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Type 1 Patients (type 1 + patient)

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Medical Sciences	100%

Selected Abstracts

Healthcare charges and utilization associated with diabetic neuropathy: impact of Type 1 diabetes and presence of other diabetes-related complications and comorbidities

DIABETIC MEDICINE, Issue 1 2009
Y. Zhao
Abstract Aims The aim was to examine the impact of Type 1 diabetes and having any other diabetes-related complication or comorbidity on healthcare charges and utilization in patients with diabetic neuropathy (DN). Methods We selected individuals aged < 65 years who continuously enrolled in a large US commercial plan from July 2004 to June 2006 and who received at least one diagnosis of DN at any time from July 2004 to June 2005. We compared the prevalence of other diabetes-related complications or comorbidities between patients with Type 1 and with Type 2 diabetes. In patients with DN with or without any other diabetes-related complication or comorbidity, we used multivariate regression to assess the marginal contribution of Type 1 diabetes on healthcare charges and utilization from July 2005 until June 2006. Results The majority of DN patients had at least one other diabetes-related complication or comorbidity. Most of the DN patients had Type 2 diabetes. DN patients with Type 1 diabetes had more comorbid medical conditions than those with Type 2 diabetes. Compared with Type 2, Type 1 patients had a higher prevalence of each individual non-DN diabetes-related complication or comorbidity, except heart disease. Controlling for comorbidities, Type 1 and Type 2 patients with DN but no other diabetes-related complication or comorbidity had similar healthcare utilization. However, Type 1 patients had significantly higher charges than those with any other diabetes-related complication or comorbidity. Conclusions Many patients with DN have Type 1 diabetes and other common diabetes-related complications or comorbidities, which can have a significant impact on healthcare charges and utilization. [source]

Absence of c- kit gene mutations in gastrointestinal stromal tumours from neurofibromatosis type 1 patients

THE JOURNAL OF PATHOLOGY, Issue 1 2004
Kazuo Kinoshita
Abstract Most sporadic gastrointestinal stromal tumours (GISTs) have somatic c- kit gene mutations that are considered to be causal. Neurofibromatosis type 1 (NF1) is caused by mutations of the NF1 gene and NF1 patients have an increased risk of developing GISTs. Since most neoplasms are considered to develop as a result of the combination of several gene mutations, these findings suggest that GISTs from NF1 patients might have somatic c- kit gene mutations and that sporadic GISTs from non-NF1 patients might have somatic NF1 gene mutations. The present study analysed 29 GISTs from seven NF1 patients for c- kit gene mutations and ten sporadic GISTs from ten non-NF1 patients for NF1 mutations. Exons 9, 11, 13, and 17 of the c- kit gene were amplified and directly sequenced after the extraction of genomic DNA from wax-embedded tissues from 26 GISTs from five NF1 patients. The whole coding region of the c- kit cDNA and the whole coding region of the NF1 cDNA were amplified and directly sequenced after RNA extraction and cDNA synthesis in three fresh GIST tissues from two NF1 patients and ten fresh GIST tissues from ten non-NF1 patients. Of the ten sporadic GISTs, eight had heterozygous mutations at exon 11, and one at exon 9, of c- kit. Heterozygous NF1 gene mutations were detected in GISTs from the two NF1 patients from whom fresh tissues were available. None of the 29 GISTs derived from NF1 patients had detectable c- kit gene mutations and none of the ten GISTs derived from non-NF1 patients had detectable NF1 mutations. These results suggest that the pathogenesis of GISTs in NF1 patients is different from that in non-NF1 patients. Copyright © 2004 John Wiley & Sons, Ltd. [source]

Comparison of mechanomyography and acceleromyography for the assessment of rocuronium induced neuromuscular block in myotonic dystrophy type 1

ANAESTHESIA, Issue 6 2010
L. E. H. Vanlinthout
Summary We measured acceleromyography and mechanomyography simultaneously with monitoring of rocuronium-induced neuromuscular block in four patients with myotonic dystrophy type 1. Furthermore, we compared neuromuscular block measures from these patients with those from normal controls from previous studies. In myotonic dystrophy type 1 patients, the dose-response curve obtained with acceleromyography was steeper and right-shifted compared with that obtained using mechanomyography. However, the effective doses to produce 95% neuromuscular block determined with both acceleromyography and mechanomyography were similar to each other and to values found in normal patients. In the three myotonic dystrophy type 1 patients with mild to moderate disease, times to recovery from block were similar to those observed in normal controls. In both patients and normal controls, neuromuscular block recovered faster with acceleromyography. However, in one patient with severe muscle wasting, recovery of neuromuscular block was prolonged. We conclude that mechanomyography and acceleromyography cannot be used interchangeably to monitor neuromuscular block in myotonic dystrophy type 1 patients. [source]

Is there a role for dynamic retinal vessel analysis in internal medicine?

ACTA OPHTHALMOLOGICA, Issue 2008
IM LANZL
Purpose Human retinal vessels and their reaction to stimuli change during life and in disease due to physiological, genetic and pathological influences. Using the Dynamic Vessel Analyzer (DVA, Fa. IMEDOS, Jena) it is possible to assess changes in retinal vessel diameters in response to vasoactive stimuli in real time and non-invasively. Methods Retinal arterial vessel reaction in the natural time course and to the average of 3 consecutive monochromatic flicker stimulations (530-600 nm, 12,5 Hz, 20 s) with a 80 s observation pause between stimulations was investigated in healthy volunteers of different age groups, obese patients, diabetes type 1 patients, systemic hypertensive patients and patients with lysosomal storage disease. Statistical data analysis of vessel reactions independent from the DVA program was performed. Results There is a statistically significant difference in retinal vascular behaviour in different age groups in a healthy population. The same is true between a healthy population and each of the diseases investigated. Lysosomal storage disease however demonstrated an increase in dilation following flicker stimulation compared to normal persons. Conclusion Flicker stimulation of the retina light evokes a prompt vessel reaction in all healthy subjects. We could demonstrate an age dependence of the retinal arterial reaction in medically healthy persons and in hypertension, diabetes and obese patients. From the increased reaction in lysosomal storage disease further understanding of different factors leading to the vascular reaction to stimuli may be derived. Application of flicker stimulus to retinal vessels represents a method to assess the endothelial function of vessels which is important to understand in systemic disease. [source]