Clinical medicine (London, England)
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Hypertrophic cardiomyopathy is one of the most frequently diagnosed primary conditions of the heart muscle. It is considered to be inherited, caused by genetic mutations encoding for sarcomere proteins. ⋯ Its prevalence is increased in hypertrophic cardiomyopathy, and the two conditions share some similar pathophysiological and clinical characteristics. In this review, we aim to summarise the effects of obesity in the cardiac phenotype, the symptoms and management in patients with hypertrophic cardiomyopathy.
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Obesity and chronic kidney disease (CKD) are common and frequently coexisting medical conditions. Already well known to be a risk factor for type 2 diabetes mellitus (T2DM), ischaemic heart disease, stroke, hypertension, malignancy and premature death, obesity also predisposes to CKD. Elevated weight leads to declining renal function through several mechanisms, including established pathways via metabolic syndrome, hypertension and T2DM, but also through relatively recently understood glomerulosclerosis, directly related to obesity. ⋯ Importantly, treatment of obesity can influence these crucial renal outcomes and significantly improve quality of life. Declining renal function also impacts the medical and surgical treatment options available to treat patients with overweight and obesity. In this article, we briefly outline the epidemiology of obesity and renal disease and review the pathological interactions between these diseases before focusing on considerations for assessment and evidence-based treatments for obesity and renal disease.
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Case Reports
Respiratory failure in a patient with hypophosphatemic rickets: can an endobronchial stent make the difference?
Abnormalities associated with phosphate metabolism can lead to thoracic deformities that result in respiratory failure, which is conventionally managed by means of supplemental oxygenation, positive airway pressure and physiotherapy. However, when these measures fail, the clinician faces a dilemma, since many patients cannot tolerate a major surgical procedure. A minimally invasive technique, insertion of an endobronchial stent, might offer a solution.
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The objective of this study was to assess whether poor sleep is independently associated with cardiovascular disease in people with type 2 diabetes mellitus (T2DM). ⋯ Poor sleep quality and higher RDW levels are associated with macrovascular disease in a T2DM population. Increased BMI as well as depression also appear to have an independent role in subclinical atherosclerosis, as assessed by CIMT.
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Obesity is a chronic disease associated with increased morbidity and mortality. Bariatric surgery can lead to sustained long-term weight loss (WL) and improvement in multiple obesity-related complications, but it is not scalable at the population level. ⋯ Tirzepatide, a dual agonist of GLP1 and GIP receptors, marks a new era in obesity pharmacotherapy in which a combination of gut hormones could approach the WL achieved with bariatric surgery. In this review, we discuss emerging obesity treatments with a focus on gut hormone combinations and the concept of a multimodal approach for obesity management.