The ultrasonographic diagnosis of bleeding into a pancreatic pseudocyst

Bleeding into a pancreatic pseudocyst is a rare but life-threatening entity. Early diagnosis is crucial in its management. There are reports suggesting that computed tomography (CT), scintigraphy, endoscopic retrograde cholangiopancreatography (ERCP), and angiography could be the diagnostic maneuvers. In this report, we present a case of arterial bleeding into a pancreatic pseudocyst, which was diagnosed by the turbulent echo-currents seen in real-time ultrasonography.     

基于蒙医白脉理论探析帕金森病＊

帕金森病是以多巴胺能神经元减少导致的以静止性震颤、肌强直、运动迟缓和姿势步态障碍为主要临床症状的疾病。此病是蒙医白脉病的一种，又称彻彻热乎病。蒙医将人体的脉络分为白脉和黑脉。白脉病是白脉系统遭受致病因素的影响后所致的一系列疾病的总称，临床上很多疾病归属于“白脉病”。为更好的实现对蒙医优势单病种的规范化研究，本文基于白脉理论，探析蒙医对帕金森病的认识，以期为未来的研究提供理论支持。     

Prevalence and correlates of dyslipidemia in HIV positive and negative adults in Western Kenya: A cross-sectional study

There is increasing morbidity and mortality from cardiovascular diseases (CVD) in sub-Saharan Africa (SSA). Dyslipidemia is a well-known CVD risk factor which has been associated with human immunodeficiency virus (HIV) infection and its treatment in high-income countries. Studies in SSA that have examined the relationship between HIV and dyslipidemia have reported mixed results. In this study, we sought to determine the prevalence of dyslipidemia in HIV positive and negative adults (>=30 years old) and evaluate for association in Western Kenya with a higher prevalence expected among HIV positive individuals.HIV positive adults receiving antiretroviral therapy (ART) and HIV negative individuals seeking HIV testing and counseling services were recruited into a cross-sectional study. Demographic and behavioral data and fasting blood samples were collected. Dyslipidemia was defined according to the National Cholesterol Education Program Adult Treatment Panel III. Associations between baseline demographic and clinical variables and dyslipidemia were analyzed using logistic regression.A total of 598 participants, 300 HIV positive and 298 HIV negative adults were enrolled. Dyslipidemia data was available for 564 (94%) participants. In total, 267 (47%) had dyslipidemia. This was not significantly different between HIV positive and HIV negative individuals (46% vs 49%, P = .4). In a multivariate analysis including both HIV positive and negative individuals, adults 50 to 59 years of age had a 2-fold increased risk of dyslipidemia (Odds ratio [OR] 2.1, 95% confidence interval (1.2–3.5) when compared to 30 to 39-years-old participants. Abdominal obesity (OR 2.5), being overweight (OR 1.9), and low fruit and vegetable intake (OR 2.2) were significantly associated with dyslipidemia. Among HIV positive participants, time since HIV diagnosis, ART duration, use of (PI) protease inhibitor-based ART, viral load suppression, current cluster of differentiation (CD4) count and nadir CD4 did not have significant associations with dyslipidemia.The prevalence of dyslipidemia is high in Western Kenya, with nearly half of all participants with lipid abnormalities. Dyslipidemia was not significantly associated with HIV status, or with HIV-specific factors. Older age, being overweight, abdominal obesity, and low fruit and vegetable intake were associated with dyslipidemia and may be targets for public health interventions to lower the prevalence of dyslipidemia and CVD risk in sub-Saharan Africa.     

An unusual presentation of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) metastasis to the lymph nodes has been reported in about one-third of autopsies, mostly to the regional chains. Involvement of cervical lymph nodes is extremely rare. We encountered an unusual case of HCC in a patient with chronic liver disease presenting with right-sided anterior cervical lymph node metastasis skipping mediastinal and supraclavicular chains. One should be aware of that unusual site of presentation and metastasis of HCC so as not to miss the diagnosis.     

Thiacetazone skin reaction in Papua New Guinea

Thiacetazone is used as a first-line antituberculosis drug in most of the developing countries of the South Pacific. Skine reactions are considered the major side effects of this drug. In Papua New Guinea, 2.5% of Melanesian patients who received thiacetazone for the treatment of tuberculosis developed skin reactions. The reaction appears to be caused by hypersensitivity rather than by toxicity and has distinct clinical features. The therapeutic regimen for tuberculosis in the developing countries of the South Pacific is not likely to change in the near future. Recognition of this potentially fatal complication of thiacetazone is important in the mamnagement of patients with tuberculosis in countries where the drug is used.     

A novel appetite peptide, nesfatin-1 in patients with non-alcoholic fatty liver disease

Abstract Background and aims. Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver pathology worldwide and is strongly associated with obesity and insulin-resistance and food intake. Nesfatin-1 is a new peptide that controls appetite and food intake. The objective of this research was to examine the serum concentrations of nesfatin-1 in NAFLD. Material and methods. Thirty NAFLD patients who had elevated liver enzymes and 40 age- and sex-matched healthy subjects were included in this study. NAFLD was diagnosed and graded with the findings of liver ultrasound scan. Nesfatin-1 concentrations were measured using an ELISA method and the relationship between nesfatin-1 and metabolic parameters were investigated. The subjects were divided into two groups according to their body mass index (≥?30 and 相似文献   

Field evaluation of spatial repellency of metofluthrin-impregnated plastic strips against Anopheles gambiae complex in Bagamoyo, coastal Tanzania

Metofluthrin is a newly synthesized pyrethroid possessing high knockdown and lethal activity against mosquitoes. Studies of metofluthrin-impregnated plastic strips have been performed with dengue vectors. This study reports the efficacy of the new prototypes of metofluthrin-impregnated plastic strips against malaria vectors, Anopheles gambiae complex, in the Kongo villages of Bagamoyo district in coastal Tanzania. The study, using 20 houses, half intervention, half control, was conducted for a 124-day period. Pyrethrum spray sheets and Centers for Disease Control and Prevention light traps were used to sample mosquito population indices. The mosquito density indices of the intervention houses were observed to be significantly lower than those of the control houses when pyrethrum spray sheet collection was used (F = 4.61, 1 df, P = 0.038; 98.7% reduction of total mosquito collection compared with that for the controls). These low indices were observed despite the large openings found in Bagamoyo houses, which were predicted to have a considerable negative effect on the spatial repellency of metofluthrin. Based on the present results, the pyrethrum spray sheet collection was the better of the 2 collection methods.     

Adrenal function in patients with active tuberculosis.

Although tuberculosis is a recognised cause of adrenal insufficiency, little is known about adrenal function in patients with active tuberculosis. Ninety Melanesian adults with active tuberculosis (30 pulmonary, 30 miliary, 30 extrapulmonary) had adrenal function assessed prospectively before and three to four weeks after starting antituberculous chemotherapy. Basal serum cortisol concentrations were normal in 55 (61%) and raised in 35 (39%) of the subjects. No patient had a low basal cortisol concentration. After Synacthen stimulation, cortisol responses were normal in 81 (92%) of the patients and subnormal in seven (8%). After antituberculous chemotherapy the response to Synacthen stimulation was normal in all but one patient. It is concluded that adrenal dysfunction is an uncommon problem in patients with active tuberculosis, and that, contrary to recent reports, antituberculous chemotherapy regimens that include rifampicin do not have an adverse effect on adrenal function.