Risk of multiple myeloma following medication use and medical conditions: a case-control study in Connecticut women.

BACKGROUND: Certain commonly used drugs and medical conditions characterized by chronic immune dysfunction and/or antigen stimulation have been suggested to affect important pathways in multiple myeloma tumor cell growth and survival. We conducted a population-based case-control study to investigate the role of medical history in the etiology of multiple myeloma among Connecticut women. METHODS: A total of 179 incident multiple myeloma cases (21-84 years, diagnosed 1996-2002) and 691 population-based controls was included in this study. Information on medical conditions, medications, and medical radiation was obtained by in-person interviews. We calculated odds ratios (OR) as measures of relative risks using logistic regression models. RESULTS: A reduced multiple myeloma risk was found among women who had used antilipid statin therapy [OR, 0.4; 95% confidence interval (95% CI), 0.2-0.8] or estrogen replacement therapy (OR, 0.6; 95% CI, 0.4-0.99) or who had a medical history of allergy (OR, 0.4; 95% CI, 0.3-0.7), scarlet fever (OR, 0.5; 95% CI, 0.2-0.9), or bursitis (OR, 0.4; 95% CI, 0.2-0.7). An increased risk of multiple myeloma was found among women who used prednisone (OR, 5.1; 95% CI, 1.8-14.4), insulin (OR, 3.1; 95% CI, 1.1-9.0), or gout medication (OR, 6.7; 95% CI, 1.2-38.0). CONCLUSIONS: If our results are confirmed, mechanistic studies examining how prior use of insulin, prednisone, and, perhaps, gout medication might promote increased occurrence of multiple myeloma and how antilipid statins, estrogen replacement therapy, and certain medical conditions might protect against multiple myeloma may provide insights to the as yet unknown etiology of multiple myeloma.     

雷洛昔芬对骨质疏松妇女心脏自律性的影响

目的：一些资料提示雷洛昔芬也许对绝经后妇女的动脉系统有益，并会降低不良心血管事件的远期发生率。心率变异性的减少可作为确定心源性死亡风险增加患者的标志物，尤其是对于心肌梗死后及老年患者。尽管关于雌激素和孕激素对绝经后妇女心率变异性的作用尚有争议，但雷洛昔芬治疗对心率变异性的影响尚不清楚。研究设计：这是一项为期6个月的前瞻性、随机、安慰剂对照试验，共纳入骨质疏松的绝经后妇女43例。其中23例接受盐酸雷洛昔芬治疗，1次／d，60mg；而另20例接受阿仑膦酸治疗，10mg／d。在基线及治疗3个月和6个月时测定心率变异性的时域指标和频域指标。结果：治疗结束时组内各研究对象的心率变异性的时域指标、平均RR、心跳间隔时间的SD值无变化。副交感神经活动的一个敏感指数——连续RR间期平方和均值的平方根，有随雷洛昔芬剂量增加而增加的趋势。心率变异性的频域指标如下：在两种治疗方案中，心率变异性的低频功率与基线值一致。治疗3个月时，雷洛昔芬治疗组的心率变异性的高频功率显著增高（P=0．039），且一直持续到治疗结束。而阿仑膦酸组只有轻微降低。因此，低频功率／高频功率、副迷走神经平衡指数在雷洛昔芬治疗3个月时显著降低（P=0．028）且持续到6个月时。阿仑膦酸治疗组患者低频功率／高频功率比未发现明显改变。结论：雷洛昔芬似乎对绝经后骨质疏松妇女的心脏自律性有益。本研究至少可以部分解释在雷洛昔芬评价试验的多结果中心血管事件高危妇女心血管事件发生率降低的情况。关于雷洛昔芬对心血管系统的影响有望在后续研究中得出最终结论。     

The effect of glutamine supplementation on hematopoietic stem cell transplant outcome in children: A case–control study

Abstract:  HSCT associated morbidity and mortality is usually attributed to high-dose chemotherapy/radiotherapy regimens used for conditioning. Glutamine (Gln), a conditionally essential amino acid during severe catabolic states, has been shown to have favorable effects in patients with malignancies and in those undergoing HSCT. However, controversy exists regarding its routine use. Studies in children investigating gln supplementation are very limited. In the present study, including 21 gln-supplemented and 20 control pediatric patients, gln supplementation was shown to reduce the duration of fever and decrease the incidence of SOS during the HSCT course. In addition, a decrease in drug-related toxicity and a trend toward reduced incidence of severe mucositis were observed.     

Different glomerulopathies accompanying non-small-cell lung cancer

The coexistence of lung cancer and glomerular lesion is not commonly reported. Malignancy-related glomerulopathy is commonly membranous glomerulonephritis. Other glomerulopathies are seldom reported. We report two cases presenting with non-small-cell lung cancer, acute renal failure and nephrotic syndrome secondary to membranoproliferative glomerulonephritis and amyloidosis.     

Long-term ultrasonographic follow-up of plantar fasciitis patients treated with steroid injection

OBJECTIVE: To evaluate the long-term efficacy of steroid injection for plantar fasciitis using clinical parameters and high-resolution ultrasonography. MATERIAL AND METHODS: Thirty patients (27 female and three male) with plantar fasciitis and 30 healthy controls matched by age, gender and body mass index (BMI), were enrolled in this study. Seventeen of the patients had bilateral and 13 had unilateral (six right, seven left) plantar fasciitis. Palpation-guided steroid injection was applied to the 47 heels of 30 plantar fasciitis patients. Ultrasound examination and pain intensity with visual analog scale (VAS) were assessed three times in each plantar fasciitis patients; before injection and at 1 and 6 months after steroid injection. Ultrasonography was performed to the controls at initial assessment. RESULTS: The plantar fascia was remarkably thicker in the plantar fasciitis group than in controls (P < 0.001). The thickness of the plantar fascia and mean VAS values in the plantar fasciitis group decreased significantly 1 month after steroid injection (P < 0.001, P < 0.001, respectively) and a further decrease was noted 6 months postinjection (P < 0.001, P < 0.001, respectively). Strong correlation was found between the changes of plantar fascia thickness and VAS values 1 month after (P < 0.001, r: 0.61) and 6 months after (P < 0.001, r: 0.49) steroid injection. The incidence of hypoechoic fascia was 73% in the plantar fasciitis group before steroid injection. It decreased significantly at 1 and 6 months postinjection (33% and 7%, respectively, P < 0.001). Gross fascia disruption or other side effects were not observed after steroid injection. CONCLUSION: Steroid injection could be used in plantar fasciitis treatment for its positive long-term effects.     

Endocrine profile of children with intrauterine growth retardation

BACKGROUND: Intrauterine growth retardation (IUGR) is a major cause of short stature in childhood. Most but not all children experience catch-up growth by 2 years of age. METHODS: We investigated the endocrine profile (thyroid function, prolactin, cortisol, C-peptide and insulin-like growth factor-I [IGF-IJ levels) of 57 children with IUGR, aged 2-10 years, and compared it with 30 controls whose birth weight was appropriate-for-gestational-age. RESULTS: The hormonal profile for both groups was similar for thyroid hormones, prolactin, C-peptide and IGF-I. Cortisol levels were significantly lower in the IUGR group compared to controls (p <0,05). When the IUGR group was divided into 'catch-up' growth and 'non-catch-up' subgroups, the latter had significantly lower IGF-I levels (p <0.001). CONCLUSIONS: Lower cortisol levels in children born with IUGR may reflect impaired function of the hypothalamic-pituitary-adrenal axis associated with this condition. The significantly lower IGF-I levels of the 'non-catch-up' subgroup may be involved in their failure to grow.