Trypanosoma cruzi infection in Triatoma sordida before and after community-wide residual insecticide spraying in the Argentinean Chaco

Triatoma sordida is a secondary vector of Trypanosoma cruzi in the Gran Chaco and Cerrado eco-regions where it frequently infests peridomestic and domestic habitats. In a well-defined area of the humid Argentine Chaco, very few T. sordida were found infected when examined by optical microscopic examination (OM). In order to further assess the role of T. sordida and the relative magnitude of subpatent bug infections, we examined the insects for T. cruzi infection, parasite Discrete Typing Units (DTUs) and bloodmeal sources using various molecular techniques. Among 205 bugs with a negative or no OM-based diagnosis, the prevalence of infection determined by kDNA-PCR was nearly the same in bugs captured before (6.3%) and 4 months after insecticide spraying (6.4%). On average, these estimates were sixfold higher than the prevalence of infection based on OM (1.1%). Only TcI was identified, a DTU typically associated with opossums and rodents. Chickens and turkeys were the only bloodmeal sources identified in the infected specimens and the main local hosts at the bugs’ capture sites. As birds are refractory to T. cruzi infection, further studies are needed to identify the infectious bloodmeal hosts. The persistent finding of infected T. sordida after community-wide insecticide spraying highlights the need of sustained vector surveillance to effectively prevent T. cruzi transmission in the domestic and peridomestic habitats.     

Weight Change and Glycemic Control After Diagnosis of Type 2 Diabetes

BACKGROUND  Limited community-based data describe weight change after diabetes diagnosis. OBJECTIVE  To evaluate weight change patterns and associations in the 1st year after diabetes mellitus type 2 diagnosis. DESIGN  Retrospective cohort study. PARTICIPANTS  Patients aged 21–75 with diabetes mellitus type 2 diagnosed between 1 January 1997 and 31 December 2004, identified from electronic medical records in Kaiser Permanente Northwest, a health maintenance organization. Eligible patients met weight measurement criteria (a baseline and three additional weight measurements) and did not have a condition associated with unintentional weight change (n = 4,135). MEASUREMENTS  We estimated 12-month patient weight trajectories using growth curve analyses, grouped similar trajectories using cluster analysis, and compared characteristics among groups. RESULTS  The four weight trajectory groups were “higher stable weight” (n = 757; 18.3%), “lower stable weight” (n = 2,236; 54.1%), “weight gain” (n = 664; 16.0%), and “weight loss” (n = 478; 11.6%). After adjustments, members of the weight-loss group were more likely than those in the weight-gain group to be older, female, take fewer medications, have had nutritionist visits, and have a lower mean HbA_1c. Those in the weight-loss group were less likely to be in a race group at higher risk for obesity, have depression or dyslipidemia, or have taken >30 days of a sulfonylurea alone or with metformin. CONCLUSIONS  A small-but-substantial group of patients had a mean weight trajectory that included a clinically significant weight loss. Weight-loss trajectories were strongly associated with better glycemic control when compared to weight gain. Patients with certain characteristics may need more support for weight loss. This study was supported by grant no. R21 DK073546–02 (Weight in Secondary Prevention) from the National Institute of Diabetes and Digestive and Kidney Diseases     

Impact of polymorphisms in WFS1 on prediabetic phenotypes in a population-based sample of middle-aged people with normal and abnormal glucose regulation

Aim/hypothesis  Recently, variants in WFS1 have been shown to be associated with type 2 diabetes. We aimed to examine metabolic risk phenotypes of WFS1 variants in glucose-tolerant people and in individuals with abnormal glucose regulation. Methods  The type 2 diabetes-associated WFS1 variant rs734312 (His611Arg) was studied in the population-based Inter99 cohort involving 4,568 glucose-tolerant individuals and 1,471 individuals with treatment-naive abnormal glucose regulation, and in an additional 3,733 treated type 2 diabetes patients. Results  The WFS1 rs734312 showed a borderline significant association with type 2 diabetes with directions and relative risks consistent with previous reports. In individuals with abnormal glucose regulation, the diabetogenic risk A allele of rs734312 was associated in an allele-dependent manner with a decrease in insulinogenic index (p = 0.025) and decreased 30-min serum insulin levels (p = 0.047) after an oral glucose load. In glucose-tolerant individuals the same allele was associated with increased fasting serum insulin concentration (p = 0.019) and homeostasis model assessment of insulin resistance (HOMA-IR; p = 0.026). To study the complex interaction of WFS1 rs734312 on insulin release and insulin resistance we introduced Hotelling’s T ² test. Assuming bivariate normal distribution, we constructed standard error ellipses of the insulinogenic index and HOMA-IR when stratified according to glucose tolerance status around the means of each WFS1 rs734312 genotype level. The interaction term between individuals with normal glucose tolerance and abnormal glucose regulation on the insulinogenic index and HOMA-IR was significantly associated with the traits (p = 0.0017). Conclusions/interpretation  Type 2 diabetes-associated risk alleles of WFS1 are associated with estimates of a decreased pancreatic beta cell function among middle-aged individuals with abnormal glucose regulation. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorised users.     

2009-2014年鄱阳湖区以传染源控制为主的血吸虫病综合防治效果观察

目的观察鄱阳湖湖沼型流行区以传染源控制为主的血吸虫病综合防治策略试点的长期防治效果。方法选择鄱阳湖血吸虫病重度流行区爱国、新和、光辉3个村为试点,全面实施以机代牛、封洲禁牧等控制传染源为主的综合防治策略,收集2009-2014年人群病情和螺情数据,比较人群血吸虫感染情况、钉螺感染率和水体危险性的变化。结果 2009-2014年,3个试点村均未发现粪检血吸虫阳性者;牛洲草洲活螺平均密度呈下降趋势,六○圩草洲活螺平均密度基本持平略有下降,2个洲滩均未发现感染性钉螺;解剖哨鼠未发现血吸虫成虫。结论实施以控制传染源为主的血吸虫病防治策略可以使血吸虫病疫情在较长时间内保持稳定。     

The wound/burn guidelines – 2: Guidelines for the diagnosis and treatment for pressure ulcers

The Wound/Burn Guidelines Committee consists of members commissioned by the Board of Directors of the Japanese Dermatological Association (JDA). It held several meetings and evaluations in writing since October 2008, and drafted five guidelines for the diagnosis and treatment including commentaries on wounds in general and the Guidelines for the Diagnosis and Treatment for Pressure Ulcers by taking opinions of the Scientific Committee and Board of Directors of JDA into consideration.     

麻杏二陈止咳颗粒质量标准研究

目的：建立麻杏二陈止咳颗粒（麻黄,陈皮,甘草）的质量标准并进行颗粒剂型的常规检查。方法：对麻杏二陈止咳颗粒进行粒度、水分、干燥失重、溶化性、装量差异、微生物限度检查。薄层色谱法（TLC）对陈皮和甘草进行定性鉴别;高效液相色谱法（HPLC）对马兜铃酸Ⅰ（C17H11NO7）进行限量检查,对盐酸麻黄碱、盐酸伪麻黄碱进行含量测定。结果：麻杏二陈止咳颗粒的粒度、水分、干燥失重、溶化性、装量差异、微生物限度检查均符合《中华人民共和国药典》2015年版的相关规定;确定每克该颗粒中马兜铃酸Ⅰ（C17H11NO7）不得超过0.66 μg;陈皮和甘草的TLC斑点清晰,阴性无干扰;HPLC色谱中阴性对照无干扰;盐酸麻黄碱、盐酸伪麻黄碱分别在10.04~100.4 μg、5.14~61.68 μg/mL范围内线性关系良好（r=0.999 9）,平均加样回收率分别为101.50%（RSD=1.15%）、100.68%（RSD=1.97%）。结论：该方法准确、稳定、可行,可用于麻杏二陈止咳颗粒的质量控制。     

个性化营养护理对肢体骨折合并糖尿病患者血糖控制及康复的影响分析

目的 分析个性化营养护理对肢体骨折合并糖尿病患者血糖控制及康复的影响.方法 选择2016年2月—2017年11月该院收治的78例肢体骨折合并糖尿病患者,按照随机的方法分成对照组和观察组,每组39例,对照组采取常规方式护理,观察组采取个性化营养护理,对比两组患者病情的恢复情况.结果 观察组护理前餐后2h、空腹的血糖水平对...     

医院三公经费内控管理的思考

三公经费是我国事业单位经费中一项主要组成部分,医院作为事业单位,三公经费的管理也尤为重要.目前,我国医院的三公管理尚且存在一些问题有待解决,该文先就目前三公经费现状与不足三公经费问题成因分析进行简单概述,再对加强医院三公经费管理的对策进行进一步分析.