Test de provocation par voie orale aux aliments chez l'enfant. Quand,pour qui et comment ? Conséquences

Whatever results are, oral food challenges (OFC) will have consequences, particularly on diet and emergency kit. Positive OFC, negative OFC and food specificities are discussed, according to the literature review. In case of positive OFC, the management and monitoring of persistent food allergy is specified. Practical recommendations are suggested.     

Oral glucose tolerance test does not affect degree of hemoglobin glycation as measured by routine assay

BackgroundHemoglobin A1c (HbA1c) is an accurate index of fluctuation in glycemia over the 2-3 months prior to quantitative assessment. During this time, hemoglobin (Hb) slowly glycates until it shows the properties of advanced glycation end-products. Glycation kinetics is intensified by prolonged glucose exposure. In subjects undergoing oral glucose tolerance testing (OGTT), immediately after ingestion, glucose is ostensibly transported by the glucose transporter 1 (GLUT1) to erythrocyte corpuscular hemoglobin. The earliest significant measurable level of hemoglobin glycation associated with this transportation is still not clear.Subjects and methodsWe attempted to explore the early impact of short-term glucose load on HbA1c levels, because it is now known that transmembrane GLUT1-mediated glucose transport occurs immediately. A total of 88 participants (46 patients and 42 clinically healthy controls) underwent fasting plasma glucose quantitation during an OGTT. HbA1c, revealed by a monoclonal anti-glycation epitope antibody and adiponectin, was quantitated before (T0) and 2 hours (T120) after 80 g glucose ingestion.ResultsWilcoxon test revealed that the HbA1c values did not significantly vary (P = 0.15) during the OGTT, whereas glucose concentration varied strongly between T0 and T120.DiscussionIt is well known that quantitative estimation of HbA1c is informative for clinical care, independently of glucose level. The molecular mechanisms and dynamics by which glucose enters/exits red blood cells are incompletely known and may differ between individuals. We here show, for the first time, that HbA1c levels do not significantly increase during OGTT, supporting the view that non-enzymatic glycation of hemoglobin occurs slowly and that glycation during the 2 hours of an OGTT is insignificant.     

医院药学城构建探讨

目的:建立医院药学城,促进硬件与学科和谐发展。方法:结合医院药学发展方向,设计本院药学城,并以理论分析其构建思路。结果:形成了以患者为中心的模式,有利于发挥药师团队作用及宣传医院药学,实现医院药学的高工效、低成本运行。结论:医院药学城为开展医院药学工作创造了良好的环境。     

La précipitation comme 1 mode suicidaire : étude épidémiologique et psychopathologique

From experience of consultation-liaison Psychiatry at General Hospital of Rennes (France), the authors report epidemiological and clinical data about 25 first attempters who used jumping suicide. They propose psychopathological hypotheses relating to the use of this suicidal method.