Liver abscess due to Yersinia bacteremia in a well-controlled type I diabetic patient

Yersiniae enterocolitica, a gram negative rod-like organism, causes terminal ileitis and mesenteric adenitis in adolescents and adults. Some forms present with liver and spleen abscesses and have worse prognosis. We report a type 1 diabetic patient with a liver abscess mimicking metastatic liver disease who was successfully treated with percutaneous drainage and antibiotic administration; culture from blood was positive for Yersinia enterocolitica, but drainage material from the liver abscess did not yield a positive result for Yersinia enterocolitica. Although the prognosis is not good in such cases, with high mortality rates, our patient recovered from the disease with appropriate treatment. (Pol J Endocrinol 2011; 62 (4): 357–360)Gram-ujemna pałeczka Yersiniae enterocolitica powoduje zapalenie końcowego odcinka jelita cienkiego i zapalenie węzłów chłonnych krezki u młodzieży i dorosłych. Czasami obserwuje się przypadki ropni wątroby lub śledziony, które wiążą się z gorszym rokowaniem. Autorzy opisują przypadek chorego na cukrzycę typu 1 z ropniem wątroby imitującym guz przerzutowy wątroby, u którego zastosowano skuteczne leczenie obejmujące drenaż przezskórny i antybiotykoterapię. W posiewie krwi wyhodowano Yersinia Enterocolitica, jednak z treści uzyskanej w wyniku drenażu ropnia nie uzyskano potwierdzenia obecności tych bakterii. Mimo że w takich przypadkach rokowanie jest niepomyślne i notuje się wysoki odsetek zgonów, dzięki odpowiedniemu leczeniu pacjent powrócił do zdrowia. (Endokrynol Pol 2011; 62 (4): 357–360

Diagnostic and prognostic value of Nesfatin-1 in sepsis and septic shock

Nesfatin-1 is an anorectic protein, and we expect it to decrease during sepsis and septic shock. We aimed to analyze it and determine the relationship between Nesfatin-1 levels and quick Sequential Organ Failure Assessment(qSOFA) score, renal Sequential Organ Failure Assessment (SOFA) score, and mortality in patients with sepsis and septic shock. Sixty-nine hospitalized adult patients diagnosed with sepsis and septic shock in the internal medicine department, were included in the study after approval of the Clinical Research Ethics Committee. Sepsis diagnosis was based on the detected focus of infection, positive blood cultures, and response to antibiotics. Twenty-one healthy controls matched for age and sex with these patients were also included in the study. Sixty-nine septic patients and twenty-one healthy volunteers were included in the study. Nesfatin-1 levels were compared with covariates. Nesfatin-1 levels in septic patients were lower than that of healthy controls. There was no significant difference in Nesfatin-1 between diabetic and non-diabetic subgroups. Patients with quick Sequential Organ Failure Assessment (qSOFA) score of three had a statistically significantly lower Nesfatin-1 level than those of patients with the score of zero, one, and two. Nesfatin-1 was correlated negatively with C reactive protein. We found a statistically significant difference in 1-month mortality between Nesfatin-1 levels below and over 80pg/mL. In order to use Nesfatin-1 as a biomarker in differentiating sepsis from healthy population, more comprehensive and more studies are needed. If supported by new studies, Nesfatin-1 levels below 80 pg / mL at first admission in septic patients may direct the clinician to broad-spectrum antibiotic therapy and earlier intensive care follow-up

The association of laminin levels with insulin resistance and non-alcoholic hepatosteatosis

Abstract Background Laminin, one of the largest glycoproteins of the basement membrane, is an important component of the extracellular matrix. Functions of the basement membrane include regulation of cell signaling behaviors and structural support. Laminin plays a critical role in the regulation of insulin action in muscle, liver, and adipose tissue. The study mainly investigates an association between the change in serum laminin levels and insulin resistance and non-alcoholic hepatosteatosis. Methods This prospective study included a total of 90 participants; 60 patients diagnosed with Grade 2–3 non-alcoholic hepatosteatosis and 30 age- and sex-matched healthy controls between December 2019 and December 2020. Routine laboratory tests including glucose, insulin, homeostatic model of assessment-insulin resistance (HOMA-IR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and C-reactive protein and laminin levels were measured in the serum of the patient and control groups. Enzyme-linked immunosorbent assay was used for the measurement of laminin levels. Results The median serum laminin levels were lower in patients with hepatic steatosis, compared to the control group (72 ng/L vs. 82 ng/L, respectively; p = 0.003). In the patients with insulin resistance, median laminin levels were lower, regardless of the presence of non-alcoholic hepatosteatosis (67 ng/L vs. 85 ng/L, respectively; p = 0.007). There was a weak, negative correlation between the laminin levels and HOMA-IR. Conclusions Our study results suggest that, although there is no exact link between laminin and non-alcoholic hepatosteatosis, serum laminin levels are lower in patients with insulin resistance by regulating the insulin effect through integrins