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Mar 29
Diabetes and sleep apnoea may lead to vision loss: Study
Patients who suffer from both Type 2 diabetes and obstructive sleep apnoea are at greater risk of losing their vision within a period of four years, a study has found.

Obstructive sleep apnoea (OSA) is a condition where the walls of the throat relax and narrow during sleep, resulting in snoring and interrupting breathing, and it is common in patients with Type 2 diabetes.

Meanwhile, diabetic retinopathy - the most common form of diabetic eye disease - affects between 40 and 50 per cent of patients with diabetes and is a leading cause of blindness in the western world.

Previous studies have shown a link between OSA and diabetic retinopathy.

However, there had been no published studies assessing the impact of OSA on the progression of diabetic retinopathy in patients with Type 2 diabetes.

"Despite improvements in glucose, blood pressure and lipid levels, diabetic retinopathy remains very common," said Abd Tahrani from the University of Birmingham in the UK.

"Meanwhile, OSA has been shown to be very common in patients with Type 2 diabetes, which is not surprising considering that excess weight contributes to the development of both of these conditions," said Tahrani.

"However, most patients who have OSA are not aware that they have the condition and the disease could go undiagnosed for years," he said.

"We have shown that patients with OSA and Type 2 diabetes, compared to those with diabetes only, are at increased risk of developing advanced diabetic retinopathy over a period of three years and seven months," he added.

The study was carried out at two diabetes clinics and involved 230 patients with Type 2 diabetes.

The patients were assessed for diabetic retinopathy using specialist retinal imaging, while OSA was assessed using a home-based, multi-channel cardio-respiratory portable device.

The results showed that diabetic retinopathy prevalence was higher in patients with OSA (42.9 per cent) compared to those without OSA (24.1 per cent).

The study found that at a follow-up appointment, on average 43 months later, the patients with OSA (18.4 per cent) were more likely to develop moderate to severe diabetic retinopathy compared to those without OSA (6.1 per cent).

It also showed that patients who received treatment for OSA using a machine connected to a face mask that delivers pressure to prevent the blockage of the airways during sleep had a lower risk of developing advanced diabetic retinopathy compared to patients who did not receive the treatment.

"We can conclude from this study that OSA is an independent predictor for the progression to moderate or severe diabetic retinopathy in patients with Type 2 diabetes," said Tahrani.

The study was published in the American Journal of Respiratory and Critical Care Medicine.

Mar 29
Common disinfectant may cause antibiotic resistance: Study
Triclosan, a common disinfectant present in household products such as body washes may make bacteria resistant to antibiotics, a study published today suggests.

Scientists from the University of Birmingham in the UK and colleagues have discovered a link between a major mechanism of antibiotic resistance and resistance to triclosan.

They found that bacteria which mutated to become resistant to quinolone antibiotics also became more resistant to triclosan.

The researchers showed that the quinolone-resistance mutation altered the way the bacteria package their DNA inside a cell and that these mutants had also turned on various self-defence mechanisms - together these gave triclosan resistance.

Quinolone antibiotics are an important and powerful group of human medicines, and this new discovery raises concerns that the use of triclosan can give antimicrobial resistance.

"We think that bacteria are tricked into thinking they are always under attack and are then primed to deal with other threats including triclosan," said Mark Webber, Honorary Senior Lecturer at the University of Birmingham.

"The worry is that this might happen in reverse and triclosan exposure might encourage growth of antibiotic resistant strains," said Webber, corresponding author of the study published in the Journal of Antimicrobial Chemotherapy.

"We found this can happen in E coli. As we run out of effective drugs, understanding how antibiotic resistance can happen and under what conditions is crucial to stopping selection of more resistant bacteria," he said.

Triclosan has been the cause for some concern which has led to a ban across the EU and US in its use in hygiene products (hand, skin and body washes), researchers said.

Many other antimicrobial agents are, however, still used in these products, they said.

Mar 29
Obesity may put children at increased risk of hip disease, suggests study
A new research suggests that obesity in chilhood may put kids at increased risk of hip disease.

Slipped Capital Femoral Epiphysis (SCFE) is the most common hip disease of adolescence. The condition always requires surgery, can cause significant pain, and often leads to a hip replacement in adolescence or early adulthood.

"Ultimately this study helps us to better understand one of the main diseases affecting the hip in childhood," said one of the study authors Daniel Perry from the Institute of Translational Medicine, University of Liverpool in Britain.

Children with a SCFE experience a decrease in their range of motion, and are often unable to complete hip flexion or fully rotate the hip inward.

Early recognition of SCFE is important as the deformity may worsen if the slip remains untreated.

In an effort to identify children at higher risk of this condition, the researchers examined hospital and community based records to explore factors associated with SCFE, and explanations for diagnostic delays.

All of the records examined were of individuals under 16-years-of-age with a diagnosis of SCFE and whose electronic medical record was held by one of 650 primary care practices in Britain between 1990 and 2013.

Using the height and weight of children recorded in the notes at some point before the disease was diagnosed, the researchers were able to identify that obese children appear at highest risk of this condition, according to the study published in the journal Archives of Disease in Childhood.

"This is the best evidence available linking this disease to childhood obesity -- which makes this condition to be one of the only obesity-related disease that can cause life-long morbidity starting in childhood," Perry said.

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