The Risk of Bladder Cancer in Type 2 Diabetes Mellitus with Combination Therapy of SGLT-2 Inhibitors and Pioglitazone

Background: Either sodium-glucose cotransporter-2 (SGLT-2) inhibitors or pioglitazone (Pio) has doubtful issues of bladder cancer, especially for the combination therapy with these two drugs. Our study aimed to investigate the risk of bladder cancer under combination therapy of SGLT-2 inhibitors and Pio. Materials and Methods: We included 97,024 patients with type 2 diabetes mellitus (T2DM) in the Chang Gung Research Database in Taiwan from 1 January 2016 to 31 December 2019. The primary outcome was newly diagnosed bladder cancer after combination therapy with SGLT-2 inhibitors and Pio. Group 1 received both study drugs, group 2 received SGLT-2 inhibitors, group 3 received Pio, and group 4 received non-study drugs (the reference group). The secondary outcome in each group was all-cause mortality. Results: In group 1, no newly diagnosed bladder cancer was detected after a mean 2.8-year follow-up and all-cause mortality decreased significantly (adjusted hazard ratio (AHR), 0.70; 95% confidence interval (CI), 0.54–0.92) in comparison to the reference group (group 4). In group 2 and group 3, no trend of increased bladder cancer was observed (group 2: AHR 0.49, 95% CI 0.05–4.94; group 3: AHR 0.48, 95% CI 0.15–1.58) and it still reduced all-cause mortality (group 2: AHR 0.83, 95% CI 0.70–0.99; group 3: AHR 0.90, 95% CI 0.83–0.99). Conclusions: In T2DM patients without previous or active bladder cancer, the combination therapy of SGLT-2 inhibitors and Pio was not associated with newly diagnosed bladder cancer and had lower all-cause mortality.

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The correlation between type 2 diabetes and fat fraction in liver and pancreas: a study using MR Dixon technique

10.21203/rs.3.rs-764415/v1 ◽

2021 ◽

Author(s):

Yu Shun ◽

lv Jieqin ◽

Zhang zhongshuai ◽

Ma Mingping ◽

Su Jiawei

Keyword(s):

Fat Content ◽

Group 4 ◽

Fat Deposits ◽

Tissue Area ◽

Liver And Pancreas ◽

Fat Fraction ◽

Group 3 ◽

Group 2 ◽

Group 1

Abstract Background The increased obesity results in ectopic fat deposits in liver and pancreas.Ectopic fat deposits affect insulin resistance and blood sugar content with Type 2 Diabetes.To assess the relationship between obesity and ectopic fat deposits and diabetes,this study used MR Dixon method for the quantification of liver and pancreas fat fraction (FF) in T2DM patients and healthy controls. Methods The FF of liver and pancreas, the maximum diameters of the pancreas, SAT, VAT and TAT were measured for 167 subjects using the MR Dixon data.Four groups were established on the basis of BMI value.For statistics, intra-and inter-group comparison was done by employing Independent Sample t Test. Results ① The average fat content in liver and pancreas, the fat content in pancreas body and tail, and VAT in Group 1 were higher than those in Group 3 (P༜0.05). ② The average fat content in liver and pancreas, the adipose fraction of the pancreas head, and VAT in the Group 2 were higher than those in Group 4 (P༜0.05). ③ The average fat content of liver and pancreas, the adipose content of the body and the tail of the pancreas, the abdominal subcutaneous adipose area (SAT), the visceral adipose tissue area (VAT), and the total abdominal adipose tissue area (TAT) in Group 2 were higher than those in the Group 1 (P༜0.05). ④ The FF of pancreas tail, SAT and TAT in Group 4 were higher than those in Group 3 (P༜0.05). Conclusion The tissue FF,which has a close relationship with T2DM,can be assessed by MR Dixon technique.The results showed that all T2DM patients should pay attention to tissue fat content regardless of BMI values.

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Longitudinal Effect of Hemoglobin Concentration With Incident Ischemic Heart Disease According to Hepatic Steatosis Status Among Koreans

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.677040 ◽

2021 ◽

Vol 8 ◽

Author(s):

Dong Hyuk Jung ◽

Yong Jae Lee ◽

Byoungjin Park

Keyword(s):

Heart Disease ◽

Ischemic Heart Disease ◽

Hepatic Steatosis ◽

Reference Group ◽

Ischemic Heart ◽

Group 4 ◽

Group 3 ◽

Group 5 ◽

Group 2 ◽

Group 1

Background: An increased hemoglobin (Hb) level may have detrimental effects on hepatic steatosis (HS) as well as cardiovascular disease (CVD). We investigated Hb's effect on incident ischemic heart disease (IHD) risk in the context of hepatic steatosis (HS).Methods: We assessed 17,521 non-diabetic participants and retrospectively screened for IHD using the Korea National Health Insurance data. High Hb was defined as Hb levels ≥16.3 g/dL in men and 13.9 g/dL in women (>75th percentile). The participants were divided into five groups: reference (group 1), mild HS only (group 2), mild HS and high Hb (group 3), severe HS only (group 4), and severe HS and high Hb (group 5). We assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD using multivariate Cox proportional hazards regression models over 50 months from the baseline survey.Results: During the follow-up period, 330 (1.9%) participants developed IHD (310 angina pectoris and 20 myocardial infarction). Compared with the reference group (group 1), the HRs for IHD were 1.04 (95% CI, 0.75–1.46) in group 2, 1.14 (95% CI, 0.70–1.85) in group 3, 1.58 (95% CI, 1.08–2.32) in group 4, and 1.79 (95% CI, 1.15–2.80) in group 5, after adjusting for IHD risk factors.Conclusions: We found the combined effect of HS and Hb levels on the incidence of IHD.

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Combined Ayurveda and Yoga Practices for Newly Diagnosed Type 2 Diabetes Mellitus: A Controlled Trial

Complementary Medicine Research ◽

10.1159/000464441 ◽

2017 ◽

Vol 25 (1) ◽

pp. 16-23

Author(s):

Purnima Datey ◽

Alex Hankey ◽

H.R. Nagendra

Keyword(s):

Type 2 Diabetes ◽

Blood Sugar ◽

Controlled Trial ◽

Newly Diagnosed ◽

Post Intervention ◽

Group 3 ◽

Group 2 ◽

Male Prisoners ◽

Group 1

Background: The increasing prevalence of type 2 diabetes in India is a cause for national concern, particularly the spiraling cost burden to the country. As one approach to stop its increase, Yoga medicine has been widely implemented, finding popularity with all social strata. Here, we report a study suggesting that treatment with fresh herbal juices and Yoga can improve the levels of blood glucose and hemoglobin A1c (HbA1c) in people with pre-diabetes. Methods: Study design: 3-arm controlled trial 3 months in duration. Participants: 157 male prisoners with newly diagnosed, high fasting blood sugar (FBS) and postprandial blood sugar (PPBS) levels. Group interventions: (1) Rasahara and Yoga, (2) Yoga, (3) no intervention. Assessments: FBS and PPBS levels were measured every 2 weeks; HbA1c and blood lipids were determined pre- and post-intervention. Results: Significant decreases occurred in the FBS (-21.13 ± 21.16 mg/dl) and PPBS levels (-15.02 ± 14.89 mg/dl) in group 1 (both p < 0.0001) and in the FBS level (20.62 ± 32.68 mg/dl) in group 2 (p = 0.0005), while the increases in group 3 attained significance only for the PPBS level (9.62 ± 21.83 mg/dl) (p = 0.0022). Observed changes in HbA1c were: group 1, -0.044 ± 0.059 mg/dl; group 2, +0.024 ± 0.456 mg/dl (not significant); and group 3, +0.365 ± 0.369 mg/dl (p < 0.0001). Conclusions: This study of Yoga for the treatment of diabetes shows that all male prisoners could benefit from the Yoga prison programs. Addition of Yoga programs to state and federal activities at all levels is now national policy in India. Follow-up studies should be carried out to obtain more robust results.

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Comparison of Different Treatment Schedules of Mitomycin C Intravesical Instillation in High-Risk Superficial Bladder Cancer Patients

Aktuelle Urologie ◽

10.1055/a-0750-5595 ◽

2018 ◽

Vol 50 (03) ◽

pp. 292-297 ◽

Cited By ~ 1

Author(s):

Hong-Ray Chen ◽

Chien-Chang Kao ◽

Chih-Wei Tsao ◽

Shou-Hung Tang ◽

Meng En ◽

...

Keyword(s):

Bladder Cancer ◽

High Risk ◽

Mitomycin C ◽

Recurrence Rate ◽

Low Grade ◽

Recurrence Rates ◽

Group 4 ◽

Group 3 ◽

Group 2 ◽

Group 1

Abstract Objective This study was performed to compare the efficacy of intravesical mitomycin C (MMC) instillation for the prophylaxis of Ta or T1 high-risk nonmuscle invasive bladder cancer (NMIBC) using different schedules. Materials and methods This retrospective cohort study was conducted on 152 patients treated with intravesical MMC from April 2009 to September 2016. The mean follow-up time was 32.67 months. All patients underwent a complete transurethral resection of bladder tumor (TURBT) and postoperative instillation of MMC within 24 h. The patients were divided into 4 treatment groups: Group 1 was followed-up without any maintenance MMC dose treatment; Group 2 received an MMC instillation once per week for the first 8 weeks; Group 3 received an MMC instillation once per week for the first 8 weeks, and once per month for the following 6 months; and Group 4 received an MMC instillation once per week for the first 8 weeks, and once per month for the following 12 months. Results The overall recurrence rate was 27.6 %. Group 1 had a significantly high (p < 0.05) recurrence rate of 50 %, while there was no difference in the recurrence rate between the last 3 schedules (Group 2:15 %; Group 3: 24.1 %; group 4: 27.2 %). Moreover, the recurrence rates of Ta or T1 tumors, and low-grade or high-grade tumors were not statistically different among these patient groups. Conclusion Our comparison of the different schedules of intravesical MMC instillation revealed a significantly higher recurrence rate with one MMC instillation post-TURBT than in patients with a maintenance dose of 8 weeks, 6 months, and 12 months. The time of the MMC maintenance schedule exhibited no significant differences between 8 weeks and 12 months. Thus, we conclude that for T1 or Ta high-risk NMIBC, MMC instillation can be performed once after TURBT, followed by a maintenance treatment once per week for 8 weeks.

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Effect of visceral obesity on main artery elasticity and vascular age in patients with hypertension, obesity, and type 2 diabetes

Russian Journal of Cardiology ◽

10.15829/1560-4071-2021-4466 ◽

2021 ◽

Vol 26 (4) ◽

pp. 4466

Author(s):

M. E. Statsenko ◽

M. V. Derevyanchenko

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Events ◽

Visceral Obesity ◽

Main Artery ◽

Group 4 ◽

Vascular Age ◽

Group 3 ◽

Group 2 ◽

Group 1

Aim. To assess the effect of visceral obesity on main artery elasticity and vascular age in patients with hypertension (HTN), obesity, and type 2 diabetes (T2D).Material and methods. A total of 320 patients with stage II-III HTN aged 4570 years were divided into 4 groups: isolated HTN (group 1), HTN and obesity (group 2), HTN, obesity and T2D (group 3), HTN and T2D without obesity (group 4). We assessed the clinical status, parameters of visceral obesity, main artery elasticity, and vascular age. We used nonparametric statistics, Spearman correlation analysis.Results. At least 50% of all patients had visceral obesity, despite no BMI-estimated obesity in groups 1 and 4: 57,5 vs 100,0 vs 100,0 vs 50,0% in groups 1, 2, 3 and 4, respectively (p<0,0001).In the groups where hypertension was combined with obesity and T2D, the proportion of patients with leptin content above 32,7 ng/ml significantly increased to 80% (in total for groups 2 and 3) compared with 25,0% among HTN people without obesity (in total for groups 1 and 4). There was a significant increase in proportion of patients with a adiponectin decrease <14,6 ng/ml among patients with a combination of HTN and T2D ± obesity (45% in total for groups 3 and 4) in comparison with those with HTN and without T2D ± obesity (22,5% in total for groups 1 and 2).The visceral adiposity index (VAI) was significantly higher among patients with HTN, obesity and T2D compared with those with isolated HTN and HTN in combination with T2D only (2,96 [2,36; 3,98] vs 1,87 [1,40; 2,67] vs 2,22 [1,61; 3,26], respectively). A higher proportion of subjects with adipose tissue dysfunction was noted in groups 2 and 3 compared to groups 1 and 4 (75 vs 81,1 vs 41,5 vs 53,4%, respectively, p1-2<0,001, p1-3<0,001, p2-4=0,023, p3-4=0,002).The proportion of patients with a pulse wave velocity >10 m/s was consistently more common among patients of group 3 compared with patients in groups 1 and 2 (77,0 vs 57,9 and 55,3%, respectively, p1-3=0,004, p2-3=0,006).Vascular age was significantly lower in group 1 compared with groups 3 and 4 (64,0 [57,8; 71,0] vs 69,0 [62,0; 73,0] and 69,5 [66,0; 74,3] years, respectively), as well as in group 2 compared with group 4 (64,0 [56,5; 70,5] vs 69,5 [66,0; 74,3] years). The 5-year risk of cardiovascular events was significantly higher among patients with hypertension, obesity and T2D and those with HTN and T2D without obesity, compared with patients with isolated HTN, and with those with HTN and obesity (5,9 [3,9; 7,9] and 6,5 [4,7; 8,7] vs 4,4 [2,7; 6,8] and 3,6 [2,4; 5,8], respectively). Correlation analysis revealed the relationship between the visceral obesity parameters, main artery elasticity, vascular age and the 5-year risk of cardiovascular events, demonstrating the special aspects of HTN course in each of the studied groups.Conclusion. The paper showed peculiarities of the effect of visceral obesity on main artery elasticity and vascular age in patients with HTN in combination with obesity and T2D.

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Estimation of Serum Glutathione Peroxidase in Streptozotocin Induced Diabetic Rat Treated with Bitter Leaf Extract

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i30b31655 ◽

2021 ◽

pp. 200-206

Author(s):

Arvin Nwakulite ◽

Emmanuel Ifeanyi Obeagu ◽

Richard Eze ◽

Valerie Esame Ugochi ◽

C.C.N. Vincent ◽

...

Keyword(s):

Glutathione Peroxidase ◽

Blood Sugar ◽

Leaf Extract ◽

Feed Water ◽

Group 4 ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

Group 1

Diabetes mellitus (DM) is a metabolic disease in which there are high blood sugar levels. Type 2 is due to the cells of the body not responding properly to the insulin produced. The aim of this study was to evaluate the enzyme activity in glutathione peroxidase in type 2 diabetic rats induced streptozotocin Wister rats. Enzyme linked immunosorbent assay (ELISA) methods was used. Thirty-two (32) adult rats of Wister strain weighing between 120 g – 200 g of both sexes equally were used. Streptozotocin was used to induce diabetes after high fat diet. The rats were randomly grouped into 4 groups of 8 rats; group 1 are rats fed with only feed and water, group 2 were given 37 mg/kg of streptozotocin with feed and water, group 3 had 37 mg/kg of streptozotocin, feed, water and treated with 2ml of freshly prepared bitter leaf extract daily, group 4 had feed, water, 37mg/kg of streptozotocin and treated with 5 mg/kg of glibenclamide (anti diabetic drug). Severity of the induced diabetic state was assessed by daily and weekly monitoring of body weights and blood glucose levels. The result of fasting blood sugar shows a significant difference (P<0.05) at group 3(7.72±0.99) compared to group 4(9.93±1.22) in week 2.There is also a significant decrease (p<0.05) at group 3(7.72±0.99) compared to group 4(9.90±1.24) in week 3.There is also a significant decrease (p<0.05) at group 3(6.22±1.20) compared to group 46.50±0.70) in week 5. There is a significant increase (p<0.05) at group 1(7.63±0.71) compared to group 4(5.78±1.40), group 2(7.45±0.87) compared to group 4(5.78±1.40)in week 4.There is also a significant decrease in GPX activity in group at group 1(424.59±102.65) compared to group 2(307.34±75.66). There is no significant difference (p>0.05) at group 2(307.34±75.66) compared to group 3(204.31±46.51). There is also no significant difference (p>0.05) at group 2(307.34±75.66) compared to group 4(206.12±55.37). No significant difference (p>0.05) at group 3(204.31±46.51) compared to group 4(206.12±55.37). In conclusion, the result of this study suggest that bitter leaf extract reduced glucose level and has no damage effect on the liver.

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Mediterranean Diet and Red Yeast Rice Supplementation for the Management of Hyperlipidemia in Statin-Intolerant Patients with or without Type 2 Diabetes

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2013/743473 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Sartore Giovanni ◽

Burlina Silvia ◽

Ragazzi Eugenio ◽

Ferraresso Stefania ◽

Valentini Romina ◽

...

Keyword(s):

Type 2 Diabetes ◽

Ldl Cholesterol ◽

Diabetic Patients ◽

Red Yeast Rice ◽

Type 2 Diabetic Patients ◽

Group 4 ◽

Group 3 ◽

Group 2 ◽

Group 1

Lipid profile could be modified by Mediterranean diet (MD) and by red yeast rice (RYR). We assessed the lipid-lowering effects of MD alone or in combination with RYR on dyslipidemic statin-intolerant subjects, with or without type 2 diabetes, for 24 weeks. We evaluated the low-density lipoprotein (LDL) cholesterol level, total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, triglyceride, liver enzyme, and creatinine phosphokinase (CPK) levels. We studied 171 patients: 46 type 2 diabetic patients treated with MD alone (Group 1), 44 type 2 diabetic patients treated with MD associated with RYR (Group 2), 38 dyslipidemic patients treated with MD alone (Group 3), and 43 dyslipidemic patients treated with MD plus RYR (Group 4). The mean percentage changes in LDL cholesterol from the baseline were-7.34±3.14% (P<0.05) for Group 1;-21.02±1.63% (P<0.001) for Group 2;-12.47±1.75% (P<0.001) for Group 3; and-22±2.19% (P<0.001) for Group 4 with significant intergroup difference (Group 1 versus Group 2,P<0.001; Group 3 versus Group 4,P>0.05). No significant increase in AST, ALT, and CPK levels was observed in all groups. Our results indicate that MD alone is effective in reducing LDL cholesterol levels in statin-intolerant patients with a presumably low cardiovascular risk, but associating MD with the administration of RYR improves patients’ LDL cholesterol levels more, and in patients with type 2 diabetes.

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Pegvisomant as Monotherapy or Combination Therapy in Somatostatin Refractory Acromegaly

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1067 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A523-A524

Author(s):

Dawid Hordejuk ◽

Edward Raymond Laws ◽

Ursula B Kaiser ◽

Le Min

Keyword(s):

Blood Pressure ◽

Combination Therapy ◽

Systolic Blood Pressure ◽

Tumor Size ◽

Dopamine Agonists ◽

Group 4 ◽

Group 3 ◽

The Mean ◽

Group 2 ◽

Group 1

Abstract Background: Pegvisomant, a growth hormone antagonist, has been widely used as monotherapy or combination therapy with somatostatin (SST) analogs and/or dopamine agonists in acromegaly poorly controlled by SST analogs. Limited information is available to compare pegvisomant monotherapy, combination with SST analogs or dopamine agonists, and combination of all three agents. Method: In this retrospective cohort study, we identified 23 patients with SST analog refractory acromegaly who received pegvisomant as monotherapy or in combination with SST analogs and/or dopamine agonists through the Research Patient Data Registry. We divided the patients into four groups: Group 1. pegvisomant alone (n=8); Group 2. pegvisomant plus a SST analog (pasireotide, octreotide or lanreotide) (n=8); Group 3. pegvisomant plus cabergoline (n=5) Group 4. Pegvisomant plus SST analog and dopamine agonist (n=2). We analyzed the changes in IGF-1, HbA1C, ALT and AST, blood pressure, and radiographic tumor size before and 6 months after treatment. Results: In 6 months, the mean IGF-1 level (ng/ml) changed from baseline 482 to 290 and decreased by 40% (P = 0.050) in group 1, changed from baseline 623 to 291 and decreased by 53% (P= 0.003) in group 2, changed from baseline 579 to 367 and decreased by 36% (p = 0.100) in group 3, and decreased 47% from 609 to 326 (P= 0.100) in group 4. The mean systolic blood pressure (mmHg) before and 6 months after treatment changed from 139 to 128 (p = 0.001) in group 1, changed from 130 to 126 (p = 0.553) in group 2, changed from 134 to 126 (p = 0.373) in group 3, and changed from 125 to 127 (p= 0.700) in group 4. Diastolic blood pressure (mmHg) changed from 82 to 76 (P = 0.110) in group 1, changed from 79 to 76 (p = 0.325) in group 2, changed from 80 to 74 (p=0.002) in group 3, and changed from 80 to 75 (p=0.126) in group 4. There were no significant changes in ALT and AST and A1C before and 6 months after treatment in all groups. In terms of radiographic tumor size change before and 6 months after the treatment, there was no change in tumor size in 5 of 5 patients in group 1. In group 2, the tumor size in 4 of 7 remained unchanged but 3 of 7 patients had increased tumor sizes. In group 3, there was no change in tumor size in 3 of 3 patients. In group 4, there was no change in tumor size in 2 of 2 patients. Conclusion: Our results suggest that in somatostain analog refractory acromegaly, combination pegvisomant and a SST analog significantly decreased IGF-1 level although decrease in IGF-1 in pegvisomant monotherapy almost reach statistical significance (P = 0.050). Although there was a trend in decrease of blood pressure in all groups, the decrease reached significant significance in systolic blood pressure in group 1 and diastolic blood pressure in group 3. Finally, except group 2, the tumor size remained unchanged.

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MON-680 Might Podocyturia Be an Early Marker for Diabetic Nephropathy in Males

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.675 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Emre Durcan ◽

Ozge Polat Korkmaz ◽

Ahmet Murt ◽

Halil Ibrahim Saygi ◽

Serdar Sahin ◽

...

Keyword(s):

Diabetic Nephropathy ◽

Preliminary Results ◽

Early Marker ◽

Group 4 ◽

Patient Groups ◽

Group 3 ◽

The Mean ◽

Group 2 ◽

Group 1

Abstract Renal involvement can develop before detection of microalbuminuria in type 2 diabetes. There is an interest in finding biomarkers to detect diabetic nephropathy (DN) earlier and identify progression risk. Podocyturia emerge as a marker for early kidney damage however standardization problems hamper its widespread use. We aimed to investigate the value of podocyturia for the detection of early DN. Herein we report our preliminary results. Our study population was composed of three type 2 diabetic patient groups and a healthy control group. Diabetic groups were defined as follows; group 1: patients without microalbuminuria who had HbA1c <7%; group 2: patients without microalbuminuria who had HbA1c> 8.5%; group 3: patients with diabetic retinopathy who had proteinuria >1g/day and/or microalbuminuria >300 mg/day and group 4: healthy volunteers without any known disease. Patients with glomerular filtration rate (GFR) below 30 ml/min were excluded. GFR was calculated using the abbreviated MDRD formula. Microalbuminuria was measured in 24 hour urine. Number of podocytes in the urine was determined by immunocytochemical staining of podocalyxin. Due to the known expression of podocalyxin in the female genital tract, only males were included. Statistical analyses were carried out using Statistical Package for the Social Sciences version (SPSS) 24.0 and statistical significance was set as p<0.05. We examined a total of 119 patients (mean age 57.35 ± 12.75 yrs.). Patient distribution in each group was as follows; group 1: 24(20%); group 2: 26(22%); group 3: 24(20%) and group 4: 45(38%) patients. There was no significant difference in mean age (p=0.582) and duration of diabetes (p=0.517) between the diabetic groups. The mean GFR was significantly lower in group 3 than in group 1 and 2 (p<0.001, p:0.007; respectively). The median podocyte measurement in urine was 0,25 (IQR: 0- 2.68) podx/ml in group 1; 0,37 (IQR: 0-2.12) podx/ml in group 2; 1,37 (IQR: 0.56-5.18) podx/ml in group 3; 0.0 (IQR: 0-0.75) podx/ml in group 4. The mean number of podocytes in urine was significantly different between the 4 groups (p=0.001). In posthoc analysis with Bonferoni correction, the mean podocytes measurement was significantly higher in group 3 than in group 1 and 4 (p=0.033, p=0.001; respectively). According to our preliminary results; podocyturia assessed by podocalyxin immunostaining does not seem to be increased in male diabetic patients without proteinuria. Further studies on larger patient groups and using different podocyte markers might clarify the value of podocyturia as an early marker of DN.

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In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽

10.1024/0301-1526/a000867 ◽

2020 ◽

Vol 49 (4) ◽

pp. 281-284

Author(s):

Atıf Yolgosteren ◽

Gencehan Kumtepe ◽

Melda Payaslioglu ◽

Cuneyt Ozakin

Keyword(s):

Vascular Graft ◽

Graft Infection ◽

Vascular Graft Infection ◽

Group 4 ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

Prosthetic Vascular Graft Infection ◽

Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

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