Consumption of fructose-sweetened beverages for 10 weeks reduces net fat oxidation and energy expenditure in overweight/obese men and women.

Background/objectivesThe results of short-term studies in humans suggest that, compared with glucose, acute consumption of fructose leads to increased postprandial energy expenditure and carbohydrate oxidation and decreased postprandial fat oxidation. The objective of this study was to determine the potential effects of increased fructose consumption compared with isocaloric glucose consumption on substrate utilization and energy expenditure following sustained consumption and under energy-balanced conditions.Subjects/methodsAs part of a parallel arm study, overweight/obese male and female subjects, 40-72 years, consumed glucose- or fructose-sweetened beverages providing 25% of energy requirements for 10 weeks. Energy expenditure and substrate utilization were assessed using indirect calorimetry at baseline and during the 10th week of intervention.ResultsConsumption of fructose, but not glucose, led to significant decreases of net postprandial fat oxidation and significant increases of net postprandial carbohydrate oxidation (P<0.0001 for both). Resting energy expenditure (REE) decreased significantly from baseline values in subjects consuming fructose (P=0.031) but not in those consuming glucose.ConclusionsIncreased consumption of fructose for 10 weeks leads to marked changes of postprandial substrate utilization including a significant reduction of net fat oxidation. In addition, we report that REE is reduced compared with baseline values in subjects consuming fructose-sweetened beverages for 10 weeks

Abdominal spilled stones: ultrasound findings

Laparoscopic cholecystectomy (LC) is the treatment of choice for uncomplicated symptomatic gallstones. Spillage of stones due to gallbladder rupture has been reported in up to 33% of all LCs, but clinical sequelae caused by dropped gallstones are uncommon. We recently observed two patients with retained stones after LC. Correct diagnosis was made by abdominal ultrasonography (US) in both cases. In the first patient, who presented with fever, malaise, and weight loss 18 months after LC, abdominal US revealed hypoechoic focal lesions containing hyperechoic images with posterior shadowing of the liver and spleen. US-guided aspiration biopsies of these lesions yielded purulent material, and the injection and aspiration of saline solution provoked rolling movements of the hyperechoic images. Laparotomy confirmed the diagnosis of abscess-containing spilled gallstones. In the second patient, multiple hyperechoic images with posterior shadowing were observed in the Morison pouch during a routine US examination. The diagnosis of retained stones was consistent with the history of gallstone spillage during LC performed 2 months previously and was confirmed by computed tomographic findings of hyperdense images in the Morison pouch. The patient was asymptomatic, and treatment was thus deferred. Our experience suggests that US can be very useful in the detection of gallstones spilled during LC

Premenstrual seizure increase influence of age, duration of disease, seizure frequency, previous complaint of perimenstrual accentuation, eeg and ct scan findings

We selected prospectively 80 mentally healthy women at menacme age, with chronic epilepsy and at least one seizure in the month preceding this study. They underwent four EEGs weekly. CT scan of the skull was done in 57 patients (71.25%). Seven patients were excluded because they had no seizures or menses. We registered 5630 seizures during 579 regular menstrual cycles over a 30 month period. RESULTS: - there was a higher incidence of seizures in the premenstrual period (p<0.001); - age did not influence the distribution of seizures during the menstrual cycle in the group studied; - patients with 11 or more years of disease showed more accentuation of premenstrual seizures than patients with 10 or less years of disease; - there was no relation between the patients frequency of seizures and the occurrence of premenstrual seizures; - the patients impression of the incidence of seizures not related to menstruation was not confirmed; - patients with abnormal skull CT scans had more accentuation of premenstrual seizures than patients with normal exams; - patients with abnormal EEGs had more premenstrual seizures than patients with normal exams. Our findings suggest that the female sexual hormones alter cerebral excitability when there is an underlying structural pathology shown by CT scan or an electrical cerebral dysfunction revealed by EEG