European journal of clinical investigation
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Eur. J. Clin. Invest. · Nov 2022
Review Meta AnalysisAssociation of Modifiable Risk Factors with Ischemic Stroke Subtypes in Asian versus Caucasian populations: A Systematic Review and meta-analysis.
Ischaemic stroke (IS) is associated with various modifiable risk factors but the association of these risk factors based on TOAST classification, which characterises IS into five subtypes: large artery atherosclerosis (LAA), small vessel occlusion (SVO), cardioembolic disease (CE), other determined aetiology (ODE) and undetermined aetiology (UDE), is unknown. We aimed to summarise the published evidence for the association of modifiable risk factors with IS subtypes based on TOAST classification, specifically focussing on the Asian versus Caucasian population. ⋯ Our findings suggest strong association of smoking, dyslipidemia and diabetes mellitus with LAA and SVO subtypes in the Caucasian population. However, only diabetes mellitus showed significant association with both LAA and SVO subtypes in Asian population as well. Thus, a majority of the traditional modifiable risk factors had a positive association in LAA and SVO, while a negative protective association was observed in CE subtype, among both the Asian and the Caucasian subgroups.
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Eur. J. Clin. Invest. · Nov 2022
Meta AnalysisElevated Fasting Insulin Results in Snoring: A View Emerged from Causal Evaluation of Glycemic Traits and Snoring.
Snoring and impaired glucose metabolism are common clinical manifestations and associated. The purpose of our study is to estimate the causal associations between snoring and glycemic traits. ⋯ Snorers are subjected to higher FBG, HbA1c, FINS and 2hGlu levels, and elevated FINS levels further provides robust causality on snoring, suggesting that behind common snoring may lie hyperinsulinemia or insulin resistance.
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Eur. J. Clin. Invest. · Nov 2022
ReviewNovel Insights into the Pathogenic Impact of Diabetes on the Gastrointestinal Tract.
Type 2 and type 1 diabetes are common endocrine disorders with a progressively increasing incidence worldwide. These chronic, systemic diseases have multiorgan implications, and the whole gastrointestinal (GI) tract represents a frequent target in terms of symptom appearance and interdependent pathophysiological mechanisms. Metabolic alterations linked with diabetic complications, neuropathy and disrupted hormone homeostasis can lead to upper and/or lower GI symptoms in up to 75% of diabetic patients, with multifactorial involvement of the oesophagus, stomach, upper and lower intestine, and of the gallbladder. ⋯ Finally, diabetes has been linked with increased cancer risk at different levels of the GI tract. The presence of GI symptoms and a comprehensive assessment of GI function should be carefully considered in the management of diabetic patients to avoid further complications and to ameliorate the quality of life. Additionally, the presence of gastrointestinal dysfunction should be adequately managed to improve metabolic homeostasis, the efficacy of antidiabetic treatments and secondary prevention strategies.
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Eur. J. Clin. Invest. · Nov 2022
ReviewClinical implications of vascular dysfunction in acute and convalescent COVID-19: a systematic review.
Accumulating evidence suggests that endothelial dysfunction is implicated in the pathogenesis and severity of coronavirus disease 2019 (COVID-19). In this context, vascular impairment in COVID-19 might be associated with clinical manifestations and could refine risk stratification in these patients. ⋯ Overall, a detrimental effect of COVID-19 on markers of endothelial function and arterial stiffness that could persist even for months after the resolution of the infection and provide prognostic value was congruent across published studies. Further research is warranted to elucidate clinical implications of this association.
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Eur. J. Clin. Invest. · Nov 2022
ReviewA precise review on NAATs-based diagnostic assays for COVID-19: A motion in fast POC molecular tests.
Diagnosis is one of the main strategies to deal with infectious and deadly diseases such as coronavirus disease 2019 (COVID-19). The global pandemic of COVID-19 has led to an immediate need to expand rapid diagnostic techniques. New isothermal-based methods are being developed for COVID-19 detection aiming to resolve the limitations related to the reverse transcription-quantitative polymerase chain reaction (RT-qPCR) method through immediate samples processing and minimizing false-negative or ambiguous results. Advances in nucleic acid amplification techniques (NAATs) can provide affordable and easy-to-use diagnostic platforms with high sensitivity and specificity in order to be available to the public as approved commercial kits. ⋯ Isothermal-coupled methods and LAMP-based molecular methods have been suggested as suitable portable tests with high diagnostic speed for use in POC testing.