Prevalence of coeliac disease in diabetic children and their first-degree relatives in West Algeria: screening with serological markers

Atypical and relatively silent forms of coeliac disease (CD) have been described in insulin-dependent diabetes mellitus (IDDM). Our aim was to evaluate the prevalence of CD-IDDM with serological markers and to investigate the presence of CD in the IDDM first-degree relatives. During 1993 94 we explored 116 IDDM patients reported as new cases and 381 first-degree relatives of IDDM patients. Determination of IgA and IgG antigliadin antibodies (AGA) and IgA antiendomysium antibodies (AEA) was made. Jejunal biopsy was performed in symptomatic patients or in those with positive serological markers, (i) Nineteen IDDM-CD were identified and 5 were suspected. Thus, the prevalence of CD in IDDM patients was between 16.4 and 20%. AGA and/or AEA were abnormal in 13 and normal in 5. Sensitivity was 80% for the three tests when used simultaneously and specificity was 100%. (ii) In the family study, 26 sera of asymptomatic first-degree relatives of IDDM patients were positive for at least one of the serological markers; 13 of them had villous atrophy. Systematic serological screening in IDDM allowed us to detect CD and evaluate the true incidence.     

多培沙明,非诺多泮和丙卡特罗对心肌缺血时电生理变化影响的比较

新型多巴胺受体激动剂多培沙明(DPX)能显著减轻缺氧和缺血豚鼠心室乳头肌静息电位,动作电位幅度和O相除极速度的降低程度及动作电位时程的缩短程度,其减轻作用明显大于非诺多泮(FODA)和丙卡特罗(PCTR)。DPX能使缺氧时缩短的有效不应期(ERP)延长,而使缺血时延长的ERP缩短,其程度明显大于FODA与PCTR。提示DPX抗缺血性心律失常的作用优于其他类型的多巴胺激动剂。     

Serum angiogenic profile in abnormal placentation

Objective: To evaluate the circulating soluble fms-like tyrosine kinase 1 (sFlt1), placental growth factor (PlGF) and vascular endothelial growth factor (VEGF) levels in women with abnormal placentation and to compare the data with the results of women with normal pregnancy.

Material and methods: Serum biomarkers of angiogenesis and maternal and perinatal characteristics of 68 pregnant women, all in the third trimester, who were diagnosed to have vaginal bleeding due to complete placenta previa with and without concomitant placenta accreta, increta and percreta as the study group and 30 pregnant women without any placentation abnormality who eventually delivered at ≥37 weeks of gestational age as the control group were evaluated.

Results: There was no statistical difference in the maternal serum values of sFlt1, PlGF, sFlt1/PlGF ratio and VEGF in groups with placental abnormality as compared to controls. Not even a single case of preeclampsia and intrauterine fetal growth restriction was encountered in the study group.

Conclusion: We demonstrated that regardless of the localization and the degree of the myometrial invasion of the placenta in the uterus, the circulatory biomarkers of angiogenesis and vascularization were comparable.     

Influence of Drain Placement on Postoperative Pain Following Laparoscopic Roux-en-Y Gastric Bypass for Morbid Obesity: Randomized Controlled Trial

Background

There is currently no evidence to support the routine use of an abdominal drain following laparoscopic Roux-en-Y gastric bypass (RYGB). Our aim was to investigate drain use in laparoscopic RYGB and its effects on postoperative pain.

Methods

Sixty-six patients were randomly divided into two groups as no-drain (n?=?36) and with-drain (n?=?30). Intraoperative (time, blood loss, complications) and postoperative outcomes (morbidities, pain scores, hospital stay) were compared.

Results

Demographics of both groups were comparable. Three patients in the no-drain group required a drain (8.3%). Median visual analog scale scores for days 1–3 for with-drain and no-drain groups were 4.5 (2–9) vs. 3 (0–8) (p?=?0.02), 3 (0–7) vs. 2 (0–7) (p?=?0.10), and 2 (0–7) vs. 0 (0–4) (p?=?0.0004), respectively. There was no difference between the groups in terms of complications and length of hospital stay.

Conclusion

Drain use increased the postoperative pain following laparoscopic RYGB. Drain placement following laparoscopic RYGB should be selective instead of a routine application.

     

应用国产神经节苷脂改善帕金森病患者临床症状的时间及效果：多地区、多中心6344例回顾性分析

目的:观察口服国产神经节苷脂对帕金森病患者临床症状的改善时间及效果。方法:于2001-01/2005-01通过脑病防治健康教育计划小组选取帕金森患者,包括黑龙江、河北、山东、河南、北京、江苏、甘肃、青海、贵州、福建、湖南、山西、湖北、四川、重庆、江西、上海、云南等地区共6344例患者,均符合《实用神经病学》有关帕金森病的诊断及分类标准,纳入口服神经节苷脂≥10mg/d,服用1个月以上且知情同意者。患者口服国产神经节苷脂口服液进行神经功能康复,每支含神经节苷脂(内含单唾液酸四己糖神经节苷脂1(占21%)、二唾液酸四已糖神经节苷脂1a(占40%)、二唾液酸四已糖神经节苷脂1b(占16%)、三唾液酸四已糖神经节苷脂1b(占19%))0.25g/L,每天早上空腹2支,晚上睡前2支或每晚临睡前4支服用。3个月为1个治疗周期,患者服用两三个周期,个别病程时间长者服用4个周期以上。服用过程中进行定期随访,观察帕金森患者在震颤、肌强直、运动迟缓、姿势异常等方面的改善情况。疗效评估:对患者服用国产神经节苷脂口服液后3个月、6个月、9个月、1年的病情改善情况进行观察。显效为震颤和肌强直消失,姿势异常消失,渐停止服用多巴胺制剂等药物;好转为上述症状减轻,多巴胺制剂等药物减少使用;无效为上述症状无改善。结果:符合纳入标准者5937例,全部进入结果分析,无脱落。不同服药时间帕金森病患者临床症状的改善情况:服用国产神经节苷脂1￣3个月有效者669例,服用4￣6个月有效者941例,服用7￣12个月有效者1713例,总有效率为56%。结论:国产神经节苷脂能有效改善帕金森患者震颤、肌强直、运动迟缓、姿势异常等临床症状,长期服用效果更好。     

纳米晶胶原基骨材料在骨科疾病中的应用

目的:观察纳米晶胶原基骨材料(简称人工骨)植入后骨愈合的时间和骨修复效果,探讨人工骨在骨科临床的应用范围。方法:于2003-03/2005-03选择江苏大学附属医院骨科收治的骨折后骨缺损患者32例,骨不连患者5例,骨肿瘤患者4例,腰椎峡部裂患者4例。均符合本临床试验所制定的诊断标准,并经X射线片确诊,患者均知情同意。①骨折后骨缺损患者:均为四肢各部位粉碎性骨折,经切开复位后有骨缺损,采用人工骨植入骨缺损处。②骨不连患者:将骨折端瘢痕及硬化骨切除、髓腔打通后,植入人工骨。③良性骨肿瘤患者:将病骨刮除后植入人工骨。④腰椎峡部裂患者:在减压,RF复位、内固定后有2例行自体骨与人工骨混合植入,1例左侧行自体骨、右侧行人工骨植入,另1例在原来行自体骨植骨基础上因愈合欠牢固,而在原植骨处加植人工骨。结果:42例患者获得随访。①骨折后骨缺损患者29例,25例在术后2～7个月先后达临床愈合。另4例中,1例尺骨缺损植人工骨处术后2年尚无骨痂形成,术后2年9个月骨缺损处愈合;1例胫骨中上段粉碎骨折于术后15个月见原骨缺损植人工骨处骨痂形成不多。其余2例为术后过早负重,发生钢板断裂,给予重新手术复位、固定。②骨不连患者5例,有2例于术后9个月愈合,3例单纯植人工骨者未愈,其中2例再手术行自体骨移植,术后1年愈合。③良性骨肿瘤患者4例,骨囊肿2例术后未见复发。骨纤维结构不良2例,术后再次手术,改行自体骨移植。④腰椎峡部裂患者4例,3例术前腰腿痛症状消失,复查X射线片见原峡部断裂影消失。1例仍感下肢麻痛,复查X射线片见植骨愈合欠佳。结论:纳米晶胶原基骨材料具有良好的生物相容性及生物可降解性能,植入体内具有良好的骨传导作用,可用于四肢粉碎性骨折所致的骨缺损;因其不具备骨诱导成分,对于骨不连、良性骨肿瘤等所致骨缺损,宜将纳米晶胶原基骨材料和自体骨混合使用。     

25-Hydroxyvitamin D levels are related to hyperinsulinemia in polycystic ovary syndrome

Aim: To determine 25-hydroxyvitamin D levels and the relationship between 25-hydroxyvitamin D and metabolic disturbances including insulin resistance in women with PCOS.

Materials and methods: We compared biochemical, hormonal parameters and 25-hydroxyvitamin D levels of 58 women with PCOS and 38 body mass index matched controls.

Results: There was no difference in 25-hydroxyvitamin D levels of women with PCOS and the control group. Low 25-hydroxyvitamin D levels in women with PCOS were related to higher insulin levels (r?=???0.271 and p?=?0.042). More than 90% of the subjects had hypovitaminosis D. The negative relationship between 25-hydroxyvitamin D levels and body mass index did not reach statistical significance.

Conclusion: Low 25-hydroxyvitamin D levels were related to hyperinsulinemia in women with PCOS.