Prevalence and health-care features of hyperglycemia in semiurban-rural communities in southern Saudi Arabia.

OBJECTIVE--To determine the prevalence of hyperglycemia in semiurban-rural Saudi Arabian communities and to assess some of its important health-care related aspects. RESEARCH DESIGN AND METHODS--A cluster of 12 villages near the city of Abha, the capital of the southern region in Saudi Arabia, with a total population of 2150 (290 families) has been included in this study. The family head was interviewed about diagnosed diabetes among family members. Also, the capillary blood glucose level was measured in subjects greater than or equal to 10 yr (the target population, n = 1419) with a reflectance meter after 2-h fasting after the main midday meal. RESULTS--The 87% of the target population who responded for screening showed a prevalence of 4.6% of diabetes, which was higher among men (5.5%, age adjusted, P less than 0.05) than among women (3.6%). Estimates were based on 57 cases ascertained by positive history of the disease (n = 49) or blood glucose level greater than 11.1 mM (200 mg/dl) without previous diagnosis of diabetes (n = 8). The prevalence of impaired glucose tolerance (blood glucose between 7.8 (140 mg/dl) and 11.0 mM (199 mg/dl) with no history of diabetes) was 3.7%, being higher among women than among men (P less than 0.01). Eighty-eight percent of the previously diagnosed cases were receiving treatment at the time of screening. However, in only 12.2% of those receiving treatment was glucose found to be controlled (level less than 7.8 mM [140 mg/dl]). CONCLUSIONS--Diabetes frequency in this Saudi community is relatively high. There is a pressing need to promote public awareness about the disease and to improve the competency of the health-care team for achieving better control and early detection of the disease.     

T-cell responses in malaria.

Malaria is caused by infection with protozoan parasites of the genus Plasmodium. It remains one of the most severe health problems in tropical regions of the world, and the rapid spread of resistance to drugs and insecticides has stimulated intensive research aimed at the development of a malaria vaccine. Despite this, no efficient operative vaccine is currently available. A large amount of information on T-cell responses to malaria antigens has been accumulated, concerning antigens derived from all stages of the parasite life cycle. The present review summarizes some of that information, and discusses factors affecting the responses of T cells to malaria antigens.     

Prevalence and patterns of soft tissue metastasis: detection with true whole-body F-18 FDG PET/CT

Background  

The aim of this retrospective study was to report the prevalence and patterns of soft tissue (ST) metastasis detected with true whole-body (TWB) F-18 FDG PET/CT acquired from the top of the skull through the bottom of the feet and to compare such findings to that of the typically acquired skull-base to upper-thigh, thus limited whole-body (LWB) field of view (FOV).     

Regulation of hepatic cortisol sulfotransferase in rats by pituitary growth hormone

Cytosolic sulfating activities of 4-pregnen-11 beta, 17 alpha, 21-triol-3,20-dione (cortisol) to the 21-sulfate were 4 to 5 times higher in livers of female than male adult rats. The activity was decreased by administration of testosterone propionate (TP) to ovariectomized, but not to intact, female rats. In male rats, the rate of cortisol sulfation was elevated by neonatal castration and was restored in part by the administration of TP to the castrated rats. In addition, the sulfating activity in adult male rats was increased by the treatment with estradiol benzoate. Hypophysectomy almost completely decreased cytosolic cortisol-sulfating activity in male rats. The activity in hypophysectomized male rats was not increased by the treatment with hydrocortisone, TP, estradiol benzoate, or somatomedin C but was restored by the intermittent injection of human growth hormone (hGH). Further, the continuous infusion of hGH, to mimic the female secretory pattern, increased more efficiently the rate of cortisol sulfation. Hypophysectomy of female rats also decreased, but not completely, the sulfating activity. Treatment of female hypophysectomized rats intermittently with hGH had no appreciable effect, but the continuous infusion increased the activity effectively. The involvement of pituitary growth hormone in the hepatic cortisol sulfation was also supported by the experiment using neonatally glutamate-treated rats and by the observation of developmental changes in the cortisol-sulfating activity. These results indicate that pituitary growth hormone is one of the major factors regulating hepatic levels of cortisol sulfation in rats and that the higher activity in the female than the male is due mainly to the difference in the secretory pattern of growth hormone in the adult animals.     

Assessing a single targeted next generation sequencing for human leukocyte antigen typing protocol for interoperability,as performed by users with variable experience

Background

A simplified protocol for HLA-typing -by NGS, developed for use with the Illumina MiSeq, was performed by technologists with varying NGS experience to assess accuracy and reproducibility.

Intrafamilial transmission of hepatitis C in Egypt

The incidence of hepatitis C (HCV) infection and associated risk factors were prospectively assessed in a cohort of 6,734 Egyptians from 2 rural villages who were negative for antibodies to HCV (anti-HCV). Initial and follow-up sera were tested for anti-HCV by enzyme immunoassay (EIA), and possible incident cases were confirmed by using the microparticle enzyme immunoassay (MEIA) and tested for HCV RNA. All follow-up serum samples converting from negative to positive without detectable HCV-RNA were further tested by recombinant immunoblot assay. Over an average of 1.6 years, asymptomatic anti-HCV seroconversion occurred in 33 people (3.1/1,000 person-years [PY]), including 28 (6.8/1,000 PY) in the Nile Delta village (AES), where prevalence was 24% and 5 (0.8/1,000 PY) in the Upper Egypt village (baseline prevalence of 9%). The strongest predictor of incident HCV was having an anti-HCV-positive family member. Among those that did, incidence was 5.8/1,000 PY, compared (P < .001) with 1.0/1,000 PY; 27 of 33 incident cases had an anti-HCV-positive family member. Parenteral exposures increased the risk of HCV but were not statistically significant; 67% of seroconverters were younger than 20 years of age, and the highest incidence rate (14.1/1,000 PY) was in children younger than 10 who were living in AES households with an anti-HCV-positive parent. In conclusion, young children would especially benefit from measures reducing exposures or preventing infection with HCV.     

Ultrasonographic Findings with Bleeding and Nonbleeding Esophageal Varices

Real time ultrasonography was carried out in 49 cirrhotic patients within 10 days of esophagoscopy, and in 20 normal subjects. Among the cirrhotic patients, 42 had varices and 18 of these had hematemesis within 3 months of study. The varices were graded 0 to 4+ endoscopically; the diameter of the portal vein, the splenic vein, the hepatic artery, and the maximal length of the spleen were determined on ultrasound. In addition, portal collateral veins and the sudden amputation of portal vein branches in the liver were identified when present. There was a significant correlation of the diameter of the portal vein and the maximal spleen length with the magnitude of varices on endoscopy; there was no significant relationship between the splenic vein or the hepatic artery diameter. Less than half the patients with varices had sonographically demonstrated collaterals or portal vein branch amputation. A sonoscore was derived allotting one point each for enlarged portal vein (greater than 1.3 cm), enlarged spleen, collaterals or two or more amputated veins. The sonoscore correlated better with the endoscopic grade of varices than any other marker. The sonoscore among the patients with varices who bled was significantly higher (p less than 0.01) than any of the other measures. It is concluded that real time ultrasound can be used to screen for varices and to identify the need for endoscopy.