Czynniki środowiskowe a ryzyko cukrzycy typu 1 — badanie kliniczno-kontrolne

Introduction: While many studies support the theory that environmental factors play a role in the development of type 1 diabetes mellitus (T1DM), controversy exists as to the contribution of any individual factor. The aim of the present study was therefore to investigate the associations of T1DM with several environmental factors. Material and methods: A case-control study was conducted on children £ 16 years old who were diagnosed with T1DM and healthy ageand sex-matched controls. Data regarding the socio-demographic status, gestational and neonatal risk factors were evaluated. Results: One hundred and one children with T1DM (41 males and 60 females), and the same number of age- and sex-matched controls, were included in the present study (mean age 10.3 ± 4.5 years). On multivariable logistic regression analysis, maternal age > 35 years at delivery, duration of > 6 months of cow milk feeding, lack of vitamin D supplementation and caesarean delivery were significantly associated with diabetes. Conclusion: In the present case-control study, certain environmental risk factors were associated with the development of T1DM. (Pol J Endocrinol 2011; 62 (2): 134–137)Wstęp: Mimo że wyniki wielu badań potwierdzają teorię o wpływie czynników środowiskowych na rozwój cukrzycy typu 1, nadal istnieją kontrowersje co do znaczenia poszczególnych czynników w patogenezie tej choroby. Celem badania było zbadanie zależności między występowaniem cukrzycy typu 1 a obecnością niektórych czynników środowiskowych. Materiał i metody: Badaniem kliniczno-kontrolnym objęto dzieci w wieku £ 16 lat, u których rozpoznano cukrzycę typu 1 i dopasowaną pod względem płci i wieku grupę kontrolną złożoną ze zdrowych dzieci. Analizowano dane socjodemograficzne oraz czynniki ryzyka związane z przebiegiem ciąży i porodu oraz okresem niemowlęcym. Wyniki: Do badania włączono 101 dzieci chorych na cukrzycę typu 1 (41 chłopców i 60 dziewcząt) i taką samą liczbę zdrowych dzieci stanowiących grupę kontrolną. Średnia wieku wynosiła 10,3 ± 4,5 lat. W wieloczynnikowej analizie regresji wykazano istnienie związku wieku matki w czasie porodu > 35 lat, podawania dziecku mleka krowiego przez > 6 miesięcy, braku suplementacji witaminy D i cesarskiego cięcie z cukrzycą u dzieci. Wnioski: W niniejszym badaniu kliniczno-kontrolnym niektóre czynniki środowiskowe wiązały się z rozwojem cukrzycy typu 1. (Endokrynol Pol 2011; 62 (2): 134–137

Oral metronidazole as antibiotic prophylaxis for patients with nonperforated appendicitis

Hassan Ravari1, Ali Jangjoo2, Jalal Motamedifar2, Kasra Moazzami31Vascular and Endovascular Surgery Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, 2Department of General Surgery, Mashhad University of Medical Sciences, Imam Reza Hospital, Mashhad, 3Department of General Surgery, Tehran University of Medical Sciences, Sina Hospital, Tehran, IranBackground: The rate of wound infection after appendectomy without antibiotic prophylaxis is 10%–30%. The role of prophylactic antibiotic therapy in nonperforated appendicitis is still controversial. Metronidazole is against anaerobic organisms and its bioavailability after oral and parenteral administration has been shown to be similar. The objective of the present study is to compare the infective complications rate after open appendectomy for nonperforated appendicitis receiving either oral or intravenous metronidazole as prophylaxis. Methods and Materials: From June 2007 to July 2009 in a randomized controlled trial, 204 patients with nonperforated appendicitis underwent an open appendectomy; 122 male and 82 female with mean age of 25 years. Among these, 102 (case group) received oral metronidazole and in 102 (control group) metronidazole was administered intravenously before surgery. The rate of wound infection and duration of the postoperative hospital stay was studied in the two groups.Results: The rate of wound infection was not significantly different in the two groups. (6% and 4% in study and control group, respectively, P = 0.861). Also the hospital stay was equal in two groups (2.3 days and 2.7 days in study and control group, respectively, P = 0.293).Conclusion: Single dose of oral metronidazole prior to operation can provide a sufficient prophylaxis for nonperforated appendicitis; so, it can be substitute the parental route of antibiotic administration. Keywords: antibiotic prophylaxis, wound infection, appendectomy, complication

Gender difference in motor impairments induced by chronic administration of vinblastine

Objective(s): Neurotoxicity of anticancer drugs complicates treatment of cancer patients. Vinblastine (VBL) is reported to induce motor and cognitive impairments in patients receiving chronic low-dose regimen. Materials and Methods: The effects of VBL treatment on motor, learning and memory functions of male and female Wistar rats were studied by behavioral related tests. Animals were given chronic intraperitoneal injections of VBL (0.2 mg/kg/week for 5 weeks) from postnatal day 23 to 52. Motor function was evaluated using grasping test and balancing was evaluated by the rotarod. Spatial learning and memory and anxiety-like behavior were determined using Morris water maze (MWM) task and open field test, respectively. Results: Administration of VBL caused severe damage to motor and balance function of male rats in comparison to female rats treated with VBL and rats treated with saline. Memory and locomotion were affected in both male and female rats compared with saline treated rats, while a sex difference was also observed in these parameters; male rats showed more impairment compared with female ones. Both male and female rats showed cognitive impairments in MWM task and no sex differences were observed in these functions. Conclusion: Results revealed that VBL is a potent neurotoxic agent and despite the profound effect of VBL on motor and cognitive functions, it seems that male rats are more susceptible to motor deficits induced by VBL

Infectious and Non-Infectious Complications among Undiagnosed Patients with Common Variable Immunodeficiency

Objective: Common variable immunodeficiency (CVID) is a heterogeneous group of disorders, characterized by hypogammaglobulinemia, defective specific antibody responses to pathogens and increased susceptibility to recurrent bacterial infections. Delay in diagnosis and inadequate treatment can lead to irreversible complications and mortality. In order to determine infectious complications among undiagnosed CVID patients, 47 patients diagnosed in the Children’s Medical Center Hospital during a period of 25 years (1984–2009) were enrolled in this study. Methods: Patients were divided into two groups including Group 1 (G1) with long diagnostic delay of more than 6 years (24 patients) and Group 2 (G2) with early diagnosis (23 patients). The clinical manifestations were recorded in a period prior to diagnosis in G1 and duration follow up in G2. The number of infections, non infectious complications, hospitalizations, and mortality rate was compared between the two groups. Findings: The patients in G1 group had 500 episodes of infections before diagnosis in 256 patient-years (0.08 per patient per year) and 203 times of hospitalization (0.03 per patient per year), which were significantly higher than in G2 patients, who had 75 episodes of infections (0.015 per patient per year) and 88 hospital admissions (0.018 per patient per year) during 207 patient follow-up years. Frequency of enteropathies and liver diseases in G1 were also significantly higher than in G2. Lack of awareness about nature of disease, especially among rural and suburban physicians, single organ involvement as a site of clinical presenting, and predomination of non infectious presentation in G1 were the major factors of delayed diagnosis. Conclusion: Diagnostic delay is a major concern in CVID patients, which could result in irreversible complications and mortality, while early diagnosis and proper initial treatment leads to better outcomes and quality of life