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Marlon E. Cerf Charna S. Chapman Christo J. Muller Johan Louw 《Metabolism: clinical and experimental》2009,58(12):1787-1792
Hyperglycemia and compromised β-cell development were demonstrated in neonatal rats programmed with a gestational high-fat diet. The aim of this study was to determine whether these changes were attributed to impaired insulin release and altered immunoreactivity of Pdx-1, glucokinase (GK), and glucose transporter (GLUT)–2 in high-fat–programmed neonates. Fetuses were maintained, via maternal nutrition, on either a standard laboratory diet (control) or a high-fat diet throughout gestation (HFG). Pancreata from 1-day–old neonates were excised for islet isolation and the subsequent measurement of insulin release at 2.8, 6.5, 13, and 22 mmol/L glucose. Other pancreata were either snap frozen for quantitative polymerase chain reaction or formalin fixed for immunohistochemistry followed by image analysis. The HFG neonates had reduced insulin release at 13- and 22-mmol/L glucose concentrations. No significant differences were found in Pdx-1, GK, or GLUT-2 messenger RNA expression. In HFG neonates, immunoreactivity of both Pdx-1 and GK was significantly reduced, with a nonsignificant reduction in GLUT-2. Gestational high-fat programming impairs insulin release and reduces Pdx-1 and GK immunoreactivity. 相似文献
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Background
The thrombotic microangiopathies (TMAs) is a heterogeneous group of relatively uncommon but serious disorders presenting with thrombocytopenia and microangiopathic haemolysis. Thrombotic thrombocytopenic purpura (TTP) is one of these microangiopathic processes. HIV infection is an acquired cause of TTP but the pathogenesis is poorly understood. HIV-associated TTP was previously described to be associated with advanced immunosuppression. The incidence of HIV-related TTP was expected to decline with access to anti-retroviral therapy (ART).Methods
We undertook an observational study of patients with a diagnosis of TTP admitted to our hospital (CMJAH). The patient demographics, laboratory test results and treatment outcomes were recorded.Results
Twenty-one patients were admitted with a diagnosis of TTP during the study period. All patients had schistocytes and severe thrombocytopaenia. The presenting symptoms were non-specific and renal dysfunction and neurological compromise were uncommon. 77% of the patients were HIV-infected and, in 7 patients, TTP was the index presentation. The remainder of the HIV infected patients were on ART and the majority were virologically suppressed. A significant female preponderance was present. Only 4 of the 21 patients tested HIV negative with a positive Coombs test in 2. All patients in this cohort received treatment with plasma exchange therapy for a median period of 12?days with a 96.5% survival rate. Neither the baseline laboratory features nor the degree of immunosuppression was predictive of the duration of therapy needed for remission.Conclusion
HIV-related TTP is still a cause of morbidity and the clinical presentation is heterogeneous which may present a diagnostic challenge in the absence of sensitive biomarkers. Early treatment with plasma exchange is effective but expensive and invasive.16.
Elizabeth Sarah Mayne Malcolm Tait Barry Frank Jacobson Evashin Pillay Susan J. Louw 《Thrombosis journal》2018,16(1):30
Background
Autoimmune paraphenomena, are associated with B-cell lymphoproliferative disorders, including monoclonal gammopathy of uncertain significance. These paraphenomena can rarely include acquired bleeding disorders.Case presentation
This case study reports an unusual clinical presentation of 2 acquired bleeding disorders, Acquired von Willebrand syndrome (disease) and Acquired Glanzmann’s thrombasthenia, in an elderly patient with monoclonal gammopathy of uncertain significance.Conclusions
Acquired bleeding disorders are often underdiagnosed and a high degree of clinical suspicion is required. The patient in this study demonstrated platelet aggregometry which was atypical for isolated Glanzmann’s thrombosthenia because of the severe concomitant endogenous decrease in von Willebrand factor. There was an absence of platelet aggregation to all tested agonists including ristocetin. Once the diagnosis was made, however, the patient showed a partial response to intravenous immunoglobulin confirming the immunological pathogenesis in this case. This case highlights the need to consider acquired bleeding disorders in patients with a possible predisposing factor.17.
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[Purpose] The aim of this review was to present the available evidence for the effect of
McConnell taping on knee biomechanics in individuals with anterior knee pain. [Methods]
The PubMed, Medline, Cinahl, SPORTDiscus, PEDro and ScienceDirect electronic databases
were searched from inception until September 2014. Experimental research on knee
biomechanical or EMG outcomes of McConnell taping compared with no tape or placebo tape
were included. Two reviewers completed the searches, selected the full text articles, and
assessed the risk of bias of eligible studies. Authors were contacted for missing data.
[Results] Eight heterogeneous studies with a total sample of 220 were included in this
review. All of the studies had a moderate to low risk of bias. Pooling of data was
possible for three outcomes: average knee extensor moment, average VMO/VL ratio and
average VMO-VL onset timing. None of these outcomes revealed significant differences.
[Conclusion] The evidence is currently insufficient to justify routine use of the
McConnell taping technique in the treatment of anterior knee pain. There is a need for
more evidence on the aetiological pathways of anterior knee pain, level one evidence, and
studies investigating other potential mechanisms of McConnell taping.Key words: Patellofemoral pain syndrome, McConnell taping, Biomechanics 相似文献