| 1. |
- Herlitz, Anders, 1981, et al.
(författare)
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Family-Centeredness as Resource and Complication in Outpatient Care with Weak Adherence, Using Adolescent Diabetes Care as a Case in Point
- 2019
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Ingår i: What about the family? : practices of responsibility in care / edited by Marian A. Verkerk, Hilde Lindemann, and Janice McLaughlin.. - Oxford : Oxford University Press. - 9780190624880 ; , s. 137-146
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Bokkapitel (refereegranskat)abstract
- Care for adolescent patients with diabetes type 1 is a recognized challenge, with known adherence problems in a context where home-/self-care and continuous vital need of day-to-day life-style adjustment. The recommended care regimen often gives rise to conflicts with broader personal and social needs and desires, and in case of weak adherence negative spirals of undermined self-confidence and/or emotional denial further deteriorating the situation may result. The need to adjust care to the specific situation is accepted within the pediatric diabetes professional community, accepting a commitment to person centeredness involving alliance with the family as a critical part. Yet, families can be involved in different ways and the issue of how to involve families and what ethical tensions that may actualize is largely unexplored. Standard models of person- and family-centeredness tell us little about how to involve family members in care similar to that of diabetes. We have elsewhere proposed an alternative approach more attuned to such circumstances, aiming at empowering patients' long-term capacities to manage their condition domestically. This “counselling, self-care, adherence (CSA) approach” offers a look at the role that family can play to improve these types of care. We will illustrate how family members can assist in the care of teenagers with diabetes, but that there are also serious risks actualized by such involvement. In particular, we will highlight ethical complications that arise when the role of a family member is changed from “parent” to “care provider.”
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| 2. |
- Gustafson, Deborah R.
(författare)
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Adipose Tissue Complexities in Dyslipidemias
- 2019
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Ingår i: Dyslipidemia. - London : IntechOpen. - 9781839680045 - 9781839680038 - 9781839680052 ; , s. 1-22
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Bokkapitel (refereegranskat)abstract
- Adipose tissue is the largest organ in the human body and, in excess, contributes to dyslipidemias and the dysregulation of other vascular and metabolic processes. Adipose tissue is heterogeneous, comprised of several cell types based on morphology, cellular age, and endocrine and paracrine function. Adipose tissue depots are also regional, primarily due to sex differences and genetic variation. Adipose tissue is also characterized as subcutaneous vs. visceral. In addition, fatty deposits exist outside of adipose tissue, such as those surrounding the heart, or as infiltration of skeletal muscle. This review focuses on adipose tissue and its contribution to dyslipidemias. Dyslipidemias are defined as circulating blood lipid levels that are too high or altered. Lipids include both traditional and nontraditional species. Leaving aside traditional definitions, adipose tissue contributes to dyslipidemias in a myriad of ways. To address a small portion of this topic, we reviewed (a) adipose tissue location and cell types, (b) body composition, (c) endocrine adipose, (d) the fat-brain axis, and (e) genetic susceptibility. The influence of these complex aspects of adipose tissue on dyslipidemias and human health, illustrating that, once again, that adipose tissue is a quintessential, multifunctional tissue of the human body, will be summarized.
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| 3. |
- Henein, Michael Y., et al.
(författare)
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Diabetes and coronary circulation : from pathology to imaging
- 2021
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Ingår i: Diabetes and cardiovascular disease. - Amsterdam : Elsevier. - 9780128174289 ; , s. 227-267
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Bokkapitel (refereegranskat)abstract
- Coronary artery disease (CAD) is the leading cause of mortality and morbidity among patients with diabetes mellitus. Despite the large fall in CAD mortality in the general population over the last four decades, the overall risk of CAD in people with diabetes did not change significantly. Compared to the general population, diabetics have a higher prevalence, extent, and severity of CAD and a higher risk of mortality due to myocardial infarction and to a lesser extent to stroke. Also, cardiovascular disease has been shown to develop earlier in individuals with diabetes and is followed by worse event-related survival than in nondiabetics. Although most data on the relationship between diabetes and CAD refer to type 2 diabetes, cardiovascular disease remains the leading cause of mortality even in patients with type 1 diabetes. Chronic hyperglycemia and insulin resistance have a key role in inducing coronary atherosclerosis by promoting inflammation and endothelial dysfunction. In diabetic patients, once the coronary atherogenesis has started, the progression from early lesions to plaque rupture or erosion follows the same pathological pathway as in the general population. Although the risk of CAD has been traditionally associated with coronary stenosis severity, more recent research has led to a paradigm shift, with more emphasis on total coronary plaque burden. Both clinical and postmortem studies have shown that diabetics have significantly greater total plaque burden compared to nondiabetics. Direct, invasive, and noninvasive visualization of atherosclerotic lesions allows accurate evaluation of the extent of disease and degree of plaque calcification. However, imaging of the presence and extent of plaque inflammatory activity, using positron emission tomography or cardiac magnetic resonance, may serve in identifying individuals with a more severe atherosclerotic disease who may benefit from intensive treatment.
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| 4. |
- Barbu, Andrea R, et al.
(författare)
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Gene Therapy
- 2010. - 4th edition
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Ingår i: Textbook of Diabetes. - Thousand Oaks, CA : Wiley-Blackwell. - 9781405191814 ; 25, s. 604-604
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 5. |
- Nilsson, Peter M, et al.
(författare)
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New Antidiabetic Agents for the Treatment of Heart Failure in Hypertensive Patients
- 2024. - 2
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Ingår i: Hypertension and Heart Failure : Epidemiology, Mechanisms and Treatment - Epidemiology, Mechanisms and Treatment. - 2366-4614 .- 2366-4606. - 9783031393143 - 9783031393150 ; , s. 79-371
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Bokkapitel (refereegranskat)abstract
- The development of newer glucose-lowering drugs for the treatment of type 2 diabetes in recent years, such as the SGLT-2 inhibitors and GLP-1 receptor agonists/analogues with well-documented clinical benefits from large trials, has influenced international guidelines. These drugs are able to reduce both macro- and microvascular events in patients with type 2 diabetes and to prevent worsening of diabetic nephropathy. One important aspect of these new drugs is also the ability to prevent or treat heart failure (HF) through improved cardiac metabolism, but also by lowering of blood pressure and improvement of central hemodynamics. In this review, the evidence for such effects on HF is discussed for each drug class separately and in combination. In the future there may come new opportunities for fixed drug combinations (FDC) to improve cost-effectiveness and compliance of diabetes treatment when antihypertensive, lipid-lowering, and glucose-lowering drugs are combined. As control of hypertension is of great importance for HF prevention in patients with diabetes in general, the combination of traditional antihypertensive drugs (i.e., blockers of the renin-angiotensin system) with newer glucose-lowering drugs that may also lower blood pressure could prove to be a successful and a very useful combination. Thus, further studies are warranted.
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| 6. |
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| 7. |
- Lerner, Ulf H, et al.
(författare)
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Cysteine proteinases in osteoclast function and recruitment
- 2004
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Ingår i: Biological Mechanisms of Tooth Movement and Craniofacial Adaptation. - Boston, Massachusetts, USA : Harvard Society for the Advancement of Orthodontics. - 0963204750 ; , s. 227-227
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 8. |
- Delli, Ahmed, et al.
(författare)
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Autoimmune (type 1) diabetes
- 2013
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Ingår i: The Autoimmune Diseases. - 0123849292 ; , s. 575-585
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Bokkapitel (refereegranskat)abstract
- Autoimmune (type 1) diabetes (AI-DM) is a multistage disorder. Children are born genetically predisposed to putative environmental exposures. These trigger an aggressive, selective and chronic autoimmune response against the pancreatic islet beta cells. This stage is marked by autoantibodies against insulin, glutamic acid decarboxylase (GAD65), IA-2 and the ZnT8 transporter. Progression to clinical onset of diabetes is highly variable but the time to onset is shortened with an increased number of islet autoantibodies. Both islet autoantibodies and diabetes are associated with HLA-DQ on chromosome 6. More than 50 non-HLA genetic factors, mostly associated with the human immune response also contribute. It remains to be clarified to what extent HLA-DQ and the non-HLA genes contribute to the initiation of the chronic islet autoimmunity, progression to diabetes, or both. Insulin replacement therapy is still the only treatment as all attempts to halt the loss of beta cells by immunosuppression or immune modulation have failed so far.
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| 9. |
- Jonsdottir, Ingibjörg H., et al.
(författare)
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Mental Health and Salivary Cortisol
- 2012
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Ingår i: The Role of Saliva Cortisol Measurement in Health and Disease. - : Bentham eBooks. - 9781608050710 - 9781608053421 ; , s. 129-166
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Bokkapitel (refereegranskat)abstract
- Abstract: The aim of this chapter was to analyze associations between measures of cortisol in salivaand mental health and to see if divergent results were functions of the methods used. Measures ofmental health outcome included Major Depressive Disorder (MDD), symptoms of depression, andsymptoms of anxiety, Burnout (BO), and Vital Exhaustion (VE). Only studies on otherwise healthyindividuals were included. Cortisol measures were grouped into single time point measures, measuresof deviations, laboratory test responses, Area Under the Curve (AUC), and response to dexamethasone.Some consistency is seen for MDD, mainly higher mean levels. The results regarding single measuresand depressive mood are less consistent, but the overall picture for depression shows poorer diurnaldeviation and response to stress. Inconsistency among papers studying depression seems to be relatedmainly to the study population. Very few significant findings were found for anxiety, therefore cortisoldoes not seem to be strongly related to anxiety. Most of the statistical analysis does not show asignificant relationship between BO and cortisol, and when these are present, the results areinconsistent. One explanation seems to be the measures of BO used, probably due to the differentconceptual basis for BO. VE measured using the Maastricht Questionnaire seems to be related to apoorer cortisol response to stress and poorer diurnal deviation. The coexistence of BO and VE in manystudies does make it difficult to conclude how the different concepts are related to cortisol. However, aninteresting difference appeared between MDD and VE in response to dexamethasone administration,showing lower suppression in MDD patients and higher suppression in VE patients. A generalconclusion for all mental health measures is that a large proportion of non-significant findings are dueto low power and few sampling days combined with low contrasts between study groups and withinstudy populations. Generally, deviation measures such as diurnal deviation seem to be more validmeasures compared with single measures to capture possible changes in the hypothalamus-pituitaryadrenal axis, measured using salivary cortisol.
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| 10. |
- Reinbothe, Thomas, 1981, et al.
(författare)
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Optogenetic Control of Pancreatic Islets
- 2016
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Ingår i: Methods in Molecular Biology, vol. 1408. - Heidelberg : Springer. - 1064-3745 .- 1940-6029. - 9781493935123 - 9781493935109 ; , s. 107-23
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Bokkapitel (refereegranskat)abstract
- In light of the emerging diabetes epidemic, new experimental approaches in islet research are needed to elucidate the mechanisms behind pancreatic islet dysfunction and to facilitate the development of more effective therapies. Optogenetics has created numerous new experimental tools enabling us to gain insights into processes little was known about before. The spatial and temporal precision that it can achieve is also attractive for studying the cells of the pancreatic islet and we set out to explore the possibilities of this technology for our purposes. We here describe how to use the islets of an "optogenetic beta-cell" mouse line in islet batch incubations and Ca(2+) imaging experiments. This protocol enables light-induced insulin release and provides an all-optical solution to control and measure intracellular Ca(2+) levels in pancreatic beta-cells. The technique is easy to set up and provides a useful tool for controlling the activity of distinct islet cell populations.
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