Lack of augmenting effect of interferon-γ on dengue virus multiplication in human peripheral blood monocytes

The effect of interferon—γ (IFN-γ) on dengue virus multiplication in human peripheral blood mono-cytes was investigated. Enriched monocytes were treated with IFN-γ and then infected with dengue virus type 2 either directly or in the presence of optimal infection-enhancing levels of antibodies. Pretreatment of monocytes from dengue-immune donors with 100 IU/ml of IFN-γ caused 12- to 97-fold and 13- to 137-fold reduction of virus yields at 24 hr after infection in the absence and presence of an anti-flavivirus monoclonal antibody, respectively. IFN-γ also diminished virus yields when infection of monocytes from a donor who lacked anti-dengue antibody was enhanced 40-fold. The percentage of infected monocytes in IFN-γ-pretreated cultures was similarly reduced. Dominance of the antiviral effect of IFN-γ in monocytes is in contrast to an augmenting effect previously observed in the promonocytic cell line U937. © 1995 Wiley-Liss, Inc.     

Large versus small mandibular counterclockwise rotation during bimaxillary surgical correction of class II deformities—a retrospective CBCT study on skeletal stability

Clinical Oral Investigations - Postsurgical skeletal relapse is a concern for class II deformities corrected with counterclockwise rotation of the occlusal plane. Therefore, the aim of this study...     

'Exaggerated adrenarche' in children presenting with premature adrenarche

OBJECTIVE Previous reports of endocrinological profiles in children presenting with premature adrenarche have not shown consistent abnormalities. We therefore aimed to review the clinical and biochemical aspects of a large number of patients presenting with premature adrenarche without virilization and determine the relation between clinical and biochemical characteristics and the frequency of adrenal steroid disorders. DESIGN AND PATIENTS Eighty-eight patients presenting with adrenarche without virilization during 1985-1992 were retrospectively reviewed. There were 72 girls and 16 boys. All were normotensive and had either prepubertal breasts or testes < 4 ml. in patients with high adrenal androgen levels, adrenal tumours had been excluded by either adrenal ultrasound or CT scan. MEASUREMENT We recorded clinical manifestations, auxological data, bone age, biochemical results including basal 17OH-progesterone (b17OHP), dehydro-epiandrosterone sulphate (DHEAS), androstenedione (Δ⁴A), testosterone, cortisol and stimulated 170HP and cortisol. ACTH stimulation tests (using soluble Synacthen 250 μg intramuscularly and collecting blood at 0, 30 and 60 minutes) were performed when clinically Indicated. 17OH-Pregnenoione (17OHPreg) was also measured during ACTH stimulation tests in 13 individuals to look for abnormalities of 3 β-hydroxysteroid dehydrogenase (3β-HSD). RESULTS The age of onset ranged from 3 to 9·5 years (mean 6·8 ± 1·3). There were no significant differences by sex for height SDS, weight SDS or % ideal body weight, but bone age advancement was greater in males (P < 0·02). The most common presenting clinical manifestation was premature appearance of pubic hair in 93·8%, the other 6·2% presenting with body Odour, acne and/or hirsutism. Twelve patients had b17OHP > 6 nmol/l of whom 5 were diagnosed as having congenital adrenal hyperplasia (CAH) resulting from 21-hydroxylase deficiency after ACTH stimulation tests. A further 33 patients who had b17OHP < 6 nmol/l had normal 17OHP and cortisol responses to ACTH stimulation. Patients, after excluding those with CAH, were divided on the basis of their DHEAS levels into prepubertal (< 1·5 μmol/l), pubertal (1·5-6 μmol/l) and above pubertal range (> 6 μmol/l). The 8 patients with DHEAS values above the pubertal range were described as having ‘exaggerated adrenarche’. There were no significant clinical differences between these 3 groups, but Significant differences were found for bone age advancement and the steroids, b17OHP, Δ⁴A and testosterone. There was a strong correlation between DHEAS and Δ⁴A(r= 0·623, P < 0·001). The ‘exaggerated adrenarche’ group had higher 17 OHPreg/17OHP ratios at 60 minutes after stimulation but these were not diagnostic for 3β-HSD deficiency. CONCLUSION The value of assessing basal steroids in children presenting with premature adrenarche Is demonstrated in this series with 5·7% being diagnosed with 21-hydroxyiase deficiency and 9·1% with ‘exaggerated adrenarche’. No relation was found between adrenal steroids and clinical features except for the acceleration of bone age. The relation between ‘exaggerated adrenarche’ and future ovarian hyperandrogenism needs further evaluation.     

Molecular and hematological profiles of hemoglobin EE disease with different forms of α-thalassemia

We describe hematologic and DNA characterization of hemoglobin (Hb) E homozygote with various forms of α-thalassemia in Thai individuals. Altogether, 131 unrelated adult subjects with Hb EE at routine Hb analysis were studied. Forty-two cases were found to carry α-thalassemia with ten different genotypes. These included 21 cases with α⁺-thalassemia heterozygote (–α^3.7/αα), one case with α⁺-thalassemia heterozygote (–α^4.2/αα), six cases with Hb Constant Spring heterozygote (α^CSα/αα), four cases with homozygous α⁺-thalassemia (–α^3.7/–α^3.7), one case with homozygous α⁺-thalassemia (–α^4.2/–α^4.2), two cases with compound α⁺-thalassemia/Hb Constant Spring (–α^3.7/α^CSα), one case with compound α⁺-thalassemia/Hb Paksé (–α^3.7/α^PSα), four cases with α⁰-thalassemia heterozygote (––^SEA/αα), and, unexpectedly, two cases with compound α⁰-thalassemia/α⁺-thalassemia [(––^SEA/–α^3.7) and (––^SEA/–α^4.2)]. The hematological expression of these Hb E homozygotes with various forms of α-thalassemia was presented comparatively with those of the 89 cases of pure Hb E homozygotes. Overlapping levels of Hb E, Hb F, and other hematological parameters were observed which did not predict clinical severity, indicating a need for α-globin gene analysis for accurate diagnosis and improved genetic counseling.     

Thalassemia and iron deficiency in a group of northeast Thai school children: relationship to the occurrence of anemia

The cross-sectional study assessed anemia, thalassemia, and hemoglobinopathies, as well as iron deficiency, among 190 northeastern Thai school children aged 10 to 11 years. The aim was to analyze the reasons for anemia among the group. Hemoglobin concentration and other hematological parameters were determined using an automated blood cell counter. Beta-thalassemia and other hemoglobinopathies were identified by high performance liquid chromatography (HPLC) analysis of hemoglobin. Alpha-thalassemia was identified by polymerase chain reaction (PCR) and related techniques. Iron deficiency was assessed using serum ferritin (SF) <20 ng/ml as indicator. Based on the WHO criteria, anemia was defined by hemoglobin (Hb) level <11.5 g/dl. Twenty five out of 190 children (13.2%; 95% CI = 8.7–18.8%) were anemic. Iron deficiency was found in only two out of 190 children (1.0%; 95% CI = 0.1–3.8%), but the two iron deficient children were not anemic. The proportion of thalassemia and hemoglobinopathies among the group was 61.1% (95% CI = 53.7–68.0%). As underlying reasons for anemia, thalassemia and hemoglobinopathies were found in 22 out of 25 (88.0%) anemic children. Beta-thalassemia and homozygous Hb E seem to be important, while this was less obvious for heterozygous α-thalassemia and heterozygous Hb E. Conclusion: The results suggest that thalassemia and hemoglobinopathies may be major contributing factors to the occurrence of anemia in this area among the children’s population.     

Glycemic control and the psychosocial benefits gained by patients with type 1 diabetes mellitus attending the diabetes camp

OBJECTIVE: The aim of this study was to evaluate the effectiveness of diabetes camp on glycemic control, knowledge, and psychosocial benefits among patients with type 1 diabetes (T1D). Glycemic control among patients with infrequent and frequent self-monitoring of blood glucose (SMBG) was also compared. METHODS: During a 5-day camp, 60 patients were taught diabetes self-management education (DSME). After camp, patients were divided into two groups based on frequency of SMBG (<3 versus 3-4 times/day) and were followed up until 6-month post-camp. Patients' HbA1c levels and knowledge were assessed at baseline, 3- and 6-month post-camp. Patients' impressions towards camp were assessed. RESULTS: In both SMBG groups, HbA1c levels decreased significantly at 3-month post-camp but did not sustain at 6-month monitoring. The patients with frequent SMBG had a lower mean HbA1c level. A significant improvement in knowledge was noted and sustained up to 6-month post-camp. The patients found diabetes camp of benefit and felt they could better cope with diabetes. CONCLUSIONS: Although the effect of the diabetes camp on glycemic control was short-lived, an improvement in knowledge and a better attitude towards having diabetes were seen among participants. PRACTICE IMPLICATIONS: The psychosocial benefits and knowledge gained by patients attending diabetes camp underline the importance of including a camp in a diabetes management plan. To improve patients' long-term glycemic control, a continuous education is required.