Burnout, bipolar or borreliosis? : a diagnostic dilemma behind prolonged disability

Peer reviewe

Subclinical inflammation associated with prolonged TIMP-1 upregulation and arterial stiffness after gestational diabetes mellitus : a hospital-based cohort study

Background: Gestational diabetes mellitus (GDM) has significant implications for the future health of the mother. Some clinical studies have suggested subclinical inflammation and vascular dysfunction after GDM. We aimed to study whether concentrations of high-sensitivity C-reactive protein (hsCRP), tissue inhibitor of metalloproteinase-1 (TIMP-1), matrix metalloproteinase-8 (MMP-8) and -9, as well as values of arterial stiffness differ between women with and without a history of GDM a few years after delivery. We also investigated possible effects of obesity on the results. Methods: We studied two cohorts-120 women with a history of GDM and 120 controls-on average 3.7 years after delivery. Serum concentrations of hsCRP were determined by immunonephelometric and immunoturbidimetric methods, MMP-8 by immunofluorometric assay, and MMP-9 and TIMP-1 by enzyme-linked immunosorbent assays. Pulse wave velocity (PWV) was determined using the foot-to-foot velocity method from carotid and femoral waveforms by using a SphygmoCor device. Arterial compliance was measured non-invasively by an HDI/PulseWave T CR-2000 arterial tonometer. All 240 women were also included in subgroup analyses to study the effect of obesity on the results. Multiple linear regression analyses were performed with adjustment for confounding factors. Results: PWV after pregnancy complicated by GDM was significantly higher than after normal pregnancy, 6.44 +/- 0.83 (SD) vs. 6.17 +/- 0.74 m/s (p = 0.009). Previous GDM was also one of the significant determinants of PWV in multiple linear regression analyses. On the other hand, compliance indices of both large (p = 0.092) and small (p = 0.681) arteries did not differ between the study cohorts. Serum TIMP-1 levels were significantly increased after previous GDM (p = 0.020). However, no differences were found in the serum levels of MMP-8, MMP-9 or hsCRP. In subgroup analyses, there were significantly higher concentrations of hsCRP (p = 0.015) and higher PWV (p <0.001) among obese women compared with non-obese ones. Conclusions: PWV values were significantly higher after GDM compared with normoglycemic pregnancies and were associated with prolonged TIMP-1 upregulation. Cardiovascular risk factors were more common in participants with high BMI than in those with previous GDM.Peer reviewe

Urheilijapojan muljahteleva sydän - tapauksen ratkaisu

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Antibiootteja vai ei? - tapauksen ratkaisu

Anamneesin kertaus Nuoret vanhemmat toivat parivuotiaan poikansa yksityislääkärin vastaanotolle korkean kuumeen vuoksi. Terveyskeskuksesta heille oli vastattu, että siellä on pitkähkö jonotusaika, ja vanhemmat olivat huolissaan

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Miten sinä hoitaisit.Heinäkuussa 2020 vanhemmat saattoivat 11-vuotiaan pojan lastenlääkärin vastaanotolle kaulalle ilmaantuneen lievästi aristavan patin vuoksi

Vältä pregabaliinia ja trisyklisiä masennuslääkkeitä iäkkään hoidossa

Amitriptyliini, nortriptyliini ja pregabaliini ovat yli 75-vuotiaiden hoidossa vältettäviä lääkeaineita. Ne saattavat lisätä kaatumisia ja murtumia sekä heikentää kognitiota ja aiheuttaa sekavuustiloja, muistuttaa Kela lääke-määräyspalautteessaan

Vielä iäkkäiden neuropaattisen kivun hoidosta

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A Nationwide Study of Campylobacter jejuni and Campylobacter coli Bacteremia in Finland Over a 10-Year Period, 1998–2007, With Special Reference to Clinical Characteristics and Antimicrobial Susceptibility

Campylobacter jejuni and Campylobacter coli bacteremia patients were mainly young and without severe underlying diseases. The bacterial isolates were typically susceptible to antimicrobial agents. The outcome was usually good, regardless of appropriate or inappropriate antimicrobial treatment given at the hospital

Chlamydophila abortus Pelvic Inflammatory Disease

We report the first documented case of an extragestational infection with Chlamydophila abortus in humans. The pathogen was identified in a patient with severe pelvic inflammatory disease (PID) by sequence analysis of the ompA gene. Our findings raise the possibility that Chlamydiaceae other than Chlamydia trachomatis are involved in PID