Corneal endothelium evaluation in type I and type II diabetes mellitus.

BACKGROUND: The purpose of this study is to evaluate the corneal endothelium in type I and type II diabetic patients. METHODS: Seventy-five diabetics divided into type I and type II groups and 62 healthy volunteers took part in the study. The mean endothelial cell density and morphology, and the central corneal thickness were evaluated and statistical analysis was done. RESULTS: All evaluated parameters were found to be significantly different in both diabetic groups with reduction of the mean cell density of 5% in type II and of 11% in type I diabetes with respect to the normal age-matched control group. Important alterations of endothelial morphology were observed. The central corneal pachymetry was significantly higher in diabetics, with p < 0.01 in the type I group and p < 0.05 in the type II group. CONCLUSION: It is concluded that corneal endothelium in diabetics should still be considered as a tissue under continuous metabolic stress with consequent high vulnerability, especially in case of any external insult such as a surgical procedure.     

A case series of symptomatic intraluminal duodenal duplication cysts: presentation, endoscopic therapy, and long-term outcome (with video)

BACKGROUND: Duodenal duplication cysts are rare congenital anomalies. Symptomatic cases have classically been treated by surgical resection, which can be complex because of the close proximity of the cysts to the papilla. OBJECTIVE: To describe a series of 8 patients with symptomatic duodenal duplication cysts who were treated endoscopically, with a special focus on the long-term outcome. DESIGN: Retrospective case series. SETTING: Three tertiary-care European academic hospitals. PATIENTS: Eight patients, age 8 to 72 years, were treated endoscopically for symptomatic intraluminal duodenal duplication cysts between 1981 and 2006. Seven patients presented with acute pancreatitis, and one patient presented with jaundice. INTERVENTION: Endoscopic incision and marsupialization of the cysts was performed by using a variety of endoscopic tools (needle-knife and regular sphincterotomes, cystotomes, and polypectomy snares). MAIN OUTCOME MEASUREMENTS: Technical success of endoscopic intervention and long-term clinical recurrence of symptoms. RESULTS: No major complications occurred. All patients remained asymptomatic at a median follow-up of 7.3 years. LIMITATIONS: Retrospective study; the small number of patients. CONCLUSIONS: The endoscopic treatment of symptomatic intraluminal duodenal duplication cysts is a safe and effective technique, with excellent long-term results. It represents a minimally invasive alternative to surgical resection and might be considered the preferred therapeutic modality for these cases.     

Circulating immune complexes in Fièvre boutonneuse

Circulating immune complexes (CIC) occurred in 36% of a group of 25 patients with Fièvre boutonneuse. CIC were present only in the first week of the disease and there was no evidence of other humoral immunological abnormalities or alterations of the coagulation factors studied. The presence of CIC was not associated with a more severe clinical manifestation or with symptoms or tissue injuries. It is considered that CIC do not play a major role in Fièvre boutonneuse.     

Reduction of volumetric bone mineral density in postmenopausal women with hepatitis C virus-correlated chronic liver disease: A peripheral quantitative computed tomography (pQCT) study

BackgroundThe prevalence of osteoporosis in chronic liver disease (CLD) varies considerably among the studies, depending on patient selection and diagnostic criteria. We aimed to measure bone turnover markers and volumetric bone mineral density (BMD) in a group of postmenopausal women with CLD using both dual energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT), in comparison with age-matched healthy subjects.MethodsThirty-five postmenopausal patients with HCV-correlated CLD and 35 healthy postmenopausal women, as controls, underwent a DXA scan at lumbar and femoral level and a pQCT measurement of the nondominant forearm. Serum concentrations of biochemical markers relevant to bone turnover were also measured.ResultsPatients showed no differences in DXA values either at lumbar or femoral level compared to controls. On the contrary, pQCT geometrical (cortical cross-sectional area) and volumetric (total and trabecular volumetric BMD) parameters were significantly reduced in the CLD women. Also the Strength–Strain Index (SSI), an estimate of diaphyseal bone resistance to bending and torsion, was significantly lower in patients than in controls. Patients with CLD presented an unbalanced bone turnover, with increased bone resorption markers.ConclusionsThe bone geometrical and volumetric parameters measured in our CLD postmenopausal women, by pQCT, show a reduced bone mineral quality and stiffness. Conversely, DXA-measurements seem unable to appreciate the bone alterations in these patients. This would encourage further studies to validate pQCT analysis as a diagnostic tool for a correct estimate of bone involvement in CLD.     

Short- and long-term motor outcome of STN-DBS in Parkinson’s Disease: focus on sex differences

Neurological Sciences - Subthalamic nucleus deep brain stimulation (STN-DBS) is an established treatment for patients with Parkinson’s disease (PD) with motor complications; the contribution...     

Small bowel exploration with video capsule endoscopy

In recent years, a revolutionary system has been developed, composed of a swallowable video capsule, able to visualize the entire small bowel. The device has been experimented on animals and man, based on miniaturization technology applied to its electronic components. The reported studies have indicated the superiority of video capsule endoscopy as compared to radiology. However, the great potentialities of this diagnostic system are still to be fully explored. In the near future, large, controlled clinical trials will solve some of the present problems.