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51.
52.
Safe vegetarian diets for children,. 总被引:2,自引:0,他引:2
53.
Background
In view of increase in incidence of exptrapulmonary tuberculosis after the epidemic of human immunodeficiency virus infection, the clinical profile of extrapulmonary tuberculosis in patients with HIV infection was studied.Method
The study population comprised patients of HIV infection with extrapulmonary tuberculosis. Work up included history, clinical examination, sputum for acid fast bacilli, chext X-ray, ultrasonography (USG) abdomen, fine needle aspiration cytology(FNAC), transbronchial needle aspiration (TBNA) and computed tomography of chest.Results
There were 50 cases, all males with mean age of 35 years. 24(48%) were without pulmonary tuberculosis and 26(52%) had pulmonary tuberculosis. 41(82%) had disseminated disease and 9(18%) involve one site. Fever and weight loss were the most frequent symptoms (79% and 58% respectively) in cases without pulmonary tuberculosis. The most frequent extrapulmonary site was lymph node in 46(92%), followed by spleen in 13(26%), pleura 9(18%), miliary 7(14%) and hepatic 1(2%). The diagnosis was confirmed by invasive methods in 30 out of 50(60%) cases [FNAC in 23(88%), TBNA in 2(25%) and pleural biopsy in 5(55%)].Conclusion
In HIV infected patients, the most common extrapulmonary site is lymph mode followed by spleen.Key Words: Extrapulmonary TB, HIV Infection 相似文献54.
Hsu FC Lenchik L Nicklas BJ Lohman K Register TC Mychaleckyj J Langefeld CD Freedman BI Bowden DW Carr JJ 《Obesity research》2005,13(2):312-319
OBJECTIVE: The purpose of this study was to investigate the heritability of body composition measured by DXA in the Diabetes Heart Study (DHS). RESEARCH METHODS AND PROCEDURES: Participants were 292 women and 262 men (age, 38 to 86 years; BMI, 17 to 57 kg/m(2)) from 244 families. There were 492 white and 49 African-American sibling pairs. DXA measurements of percentage fat mass (FM), whole body FM, and lean mass (LM), as well as regional measurements of trunk fat mass (TFM) and appendicular lean mass (ALM), were obtained. Heritability of FM, LM, and BMI were estimated using Sequential Oligogenic Linkage Analysis Routines. RESULTS: After adjusting for age, gender, ethnicity, and height, the heritability estimates of various compositional attributes were %FM = 0.64, whole body FM = 0.71, TFM = 0.63, whole body LM = 0.60, ALM = 0.66, and BMI = 0.64 (all p < 0.0001). Additional adjustment for diabetes status, smoking, dietary intake, and physical activity resulted in only minor changes in the heritability estimates (h(2) = 0.63 to 0.72, all p < 0.0001). Furthermore, heritability of TFM after additional adjustment for whole body FM was significant (h(2) = 0.55, p < 0.0001), and heritability of ALM after additional adjustment for whole body LM was also significant (h(2) = 0.51, p < 0.0001). DISCUSSION: These data suggest that FM and LM measured by DXA are highly heritable and can be effectively used in designing linkage studies to locate genes governing body composition. In addition, regional distribution of FM and LM may be genetically determined. 相似文献
55.
56.
Nilsson PM Cederholm J Gudbjörnsdottir S Eliasson B;Steering Committee of the National Diabetes Register of Sweden 《Journal of hypertension》2005,23(12):2305-2311
BACKGROUND: Hypertension in patients with diabetes is a well recognized cardiovascular risk factor for which the benefits of treatment are strongly evidence based. Less is known about predictors for successful long-term blood pressure control in these patients, including the potential role of body mass index (BMI), glycaemic control, microalbuminuria and smoking. MATERIAL AND METHODS: We used longitudinal data on risk factor levels from repeated clinical surveys of 1759 type 2 diabetic patients in the Swedish National Diabetes Register (NDR), a nationwide annual registration of quality indicators in diabetes care. Subjects with successful blood pressure (BP) control (systolic BP < 135 mmHg and diastolic BP < 85 mmHg) at baseline in 1997, in 2001, and at follow-up in 2003, were compared to subjects with BP control >or= 135/85 mmHg. RESULTS: Logistic regression analysis disclosed that successful BP control during the study period was predicted by lower BMI (P < 0.001), a lower frequency of microalbuminuria (P = 0.002), and lower age (P < 0.001) at baseline in 1997, and was still associated with lower BMI (P < 0.001), a lower frequency of microalbuminuria (P = 0.01) and lower age (P < 0.001) at follow-up. Successful BP control was also associated at follow-up with a lower frequency of the metabolic syndrome (30 versus 75%) and lower predicted 10-year risks [United Kingdom Prospective Diabetes Study (UKPDS) Risk Engine] of coronary heart disease (14 versus 29%) and stroke (10 versus 22%) (all P < 0.001). CONCLUSION: A lower BMI and absence of microalbuminuria were strong independent predictors of long-term successful BP control in type 2 diabetic patients, also characterized by a lower frequency of the metabolic syndrome and lower 10-year risk of cardiovascular disease. This implies the long-term benefits on BP control of lifestyle measures as well as control of microalbuminuria. 相似文献
57.
Lenchik L Hsu FC Register TC Lohman KK Freedman BI Langefeld CD Bowden DW Carr JJ 《Calcified tissue international》2004,75(4):305-312
The heritability of trabecular volumetric bone mineral density (BMD) determined by quantitative computed tomography (QCT) has not yet been reported. The purpose of this study was to investigate the heritability of BMD as determined by QCT and DXA in 124 women and 120 men (age 39–83 years, BMI 17–75, 84% type 2 diabetics) from 101 families (232 sibling pairs) in the Diabetes Heart Study. Volumetric BMD had a heritability (h2) estimate of 0.73 (SE = 0.15, P < 0.0001) at the lumbar spine and 0.71 (SE = 0.15, P < 0.0001) at the thoracic spine. Areal BMD heritability estimates were 0.56 for PA spine, 0.43 for total hip, 0.43 for femoral neck, 0.45 for distal radius, 0.42 for mid-radius, and 0.52 for whole body (all P < 0.01). After accounting for familial correlation using generalized estimating equations, volumetric BMD was inversely associated with age (r = –0.52, P < 0.0001) and duration of diabetes (r = –0.24, P < 0.01) and positively associated with body weight (r = 0.25, P < 0.01). In multivariate analysis, adjustment for age, sex, and race lowered the h2 estimates for volumetric BMD at the lumbar (h2 = 0.41, P < 0.01) and thoracic (h2 = 0.48, P < 0.001) spine, increased the h2 estimate for areal BMD at the mid radius (h2 = 0.58, P < 0.0001), and had little effect on the h2 estimate for areal BMD at other sites (h2 = 0.41–0.55, all P < 0.01). Additional adjustment for BMI, duration of diabetes, and physical activity had little effect on the h2 estimates for volumetric BMD or areal BMD except at the hip where they were lowered (h2 = 0.31–0.33, all P < 0.05). These data suggest that, like areal BMD, volumetric BMD is highly heritable and may be used in designing linkage studies to locate genes governing bone metabolism. 相似文献
58.
Risk of cancer in patients with
Guillain-Barré syndrome (GBS) 总被引:1,自引:0,他引:1
Vigliani MC Magistrello M Polo P Mutani R Chiò A;Piemonte Valle d'Aosta Register for Guillain-Barré Syndrome 《Journal of neurology》2004,251(3):321-326
Abstract. The possible relationship between Guillain-Barré syndrome
(GBS) and cancer is still controversial and the existence of a
paraneoplastic GBS remains unconfirmed. To better define whether
there is a relationship between GBS and malignancy, we compared
the observed and the expected number of patients with tumours in
a population-based cohort of subjects with GBS. Clinical
differences between GBS patients with or without malignancies
were analysed. Data were obtained from the Piemonte and Valle
dAosta Register for GBS (PARGBS) (years 1990–1998). GBS was
diagnosed according to NINCDS criteria. The number of expected
cases of malignancy in the PARGBS population was calculated
using the incidence rate of all types of cancer (ICD codes
140–208) in Piemonte [1985–1987], and in the most important town
of this region, that is Turin (years 1993–1997). In the
nine-year period, 435 incident patients with GBS were found.
Nine of them developed cancer in the six months preceding or
following GBS; in seven of them, the diagnosis of cancer and GBS
was concomitant. The expected number of malignant tumours was
3.7 (using the incidence in Piemonte) and 3.8 (using the
incidence in Turin); therefore, the odds ratios were 2.43 (95 %
CI, 1.11–4.62) and 2.37 (95% CI, 1.09–4.50), respectively
(p < 0.01). Although the cases with malignancies were
clinically similar to the other cases of GBS observed through
the Register, the mortality in GBS patients with cancer was
higher and was the final cause of death in two patients affected
by severe cancer. These results suggest a possible correlation
between some cases of GBS and cancer. However, GBS in cancer
patients does not meet all the criteria for paraneoplastic
diseases.* Piemonte and Valle dAosta
Register for GBS (PARGBS): Coordinating center:
2nd Division of Neurology, Department
of Neuroscience, University of Torino, Italy.
Project coordinator: A. Chiò,
MD. Study monitors: A. Calvo,
MD, N. Di Vito, MD, M. Vercellino, MD. Scientific Committee: A. Bertolotto,
MD, E. Bottacchi, MD, A. Chiò, MD, D. Cocito, MD, M. T.
Giordana, MD, M. Leone, MD, L. Mazzini, MD, G. Mora, MD.
Collaborating centers: A.
Chiò, MD, A. A. Terreni, MD, D. Schiffer, MD, R. Mutani, MD, D.
Cocito, MD, B. Bergamasco, MD, I. Rainero, MD (Department of
Neuroscience, Section of Neurology, University of Torino, and
Azienda Ospedaliera San Giovanni Battista, Torino), A.
Bertolotto, MD, A. Tribolo, MD, R. Sciolla, MD, F. Mondino, MD,
M. T. Giordana, MD (Department of Neuroscience, Section of
Neurology, University of Torino, and Azienda Ospedaliera San
Luigi Gonzaga, Orbassano), M. Leone, MD, P. Gaviani, MD, F.
Monaco, MD (Department of Neurology, Amedeo Avogadro
University, Novara), M. De Mattei, MD, E. Morgando, MD
(Department of Neurology, Azienda Ospedaliera San Giovanni,
Torino), L. Sosso, MD, M. Gionco, MD (Department of Neurology,
Ospedale Mauriziano, Torino), U. Morino, MD, M. Nobili, MD
(Department of Neurology, Ospedale Martini, Torino), L.
Appendino, MD (Department of Neurology, Ospedale Maria Vittoria,
Torino), D. Piazza, MD (Department of Neurology, Ospedale S.
Giovanni Bosco, Torino), E. Oddenino, MD, W. Liboni, MD
(Department of Neurology, Ospedale Gradenigo, Torino), G. Vaula,
MD, G. Ferrari, MD (Department of Neurology, Ivrea), M. Favero,
MD, C. Doriguzzi Bozzo, MD (Department of Neurology, Pinerolo),
P. Santamaria, MD (Department of Neurology, Vercelli), U.
Massazza, MD, E. Bollani, MD (Department of Neurology, Biella),
A. Villani, MD, R. Conti, MD (Department of Neurology,
Domodossola), G. Mora, MD, C. Balzarini, MD (Department of
Neurological Rehabilitation, Fondazione S. Maugeri, Clinica del
Lavoro e della Riabilitazione, IRCCS, Scientific Institute of
Veruno), M. Palermo, MD (Department of Neurology, Alessandria),
F. Vergnano, MD (Department of Neurology, Casale Monferrato), S.
Cordera, MD, C. Buffa, MD (Department of Neurology, Novi
Ligure), M. T. Penza, MD (Department of Neurology, Tortona), F.
Fassio, MD (Department of Neurology, Asti), P. Meineri, MD
(Department of Neurology, Azienda Ospedaliera Santa Croce e
Carle, Cuneo), A. Cognazzo, MD, C. Mocellini, MD, A. Dutto, MD,
A. Cucatto, MD (Department of Neurology, Savigliano), C.
Cavestro, MD, W. Troni, MD (Department of Neurology, Alba), G.
Corso, MD, E. Bottacchi, MD (Department of Neurology,
Aosta). 相似文献
59.
60.
Lees CJ Register TC Turner CH Wang T Stancill M Jerome CP 《Menopause (New York, N.Y.)》2002,9(5):320-328
OBJECTIVE: The purpose of this study was to determine the effect of raloxifene on bone density, strength, metabolism, and histomorphometric characteristics in ovariectomized cynomolgus monkeys. DESIGN: A prospective, longitudinal study was designed to examine the effects of conjugated equine estrogens (0.04 mg/kg, CEE) and raloxifene (1 or 5 mg/kg, R1 and R5, respectively) on bone density, biomarkers, histomorphometry, and strength. Control groups included ovariectomized and sham-operated monkeys. Treatment was initiated the day after ovariectomy and continued for 24 months. Bone biomarker data were collected at baseline and every 3 months after surgery. Bone mass was determined at baseline and every 6 months after ovariectomy. Iliac biopsies were collected at baseline and 16 months postovariectomy, and the second lumbar vertebra and left midshaft femur collected at necropsy were examined histomorphometrically. Bone biomechanical properties were determined for the right femur and vertebrae. RESULTS: Compared with the placebo-treated ovariectomized monkeys, the high-dose raloxifene group had lower levels of alkaline phosphatase, tartrate-resistant acid phosphatase, urinary CrossLaps (collagen degradation products), and greater bone mass in the lumbar vertebrae. In the endocortical compartment, the high-dose raloxifene group had significantly lower mineralizing surface, mineral apposition rate, and bone formation rate in the iliac biopsy collected at 16 months and lower bone formation rate in the second lumbar vertebra. Within the midshaft femur, low-dose raloxifene significantly decreased the osteonal and total bone formation rates and also prevented the decrease in Young's modulus induced by ovariectomy in the midshaft femur. CONCLUSIONS: High-dose raloxifene prevented the development of osteopenia in the ovariectomized monkey by reducing bone turnover, albeit to a lesser extent than CEE. Histomorphometric and biomarker data suggest that mechanisms underlying the effect of raloxifene differ somewhat from that of CEE. 相似文献