Effects of deranged glucose homeostasis on peripheral arterial stiffness index in patients with pre-diabetes mellitus.
(9/10)
Premature arteriosclerosis may be one of the mechanisms linking pre-diabetes mellitus (pre-DM) and cardiovascular disease. We sought to characterize premature arteriosclerosis in pre-DM using different arterial stiffness indices and to find the independent contributors of this process. We recruited 33 patients without DM, 53 patients with pre-DM, and 34 subjects with DM. Both the compliance index (CI) and stiffness index (SI) were measured. Patients with pre-DM and DM had lower CI (3.8 +/- 2.1 versus 5.2 +/- 3.0 units; P < 0.05 and 3.6 +/- 1.8 versus 5.2 +/- 3.0 units; P < 0.05, respectively) and higher SI (8.0 +/- 2.0 versus 6.7 +/- 1.6 m/s; P < 0.01 and 9.4 +/- 2.3 versus 6.7 +/- 1.6 m/s; P < 0.001, respectively) than patients without DM. Using multivariate linear regression analysis, age, heart rate, and HOMA index were independent determinants for SI (whole model: R(2) = 0.47, P < 0.001), whereas male gender, hsCRP, and HOMA index were independent determinants for CI (whole model: R(2) = 0.34, P < 0.01). The HOMA index was an independent determinant for arterial stiffness. Increased insulin resistance may associate with increased arterial stiffness at peripheral arteries in pre-DM patients. (+info)
Ward round--A rare tumor of the kidney resulting in hypertension, renal failure and a cerebrovascular accident in a young female.
(10/10)
A 17-year-old girl was admitted to our hospital with severe refractory hypertension evolving over approximately 4 years. Despite not having the resources to identify plasma-renin levels and using standard imaging techniques, a juxtaglomerular cell tumor was suspected and was histologically confirmed after surgical excision. This is a potentially lethal condition if left untreated and surgical excision is curative. The benign nature of the tumor is emphasized and its chemical, radiological and microscopic appearance discussed according to the literature. To the best of our knowledge, this is the first reported case of a patient surviving a cerebrovascular accident associated with a juxtaglomerular cell tumor. (+info)