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Selected AbstractsGlibenclamide improves postprandial hypertriglyceridaemia in Type 2 diabetic patients by reducing chylomicrons but not the very low-density lipoprotein subfraction levelsDIABETIC MEDICINE, Issue 10 2001I. Skrapari Abstract Aim, There are scarce data dealing with the degree of postprandial lipaemia after sulphonylurea administration. The aim of this study was to examine the effect of acute glibenclamide administration on postprandial lipaemia in Type 2 diabetic patients. Methods, Eight randomly selected Type 2 diabetic individuals, aged 43,65 years (mean, 54 years), who had never received any anti-diabetic drug, were included in the study. Each patient was given a 485 kcal mixed meal (45% fat, 40% carbohydrate and 15% protein) twice on separate days after an overnight fast: once with placebo and once with 5 mg glibenclamide, per os, in a random order. The two tests were performed with an interval of 7 days. Venous blood samples were drawn just before and 2 h, 4 h and 6 h after meal consumption. Total triglyceride levels in plasma, in chylomicrons (CM), in CM-deficient plasma, in very low-density lipoprotein (VLDL) subfractions (VLDL-1, VLDL-2) and in intermediate-density lipoprotein (IDL) were determined. Free fatty acid (FFA) and total cholesterol levels in plasma, as well as high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol levels in CM-deficient plasma, were also measured. Finally, serum glucose, insulin and C-peptide concentrations were measured in each sample. Results, As expected there was a significant decrease in postprandial glycaemia after glibenclamide administration compared to placebo (mean area under the curve values: AUC = 53.3 ± 18.2 and 69.1 ± 21.6 mm/h, P = 0.00009). In addition, the mean AUC values of insulin and C-peptide were significantly greater after drug administration. The AUC values of total plasma triglyceride and of CM triglyceride following glibenclamide administration were significantly lower compared to placebo, while the AUC values of postprandial triglyceride in CM-deficient plasma and of postprandial triglyceride in VLDL-1, VLDL-2 and IDL were not different after drug administration compared to placebo. Finally, no significant differences were noted in the AUC values of total cholesterol, LDL cholesterol, HDL cholesterol and plasma FFA levels after glibenclamide administration. Conclusions, These results demonstrate that glibenclamide administration improves postprandial hypertriglyceridaemia acutely by reducing postprandial triglycerides of intestinal origin. Diabet. Med. 18, 781,785 (2001) [source] Understanding hydrological processes with scarce data in a mountain environmentHYDROLOGICAL PROCESSES, Issue 12 2008A. Chaponnière Abstract Performance of process-based hydrological models is usually assessed through comparison between simulated and measured streamflow. Although necessary, this analysis is not sufficient to estimate the quality and realism of the modelling since streamflow integrates all processes of the water cycle, including intermediate production or redistribution processes such as snowmelt or groundwater flow. Assessing the performance of hydrological models in simulating accurately intermediate processes is often difficult and requires heavy experimental investments. In this study, conceptual hydrological modelling (using SWAT) of a semi-arid mountainous watershed in the High Atlas in Morocco is attempted. Our objective is to analyse whether good intermediate processes simulation is reached when global-satisfying streamflow simulation is possible. First, parameters presenting intercorrelation issues are identified: from the soil, the groundwater and, to a lesser extent, from the snow. Second, methodologies are developed to retrieve information from accessible intermediate hydrological processes. A geochemical method is used to quantify the contribution of a superficial and a deep reservoir to streamflow. It is shown that, for this specific process, the model formalism is not adapted to our study area and thus leads to poor simulation results. A remote-sensing methodology is proposed to retrieve the snow surfaces. Comparison with the simulation shows that this process can be satisfyingly simulated by the model. The multidisciplinary approach adopted in this study, although supported by the hydrological community, is still uncommon. Copyright © 2007 John Wiley & Sons, Ltd. [source] Bone Health in Children and Adolescents After Renal Transplantation,,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 10 2009Helena Valta MD Abstract The basis for lifelong bone health is established in childhood and adolescence. Whereas pediatric renal transplant (RTx) patients are at risk for impaired bone mass gain and fractures, scarce data on this subject are available. We performed a cross-sectional and longitudinal study of bone health in a national cohort of 106 pediatric RTx patients (median age, 12.6 yr; median follow-up, 5.1 yr after RTx). The patients underwent clinical evaluation, DXA for BMD, and spinal imaging for vertebral fractures. In longitudinal analysis, the median lumbar spine BMD Z-score was lowest (median, ,1.0) at 1 yr postoperatively but increased to a peak value of ,0.2 at 5 yr. In boys, the lumbar spine BMD Z-score increased also during puberty but decreased in girls. In cross-sectional analysis, the lumbar spine, hip, and whole body BMD Z-scores were < ,2 SD in 4%, 6%, and 6% of the patients, respectively. Sixteen percent had sustained peripheral fractures, and 8% had vertebral fractures. Female sex and age >15 yr (OR, 56.26; 95% CI, 5.17,611.82; p = 0.0007) as well as high plasma PTH levels (OR, 4.03; 95% CI, 1.37,11.85; p = 0.009) were significant predictors for low BMD. Three-year cumulative glucocorticoid dose, outside the immediate post-RTx years, was not associated with BMD parameters. The observed BMD results were satisfactory. However, the high (8%) prevalence of vertebral fractures warrants careful evaluation of bone health in these patients. [source] The risk of thrombosis in patients with acute leukemia: occurrence of thrombosis at diagnosis and during treatmentJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 9 2005V. DE STEFANO Summary.,Background:,Thromboembolism can occur during acute leukemia, especially acute lymphoid leukemia (ALL) treated with l -asparaginase. Yet, most reports are anecdotical and scarce data are available on the risk of thrombosis in acute myeloid leukemia (AML). Objectives:,To evaluate the risk of thrombosis in patients with acute leukemia. Patients and methods:,Three-hundred and seventy-nine consecutive adult patients with newly diagnosed acute leukemia were recruited in an observational cohort study conducted from January 1994 to December 2003. Diagnosis was ALL in 69 patients, acute promyelocytic leukemia (APL; FAB subtype M3) in 31, and non-M3 AML in 279. All first or recurrent symptomatic thromboembolic events objectively diagnosed were recorded. Results:,Twenty-four patients of the overall 379 (6.3%; 95% CI 4.1%,9.2%) had a first thrombosis, venous in 80% of the cases and arterial in 20%. At diagnosis, thrombosis was a presenting manifestation in 13 cases (3.4% of the whole cohort): 1.4% in ALL, 9.6% in APL, and 3.2% in non-M3 AML patients. Follow-up was carried out on 343 patients without thrombosis at diagnosis and further 11 thrombotic events (3.2%) were recorded. At 6 months from diagnosis, the cumulative incidence of thrombosis was 10.6% in ALL, 8.4% in APL, and 1.7% in non-M3 AML patients. The patients who received l -asparaginase had a 4.9-fold increased risk of thrombosis in comparison with those who did not (95% CI 1.5,16.0). The fatality rate due to thrombosis was 0.8%. Conclusions:,In patients with acute leukemia, the risk of thrombosis is not negligible. Thombosis can be a presenting symptom at diagnosis in a significant portion of cases with APL (9.6%) and non-M3 AML (3.2%); a similar rate of thrombosis can occur during the subsequent course of the disease. The incidence of symptomatic thrombosis at diagnosis is relatively low in ALL patients (1.4%), but is significantly increased by further treatment up to 10.6%. Strategies of antithrombotic prophylaxis should be investigated in this setting. [source] Treatment-dependent Loss of Polyfunctional CD8+ T-cell Responses in HIV-infected Kidney Transplant Recipients Is Associated with Herpesvirus ReactivationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 4 2009O. Gasser Antiretroviral-therapy has dramatically changed the course of HIV infection and HIV-infected (HIV(+)) individuals are becoming more frequently eligible for solid-organ transplantation. However, only scarce data are available on how immunosuppressive (IS) strategies relate to transplantation outcome and immune function. We determined the impact of transplantation and immune-depleting treatment on CD4+ T-cell counts, HIV-, EBV-, and Cytomegalovirus (CMV)-viral loads and virus-specific T-cell immunity in a 1-year prospective cohort of 27 HIV(+) kidney transplant recipients. While the results show an increasing breadth and magnitude of the herpesvirus-specific cytotoxic T-cell (CTL) response over-time, they also revealed a significant depletion of polyfunctional virus-specific CTL in individuals receiving thymoglobulin as a lymphocyte-depleting treatment. The disappearance of polyfunctional CTL was accompanied by virologic EBV-reactivation events, directly linking the absence of specific polyfunctional CTL to viral reactivation. The data provide first insights into the immune-reserve in HIV+ infected transplant recipients and highlight new immunological effects of thymoglobulin treatment. Long-term studies will be needed to assess the clinical risk associated with thymoglobulin treatment, in particular with regards to EBV-associated lymphoproliferative diseases. [source] | ||||||||||