The Role of Biofactors in Diabetic Microvascular Complications.

Microvascular complications are responsible for a major proportion of the burden associated with diabetes contributing to substantial morbidity, mortality, and healthcare burden in people with diabetes. Retinopathy, nephropathy, and neuropathy constitute the leading causes of blindness, end-stage renal disease, and lower-extremity amputations, respectively. Since the efficacy of causal therapies of diabetic microvascular complications is limited, especially in type 2 diabetes, there is an unmet need for adjunct treatments which should be effective despite ongoing hyperglycemia.

Emerging drugs for the treatment of diabetic retinopathy.

Introduction: Diabetic retinopathy (DR) is one of the main pathological features of the diabetes mellitus spectrum. It is estimated that in 2020 about 4 million people worldwide suffered from blindness or visual impairment caused by DR. Many patients cannot access treatment, mostly because of high costs, while others discontinue it prematurely due to the high number of intravitreal administrations required, or the occurrence of ocular complications, or discomfort in quality of life.

Intravitreal anti-VEGF agents and cardiovascular risk.

Antagonists of Vascular Endothelial Growth Factor (Anti-VEGF) are widely administered by intravitreal injection for the treatment of ocular pathologies such as Age-related Macular Degeneration, Diabetic Macular Edema, Proliferative Diabetic Retinopathy and occlusion of retinal vessels. Anti-VEGF agents, in particular bevacizumab, were introduced in oncology to inhibit tumor-induced angiogenesis feeding neoplastic tissues. Subsequently, other specific agents were developed for intraocular administration.

Detection of perimacular red dots and blots when screening for diabetic retinopathy: Refer or not refer?

Purpose: Detection of microaneurysms and/or microhaemorrhages near the fovea when screening for diabetic retinopathy poses a problem because referral to retinal specialists may alarm patients and unnecessarily burden ophthalmologists.

Methods: Six-month prospective study of patients found to have minimal red lesions within one disc diameter of the fovea when screened for diabetic retinopathy. Two 45° digital photographs, one centred on the macula and the other nasal including the optic disc, were taken for each eye.

Giant coronary artery aneurysm in association with systemic arterial ectasia. A case report.

Since the advent of coronary angiography, coronary artery aneurysm has been diagnosed with increased frequency. The etiology of coronary artery aneurysm is atherosclerosis in 50%, followed by other causes. In a 71-year-old man with previously documented abdominal aortic aneurysm of 6 cm diameter and ectasia of both left and right middle cerebral arteries, thoracic magnetic resonance imaging (MRI) demonstrated a large hollow para-cardiac mass (maximum diameter of 7 cm) lying in the anterior-lateral part of the atrio-ventricular sulcus.

[Pruritus. Physiopathology, clinical features, and treatment].

Pruritus is a subjective disturbance that accompanies many dermatological, allergic and internal medicine disorders. It may well be the only symptom that leads a patient to consult a doctor. In situations of this kind, the cause of the complaint is very hard to determine and the tests employed often fail to give a clear-cut answer.

Bronchial reactivity in subjects with urticaria.

Background: Respiratory symptoms (rhinitis, asthma) accompany some skin diseases with a proven immunological or allergic pathogenesis whereas the immunological and allergological findings are sometimes negative in subjects with chronic urticarial skin symptoms and no cause can be found. This paper explores the possibility of airway inflammation in cases of this kind.

Methods: Nonspecific bronchostimulation with methacholine was carried out in 12 subjects with a clinical history of urticaria and negative immunological and allergological findings.

[Muscle fatigue and dyspnea].

Calm breathing requires little effort on the part of the inspiratory muscles to overcome the elastic and non-elastic resistances of the chest-lung system. Spontaneous expiration is passive and does not engage the respiratory muscles. In the event of restriction or obstruction, however, there are changes in these two types of resistance and their distribution.