[Transcranial physical methods for correction of neuroendocrine and cerebral disorders in adolescent girls with obesity].

AIM: To evaluate the efficiency of combined central and local physiotherapeutic procedures in correcting neuroendocrine and menstrual disorders in pubertal girls (PG) with obesity. SUBJECTS AND METHODS: Eighty-seven PGs, including 67 with different levels of obesity and 20 healthy non-obese girls, were examined. The hormonal profile, lipidogram, and fasting insulin and glucose levels were studied. Body mass index (BMI) and waist and hip circumferences were estimated. The functional state of the central nervous system was studied by electroencephalography. The parameters of the autonomic nervous system were estimated by cardiointervalography. The PGs with obesity were divided into 2 groups: a study group (SG) (n = 40) and a control group (CG) (n = 27). The healthy PGs (n = 20) formed a comparison group. The SG patients received bitemporal transcranial magnetic therapy in combination with frontomastoid transcranial electrostimulation, as well as myoelectrostimulation of the anterior abdominal wall, by transferring the area of stimulation from right to left hypochondrium. A course consisted of 10-15 daily sessions. CG had placebo physioprocedures (with disconnected electrodes). RESULTS: After 6-month treatment, SG and CG showed average reductions in BMI by 5.9 and 2.5 kg/m2, respectively. Lipidograms normalized in 70%; menstrual cycles were restored in 25 of 30 patients with impaired cycles in SG and in 1 of 22 in CG. Hormonal profiles were significantly improved in 62.5% of the patients in SG and unchanged in CG. CONCLUSION: The high efficiency of combined (central and local) physiotherapeutic procedures is likely to be dueto the normalization of pituitary-ovarian relationships and enables one to recommend the proposed procedure in a rehabilitation program for PGs with obesity and reproductive system disorders.

Improved glycaemic control with reduced hypoglycaemic episodes and without weight gain using long-term modern premixed insulins in type 2 diabetes.

OBJECTIVE: The primary goal of the study was to evaluate retrospectively efficacy of long-term modern premixed insulin (MPI) administration. The secondary aims were to monitor weight gain, hypoglycaemia and compliance during MPI therapy. RESEARCH DESIGN AND METHODS: One hundred and fifteen outpatients with type 2 diabetes (64 male patients, 51 female patients; mean age 62.4±12.2 years; mean duration of diabetes 10±8 years; mean weight 84.3±14.8 kg) were included in this study. Patients were prescribed one of three MPIs thrice-daily: biphasic insulin lispro 25, biphasic insulin lispro 50, or biphasic insulin aspart 30. Metformin was combined with MPI in 81 patients. Data prior to and during MPI treatment were retrieved from computerised patient medical files. RESULTS: After a mean treatment period of 2.9±0.9 years, mean A1C levels and fasting blood glucose decreased from 8.7±1.4% and 193±59 mg/dl to 7.3±1.1% and 141±41 mg/dl (p<0.001 for both), respectively. Thirty-six per cent of the cohort achieved target A1C level of ≤7%. Serum triglycerides decreased from 183±109 mg/dl to 151±76 mg/dl (p<0.001). Weight did not change during MPI treatment. Frequency of minor hypoglycaemic episodes decreased significantly during MPI administration. No major hypoglycaemic event was reported. Number of incompliant patients decreased significantly from 39 to 25 (p=0.001) during MPI treatment. CONCLUSIONS: Modern premixed insulins represent an effective and safe long-term therapy for patients with type 2 diabetes. Specifically, the regimen of thrice-daily injections combined with metformin is a viable treatment option.

Dose distribution for a 32P-impregnated coronary stent: comparison of theoretical calculations and measurements with radiochromic film.

PURPOSE: Restenosis, caused by proliferation of smooth-muscle cells, limits the efficacy of catheter-based revascularization of coronary arteries. Irradiation has been shown to inhibit growth of smooth-muscle cells in vitro and to prevent restenosis in animal models following stent placement. An intraarterial source of 32P, a pure beta emitter with a half-life of 14.28 days and a 90% range in water of 3.6 mm, is almost ideal for irradiating just arterial wall without exposing any other part of the patient's heart or any other organs, while posing minimal hazards to medical personnel. Two types of previously developed coronary stent impregnated with 32P were investigated. This study aimed to calculate and measure the dose outside of two types of 32P-impregnated beta-emitting coronary stents under conditions closely simulating clinical use. METHODS AND MATERIALS: The dose distributions in water surrounding these stents were calculated using a convolution method and measured by exposing radiochromic film in a solid-water phantom. RESULTS: Experimental results were in excellent agreement with theoretical calculations. CONCLUSIONS: Radiochromic dosimetry can be used to measure the dose distribution around a beta-emitting intraarterial stent at distances as small as 0.1 mm from the stent surface. A simple cylindrical shell model is adequate for calculating the dose at points farther than 0.5 mm from the stent surface.

United States experience with oxprenolol in hypertension.

Double-blind, randomized, parallel-group studies have confirmed that oxprenolol, either alone or in combination with a thiazide, is effective in reducing elevated blood pressure. In 2 of 3 comparisons with placebo, the blood pressure reduction was significantly more effective with oxprenolol; in 1 study, even though the placebo response was pronounced, oxprenolol was still more effective than placebo. In 2 studies propranolol reduced blood pressure by about 2 mm Hg more than oxprenolol. In the larger, longer-term study this difference was significant at the end of the dose-titration period, but there were no significant differences between the 2 treatment groups at study end. Moreover, oxprenolol reduced heart rate less and was associated with fewer side effects. Oxprenolol effectively lowered blood pressure when given once daily and was well tolerated, even in large doses. Blood pressure was reduced less with oxprenolol than with hydrochlorothiazide, -14/-11 versus -20/-13 mm Hg. The mean reduction with oxprenolol was less for black patients than for white. In a 1-year safety study, 86% of the patients continued to have a diastolic pressure of less than 90 mm Hg at study end.

[Mental, autonomic and neurophysiological disturbances in patients with obesity and their treatment with transcranial stimulation].

Authors studied 85 patients, aged from 45 to 68 years, suffered from obesity (stage I and stage II) for more than 5 years with concomitant arterial hypertension and atherosclerosis. Patients were randomized into two groups. Patients of the main group received transcranial stimulation (TS) along with standard treatment with antiaggregant vascular drugs and hypocaloric diet. Patients of the control group received placebo TS procedures with turned-off electrodes. The TS treatment was carried out using frontal-mastoid recording with the by-turn stimulation of the right and left hemispheres (frequency = 10Hz, number of daily sessions = 10-12). Psychometric scales, rhythmocardiography, EEG and evaluation of lipid peroxidation activity were used to assess the patient's status. Positive changes for most of the parameters used in the study were noted in the main group compared to the control one. The body-mass index was decreased by 9.8% in the main group.

Síndrome coronario agudo y anafilaxia / Acute coronary syndrome and anafilaxia

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Adherence of Staphylococcus aureus to squamous epithelium: role of fibronectin and teichoic acid.

For bacteria to colonize mucosal surfaces, they must be able to attach to epithelial cells. One of the most important factors in determining this attachment is bacterial adherence. The preferential adherence of a bacteria to a particular tissue influences the site of infection and the virulence of the organism. The glycoprotein fibronectin mediates adhesion of the bacteria to eukaryotic cells. Recent investigations have revealed that the precise locations of the binding sites for Staphylococcus aureus are close to the NH2-terminal and at the COOH-terminal regions of the fibronectin molecule. Teichoic acids are major cell-wall components of staphylococci that have been found to mediate the capacity of the bacteria to adhere to epithelial cells. By use of biologic assays based on the specific adherence of S. aureus to nasal epithelium, it was determined that the binding site for fibronectin appears to be teichoic acid.