Near-normalisation of diurnal glucose concentrations by continuous administration of glucagon-like peptide-1 (GLP-1) in subjects with NIDDM

Summary The gut hormone, glucagon-like peptide-1 (GLP-1) is a potent insulin secretogogue with potential as a therapy for non-insulin-dependent diabetes mellitus (NIDDM). GLP-1 has been shown to reduce glucose concentrations, both basally, and, independently, in response to a single meal. For it to be an effective treatment, it would need to be administered as a long-acting therapy, but this might not be feasible due to the profound delay in gastric emptying induced by GLP-1. In order to assess the feasibility and efficacy of continuous administration of GLP-1 in NIDDM, we determined the effects of continuous intravenous infusion of GLP-1 (7–36) amide, from 22.00–17.00 hours, on glucose and insulin concentrations overnight and in response to three standard meals, in eight subjects with NIDDM. These were compared with responses to 0.9 % NaCl infusion and responses in six non-diabetic control subjects who were not receiving GLP-1. Effects on beta-cell function were assessed in the basal state using homeostasis model assessment (HOMA) and in the postprandial state by dividing incremental insulin responses to breakfast by incremental glucose responses. To assess possible clinical benefit from priming of beta cells by GLP-1 given overnight only, a third study assessed the effect of GLP-1 given from 22.00–07.30 hours on subsequent glucose responses the next day. Continuous GLP-1 infusion markedly reduced overnight glucose concentrations (mean from 24.00–08.00 hours) from median (range) 7.8 (6.1–13.8) to 5.1 (4.0–9.2) mmol/l (p < 0.02), not significantly different from control subjects, 5.6 (5.0–5.8) mmol/l. Daytime glucose concentrations (mean from 08.00–17.00 hours) were reduced from 11.0 (9.3–16.4) to 7.6 (4.9–11.5) mmol/l (p < 0.02), not significantly different from control subjects, 6.7 (6.5–7.0) mmol/l. GLP-1 improved beta-cell function in the basal state from 62 (13–102) to 116 (46–180) %β (p < 0.02) and following breakfast from 57 (19–185) to 113 (31–494) pmol/mmol (p < 0.02). GLP-1 only given overnight did not improve the glucose responses to meals the next day. In conclusion, continuous infusion of GLP-1 markedly reduced diurnal glucose concentrations, suggesting that continuous GLP-1 administration may be a useful therapy in NIDDM. [Diabetologia (1997) 40: 205–211] Received: 3 July 1996 and in final revised form: 23 October 1996     

不同稀释浓度的痰热清注射液对急性上呼吸道感染患儿的疗效与安全性影响

目的:考察不同稀释浓度的痰热清注射液对儿童急性上呼吸道感染(children with acute upper respiratory tract infection,AURTI)的疗效与安全性。方法:抽取2018年1月—12月间收治的采用痰热清注射液治疗的AURTI患儿108例资料,按照痰热清注射液的稀释浓度不同将其分为高浓度组29例、中浓度组40例和低浓度组39例;分析不同痰热清注射液的稀释浓度对各组患儿的临床症状复常时间、总有效率和用药期间不良反应发生率差异。结果:高、中浓度组患儿用药后症状和体征的恢复时间相当(<5 d),但早于低浓度组(<7 d);高、中浓度组用药后的总有效率分别为89.66%和87.50%,经两组间比较其差异无统计学意义(P>0.05),但均显著高于低浓度组(64.10%);中、低浓度组患儿治疗期间不良反应发生率分别为7.50%和5.13%,经两组间比较其差异无统计学意义(P>0.05),但均显著低于高浓度组(31.03%)。结论:痰热清注射液不同稀释浓度对治疗AURTI患儿的疗效和安全性影响较大;适当稀释痰热清注射液的浓度不仅具有良好的临床疗效,而且安全性较高。     

Antimicrobial resistance pattern and in vivo activity of azithromycin in Salmonella isolates

We evaluated antimicrobial susceptibility pattern of 42 Salmonella isolates from February 2012 through January 2013. We also determined the minimum inhibitory concentrations (MICs) of azithromycin against Salmonella isolates and compared them with corresponding disc diffusion sizes. Entire 42 isolates were sensitive to chloramphenicol, 41 (97.6%) were sensitive to cotrimoxazole and amoxicillin each. MICs for azithromycin ranged from 2 μg/ml to 24 μg/ml, corresponding zone diameters ranged from 15 mm to 33 mm and the two were significantly correlated (P = 0.001). Our results indicate that whereas, azithromycin is a potential therapeutic option, the sensitivity to the first line drugs and absence of multidrug resistance reinforce the concept of antimicrobial recycling.     

Turner综合征自发性青春发育分析

目的探讨先天性卵巢发育不全综合征（Turnersyndrome,TS）患儿自发的青春发育与染色体核型及性激素水平之间的关系。方法30例Turner综合征患儿进行染色体检查,评估第二性征及性腺发育情况,检测性激素水平。结果染色体核型分4组,第1组45,XO,10例;第2组嵌合型,9例;第3组x染色体结构畸变,10例;第4组伴有Y染色体,1例。30例患儿随访至15周岁,其中10例出现不同程度的自发性青春发育,20例呈无性发育,4组患儿中以嵌合型TS出现自发青春发育几率最大。有青春发育患儿的性激素水平与无性发育患儿的性激素水平有显著差异。结论Turner综合征患儿自发性青春发育与染色体核型及性激素水平有密切相关性。     

Intravenous iron sucrose for restless legs syndrome in pregnant women with low serum ferritin

We report on two pregnant women who either had de novo restless legs syndrome (RLS) or had marked enhancement of preexisting RLS symptoms during pregnancy. Both patients had ferritin values <50 μg/L at baseline. The patients had relevant sleep disorders and daytime symptoms caused by RLS. The women were treated in an open paradigm with intravenous iron sucrose. A few weeks after therapy, both patients experienced a significant reduction or even remission of RLS symptoms. Their quality of life and sleep substantially improved and no treatment-related adverse effects were observed. According to our initial experience, intravenous iron sucrose administration appears to be an effective therapy in RLS patients with low ferritin values during pregnancy.     

Turku sugar studies V: Final report on the effect of sucrose,fructose and xylitol diets on the caries incidence in man

The purpose was to study differences in the caries increment rate as influenced by various sugars. The trial involved almost complete substitution of sucrose (S) by fructose (F) or xylitol (X) during a period of 2 years. There were no significant initial differences as to caries status between the prospective sugar groups; 35 subjects in the S-group, 38 in the F-group, and 52 in the X-group. During the entire study 10 subjects discontinued or were excluded. The clinical and radiographical observer error was reported and discussed. After 2 years the mean increment of decayed, missed and tilled tooth surfaces was 7.2 in the S-group, 3.8 in the F-group, and 0.0 in the X-group. The weakness of the DMFS-index in not showing the development of new secondary caries and the increase in size of the lesions was overcome by expressing the caries activity in terms of indices showing the total quantitative and qualitative development. The results showed a massive reduction of the caries increment in relation to xylitol consumption. Fructose was found to be less cariogenic than sucrose. It was suggested that the non- and anticariogenic properties of xylitol principally depend on its lack of suitability for microbial metabolism and physico-chemical effects in plaque and saliva.     

Urinary bisphenol A concentrations and in vitro fertilization outcomes among women from a fertility clinic

Bisphenol A (BPA) is a widespread environmental endocrine disrupting chemical. Although many animals and in vitro studies reported that BPA may affect female fertility through the effect on maturing oocytes and meiotic cell division, but the data from human studies are limited and inconclusive. The study was conducted to examine the association between urinary BPA concentration and in vitro reproductive outcomes (metaphase II (MII) oocyte yield, top quality embryo, fertilization rate, implantation rate and clinical pregnancy) among women from an infertility clinic.The study participants were enrolled in the Infertility Center in Poland. 450 women aged 24-44 (n = 674 IVF cycles) provided urine samples. The urinary concentrations of BPA were evaluated using validated gas chromatography ion-tap mass spectrometry method. Clinical outcomes of IVF treatment were abstracted from patients electronic chart records. To assess the relationship between urinary BPA concentrations early examined reproductive outcomes generalized linear mixed models were used.The detection rate of BPA in urine samples was 98% and the geometric mean 1.59 ± 2.15 ng/ml. A significant decrease was observed between urinary concentration of BPA and implantation (p = 0.04) and decreased MII oocyte count (p = 0.03). There was no association between other examined IVF outcomes: embryo quality, fertilization rate and clinical pregnancy and BPA exposure.Exposure to BPA may have a negative effect during the early stages of human development. The studies among the larger and more diverse population are needed to confirm the results.