Zaburzenia przewodu pokarmowego i terapia żywieniowa dzieci z zaburzeniami ze spektrum autyzmu – aktualny stan wiedzy

The incidence of autism spectrum disorders is steadily growing. The ultimate cause of the disease still has not been determined. However with a high probability it is known that the pathogenesis of characterized disorders is multifactorial. One of the aspects that could have a negative impact on the patient's behavior is abnormal distribution of gluten, casein, and probably another nutrients, which is the result of epithelium of the small intestine enzymes deficiency. On this basis, so called opioid theory assumes that enzymatic deficiency leads to the formation of exorphins – substances with opioid activity. With proven coexistence of increased intestinal permeability in ASD patients, improperly digested food particles may be transported to the central nervous system (cerebrospinal axis – intestinal), adversely affecting the child's behavior. Reports of opioids food potential effects on the child's behavior, as well as frequently reported gastrointestinal disorders in ASD patients are the cause of the elimination diet implementation by a large group of parents and carers of children with ASD. Meanwhile, there is still no objective, randomized clinical trials, indicating elimination diet real impact for the patient with ASD. Reports regarding the effectiveness of nutritional therapy are derived mainly from therapists and parents/carers of children with autism spectrum disorders. The potential benefits, which may result from the possible modification of diet, point to the urgent need for well-designed clinical studies in this field.     

Oxidative stress is enhanced by hypothermia imposed on cerulein-induced pancreatitis in rats

BACKGROUND: Hypothermia is a frequent event in severe acute pancreatitis (AP) and its real effects on the normal pancreas have not been well demonstrated. Moreover, neither have its effects on the outcome of acute pancreatitis been fully investigated. One hypothesis is that oxidative stress may be implicated in lesions caused or treated by hypothermia. AIM OF THE STUDY: To investigate the effect of hypothermia in cerulein-induced acute pancreatitis (CIAP) in rats and the role played by oxidative stress in this process. METHODS: Male Wistar rats were divided into hypothermic and normothermic groups. Hypothermia was induced with a cold mattress and rectal temperature was kept at 30 masculineC for one hour. Acute pancreatitis was induced with 2 doses of cerulein (20 ìg/kg) administered at a one-hour interval. Serum amylase, pancreas vascular permeability by Evan's blue method, pancreas wet-to-dry weight ratio and histopathology were analyzed in each group. RESULTS: When compared with normothermic rats, hypothermic animals, with cerulein-induced acute pancreatitis, showed higher levels of pancreatic vascular permeability (p < 0.05), pancreas wet-to-dry weight ratio (p = 0.03), and histologically verified edema (p < 0.05), but similar serum amylase levels. The hypothermic group showed a higher oxidized-reduced glutathione ratio than the normothermic group. CONCLUSION: Moderate hypothermia produced a greater inflammatory response in established acute pancreatitis induced by cerulein in rats. Moreover, this study suggests that oxidative stress may be one of the mechanisms responsible for the worse outcome in hypothermic rats with cerulein-induced acute pancreatitis.     

Abdomen agudo in utero, gastrosquisis etiológica y consumo de cocaína materna. Reporte de caso

Omphalocele and gastroschisis are the most common abdominal wall defects. Both entities require early diagnosis and surgical treatment for a favorable prognosis. These abnormalities are the fourth most common birth defects and an increased incidence worldwide has been reported in the last 30 years. The most frequent complications of gastroschisis are related to bowel loops. We describe the case of a young woman who was pregnant for the first time; a defect in the fetal abdominal wall (gastroschisis) developed as a result of cocaine use, manifesting as acute abdomen and requiring emergency neonatal surgery.     

小儿退热液对流感等病毒及常见致病菌作用的研究

小儿退熬液在体外细胞培养上，能抑制或延缓流感等病毒所致的细胞病变作用；对体内流感病毒所引起的小鼠肺炎，抑制作用较为明显；免疫荧光试验证明，其能十分明显地抑制小鼠肺内流感病毒的增殖量；能较强地抑制与呼吸道感染有关的常见致病菌。     

针灸推拿治疗慢性肾脏病的临床研究进展

综述国内外针灸推拿治疗慢性肾脏病(chronic kidney disease,CKD)的临床研究,认为针灸推拿疗法在改善透析或非透析CKD患者肾功能,以及改善患者的睡眠障碍、负面情绪、皮肤瘙痒、高血压、营养不良、水肿、腰酸腰痛等相关症状或并发症方面,具有一定疗效,值得推广。     

Mapping of the functional anatomy of lymphatic drainage to the axilla in early breast cancer: A cohort study of 933 cases

IntroductionThe aims of this study were to investigate the correlation between lymphatic drainage and the sentinel lymph node (SLN) status of the subregions in the context of the clinic-pathological parameters of the tumour and the coverage of the axillary volumes by standard and high tangential fields (STgF and HTgF) for whole breast radiotherapy and axillary reverse mapping (ARM).Patients and methods933 women with early breast cancer and clinically negative axillary status underwent breast surgery and SLN biopsy followed by axillary lymph node dissection in SLN-positive cases. The subregional localisation of the SLN(s) was registered and statistically analysed with the clinic-pathological characteristics of the breast tumour. In node-positive patients treated with breast-conserving therapy in whom the SLNs were found in the anterior or posterior axillary subregions, the axillary volumes were contoured using the Radiation Therapy Oncology Group contouring atlas (n = 61).ResultsIn 91.1% (n = 797) of the cases, the SLN appeared in the anterior, posterior or central subregions.Using HTgF, Level I or II were completely covered in 65.6% (40/61) and 6.6% (4/61) of the cases, respectively. With STgF, the complete coverage was 0% for both levels.6.8% (n = 63) of all cases had one positive lymph node in the expected ARM lymph node regions.DiscussionA SLN is more than likely to be present in the anterior, posterior and central axillary subregions. Tangential fields allow only limited coverage of the axillary volumes. Preserving the lateral subregion during ARM may increase the possibility of understaging.     

New medicinal properties of mangostins: Analgesic activity and pharmacological characterization of active ingredients from the fruit hull of Garcinia mangostana L.

The fruit hull of Garcinia mangostana L. contains oxygenated and prenylated phenol derivatives, such as xanthones or xanthen-9H-ones, and is used by people in Southeast Asia as a traditional medicine for the treatment of abdominal pain, dysentery, wound infections, suppuration, and chronic ulcer. We isolated the active ingredients from the crude ethanol extract of G.mangostana L. (CEM) and investigated their analgesic effects and underlying mechanisms. CEM at intragastric (i.g.) doses of 0.5, 1, and 3 g/kg clearly exhibited antinociceptive effects in the hot-plate and acetic acid-induced writhing tests in mice. Two isolated compounds, α-mangostin and γ-mangostin, exhibited analgesic effects at doses of 25 and 50 mg/kg (i.g.) in the hot-plate and formalin tests, respectively. CEM at doses of 0.5, 1, and 3 g/kg significantly inhibited xylene-induced release of inflammatory mediators. CEM, α-mangostin, and γ-mangostin each dose-dependently demonstrated the ability to scavenge reactive oxygen species. In conclusion, our results demonstrate that CEM and mangostins possess potent peripheral and central antinociceptive effects in mice and suggest that xanthones may be developed as novel analgesics and anti-inflammatory drugs.     

Comparação das Novas Equações de Martin/Hopkins e Sampson para o Cálculo do Colesterol de Lipoproteína de Baixa Densidade em Pacientes Diabéticos

BackgroundThe accurate determination of low-density lipoprotein cholesterol (LDL-C) is important to reach guideline-recommended LDL-C concentrations and to reduce adverse cardiovascular outcomes in diabetic patients. The commonly used Friedewald equation (LDL-Cf), gives inaccurate results in diabetic patients due to accompanying diabetic dyslipidemia. Recently two new equations – Martin/Hopkins (LDL-Cmh) and Sampson (LDL-Cs) – were developed to improve the accuracy of LDL-C estimation, but data are insufficient to suggest the superiority of one equation over the other one.ObjectiveThe present study compared the accuracy and clinical usefulness of novel Martin/Hopkins and Sampson equations in diabetic patients.MethodsThis study included 402 patients with diabetes. Patients’ cardiovascular risk and LDL-C targets were calculated per European guidelines. Calculated LDL-Cmh, LDL-Cs, and LDL-Cf concentrations were compared with direct LDL-C concentration (LDL-Cd) to test agreement between these equations and LDL-Cd. A p-value <0.05 was accepted as statistically significant.ResultsBoth LDL-Cmh and LDL-Cs had a better agreement with LDL-Cd as compared to LDL-Cf, but no statistical differences were found among novel equations for agreement with LDL-Cd (Cronbach’s alpha 0.955 for both, p=1). Likewise, LDL-Cmh and LDL-Cs showed a similar degree of agreement with LDL-Cd in determining whether a patient was in a guideline-recommended LDL-C target (96.3% for LDL-Cmh and 96.0% for LDL-Cs), which were marginally better than LDL-Cf (94.6%). In patients with a triglyceride concentration >400 mg/dl, agreement with LDL-Cd was poor, regardless of the method used.ConclusionMartin/Hopkins and Sampson’s equations show a similar accuracy for calculating LDL-C concentrations in patients with diabetes, and both equations were marginally better than the Friedewald equation.     

中医计划护理初探

计划护理是在责任制护理的基础上,根据病人的病情,由责任护士制定的,具有逻辑性,符合科学管理方法的完整性护理措施。在中医计划护理中主要体现了辨证施护,治病求本的原则。１护理诊断的确立护理诊断是针对患者的病因、脏腑功能、临床病症,以及外在环境等问题,以四...     

Genetic diversity and genotype multiplicity of Plasmodium falciparum infections in symptomatic individuals in the maritime region of Togo

Objective To assess the genotype prevalence and the multiplicity of Plasmodium falciparum infections in the maritime region of Togo. Methods We enrolled 309 symptomatic individuals aged from 6 months to 15 years from Bè/Lomé and Tsévié, two malaria endemic zones. The number and the proportions of merozoite surface proteins 1, 2 and 3 genotypes in patients were determined using capillary electrophoresis genotyping. We further investigated the possible association between transaminases and homocysteine, and the severity of the disease. Results Of the 309 samples genotyped, 210 tested positive to msp‐1, 227 to msp‐2 and 193 to msp‐3. The nested PCR revealed 22 different alleles for the allelic family msp‐1, 33 for msp‐2 and 13 for msp‐3. At each locus, the family distribution was 54.58% of K1, 25% of MAD20 and 20.42% of RO33 for msp‐1, and 51.71% and 48.29% of FC27 and 3D7, respectively, for msp‐2. For all these allelic variants, the distribution was associated with neither the severity of malaria nor the zone of habitation. Pearson correlation coefficients between either the levels of homocysteine or the transaminase and the severity of the disease were very low. Conclusion The severity of malaria was not associated with higher multiplicity of infections and did not appear restricted to particular genotypes. More comprehensive explorations including immunity, genetic factors, nutritional and sociologic status of the population could clarify the situation.