Insulin sensitivity indices: Fasting versus glucose-stimulated ýndices in pediatric non-alcoholic fatty liver disease

OBJECTIVE: We aimed to compare insulin sensitivity indices, fasting vs glucose stimulated, in children and adolescents with non-alcoholic fatty liver disease. PATIENTS AND METHODS: Two hundredeleven obese children with median age of 11.24 ± 2.65 years were evaluated. After initial clinical and anthropometric examination, B-mode ultrasonography (USG) was performed and all subjects underwent Oral Glucose Tolerance Test (OGTT). Quantitative insulin sensitivity check index (QUICKI), homeostatic model assessment for insulin resistance (Homa-IR), the insulinogenic index (IGI), the Matsuda index, and the oral glucose insulin sensitivity (OGIS) model were used to determine peripheral insulin sensitivity. RESULTS: 59.24% (68 boys, 57 girls) of obese children had NALFD. The prevalence of FLD in obese adolescents was significantly higher than in prepubertal children (65.8% vs. 51.5%). Fasting glucose, insulin, Homa-IR, QUICKI, and OGIS and Matsuda were significantly different between subjects with and without NALFD. Insulin and glucose indices were not found to be significantly different in the prepubertal group, whereas Homa-IR, QUICKI, Matsuda, and OGIS were significantly different in the pubertal group. Age, waist circumference, and OUICKI were found to be risk factors associated with the presence of NALFD in the logistic-regression analysis. CONCLUSIONS: Age, waist circumference, and OUICKI were found to be risk factors associated with NALFD. As the value of QUICKI decreases, the probability of having steatosis increases. Although OGTT results gave the information about the glucose tolerance of a subject, indices derived from OGTT were not found to be superior to the traditional surrogates such as Homa-IR or QUICKI

Roles of the Oxidative Stress and ADMA in the Development of Deep Venous Thrombosis

Venous thromboembolism has multifactorial origin and occurs in the context of complex interactions between environmental and genetic predisposing factors. Oxidative stress plays an important role in the physiopathology of venous thrombosis. Current study examined the role of oxidative stress and asymmetric dimethylarginine in the development of DVT with the parameters such as serum malondialdehyde (MDA), glutathione peroxidase (GSH-Px), catalase, ADMA, homocysteine, folic acid, vitamin B6, and vitamin B12 levels. Serum MDA levels were found significantly (P0.05). This study showed that patients with DVT have increased oxidative stress compared with the healthy volunteers whereas there was no significant difference between the groups in terms of serum ADMA levels. Thus serum ADMA levels seemed to be not related with development of DVT

Komparativna studija izmjerenog i procijenjenog vo2max u višestupanjskom funkcionalnom testu pripremljenosti nogometaša juniora

The multi-stage 20-m shuttle run test (MSRT) is one of the most popular field tests using equations based on test results or the final speed for an indirect estimation of maximal oxygen uptake (VO2max). The aim of this study was to compare the real VO2max value to the predicted value of VO2max by MSRT and rate the usefulness of the MSRT as a predictor of VO2max in young football players. Fifteen young football players, nominees for the 2004/2005 national Under-18 team, were included in this study. The subjects were 17.9±.2 years old, had an average height of 178.8±7 cm and an average weight of 71.8±7.5 kg. The players came from different Slovenian junior premier football league clubs and trained on average 4 to 5 times per week. Testing was conducted on all subjects over two days, between 9 a.m. and 2 p.m., on synthetic turf. A mobile device for the measurement of O2 and CO2 in expired air and ventilation during MSRT was used. On the basis of the test result (the number of levels and repetitions between them) VO2max was calculated. The correlation between the measured and predicted VO2max was determined with Pearson’s correlation coefficient. The comparison of both mean values showed that the measured value was significantly higher (p<.05), by as much as 8.5 ml O2 kg-1•min-1, than the MSRT-predicted VO2max. Variables were statistically correlated, but the correlation coefficient amounted to only .58. This study has shown that an indirect evaluation of aerobic capacity based on the multi-stage 20 m shuttle run test can lead to wrong conclusions in young soccer players. The correlation observed between the measured and predicted VO2max was too weak to predict the aerobic capacity of young football players with certainty.Višestupanjski test povratnog trčanja dionica od 20 metara (MSRT) je jedan od najpopularnijih terenskih testova koji koriste jednadžbe za procjenu maksimalnog primitka kisika (VO2max) na temelju ukupnog rezultata testa ili konačne brzine trčanja na kraju testa. Cilj ovog istraživanja bio je usporediti stvarne vrijednosti VO2max s procijenjenim vrijednostima VO2max dobivenima pomoću MSRT te ocijeniti korisnost toga terenskog višestupanjskog testa kao prediktora VO2max u mladih nogometaša. U istraživanje je bilo uključeno 15 mladih nogometaša izabranih za slovensku nacionalnu selekciju U18 u sezoni 2004./2005. Ispitanici su bili u dobi od 17,9±0,2 godina, prosječne visine 178,8±7 cm i prosječne težine 71,8±7,5 kg. Igrači su bili članovi različitih slovenskih prvoligaških juniorskih klubova i trenirali su u prosjeku 4 do 5 puta tjedno. Testiranje je provedeno na svim ispitanicima tijekom dva dana, u vremenu između 9 i 14 sati na umjetnoj travi. Korišteni su prijenosni uređaji za mjerenje O2 i CO2 u izdahnutomu zraku i ventilacije tijekom provedbe MSRT. Na temelju rezultata testa (razina otkaza i broj ponavljanja unutar razine otkaza) izračunat je VO2max. Povezanost između izmjerenoga i procijenjenoga VO2max utvrđena je Pearsonovim koeficijentom korelacije. Usporedba prosječnih vrijednosti pokazala je da je izmjerena vrijednost VO2max bila statistički značajno viša (p<0,05) za 8,5 ml O2 kg-1•min-1 od procijenjene vrijednosti VO2max koja je izračunata pomoću MSRT. Korelacija između varijabli bila je statistički značajna, ali je korelacijski koeficijent bio samo 0,58. Ovo je istraživanje pokazalo da neizravno vrednovanje aerobnoga kapaciteta rezultatima u testu MSRT može dovesti do pogrešnih zaključaka na populaciji mladih nogometaša. Utvrđena povezanost između izmjerene i procijenjene vrijednosti VO2max bila je preslaba da bi sa sigurnošću mogla poduprijeti procjenu aerobnoga kapaciteta u mladih nogometaša

Treatment of head lice with dimeticone 4% lotion: comparison of two formulations in a randomised controlled trial in rural Turkey

<p>Abstract</p> <p>Background</p> <p>Dimeticone 4% lotion was shown to be an effective treatment for head louse infestation in two randomised controlled trials in England. It is not affected by insecticide resistance but efficacy obtained (70-75%) was lower than expected. This study was designed to evaluate efficacy of dimeticone 4% lotion in a geographically, socially, and culturally different setting, in rural Turkey and, in order to achieve blinding, it was compared with a potential alternative formulation.</p> <p>Methods</p> <p>Children from two village schools were screened for head lice by detection combing. All infested students and family members could participate, giving access to treatment for the whole community. Two investigator applied treatments were given 7 days apart. Outcome was assessed by detection combing three times between treatments and twice the week following second treatment.</p> <p>Results</p> <p>In the intention to treat group 35/36 treated using dimeticone 4% had no lice after the second treatment but there were two protocol violators giving 91.7% treatment success. The alternative product gave 30/36 (83.3%) treatment success, a difference of 8.4% (95% CI -9.8% to 26.2%). The cure rates per-protocol were 33/34 (97.1%) and 30/35 (85.7%) respectively. We were unable to find any newly emerged louse nymphs on 77.8% of dimeticone 4% treated participants or on 66.7% of those treated with the alternative formulation. No adverse events were identified.</p> <p>Conclusion</p> <p>Our results confirm the efficacy of dimeticone 4% lotion against lice and eggs and we found no detectable difference between this product and dimeticone 4% lotion with nerolidol 2% added. We believe that the high cure rate was related to the lower intensity of infestation in Turkey, together with the level of community engagement, compared with previous studies in the UK.</p> <p>Trial Registration</p> <p>Current Controlled Trials ISRCTN10431107</p

ACTA TROPICA

In three randomly selected villages of Manisa, Turkey, 630 primary school children were examined for cystic echinococcosis (CE) by a portable ultrasound scanner (US) and chest microfilm. Sera samples of 483 (76.7%) children were tested for anti-E. granulosus antibodies by ELISA and indirect hemagglutination (IHA) tests. Hepatic CE were detected in two cases (0.3%) by US, while 43 (8.9%) and 49 (10.1%) cases were found to be positive for CE by ELISA and IHA, respectively. The high seropositivity levels could have been attributed to extra-abdominal or abortive Echinococcus infections, but probably most of them were false-positives. Due to the discrepancy in results, US should be selected as the primary test in field studies and serologic tests should be performed in all cases with suspected lesions. We could not find any reported community based study on CE in Turkey, in which US was applied; but our results suggest that extensive epidemiological studies are required. (C) 2004 Elsevier B.V. All fights reserved

SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY

Objective. Sixteen patients who were operated on with a preoperative diagnosis of renal tumor were diagnosed with renal oncocytoma between 1991 and 2004. The reliability of preoperative diagnosis, the role of screening CT in organ preservation and the need for follow-up for renal oncocytomas are discussed in the light of literature findings. Material and methods. Among 345 patients diagnosed with renal tumors in the previous 13 years, the clinical and radiological features of the 16 patients with renal oncocytomas and the results during the postoperative follow-up period were evaluated in this retrospective study. The female: male ratio was 4.3. Two of the patients complained of hematuria whereas the other 14 experienced lumbocostal pain. The mean dimensions of the tumors on CT scans were 5.79/2.88 cm. Central fibrous scarring existed in three patients. Two patients underwent tumor enucleation, three underwent partial nephrectomy and 11 underwent radical nephrectomy. Results. Screening CT could not achieve a precise preoperative differential diagnosis from malignant renal mass. The organ preservation ratio was approximately 1: 3 based on the radiological diagnosis. Screening CT scans showed oncocytomas with diameters greater than those reported in the literature, indicating a need for urgent nephrectomy. No recurrences, metastases or deaths due to renal oncocytoma were observed in the postoperative follow-up period ( mean 6.79/4 years; range 1 - 13 years). Conclusions. Preoperative diagnosis of renal oncocytoma is very difficult. The postoperative follow-up period in our series was 13 years, which is significantly longer than the duration proposed in the literature

EUROPEAN JOURNAL OF PEDIATRICS

The aims of our study were: (1) to evaluate the frequency of asymptomatic fatty liver disease (FLD) using both Doppler and B-mode ultrasound (US) in overweight and obese adolescents; (2) to compare metabolic findings of fatty liver (FL) assessed by two methods; and (3) to evaluate metabolic predictors of FL shown by these methods. Fifty-nine overweight and obese adolescents aged between 9.0 and 17.0 years and 41 non-obese healthy adolescents were included in this study. B-mode and right hepatic vein Doppler ultrasonography (US) were performed and anthropometric indices, lipid profiles, and adiponectin levels were evaluated in all adolescents. HDL-C levels were significantly lower in patients with FL detected by Doppler US compared to patients without FL (p < 0.05). HDL-C levels were inversely correlated with presence of FL assessed by two methods (r = -0.285, p = 0.004; r = -0.328, p = 0.001, respectively) and adiponectin levels were correlated with presence of FL only detected by B-mode US (r = -0.263, p = 0.008). Adiponectin levels were significantly lower in patients with FL than those without FL assessed by B-Mode US (p = 0.049). Multiple regression analysis revealed that HDL-C levels was the most important predictor of FL assessed by Doppler US (p = 0.027), while body mass index was the determinant of FL assessed by two methods (p < 0.001) in asymptomatic overweight and obese adolescents. It was found that FLD, identified by both B-mode and Doppler US, is seen frequently in asymptomatic overweight and obese adolescents. Elevated BMI is associated with increased risk of FL assessed by two ultrasonographic methods. When using Doppler US, low HDL-C levels can be used as a good predictor for presence of FLD in overweight and obese adolescents

MEANDROS MEDICAL AND DENTAL JOURNAL

Osteopetrosis, also called as marble bone, stone bone or Albers-SchOnberg disease is a very rare hereditary entity. In this disease, the balance between bone-forming osteoblasts and bone resorbing osteoclasts is altered. Our patient was an 8-year-old girl who was diagnosed with osteopetrosis and followed by the pediatric hematology department. She has been referred to our hospital several times with the complaints of cough, fatigue and hip and leg pain. X-ray examinations showed typical signs of osteopetrosis. The patient also had anemia, thrombocytopenia and hepatosplenomegaly and received blood transfusions several times. In these patients, usually the sign of sclerotic bone detected by x-ray establishes the diagnosis. Our patient had anemia, hepatosplenomegaly and loss of vision in addition to the typical radiologic signs. In newborns, the diagnosis of osteopetrosis can be established if osteosclerosis is associated with widening of the long bones. Since the signs were prominent in the newborn period, our patient was assumed to have autosomal recessive (OR) form of the disease which has a poorer prognosis. In conclusion, anemia, thrombocytopenia, and hepatosplenomegaly, which are common, but are not specific signs, must suggest osteopetrosis when sclerosis of bone accompanies and, the child must be given a chance for bone marrow transplantation

CLINICAL IMAGING

The aim of this study was to investigate the significance of color Doppler ultrasound (CDUS) findings in the differential diagnosis of suspicious nodular skin lesions and to compare the results according to the Giovagnorio 1999 classification and the modified classification. Forty nodular skin lesions were evaluated with CDUS and US. The number of arteries and veins was recorded in hypervascular lesions. Findings were compared with histopathological results. The specificity and predictivity of the modified classification were higher than those of the Giovagnorio 1999 classification. (c) 2006 Elsevier Inc. All rights reserved