–350 μmol/l were randomly assigned to receive structured care (n = 104) or usual care (n = 101) for 2 years. The structured care group was managed according to a prespecified protocol with the following treatment goals: blood pressure 500 μmol/l or dialysis). RESULTS Of these 205 patients (mean ± SD age 65 ± 7.2 years; disease duration 14 ± 7.9 years), the structured care group achieved better control than the usual care group (diastolic blood pressure 68 ± 12 vs. 71 ± 12 mmHg, respectively, P = 0.02; A1C 7.3 ± 1.3 vs. 8.0 ± 1.6%, P < 0.01). After adjustment for age, sex, and study sites, the structured care (23.1%, n = 24) and usual care (23.8%, n = 24; NS) groups had similar end points, but more patients in the structured care group attained ≥3 treatment goals (61%, n = 63, vs. 28%, n = 28; P < 0.001). Patients who attained ≥3 treatment targets (n = 91) had reduced risk of the primary end point (14 vs. 34; relative risk 0.43 [95% CI 0.21–0.86] compared with that of those who attained ≤2 targets (n = 114). CONCLUSIONS Attainment of multiple treatment targets reduced the renal end point and death in type 2 diabetes. In addition to protocol, audits and feedback are needed to improve outcomes.

Published
2009

2. PROGINS Alu sequence insertion is associated with hyperprolactinaemia but not leiomyoma susceptibility.

Author

Hsieh YY, Chan IP, Wang HI, Chang CC, Huang CW, and Lin CS

Subjects
Adult, Alleles, Asian People, Case-Control Studies, Female, Genetic Predisposition to Disease, Genotype, Humans, Hyperprolactinemia ethnology, Leiomyoma ethnology, Leiomyoma genetics, Polymorphism, Genetic, Taiwan, Uterine Neoplasms ethnology, Uterine Neoplasms genetics, Alu Elements, Hyperprolactinemia genetics, Receptors, Progesterone genetics
Abstract

Objective: Leiomyoma and hyperprolactinaemia are both progesterone-dependent diseases. Hormone-related genes, such as the progesterone receptor (PGR), might be involved in their pathogenesis., Design and Measurements: Subjects were divided into three groups: (i) leiomyoma (n = 120); (ii) hyperprolactinaemia (n = 101); (iii) normal controls (n = 140). We investigated the Alu (306-bp DNA) insertion in intron G of the PGR gene in all individuals. PGR gene polymorphisms [T1 (wild-type); T2 (PROGINS, with Alu insertion)] were determined by PCR and electrophoresis. Genotype and allele frequencies of the PROGINS in each group were detected and compared., Results: We observed no significant difference of the PGR*T1/T2 genotypes and allele frequencies between leiomyoma and other two groups. The proportions of T1 homozygote/heterozygote/T2 homozygote in each group were (i) 90/8.3/1.7%; (ii) 84.2/9.9/5.9%; (iii) 92.9/6.4/0.7%. In contrast, a higher percentage of T2-related genotype and allele were noted in hyperprolactinaemic women compared to other two groups. The proportions of T1/T2 alleles in each group were: (i) 94.2/5.8%; (ii) 89.1/10.9%; (iii) 96.1/3.9%., Conclusions: The PROGIN*T2-related genotype and allele are related to a higher susceptibility to hyperprolactinaemia. The PROGINS polymorphism is not associated with leiomyoma development.

Published
2005
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3. [Disturbance of immune characteristics of the mucous membranes of the respiratory tract in bronchopulmonary diseases in children].

Author

Pan IP, Matveeva LA, and Fedorova TS

Subjects
Acute Disease, Adolescent, Asthma blood, Cell Count, Child, Eosinophils cytology, Epithelial Cells pathology, Female, Humans, Immunoglobulin A blood, Immunoglobulin A, Secretory analysis, Immunoglobulin G blood, Male, Neutrophils cytology, Pneumonia blood, Respiratory Mucosa metabolism, Respiratory Mucosa pathology, Saliva immunology, Asthma immunology, Pneumonia immunology, Respiratory Mucosa immunology
Abstract

A total of 100 children with bronchopulmonary diseases were examined. Of these, in 80 bronchial asthma and in 20 children acute pneumonia were diagnosed. The deficiency of local cell mediated and humoral factors on the mucous membranes of the upper respiratory tracts was established. In the squamous and columnar epithelium cells an increased destruction and cytolysis was noted leading to disturbances in the integrity of the protective barrier of the epithelial cover. In addition, this study revealed the deficiency of neutrophilic leukocytes, pronounced local eosinophilia and the low level of humoral protective factors. In acute pneumonia an increase in the amount of neutrophilic leukocytes in the secretion of the nasal cavity together with the appearance of destructive processes in epithelial cells took place. Pronounced deficiency in serum IgA and IgG was accompanied by compensatory increase in secretory IgA.

Published
2003

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