This was a retrospective and descriptive study conducted from 1 July 2006 to 31 July 2011 and carried on 122 cases of diabetic foot collected a total of 706 diabetic patients hospitalized over a period of 5 years. Obj...This was a retrospective and descriptive study conducted from 1 July 2006 to 31 July 2011 and carried on 122 cases of diabetic foot collected a total of 706 diabetic patients hospitalized over a period of 5 years. Objective: To study the characteristics of diabetic feet in Cotonou. Results: The mean age of patients was 58.05 years ± 10.65 years, ranging from 35 years to 70 years. The sex ratio was 1.5. Duration of diabetes before the onset of diabetic foot was 11 years. The overall prevalence of diabetic foot was 21.53%. Of these, 95% had neuropathy, 70.40% had arterial disease and all had a foot infection. The amputation rate was 31.96% and the mortality rate was 17.21%. Conclusion: The occurrence of diabetic foot is earlier than in the West, and hence there is a need for early treatment of diabetes.展开更多
Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can...Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can predispose to a number of pathological changes and clinical diseases,including diabetes;hypertension;atherosclerosis;coronary artery disease and stroke;obstructive sleep apnea;depression;weight-related arthropathies and endometrial and breast cancer.A body weight 20%above ideal for age,gender and height is a severe health risk.Bariatric surgery is a set of surgical methods to treat morbid obesity when other treatments such as diet,increased physical activity,behavioral changes and drugs have failed.The two most common procedures currently used are sleeve gastrectomy and gastric bypass.This procedure has gained popularity recently and is generally considered safe and effective.Although current data show that perioperative mortality is low and better control of comorbidities and short-term complications is achieved,more randomized trials are needed to evaluate the long-term outcomes of bariatric procedures.This review aims to synthesize and summarize the growing evidence on the long-term effectiveness,outcomes and complications of bariatric surgery.展开更多
Introduction: The pathologies associated with excessive weight gain during pregnancy are numerous and frequent. They are the cause of significant maternal and perinatal morbidity and mortality and thus pose a real pub...Introduction: The pathologies associated with excessive weight gain during pregnancy are numerous and frequent. They are the cause of significant maternal and perinatal morbidity and mortality and thus pose a real public health problem. Patients and method: The main objective of our work was to study the influence of excessive weight gain on maternal and perinatal morbidity and mortality in a university hospital in Cotonou. Study method: The study took place at the CUGO. This was a descriptive and analytical study with retrospective data collection over a period of 10 years from January 1, 2012 to December 31, 2021. The analysis focused on the description of pregnant women and the search for factors associated with an excessive weight gain during pregnancy and which influence maternal and perinatal prognosis. The different odds ratios and their confidence intervals were calculated. The significance level was 5%. Results: A total of 690 pregnant women were included and divided into four sub-populations according to their pre-gestational or first trimester BMI: 05.94% underweight pregnant women, 41.74% normal BMI pregnant women, 28.55% of overweight pregnant women and 23.77% obese pregnant women. The average age of pregnant women was 30.41 years ± 5.40 years. They were civil servants (35.80%) and resided in Cotonou in 93.91% of cases. Pregnant women had a history of hypertension in nearly 3% of cases. Pregnancy hypertension (07.97%) was the main pathology associated with pregnancy in our study. Weight gain was excessive in overweight pregnant women and obese pregnant women in the same proportion 41.12%. The average weight gain was 9.42 kg for underweight pregnant women, 8.35 kg for pregnant women with a normal BMI, 8.46 kg for overweight pregnant women and 7.45 kg for obese pregnant women. Pregnant women who had gained excessive weight during pregnancy had a 9 times higher risk of having pregnancy-induced hypertension (OR = 9.5 and p ≤ 0.0001). They also presented a 6 times higher risk of having pre-eclampsia (OR = 6.6;p ≤ 0.0001). The risk of gestational diabetes is also high (OR = 3.82;p ≤ 0.0001). There is also a risk of macrosomia (OR = 3.33 and p = 0.007) and the risk of cesarean delivery 2 times higher: OR = 2.15 and p = 0.0004. There was no statistically significant link between excessive weight gain and term at delivery, the condition of the newborn at birth, and neonatal mortality. Conclusion: Excessive weight gain during pregnancy in our study was assessed in several pregnant women with a high prevalence. It is the source of several maternal and fetal complications.展开更多
Diabetes mellitus is one of the most common comorbid conditions encountered in patients with severe acute respiratory syndrome coronavirus 2 infection accompanied by significantly increased mortality,prolonged hospita...Diabetes mellitus is one of the most common comorbid conditions encountered in patients with severe acute respiratory syndrome coronavirus 2 infection accompanied by significantly increased mortality,prolonged hospital stay,and requirement of invasive mechanical ventilation.This review aims to present the effectiveness and safety profile of available coronavirus disease 2019(COVID-19)vaccines in people with diabetes as a potential cause of hesitancy for vaccination.Data from published research proves a robust immune response following immunization for COVID-19 in diabetic patients with substantial production of virus-neutralizing antibodies;however,the observed immune response was unequivocally weaker than that in individuals without diabetes.This observation was further enhanced by the findings that worse glycemic control was associated with more suppressed antibody production.In contrast,individuals with optimal glycemic control performed similarly to healthy controls.In addition to the need for strict glucose monitoring and adequate diabetes treatment,those findings reinforce the concept of diabetes-induced secondary immune deficiency and necessitate the application of booster doses to diabetic patients with priority.Nevertheless,after vaccination,reported adverse events were not different from those in the general population.No increase in severe adverse events was documented.While single case reports detected transient increases in blood glucose post-vaccination,more extensive trials could not replicate such a relationship.展开更多
Today the HIV infection is a chronic disease with significantly longer duration of the life of the patients. Problems of pressing interest are the persistent immune activation and chronic inflammation during the treat...Today the HIV infection is a chronic disease with significantly longer duration of the life of the patients. Problems of pressing interest are the persistent immune activation and chronic inflammation during the treatment with antiretroviral therapy. Taking this into account, different factors which could affect the immune system and the progress of the HIV infection are being researched. Vitamin D (25(OH)D) is one of those factors if we take note of its effect on the innate and acquired immunity. The aim of this study was to assess 25-hydroxyvitamin D (vitamin D) status in one part of the Bulgarian HIV-infected adult population and to assess connection between 25-hydroxyvitamin D (vitamin D) status and plasma levels of some major cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ). The study includes 145 HIV-positive patients, who are being monitored in the Department for acquired immune deficiency at Specialized Hospital for Infectious and Parasitic Diseases “Proff. Ivan Kirov”—Sofia. From all of the monitored patients only in 15% of the tested we found normal 25(OH)D serum levels, and in 12% of the patients we found deficiency. The largest group is that of patients with insufficiency of vitamin D. We didn’t discovered significant difference in the 25(OH)D average values between men and women. There were no significant differences in the average values of the 25(OH)D serum levels when dividing the patients according to their antiretroviral therapy, but after separating the patients by gender, we found that the untreated women had average values of 25(OH)D higher than that of the women treated with EFV. On the next stage of the survey on the 60 HIV-infected patients, who are from the first tested group, we additionally defined the cytokine profile. Our results suggests that increasing 25(OH)D deficiency worsens the damaging of the cellular immune response. The lower levels of vitamin Dare associated with increased levels of IL-6, decreased levels of IL-10, IFN-γ and TNF-α. There’s active immune inflammation when there are reduced 25(OH)D serum levels and it leads to stimulated secretion of the regulatory cytokines and suppression of the Th1 antiviral response. The phase of advanced 25(OH)D deficiency is characterized by parallel depletion of the regulatory and effecter capabilities of CD4 lymphocytes. The recovery of the CD4 lymphocyte pool is difficult because of the lower than average 25(OH)D serum levels, regardless of the conducted antiretroviral therapy.展开更多
Background: Osteoporosis is a systemic metabolic disease of skeleton, characterized by decrease of bone mass and impaired microarchitecture of bone tissue, leading to increased fragility and fractures. Methods: We scr...Background: Osteoporosis is a systemic metabolic disease of skeleton, characterized by decrease of bone mass and impaired microarchitecture of bone tissue, leading to increased fragility and fractures. Methods: We screened 1855 postmenopausal female, aged from 50 to 80, the residents of Tashkent, Namangan and Qarshi, three cities with the largest populations in Uzbekistan. The duration of postmenopausal period was ≥1 year. Results: The study revealed unequal prevalence of OP with the least in Qarshi (27.3%) compared to Tashkent (33.5%) and Namangan (51.1%). Conclusions: Osteoporosis is common among women at age 50 and over, who live in the cities with largest population in Uzbekistan (Tashkent, Namangan and Qarshi). The risk factors in the studied cohort of women included decrease of body mass, irregular consumption of dairy products and irregular physical activity, history of fractures, and duration of menopause.展开更多
The effect of progesterone therapy on E2/P ratio changes during the luteal phase, and its consequences are on mastalgia and cyst, within a fibrocystic breast disease (FBD). Fifty women with FBD were included. Informat...The effect of progesterone therapy on E2/P ratio changes during the luteal phase, and its consequences are on mastalgia and cyst, within a fibrocystic breast disease (FBD). Fifty women with FBD were included. Information for mastalgia and mastodynia were checked with a questionnaire. All women had (E2) and (P) concentration checked before and during the therapy on the 21st and 24th day of a cycle, ultrasound measured size and number of cysts before and during the therapy. T-test, X<sup>2</sup>-test, McNemar test, Wilcoxon test and Friedman test were used for statistics. There was a decrease E2/P relation during the therapy vs. before the treatment p < 0.01, as well as the decrease of E2 level on the 24th day during the therapy vs. same day of E2 level, before the therapy (p = 0.164). There was an increase of p level on the 24th day vs. on 24th day before the therapy (p < 0.001). During the therapy, it was found decrease in pain and tension (p < 0.001), and the number and size of the cysts (p < 0.001). Mastalgia and mastodynia significantly decreased during the local p gel therapy, and there was a significantly lower number and size of the cysts in patients with FBD.展开更多
Background: In 2008 Non-communicable diseases (NCDs) were responsible for 63% of deaths worldwide and 80% of these deaths occurred in developing countries. Four of them were responsible for more than 80% of mortality ...Background: In 2008 Non-communicable diseases (NCDs) were responsible for 63% of deaths worldwide and 80% of these deaths occurred in developing countries. Four of them were responsible for more than 80% of mortality from NCDs, which were cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. They shared the same risk factors. Objective: To determine the prevalence of NCD risk factors in patients admitted to consult in the outpatient unit of the National Teaching Hospital of Cotonou. Patients and Methods: This was a transversal, descriptive and analytical study which took place from 15 June 2011 to 16 September 2011. It focused on 1000 subjects found after a recruitment of all patients coming to consult during the study period. The collection technique was a questionnaire followed by physical measures (weight, height, blood pressure and waist) and biological measures (fasting glucose and cholesterol). The data were analyzed with the software Epi-3.3.2 info. Results: The mainly prevalent behavioural risk factors were smoking (10.2%), alcohol consumption (60.3%), insufficient intake of fruits and vegetables (84.2%), and physical inactivity (57.6%). The prevalent physical risk factors were hypertension (47.4%), obesity (27.5%), and overweight (35.3%). The prevalent biological risk factors were diabetes (28.5%), and hypercholesterolemia (10.4%). The level of cardiovascular risk was higher than 40% in 81 people (8.1%). Conclusion: This study shows the importance of risk factors for NCDs in outpatient Unit in the National Teaching Hospital of Cotonou.展开更多
Objective: To study the epidemiological, clinical and therapeutic profile of diabetic metabolic emergencies. Patients and methods: This was a prospective study in descriptive and analytical referred conducted over a p...Objective: To study the epidemiological, clinical and therapeutic profile of diabetic metabolic emergencies. Patients and methods: This was a prospective study in descriptive and analytical referred conducted over a period of 6 months in the National Teaching Hosptial HKM of Cotonou December 1, 2011 to May 31, 2012. The patients included in the case of our study were those who, conscious or comatose, had submitted a diabetic hypoglycemia or abnormal blood sugar (2.5 g/l), with a positive glycosuria and ketonuria positive or not. All patients gave their consent for this study. Results: 2786 patients were admitted to the emergency room, 57 (2%) of acute metabolic decompensation of diabetes. DKA accounted for 1.1%, hyperosmolar hyperglycemic syndrome 0.5% and 0.4% hypoglycemia. For hyperglycemic decompensation, sex ratio was 0.8 for females with a mean age of 50.7 ± 16.9 (16-84). For hypoglycemia, male gender was predominant. As decompensation factors for hyperglycemia, infection was found in 54% (n = 30) of cases and stroke by 29% hypertension (n = 15). As for hypoglycemia triggers were dominated by dietary error (50%) and therapeutic errors (25%). 63% (n = 36) of patients underwent resuscitation. More than 3 out of 4 patients were resuscitated to insulin. 98% of patients were rehydrated. The outcome was favorable in 56% of cases. The death rate was 25 % (n = 14). Conclusion: Diabetes mellitus is a serious condition and its severity is mainly due to complications which can be acute or chronic.展开更多
Pancreatic islet transplantation is a minimally invasive procedure aiming to reverse the effects of insulin deficiency in patients with type 1 diabetes(T1D)by transplanting pancreatic beta cells.Overall,pancreatic isl...Pancreatic islet transplantation is a minimally invasive procedure aiming to reverse the effects of insulin deficiency in patients with type 1 diabetes(T1D)by transplanting pancreatic beta cells.Overall,pancreatic islet transplantation has improved to a great extent,and cellular replacement will likely become the mainstay treatment.We review pancreatic islet transplantation as a treatment for T1D and the immunological challenges faced.Published data demonstrated that the time for islet cell transfusion varied between 2 and 10 h.Approximately 54%of the patients gained insulin independence at the end of the first year,while only 20%remained insulin-free at the end of the second year.Eventually,most transplanted patients return to using some form of exogenous insulin within a few years after the transplantation,which imposed the need to improve immunological factors before transplantation.We also discuss the immunosuppressive regimens,apoptotic donor lymphocytes,anti-TIM-1 antibodies,mixed chimerism-based tolerance induction,induction of antigen-specific tolerance utilizing ethylene carbodiimide-fixed splenocytes,pretransplant infusions of donor apoptotic cells,B cell depletion,preconditioning of isolated islets,inducing local immunotolerance,cell encapsulation and immunoisolation,using of biomaterials,immunomodulatory cells,etc.展开更多
Objective To study the fasting serum levels of obesity related factors: FFA, leptin and adi-ponectin in subjects with varying glucose tolerance and their relationship with BMI, insulin sensitivity index and isletbeta-...Objective To study the fasting serum levels of obesity related factors: FFA, leptin and adi-ponectin in subjects with varying glucose tolerance and their relationship with BMI, insulin sensitivity index and isletbeta-cell function. Methods Serum levels of FFA, leptin and adiponectin in 24 normal, 32 simple obese, 34IGT and 36 T2DM subjects were measured by ACS-ACOD assay or RIA. Results The serum levels of leptin andFFA in three groups:simple obese, IGT and DM were much higher than those in normal control (P <0. 001). Incontrast, serum level of adiponectin of simple obese, IGT and DM groups were significant lower than that of normalcontrol, among them DM subjects had the lowest level (P <0. 001). Correlation analysis showed that FFA was pos-itively correlated to BMI, WHR, FBG, fasting insulin level and negatively correlated to SI; adiponectin was negativelycorrelated to BMI, WHR, FBG, PBG, but positively correlated to SI and AIRg; and leptin was positively correlated toBMI, fasting insulin and AIRg when negatively correlated to FBG and SI. None of them was correlated to age.Conclusion Subjects with insulin resistance have high serum FFA and leptin levels but low serum adiponectin level.With the glucose tolerance deterioration, serum FFA level increases much higher while the adiponectin deceases muchlower. Unlike insulin, none of these obesity related factors can be used as the simple indicating or determining factorof SI, though each of them, to different extent, takes part in the development of insulin resistance.展开更多
Non-healing diabetic foot ulcers(DFU)are the most notable and striking complications of diabetes mellitus.More than 25% of nonhealing DFU can ultimately lead to amputation of the lower extremity within 6-18 mo after t...Non-healing diabetic foot ulcers(DFU)are the most notable and striking complications of diabetes mellitus.More than 25% of nonhealing DFU can ultimately lead to amputation of the lower extremity within 6-18 mo after the first manifestation of the wound.Although wound healing is complex,nutritional status is crucial in soft tissue repair.Malnutrition is highly prevalent and overlooked in patients with diabetes and chronic wounds.Moreover,to date,we do not have clear recommendations or evidence about the use of nutritional supplements for improving wound healing in patients with DFU.In this article the authors briefly analyzed the current evidence on the use of nutritional supplements of proteins or amino acids,fatty acids,probiotics,vitamins,and trace elements in the wound healing process in patients with DFU.展开更多
Background: The prevalence of child obesity is increasing rapidly worldwide as well as Turkey due to skipped main meals and increased snacking. The objectives were to study the prevalence rates of overweight and obesi...Background: The prevalence of child obesity is increasing rapidly worldwide as well as Turkey due to skipped main meals and increased snacking. The objectives were to study the prevalence rates of overweight and obesity in a group of Turkish children, and to analyze the relationship between eating habits and lifestyle and obesity. Methods: The study was carried out in 6 schools in urban regions in the city of Eskisehir, Western Turkey between February and May2008. Atotal of 1421 students aged 7 - 14 years (708 boys and 713 girls) were examined. Eating habits and life-style were obtained by evaluation of a standard set of 15 questions prepared using the literature. Results: Most obese students reported having a snack in the afternoon, not spending at least five hours of leisure time per week in physical activities, being high income level, that their mother’ education level was university, eating less fruits, eating less vegetables, having more dessert after any meal, eating more potato chips, watching television more, living a physically active life less, less breast feeding, that their father consumed alcohol, that their father was overweight/ obese, their mother wase overweight/obese (statistically important relationships for each one). Conclusions: A small portion of 7 - 14-year-old Turkish children are at increased health risk owing to overweight and obesity in an urban po- pulation in a developing country.展开更多
Objective: To evaluate vitamin D status in relation to serum levels for parathyroid hormone (PTH) and corrected calcium among endocrine outpatients. Methods: A total of 760 patients (mean(SD) age: 40.0(12.6) years, 94...Objective: To evaluate vitamin D status in relation to serum levels for parathyroid hormone (PTH) and corrected calcium among endocrine outpatients. Methods: A total of 760 patients (mean(SD) age: 40.0(12.6) years, 94.6% were females) admitted to our endocrinology outpatient clinic were included and evaluated with respect to patient demographics, serum levels for 25-hydroxyvitamin D (25(OH) D, ng/mL), PTH (pg/mL) and corrected calcium (mg/dL) as well as the vitamin D status. Results: Vitamin D deficiency was determined in 65.0% and elevated PTH levels in 20.3% of patients. iPTH levels were significantly higher in females than in males (58.9(40.4) vs. 45.1(26.2) pg/mL, p = 0.031) and in summer than in winter cases (63.9(47.7) vs. 54.2(32.8) pg/mL, p = 0.002), whereas no difference was found in serum levels for 25(OH) D, corrected calcium and phosphate with respect to gender and season. Significantly higher levels for iPTH were noted in vitamin D deficient patients (60.7(43.9) pg/mL) than in normal (51.1(33.4) pg/mL) and vitamin D insufficient (57.1(26.0) pg/mL) cases (p = 0.03). iPTH levels were correlated positively with age (r = 0.116, p = 0.001) and negatively with corrected calcium (r = −0.097, p = 0.008), P (r = −0.224, p = 0.000) and 25(OH) D (r = −0.134, p = 0.000), whereas no correlation was noted between 25(OH) D and corrected calcium levels. Conclusion: Our findings indicated that vitamin D deficiency in 65.0%, whereas PTH elevation only in 20.3% of endocrine outpatients, despite the significantly negative correlation of PTH to 25(OH) D and significantly higher levels of PTH among vitamin D deficient cases than in vitamin D insufficient and sufficient cases. Gender’s and seasonal differences had influence on serum levels for PTH but not on either 25(OH) D or corrected calcium, and no correlation was evident between 25(OH) D and corrected calcium levels.展开更多
Apelin is a new adipokine associated with obesity. Data about the relationship of apelin to the metabolic syndrome (MS) are still scarce. Late-onset hypogonadism (LOH) is common in men with MS, but we did not find dat...Apelin is a new adipokine associated with obesity. Data about the relationship of apelin to the metabolic syndrome (MS) are still scarce. Late-onset hypogonadism (LOH) is common in men with MS, but we did not find data about the levels of apelin in men with LOH. The aim of this study is to determine the levels of apelin in men with MS with or without LOH. Patients and Methods: 99 men are included in the study. Of them 65 have MS (IDF 2005) and they are divided according to their morning total testosterone (TT) level (cutoff 10.4 nmol/l) into two groups: MS-low T (N = 21) and MS-normal T (N = 44). The control group consists of 34 men without MS and with normal T. Apelin is determined in serum using enzyme linked immunosorbent assay. Some of the men were additionally assigned to testosterone treatment and monitored. Results: MS men are at mean age (±SD) = 50.4 ± 9.6 years and TT = 13.6 ± 5.4 nmol/l. The control group is at age = 51.5 ± 6.4 years (NS) and TT = 17.9 ± 5.6 nmol/l (p 0.001). The levels of apelin are higher in the MS group—1.61 ± 0.53 ng/ml compared to the control one—1.38 ± 0.57 ng/ml (p 0.05). There is no difference between MS-lowT—1.53 ± 0.52 ng/ml and MS-normal T —1.65 ± 0.53 ng/ml sub-groups. The MS-normal T differs from the control group (p 0.05). Significant correlation of testosterone with apelin levels is not found. Although apelin correlates with other laboratory parameters: LDL-levels in the MS-patients (Pearson’s = 0.311, p 0.05);HbA1c in men with T2DM (Pearson’s = 0.285, p 0.05);serum creatinine levels (Pearson’s = 0.257, p 0.001). The patients that are assigned to testosterone substitution show a trend for lowering apelin levels. Conclusions: In this study, higher apelin levels are found in the presence of MS compared to healthy men, but do not differ between men having MS with low or normal T.展开更多
Objective: To investigate after intracytoplasmic sperminjection(ICSI) the paternal-derived pronuclei of zygotes with three pronuclei(3PN) for numerical-chromosome anomalies by using fluorescence in situ hybridization....Objective: To investigate after intracytoplasmic sperminjection(ICSI) the paternal-derived pronuclei of zygotes with three pronuclei(3PN) for numerical-chromosome anomalies by using fluorescence in situ hybridization. Design: A total of 211 ICSI 3PN zygotes have been analyzed for numerical-chromosome anomalies in paternally derived pronuclei and compared with the group of 82 zygotes originated during IVF. In the ICSI group, 163 zygotes were evaluated for numerical-chromosome anomalies by using DNA probes for chromosomes 18, X, and Y, and 48 zygotes, for chromosomes 21, X, and Y. In the IVF group, 68 zygotes were evaluated for numerical-chromosome anomalies by using probes for chromosomes 18, X, and Y, and 14 zygotes, by using chromosomes 21, X, and Y. Setting and Patient(s): Tripronuclear zygotes were obtained from 74 and 176 patients participating in IVF and ICSI treatment cycles at a university hospital in Switzerland. Intervention(s): To evaluate the frequency of numerical-chromosome anomalies in different populations of infertile patients, a total of 211 ICSI zygotes were divided into three groups of zygotes from men with oligozoospermia(n=124), severe oligozoosper-mia(n=53), and azoospermia(n=34). Main Outcome Measure(s): Incidence of sex-chromosome aneuploidy, diploidy, and aneuploidy for chromosomes 18 or 21. Result(s): Overall incidence of numerical-chromosome anomalies in paternal-derived pronuclei after ICSI(9.5%) was significantly higher than the rate found in paternal-derived pronuclei of IVF zygotes(1.2%). Among ICSI zygotes, sex-chromosome aneuploidy(5.2%) and diploidy(2.8%) were two dominant numerical anomalies in paternal-derived pronuclei. In contrast, aneuploidy for autosomes 18 or 21 was not significantly different when comparing ICSI with IVF zygotes. Regarding different groups of infertile patients, the highest incidence of numerical chromosome anomalies was found in zygotes originating from men with severe oligozoospermia(13.2%), followed by those originating from men with azoospermia(8.8%) and oligozoospermia(8.1%). Conclusion(s): Sex-chromosome aneuploidy and diploidy were the most frequent numerical-chromosome anomalies found in paternal pronuclei of ICSI 3PN zygotes. Surprisingly, no statistically significant difference in the incidence of numerical-chromosome anomalies was observed in the three groups of pronuclei derived from men with oligozoospermia, severe oligozoospermia, and azoospermia.展开更多
A candidate identification questionnaire (CIQ) was tested to determine its predictive value for patient-reported satisfaction in patients switched from once-weekly or once-daily treatment with a bisphosphonate to once...A candidate identification questionnaire (CIQ) was tested to determine its predictive value for patient-reported satisfaction in patients switched from once-weekly or once-daily treatment with a bisphosphonate to once-monthly dosing. This was a prospective, open-label, multicenter international study in patients with postmenopausal osteoporosis who had been receiving once-daily or once-weekly alendronate or risendronate for at least 3 months. Patients completed a CIQ, then commenced 150 mg monthly ibandronate for 6 months. Patients completed the Osteoporosis Patient Satisfaction Questionnaire (OPSAT-QTM) at baseline for 6 months. Scores were converted to composite satisfaction scores (CSS, scale 0-100). Totally 677 patients completed a CIQ, 645 were enrolled in the treatment phase and comprised the intent-to-treat (ITT) population, and 630 completed the study. In the ITT population, 68.1% patients answered “yes” to one or more CIQ questions. OPSAT-Q scores increased for the convenience, quality of life and overall satisfaction domains (p scores for the side effects domains were significant (p < 0.001) in the CIQ “yes” group, but not for the degree of bother (decrease in mean of 0.1 points, p = 0.50) or duration (no change, p = 0.84) of non-gastrointestinal side effects. Of 638 patients who completed the preference questionnaire, 93.0% of patients preferred the once-monthly dosing schedule and 563 patients (90.7%) found it more convenient. The most common adverse events were dyspepsia (1.9%), nausea (1.1%), and upper abdominal pain (0.9%). Patients are likely to prefer treatment with monthly ibandronate to a weekly or monthly bisphosphonate irrespective of their stated preference before switching treatment.展开更多
文摘This was a retrospective and descriptive study conducted from 1 July 2006 to 31 July 2011 and carried on 122 cases of diabetic foot collected a total of 706 diabetic patients hospitalized over a period of 5 years. Objective: To study the characteristics of diabetic feet in Cotonou. Results: The mean age of patients was 58.05 years ± 10.65 years, ranging from 35 years to 70 years. The sex ratio was 1.5. Duration of diabetes before the onset of diabetic foot was 11 years. The overall prevalence of diabetic foot was 21.53%. Of these, 95% had neuropathy, 70.40% had arterial disease and all had a foot infection. The amputation rate was 31.96% and the mortality rate was 17.21%. Conclusion: The occurrence of diabetic foot is earlier than in the West, and hence there is a need for early treatment of diabetes.
基金Supported by the European Union-NextGenerationEU,through the National Recovery and Resilience Plan of the Republic of Bulgaria,No. BG-RRP-2.004-0008-C01。
文摘Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can predispose to a number of pathological changes and clinical diseases,including diabetes;hypertension;atherosclerosis;coronary artery disease and stroke;obstructive sleep apnea;depression;weight-related arthropathies and endometrial and breast cancer.A body weight 20%above ideal for age,gender and height is a severe health risk.Bariatric surgery is a set of surgical methods to treat morbid obesity when other treatments such as diet,increased physical activity,behavioral changes and drugs have failed.The two most common procedures currently used are sleeve gastrectomy and gastric bypass.This procedure has gained popularity recently and is generally considered safe and effective.Although current data show that perioperative mortality is low and better control of comorbidities and short-term complications is achieved,more randomized trials are needed to evaluate the long-term outcomes of bariatric procedures.This review aims to synthesize and summarize the growing evidence on the long-term effectiveness,outcomes and complications of bariatric surgery.
文摘Introduction: The pathologies associated with excessive weight gain during pregnancy are numerous and frequent. They are the cause of significant maternal and perinatal morbidity and mortality and thus pose a real public health problem. Patients and method: The main objective of our work was to study the influence of excessive weight gain on maternal and perinatal morbidity and mortality in a university hospital in Cotonou. Study method: The study took place at the CUGO. This was a descriptive and analytical study with retrospective data collection over a period of 10 years from January 1, 2012 to December 31, 2021. The analysis focused on the description of pregnant women and the search for factors associated with an excessive weight gain during pregnancy and which influence maternal and perinatal prognosis. The different odds ratios and their confidence intervals were calculated. The significance level was 5%. Results: A total of 690 pregnant women were included and divided into four sub-populations according to their pre-gestational or first trimester BMI: 05.94% underweight pregnant women, 41.74% normal BMI pregnant women, 28.55% of overweight pregnant women and 23.77% obese pregnant women. The average age of pregnant women was 30.41 years ± 5.40 years. They were civil servants (35.80%) and resided in Cotonou in 93.91% of cases. Pregnant women had a history of hypertension in nearly 3% of cases. Pregnancy hypertension (07.97%) was the main pathology associated with pregnancy in our study. Weight gain was excessive in overweight pregnant women and obese pregnant women in the same proportion 41.12%. The average weight gain was 9.42 kg for underweight pregnant women, 8.35 kg for pregnant women with a normal BMI, 8.46 kg for overweight pregnant women and 7.45 kg for obese pregnant women. Pregnant women who had gained excessive weight during pregnancy had a 9 times higher risk of having pregnancy-induced hypertension (OR = 9.5 and p ≤ 0.0001). They also presented a 6 times higher risk of having pre-eclampsia (OR = 6.6;p ≤ 0.0001). The risk of gestational diabetes is also high (OR = 3.82;p ≤ 0.0001). There is also a risk of macrosomia (OR = 3.33 and p = 0.007) and the risk of cesarean delivery 2 times higher: OR = 2.15 and p = 0.0004. There was no statistically significant link between excessive weight gain and term at delivery, the condition of the newborn at birth, and neonatal mortality. Conclusion: Excessive weight gain during pregnancy in our study was assessed in several pregnant women with a high prevalence. It is the source of several maternal and fetal complications.
文摘Diabetes mellitus is one of the most common comorbid conditions encountered in patients with severe acute respiratory syndrome coronavirus 2 infection accompanied by significantly increased mortality,prolonged hospital stay,and requirement of invasive mechanical ventilation.This review aims to present the effectiveness and safety profile of available coronavirus disease 2019(COVID-19)vaccines in people with diabetes as a potential cause of hesitancy for vaccination.Data from published research proves a robust immune response following immunization for COVID-19 in diabetic patients with substantial production of virus-neutralizing antibodies;however,the observed immune response was unequivocally weaker than that in individuals without diabetes.This observation was further enhanced by the findings that worse glycemic control was associated with more suppressed antibody production.In contrast,individuals with optimal glycemic control performed similarly to healthy controls.In addition to the need for strict glucose monitoring and adequate diabetes treatment,those findings reinforce the concept of diabetes-induced secondary immune deficiency and necessitate the application of booster doses to diabetic patients with priority.Nevertheless,after vaccination,reported adverse events were not different from those in the general population.No increase in severe adverse events was documented.While single case reports detected transient increases in blood glucose post-vaccination,more extensive trials could not replicate such a relationship.
文摘Today the HIV infection is a chronic disease with significantly longer duration of the life of the patients. Problems of pressing interest are the persistent immune activation and chronic inflammation during the treatment with antiretroviral therapy. Taking this into account, different factors which could affect the immune system and the progress of the HIV infection are being researched. Vitamin D (25(OH)D) is one of those factors if we take note of its effect on the innate and acquired immunity. The aim of this study was to assess 25-hydroxyvitamin D (vitamin D) status in one part of the Bulgarian HIV-infected adult population and to assess connection between 25-hydroxyvitamin D (vitamin D) status and plasma levels of some major cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ). The study includes 145 HIV-positive patients, who are being monitored in the Department for acquired immune deficiency at Specialized Hospital for Infectious and Parasitic Diseases “Proff. Ivan Kirov”—Sofia. From all of the monitored patients only in 15% of the tested we found normal 25(OH)D serum levels, and in 12% of the patients we found deficiency. The largest group is that of patients with insufficiency of vitamin D. We didn’t discovered significant difference in the 25(OH)D average values between men and women. There were no significant differences in the average values of the 25(OH)D serum levels when dividing the patients according to their antiretroviral therapy, but after separating the patients by gender, we found that the untreated women had average values of 25(OH)D higher than that of the women treated with EFV. On the next stage of the survey on the 60 HIV-infected patients, who are from the first tested group, we additionally defined the cytokine profile. Our results suggests that increasing 25(OH)D deficiency worsens the damaging of the cellular immune response. The lower levels of vitamin Dare associated with increased levels of IL-6, decreased levels of IL-10, IFN-γ and TNF-α. There’s active immune inflammation when there are reduced 25(OH)D serum levels and it leads to stimulated secretion of the regulatory cytokines and suppression of the Th1 antiviral response. The phase of advanced 25(OH)D deficiency is characterized by parallel depletion of the regulatory and effecter capabilities of CD4 lymphocytes. The recovery of the CD4 lymphocyte pool is difficult because of the lower than average 25(OH)D serum levels, regardless of the conducted antiretroviral therapy.
文摘Background: Osteoporosis is a systemic metabolic disease of skeleton, characterized by decrease of bone mass and impaired microarchitecture of bone tissue, leading to increased fragility and fractures. Methods: We screened 1855 postmenopausal female, aged from 50 to 80, the residents of Tashkent, Namangan and Qarshi, three cities with the largest populations in Uzbekistan. The duration of postmenopausal period was ≥1 year. Results: The study revealed unequal prevalence of OP with the least in Qarshi (27.3%) compared to Tashkent (33.5%) and Namangan (51.1%). Conclusions: Osteoporosis is common among women at age 50 and over, who live in the cities with largest population in Uzbekistan (Tashkent, Namangan and Qarshi). The risk factors in the studied cohort of women included decrease of body mass, irregular consumption of dairy products and irregular physical activity, history of fractures, and duration of menopause.
文摘The effect of progesterone therapy on E2/P ratio changes during the luteal phase, and its consequences are on mastalgia and cyst, within a fibrocystic breast disease (FBD). Fifty women with FBD were included. Information for mastalgia and mastodynia were checked with a questionnaire. All women had (E2) and (P) concentration checked before and during the therapy on the 21st and 24th day of a cycle, ultrasound measured size and number of cysts before and during the therapy. T-test, X<sup>2</sup>-test, McNemar test, Wilcoxon test and Friedman test were used for statistics. There was a decrease E2/P relation during the therapy vs. before the treatment p < 0.01, as well as the decrease of E2 level on the 24th day during the therapy vs. same day of E2 level, before the therapy (p = 0.164). There was an increase of p level on the 24th day vs. on 24th day before the therapy (p < 0.001). During the therapy, it was found decrease in pain and tension (p < 0.001), and the number and size of the cysts (p < 0.001). Mastalgia and mastodynia significantly decreased during the local p gel therapy, and there was a significantly lower number and size of the cysts in patients with FBD.
文摘Background: In 2008 Non-communicable diseases (NCDs) were responsible for 63% of deaths worldwide and 80% of these deaths occurred in developing countries. Four of them were responsible for more than 80% of mortality from NCDs, which were cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. They shared the same risk factors. Objective: To determine the prevalence of NCD risk factors in patients admitted to consult in the outpatient unit of the National Teaching Hospital of Cotonou. Patients and Methods: This was a transversal, descriptive and analytical study which took place from 15 June 2011 to 16 September 2011. It focused on 1000 subjects found after a recruitment of all patients coming to consult during the study period. The collection technique was a questionnaire followed by physical measures (weight, height, blood pressure and waist) and biological measures (fasting glucose and cholesterol). The data were analyzed with the software Epi-3.3.2 info. Results: The mainly prevalent behavioural risk factors were smoking (10.2%), alcohol consumption (60.3%), insufficient intake of fruits and vegetables (84.2%), and physical inactivity (57.6%). The prevalent physical risk factors were hypertension (47.4%), obesity (27.5%), and overweight (35.3%). The prevalent biological risk factors were diabetes (28.5%), and hypercholesterolemia (10.4%). The level of cardiovascular risk was higher than 40% in 81 people (8.1%). Conclusion: This study shows the importance of risk factors for NCDs in outpatient Unit in the National Teaching Hospital of Cotonou.
文摘Objective: To study the epidemiological, clinical and therapeutic profile of diabetic metabolic emergencies. Patients and methods: This was a prospective study in descriptive and analytical referred conducted over a period of 6 months in the National Teaching Hosptial HKM of Cotonou December 1, 2011 to May 31, 2012. The patients included in the case of our study were those who, conscious or comatose, had submitted a diabetic hypoglycemia or abnormal blood sugar (2.5 g/l), with a positive glycosuria and ketonuria positive or not. All patients gave their consent for this study. Results: 2786 patients were admitted to the emergency room, 57 (2%) of acute metabolic decompensation of diabetes. DKA accounted for 1.1%, hyperosmolar hyperglycemic syndrome 0.5% and 0.4% hypoglycemia. For hyperglycemic decompensation, sex ratio was 0.8 for females with a mean age of 50.7 ± 16.9 (16-84). For hypoglycemia, male gender was predominant. As decompensation factors for hyperglycemia, infection was found in 54% (n = 30) of cases and stroke by 29% hypertension (n = 15). As for hypoglycemia triggers were dominated by dietary error (50%) and therapeutic errors (25%). 63% (n = 36) of patients underwent resuscitation. More than 3 out of 4 patients were resuscitated to insulin. 98% of patients were rehydrated. The outcome was favorable in 56% of cases. The death rate was 25 % (n = 14). Conclusion: Diabetes mellitus is a serious condition and its severity is mainly due to complications which can be acute or chronic.
基金Supported by European Union-NextGenerationEU,through The National Recovery and Resilience Plan of the Republic of Bulgaria,No.BG-RRP-2.004-0008-C01.
文摘Pancreatic islet transplantation is a minimally invasive procedure aiming to reverse the effects of insulin deficiency in patients with type 1 diabetes(T1D)by transplanting pancreatic beta cells.Overall,pancreatic islet transplantation has improved to a great extent,and cellular replacement will likely become the mainstay treatment.We review pancreatic islet transplantation as a treatment for T1D and the immunological challenges faced.Published data demonstrated that the time for islet cell transfusion varied between 2 and 10 h.Approximately 54%of the patients gained insulin independence at the end of the first year,while only 20%remained insulin-free at the end of the second year.Eventually,most transplanted patients return to using some form of exogenous insulin within a few years after the transplantation,which imposed the need to improve immunological factors before transplantation.We also discuss the immunosuppressive regimens,apoptotic donor lymphocytes,anti-TIM-1 antibodies,mixed chimerism-based tolerance induction,induction of antigen-specific tolerance utilizing ethylene carbodiimide-fixed splenocytes,pretransplant infusions of donor apoptotic cells,B cell depletion,preconditioning of isolated islets,inducing local immunotolerance,cell encapsulation and immunoisolation,using of biomaterials,immunomodulatory cells,etc.
基金Supported by IGT Intervention Program, Key Task of Shanghai Board of Health (01ZD002(2) ) .
文摘Objective To study the fasting serum levels of obesity related factors: FFA, leptin and adi-ponectin in subjects with varying glucose tolerance and their relationship with BMI, insulin sensitivity index and isletbeta-cell function. Methods Serum levels of FFA, leptin and adiponectin in 24 normal, 32 simple obese, 34IGT and 36 T2DM subjects were measured by ACS-ACOD assay or RIA. Results The serum levels of leptin andFFA in three groups:simple obese, IGT and DM were much higher than those in normal control (P <0. 001). Incontrast, serum level of adiponectin of simple obese, IGT and DM groups were significant lower than that of normalcontrol, among them DM subjects had the lowest level (P <0. 001). Correlation analysis showed that FFA was pos-itively correlated to BMI, WHR, FBG, fasting insulin level and negatively correlated to SI; adiponectin was negativelycorrelated to BMI, WHR, FBG, PBG, but positively correlated to SI and AIRg; and leptin was positively correlated toBMI, fasting insulin and AIRg when negatively correlated to FBG and SI. None of them was correlated to age.Conclusion Subjects with insulin resistance have high serum FFA and leptin levels but low serum adiponectin level.With the glucose tolerance deterioration, serum FFA level increases much higher while the adiponectin deceases muchlower. Unlike insulin, none of these obesity related factors can be used as the simple indicating or determining factorof SI, though each of them, to different extent, takes part in the development of insulin resistance.
文摘Non-healing diabetic foot ulcers(DFU)are the most notable and striking complications of diabetes mellitus.More than 25% of nonhealing DFU can ultimately lead to amputation of the lower extremity within 6-18 mo after the first manifestation of the wound.Although wound healing is complex,nutritional status is crucial in soft tissue repair.Malnutrition is highly prevalent and overlooked in patients with diabetes and chronic wounds.Moreover,to date,we do not have clear recommendations or evidence about the use of nutritional supplements for improving wound healing in patients with DFU.In this article the authors briefly analyzed the current evidence on the use of nutritional supplements of proteins or amino acids,fatty acids,probiotics,vitamins,and trace elements in the wound healing process in patients with DFU.
文摘Background: The prevalence of child obesity is increasing rapidly worldwide as well as Turkey due to skipped main meals and increased snacking. The objectives were to study the prevalence rates of overweight and obesity in a group of Turkish children, and to analyze the relationship between eating habits and lifestyle and obesity. Methods: The study was carried out in 6 schools in urban regions in the city of Eskisehir, Western Turkey between February and May2008. Atotal of 1421 students aged 7 - 14 years (708 boys and 713 girls) were examined. Eating habits and life-style were obtained by evaluation of a standard set of 15 questions prepared using the literature. Results: Most obese students reported having a snack in the afternoon, not spending at least five hours of leisure time per week in physical activities, being high income level, that their mother’ education level was university, eating less fruits, eating less vegetables, having more dessert after any meal, eating more potato chips, watching television more, living a physically active life less, less breast feeding, that their father consumed alcohol, that their father was overweight/ obese, their mother wase overweight/obese (statistically important relationships for each one). Conclusions: A small portion of 7 - 14-year-old Turkish children are at increased health risk owing to overweight and obesity in an urban po- pulation in a developing country.
文摘Objective: To evaluate vitamin D status in relation to serum levels for parathyroid hormone (PTH) and corrected calcium among endocrine outpatients. Methods: A total of 760 patients (mean(SD) age: 40.0(12.6) years, 94.6% were females) admitted to our endocrinology outpatient clinic were included and evaluated with respect to patient demographics, serum levels for 25-hydroxyvitamin D (25(OH) D, ng/mL), PTH (pg/mL) and corrected calcium (mg/dL) as well as the vitamin D status. Results: Vitamin D deficiency was determined in 65.0% and elevated PTH levels in 20.3% of patients. iPTH levels were significantly higher in females than in males (58.9(40.4) vs. 45.1(26.2) pg/mL, p = 0.031) and in summer than in winter cases (63.9(47.7) vs. 54.2(32.8) pg/mL, p = 0.002), whereas no difference was found in serum levels for 25(OH) D, corrected calcium and phosphate with respect to gender and season. Significantly higher levels for iPTH were noted in vitamin D deficient patients (60.7(43.9) pg/mL) than in normal (51.1(33.4) pg/mL) and vitamin D insufficient (57.1(26.0) pg/mL) cases (p = 0.03). iPTH levels were correlated positively with age (r = 0.116, p = 0.001) and negatively with corrected calcium (r = −0.097, p = 0.008), P (r = −0.224, p = 0.000) and 25(OH) D (r = −0.134, p = 0.000), whereas no correlation was noted between 25(OH) D and corrected calcium levels. Conclusion: Our findings indicated that vitamin D deficiency in 65.0%, whereas PTH elevation only in 20.3% of endocrine outpatients, despite the significantly negative correlation of PTH to 25(OH) D and significantly higher levels of PTH among vitamin D deficient cases than in vitamin D insufficient and sufficient cases. Gender’s and seasonal differences had influence on serum levels for PTH but not on either 25(OH) D or corrected calcium, and no correlation was evident between 25(OH) D and corrected calcium levels.
文摘Apelin is a new adipokine associated with obesity. Data about the relationship of apelin to the metabolic syndrome (MS) are still scarce. Late-onset hypogonadism (LOH) is common in men with MS, but we did not find data about the levels of apelin in men with LOH. The aim of this study is to determine the levels of apelin in men with MS with or without LOH. Patients and Methods: 99 men are included in the study. Of them 65 have MS (IDF 2005) and they are divided according to their morning total testosterone (TT) level (cutoff 10.4 nmol/l) into two groups: MS-low T (N = 21) and MS-normal T (N = 44). The control group consists of 34 men without MS and with normal T. Apelin is determined in serum using enzyme linked immunosorbent assay. Some of the men were additionally assigned to testosterone treatment and monitored. Results: MS men are at mean age (±SD) = 50.4 ± 9.6 years and TT = 13.6 ± 5.4 nmol/l. The control group is at age = 51.5 ± 6.4 years (NS) and TT = 17.9 ± 5.6 nmol/l (p 0.001). The levels of apelin are higher in the MS group—1.61 ± 0.53 ng/ml compared to the control one—1.38 ± 0.57 ng/ml (p 0.05). There is no difference between MS-lowT—1.53 ± 0.52 ng/ml and MS-normal T —1.65 ± 0.53 ng/ml sub-groups. The MS-normal T differs from the control group (p 0.05). Significant correlation of testosterone with apelin levels is not found. Although apelin correlates with other laboratory parameters: LDL-levels in the MS-patients (Pearson’s = 0.311, p 0.05);HbA1c in men with T2DM (Pearson’s = 0.285, p 0.05);serum creatinine levels (Pearson’s = 0.257, p 0.001). The patients that are assigned to testosterone substitution show a trend for lowering apelin levels. Conclusions: In this study, higher apelin levels are found in the presence of MS compared to healthy men, but do not differ between men having MS with low or normal T.
文摘Objective: To investigate after intracytoplasmic sperminjection(ICSI) the paternal-derived pronuclei of zygotes with three pronuclei(3PN) for numerical-chromosome anomalies by using fluorescence in situ hybridization. Design: A total of 211 ICSI 3PN zygotes have been analyzed for numerical-chromosome anomalies in paternally derived pronuclei and compared with the group of 82 zygotes originated during IVF. In the ICSI group, 163 zygotes were evaluated for numerical-chromosome anomalies by using DNA probes for chromosomes 18, X, and Y, and 48 zygotes, for chromosomes 21, X, and Y. In the IVF group, 68 zygotes were evaluated for numerical-chromosome anomalies by using probes for chromosomes 18, X, and Y, and 14 zygotes, by using chromosomes 21, X, and Y. Setting and Patient(s): Tripronuclear zygotes were obtained from 74 and 176 patients participating in IVF and ICSI treatment cycles at a university hospital in Switzerland. Intervention(s): To evaluate the frequency of numerical-chromosome anomalies in different populations of infertile patients, a total of 211 ICSI zygotes were divided into three groups of zygotes from men with oligozoospermia(n=124), severe oligozoosper-mia(n=53), and azoospermia(n=34). Main Outcome Measure(s): Incidence of sex-chromosome aneuploidy, diploidy, and aneuploidy for chromosomes 18 or 21. Result(s): Overall incidence of numerical-chromosome anomalies in paternal-derived pronuclei after ICSI(9.5%) was significantly higher than the rate found in paternal-derived pronuclei of IVF zygotes(1.2%). Among ICSI zygotes, sex-chromosome aneuploidy(5.2%) and diploidy(2.8%) were two dominant numerical anomalies in paternal-derived pronuclei. In contrast, aneuploidy for autosomes 18 or 21 was not significantly different when comparing ICSI with IVF zygotes. Regarding different groups of infertile patients, the highest incidence of numerical chromosome anomalies was found in zygotes originating from men with severe oligozoospermia(13.2%), followed by those originating from men with azoospermia(8.8%) and oligozoospermia(8.1%). Conclusion(s): Sex-chromosome aneuploidy and diploidy were the most frequent numerical-chromosome anomalies found in paternal pronuclei of ICSI 3PN zygotes. Surprisingly, no statistically significant difference in the incidence of numerical-chromosome anomalies was observed in the three groups of pronuclei derived from men with oligozoospermia, severe oligozoospermia, and azoospermia.
文摘A candidate identification questionnaire (CIQ) was tested to determine its predictive value for patient-reported satisfaction in patients switched from once-weekly or once-daily treatment with a bisphosphonate to once-monthly dosing. This was a prospective, open-label, multicenter international study in patients with postmenopausal osteoporosis who had been receiving once-daily or once-weekly alendronate or risendronate for at least 3 months. Patients completed a CIQ, then commenced 150 mg monthly ibandronate for 6 months. Patients completed the Osteoporosis Patient Satisfaction Questionnaire (OPSAT-QTM) at baseline for 6 months. Scores were converted to composite satisfaction scores (CSS, scale 0-100). Totally 677 patients completed a CIQ, 645 were enrolled in the treatment phase and comprised the intent-to-treat (ITT) population, and 630 completed the study. In the ITT population, 68.1% patients answered “yes” to one or more CIQ questions. OPSAT-Q scores increased for the convenience, quality of life and overall satisfaction domains (p scores for the side effects domains were significant (p < 0.001) in the CIQ “yes” group, but not for the degree of bother (decrease in mean of 0.1 points, p = 0.50) or duration (no change, p = 0.84) of non-gastrointestinal side effects. Of 638 patients who completed the preference questionnaire, 93.0% of patients preferred the once-monthly dosing schedule and 563 patients (90.7%) found it more convenient. The most common adverse events were dyspepsia (1.9%), nausea (1.1%), and upper abdominal pain (0.9%). Patients are likely to prefer treatment with monthly ibandronate to a weekly or monthly bisphosphonate irrespective of their stated preference before switching treatment.
