Studies on the clinical significance of nonesterified and total cholesterol in urine

Gas-liquid chromatographic determinations of nonesterified and total urinary cholesterol were performed in 137 normals, 264 patients with various internal diseases without evidence of neoplasias or diseases of the kidney or urinary tract, 497 patients with malignancies and 236 patients with diseases of the kidney, urinary tract infections or prostatic adenoma with residual urine. A normal range (mean±2 SD) of 0.2–2.2 mg/24 hours nonesterified cholesterol (NEC) and of 0.3–3.0 mg/24 hours total cholesterol (TC) was calculated. Values of urinary cholesterol excretion were independent of age and sex and did not correlate with cholesterol levels in plasma. Patients with various internal diseases, without evidence of neoplasias nor diseases of the kidney or obstruction of the urinary tract, showed normal urinary cholesterol excretions, as did patients with infections of the urinary tract. However, elevated urinary cholesterol was found in patients with diseases of the kidney or urinary tract obstruction (prostatic adenoma with residual urine), malignant diseases of the urogenital tract and metastasing carcinoma of the breast. In patients with other malignant diseases urinary cholesterol was usually normal. Lesions of the urothelial cell membranes are considered to be the most likely cause of urinary cholesterol hyperexcretion. The clinical value of urinary cholesterol determinations as a possible screening test for urogenital carcinomas in unselected populations is limited by lacking specificity, expensive methodology and low prevalence of the mentioned carcinomas, although elevated urinary cholesterol excretions have been observed in early clinical stages of urogenital cancers

Lecture notes by internal diseases

ВНУТРЕННИЕ БОЛЕЗНИУЧЕБНЫЕ ПОСОБИЯКурс лекций по внутренним болезням на английском языке предназначен для студентов факультетов подготовки иностранных граждан по специальности "Лечебное дело"

The Government’s Moral Crusade: America’s Campaign against Venereal Diseases at Home during World War I

During World War I, the American Government with the help of non-profit organizations waged an internal and external campaign against venereal diseases. With the creation of the Committee of Training Camp Activities, the Federal Government identified venereal diseases as a threat to the war effort. Internally, the government restructured the atmosphere of training camps by offering intellectual and athletic activities that stimulate the mind rather than sexual desires. Externally, the government used its prestige and power to eliminate factors that caused venereal diseases, including prostitution and red-light districts. Although the internal and external reforms succeeded in restricting the potentiality of venereal diseases, it, nevertheless limited an individual’s freedom and inspired negative connotations that women struggle to evade today

Hubungan Kadar Apolipoprotein B Dengan Aterosklerosis Arteri Karotis Interna Pada Pasien Pasca Stroke Iskemik

Background: Ischemic stroke is caused by brain artery obstruction or narrowing called atherosclerosis. Its marker is the thickness of tunica intima-media (intima-media thickness / IMT) of the artery. Apolipoprotein B is the indicator of atherosclerosis diseases. Most previous studies find association between apolipoprotein B level with cardiovascular disease, while the association between apolipoprotein B with atherosclerosis in post ischemic stroke patients has not been studied yet. Objective: To investigate association between apolipoprotein B level and internal carotid artery atherosclerosis based on thickness of intima-media in patients post ischemic stroke. Method : This cross-sectional study was done in post ischemic stroke subjects in outpatient clinic of Neurology Department Kariadi Hospital Semarang, during December until February 2011. Apolipoprotein B level was measured with Integra method. The thickness of tunica intima-media of the internal carotid artery was measured by Ultrasonografi Duplex. Result: Fourty four patients post ischemic stroke that met the inclusion and exclusion criteria, comprise of 22 male (50%) and 22 female (50%). Atherosclerosis was defined as tunica intimamedia thickness >0.9 mm, was found in 24 subjects (54.6%). Apolipoprotein B level, which designated as high (apoB >105 mg/dl), was found in 25 subjects (56.8%). Multyvariat logistics regression test proved there was significant correlation between apolipoprotein B level with internal carotid artery atherosclerosis (p = 0.0001). Conclusion: Apolipoprotein B level significantly has correlation with atherosclerosis of internal carotid artery based on thickness of intima-media in patients post ischemic stroke. Key words: apolipoprotein B level, internal carotid artery atherosclerosis, ischemic stroke

Evaluation of a Dutch version of the AIMS2 for patients with rheumatoid arthritis

DUTCH-AIMS2, a Dutch version of AIMS2 and successor to DUTCH-AIMS, is an instrument to assess health status among patients with rheumatic diseases. It provides measurements of 12 areas of health status on scales for health status proper, satisfaction, attribution and arthritis impact. We assessed the reliability of its scales in terms of internal consistency and their validity according to both internal standards and external standards. Correctly completed questionnaires were returned by 231 RA patients and 131 controls. Internal consistency coefficients for the health status scales ranged from 0.66 and 0.89, but most exceeded 0.80. Within-scale factor analyses produced single factors in all composite health status scales for both patients and controls, with only two exceptions. Factor analysis also identified a physical, social and psychological dimension among 11 areas of health. External validity was established by strong correlations between DUTCH-AIMS2 health status scales and functional class, laboratory parameters, and self-assessments of fatigue, loneliness, pain, functional disability and social support. DUTCH-AIMS2 is acceptably reliable and valid for use in a variety of settings

Development and preliminary validation of a new screening questionnaire for identifying atopic children

Background: Allergic diseases represent a frequent and increasing condition affecting children. A screening questionnaire allowing an easy identification of children with symptoms of allergic diseases may improve management and clinical outcome. The aim of this study was to develop and validate an easy-to-use screening questionnaire to detect children requiring further allergological evaluations. Methods: A 10-item questionnaire, evaluating the presence and the history of the most frequent allergic conditions affecting children, including allergic asthma, allergic rhinitis and conjunctivitis, food allergy, and atopic dermatitis, was developed and administered to 214 parents of children from 5 to 10 years of age (163 with allergic disease and 51 healthy, nonallergic children). Validation was performed by Pearson's correlation between the clinical diagnosis and the responses to the questionnaire. Internal consistency was computed by Cronbach's alpha correlation coefficient. Sensitivity and specificity of the novel questionnaire were assessed by the receiver operating characteristic (ROC) curve. Results: Validation analysis of the new children atopy (ChAt) questionnaire showed good internal consistency with a Cronbach's alpha of 0.757. Responses to the items evaluating the presence of individual allergic conditions significantly correlated with the clinical diagnosis (p<0.001). The ROC curve showed an area of 0.956 and identified a cutoff value >2 of the ChAt questionnaire total score for detection of allergy (sensitivity =0.92 and specificity =0.902). Conclusion: The novel ChAt questionnaire represents a simple tool able to detect the presence of all major allergic diseases in a pediatric population allowing an early identification of allergic multimorbidity and potentially facilitating clinical management

Tongue Image Analysis for Diabetes Mellitus Diagnosis Based on SOM Kohonen

Tongue diagnosis is an important diagnostic method for evaluating the condition of internal organ by looking at the image of tongue . However, due to its qualitative, subjective and experience-based nature, traditional tongue diagnosis has a very limited application in clinical medicine. Moreover, traditional tongue diagnosis is always concerned with the identification of syndromes rather than with the connection between tongue abnormal appearances and diseases. This is not well understood in Western medicine, thus greatly obstruct its wider use in the world. In this paper, we present a novel computerized tongue inspection method aiming to address these problems. First, two kinds of quantitative features, chromatic and textural measures, are extracted from tongue images by using popular digital image processing techniques. Then, SOM Kohonen are employed to model the relationship between these quantitative features and diseases. The effectiveness of the method is tested on 35 patients affected by Diabetes Mellitus as well as other 30 healthy volunteers, and the diagnostic results predicted by the previously trained SOM Kohonen classifiers are compared with the HOMA-B

Lecture notes by internal diseases

ВНУТРЕННИЕ БОЛЕЗНИУЧЕБНЫЕ ПОСОБИЯКурс лекций по внутренним болезням на английском языке предназначен для студентов факультетов подготовки иностранных граждан по специальности "Лечебное дело"

Gerstmann-Sträussler-Scheinker disease revisited: accumulation of covalently-linked multimers of internal prion protein fragments

Despite their phenotypic heterogeneity, most human prion diseases belong to two broadly defined groups: Creutzfeldt-Jakob disease (CJD) and Gerstmann-Sträussler-Scheinker disease (GSS). While the structural characteristics of the disease-related proteinase K-resistant prion protein (resPrPD) associated with the CJD group are fairly well established, many features of GSS-associated resPrPD are unclear. Electrophoretic profiles of resPrPD associated with GSS variants typically show 6-8 kDa bands corresponding to the internal PrP fragments as well as a variable number of higher molecular weight bands, the molecular nature of which has not been investigated. Here we have performed systematic studies of purified resPrPD species extracted from GSS cases with the A117V (GSSA117V) and F198S (GSSF198S) PrP gene mutations. The combined analysis based on epitope mapping, deglycosylation treatment and direct amino acid sequencing by mass spectrometry provided a conclusive evidence that high molecular weight resPrPD species seen in electrophoretic profiles represent covalently-linked multimers of the internal ~ 7 and ~ 8 kDa fragments. This finding reveals a mechanism of resPrPD aggregate formation that has not been previously established in prion diseases