The American journal of the medical sciences
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Our purpose was to investigate the relationship between oxygen saturation (SpO2) and dynamic interstitial glucose level (IGL) in patients with obstructive sleep apnea (OSA) along with type 2 diabetes mellitus (T2DM), and to investigate the potential mechanisms thereof. ⋯ Severe and moderate OSA with T2DM is marked by a delayed IGL peak following LSpO2. Nocturnal hypoxemia causes hyperglycemia in patients with OSA along with T2DM.
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Pulse wave velocity is a marker of arterial stiffness. Unequal arterial stiffness has been associated with increased risk of cardiovascular events. This study calculated bilateral brachial-ankle pulse wave velocity (baPWV) differences and investigated the associations of unequal bilateral baPWV with overall and cardiovascular mortality in patients receiving hemodialysis (HD). ⋯ ΔbaPWV was associated with an increased risk of cardiovascular and overall mortality in patients receiving HD. Earlier evaluation of ΔbaPWV may facilitate the identification of patients receiving HD who have an increased risk of cardiovascular and overall mortality.
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Governments around the world exert a substantial degree of influence over physician reimbursement, but the structure and level of that influence varies greatly. This article defines and analyzes the role of government in physician reimbursement both internationally and in the United States. ⋯ We conclude the article by examining the ways in which recent legislation including the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act would likely change the role of government in physician reimbursement in the United States.
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Patients with diabetes and chronic kidney disease (CKD) without proteinuria are often believed to have a cause of CKD other than diabetes. It was hypothesized that if this is true, the rate of renal function decline should be similar among nonproteinuric patients with and without diabetes. ⋯ Patients with diabetes had more rapid decline in kidney function compared with individuals without diabetes, despite the absence of proteinuria. These results suggest that even in the absence of proteinuria, diabetes may be associated with CKD.