Platelets from diabetic subjects show diminished sensitivity to prostacyclin

Abstract. Prostacyclin, an unstable metabolite of arachidonic acid metabolism, has been shown to have potent platelet antiaggregatory and vasodilator activity. Available evidence suggests that arterial prostacyclin production is diminished in the diabetic state. In this study we have examined the sensitivity of platelets from diabetic subjects to the antiaggregatory effects of prostacyclin in vitro and report that platelets from some diabetic patients show diminished sensitivity to the antiaggregatory effects of prostacyclin. Thus diabetic subjects may not only have diminished prostacyclin production but also their platelets may be less sensitive to its effects. These findings may help to explain the increase in vascular disease observed in diabetic patients.     

Incidence of musculoskeletal pain and rheumatic disorders in a Bangladeshi rural community: a WHO‐APLAR‐COPCORD study

Aim: To estimate the incidence of musculoskeletal pain and rheumatic disorders in a Bangladeshi rural community. Methods: This study was conducted in six villages near Dhaka from January 2001 to June 2002. Door‐to‐door case finding by interviewers was followed by interviewing and examination of positive respondents by trained doctors. The respondents with inflammatory arthropathies were reviewed 5 years later, in December 2006. Results: Four hundred and forty‐one (M = 163, F = 278) out of 2685 adults (M = 1324, F = 1361) developed new musculoskeletal pain yielding an incidence rates of 10.9/100 person‐years (PY) (M = 8.2, F = 13.6). The incidence was highest in the 35–44‐year age group in both genders. It was highest in housewives, followed by weavers and cultivators. The spine (7.5/100 PY) was the most common affected part followed by knees (6.5), shoulder (6.2) and neck (6.2). The most common cause of new musculoskeletal pain was non‐specific low back pain, followed by fibromyalgia and knee osteoarthritis. Forty‐one subjects (M = 17, F = 24) developed inflammatory joint or spinal pain (1000/100,000 PY). The incidence of rheumatoid arthritis, combined spondyloarthropothies, ankylosing spondylitis, reactive arthropathy and psoriatic arthritis were 120 (M = 101, F = 147), 150 (M = 252, F = 49), 75 (M = 151, F = 0), 50 (M = 101, F = 0) and 25 (M = 0, F = 49) per 100,000 PY, respectively. Thirty‐one cases had undiagnosed arthropathies (770/100,000 PY). Seven were unavailable in December, 2006 and one died. The remaining 23 were symptom‐free. Conclusions: The incidence of musculoskeletal pain and rheumatic disorders is considerable in this Bangladeshi rural community. Common incident disorders are non‐specific low back pain, fibromyalgia and osteoarthritis of knees. Inflammatory arthropathies are not common. The majority of undiagnosed arthopathies undergo spontaneous lasting remission.     

Spontaneous Echo Contrast in a Polycythemic Patient with a Ventricular Septal Defect

We describe the unusual case of spontaneous echo contrast (SEC) and thrombus occurring in a 23-year-old male with a ventricular septal defect (VSD), Eisenmenger's complex, and severe polycythemia. The contrast effect was faintly seen by transthoracic echocardiography, and was seen clearly by transesophageal echocardiography. The SEC was present in all four cardiac chambers and was particularly obvious in the left ventricle (LV). In addition, there was a large thrombus in the LV. The velocity across the VSD was 1 ml sec. The patient's hematocrit was 74%. The platelet count was normal and total proteins were 8.9 gm%. The widespread SEC may be related to rheologic abnormalities related to the secondary polycythemia and, perhaps, became more obvious due to the moderate LV dysfunction.     

Oocyte and follicular fluid characteristics in women with mild endometriosis

Summary. The follicular development, fertilization and cleavage rates and follicular fluid endocrinology were assessed in 20 women with mild endometriosis during a spontaneous menstrual cycle. Diagnostic lapa-roscopy was performed 32 h after the onset of the endogenous luteinizing hormone (LH) surge in the 20 women with laparoscopically confirmed mild endometriosis and in a control group of ten women with tubal infertility. There was no significant difference in oocyte maturity or fertilization and cleavage rates between the women with mild endometriosis and those in the control group. The endocrine milieu of the pre-ovulatory oocyte at the time of aspiration was similar in the two groups     

Neuroblastoma and Poland syndrome in a 15-year-old boy

A 15-year-old boy with neuroblastoma associated with Poland syndrome is presented. He was admitted with a 2-month history of progressive back pain and a 3-day history of weakness of the lower extremities, encopresis and enuresis. On physical examination, in addition to paraplegia, absence of the pectoralis major muscle was diagnosed on the right side of his chest. A large heterogeneous mass in the right side of the thorax was revealed on computerized tomography. Neuroblastoma was diagnosed on histopathological analysis of the mass. To the authors' knowledge this is the first case of neuroblastoma associated with Poland syndrome in the literature.     

Crohn's disease in children from the western region of Saudi Arabia

In this paper, we describe 17 children with Crohn's disease seen at King Abdulaziz Unviersity Hospital, Jeddah, Saudi Arabia, who were followed up during a period of 10 years (1980–90). Their ages ranged from 5 to 15 years. The average duration of symptoms prior to presentation was 25 months (ranging from 4 days to 4 years). In this article, we describe the clinical picture, laboratory investigations and results, as well as the treatment of the affected children.