Evaluation of total energy balance and food habits of obese children

Total daily energy expenditure (TDEE) and time spent for activities of different intensities (heart rate monitoring method), as well as dietary and food habits (24-hour dietary recall) in two groups of 12-14 year-old boys, including 35 obese (weight 67.0 kg +/- 9.3, height 162 cm +/- 7.6) and 35 control group boys (weight 46.0 kg +/- 6.5, height 160 cm +/- 7.5) were estimated. Obese boys spent more time at rest and less time on physical activities than nonobese (p < 0.001). That resulted in differences of TDEE expressed per unit of body mass (p < 0.001). Time for sleeping and time in school was not statistically different in the two groups. The evaluation of nutritional habits indicated that the obese boys, when compared with controls, had higher energy intake and significantly higher percentage of fat energy in total energy intake, low intake of fruits and vegetables and irregular frequency of meals during the day. Diets of boys were not balanced with respect to calcium and phosphorus.     

骨髓活检在多发性骨髓瘤诊断及鉴别诊断中的价值

目的:探讨骨髓活检在多发性骨髓瘤(MM)诊断与鉴别诊断中的价值。方法:同步观察多发性骨髓瘤38例患者骨髓涂片和活检塑料包埋切片。并与反应性浆细胞增多症20例患者作比较,以正常人20例作对照。观察骨髓增生程度、浆细胞增殖模式及浸润程度、网硬蛋白积分。结果:MM组患者骨髓造血组织在切片中的增生度明显高于涂片,两者差异有统计学意义(P<0.05);与反应性浆细胞增多症及正常对照组比较差异亦有统计学意义(P<0.05)。MM组切片中浆细胞以簇片-间质型、结节-间质型、结节型及塞实型浸润为主,以结节出现为阳性诊断敏感性36例(94.7%)明显高于涂片中浆细胞>15%的指标(71.0%);MM组网硬蛋白纤维积分为1 以上为63.2%,与反应性浆细胞增多症组及正常对照组比较差异有统计学意义(均为P<0.05)。结论:骨髓活检能准确反映骨髓组织的增生程度、浆细胞浸润情况及增殖模式、纤维增生程度,对MM的诊断及鉴别诊断有较高价值。     

白血病患者血清VEGF、EGF联合检测的临床意义

目的:检测白血病患者血清中血管内皮生长因子(VEGF)与表皮生长因子(EGF)的浓度,探讨VEGF和EGF在白血病患者血液中的表达及二者之间的关系和意义.方法:应用酶联免疫技术(ELISA法)检测20例白血病患者及40名健康人血清中VEGF和EGF浓度.结果:40例白血病患者血清VEGF含量为398.6±114.8pg/ml,对照组血清VEGF的含量为108.5±50.6 pg/ml,两组比较具有显著的相关性(P＜0.05);40例白血病患者血清EGF含量为1.80±0.52μg/L,40例正常对照组血清EGF含量为0.76±0.80μg/L,见表1.结论:白血病患者血清VEGF、EGF浓度显著高于健康对照组,且二者呈显著正相关.     

Deep venous thrombosis of the arm: etiology, diagnosis and treatment

Thrombosis of the upper extremity is frequently (30-52%) related to the use of an indwelling venous catheter, but it can also occur in healthy individuals after exercise. In the past it was considered a relatively benign thrombotic event, which was treated conservatively, sometimes even without anticoagulant therapy. Recent studies have shown that complications of deep venous thrombosis of the upper extremity occur frequently: pulmonary embolism (8-36%), recurrence thrombosis after cessation of anticoagulant treatment (2-15%) and post-thrombotic syndrome (up to 50%). Therefore when thrombosis of the upper extremity is clinically suspected, it should be objectively diagnosed by compression echography followed if negative by phlebography, with anticoagulant treatment directly afterward, preferably with low-molecular heparin and then acenocoumarol or phenprocoumon.     

Hospital infections in general surgery wards

In 1997 the hospital infections programme was accepted by the National Association for Infectious Diseases (Polskie Towarzystwo Zakazeń Szpitalnych--PTZSz). About 100 hospitals from Poland participated in the surveillence system introducing nosocomial infection registration cards in their units. The results of the research were sent to the PTZSz. The results from general surgery departments in 1998 were analysed. This year 79 general surgery units took part in nosocomial infection programme of PTZSz, sending from 1 to 2259 questionnaires. The analysis included 48,964 nosocomial infection registration cards. Nosocomial infection developed in 1,031 cases in the general surgery departments what accounted for 2.11% of all treated patient in that period. Surgical site infections were the most often place of nosocomial infections (37.1%), next skin and soft tissue infections (20.1%), and finally respiratory tract infections (17.6%). The average duration of hospitalization in general surgery departments was 10.2 days. In case of nosocomial infection occurrence the time of treatment was extended three times. The most frequent aetiological pathogenes of nosocomial infections were as follows: Escherichia coli and Staphylococcus aureus.     

Horizontal appendicular dysmetria in four patients with a typical Wallenberg's syndrome

During the acute stage of a Wallenberg's syndrome ipsilateral appendicular dysmetria is frequently seen. The dysmetria is more apparent in the ipsilateral upper extremity. These patients also have a peculiar type of dysmetric eye movements that are characterized by hypermetric saccades toward the side of the lesion and hypometric saccades to the opposite side. We examined four patients with acute Wallenberg's syndrome and found horizontal dysmetria of the affected extremity. Hypermetric arm and hand movements were present to the side of the lesion and hypometric movements toward the opposite side. This type of dysmetria is probably related to the same patophysiological mechanism that underlies dysmetric eye movements in the Wallenberg's syndrome. The dysmetria tends to disappear with time although it continues to be present in some patients six months after the ischemic damage.     

CCR5 and beta-chemokines in HIV-1 infected children

The duration from initial infection with HIV-1 to CD4 lymphocyte depletion and progression to AIDS varies among infected individuals. Despite treatment with highly active antiretroviral therapy (HAART), patients still show different stages of disease progression. We examined the role of beta-chemokines and its receptor, CCR5 in HIV-1 infected children in order to define determinants of HIV progression among treated individuals. Population was divided in two groups: Group 1--Long Term Non Progressors (LTNP) includes 10 patients with B1-B2 CDC disease classification and with a less aggressive therapy (only 2 in HAART); Group 2--Rapid Progressors (RP) includes 9 patients with C3 disease classification. All the patients had a CCR5 wild type (wt) genotype indicating that they do not have the 32 base-pair deletion associated with slower progression. There was an increased production of MIP 1-beta in 8/10 LTNP but only in 4/9 Progressors (Paired t-test/Wilcoxon Sign test, p-value < 0.05). The change in the levels of MIP-1 beta after PHA stimulation was statistically significant in both groups. The levels of RANTES increased in LTNP and RP and the change of the levels after mitogen stimulation was statistically significant for both groups included. The production of RANTES and MIP-1 beta in response to stimulation between both groups was not statistically significant. The production of MIP-1 alpha was variable in both groups and the difference in the levels after mitogen stimulation between the groups was not statistically significant. These results suggest that beta-chemokines do not play an important role in HIV-1 progression in children undergoing HAART.