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Biomedical subjects

V Fonseca

Publications and source records attributed to V Fonseca.

78 records · Page 5Linked to original sources
PubMed1984

Persistence of parathyroid hypersecretion after vitamin D treatment in Asian vegetarians.

An investigation into plasma calcium concentrations and the biochemical factors which regulate it in vegetarian Asian subjects without clinical or radiological features of osteomalacia revealed the presence of low serum 25-hydroxyvitamin D concentrations and elevated PTH concentrations, even in the presence of calcium levels in the normal range (up to 2.35 mmol/liter). These elevated PTH concentrations, though not as high as those in osteomalacic patients with hypocalcemia, often persisted despite treatment with vitamin D, normalization of 25-hydroxyvitamin D, and an increase in calcium concentrations. In one patient the PTH concentration remained high even when the plasma calcium concentration became supranormal. Therefore, secondary hyperparathyroidism is commonly associated with vegetarianism, and may play an important role in maintaining calcium concentrations within the normal range. Persistent elevation of PTH despite normalization of 25-hydroxyvitamin D also points to autonomous PTH hypersecretion, which may result in osteolysis in the long term, and raises the question of the need for vitamin D supplementation in vegetarians with low dietary intake of vitamin D.

25-Hydroxyvitamin D 2↗
PubMedDate not supplied

Differential alterations of spontaneous and stimulated 45Ca(2+) uptake by platelets from patients with type I and type II diabetes mellitus.

Diabetes mellitus (DM) is associated with hyperaggregability of platelets. Although the mechanisms underlying this abnormality remain unknown, Ca(2+) imbalance has been implicated. Both activators (alpha-adrenoceptor agonists, collagen, and ADP) and inhibitors (beta-adrenoceptor agonists, iloprost and dibutyryl cAMP) of platelet function, respectively, elicit the uptake of [45Ca(2+)] in human platelets. It was determined that the [45Ca(2+)] uptake methods employed reflected signal transduction events at the plasma membrane rather than absolute changes of Ca(2+) fluxes or levels of cytosolic Ca(2+). In the present study, basal (unstimulated) [45Ca(2+)] uptake by platelets from both type I and type II diabetic patients was significantly enhanced when compared to age-matched controls. When basal values were subtracted from stimulated values, there were highly significant decreases in [45Ca(2+)] uptake in platelets from type I diabetic patients compared to controls when stimulated with adrenaline, isoprenaline, noradrenaline, collagen, A23187, or iloprost. In contrast, when basal values were subtracted from stimulated values there were significant increases in [45Ca(2+)] uptake by platelets from type II diabetic patients when stimulated with adrenaline, isoprenaline, noradrenaline, A23187, iloprost, and collagen. It is concluded that in type I and type II DM there are differential alterations in [45Ca(2+)] sequestration linked to inhibitors and stimulators of platelet activation. These data indicate that the hyperaggregability of platelets that is associated with both type I and type II DM may be due to an aetiology other than Ca(2+) mobilization linked to signal transduction.

Adult↗
PubMedDate not supplied

Hypertension education: an important and neglected part of the diabetes education curriculum?

This review highlights the important role of hypertension education in reducing the impact of hypertension on the development and progression of diabetes-related complications. Hypertension is commonly associated with diabetes mellitus and can significantly affect the progression of the complications of diabetes. Lifestyle changes similar to those recommended for diabetes management can result in a lowering of blood pressure and can be maintained on a long-term basis to benefit patients with diabetes and mild hypertension. Recently, a team approach in a hypertension clinic model similar to the team approach for diabetes treatment was shown to be effective in diabetes management. Increased awareness of hypertension education may contribute greatly to reducing the complications of diabetes. Hypertension education should be an important component of the diabetes education curriculum.

Antihypertensive Agents↗
PubMedDate not supplied

Diarrhea and metformin in a diabetic clinic.

In a questionnaire-based survey of 285 randomly selected diabetic patients, diarrhea was found to occur in 8%; this was found to be similar to that in 150 nondiabetic control patients attending other medical clinics (8%). When the diabetic patients were divided into separate therapeutic groups, metformin-treated (with or without sulfonylureas) patients had a markedly greater prevalence of diarrhea (20%) than those not on this drug (6%). A majority of patients with metformin-associated diarrhea had soiling of clothes as a problem, while at least two complained of frank loss of control over their anal sphincter. These patients did not have autonomic neuropathy, and in all who stopped this drug, diarrhea settled within 2-5 days. Only 6% of insulin-dependent diabetic individuals (IDD) had diarrhea, one of whom had explosive nocturnal stools with incontinence and features diagnostic of autonomic neuropathy. Metformin is by far the commonest cause of diarrhea and incontinence in our diabetic clinic, where it is used routinely. In contrast, diarrhea due to autonomic neuropathy is rare.

Diabetes Mellitus, Type 1↗