Anemia in diabetic patients at an internal medicine ward: clinical correlates and prognostic significance.

Background: Characteristics and prognostic significance of anemia in hospitalized diabetic patients are unknown.

Methods: We studied 3145 unselected patients admitted to two Internal Medicine Departments, 872 (27.7%) of whom were diabetic.

Clinical variables affecting survival in patients with decompensated diastolic versus systolic heart failure.

Background: The impact of various clinical variables on long-term survival of patients with acutely decompensated diastolic heart failure (DHF) compared to systolic heart failure (SHF) has not been sufficiently investigated.

Methods: Clinical, laboratory, electrocardiographic and echocardiographic data were collected and analyzed for all-cause mortality in 473 furosemide-treated patients aged >or=60 years, hospitalized for acutely decompensated HF.

Results: Diastolic heart failure patients (n = 183) were more likely to be older, female, hypertensive, obese, with shorter preexisting HF duration, atrial fibrillation, lower New York Heart Association (NYHA) class, lower maintenance furosemide dosages, and to receive calcium antagonists.

Seating-induced postural hypotension is common in older patients with decompensated heart failure and may be prevented by lower limb compression bandaging.

Background: Postural hypotension induced by transition from supine to sitting position and measures for its prevention in heart failure has not been investigated.

Objective: Our purpose was to evaluate the prevalence of postural hypotension and associated clinical manifestations as well as the contribution of various risk factors for postural hypotension on transition from lying to sitting in older patients with decompensated heart failure, and to study the eventual preventive effect of leg bandaging.

Methods: Seating-induced postural hypotension (>or=20 mm Hg systolic and/or >or=10 mm Hg diastolic blood pressure fall) was assessed on the first study day in 108 patients aged >or=60 years, hospitalized for acutely decompensated heart failure.

Magnesium and C-reactive protein in heart failure: an anti-inflammatory effect of magnesium administration?

Background: Little is known about the relationship between serum magnesium (Mg) and C-reactive protein (CRP) in heart failure (HF).

Aim Of The Study: To investigate the relationship, if any, between serum Mg and CRP in HF patients and, concomitantly, to test a hypothesis that Mg supplementation might affect serum CRP levels.

Methods: Serum Mg and CRP were evaluated in 68 patients with chronic systolic HF leading to hospital admission and 65 patients requiring hospitalization for other causes.

Patient-dependent variables affecting treatment and prediction of acute coronary syndrome are age-related. A study performed in Israel.

Background: Acute coronary syndrome (ACS) prevails in older patients and is associated with higher morbidity and mortality. Little is known about patient-related variables that may affect course and treatment of ACS in older vs. younger with acute chest pain.

Apoptosis and proliferation of mesangial cells isolated from kidneys undergoing compensatory growth following contralateral nephrectomy: role of the renin-angiotensin system.

Background: Contralateral nephrectomy stimulates compensatory growth of the remaining kidney. Intensive growth is frequently associated with increased apoptosis. The proliferation and apoptosis of cultured rat mesangial cells isolated from the remaining kidney following contralateral nephrectomy were evaluated.

Intracellular magnesium in elderly patients with heart failure: effects of diabetes and renal dysfunction.

Hypomagnesemia is frequent in diabetes mellitus (DM), while renal dysfunction (RD) may be associated with hypermagnesemia. Severe cardiac arrhythmias and other adverse clinical manifestations are frequent in heart failure (HF), in DM and in RD. Depletion of intracellular magnesium (icMg), which may coexist with normal serum Mg, might contribute to these deleterious effects.

Patient-related variables predicting acute coronary syndrome following admission for chest pain of possible coronary origin.

Objective: Improving risk stratification of patients experiencing acute chest pain with non-revealing electrocardiogram and cardiac biomarkers could reduce missed acute coronary syndrome and avoid unnecessary hospitalization.

Methods: We assessed the ability of situational, circumstantial, and other patient-related variables in predicting acute coronary syndrome in 921 consecutive patients randomly admitted to this medical department with chest pain of possible coronary origin. A reference group comprised 107 patients referred promptly to the coronary care unit with acute myocardial infarction.

Renal functional deterioration is not affected by the magnitude of sodium consumption in a normotensive model of moderate renal failure.

Background/aims: High sodium consumption has been repeatedly reported to exert deleterious effects on severe chronic renal failure progression, mainly via glomerular mechanisms. However, the role of high sodium intake in renal function deterioration in a model of moderate chronic tubulointerstitial disease has not yet been addressed. We evaluated the effects of exaggerated dietary sodium and the resultant increase in proteinuria on renal function deterioration in experimental tubulointerstitial disease in rats.

First morning standing up may be risky in acutely ill older inpatients.

Information about orthostatic hypotension (OH) among elderly patients hospitalized for acute conditions in short-term facilities is scarce. Many older inpatients carry various predisposing factors for OH. However, its existence goes frequently unrecognized.

Control of hypertension with captopril affords better renal protection as compared with irbesartan in salt-loaded uremic rats.

Background/aim: Hypertension induced by exaggerated sodium consumption accelerates the progression of renal failure. We investigated the effects of a high-sodium (HS) diet on the progression of renal failure in rats maintained normotensive by angiotensin-converting enzyme inhibition or AT-1 blockade.

Methods: In 70 Sprague-Dawley rats, renal failure was induced by five-sixths nephrectomy.

Heart failure in diabetes mellitus: clinical features and prognostic implications.

We defined the prevalence and impact on survival of clinical bedside variables in 385 patients with symptomatic congestive heart failure (CHF), of whom there were 176 with and 209 without diabetes mellitus. Patients were consecutively hospitalized and admitted for various acute conditions. Following discharge all-cause mortality was recorded.

Lower limb compression bandaging is effective in preventing signs and symptoms of seating-induced postural hypotension.

Background And Aims: Data concerning postural hypotension (PH) induced by transition from supine to sitting position are scarce and measures for its prevention have not been investigated. Our objective was to assess the preventive role of lower limb compression bandaging on PH and associated manifestations in older inpatients when seated from lying position.

Methods: In a randomized crossover study, 61 patients aged >65 years were enrolled.

Hypertension but not sodium intake determines progression of renal failure in experimentally uremic rats.

Background/aims: High sodium intake is implicated in contributing to progression of chronic renal failure. We studied the effect of high sodium consumption on progression of rat experimental renal failure while sodium-induced hypertension was pharmacologically controlled.

Methods: 64 Sprague-Dawley rats underwent 5/6 nephrectomy.

Seated postural hypotension is common among older inpatients.

Bed-rest > 12 hours produced postural hypotension (PH) in 54% of seated older inpatients. PH was multifactorial, equally initiated throughout 5 minutes and symptoms arised frequently following small blood pressure drops. In this context PH should be anticipated and prevented.

Dietary intake of various nutrients in older patients with congestive heart failure.

Background And Aims: Anorexia, nausea and premature satiety with eating, prevalent in congestive heart failure (CHF), have been held responsible for reduced dietary intake and deficiency of magnesium, potassium and probably other nutrients. Since solid data is not available, this study was undertaken with the following aims (1) to assess dietary intake in CHF, (2) to compare dietary intake in older CHF patients with a similar patient population free of CHF (control group), and (3) to evaluate these data in patients with moderate versus severe CHF.

Methods And Results: Dietary intake of 57 consecutively hospitalized furosemide-treated CHF patients over the age of 60 was compared with that of 40 similar patients free of CHF.

Contrast media augmented apoptosis of cultured renal mesangial, tubular, epithelial, endothelial, and hepatic cells.

Rationale And Objective: Nephrotoxicity of contrast media, resulting in apoptosis and acute necrosis of tubular cells, is well documented. No studies concerning mesangial cells apoptosis have been published yet.

Aim: Apoptosis of cultured mesangial, tubular, and hepatic cell lines was investigated following exposure to different contrast media.

Cell-associated magnesium and QT dispersion in hemodialysis patients.

Background: Impaired magnesium (Mg) homeostasis has been implicated in a variety of cardiovascular disturbances, including ventricular arrhythmias and changes in the interval between the onset of wave Q to the end of wave T (QT interval) on electrocardiogram. Cardiac arrhythmias are common in patients on hemodialysis therapy.

Methods: We investigated the relationship between QT interval corrected for heart rate (QTc) dispersion and Mg content in peripheral blood mononuclear cells (PBMC) of chronic hemodialysis patients treated with high-dose calcium carbonate providing Mg in excess (group I; n = 18) or low-dose calcium carbonate and smaller Mg load (group II; n = 13).