A comparative study of thyroid hormone levels in young diabetic and non-diabetic patients

Thyroid disorders can adversely affect diabetes control. The aim of the study was to compare thyroid hormone levels in type 1 diabetic patients with that of non-diabetic patients. Fifty two type 1 Diabetic patients were consecutively selected from among those attending the outpatient department of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorder (BIRDEM) hospital. Fifty three healthy non-diabetic volunteers were selected from the students of a university. Both groups were below 30 years of age. The patients with type 1 diabetes have significantly lower serum FT3 levels (P <0.001) when compared to the control groups. There was no significant difference between controls and study subjects in terms of serum FT4 (P?=?0.376) and TSH (P?=?0.821) concentration. We conclude that alteration of FT3 is a common feature in these subjects with type 1 diabetes mellitus.     

Spontaneous coronary artery dissection: management options in the stent era

Spontaneous coronary artery dissection (SCAD) is a rare cause of coronary obstruction, usually affecting women in the childbearing age. Pathogenetic mechanisms are elusive, and optimal treatment is not established. We describe a case of spontaneous coronary artery dissection that was successfully treated by coronary stenting. The published literature regarding the outcome of this modality of treatment in patients with SCAD is reviewed. A patient with spontaneous coronary artery dissection treated by stenting is described along with a review of the published literature regarding treatment of similar patients.     

Detection of high frequencies of HIV-1 cross-subtype reactive CD8 T lymphocytes in the peripheral blood of HIV-1-infected Kenyans

OBJECTIVES: To quantitate rapidly the frequency of HIV-1 subtype-specific and broadly HIV-1 cross-subtype-reactive CD8 T cells in the peripheral blood of HIV-1-infected individuals from a geographical region of multiple subtype endemicity. METHODS: Autologous B-lymphoblastoid cell lines infected with recombinant vaccinia-viruses expressing gag, env and nef gene products from HIV-1 subtypes A-H were used as antigen-presenting cells to stimulate CD8 T cells from cryopreserved peripheral blood mononuclear cells. Cross-subtype and subtype-specific CD8 cell responses were assessed by flow cytometry for the upregulation of IFN-gamma gene expression in specifically activated CD8 T cells. RESULTS: Strikingly high frequencies of circulating CD8 T cells (up to 11.3% of peripheral CD8 T cells) with specificity for HIV-1 were detectable using this methodology. Both subtype-specific and broadly cross-subtype-reactive CD8 T cells were detected as assessed by IFN-gamma production after stimulation. The pattern of cross-subtype reactivity appeared to be random when the results were assessed as a population, but analysis of the full-length sequence of the infecting virus for each individual showed some skewing of the CD8 cell response towards the infecting subtype. CONCLUSION: High frequencies of HIV-1 cross-subtype-reactive peripheral CD8 T cells can be detected in individuals from a multiple subtype endemic region, providing an incentive for vaccine advancement in such locations. The future assessment of the subtype specificity of cellular immune responses requires full-length sequencing of the infecting virus in conjunction with a comprehensive analysis of phenotypic and functional parameters.     

Pitfalls in the echocardiographic diagnosis of intracardiac and extracardiac masses

Transthoracic and transesophageal two-dimensional (2-D) echocardiography remain the procedures of choice for evaluating cardiac mass lesions. Potential errors in diagnosis can be made, however, if the mass lesion's size, shape, mobility, and attachment to other cardiac structures are not clearly delineated. Usually a left atrial myxoma arises from the interatrial septum at the level of the fossa ovalis. Pitfalls in diagnosis occur when the tumor size is very small, or its attachment site is atypical or ill-defined. Atrial thrombi classically reside in an atrial appendage, but can also form in the body of the left atrium. The presence of atrial fibrillation rhythm, enlarged atrial chamber, prosthetic mitral/tricuspid valves, stenotic mitral/tricuspid valves, low cardiac output state, and spontaneous atrial contrast echoes are all features that favor the mass in question being a thrombus. Ventricular thrombi usually occur with poorly functioning ventricles. The diagnosis of ventricular thrombus should be made with great caution if the systolic function is normal, or if the mass has a band or thread-like appearance. A thorough knowledge of normal anatomical variants that can mimic pathological lesions is also important for reaching a correct diagnosis. Last but not least, as in all testing modalities, the patient's clinical picture should be correlated with the echocardiographic findings.     

Electrochemical oxidation of As(iii) on Pd immobilized Pt surface: kinetics and sensing performance

Pd nanoparticles were electrochemically immobilized on a Pt surface in the presence of sodium dodecyl sulfate (SDS) molecules to study the electrokinetics of arsenite oxidation reactions and the corresponding sensing activities. The X-ray photoelectron spectroscopy (XPS) analysis showed that on the Pt surface, Pd atoms exist as adatoms and the contents of Pd(0) and Pd(ii) were 75.72 and 24.28 at%, respectively, and the particle sizes were in the range of 61–145 nm. The experimental results revealed that the catalytic efficiency as well as the charge transfer resistance (at the redox potential of the Fe(ii)/Fe(iii) couple) increased in the order of Pt < Pt–Pd < Pt–Pd_sds. A Pt–Pd_sds electrode exhibited an open circuit potential (OCP) of 0.65 V in acidic conditions; however, when 50.0 mM NaAsO₂ was present, the OCP value shifted to 0.42 V. It has been projected that the As(iii) oxidation proceeds using a sequential pathway: As(iii) → As(iv) → As(v). After optimization of the square wave voltammetric data, the limits of detection of As(iii) were obtained as 1.3 μg L⁻¹ and 0.2 μg L⁻¹ when the surface modification of the Pt surface was executed with Pd particles in the absence and presence of the SDS surfactant, respectively. Finally, real samples were analyzed with excellent recovery performance.

Amplification of true surface area can be improved when Pd particles are deposited on a substrate in the presence of sodium dodecyl sulfate (SDS) surfactant. In acidic medium, As(iii) undergoes a two-step oxidation process.     

Salbutamol in acute organophosphorus insecticide poisoning – a pilotdose-response phase II study

Background: Treatment of acute organophosphorus (OP) insecticide poisoning is difficult, with many patients dying despite best care. Pre-clinical studies have shown benefit from salbutamol, possibly due speeding alveolar fluid clearance or reducing bronchoconstriction. In this small pilot dose-response study, we aimed to explore whether addition of nebulized salbutamol to standard care might improve resuscitation.

Methods: We performed a single-blind phase II study comparing the effect of two different doses of nebulized salbutamol versus saline placebo, in addition to standard treatment. Primary outcome was oxygen saturations over the first 60?min of resuscitation; secondary outcomes included heart rate, incidence of dysrhythmias, time to ‘atropinization’, atropine dose required, and mortality.

Result: Seventy-five patients were randomized to receive 5?mg (Salb5, n?=?25) or 2.5mg (Salb2.5, n?=?25) of salbutamol, or saline placebo (NoSalb, n?=?25), by nebulizer. Oxygen saturations did not differ between groups over the first 60?min of resuscitation (median AUC NoSalb: 1376 [95% CI 1282 to 1470], Salb2.5: 1395 [1305 to 1486], Salb5: 1233 [1100 to 1367]; p?=?.9898). Heart rate was also similar across the three arms. Median time to full atropinization, and atropine dose required, were the same for all three arms (NoSalb 15.0 [10–16] min and 12.6 [8.0–13.4] mg, Salb2.5 15.0 [10–16] min and 12.6 [9.3–16.8] mg, and Salb5 15.0 [10–20] min and 12.6 [10.7–20.6] mg; p?=?.4805 and p?=?.1871, respectively). Three (12%) patients died in the Salb2.5 and Salb5 groups and two (8%) in the NoSalb group.

Conclusion: This pilot study, within the limitations of its small size and variation between patients, found no apparent evidence that administration of nebulized salbutamol improved resuscitation of patients with acute OP insecticide self-poisoning. The data obtained provides a basis to design further studies to ultimately test the role of salbutamol in OP insecticide poisoning.