Quality of life after thyroid surgery.

PURPOSE: The purpose of this study was to inquire how patients' quality of life is affected after thyroid surgery and the factors involved. METHODS: A semi-structured questionnaire and the World Health Organization Quality of Life Scale (WHOQOL-BREF) were applied to 101 patients prior to surgery. Thereafter data was collected in the early and again in the late post-operative period. RESULTS: Mean general health score for pre-operative quality of life was 6.72 ± 1.53 (3-10), mean physical field score was 22.81 ± 2.77 (17-31), mean psychological field score was 21.69 ± 2.78 (15-28), mean social field score was 11.10 ± 1.94 (5-15) and mean environmental field score was 27.86 ± 4.30 (18-39). In the early post-operative period, mean general health score was 7.05 ± 1.45 (4-10), mean physical field score was 22.84 ± 2.83 (14-29), mean psychological field score was 21.67 ± 2.32 (16-27), mean social field score was 10.89 ± 1.96 (5-15) and mean environmental field score was 28.56 ± 4.18 (18-40). In the late post-operative period, the general health score for quality of life was 7.43 ± 1.34 (4-10), mean physical field score was 23.59 ± 2.70 (17-35), mean psychological field score was 21.75 ± 2.34 (14-29), mean social field score was 11.23 ± 1.94 (6-15) and mean on-field environment score was 29.30 ± 3.96 (16-40). The pre-operative levels of symptoms were found to be higher than early and late post-operative periods. CONCLUSIONS: Quality of life increased after total thyroidectomy and statistically significant improvement was observed in late post-operative stage.

Study of water adsorption and capillary bridge formation for SiO(2) nanoparticle layers by means of a combined in situ FT-IR reflection spectroscopy and QCM-D set-up.

Water adsorption and capillary bridge formation within a layer of SiO2-nanoparticles were studied in situ by means of a combination of quartz crystal microbalance (QCM-D) with dissipation analysis and Fourier transformation infrared reflection absorption spectroscopy (FT-IRRAS). FT-IR data were employed to distinguish the "ice-like" and "liquid-like" contributions and to support the analysis of the QCM-D data concerning mass change and dissipation. Combined measurements show that for SiO2-nanoparticles with a diameter of about 250 nm, the formation of two adsorbed monolayers of water as well as bulk water leads to a rather linear increase in the dissipation for relative humidity values of up to 60% which is followed by a strong increase in dissipation during the actual liquid bridge formation. Subsequently, the dissipation drops again when the relative humidity is further increased to values >90%.

Effects of bovine serum concentrate, with or without supplemental micronutrients, on the growth, morbidity, and micronutrient status of young children in a low-income, peri-urban Guatemalan community.

OBJECTIVE: To determine the effects of dietary supplements containing bovine serum concentrate (BSC, a source of immunoglobulins) and/or multiple micronutrients (MMN) on children's growth velocity, rates of common infections, and MN status. DESIGN: Randomized, controlled, community-based intervention trial. SETTING: Low-income, peri-urban Guatemalan community. SUBJECTS: Children aged 6-7 months initially. INTERVENTIONS: Children received one of four maize-based dietary supplements daily for 8 months, containing: (1) BSC, (2) whey protein concentrate (WPC, control group), (3) WPC+MMN, or (4) BSC+MMN. RESULTS: There were no significant differences in growth or rates of morbidity by treatment group. Children who received MMN had lower rates of anemia and (in the group that received WPC+MMN) less of a decline in serum ferritin than those who did not, but there were no differences in other biochemical indicators of MN status by treatment group. CONCLUSIONS: MMN supplementation reduced anemia and iron deficiency in this population, but the MMN content and source of protein in the supplements did not affect other indicators of MN status, growth or morbidity.

Nondipping and its relation to glomerulopathy and hyperfiltration in adolescents with type 1 diabetes.

OBJECTIVE: To determine whether there is a relation between dipping/nondipping status and end-organ damage (measured as renal glomerulopathy) and long-term renal function in order to predict the development of nephropathy in normoalbuminuric patients with type 1 diabetes. RESEARCH DESIGN AND METHODS: Analysis of renal biopsy and ambulatory blood pressure measurements was done in relation to renal function tests performed during a 10-year period. Forty unselected patients (16 girls), with a mean age of 17.7 years and a mean duration of 10.7 years, were studied. The renal biopsies were examined by electron microscopy. Ambulatory blood pressure was monitored (Space Labs 90 207). Systolic nondippers were defined as a <7%, diastolic nondippers as a <14%, and mean arterial blood pressure (MAP) nondippers as a <12% fall in blood pressure during the night. Renal function was evaluated every other year by clearances of inulin (glomerular filtration rate [GFR]) and para-amino hippurate (effective renal plasma flow [ERPF]), and filtration fraction (GFR/ERPF) was calculated. Overnight urinary albumin excretion rate and long-term mean HbA(1c) were measured. RESULTS: MAP (27% of the patients) and diastolic nondippers (12%) had a significantly thicker basement membrane; larger mesangial matrix volume fraction; and higher long-term GFR, nighttime heart rate, and mean HbA(1c) than dippers. CONCLUSIONS: Nondipping status was related to more renal morphological changes and long-term hyperfiltration in normoalbuminuric adolescents and young adults, despite a short duration of type 1 diabetes. Nondipping status may be an early predictor of later nephropathy.

The peripheral blood lymphocyte pattern in psoriasis preceded by an infection.

BACKGROUND: There is a great deal of information to suggest that activated T cells play a major role in the pathogenesis of psoriasis. Less is known about the possible influence of a trigger bacterial antigen on circulating blood cells. The purpose of our study was to analyze the quantity and subpopulations of activated lymphocytes in peripheral blood in patients with psoriasis preceded by an infection and in a control group. MATERIAL AND METHODS: Thirty-two patients with psoriasis induced by an infection and twenty-two healthy controls were examined. The T lymphocytes in peripheral blood were examined by means of flow cytometry, using panels of monoclonal antibodies. Expression was estimated by reference to the fluorescence intensity of the surface antigens studied. RESULTS: A decreased percentage of CD3+, CD4+, and CD4+-bearing IL-6 receptor cells, a decreased expression of CD3, CD19, and CD4 antigens, and a significantly increased percentage of CD45RO+CD4+ were found in the studied subpopulation of lymphocytes. CONCLUSIONS: Our research demonstrated changes in the percentage and expression of certain subpopulations of T lymphocytes in peripheral blood in the course of psoriasis preceded by a bacterial infection, which suggests not only local, but also systemic activation of the immune system.

[Effectiveness of a micronized purified flavonoid fraction (MPFF) in the healing process of lower limb ulcers. An open multicentre study, controlled and randomized]. / Efficacia della frazione flavonoica purificata micronizzata (FFPM) nell'aumentare la guarigione della ulcere agli arti inferiori. Studio multicentrico in aperto, controllato e randomizato.

OBJECTIVE: To determine the increase in healing rate of venous ulcer in patients receiving a micronised purified flavonoid fraction (MPFF) as supplementation to standard local care. DESIGN: A randomised, open, controlled, multicentre study. SETTING: Departments of Dermatology and University Outpatients Clinics. PATIENTS: One hundred and forty patients with chronic venous insufficiency and venous ulcers. INTERVENTION: PATIENTS received standard compressive therapy plus external treatment alone or 2 tablets of MPFF daily in addition to the above treatment for 24 weeks. MAIN OUTCOME MEASURE: Healing of ulcers and their reduction in size after 24 weeks of treatment. RESULTS: The percentage of patients whose ulcers healed completely was found to be markedly higher in those receiving MPFF in addition to standard external and compressive treatment than in those treated with conventional therapy alone (46.5% vs 27.5%; p<0.05. OR=2.3, 95% CI 1.1-4.6). Ulcers with diameters <3 cm were cured in 71% of patients in the MPFF group and in 50% of patients in the control group, whereas ulcers between 3 and 6 cm in diameter were cured in 60% and 32% of patients (p<0.05), respectively. The mean reduction in ulcer size was also found to be greater in patients treated with MPFF (80%) than in the control group (65%) (p<0.05). The cost-effectiveness ratio (cost per healed ulcer) in the MPFF group was 1026.2 compared with 1871.8 in the control group. CONCLUSIONS: These results indicate that MPFF significantly improves the cure rate in patients with chronic venous insufficiency.

Determinants of fasting glucose in young Guatemalan adults.

OBJECTIVE: To examine correlates of fasting glucose, a precursor for type 2 diabetes mellitus, in young adults in Guatemala, a country undergoing an epidemiologic transition. DESIGN: Cross-sectional. METHODS: Anthropometric, lifestyle, dietary, serum lipid, and socioeconomic characteristic data were collected on 189 men and 201 women (mean age 24.4 years) born in four villages in Eastern Guatemala. We used linear regression to identify parsimonious predictive models, including 2-way interactions. RESULTS: In men, mean fasting glucose was 87.3 mg/dL (SD 10.2); our model explained 30% of variance. Body mass index (BMI), abdomen-to-hip ratio (AHR), and total cholesterol showed graded positive effects. BMI and AHR interacted (P<.001); men with high BMI and high AHR had the highest fasting glucose levels. No dietary factors independently predicted fasting glucose. In women, mean fasting glucose was 83.9 mg/dL (SD 8.5); 22% of variance was explained by BMI, energy-adjusted fat intake, physical activity, birth village, and current residence (rural/urban). BMI and fasting glucose were positively related. Urban residence interacted with birth village (P=.06) and physical activity (P=.13). CONCLUSIONS: The major conclusion drawn from this study is that increased adiposity, even among lean individuals, is the largest environmental predictor of fasting glucose. Prevention and control of obesity in young adults in transitioning countries are key strategies for the prevention of diabetes.

Expression of selected T-cell antigens in the skin infiltration in primary cutaneous T-cell lymphomas.

Skin biopsy specimens obtained from 16 patients with mycosis fungoides (MF) were examined immunohistochemically to assess phenotype of T-cells. Cases of benign chronic skin disorders (BCD) were included in control group. Examination of skin biopsies obtained from patients with MF revealed aberrant immunophenotypes of T-cells (loss of one or more of T-cell markers CD7, CD5, CD8, and rarely CD3). The expression of CD1a antigen both in the dermis and epidermis of the studied groups was similar and normal. No correlation between this loss of antigenicity and the prognosis was observed. These disturbances were seen in most of the cases of the early MF, but not seen in inflammatory skin diseases. In conclusion, the presence of aberrant immunophenotype of T-cells in skin infiltration may be useful in the diagnosis and differentiation of MF.

CD45RO and CD45RA cells in peripheral blood in psoriatic patients preceded by an infection.

A group of 28 psoriatic patients was examined before a topical treatment and afterwards. Samples of peripheral blood were obtained and analysed in a flow cytometry with respect to subpopulation of lymphocytes with a particular care paid to percentage and expression of CD45RO and CD45RA cells. The received results were compared with those from the group of 22 healthy controls. The study showed that the mean percentage of CD45RO+ cells in the psoriatic patients was significantly higher than in the control group (p < 0.005). In the psoriatic group there were no statistically significant differences between the values of any of the parameters studied before and after the treatment.

Postheparin serum lipolytic activity in psoriatic males.

INTRODUCTION: As numerous papers have presented many disturbances of blood lipid composition and changes in lipolytic enzyme activity, it was considered appropriate to investigate the postheparin lipolytic activity in serum of psoriatic males. The course of serum lipolytic process provoked by intravenous application of heparin was observed by measuring the concentration of the major substrates and products: triglycerides (TG), free fatty acids (FFA) and glycerol (G) before intravenous bolus of heparin 10 units per 1 kg b.w. and after 30 minutes. MATERIAL AND METHODS: The study group consisted of 30 psoriatic males with mean age 29.7 +/- 9.6 and mean BMI 24.2 +/- 3.3 and was compared with 35 healthy males with corresponding mean age and mean BMI. The release of glycerol and FFA and the reduction of TG concentrations following intravenous heparin were observed. RESULTS: Psoriatic sera demonstrated higher concentrations of triglycerides, glycerol and free fatty acids before and after the lipolysis compared with the controls. The course of postheparin lipolysis in psoriatic males seems to be changed as compared with the control group.

Is there any correlation between the total number of neutrophils in plasma and concentration of interleukin-8 in psoriatic patients?

INTRODUCTION: Interleukin-8 is a chemotactic agent for neutrophils which causes their simultaneous activation. This cytokine of the chemokines family contributes considerably to the processes observed in the psoriatic epidermis with the participation of neutrophils. MATERIAL AND METHODS: The level of IL-8 in plasma of psoriatic patients during the period of acute and chronic relapses, the number of neutrophils in blood, and the correlation between these parameters were analysed. The study included 55 patients affected by psoriasis (psoriasis severity and activity index ranging from 16.20 to 70.20) and 10 people of the control group. Psoriatic patients were divided into two groups: 'acute psoriasis'--with an acute relapse of the disease (up to one month)--15 patients, and 'chronic psoriasis'--with a longer period of relapse--40 patients. IL-8 plasma levels were determined with the use of the ELISA method. The total number of neutrophils was assessed in blood and smears, and calculations were performed. RESULTS: The results of the study showed higher levels of IL-8 in the plasma of patients with acute psoriasis, however, an elevated number of neutrophils in this group was not statistically significant.

[Eating behavior from birth to 5 years]. / Prácticas alimentarias en los primeros cinco años de edad.

Dietary and nutritional recommendations made in 1993 by a group of Latin American specialists are still valid. They were based on physiological maturation, nutritional requirements, desirable eating habits, and cultural and economic patterns. Exclusive breast-feeding for 4-6 months is ideal for every child. It should continue as part of a mixed diet that is culturally acceptable. Other foods must be added to satisfy nutritional needs and expose the child to different textures and flavors. When breast-feeding is not possible, the following options should be used, in order of preference: 1) Milk from a wet nurse; 2) Milk formulas designed in accordance to gastrointestinal and renal maturation; 3) Cow's mil properly diluted, reconstituted and boiled, o; 4) Vegetable base formulas. These foods must be fortified or supplemented with certain vitamins, minerals and essential fatty acids. The first semi-solid foods should be cereals without gluten, tubers and fruits with low allergenic potential. Additional animal and vegetable foods should be added after six months, withholding those associated with a higher allergenic risk until after 8 or 12 months. All foods accustomed in the household must be introduced gradually in the second year, making sure to provide adequate intakes of energy and nutrients. Other important aspects are hygienic handling of foods, frequency of feeding, and a positive attitude of parents and child-carers during meals to avoid rejection of certain foods or stimulation of over-eating.

Serum level of sELAM-1 in psoriatic patients correlates with disease activity.

BACKGROUND: Endothelial leucocyte adhesion molecule-1 (ELAM-1) acts as an adhesion ligand for neutrophils and monocytes and the expression of this molecule on the vascular endothelium may reflect its ability to recruit neutrophils from circulation. The next step is the transendothelial migration of neutrophils into lesional psoriatic skin. ELAM-1 may also exist in a soluble form. METHODS: We determined the serum levels of ELAM-1 by ELISA in 41 patients with psoriasis and 20 controls. RESULTS: Patients with acute psoriasis displayed higher levels of ELAM-1 (85.45 +/- 47.72 ng/ml) than controls (36.02 +/- 15.60 ng/ml) and patients with chronic disease (61.24 +/- 27.91 ng/ml). In 25 patients we measured the serum level of ELAM-1 twice: at the beginning and after treatment of the disease and we did not find any significant changes. We also found a correlation between serum ELAM-1 and PASI score. CONCLUSIONS: These data suggest that there is a high serum level of E-selectin in psoriatic subjects even after clearing of the disease. Serum E-selectin may reflect the general activation of endothelial cells in the disease and may be a new sensitive marker of disease activity.

Concentration of an epidermal growth factor in blood serum of males during topical treatment of psoriasis.

Epidermal growth factor (EGF) is a mitogen that stimulates cell division of various cells of epidermal origin. The present study was undertaken to clarify whether the serum level of EGF is correlated with the disease activity during local therapy with dithranol in psoriasis. We examined serum EGF concentrations in acute and chronic psoriasis before and after topical treatment with dithranol and the correlation with Psoriasis Activity and Severity Index (PASI). Male patients were divided into two groups: acute psoriasis (AP, 18 cases) and chronic psoriasis (CP, 17 cases). A control group C consisted of 20 healthy male volunteers. Radioimmunoassay of EGF was performed using the reagent pack (Amersham, UK). In the CP group mean EGF was higher before treatment than in the AP and C groups, but not significantly. EGF concentration after local treatment was higher in the CP group than the AP group (P < 0.02); the AP group, however, showed statistically significant decrease of EGF after the treatment (P < 0.04). No correlation between EGF and PASI was found. Serum EGF concentration increased in 19/35 treated patients.