Prevalence Of DD Research Articles

Prevalence of diabetes distress and its correlates among adults with type 2 diabetes mellitus in a primary health center of Bihar - A cross-sectional study.

Diabetes is a chronic disease associated with many complications. Approximately 20% of people living with diabetes suffer from some form of depression. "Diabetes distress" (DD) is used to describe the significant negative psychological reactions related to emotional burdens and worries specific to an individual's experience to manage severe, complicated chronic disease such as diabetes. To determine the proportion having DD and to identify the sociodemographic and morbidity related factors associated with the presence of DD among adults with Type2DM who are being treated at PHC Naubatpur, Bihar. This facility based cross-sectional analytical study was done over 3 months among 260 Type2DM patients attending PHC Naubatpur. Sociodemographic details and morbidity related details were collected followed by PAID questionnaire to assess DD. Around 60% of the participants were of age ≤60 years. Majority (63.8%) of the participants were having diabetes from past 1-10years. One-fourth (24.6%) of them were having score of ≥40, therefore having DD. Alcohol consumption and presence of diabetes complications in the participants were found to be independent predictors of DD. This study showed a high (24.6%) prevalence of DD. It is essential to identify high-risk patients with different mental health needs. Healthcare providers should focus on reducing DD and devise ways to increase self-care practices and coping skills.

Digital dermatitis in Swedish dairy herds assessed by ELISA targeting Treponema phagedenis in bulk tank milk

BackgroundDigital dermatitis (DD) is a contagious hoof infection affecting cattle worldwide. The disease causes lameness and a reduction in animal welfare, which ultimately leads to major decreases in milk production in dairy cattle. The disease is most likely of polymicrobial origin with Treponema phagedenis and other Treponema spp. playing a key role; however, the etiology is not fully understood. Diagnosis of the disease is based on visual assessment of the feet by trained hoof-trimmers and veterinarians, as a more reliable diagnostic method is lacking. The aim of this study was to evaluate the use of an enzyme-linked immunosorbent assay (ELISA) on bulk tank milk samples testing for the presence of T. phagedenis antibodies as a proxy to assess herd prevalence of DD in Swedish dairy cattle herds.ResultsBulk tank milk samples were collected in 2013 from 612 dairy herds spread across Sweden. A nationwide DD apparent prevalence of 11.9% (8.1–14.4% CI95%) was found, with the highest proportion of test-positive herds in the South Swedish regions (31.3%; 19.9–42.4% CI95%).ConclusionsThis study reveals an underestimation of DD prevalence based on test results compared to hoof trimming data, highlighting the critical need for a reliable and accurate diagnostic method. Such a method is essential for disease monitoring and the development of effective control strategies. The novelty of ELISA-based diagnostic methods for DD, coupled with the disease’s polymicrobial origin, suggests an avenue for improvement. Developing an expanded ELISA, incorporating antigens from various bacterial species implicated in the disease, could enhance diagnostic accuracy. The significance of this study is underscored by the extensive analysis of a substantial sample size (612). Notably, this investigation stands as the largest assessment to date, evaluating the application of ELISA on bulk tank milk for DD diagnosis at the herd level.

Diaphragmatic dysfunction in hemodialysis patients: risk factors and effect of incentive spirometry training

BackgroundDiaphragmatic dysfunction (DD) in hemodialysis patients is a scarcely studied issue. Incentive spirometry (IS) is a commonly prescribed maneuver used to prevent or manage pulmonary complications. The present study aimed to identify the prevalence and risk factors of DD in 100 HD patients. Moreover, we assessed the role of IS in management of DD in those patients.MethodsThe present study followed a hybrid design with two phases. In the first cross-sectional phase, 100 consecutive maintenance HD patients for at least 3 years were evaluated for the presence of DD using ultrasound. In the second interventional phase, patients with DD (n = 43) were randomly assigned to receive IS (n = 22) or standard care (n = 21) for management of DD.ResultsComparison between patients with DD and patients without regarding clinical and laboratory data revealed that the former group had significantly higher frequency of males [29 (67.4%)/14 (32.6%) vs. 26 (45.6%)/31 (54.4%), p = 0.03] with lower BMI [23.8 ± 3.8 vs. 26.3 ± 3.5 kg/m2, p < 0.001] and longer HD duration (82.2 ± 42.1 vs. 64.8 ± 36.9 months, p = 0.031). Moreover, it was noted that DD group had significantly higher frequency of patients with moderate/severe malnutrition (81.4% vs. 45.6%, p = 0.005), lower Hb levels (9.6 ± 1.5 vs. 10.3 ± 1.4 gm/dL, p = 0.011), lower albumin levels (3.4 ± 0.4 vs. 4.1 ± 0.5 gm/dL, p < 0.001) and higher hsCRP levels [median (IQR) 113.6 (90.9–130.4) vs. 91.1 (50.9–105.6) mg/dL, p < 0.001] as compared to patients without DD. While no significant differences were found between patients receiving study interventions at baseline, patients submitted to IS training showed significant improvement of diaphragmatic excursion measurements as compared to the standard care group.ConclusionsIn conclusion, DD is commonly encountered in HD patients. Probable risk factors include longer HD duration and low albumin levels. Use of IS can improve diaphragmatic excursion in affected patients.

Variation in identifying children and adolescents with disability and developmental disability in population-based public health surveys

BackgroundThe term “developmental disability” (DD) is inconsistently defined and applied depending on purpose and across sources, including in legislation. ObjectiveThis project aimed to identify existing definitions of disability and DD and to determine the extent to which each definition could be operationalized to produce prevalence estimates using data from U.S. national surveys. MethodsUsing data among children <18 years from the 2016–2018 National Health Interview Survey (NHIS) and National Survey of Children's Health (NSCH), we estimated the prevalence of two definitions of disability (Washington Group Short Set on Functioning, American Community Survey) and seven definitions of DD [Health and Human Services (ever/current), Developmental Disabilities Assistance and Bill of Rights Act of 2000 (1+, 2+, or 3+ components), and Diagnostic and Statistical Manual of Mental Disorders, 5th ed (ever/current)]. Complex sample design variables and weights were used to calculate nationally representative prevalence. ResultsDisability (NHIS: 5.2–6.3%; NSCH: 9.2–11.9%) and DD prevalence (NHIS: 0.6–18.0% and NSCH: 0.2–22.2%) varied depending on the definition and data source. For the same definition, NSCH prevalence estimates tended to be higher than NHIS estimates. ConclusionsThe substantial variability in estimated prevalence of disability and DD among children in the United States may be in part due to the surveys not representing all components of each definition. Different or additional questions in national surveys may better capture existing definitions of disability and DD. Considering the data collection goals may help determine the optimal definition to provide useful information for public health action.

The prevalence of Dupuytren’s disease in patients with diabetes mellitus

BackgroundDupuytren’s disease (DD) is a fibroproliferative hand disorder associated with various medical conditions, including diabetes mellitus (DM). The reported prevalence of DM among DD patients varies widely, primarily due to small sample sizes in previous studies.MethodsThis was a retrospective cohort study using data from the TriNetX Research Database. We analyzed the overall prevalence of DD between 2010 and 2020, comparing the DM, type 1 diabetes mellitus (T1DM), and type 2 diabetes mellitus (T2DM) cohorts. Within the DM group, patients were further categorized based on hemoglobin A1c (HbA1c) values and prescribed anti-diabetic agents (insulin or metformin). We compared the prevalence of DD diagnosis in each group using prevalence ratios and differences.ResultsThere is a higher prevalence of DD in patients with T2DM than in patients with T1DM (relative risk [RR]: 1.641; 95% confidence interval [CI]: [1.356, 1.986]). Among patients with diabetes, there is a higher prevalence of DD in those taking insulin compared to those taking metformin (RR: 0.801, 95% CI: [0.774, 0.83]). The prevalence of DD varies depending on HbA1c levels, with a prevalence of 0.463% in patients having levels within the diabetic range, while lower prevalences of 0.392% and 0.416% are found in patients with prediabetes or uncontrolled diabetes, respectively.ConclusionsThis study provides further insight into the relationship between DM and DD. These findings may be attributed to the increased accumulation of advanced glycosylated end products (AGEs) in patients with diabetes. Future research exploring the connection between AGE accumulation and DD development may enhance our understanding of the relationship between DD and DM.

The prevalence of diabetes distress among patients with type 2 diabetes in Jordan

ObjectivesDiabetes distress (DD) is a state of emotional distress that evolves from living with chronic disease and the burden of daily adjustments of medications and lifestyle. This study investigated the prevalence of DD in patients with type 2 diabetes mellitus (T2DM) in Jordan and the related sociodemographic and medical factors. MethodsWe conducted a cross-sectional study in 608 patients with T2DM in Jordan, ranging from ages 15 to 80 years. The participants filled out a questionnaire where they were asked to self-assess their DD using the Diabetes Distress Scale. In all, 32 participants were excluded according to the exclusion criteria, which resulted in 576 people being included in this study. ResultsThe overall prevalence of DD was 53% (25% had moderate distress and 28% had high distress). Emotional distress had the highest prevalence among the DD subscales, with a total prevalence of 58.8%. The data showed a significant association of DD with different factors including age, the presence of diabetic complications, the type of medication used, and medication adherence. ConclusionThis study showed a high prevalence of DD (53%). This finding should raise awareness to healthcare providers about the importance of screening for DD as part of the treatment guidelines, especially in patients who are on multiple medication regimens for DM; patients who have previous medical complications related to DM; and those who exhibit poor adherence to medications, which was found to be a risk factor of DD in this study.

Gaming Disorder Seen Through the Prism of Dual Diagnosis: Prevalence and Associated Factors.

IntroductionDual diagnosis (DD) is defined as the co-occurrence of at least a psychiatric disorder and at least an addictive disorder. Most studies about DD considered substance use disorders. In 2018, gaming disorder (GD) was recognized as a formal disorder and integrated into the category of addictive disorders in the 11th version of the International Classification of Diseases. Our objectives were to measure DD prevalence among GD patients and to assess factors associated with the presence of DD.MethodsAs part of the EVALuation of behavioral ADDictions (EVALADD) cohort, 92 patients with GD were included in the present study. Psychiatric disorders, including anxiety, mood, and psychotic disorders, were explored with the Mini International Neuropsychiatric Interview (MINI 5.0.0). Probable adult attention-deficit/hyperactivity disorder (ADHD) was screened with the Wender Utah Rating Scale (WURS) in childhood and with the ADHD Self-Report Scale-V1.1 (ASRS) in adulthood. Finally, personality was assessed using the 125-item version of the Temperament and Character Inventory (TCI-125), motives for gaming with the Videogame Motives Questionnaire (VMQ) and attachment styles with the Relationship Scales Questionnaire (RSQ). To measure the prevalence of DD among GD patients, we considered the occurrence of current GD with current anxiety, mood, or psychotic disorders, or with probable current ADHD. We also performed a multivariate analysis to identify independent factors associated with DD.ResultsMore than half (55.4%) of GD patients suffered from DD. We found a high prevalence of probable ADHD (38%) and anxiety disorders (29% suffering from generalized anxiety disorder, social, agoraphobia or panic disorder). Four variables were significantly associated with DD: suicidal thoughts [odds ratio (OR) = 6.83, 95% confidence interval (95%CI) (1.66–28.09)], VMQ “coping” scores [OR = 1.18, 95%CI (1.01–1.38)], TCI-125 “harm avoidance” scores [OR = 1.04, 95%CI (1.01–1.07)] and “novelty seeking” scores [OR = 1.03, 95%CI (1.00–1.06)].DiscussionThe prevalence of certain psychiatric disorders among GD patients far exceeded that observed in the general population. Both ADHD and suicidal ideations should particularly be screened among GD patients. Specific interventions targeting personality dimensions associated with DD but also on the management of negative affect should represent new treatment opportunities.

PD23-10 PEYRONIE’S DISEASE: A FAMILIAL, HERITABLE CONDITION

You have accessJournal of UrologyCME1 May 2022PD23-10 PEYRONIE’S DISEASE: A FAMILIAL, HERITABLE CONDITION Michael Christensen, Kristy Allen-Brady, and Alexander Pastuszak Michael ChristensenMichael Christensen More articles by this author , Kristy Allen-BradyKristy Allen-Brady More articles by this author , and Alexander PastuszakAlexander Pastuszak More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002565.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Peyronie’s Disease (PD) is a superficial fibrosing disorder characterized by inelastic fibrous plaques within the tunica albuginea. Dupuytren’s and Ledderhose disease (DD and LD respectively) are related diseases that affect tissues in the palmar and plantar fascia, respectively. Using a large population database, we previously reported an increased relative risk of disease to relatives of PD probands. We also observed that 75% of PD cases existed within high-risk pedigrees. Both of these findings suggest a genetic component to this disease. Here, we describe the identification of a single high-risk pedigree from which we are identifying genetic variants that may predispose to these disorders. METHODS: The Utah Population Database (UPDB), a resource that includes genealogy information linked to electronic medical records (available since 1995), was used to identify men and their relatives with PD, as well as high risk PD pedigrees. Pedigrees with a significant excess (p<0.05) of observed PD cases among descendants were termed high-risk. For genetic sequencing, individuals from a pedigree demonstrating a high degree of prevalence of PD, DD, and LD were recruited to provide samples from which genomic DNA (gDNA) was extracted. Whole genome sequencing is being conducted on these samples and variants will be evaluated based on variant type, population frequency, role in signaling pathways/gene ontology, co-segregation within the family, and potential impact on protein function. RESULTS: Previous analyses found that 75% of individuals with PD were part of high-risk PD pedigrees. One such high-risk pedigree containing a founder and 19 descendants was identified from our clinic. The founder and two descendants in the pedigree are deceased. Of the living descendants, 9 are male and 8 are female. Twelve of the descendants have responded to survey requests. Of these, 2/6 males report symptoms of PD (33%), 4/12 of the respondents report symptoms of Dupuytren’s Disease (33%), and 3/12 report symptoms of Ledderhose Disease (25%). Saliva samples from respondent individuals have been collected for whole-genome sequencing, which is being initiated. CONCLUSIONS: Most PD cases identified in the UPDB were part of high-risk PD pedigrees, suggesting a familial component to PD, which may extend to other fibrosing disorders. Next-generation sequencing of gDNA from individuals within a high-risk pedigree will determine if genetic variants that may predispose to superficial fibrosing disorders exist within such a pedigree. Source of Funding: Mentored Career Development Award (K08DK115835-01) from the National Institute of Diabetes and Digestive and Kidney Diseases (A.P.) & Sexual Medicine Society of North America Pfizer Research Fellowship in Men’s Health (M.B.C.) © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e413 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Christensen More articles by this author Kristy Allen-Brady More articles by this author Alexander Pastuszak More articles by this author Expand All Advertisement PDF DownloadLoading ...

Association of Angiotensin-Converting Enzyme Inhibitor Gen PolyMorphism with Electrocardiography and Echocardiography Findings in Hemodialysis Patients

Background: Gene polymorphism of angiotensin-converting enzyme (ACE) may be associated with adverse prognosis and increased cardiovascular complications in hemodialysis patients. Objectives: This study aimed to compare the frequency of ACE gene polymorphism in both hemodialysis patients and normal individuals considering echocardiographic findings. Methods: This cross-sectional study included 110 hemodialysis patients (case) and 113 healthy subjects (control). Gene polymorphism of ACE was evaluated in both groups. ECG and echocardiography tests were performed for all patients. Correlations between gene polymorphisms and other variables were analyzed in this study. Polymerase chain reaction (PCR) was used to identify the short deletion allele (D with 190bp), large insertion allele (I with 490bp), and ID genotype which has both alleles. Results: Case and control groups included 46 and 54 female and 64 and 59 male patients, respectively. There were no significant differences between the prevalence of DD, II, and DI alleles of the ACE gene with DI as the most common allele in both groups. No significant differences were found between systolic and diastolic blood pressure and heart rate in DD, DI, and II alleles of the case group. Echocardiographic findings of the patients showed no significant differences between DD, DI, and II genotypes of the case group and intraventricular septal end-diastole (IVSd), MVE vel, MVA vel, MVE/A ratio, MV DT, and MV Dec slope. The mean±SD left ventricular end-diastolic diameter (LVEDD) in II, ID, and DD patients were 4.3±0.72, 4.52±0.66, and 4.89±0.93 respectively (P=0.046). Conclusion: The findings of the present study showed that there were no differences in the prevalence of alleles of an ACE gene in hemodialysis patients and control groups. Moreover, no significant associations were observed between alleles of an ACE gene in the patients' group and echocardiographic findings except in left ventricular end-diastolic diameter.

Prevalence and predictors of diabetes distress among adults with type 2 diabetes mellitus: a facility-based cross-sectional study of Bangladesh

IntroductionDiabetes distress (DD) is common and has considerable impacts on diabetes management. Unfortunately, DD is less discussed and frequently underestimated. This study evaluated the prevalence and predictors of DD in adults with type 2 diabetes mellitus (T2DM).MethodsA cross-sectional study was conducted at several specialized endocrinology outpatient clinics in Bangladesh from July 2019 to June 2020; 259 adults with T2DM participated. Participants’ DD and depression were measured using the 17-item Diabetes Distress Scale (DDS-17) and 9-item Patient Health Questionnaire (PHQ-9), respectively. DDS-17 scores ≥2 and PHQ-9 scores ≥10 were the cutoffs for DD and significant depression, respectively.ResultsThe mean (±SD) age of the participants was 50.36 (±12.7) years, with the majority (54.8%) being male; their median (IQR) duration of diabetes was 6 (3–11) years. Among the study participants, 52.5% had DD (29.7% moderate and 22.8% high DD). The prevalence of emotional burden, physician-related distress, regimen-related distress, and interpersonal distress was 68.7, 28.6, 66, and 37.7%, respectively. Depression was present in 40.5%; 28.6% of the participants had DD and depression. The total DDS-17 score was positively correlated with the PHQ-9 score (r = 0.325, p < 0.001). Rural residence (OR 1.94), presence of any diabetic complication (OR 3.125), insulin use (OR 2.687), and presence of major depression (OR 4.753) were positive predictors of DD. In contrast, age ≥ 40 years at diabetes diagnosis (OR 0.047) and diabetes duration of > 10 years (OR 0.240) were negative predictors of DD (p < 0.05 in all instances).ConclusionsThe prevalence of DD in our setting is notably high; DD and depression frequently overlap. Screening for diabetes distress may be considered, especially in high-risk patients.

Diastolic dysfunction in people with HIV without known cardiovascular risk factors in Western Kenya

ObjectivesDiastolic dysfunction (DD) has been reported to be highly prevalent in people living with HIV (PLWH) on antiretroviral therapy (ART) leading to the hypothesis that it may be an early...

Metabolic factors and the risk of Dupuytren\u2019s disease: data from 30,000 individuals followed for over 20\xa0years

Dupuytren’s disease (DD) is a fibroproliferative disorder affecting the palmar fascia of the hand. Risk factors include diabetes mellitus (DM), whereas a high body mass index (BMI) is associated with a lower prevalence of DD. The aim of this study was to further elucidate risk and protective factors for the development of DD using longitudinal population-based data from the Malmö Diet and Cancer Study (MDCS). During 1991–1996, the inhabitants aged 46–73 years in the city of Malmö, Sweden were invited to participate in the population-based MDCS (41% participation rate). Data on incident DD were retrieved from Swedish national registers. Associations between DM, alcohol consumption, BMI, and serum apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB) at baseline were analysed in multivariable Cox regression models adjusted for known confounders. Among 30,446 recruited participants, 347 men and 194 women were diagnosed with DD during a median follow-up time of 23 years. DM (men HR 2.23; 95% CI 1.50–3.30, women HR 2.69; 95% CI 1.48–4.90) and alcohol consumption (men HR 2.46; 95% CI 1.85–3.27, women HR 3.56; 95% CI 1.95–6.50) were independently associated with incident DD in the Cox regression models. Furthermore, inverse associations with incident DD were found for obesity among men, and ApoB/ApoA1 ratio among both sexes. DM and excess alcohol consumption constituted major risk factors for the development of DD. Furthermore, an inverse association between obesity among men and DD, and also between ApoB/ApoA1 ratio and DD was found in both sexes.

Contributing factors to diaper dermatitis and NICU length of stay

ObjectiveDiaper dermatitis (DD) among NICU infants is preventable and under-recognized. The role of clinical characteristics (CC) on DD is also poorly described. This study examined the: 1) prevalence of DD in NICU; 2) relationship of factors including CC and DD; and 3) contribution of DD and CC factors on NICU Length of stay (LOS). MethodRetrospective chart review data was collected on all infants admitted to the NICU. Analyses included bivariate and multivariable logistic regression for DD outcome and negative binomial regression model for predicting infants’ NICU LOS. ResultsDD prevalence in the NICU sample was 34% (n = 180), 70% White, 56% male, 72% infants born at higher gestational age, and 62.2% born vaginally. Logistic regression results showed that Black infants have lower AOR of DD, whereas, NICU LOS (OR 1.02; 95% CI 1.01, 1.03), number of skin injuries (OR 1.22; 95% CI 1.01–1.47), and older gestational age (OR 3.73; 95%CI 0.83–0.95) increased the odds of DD. Significant interaction of gestational age group and days to full feed was identified. ConclusionDD is common among NICU infants and several CC play an integral role as risk and moderating factors for DD. Routine collection of infant skin integrity data is currently lacking in large collaborative databases, which limits better understanding of DD in NICU. Improvements in preventative measures could benefit from continued study of the impact nutrition and LOS have on DD development. Better systems of collecting and analyzing DD data and its impact on NICU LOS are needed.

Role of Angiotensin-Converting Enzyme (ACE) gene polymorphism and ACE activity in predicting outcome after acute myocardial infarction.

The Ace polymorphism had shown association with ACE activity, premature atherosclerosis, myocardial infarction, LV dysfunction, LV remodelling, severity and extent of CAD and mortality after MI. Though ACE I/D polymorphism has been reported to be associated with various cardiovascular diseases it remained a controversial risk factor and studies have presented conflicting results. This study was designed to determine the association between ACE) gene insertion/deletion (I/D) polymorphism, ACE activity and acute STEMI in Indian population and to determine its influence on outcome after acute MI. We investigated 934 patients diagnosed with acute STEMI who underwent thrombolysis. ACE I/D polymorphism was detected by polymerase chain reaction and ACE activity was measured in 615 patients. The prevalence of DD, ID, and II genotypes in our study group were 41.97%, 34.36%, and 23.66% respectively. The ACE polymorphism was not significantly associated with the type of myocardial infarction, the LV ejection fraction, the number of vessels diseased and patency of the vessel after thrombolysis. The polymorphism had no influence on in hospital mortality (P=0.453). The ACE activity also showed no influence on in hospital mortality (P=0.482). The age>60years, Male gender, occluded artery and severe LV dysfunction (LVEF<35%) were predictors of in-hospital mortality on multivariate regression analysis. There was no differences among ACE (I/D) polymorphism observed in STEMI population. Neither ACE I/D polymorphism nor ACE activity predicted in-hospital mortality inpatients admitted with acute STEMI.

Can abacus course eradicate developmental dyscalculia

AbstractDevelopmental dyscalculia (DD) is a specific mathematical learning disability, with a prevalence of around 3%–7% in the school‐aged population. It negatively affects individuals, and even the national, development. Previous DD‐intervention programs usually targeted on numerosity, number, simple arithmetic, or even general cognitive ability. The current study investigated the effect that a long‐term (2–3 years) abacus course had on the prevalence of DD. Twelve classes of students were tested, half of which received an abacus course. Results showed that although no children were diagnosed as DD in the abacus classes, its prevalence was 6.4% in the control classes. Students with an abacus course demonstrated better performance in arithmetic computation and spatial short‐term memory after controlling for age, gender, grade, and other basic cognitive abilities. The results suggest that the abacus course could be an effective tool for DD intervention in natural education settings.

The prevalence and predictors of diabetes distress in elderly with type 2 diabetes mellitus

AimsDiabetes distress (DD) leads to damaging consequences in patients with type 2 diabetes mellitus (T2DM). Few studies have been carried out on the DD among elderly in Iran. The aim of the current study was to investigate the prevalence of DD and some of its related factors on the elderly living in Qom, Iran. MethodsThis study was cross-sectional, in design. It lasted for three months (December to February 2018). 519 community dwelling(aged 60 and over) participated in the study. Participants’ distress measured by diabetes distress scale (DDS). The cut of 3(≥3) was considered as the presence of distress. In addition, socio-demographic information was assessed. In order to determine predictors factors of DD, the logistic regression analysis was applied. ResultsThe mean age (±SD) of the participants was 68.38 (SD:6.78) with the majority being female (53.6%). Among them, 48.6% were identified with DD. A multi-variable logistic regression analysis showed that being female (OR = 1.94, [ 1.30–2.31]), sedentary lifestyle (OR = 3.59, [1.43–9.03]), complications (OR = 3.10, [2.06–4.67]), body mass index (BMI) of 25 or more (OR = 2.46, [1.54–3.94]), duration of disease below 10 years (OR = 2.60, [ 1.56–4.31]), two comorbidity (OR = 2.07, [ 1.19–3.61]) and three or more comorbidity (OR = 3.51, [ 1.20–10.27]) are the predictors of DD. ConclusionsDD is notably prevalent among the elderly with T2DM. Attention to psychological aspects of diabetes is a health priority, especially among women and other high-risk groups.

Асоціація діастолічної функції лівого шлуночка серця з індексом маси тіла у жінок 40–60 років зі збереженою фракцією викиду

Introduction. Diastolic heart failure is a variant of the universal complication of diseases and heart lesions, characterized by impaired function and myocardial remodeling. Since these processes begin before the onset of symptoms, special attention is paid to identifying subclinical diastolic LV dysfunctions, as a predictor of the formation of heart failure. The objective: was to determine and characterize the prevalence of LVDD in the population of women 40–60 years old depending on BMI. Materials and methods. We examined women aged 40–60 years without clinical signs of heart failure, with preserved LVEF, who underwent an ultrasound examination to identify preclinical LVDD. Diastolic function was divided into normal and DD. Then DD was ranked as mild, moderate, and severe. Statistical processing was performed using Statistica for Windows. Results. Abnormal diastolic function detected in 383 (58.4%) patients, with the most common stage being 1: 359 (93.7%). With stage 2 DD, 23 (6.0%) patients were detected and stage 3 DD was detected in 1 (0.3%). BMI increased in proportion to the stages of DD (p&lt;0.001). More patients with normal diastolic function have normal weight or overweight, while patients with DD were predominantly obese (p&lt;0.001). As BMI increased, the prevalence of normal diastolic function decreased, while the prevalence of DD increased (p&lt;0.0001). Conclusions. An increase in BMI is associated with DD in both groups of patients with obesity, hypertension and diabetes, and in an isolated group of normotensive patients without diabetes. These results may indicate that BMI is an independent predictor of DD. Key words: diastolic dysfunction, obesity, body mass index.

ACE/ACTN3 GENETIC POLYMORPHISMS AND ATHLETIC PERFORMANCE OF FEMALE SOCCER PLAYERS`

ABSTRACT Objective: Previous studies have shown controversial relationships between ACE and ACTN3 gene polymorphisms and sports performance. Thus, the aim of our study was to assess anaerobic and aerobic performance indicators of young female soccer players with different ACE/ACTN3 gene profiles. Methods: Twenty-seven female soccer players aged 16-18 underwent acceleration, speed, strength, anaerobic power and aerobic endurance tests and had their ACE and ACTN3 polymorphisms determined. Results: Based on genetic analysis, they were divided into the following groups: ACE II (n=2), ACE ID (n=11), ACE DD (n=14), ACTN3 XX (n=5), ACTN3 RR (n=7) and ACTN3 RX (n=15). ACE DD and ACE ID groups differed significantly in terms of results achieved on the 5 m sprint test (1.15±0.05 s vs 1.10±0.05 s, P=0.42). ACTN3 RR and RX achieved better results than the ACTN3 XX group in seven continuous vertical jumps (26.57±1.59 cm vs 25.77±2.51 cm vs 22.86±1.16 cm, respectively; P=0.007 for RR vs XX and P=0.021 for RX vs XX). Conclusion: High prevalence of ACE DD and ACTN3 RX genotypes in our subjects may suggest that faster and more powerful young females tend to perform better in soccer. Nevertheless, the absence of differences in most of the physical test results indicates that different genotypes are compatible with high-level soccer performance, meaning that it is the phenotype-genotype interaction that makes a successful female soccer player. Level of Evidence I, Prognostic studies — Investigating the effect of a patient characteristic on disease outcome.

Diastolic dysfunction in rheumatoid arthritis patients with low disease activity

Introduction/objectivesPatients with rheumatoid arthritis (RA) are at increased risk for congestive heart failure (CHF) and left ventricular diastolic dysfunction (LVDD), as compared to the general population. High disease activity is to be associated with higher incidence of cardiovascular disease (CVD), CHF, and mortality in RA patients. LVDD is not anticipated in RA patients without CVD symptoms and may be underdiagnosed especially in those with low disease activity.MethodThe study group consisted of 70 RA patients (54 women, 16 men) with no CVD and 33 healthy controls, of comparable age. All RA patients had low disease activity (DAS28 ≤ 3.2) from 2 to 7 years. Laboratory and imaging assessments included metabolic, RA-related, and cardiovascular parameters. Echocardiographic and Doppler studies were conducted in patients and controls with assessment of ejection fraction (EF) and diastolic dysfunction (assessed as E/A ratio).ResultsThe mean E/A ratio did not differ significantly between RA patients and healthy controls (1.08 (0.28) vs 0.99 (0.21), NS); comparable numbers of patients and controls had abnormal E/A (< 1.0) (26 (37.1%) vs 10 (30.3%), NS). Patients with decreased E/A were significantly older and had higher disease duration, activity, and presence of bone erosions than their RA counterparts with normal E/A. The mean EF was not significantly different in patients and controls.ConclusionsThe prevalence of DD as expressed by E/A ratio in RA patients with continued low disease activity was not different from that of controls. Higher disease duration and severity may predispose to DD occurrence in patients with preserved EF.

Dual diagnosis: an intriguing and actual nosographic issue too long neglected

The term “dual diagnosis” (DD) has been used in clinical practice for years. However, there is confusion about these medical cases, which consist in the presence of both a psychiatric disorder and a substance abuse disorder (in this case, alcohol). There are evidences that in the alcohol use disorder (AUD) population, 50.3% of patients had a psychiatric comorbidity during their lifetime. Nevertheless, to these days there are not any thorough guidelines for the management of these patients. A precise nosography would prevent delay in diagnosis and treatment and all the self-evident negative outcomes of those delays. A literature search was performed in PubMed, Web of Science, and Scopus, including studies published between 1980 and 2015. Search terms were: “guidelines”, “treatment”, “comorbidity”, “substance abuse”, “alcohol”, “dual-diagnosis”, “etiopathogenesis”, “outpatient”, “inpatient”, “unit”, “diagnosis”. Out of 1045 titles, 43 studies were included in this article for their relevance on definition and nosography of DD. Taking into account the state of art available in the literature, we contributed to clarify the definition of DD in the alcohol addiction field. Clinical data confirm high prevalence of DD, and allow to better describe and understand the complex relationship between alcohol dependence and other psychiatric diseases. We believe that a clear nosographic framework and a precise diagnostic process are essential for a timely management of every case, using specific guidelines to standardize and improve clinical practice. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which introduces dimensional approach, could be a useful tool to improve diagnostic accuracy.