First hospital admission due to heart failure: In-hospital mortality and patient profile.

Objectives: We evaluated the patient profile and outcomes of first heart failure (HF) related hospital admission patients in the 2010-2014 period.

Design: Retrospective, single-centre, cohort study.

Setting: We used administrative data from a tertiary care hospital (Hospital Universitari de Bellvitge, Barcelona, Spain).

[Impact of the financial crisis on activity and efficiency at a high-technology university hospital].

Objective: The financial crisis that begun in 2008 significantly decreased the budget of the public health system on Spain. The aim of this study was to evaluate the impact of the financial crisis on the activity, quality and efficiency of a high-technology university hospital.

Methods: We retrospectively analyzed the outcomes of four sets of hospital management indicators between 2007 and 2016 (A: activity; B: quality and complexity of inpatientcare; C: staff, global production and budget expenses; D: patients satisfaction survey).

Differential regulation of insulin action and tumor necrosis factor alpha system activity by metformin.

Background: Tumor necrosis factor alpha has a key role in insulin resistance. We study the effects of metformin on glucose tolerance, insulin resistance, beta cell function, and soluble tumor necrosis factor receptor (sTNFR) levels.

Methods: We performed a double-blind, randomized metformin-placebo study.

Type 1 diabetes mellitus in Catalonia: chronic complications and metabolic control ten years after onset.

Background: The purpose of this article is to describe the prevalence of microvascular (retinopathy, nephropathy and neuropathy) and acute diabetic complications, and the metabolic control status, in Catalonian patients with type 1 diabetes mellitus ten years after diagnosis.

Material/methods: We performed a cross-sectional population study evaluating 427 Type 1 diabetic patients diagnosed between 1987 and 1988 in 15 hospitals in Catalonia. 278 subjects were located, and all the study parameters were collected from their hospital medical records.

Thyroid volume as measured by ultrasonography in patients With type 1 diabetes mellitus without thyroid dysfunction.

The aim of this cross-sectional study was to assess and compare thyroid volume and its derminants in a cohort of type 1 diabetes mellitus (DM1) and compare the results to a healthy control group. We studied 65 DM1 patients treated with an intensive insulin regimen and 65 matched controls. In all participants we evaluated weight, height, BMI, waist-hip ratio, body surface area and body composition variables determined by using a bioelectrical impedance analyser.

Hypothalamic-pituitary sarcoidosis with hypopituitarism. Long-term remission with methylprednisolone pulse therapy.

A 29-year-old man presented with diplopia and decreased strength in the left arm. A magnetic resonance image (MRI) showed an extensive hypothalamic and pituitary gland mass, and hormonal studies showed partial hypopituitarism and mild hyperprolactinemia without diabetes insipidus. Biopsies of the hypothalamic lesion and of a mediastinal lymph node demonstrated noncaseating granulomas, and a Kveim-Siltzbach test was positive.

Body composition assessment in type 1 diabetes mellitus patients over 15 years old.

Background: The aim of the present study was to assess the anthropometric characteristics and body composition in type 1 diabetic patients and compare the results with a randomly selected control population.

Material And Methods: We studied 75 type 1 diabetic patients, 43 male and 32 female, recruited from consecutive diagnosed type 1 diabetic patients attending the Endocrine Unit and treated with a intensive insulin regimen, and 93 control subjects, 44 males and 49 females representative of the census of this city. We performed a dietary recall in patients and determined anthropometric characteristics, both in patients and controls, body weight, height, body-mass index, waist-hip ratio and body composition parameters: total body water, free-fat mass, body free-fat mass, fat mass and body fat by bioelectrical impedance analyser.

Leptin in type 2 diabetic or myotonic dystrophic women.

Background: Insulin resistance is an important determinant of circulating leptin concentrations in humans, but its independent contribution on plasma leptin levels are controversial. In the present study, we characterized plasma leptin levels and their regulation in women with 2 different insulin resistance states: type 2 diabetes and myotonic dystrophy disease, and in controls.

Material And Methods: We studied 3 groups of women: 21 type 2 diabetic patients, 20 myotonic dystrophic patients and a control group of 20 normoglycemic subjects, matched in age and body mass index.

[Analysis of mutations A3243G, C3256T and mitochondrial deletions in 41 diabetic patients].

Background: Mutations or deletions of mitochondrial DNA (mtDNA) define a new diabetes subtype.

Patients And Method: The A3243G and C3256T mutations and mtDNA deletions were studied in 41 diabetic patients with maternally inherited diabetes mellitus or deafness.

Results: The A3243G mutation was found in one out of forty-one diabetic patients (2.

Insulin regulation of leptin synthesis and secretion in humans: the model of myotonic dystrophy.

Objective: Myotonic dystrophy (MyD) is a systemic disorder in which insulin resistance is well recognized. In the present study we have characterized plasma leptin levels in patients with MyD and in age, sex and body mass index (BMI) matched controls and assessed the influence of leptin on the clinical manifestations of MyD.

Design And Patients: Body composition, plasma leptin, fasting and post-oral glucose tolerance test insulin, IGF-I and IGFBP3 were studied in 34 MyD patients and 33 controls.

[Insulin resistance and metabolic syndrome in first-degree relatives of patients with NIDDM].

Background: Relatives of type 2 diabetes mellitus (DM2) patients present or can develop the plurimetabolic syndrome (MS). Insulin sensitivity determination could be useful to detect relatives with higher risk.

Patients And Methods: Insulin sensitivity (IS) and MS in 106 first degree relatives of DM2 and 52 control subjects, matched for age, sex and body mass index (BMI).

Clinical presentation and early course of type 1 diabetes in patients with and without thyroid autoimmunity.

Objective: To evaluate the prevalence of thyroid autoimmunity (TAI) in patients with recent-onset type 1 diabetes and to determine the influence of TAI on the clinical presentation and evolution of type 1 diabetes.

Research Design And Methods: We studied 111 newly diagnosed type 1 diabetes patients > 13 years old. The diagnosis of TAI was based on medical history and measurement of thyroid peroxidase (microsomal) antibodies (TPOAs).

[Diabetes mellitus associated with the A3243G mutation of mitochondrial DNA. Apropos a case].

The mitochondrial A3243G mutation of the tRNA(Leu) has been described in pedigrees with maternally inherited diabetes mellitus and deafness. Ten diabetic patients with sensorineural deafness were studied. Polymerase chain reaction and enzyme restriction analysis with Apa I were performed.

[Autoimmune thyroid pathology in recently diagnosed diabetes mellitus type 1].

Objective: To analyze the prevalence of autoimmune thyroid disease among adult patients with recently diagnosed diabetes mellitus type I and its possible correlation with beta-cell autoimmunity markers (ICA, GAD, and IA 2) and with the presentation characteristics of diabetes mellitus.

Patients And Methods: A total of 100 patients diagnosed from 1992 to 1996 were included and anti-thyroid antibodies (Ac), anti-thyroglobulin (aTG) and antiperoxidase (aTPO) were measured. A comparison followed of the clinical characteristics, biochemical markers, and beta-cell immunity markers between the group of patients with positive and negative antibody determinations.

Serum ferritin as a component of the insulin resistance syndrome.

Objective: In epidemiological studies, serum ferritin was the second-strongest determinant of blood glucose (after BMI) in regression models and the third-strongest determinant of serum insulin (after BMI and age). Its concentration also correlated positively with plasma triglycerides and apolipoprotein B concentrations, and negatively with HDL2 cholesterol. We hypothesized that serum ferritin could be a marker of insulin resistance.

[The influence of clinical presentation and metabolic control of insulin dependent diabetes in the evolution of residual insulin secretion. A prospective study at five years].

Background: To study the influence of clinical, metabolic and immunological parameters during the first years of the evolution of insulin-dependent diabetes mellitus (IDDM) on the long-term residual insulin secretion (IS).

Patients And Methods: 186 IDDM subjects diagnosed from 1986 to 1993 were included; 135 subjects have completed a two year follow-up, and 57 have completed a five year follow-up. The influence of individual characteristics at diagnosis (age, sex, clinical presentation, islet-cell antibodies) and during the first two years of follow-up (IS, metabolic control) on IS at five years was evaluated by multiple linear regression.

Improved metabolic control preserved beta-cell function two years after diagnosis of insulin-dependent diabetes mellitus.

To determine whether improved metabolic control during the first two years of insulin-dependent diabetes (IDDM) modified beta cell function, we studied 108 subjects with recent-onset IDDM diagnosed between March 1986 and April 1992 and followed up prospectively for 2 years. Two insulin regimens were used: 1) conventional insulin treatment (CIT) (1986-90, n = 67) involving a mixture of regular and intermediate insulin before breakfast and dinner; and 2) intensive insulin treatment (IIT) (1990-92, n = 41) providing regular insulin before breakfast and lunch, and a mixture of regular and long-acting insulin before dinner. Glucagon-stimulated C-peptide was determined at diagnosis and at 3, 6, 12 and 24 months.

The TNF-alpha gene Nco I polymorphism influences the relationship among insulin resistance, percent body fat, and increased serum leptin levels.

Tumor necrosis factor-alpha (TNF-alpha), acting as a modulator of gene expression in adipocytes, is implicated in the development of insulin resistance and obesity. The aim of this study was to investigate whether the Nco I polymorphism of the TNF-alpha gene influences the relationship among insulin resistance, percent body fat, and serum leptin levels. A sample of 38 subjects (19 men, mean age 36.

Beta-cell dysfunction in first-degree relatives of patients with non-insulin-dependent diabetes mellitus.

To analyse the relationship between age, glucose tolerance, beta-cell function, and insulin sensitivity in preclinical states of non-insulin-dependent (Type 2) diabetes mellitus (NIDDM), we have done a cross-sectional, age-stratified analysis of 86 non-diabetic first-degree relatives of NIDDM patients and 49 controls with similar age, sex, and BMI. A 5 mg kg ideal body weight-1 min-1 for 60 min of continuous infusion of glucose with model assessment (CIGMA) of serum glucose and C-peptide values at the end of the infusion was used to determine glucose tolerance and beta-cell function. Insulin sensitivity was estimated by modelling basal serum glucose and insulin values.

Ketoacidosis at diagnosis is predictive of lower residual beta-cell function and poor metabolic control in type 1 diabetes.

To determine the factors at diagnosis predictive of changes in residual beta-cell function and metabolic control in Type 1 diabetes, 125 patients older than 7 years of age consecutively diagnosed between March 1986 and June 1991 were followed prospectively for two years. The effect of age, gender and the presence of ketoacidosis (DKA) and islet-cell antibodies (ICA) on beta-cell function, metabolic control and insulin requirements were studied by multivariate analysis of variance (repeated measurements over time) in 90 patients who completed follow-up. DKA had an independent negative effect on residual beta-cell function over time (p = 0.

Increased prothrombin fragment 1 + 2 and D-dimer in first-degree relatives of type 2 diabetic patients. Prethrombotic state in relatives of type 2 diabetic patients.

To evaluate whether or not activated coagulation is present in the preclinical phases of type 2 diabetes mellitus, we studied 46 non-diabetic first-degree relatives of type 2 diabetic patients and 21 matched controls with no family history of diabetes. We determined the plasma levels of prothrombin fragment 1 + 2, D-dimer, fibrinogen, plasminogen activator inhibitor type 1, tissue plasminogen activator, von Willebrand factor and coagulation factors VII and VIII. Glucose tolerance, beta-cell function and insulin sensitivity were assessed in all subjects by a continuous glucose infusion of 5 mg.

Expression of ICAM-1 in distant metastatic thyroid carcinoma.

Distant metastasis from follicular thyroid carcinoma developed in a 48-year-old woman 11 yr after the resection of the primary tumor. Distant metastasis consisted in invasion of the left infraspinatus muscle by malignant thyroid cells. After its surgical removal, in the following 6-8 months multiple metastasis to distant skeletal muscle and brain appeared, and despite chemotherapy and local radiotherapy, the patient finally died.

Study on growth hormone and insulin secretion in myotonic dystrophy.

Growth hormone (GH) levels were measured in 12 patients with myotonic dystrophy (MD; 7 men and 5 women, aged 21-49 years) and 14 volunteers after administration of 100 micrograms GH-releasing hormone (GHRH; 1-29). A 75-g oral glucose tolerance test was carried out to determine glucose, insulin, plasma C-peptide, and urinary C-peptide. The GH level in six MD patients responded normally to GHRH (group I), with a peak of 17.