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PL
Na przestrzeni dziejów ludzkie oko zostało wymienione przez autorów jako coś najcenniejszego dla człowieka. Odsłania ono cały świat zewnętrzny dla naszej świadomości, daje życie, wyraz i godność twarzy. Dlatego utrata oka zawsze była postrzegana jako największe nieszczęście i wymagało wcześniejszego zastąpienia, aby pacjent mógł wrócić do normalnego życia. Światowa Organizacja Zdrowia szacuje że na świecie niewidomych osób jest 39 milionów (szacunki mówią o 115 mln chorych w 2050 roku). Z danych GUS wynika, że w Polsce osób z dysfunkcją wzroku jest 1,5 mln. W niniejszej pracy przeglądowej opisano rozwiązania techniczne pomagające w poprawie estetyki jak i uzyskaniu poprawy funkcji uszkodzonego narządu wzroku. Omówiono choroby, które maja wpływ na widzenie i mogą zostać uleczone za pomocą protez (zaćma, choroby zwyrodnieniowe siatkówki). Omówiono także komercyjne przykłady bionicznego oka dla zapewnienia sztucznej wizji niewidomym pacjentom. Dodatkowo przybliżono inne kierunki badań zmierzające do poprawy widzenia tj. terapie genową, komórki macierzyste, hodowle tkankowe. Jak pokazano przejście z projektu badawczego do badań klinicznych otworzyło zupełnie nowy obszar terapii siatkówki i dało po raz pierwszy pacjentom z głęboką utratą widzenia opcję skutecznego leczenia.
EN
Throughout history, the human eye has been mentioned by the authors as something the most valuable for a man. It reveals the entire external world for our consciousness, gives life, expression and face dignity. Therefore, the loss of the eye has always been perceived as the greatest misfortune and required earlier replacement so that the patient could return to a normal life. The World Health Organization (WHO) estimates that there are 39 million blind people in the world (estimates are 115 million in 2050). According to GUS data, there are 1.5 million people with sight dysfunction in Poland. This review describes technical solutions that can help improve esthetics and improve the function of the damaged vision organ. Diseases that affect vision and can be healed using prostheses are discussed (cataracts, retinal degenerative diseases). Bionic eye examples to provide artificial vision to blind patients are discussed. Other directions of vision improvement have also been called, i.e. gene therapy, stem cells, and tissue cultures. As shown, the transition from a research project to clinical practice has opened up a whole new area of retinal therapy and gave patients with profound vision loss the option of effective treatment for the first time.
3
Content available remote Analysis of data generated by insulin pump using LabVIEW environment
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EN
Diabetes mellitus is a group of metabolic diseases characterized by impaired insulin secretion or action affecting around 200 million people worldwide. Type 1 diabetes makes up 10% of all diabetes cases. Currently, the most physiological way of insulin delivery involves the use of an insulin pump, which administers insulin in a continuous manner. During an outpatient visit insulin pump data are read and analyzed to optimize treatment and improve patients metabolic control. There are commercial software companies producing insulin pumps which present data in a report format. The aim of this project was to write a program in a LabVIEW environment which would analyze the insulin pump data. The program includes structured bookmarks, statistics on glucose (different systems of measurement), insulin, nutritional information, uses advanced tools in the pump, and presents the entire recorded history of pump data (commercial version statistics use only two week time intervals). Implemented as an innovative feature that compares the blood glucose meter to indicate the continuous glucose monitoring system. The software built for this purpose can be used in diabetes clinics to analyze insulin pump data and to research on the application of new diabetes technology. The current version can be treated as a foundation for possible further expansion of the program functionality.
EN
Introduction and Objective. The ability to perceive the symptoms of hypoglycemia during the early decrease in plasma glucose concentration may be critical for the safety of T1DM patients treated with intensive insulin therapy, including those treated with continuous subcutaneous insulin infusion (CSII). In the presented observational study an attempt was made to asses clinical factors that might affect subjective awareness of hypoglycemia in CSII-treated T1DM patients, with special attention to factors specific for this mode of treatment. Materials and Methods. For the purpose of the study, data of 110 CSII-treated T1DM patients were collected (78 females and 32 males). The records were analyzed from glucose meters (200-300 measurements/download, depending on meter type) and insulin pumps (total insulin dose, basal/bolus ratio, number of boluses/day, bolus calculator and dual wave/square bolus usage, continuous glucose monitoring data) from the last 3 years. Results. It was found that the level of subjective hypoglycemia perception inversely correlated with the number of hypoglycemic episodes per 100 measurements, age, duration of diabetes, time on insulin pump, and positively correlated with mean glycemia (n = 98; r = 0.22; p = 0.0286). With respect to CSII-related factors, hypoglycemia perception inversely correlated with the percentage of basal insulin (n = 106; r = -0.20; p = 0.0354). In stepwise regression analysis, independent predictors for impaired hypoglycemia perception were: age β = -0.29 (p = 0.023), duration of diabetes β = -0.24 (p = 0.029) and number of the hypoglycemia episodes for 100 measurements β = -0.33 (p = 0.0005). Conclusions. Risk factors for impaired hypoglycemia perception in CSII-treated patients include those identified previously for the general population of T1DM individuals. In addition, the presented results suggest that a higher basal/bolus ratio may lead to impairment of the ability to perceive early symptoms of hypoglycemia.
EN
Background. It has been established that in Type 1 Diabetes Mellitus (T1DM), regardless of the insulin therapy model used, diet and proper eating habits are still important in the treatment of the disease. The dietary intervention in these patients is aimed at maintaining proper body weight, obtaining target fasting and post meal blood glucose levels, optimizing lipid profiles. Objective. The aim of the study was to assess dietary habits in a homogeneous group of adults with T1DM treated with personal insulin pumps. Material and methods. The study included 141 adult patients (57% women) with type 1 diabetes treated with personal insulin pumps. The surveyed population was characterized by an average age of 25.8 ± 6.2 years, an average duration of diabetes 13.9 ± 6.9 years, and treatment with a personal pump for 8.2 ± 4.1 years and mean BMI 23.0 ± 2.8 g/m2. All were dwellers of south-eastern Poland. The validated KomPAN questionnaire was used to assess the frequency of consumption of individual food products. Results. The mean percentage of HbA1c in the study group was 7.3% [56 mmol/mol]. The mean total cholesterol level was 4.4 mmol/l, HDL - 1.7 mmol/l, LDL - 2.3 mmol/l and triglycerides - 0.8 mmol/l. In the multivariate regression model, no correlation was found between dietary quality parameters and metabolic compensation measured with HbA1c or lipidogram and the place of residence (village, small town, big city). However, there were differences in the quality of the diet depending on the sex. Women were characterized by higher index of a healthy diet (pHDI-10) (26.3 vs 21.4, p=0.005) and lower index of unhealthy diet (nHDI-14) (13.3 vs 18.6, p <0.001) than men. Conclusions. The results of this study clearly suggest, that despite good metabolic control, patients require more education on the choice of healthy product groups.
PL
Wprowadzenie. Uważa się, że w cukrzycy typu 1 (T1DM), niezależnie od zastosowanego modelu insulinoterapii, dieta i prawidłowe nawyki żywieniowe są kluczowe w leczeniu cukrzycy. Stosowanie odpowiedniej diety ma na celu utrzymanie prawidłowej masy ciała, uzyskanie prawidłowego poziomu glukozy we krwi po posiłku, optymalnego profil lipidowy i prawidłowe wartości ciśnienia krwi. Cel. Celem badania była ocena diety i kontrola metaboliczna w homogennej grupie osób dorosłych z T1DM leczonych osobistymi pompami insulinowymi. Materiał i metody: Badaniem objęto 141 dorosłych pacjentów (57% kobiet) z cukrzycą typu 1 leczonych osobistymi pompami insulinowymi. Badana populacja charakteryzowała się średnim wiekiem 25,8 ± 6,2 lat, średnim czasem trwania cukrzycy 13,9 ± 6,9 lat oraz średnim czasem leczenia osobistą pompą przez 8,2 ± 4,1 lat i średnim BMI 23,0 ± 2,8 g / m2. Wszyscy byli mieszkańcami południowo-wschodniej Polski. Walidowany kwestionariusz KomPAN wykorzystano do oceny częstotliwości spożycia poszczególnych produktów spożywczych. Wyniki. Średni odsetek HbA1c w grupie badanej wynosił 7,3% [56 mmol/mol]. Średni poziom całkowitego cholesterolu wynosił 4,4 mmol / l, HDL - 1,7 mmol / l, LDL - 2,3 mmol / l i triglicerydów - 0,8 mmol / l. W modelu regresji wielorakiej nie stwierdzono korelacji między wskaźnikami diety i wyrównaniem metabolicznym mierzonym za pomocą HbA1c lub lipidogramu oraz miejscem zamieszkania (wieś, małe miasteczko, duże miasto). Jednak różnice w jakości diety zależały od płci. Kobiety charakteryzowały się wyższym wskaźnikiem zdrowej diety (pHDI-10) (26,3 vs 21,4, p = 0,005) i niższym wskaźnikiem niezdrowej diety (nHDI-14) (13,3 vs 18,6, p <0,001) niż mężczyźni. Wnioski: Wyniki tego badania wyraźnie wskazują, że pomimo dobrej kontroli metabolicznej pacjenci wymagają większej edukacji w zakresie wyboru zdrowych grup produktów.
EN
Introduction and objective. Continuous subcutaneous insulin infusion (CSII) via personal insulin pump is a valuable therapeutic tool in T1DM patients. However, adherence to recommended CSII- related behaviours may be of concern to young adults with intensive, variable daily activities (students, young professionals). The aim of this observational study was to estimate treatment outcomes in young adult patients with T1DM, and compare them with older individuals. Materials and methods. Overall, 140 adults with T1DM on CSII were examined, divided into 2 subgroups: 77 patients younger than 26 years of age (mean 20.6 years) and 63 older subjects (mean 39.0). We compared the glycaemic control in both groups of T1DM subjects and analyzed treatment attitudes to identify potentially modifiable behaviours influencing the efficacy of the treatment. Results. The younger individuals were characterized by significantly worse treatment outcomes, compared to the older ones: the mean HbA1c levels were 7.6 ± 1.3% and 6.9±1.3% (p=0.00001), while the mean glucose levels based on glucometer downloads were 161±33.6 mg/dL and 136±21.8 mg/dL (p=0.00001), respectively. The frequency of self-monitoring of blood glucose (SMBG) was lower in younger individuals (5.3±2.1 vs. 7.0±2.8 daily, p=0.0005, respectively); they were also less frequently used advanced pump functions, e.g. the bolus calculator (48% vs. 67% users, p=0.0014, respectively). Conclusions. The efficacy of CSII treatment observed in young T1DM adults was worse than in older patients. The reason for this phenomenon remains unclear, it may be due simply to age-dependend behaviours, to social environment, or both.
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