Objective Vitamin B12 deficiency resulting from metformin use has been demonstrated in multiple studies. In this study, we aimed to evaluate the prevalence of vitamin B12 deficiency in patients with chronic metformin use and the relationship between vitamin B12 deficiency and diabetic neuropathy. Methods A cross-sectional study was conducted with 162 patients. Vitamin B12 levels were measured by chemiluminescence immunoassay. Diabetic neuropathy was evaluated by patient record, nerve conduction and Michigan test for the diagnosis of diabetic neuropathy. Additional data, including demographic characteristics were collected. A linear regression model was used to evaluate variables that correlated with vitamin B12 levels and diabetic neuropathy. Results Low vitamin B12 levels were found in 7.3% (95% CI: 4.0–12%) of patients. In those with diabetic neuropathy, altered (low and borderline) vitamin B12 level was 64% (95% CI: 47–78%) compared to 17% (95% CI: 10–26%) in patients without diabetic neuropathy (coefficient: −110.8; CI 95%: −165.8, −59.7). Those taking a higher metformin dose had lower levels of vitamin B12 (coefficient: −0.061; CI 95%: −0.09, −0.024). In addition, female patients had higher levels of vitamin B12 compared to men (coefficient: 49.1; CI 95%: 2.3–95). Conclusions Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. Higher doses of metformin and male sex were factors related to lower levels of vitamin B12.
Objectives: Primary Sjögren syndrome (SS) is diagnosed based on the American European Consensus Group (AECG) criteria, but lacks specificity, not only in the involvement of salivary glands, but also in extra-glandular involvement. Whole-body somatostatin receptor scintigraphy with 99mTc-HYNIC-TOC scintigraphy could overcome these limitations. The aims of this study were to evaluate salivary gland uptake of 99mTc-HYNIC-TOC in untreated patients with de-novo diagnosis of SS as compared to control subjects and as compared to conventional sialoscintigraphy with 99mTcO4−. We also aimed to evaluate the involvement of joints. Methods: 99mTc-HYNIC-TOC was used with SS patients and uptake in joints and salivary glands was analyzed semi-quantitatively. Patients also underwent 99mTcO4 sialoscintigraphy. The control group that we analyzed consisted of 30 patients with neuroendocrine tumors. Results: Fifty-two females and 10 males fully met the AECG criteria for SS, and were included. A target background ratio (TBR) >1.18 in submandibular glands correctly classified 93% of the patients with SS in comparison to 27% for 99mTcO4 sialoscintigraphy. The area under the curve (ROC) analysis for TBR in submandibular glands was 0.95. In joints there was a huge variety in uptake. The median TBR was significantly higher in salivary glands in patients with SS compared to controls. Conclusions: 99mTc-HYNIC-TOC scintigraphy identified active inflammatory processes not only in the salivary glands, but, unexpectedly, also in many joints in patients with primary SS, contrary to popular belief. This technique provides an objective parameter to evaluate the inflammation burden in salivary glands and joints and could be used to evaluate response to treatment.
Background Evaluation of health-related quality of life (HRQoL) is considered an important aspect of clinical assessment and health research. Chronic Otitis Media (COM) is related to the quality of life deterioration subsequent to COM symptoms, social communication impairments, and lower work performance. However, there is no reliable information regarding the impact of this disease on health and quality of life in many resource-poor countries. Therefore, we translated into Spanish the Chronic Otitis Media Questionnaire-12 (COMQ-12) for the evaluation of HRQoL of Chronic Otitis Media (COM) in adult patients. Also, we assessed the psychometric properties of the Spanish version of the questionnaire. Methods Two otology referral centers in Bogotá, Colombia were included. The Spanish version of COMQ-12 was applied twice to 200 adult patients with confirmed COM diagnosis and 31 healthy controls to perform the validation process and assess the internal consistency of this questionnaire. Psychometric characteristics (internal consistency, test–retest reliability, and construct validity) of the COMQ-12 were assessed. Exploratory Factor Analysis and Confirmatory Factor Analysis were conducted via structural equation modeling to test the questionnaire’s structure. Results The Spanish version of the COMQ-12 showed good internal consistency (Cronbach’s Alpha: 0.86, McDonald’s Omega: 0.89). Coefficients corresponding to Lin’s Concordance test and test–retest reliability were 0.95 and 0.83 respectively. Correlation between the Visual Analogue Scale (VAS) and the COMQ-12 was 0.68 (95% CI 0.59–0.75, p value < 0.001). Factor analysis of the Spanish version of the COMQ-12 indicated a questionnaire structure with three domains: smelly discharge related symptoms; hearing loss related symptoms; and impact on work, lifestyle, and health services. Conclusion This Spanish version of the COMQ-12 showed high reliability and high internal consistency. This questionnaire can be used as an objective clinical tool to assess the HRQoL of patients who have a COM diagnosis. Trial registration Hospital Universitario Fundación Santa Fe, Ethical Committee Registration ID: CCEI-8807-2018. Hospital de San José, Ethical Committee: Record number 500, DI-I-0632-18.
Introduction: The prevalence of allergic diseases is increasing worldwide, affecting about 30% of the population in low to middle-income countries. Research trends on allergic diseases within rural pediatric populations of Latin American countries is scarce. This study aimed to determine the prevalence of allergic diseases (allergic rhinitis, asthma, and atopic dermatitis) and their associated factors using the International Study of Asthma and Allergies in Childhood-III (ISAAC-III) questionnaire in school-aged children from two rural municipalities in Colombia.Materials and methods: This is a cross-sectional study. The ISAAC-III questionnaire was applied to school-aged children attending elementary schools in the municipalities of Soracá and Palmas del Socorro during 2018. The questionnaires were applied to adolescents aged 13–14 years and the parents of 6–7 years old children. Associations were estimated via bivariate and multivariate analysis. Results: Among 261 school-aged children (58.2% adolescents), the prevalence of allergic dis-eases was: allergic rhinitis 11.49% (95% CI: 8.05–15.78), asthma 8.81% (95% CI: 5.82–12.7), and atopic dermatitis 6.13% (95% CI: 3.69–9.53). Associated factors for allergic rhinitis included: female sex (PR: 2.68, 95% CI: 1.17–5.26), asthma (PR: 4.69, 95% CI: 1.96–8.31), atopic dermatitis (PR: 3.55, 95% CI: 1.09–7.83), and higher maternal education (PR: 4.16, 95% CI: 1.45–8.25).Conclusions: The prevalence of allergic diseases in this rural pediatric population was lower compared with that of the previous reports from urban populations. Associated factors found in this study support previous studies. Research addressing modifiable environmental associ-ations is so far scarce in Latin America; further studies are needed to reduce the burden of these diseases in rural populations.
Background Evaluation of health-related quality of life (HRQoL) is considered an important aspect of clinical assessment and health research. Chronic Otitis Media (COM) is related to the quality of life deterioration subsequent to COM symptoms, social communication impairments and lower work performance. However, there is no reliable information regarding the impact of this disease on health and quality of life in many resource-poor countries. Therefore, we translated into Spanish and culturally adapted the Chronic Otitis Media Questionnaire-12 (COMQ-12) for the evaluation of Health-Related Quality of Life (HRQoL) of Chronic Otitis Media (COM) in adult patients. Also, we assessed the psychometric properties of our version of the questionnaire.Methods Two otology referral centers in Bogotá, Colombia were included. The Spanish version of COMQ-12 was applied twice to 200 adult patients with confirmed COM diagnosis and to 31 healthy controls in order to perform the validation process and assess the internal consistency of this questionnaire. Psychometric characteristics (replicability, reliability, and validity) of the COMQ-12 were assessed. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were conducted via structural equation modeling (SEM) in order to test the questionnaire’s structure.Results The Spanish version of the COMQ-12 showed good internal consistency (Cronbach’s Alpha=0.8526, McDonald’s Omega = 0.8901). Coefficients corresponding to Lin’s Concordance test and test-retest reliability were 0.945 and 0.82 respectively. Correlation between the Visual Analogue Scale (VAS) and the COMQ-12 was = 0.676 (IC 95% = 0.593; 0.745). Factor analysis of the Spanish version of the COMQ-12 indicated a questionnaire structure with three domains: smelly discharge related symptoms; hearing loss related symptoms; and impact on work, lifestyle and health services.Conclusion This Spanish version of the COMQ-12 showed high reliability and high internal consistency. This questionnaire can be used as an objective clinical tool to assess the HRQoL of patients who have a COM diagnosis.
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