1. Attachment in close relationships and glycemic outcomes in children with type 1 diabetesSimona Klemenčič, Jasna Klara Lipovšek, Anja Turin, Klemen Dovč, Nataša Bratina, Yael Shmueli-Goetz, Katarina Trebušak Podkrajšek, Barbka Repič-Lampret, Barbara Jenko Bizjan, Sašo Karakatič, Tadej Battelino, Maja Drobnič Radobuljac, 2023, original scientific article Abstract: Background: Our aim was to determine whether child attachment to parents, parent attachment style, and morning cortisol levels were related to diabetes outcomes measured by average glycated hemoglobin (HbA1c), HbA1c variability over 4 years and time in range (TIR) in children with type 1 diabetes (T1D). Research design and methods: 101 children with T1D and one of their parents were assessed at baseline for child attachment (Child Attachment Interview; CAI) and parent attachment (Relationship Structures Questionnaire; ECR-RS). Serum samples were collected for cortisol measurements before the interviews. HbA1c levels were measured during a 4-year follow-up period at regular 3-monthly visits, and data for TIR were exported from blood glucose measuring devices. Multivariate linear regression models were constructed to identify independent predictors of glycemic outcomes. Results: More girls than boys exhibited secure attachment to their mothers. The results of the regression models showed that securely attached girls (CAI) had higher average HbA1c than did insecurely attached girls (B = -0.64, p = 0.03). In boys, the more insecure the parent's attachment style, the worse the child's glycemic outcome: the higher the average Hb1Ac (B = 0.51, p = 0.005), the higher the HbA1c variability (B = 0.017, p = 0.011), and the lower the TIR (B = -8.543, p = 0.002). Conclusions: Attachment in close relationships is associated with glycemic outcomes in children with T1D, and we observed significant differences between sexes. A sex- and attachment-specific approach is recommended when treating children with less favorable glycemic outcomes. Special attention and tailored support should be offered to securely attached girls in transferring responsibility for diabetes care and at least to male children of insecurely attached parents to prevent suboptimal glycemic control. Further studies in larger samples and more daily cortisol measurements may help us better understand the links between stress response, attachment and T1D.
Keywords: attachment, childhood and adolescence, cortisol, diabetes control, time in range
Published in DKUM: 21.05.2024; Views: 152; Downloads: 10
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2. Percutaneous balloon aortic valvuloplasty: palliative treatment for inoperable patients?Klemen Dovč, Andrej Markota, Vojko Kanič, Mirko Bombek, Gregor Prosen, 2011, original scientific article Abstract: Purpose: The number of elderly patients with severe aortic stenosis and comorbidities is increasing in the aging populations of "developed" countries. Unacceptably high perioperative mortality and morbidity makes the decision to undertake surgical aortic valve replacement in this group of patients difficult and unlikely. Development of less invasive procedures such as balloon aortic valvuloplasty and transcatheter aortic valve replacement is emerging as another treatment option. Case report: A 84-year-old female with previous left-sided hemiparesis after stroke and severe aortic stenosis presented with pulmonary edema to our institution. Non-invasive ventilation and inotropic support were unsuccessful. Balloon aortic valvuloplasty was done as emergency procedure and she improved immediately. She was discharged after 25 days of inhospital treatment. She died 8 weeks later of unrelated reasons (infected decubitus and sepsis). Conclusion: Balloon aortic valvuloplasty might be used as temporary and interim therapeutical options for patients with severe aortic stenosis and acute left ventricular failure who have unacceptably high risks when aortic valve replacement or emergency transcatheter aortic valve implantation is considered. Balloon aortic valvuloplasty may be used as a bridge to both procedures
Keywords: aortna stenoza, balonska aortna valvuloplastika, akutno srčno popuščanje
Published in DKUM: 10.07.2015; Views: 1733; Downloads: 72
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