Diagnosis of Macrovascular Complications in Diabetes Mellitus Using Arterial Stiffness Measured by the Cardio-Ankle Vascular Index

Arterial anti-aging treatment is important, but there had not been a good marker of arterial aging. One candidate of the markers was arterial stiffness. But, it has been difficult to measure proper arterial stiffness invivo, noninvasively.

Diabetes Mellitus 

Pulse wave velocity (PWV) which was reflecting arterial stiffness, was used for last 30 years, but was inherently changed at the blood pressure at measuring time. The cardio-ankle vascular index (CAVI) was recently developed marker reflecting arterial stiffness of the arterial tree from the origin of the aorta to the ankle. The conspicuous feature of CAVI is independency from the blood pressure at measuring time. CAVI increased with aging both in males than in females. So, CAVI could be a good marker reflecting arterial aging. Furthermore, CAVI showed high value in most of those with various risks of coronary artery disease, and especially high in those with diabetes mellitus and even with prediabetes condition. Diabetes mellitus is kwon to be a strong factor for arterial aging. Read more>>>>>>

The Plausibility of Universal Health Care in the United States

Though the United States is one of the wealthiest nations in the world, the disparities in income are only surpassed by the inequalities in access to health care. Because of the close tie between the health care crisis and the fiscalhealth of the country as a whole, proposals have been made to introduce universal health care, to adapt existing systems and to support efforts, including what has been deemed “ObamaCare” to move towards greater accountability in obtaining and maintaining health insurance for the millions of uninsured and underinsured. Though most countries in the developed world perceive health care as a basic human right, the United States has yet to determine a way of creating and funding a single-payer universal health care system that will address the inequalities that exist and provide a better option for preventative medicine, interventive medicine, and long-term care.

One of the central problems for this country is that our political process is divided ideologically and health care paradigms do not appear to address issues on both sides. While there is support for a national health program that would ensure access to the working poor, fiscal conservatives view this as a system that cannot be afforded and that would expand debt in an uncontrollable manner. In fact, there is a clear division between the patriarchal perspectives of the democrats and the growing Tea Party call for personal responsibility.(Read More)

An Oral Abscess as the Entrance Leading to Endocarditis: A Sexual Behavior Role.

The risk factors for infective endocarditis (IE) in the population are changing: the reported worldwideincrease in the incidence of IE has been associated with the widespread use of medical devices and procedures responsible of heath care associated infection. 

Endocarditis incurred by Streptococcus agalactiae in adults (nonpregnant females and men) has increased in recent years, even though the source of infection due to this bacterium and the portal of entry are unclear and not often well documented.Concerning the possible sexual port of entry in the cause of endocarditis, this mode of transmission should be suspected in a search of clinical history, especially in recurrent endocarditis.(Read more)

Corticosteroid Administration in COPD: Summary of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guidelines 2017

Administration of Inhaled Corticosteroids (ICS) in Chronic Obstructive Pulmonary Disease (COPD) has always remained controversial because of its questionable benefit in this disease. Although several clinicians believe that corticosteroids have little or no role in controlling inflammation in COPD, its use in stable to heavilyexacerbated COPD has been in practice especially in the developing countrieswhere COPD is often over diagnosed/ underdiagnosed or misdiagnosed. Neutrophils being the crucial players in inflammation in COPD, steroids are considered to have a less functional effect on this type of inflammation as steroids especially glucocorticoids has been shown to enhance the survival of neutrophils and increase their functional responsiveness. Therefore, such treatment might lead to incurring detrimental effects on the patients by enhancing the exacerbation.

Although some evidence have suggested that some drugs such as β2-agonists, methylxanthines (theophylline) or antibiotics (macrolides) may somewhat facilitate corticosteroid sensitivity in COPD, their functional aspects and clinical relevance are not quite clear. Moreover, since the effect of ICS may be modulated by these other add-on drugs, the effect of ICS alone in COPD has remained questionable. Most of the studies showed that ICS alone does not effectively reverse the progressive decline of FEV1 or mortality in patients with COPD. The TOwards a Revolution in COPD Health (TORCH) trial showed higher mortality among COPD patients treated with ICS alone than those who received ICS (Inhaled Corticosteroids) +LABA (Long acting β2-agonists).(Read more)