Non alcoholic fatty liver disease and risk of incident diabetes in subjects who are not obese

Background and aims

It is not known whether non alcoholic fatty liver disease (NAFLD) is a risk factor for diabetes in non obese, non centrally-obese subjects. Our aim was to investigate relationships between fatty liver, insulin resistance and a biomarker score for liver fibrosis with incident diabetes at follow up, in subjects who were neither obese nor centrally-obese.

Association between de novo lipogenesis susceptibility genes and coronary artery disease

Background and aimsCoronary artery disease (CAD) is the principal cause of death in individuals with non-alcoholic fatty liver disease (NAFLD). The aim of this study was to use genetic epidemiology to study the association between de novo lipogenesis (DNL), one of the major pathways leading to NAFLD, and CAD risk.Methods and resultsDNL susceptibility genes were used as instruments and selected using three approaches: 1) genes that are associated with both high serum triglycerides and low sex hormone-binding globulin, both downstream consequences of DNL (unbiased approach), 2) genes that have a known role in DNL (biased approach), and 3) genes that have been associated with serum fatty acids, used as a proxy of DNL. Gene-CAD effect estimates were retrieved from the meta-analysis of CARDIoGRAM and the UK Biobank (～76014 cases and ～264785 controls). Effect estimates were clustered using a fixed-effects meta-analysis. Twenty-two DNL susceptibility genes were identified by the unbiased approach, nine genes by the biased approach and seven genes were associated with plasma fatty acids. Clustering of genes selected in the unbiased and biased approach showed a statistically significant association with CAD (OR:1.016, 95%CI:1.012; 1.020 and OR:1.013, 95%CI:1.007; 1.020, respectively), while clustering of fatty acid genes did not (OR:1.004, 95%CI:0.996–1.011). Subsequent exclusion of potential influential outliers did reveal a statistically significant association (OR:1.009, 95%CI:1.000; 1.018).ConclusionsDNL susceptibility genes are associated with an increased risk of CAD. These findings suggest that DNL may be involved in the pathogenesis of CAD and favor further development of strategies that target NAFLD through DNL.     

Effect of the COVID-19 Pandemic on Surgical Breast Cancer Care in the Netherlands: A Multicenter Retrospective Cohort Study

BackgroundCoronavirus disease 2019 (COVID-19) has put a strain on regular healthcare worldwide. In the Netherlands, the national screening programs, including for breast cancer, were halted temporarily. This posed a challenge to breast cancer care, because ∼40% of cases are detected through national screening. Therefore, the aim of the present study was to evaluate the effects of the COVID-19 pandemic on the surgical care of patients with breast cancer in the Netherlands.Materials and MethodsThe present multicenter retrospective cohort study investigated the effects of COVID-19 on patients with breast cancer who had undergone surgery from March 9 to May 17, 2020. The primary endpoints were the number of surgical procedures performed during the study period, tumor characteristics, surgery type, and route of referral. The secondary endpoint was the incidence of postoperative complications during the study period.ResultsA total of 217 consecutive patients with breast cancer requiring surgery were included. We found an overall decrease in the number of patients with breast cancer who were undergoing surgery. The most significant decline was seen in surgery for T1-T2 and N0 tumors. A decline in the number of referrals from both the national screening program and general practitioners was observed. The incidence of postoperative complications remained stable during the study period.ConclusionsThe temporary halt of the national screening program for breast cancer resulted in fewer surgical procedures during the study period and a pronounced decrease in surgery of the lower tumor stages.     

Castleman's disease in two patients with spondyloarthritis treated by Tumor Necrosis Factor-alpha antagonists

Castleman's disease is a rare lymphoproliferative syndrome involving several anatomical and clinical entities. We report two cases of Castleman's disease in patients with spondyloarthritis (with and without psoriasis) treated with Tumor Necrosis Factor-alpha blockers. During follow-up, imaging examinations, carried out for disease assessment, fortuitously revealed a pelvic mass close to the psoas or an atypical cervical adenopathy. Both lesions were in moderate hypermetabolism on Positron emission tomography–computed tomography. After surgical excision and histological analysis, Castleman's disease was diagnosed without signs of malignancy. To the best of our knowledge, these are the first cases of Castleman's disease diagnosed in a context of spondyloarthritis treated with Tumor Necrosis Factor-alpha blockers. The relationship between these two pathologies and the link with Tumor Necrosis Factor-alpha blockers agents has not been explored in the literature until now.     

长春西部地区1258例过敏原特异性IgE检测结果分析

目的了解长春西部地区过敏原特异性IgE分布情况。方法应用免疫印迹法检测1 258例患者的19种吸入性及食物性过敏原特异性IgE抗体,统计过敏原结果及种类。结果 1 258例患者,检出至少一种特异性IgE阳性率为34.0%。男性阳性率为33.5%;女性阳性率为34.5%。男女间阳性率差异无统计学意义(P> 0.05)。吸入性过敏原阳性率由高到低依次为:普通豚草14.2%、艾蒿11.4%、屋尘螨/粉尘螨8.1%、猫毛3.8%、狗上皮2.4%、柳树/杨树/榆树2.1%,屋尘1.6%、蟑螂1.6%、点青霉/分枝孢霉/烟曲霉/交链孢霉1.2%、葎草1.1%。食物性过敏原阳性率由高到低依次为:鸡蛋白2.9%、鳕鱼/龙虾/扇贝2.7%、牛奶2.3%、黄豆1.9%、蟹1.5%、虾1.3%、牛肉1.2%、花生1.0%、羊肉0.8%。混合过敏达到了相当高的比例。结论长春西部地区吸入性过敏原以普通豚草、艾蒿和屋尘螨/粉尘螨为主;食物性过敏原以鸡蛋白、鳕鱼/龙虾/扇贝、牛奶为主,明确过敏原,对过敏性患者的预防和治疗有重大意义。     

Percepciones y deseos sobre el parto en gestantes a término en Zamora

ObjectiveTo describe perceptions and wishes regarding childbirth in a group of full-term pregnant women in Zamora.MethodQualitative study of phenomenological character. Participants and scope of study: pregnant women (37-38 weeks), Zamora Sur and Santa Elena health centres (Zamora, Spain). Data collection: semi-structured interviews, until data saturation (16 interviews). Data analysis: analysis of thematic content.ResultsThe maternal feelings varied from joy to fear or stress. The interviewees said they did not feel capable of enduring the pain of childbirth. The needs that they felt most important were having support and accompaniment during delivery (especially of their partner) and receiving good treatment from the healthcare workers.ConclusionsThe importance and repercussion of childbirth for women are not only biological, but also largely mental, emotional and social. It is conditioned by multiple factors: maternal feelings, their ability to deal with the pain of childbirth, their needs, the changes they have made, the support they have and the health professionals who care for them.     

OSAHS患儿扁桃体和腺样体术后免疫功能的变化

目的 阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是耳鼻咽喉科的一种常见病，儿童发病率呈上升趋势，调查显示儿童OSAHS发生率为4%~5%，2~6岁是发病的高峰期。OSAHS不仅严重影响儿童的睡眠质量，还会引起儿童生长发育迟缓、智力缺陷等一系列不良反应，OSAHS患儿的主要病因是扁桃体和/或腺样体肥大，因此最有效的治疗方法是扁桃体切除术和腺样体切除术。而扁桃体和腺样体是儿童淋巴组织系统的重要组成部分，在机体的防御和保护功能中发挥着重要作用。手术治疗OSAHS是否影响儿童的免疫功能目前存在争议。一些学者认为扁桃体切除和腺样体切除后儿童的免疫力降低，而另一些学者认为OSAHS儿童的免疫力在手术后保持不变，甚至比手术前有所提高。本文就儿童OSAHS手术前后免疫指标的变化作一综述。