The efficacy of x-ray skeletal diagnosis in chronic alcoholics

Within an interdisciplinary study of diseases accompanying alcoholism skeletal changes were investigated in dependent alcoholics. We scanned 147 patients for osteoarthropathy, osteoporosis/osteomalacia and posttraumatic conditions. The monitored regions show trends confirming the results from the literature. If we consider, that according to our selection principle relatively early stages of alcoholism were analyzed. In the conclusions we are recommending to investigate alcohol-induced skeletal effects more closely and specifically, primarily with regard to osteoporosis/osteomalacia. Even if the effectiveness of the study may be lower, it should be extended to relapses and non-cooperative cases.     

Epidemiology of atopy patch tests with food and inhalant allergens in an unselected population of children

Atopy patch test (APT) has been used as a diagnostic tool in patients with suspected food or inhalant allergy. This study assessed the prevalence of positive APT with food or inhalant allergens in an unselected population of schoolchildren. We also evaluated the link between positive APT reactions and skin‐prick tests (SPT) for food and inhalant allergens, circulating eosinophils and histamine skin reactivity. We studied an unselected population of 380 children aged 9 or 13 yr living in Rome, Italy. APTs were carried out with food (native or standardized) and inhalant allergens. All the children also underwent skin‐prick testing with five common inhalant and four food allergens. We also measured eosinophil cell counts and histamine skin reactivity. The prevalence of positive APT reactions for foods in unselected children ranged between 4% and 11% for hen’s egg, tomato, and wheat flour and was similar for both age groups studied. The prevalence of positive APT for milk was significantly lower in children aged 13 than in children aged 9 (p = 0.013). No concordance emerged between positive APT and SPT for foods. Conversely, APT and SPT for inhalant allergens yielded statistically significant concordance (p < 0.001). APT produces positive reactions for food or inhalant allergens in a significant number of subjects in the general population of schoolchildren. Age influences the prevalence of positive APTs with cow’s milk to some extent. Inhalant allergens probably induce a positive APT reaction through an immunoglobulin E‐linked process, while food allergens probably do not.     

Text message-based lifestyle intervention in primary care patients with hypertension: a randomized controlled pilot trial

Abstract

Objective

To evaluate the feasibility of a randomized controlled pilot study with lifestyle-promoting text messages as a treatment for hypertension in primary care.     

Concentrations of N-terminal pro-brain natriuretic peptide and troponin T in plasma of 75-year-old apparently healthy persons.

Clinical chemical reference values for older persons are sparse and mostly intermixed with those for younger persons. We had a unique opportunity to obtain blood samples from volunteers who were 75 years old and living in two districts of Vienna, Austria. Consequently, we utilized stored plasma samples to obtain reference intervals for 120 apparently healthy 75-year-old participants for pro-brain natriuretic peptide (proBNP), as well as for troponin T. The N-terminal (NT)-proBNP protein assay is currently used as a diagnostic and prognostic aid in patients with heart failure and as a prognostic marker in acute coronary syndromes. Specifically, the concentration of NT-proBNP in serum or plasma aids in the prognosis of ventricular systolic dysfunction and helps to differentiate between cardiac and non-cardiac causes. The median NT-proBNP plasma value for men and women in our cohort was calculated as 98 pg/ml, comparing favorably with reported values, in that a NT-proBNP concentration less than 100 pg/ml excludes acutely decompensated heart failure. Our calculated 97.5 percentile was slightly higher (359 pg/ml) than the 97.5 percentile in a group of 50-65-year-old persons (198 and 222 pg/ml for men and women, respectively) revealing the influence of age on this parameter. Because of its high tissue-specificity, cardiac troponin T is a cardiospecific, highly sensitive marker for myocardial damage. However, the troponin T concentrations in the plasma specimens from this cohort were all below the detection limit of 0.01 ng/ml, preventing any further data handling.     

Relevance of the Thought–Shape Fusion Trait Questionnaire for healthy women and women presenting symptoms of eating disorders and mixed mental disorders

Thought–shape fusion (TSF) describes the experience of marked concerns about body weight/shape, feelings of fatness, the perception of weight gain, and the impression of moral wrongdoing after thinking about eating fattening/forbidden foods. This study sets out to evaluate the short version of the TSF trait questionnaire (TSF). The sample consists of 315 healthy control women, 244 women with clinical and subthreshold eating disorders, and 113 women with mixed mental disorders (mixed). The factor structure of the TSF questionnaire was examined using exploratory and subsequent confirmatory factor analyses. The questionnaire distinguishes between a Concept scale and a Clinical Impact scale. However, a lack of measurement invariances refers to significant differences between groups in terms of factor loadings, thresholds, and residuals, which questions cross‐group validity. Results indicate that the concept is understood differently in the 3 groups and refers to the suitability of the questionnaire primarily for individuals presenting with symptoms of eating disorders.     

Rituximab in refractory nephrotic syndrome

The aim of this study was to establish the efficacy and safety of rituximab in refractory nephrotic syndrome (NS). Members of the International Paediatric Nephrology Association were asked to retrospectively fill in a questionnaire with details on the use of rituximab in their centres. We divided the data into three groups: group 1, patients with steroid-dependent and frequently relapsing NS; group 2, with steroid-resistant NS; group 3, with post-transplant recurrence of NS. Seventy questionnaires from 25 centres described the outcome of 28, 27 and 15 patients in groups 1, 2 and 3, respectively. Of these, 82% of patients in group 1, 44% of patients in group 2 and 60% of patients in group 3 had a good initial response. Side effects were observed in 27% of the patients, and these were mostly acute reactions. We present a large multicentre series of children with refractory NS. Children in group 1 showed the best response. The good initial response in group 3 can be biased by the accompanying treatments that were administered at the same time as rituximab. Controlled prospective trials are required to establish the value of rituximab in idiopathic NS.