Relationships between gastric emptying, intragastric meal distribution and blood glucose concentrations in diabetes mellitus

The aim of this study was to evaluate the prevalence of disordered intragastric meal distribution and the relationships between gastric emptying, intragastric distribution, glycemic control and gastrointestinal symptoms in diabetes mellitus. METHODS: Eighty-six patients with diabetes mellitus had measurements of gastric emptying and intragastric distribution of a radioisotopically labeled solid/liquid meal (100 g beef and 150 ml 10% dextrose), glycemic control (plasma glucose concentrations), upper gastrointestinal symptoms (questionnaire) and autonomic nerve function (cardiovascular reflexes). Results were compared to those obtained in 20 normal volunteers. RESULTS: Solid and liquid gastric emptying were delayed in the diabetic patients and correlated weakly. Intragastric meal distribution was also often abnormal, with increased retention of both solid and liquid in the proximal stomach and increased retention of solid but not liquid in the distal stomach. In all patients with increased retention of solid in the proximal stomach, emptying from the total stomach was delayed. Gastric emptying of liquid was slower in those subjects who had a mean plasma glucose > 15 mmol/liter during the gastric emptying measurement, when compared to the remainder of the group. CONCLUSION: In patients with diabetes mellitus, there is poor relationship between solid and liquid gastric emptying and intragastric meal distribution is frequently abnormal. Interpretation of the results of gastric emptying measurements should consider meal composition and plasma glucose concentrations.     

Risk of human immunodeficiency virus infection among pregnant crack cocaine users in a rural community

OBJECTIVE: To investigate why women who use crack cocaine are at increased risk of human immunodeficiency virus (HIV) infection. METHODS: One thousand one hundred fifty-two (99.7%) of 1155 consecutive prenatal patients attending a rural public health clinic were interviewed about drug use and sexual practices and tested for HIV infection and other sexually transmitted diseases. RESULTS: Fifty-one (4.7%) of 1096 pregnant women reported ever using crack cocaine, but only five (10%) of the crack cocaine users had ever injected drugs. Eighteen (35%) of the crack users were HIV infected compared with 22 (2%) of the 1045 women who reported never using crack (odds ratio 25, 95% confidence interval 12-52; P < .001). Crack users were more likely to have had a known HIV-infected sex partner, exchanged sex for money or drugs, and tested positive for syphilis than were non-crack users (for each comparison, P < .001). Before using crack, 18% of crack users had exchanged sex for money or drugs and 8% had averaged three or more sex partners per month; in contrast, after beginning to use crack, 76% of crack users exchanged sex for money or drugs and 63% averaged three or more sex partners per month (for both comparisons, P < .001). Crack users who were not HIV infected were more likely to have almost always used condoms and/or had fewer than three sex partners per month than were HIV-infected crack users (P < .01). CONCLUSION: Women who reported using crack cocaine were at an increased risk of HIV infection because crack use was associated with a significant increase in unprotected sexual contact.     

The gender gap in occupational role attainment: A social dominance approach.

Investigated the evidence of a gender gap in occupational role attainment in 3 experiments with 316 undergraduates. The authors present archival evidence that men disproportionately hold occupational roles that enhance group-based inequality and that women disproportionately hold roles that attenuate group-based inequality. Evidence for 3 processes that may contribute to this pattern was found: self-selection that is based on gender-linked differences in support for group inequality (social dominance orientation), hiring biases that are based on matching job applicants' group equality values with the hierarchy function of the job, and gender-stereotyped hiring biases. These processes were found across a number of occupations and participant variables. The social systems nature of these processes and the implications of the results for theoretical understandings of gender roles, social inequality, and theories of stereotyping are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cortical blindness as a complication of acute glomerulonephritis

Two hundred and ten pneumococcal isolates underwent ceftizoxime disk (30 micrograms) screening to predict cephalosporin resistance. Forty-six isolates failed screening with 36 (78%) demonstrating intermediate/resistant MICs. Sensitivity and specificity were 100 and 95%, respectively. The ceftizoxime disk screen is an effective method of identifying potentially cephalosporin-resistant isolates.     

Smoking screening and management in primary care practices

This study examined how pain coping efficacy and pain coping strategies were related to reports of pain during mammography. Subjects were 125 women over the age of 50 undergoing screening mammograms. Prior to their mammogram, all subjects completed the Coping Strategies Questionnaire (CSQ) to assess how they cope with day-to-day pain experiences. Ratings of pain during the mammogram were collected using a 6-point pain/discomfort scale, a 100-mm Visual Analog Scale, the adjective checklist of the McGill Pain Questionnaire, and the Brief Pain Inventory. Up to 93% of the women reported the mammogram examination was painful. On average, women rated the mammography pain in the low to moderate range. Considerable variability in pain ratings was found, however, with some women reporting severe pain and others reporting little or no pain. Correlational analyses were conducted to examine how coping efficacy (CSQ ratings of ability to decrease pain and ability to control pain) and coping strategies (CSQ pain coping strategy subscales) related to variations in pain report. There was a pattern for ratings of ability to decrease pain to be related to lower ratings of current mammography pain. Women who rated their ability to decrease pain as high reported lower average levels of mammography pain, lower ratings on the mammography pain/discomfort scale, and were much more likely to report having had lower levels of pain during their last mammogram. These findings suggest that women who rate their coping efficacy in decreasing day-to-day pain as low may be at higher risk for having a painful mammogram. Individual pain coping strategies were not generally correlated with pain ratings. Behavioral interventions (e.g., patient controlled breast compression) and cognitive therapy interventions (e.g., training in the use of calming self-statements or distraction techniques) designed to increase coping efficacy potentially could be useful in reducing pain in women who are at risk for pain during mammography.     

Gastroesophageal reflux disease and respiratory disease

The patients treated for oesophageal atresia present a correlation between the clinical sintomatology after recanalization characterized by disfagia, dispnea, recurrent cough, chronic pneumopaties and oesophageal anomalies. Where morphological alterations accounting for the presence of gastro-oesophageal reflux (GOR) were not evident, possible functional alterations of the motility were considered. The incidence of GOR was considerably high and, expression of a congenital alteration of the lower oesophageal sphincter and of oesophageal peristalsis, becomes even more severe due to further stretching of the gastro-esophageal junction. The authors underline that the early demonstration of histological changes, even before recanalization, and the motility disorders of the oesophagus have to be well studied, while the LES is normalized, in order to prevent and treat the possible appearance of the well-known complications of GOR.     

Regulation of p53 levels by the E1B 55-kilodalton protein and E4orf6 in adenovirus-infected cells

The adenovirus type 5 243R E1A protein induces p53-dependent apoptosis in the absence of the 19- and 55-kDa E1B polypeptides. This effect appears to result from an accumulation of p53 protein and is unrelated to expression of E1B products. We now report that in the presence of the E1B 55-kDa polypeptide, the 289R E1A protein does not induce such p53 accumulation and, in fact, is able to block that induced by E1A 243R. This inhibition also requires the 289R-dependent transactivation of E4orf6 expression. E4orf6 is known to form complexes with the E1B 55-kDa protein and to function both in the transport and stabilization of viral mRNA and in shutoff of host cell protein synthesis. We demonstrated that the block in p53 accumulation is not due to the generalized shutoff of host cell metabolism. Rather, it appears to result from a mechanism targeted specifically to p53, most likely involving a decrease in the stability of p53 protein. The E1B 55-kDa protein is known to interact with both E4orf6 and p53, and as demonstrated recently by others, we showed that E4orf6 also binds directly to p53. Thus, multiple interactions between all three proteins may regulate p53 stability, resulting in the maintenance of low levels of p53 following virus infection.     

Focal transmantle dysplasia: a specific malformation of cortical development

We report 18 patients who presented prior to age 20 years with epilepsy or fixed neurologic deficits. MRI showed signal abnormality extending from the cortex to the superolateral wall of the lateral ventricle. Histology showed cortical disorganization, neuronal cytomegaly, balloon cells, indistinct cortical gray matter-white matter junctions, and variable accompanying astrogliosis. We propose that this transmantle dysplasia is a specific anomaly resulting from abnormal stem cell development.