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1.
Horm Metab Res ; 42(10): 746-53, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20665427

RESUMEN

During acute psychological stress, the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system are activated. The released stress hormones influence glucose metabolism, can activate immune cells, and modulate subclinical inflammation. The aim of our study was to analyze the effect of acute psychological stress on glucose metabolism and the inflammatory status in patients with post-traumatic stress disorder (PTSD). We included 15 overweight male Bosnian war refugees with PTSD into the study (mean age 44+/-11 years, BMI 29.3+/-4.3 kg/m (2)). All subjects underwent an oral glucose tolerance test (OGTT) with either acute stress (trauma script exposure) or a resting period in a cross-over design. Blood was drawn over 2.5 h and metabolic markers were measured. Systemic levels of immune markers were determined using high-sensitive ELISA or bead-based multiplex assay. Immune gene expression was quantified by RT-PCR. After being exposed to acute stress, cortisol levels and heart frequency tended to be increased. Higher blood glucose and insulin levels after stress exposure were observed (p<0.05). Systemic levels of the chemokines interferon-gamma-inducible protein-10 and macrophage chemoattractant protein-1 were decreased compared to the control day (both p<0.05) and the expression of the proinflammatory regulator IKK beta was significantly reduced after stress exposure (p<0.001). In conclusion, acute stress induces postprandial blood glucose peaks and elevated insulin levels and a selective decrease of systemic immune markers and the proinflammatory regulator of the NF kappaB cascade, which are associated with type 2 diabetes. This points towards an independent effect of acute psychological stress on glucose metabolism and inflammation.


Asunto(s)
Glucemia/metabolismo , Inflamación/patología , Trastornos por Estrés Postraumático/complicaciones , Trastornos por Estrés Postraumático/psicología , Estrés Psicológico/complicaciones , Estrés Psicológico/metabolismo , Enfermedad Aguda , Adulto , Biomarcadores/metabolismo , Regulación de la Expresión Génica , Humanos , Inflamación/sangre , Inflamación/complicaciones , Inflamación/genética , Insulina/sangre , Masculino , Persona de Mediana Edad , Trastornos por Estrés Postraumático/sangre , Trastornos por Estrés Postraumático/genética , Estrés Psicológico/sangre , Estrés Psicológico/genética
2.
Acta Chir Belg ; 106(6): 688-91, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-17290696

RESUMEN

BACKGROUND: The surgical approach to liver echinococcosis is still a controversial issue. This study shows our results of surgical treatment of liver hydatid cysts during a 5-year period. METHODS: A prospective study of 21 patients operated on in a 5-year period (1999-2003), in Dubrava University Hospital in Zagreb, Croatia, with hepatic hydatid cyst. All patients were pre-operatively treated with albendazole. In 12 patients, total pericystectomy without opening the cyst cavity was performed, 9 open and 3 laparoscopic. In the other 9 patients, partial pericystectomy was done, 6 open and 3 laparoscopic. RESULTS: There was no mortality after 5-65 months follow-up, but in 1 patient, in the open partial pericystectomy group, recurrence of the disease occurred after 3 years. When a laparoscopic procedure was done, there were no complications or recurrence. The median operative duration for open surgery was 100.0 min (range 60.0-210.0), and for laparoscopic surgery 67.5 min (range 60.0-120.0). The median length of hospitalisation for open surgery was 8.0 days (range 7.0-14.0), and for laparoscopic surgery 5.0 days (range 4.0-7.0). CONCLUSION: Total pericystectomy without opening the cyst cavity, preceded by pre-operative albendazole therapy is the method of choice for hepatic hydatid cyst treatment. Despite the small group of patients, our first results show laparoscopic total pericystectomy without opening the cyst cavity, in the treatment of hepatic hydatid cyst, as a good alternative to open surgery in selected patients.


Asunto(s)
Equinococosis Hepática/terapia , Laparoscopía , Adolescente , Adulto , Anciano , Albendazol/uso terapéutico , Antihelmínticos/uso terapéutico , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Cuidados Preoperatorios , Estudios Prospectivos , Recurrencia , Resultado del Tratamiento
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