Evaluation de l’utilisation du pepsinogène sanguin comme biomarqueur de l’intégrité de la muqueuse gastrique chez le porc. 2. Méthodes de dosage et intérêt en pathologie porcine

Pepsinogen is one component of the gastric juice which participes in the digestion. This macromolecule enters the blood circulation in a small measurable quantities in healthy subjects. Therefore, blood pepsinogen is claimed to be an indicator of the integrity of the gastric mucosa. This paper was written to review the use of porcine in the diagnostic of stomach ulcers and Hyostrongylus rubidus infection. The methods of measurement of blood pepsinogen and the diagnostic values are discussed.Le pepsinogène est une composante du suc gastrique qui participe à la digestion des protéines alimentaires. Il est aussi parmi les macromolécules qui entrent dans la circulation sanguine en faibles quantités mesurables chez des sujets normaux. Son dosage est utilisé dans la mise en évidence de certaines pathologies gastriques chez le porc. Cette synthèse décrit les méthodes de dosage et des valeurs sériques ou plasmatiques du pepsinogène en relation avec des ulcères ou les infestations parasitaires à Hyostrongylus rubidus chez le por

eGFR and creatinine clearance in relation to metabolic changes in an unselected patient population

Background: It is widely assumed that moderate to severe renal failure (creatinine clearance Methods: A select, retrospective cohort study was conducted. Creatinine clearance was measured by collecting 24-hour urines. The individual eGFRs were calculated with the MDRD-4 formula and patients were then divided by renal function category (15, 15-30, 30-45, 45-60, 60-90, >90 ml/min(/1.73 m(2))). Per clearance category the number of people with anaemia, hypokalaemia, uraemia and hyperphosphataemia was evaluated. Results: The median creatinine clearance rate was 67.3 ml/min (quartiles: 42.9-95.8) versus a median MDRD4-eGFR of 51.6 ml/min/1.73 m(2) (35.8-67.7). Anaemia, hyperkalaemia, hypocalcaemia, and uraemia were found to be present at higher levels of creatinine clearance rate and eGFR than previously reported (p Conclusion: Metabolic changes in an in- and outpatient hospital population are present at earlier stages than was stated in recent guidelines, especially when creatinine clearance levels are used as indicators. This might have implications for testing and treatment of patients with suspected kidney disease and/or loss of renal function. (C) 2009 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved

Equations estimating renal function in patients with diabetes

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Glycaemic control and the risk of mortality in elderly type 2 diabetic patients (ZODIAC-20)

P>Aims: Studies on macrovascular consequences of glucose control in elderly patients (> 75 years) with type 2 diabetes mellitus (T2DM) are lacking. The present study aimed to investigate the relationship between HbA(1c) and mortality in this specific population. Methods: Between 1998 and 1999, 374 primary care patients with T2DM aged older than 75 years participated in the Zwolle Outpatient Diabetes project Integrating Available Care study, a prospective observational study. Early 2009, data on mortality were collected. Updated means for annually measured HbA(1c) values were calculated after a follow-up time of 10 years. Updated mean HbA(1c) was used as a time-dependent covariate in a Cox proportional hazard model. Main outcome measures were all-cause and cardiovascular disease (CVD) mortality. Analyses were performed in strata according to diabetes duration (< 5, 5-11 and >= 11 years). Results: In the group with a diabetes duration < 5 years, an increase of 1% in the updated mean HbA(1c) level was associated with an increase in all-cause and CVD mortality risk of 51% (95% CI 17-95%) and 72% (95% CI 19-148%), respectively. Glycaemic control was not related to mortality for patients with a diabetes duration >= 5 years. Conclusion: Poor glycaemic control is related to increased all-cause and CVD mortality in patients > 75 years with T2DM of short duration (< 5 years). Discussion: Because of the observational study design, our results should be interpreted with caution. Nevertheless, they are suggestive that improving glycaemic control may be beneficial in elderly patients with T2DM, especially in those with recently diagnosed T2DM. Randomised-controlled trials are necessary to investigate whether this holds true