1.  Peer Reviewed Title: Polycystic ovary syndrome and cardiovascular risk in young patients treated with drospirenone-ethinylestradiol or contraceptive vaginal ring. A prospective, randomized, pilot study. Author: Battaglia C; Mancini F; Fabbri R; Persico N; Busacchi P; Facchinetti F; Venturoli S Source: Fertility and Sterility. 2009 Jul 8; Abstract: OBJECTIVE: To compare the effects of a pill containing drospirenone with those of a combined contraceptive vaginal ring on the lipid and carbohydrate metabolism and on the surrogate markers of arterial function. SETTING: Bologna University School of Medicine. PATIENT(S): Thirty-seven women with polycystic ovary syndrome (PCOS) were randomly submitted to drospirenone + ethinylestradiol (group I; n = 19) or combined contraceptive vaginal ring (group II; n = 18) therapy. The duration of the study was 6 months. INTERVENTION(S): The effect of treatments was assessed after 6 months of therapy. MAIN OUTCOME MEASURE(S): Utero-ovarian ultrasound analysis and color Doppler evaluation of uterine and stromal ovarian arteries. In addition, analysis of brachial artery flow-mediated vasodilatation and 24-hour ambulatory blood pressure monitoring were performed. Fasting blood samples were drawn for testing biochemical and hormonal parameters and nitrites/nitrates. RESULT(S): Both treatments improved hirsutism, hyperandrogenemia, and ultrasound and color Doppler ovarian parameters. Both drospirenone + ethinylestradiol or contraceptive vaginal ring induced a slight but significant increase of diurnal and 24-hour blood pressure. Although both therapies worsened the lipid profile, the oral pill administration was associated with a more evident increase of circulating triglycerides. The 6-month treatment with the vaginal ring significantly improved the area under the curve for glucose, insulin, and C-peptide, whereas the drospirenone + ethinylestradiol pill induced an increase in the insulinogenic index and homeostatic model assessment estimate for insulin resistance values. CONCLUSION(S): Vaginal hormonal contraception appears to be preferable to oral ethinylestradiol + drospirenone administration in hyperinsulinemic patients with PCOS. Language: English Keywords: ITALY | RESEARCH REPORT | PROSPECTIVE STUDIES | COMPARATIVE STUDIES | CLIENTS | OVARIAN CYSTS | ORAL CONTRACEPTIVES, COMBINED | ETHINYL ESTRADIOL | LOW-DOSE PROGESTINS | VAGINAL RING | CARDIOVASCULAR EFFECTS | CARBOHYDRATE METABOLIC EFFECTS | LIPID METABOLIC EFFECTS | BLOOD PRESSURE | ULTRASONICS | Developed Countries | Europe, Southern | Europe | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Diseases | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Progestin | Physiology | Biology | Metabolic Effects | Lipids | Hemic System | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342128 |
| 2. Title: Metabolic profile and sex hormone binding globulin (SHBG) in different reproductive phases of Czech women and their relations to weight, body composition and fat distribution. Author: KOSKOVA I; PETRASEK R; VONDRA K; DUSKOVA M; STARKA L Source: Physiological Research / Academia Scientiarum Bohemoslovaca. 2009;58(3):393-402. Abstract: In our study, 213 healthy Czech women aged 20 to 65 years were examined and divided into fully reproductive, premenopausal, menopausal and postmenopausal groups. In all subjects body composition was determined by classical anthropometry and metabolic profile was assessed. A total of 146 subjects completed 3-year longitudinal study. Total and LDL cholesterol increased and ratio HDL/total cholesterol decreased with age (p<0.001), most significantly in menopause. Triacylglycerols increased only up to menopause. HDL had a very slight trend to decrease in menopause and postmenopause. Fasting blood glucose level increased progressively (p<0.001), in postmenopause frequently exceeded normal range. Higher BMI, total fat mass and central fat indices were associated with higher total and LDL cholesterol, triacylglycerols, C-peptide, insulin and fasting blood glucose level (p<0.001; fasting blood glucose level to waist-to-hip ratio: p<0.01) and lower HDL cholesterol (p<0.001). Higher C-peptide and insulin were associated with lower HDL cholesterol and higher triacylglycerols (p<0.001). Fasting glucose correlated with LDL cholesterol (p<0.01). Higher SHBG was associated with higher HDL and lower LDL cholesterol (p<0.001). Hormone replacement treatment was related to lower fasting blood glucose level in postmenopausal women (p<0.01). Oral contraception is suggestive of a positive influence on lipid spectrum by increasing the ratio HDL/total cholesterol. Markers of lipid and carbohydrate metabolism are not only age-related, but they are also related to BMI, total fat mass and central fat indices. Therefore, preventive programs should be focused above all on menopausal women. Language: English Keywords: CZECHOSLOVAKIA | RESEARCH REPORT | LONGITUDINAL STUDIES | WOMEN | CARBOHYDRATE METABOLIC EFFECTS | LIPID METABOLIC EFFECTS | CHOLESTEROL | BODY WEIGHT | ANTHROPOMETRY | AGE FACTORS | MENOPAUSE | ORAL CONTRACEPTIVES | HORMONE REPLACEMENT THERAPY | Europe, Central | Europe | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Metabolic Effects | Physiology | Biology | Lipids | Measurement | Population Characteristics | Reproduction | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342621 |
| 3. Title: Maternal mid-pregnancy serum triglyceride levels and neonatal birth weight. Author: Kushtagi P; Arvapally S Source: International Journal of Gynaecology and Obstetrics. 2009 Mar 25; Abstract: Although disturbances in maternal glucose metabolism and resultant fetal hyperinsulinemia are known to significantly impact fetal overgrowth, it has been suggested that other fuels such as lipids and amino acids may be the determinants of fetal growth in nondiabetics. Maternal serum lipid levels increase in mid to late pregnancy; and in women with gestational diabetes, elevated triglycerides were significantly associated with birth weight corrected for gestational age. Although the role of maternal hyperlipidemia in fetal growth is not known, maternal fasting serum triglyceride levels at 24 to 32 weeks of pregnancy were shown to be significantly and positively associated with neonatal weight at term, independent of maternal prepregnancy obesity, weight gain during pregnancy, or mid-pregnancy plasma glucose levels (either fasting or postprandial) in Japanese and white women. The aim of the present study was to determine the relationship between maternal mid-pregnancy serum lipid levels and neonatal birth weight in our region. (excerpt) Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | INFANT | BIRTH WEIGHT | PREGNANCY, SECOND TRIMESTER | LIPIDS | LIPID METABOLIC EFFECTS | MATERNAL NUTRITION | CHOLESTEROL | GLUCOSE METABOLISM EFFECTS | BODY WEIGHT | Asia, Southern | Asia | Developing Countries | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Physiology | Biology | Pregnancy | Reproduction | Nutrition | Health | Carbohydrate Metabolic Effects | Metabolic Effects Document Number: 341469 |
| 4. Title: Metabolic and cardiovascular impact of oral contraceptives in polycystic ovary syndrome. Author: Soares GM; Vieira CS; de Paula Martins W; Dos Reis RM; de Sa MF; Ferriani RA Source: International Journal of Clinical Practice. 2009 Jan;63(1):160-9. Abstract: Chronic anovulation, polycystic ovarian morphology and hyperandrogenism are the diagnostic criteria for polycystic ovary syndrome (PCOS). Metabolic disturbances are more common in PCOS women who are prone to develop metabolic syndrome and to present higher levels of some cardiovascular disease risk marker. Oral contraceptives are widely used in PCOS, but conflicting data have been reported regarding their impact on carbohydrate and lipid metabolism on PCOS women. This paper presents a critical evaluation of combined oral contraceptives (COCs) metabolic effect - carbohydrate metabolism and insulin sensitivity, lipid metabolism, haemostasis, body weight, arterial pressure and cardiovascular impact - on PCOS women. Because of the paucity of data on the impact of COCs on cardiovascular and metabolic parameters in PCOS patients, most of there commendations are based on studies involving ovulatory women. The use of low-dose COCs is preferable in PCOS, especially among patients with glucose intolerance, insulin resistance and uncomplicated diabetes mellitus. Although reported as a side effect of COCs, marked weight gain has not been confirmed among users. However, when arterial hypertension or elevated risk for thromboembolism is present, progestogen-only hormonal contraceptives should be used instead of COCs. Regarding dyslipidaemia, COCs reduce low-density lipoprotein and total cholesterol and elevate high-density lipoprotein and triglycerides, and therefore are not recommended for women with high triglycerides levels. The choice of a COC, which alleviates the PCOS-induced hyperandrogenism without significant negative impact on cardiovascular risk, is one of the greatest challenges faced by gynaecologists nowadays. Language: English Keywords: BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | OVARIAN CYSTS | CARDIOVASCULAR EFFECTS | ORAL CONTRACEPTIVES, COMBINED | BODY WEIGHT | CARBOHYDRATE METABOLIC EFFECTS | ORAL CONTRACEPTIVES, SIDE EFFECTS | LIPID METABOLIC EFFECTS | CONTRACEPTIVE SAFETY | BLOOD PRESSURE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Economic Development | Economic Factors | Diseases | Physiology | Biology | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Metabolic Effects | Safety | Public Health | Health | Lipids | Hemic System Document Number: 341138 |
| 5. Title: HIV-related lipodystrophy in Africa and Asia. Author: Womack J Source: AIDS Reader. 2009 Apr;19(4):131-9, 148-52. Abstract: This article reviews the medical literature for information about lipodystrophy in Africa and Asia. These 2 regions were selected because both are of particular interest to the declaration for universal access. Africa represents the epidemic's epicenter. Asia, especially India and China, will soon have HIV / AIDS prevalence rates that will outstrip those seen in the rest of the world combined. The methodology is summarized first: how articles were selected, the inclusion and exclusion criteria used, and how information was synthesized. The results and discussion focus on 3 specific areas: how lipodystrophy is defined and measured, the study populations, and the persons excluded from these studies. A summary of what is and what is not yet known about lipodystrophy in Africa and Asia is also included. Language: English Keywords: AFRICA | ASIA | LITERATURE REVIEW | UNAIDS | PERSONS LIVING WITH HIV/AIDS | LIPID METABOLIC EFFECTS | GLUCOSE METABOLISM EFFECTS | DIABETES | HEART DISEASES | RISK FACTORS | PREVENTION AND CONTROL | QUALITY OF LIFE | TREATMENT | OBSTACLES | Developing Countries | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Lipids | Physiology | Biology | Carbohydrate Metabolic Effects | Metabolic Effects | Health | Social Welfare | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Organization and Administration Document Number: 341055 |
| 6. Title: Reduction of unnecessary transfusion and intravenous fluids in severely malnourished children is not enough to reduce mortality. Author: Bachou H; Tumwine JK; Mwadime RK; Ahmed T; Tylleskar T Source: Annals of Tropical Paediatrics. 2008 Mar; 28(1):23-33. Abstract: The aim was to test whether standardising the use of blood transfusions and intravenous (IV) infusions could reduce fatality in severely malnourished children admitted to Mulago Hospital, Kampala. Improved adherence to the WHO protocol for blood transfusion and IV fluids was effected in patients with severe malnutrition by continuous medical education. A 'before and after' design was used to study 450 severely malnourished children (weight-for-height less than -3 Z-score or presence of oedema) under 60 months of age. A total of 220 pre- and 230 post-'improved practice' patients were enrolled consecutively during the periods September to November 2003 and September to December 2004, respectively. Patients were followed up until discharge or death. The Kaplan-Meier survival curve and the Cox regression hazard model were used for univariate and multivariate analyses, respectively. Overall case fatality was 23.6% (52/220) in the pre-period and 24.8% (57/230) in the post-period (p = 0.78). Most of the deaths occurred in the 1st week of admission (73%, 38/52 in the pre-period and 61%, 35/57 in the post-period) and were of children who had received blood transfusion or IV infusion or both in the pre-period. Mortality in children transfused and/or infused was significantly reduced in the post-period (82%, 31/38 in the preperiod vs 23%, 8/35 in the post-period, p = 0.008). In the post-period, there was a significant reduction in the number of inappropriate blood transfusions (18%, 34/194 vs 3.5%, 8/230, p = 0.01) and IV fluid infusions (27%, 52/194 vs 9%, 20/230, p less than 0.001). Survival improved in children who received blood transfusions in the post-period [hazards ratio (HR) 0.22, 95% CI 0.30-1.67 vs HR 4.80, 95% CI 1.71-13.51], as did that of children who received IV infusions (HR 2.10, 95% CI 0.84-5.23 vs HR 3.91, 95% CI 1.10-14.04). Management according to the WHO protocol for severe malnutrition can reduce the need for blood and IV infusions. However, further studies are required to verify whether full implementation of the WHO protocol reduces the high case fatality in sub-Saharan hospitals. (author's) Language: English Keywords: UGANDA | RESEARCH REPORT | CHILD | MALNUTRITION | BODY WEIGHT | DEHYDRATION | TREATMENT | BLOOD TRANSFUSION | CHILD SURVIVAL | MORTALITY | PREVENTION AND CONTROL | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition Disorders | Diseases | Physiology | Biology | Metabolic Effects | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Survivorship | Length of Life | Population Dynamics Document Number: 325072 |
| 7. Title: Sex differences in the control of glucose homeostasis. Author: Blaak E Source: Current Opinion In Clinical Nutrition and Metabolic Care. 2008 Jul;11(4):500-4. Abstract: PURPOSE OF REVIEW: A markedly higher prevalence of impaired glucose tolerance has been reported in women than in men, whereas the opposite was seen for impaired fasting glucose. The present review focuses on the underlying mechanisms. RECENT FINDINGS: An increased meal glucose appearance and disturbances in postprandial glucose disposal may contribute to higher glucose concentrations in women. An increased, similar or reduced insulin sensitivity has been reported in women than in men, which makes it unclear to what extent a disturbed insulin-mediated glucose disposal may contribute to increased postprandial glucose concentrations in women. This discrepancy may be explained by differences in the phase of menstrual cycle during the study, the use of oral contraceptives and different degrees of physical fitness. Nevertheless, there are consistent data indicating that women are protected against fatty acid-induced insulin resistance. Furthermore, both disturbances in endogenous glucose output and metabolic clearance of glucose may contribute to the reduced fasting glucose concentrations in women. SUMMARY: There is an urgent need for studies that test whether sex-related disturbances in glucose metabolism may be involved in the pathogenesis of type 2 diabetes and the metabolic syndrome, taking age, menstrual cycle, the use of oral contraceptives and physical activity into account. Language: English Keywords: NETHERLANDS | LITERATURE REVIEW | CLINICAL RESEARCH | ADULTS | WOMEN | PREVALENCE | SEX FACTORS | GLUCOSE METABOLISM EFFECTS | TIME FACTORS | DIABETES | AGE FACTORS | MENSTRUAL CYCLE | ORAL CONTRACEPTIVES, SIDE EFFECTS | FITNESS | Developed Countries | Europe, Western | Europe | Research Methodology | Population Characteristics | Demographic Factors | Population | Measurement | Carbohydrate Metabolic Effects | Metabolic Effects | Physiology | Biology | Population Dynamics | Diseases | Menstruation | Reproduction | Contraceptive Safety | Safety | Public Health | Health Document Number: 328649 |
| 8. Title: Prevalence of polycystic ovary syndrome in unselected women from southern China. Author: Chen X; Yang D; Mo Y; Li L; Chen Y Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2008 Jul;139(1):59-64. Abstract: The objective was to determine the prevalence and metabolic parameters of polycystic ovary syndrome (PCOS) in southern China. The study was observational with a parallel study. Participants were studied in a medical examination center. A population of 915 women of reproductive age was investigated at the time of their annual physical examination to determine the prevalence of PCOS in unselected women from southern China. Our results demonstrated a 2.2% (20/915) prevalence of PCOS. Women with PCOS had higher levels of luteinizing hormone and higher luteinizing hormone/follicle-stimulating hormone ratios than those in the other groups. Women with PCOS had higher fasting insulin levels and lower fasting glucose/fasting insulin ratios than women in any of the other groups. Some clinical and biochemical characteristics were apparent in PCOS patients in our population, and ethnic differences may be considered when studying the clinical and metabolic features of PCOS in China. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | OVARIAN EFFECTS | PREVALENCE | LUTEINIZING HORMONE | GLUCOSE METABOLISM EFFECTS | Asia, Eastern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Measurement | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Carbohydrate Metabolic Effects | Metabolic Effects Document Number: 327515 |
9.  Peer Reviewed Title: Use of metformin in polycistic ovary syndrome: A meta-analysis. Author: Creanga AA; Bradley HM; McCormick C; Witkop CT Source: Obstetrics and Gynecology. 2008 Apr;111(4):959-968. Abstract: The objective was to update the state of evidence on the efficacy of metformin, used either alone or in combination with clomiphene citrate in women with polycystic ovary syndrome, by examining three outcomes: ovulation, pregnancy, and live birth. Sources of heterogeneity among the published randomized controlled trials are systematically assessed. An electronic literature search was performed using MEDLINE, EMBASE, SCOPUS, CENTRAL, Cochrane, and U.S. Food and Drug Administration databases, restricted to studies conducted on humans and published in English. Of the 406 potentially relevant articles identified, 17 met criteria for inclusion in the meta-analysis, rendering a total sample of 1,639 women. Study quality was examined in terms of randomization scheme, masking process, adequacy of allocation concealment, statistical power, and loss to follow-up; publication bias was also assessed. Meta-analytic procedures were used to compare metformin with placebo, and metformin plus clomiphene with clomiphene alone, for all study outcomes. Exploratory analyses were conducted to assess differences in treatment effects between clomiphene-resistant and nonresistant patients, obese and nonobese patients, and trials with long and short durations of follow-up. Metformin improved the odds of ovulation in women with polycystic ovary syndrome when compared with placebo (odds ratio [OR] 2.94; 95% confidence interval [CI] 1.43-6.02; number-needed-to-treat 4.0) and appears more effective for non-clomiphene-resistant women. Metformin and clomiphene increased the likelihood of ovulation (OR 4.39; 95% CI 1.94 -9.96; number-needed-to-treat 3.7) and pregnancy (OR 2.67; 95% CI 1.45-4.94; number-needed-to-treat 4.6) when compared with clomiphene alone, especially in clomiphene-resistant and obese women with polycystic ovary syndrome. These treatment effects were greater for trials with shorter follow-up. Using all available evidence, this metaanalysis suggests that metformin increases the likelihood of ovulation and, in combination with clomiphene, increases the odds of both ovulation and pregnancy in women with polycystic ovary syndrome. (author's) Language: English Keywords: GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | OVARIAN EFFECTS | GLUCOSE METABOLISM EFFECTS | DRUGS | DRUG RESISTANCE | DRUG INTERACTIONS | INFERTILITY | OVULATION | PREGNANCY | PREGNANCY OUTCOMES | Demographic Factors | Population | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Carbohydrate Metabolic Effects | Metabolic Effects | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction Document Number: 325771 |
| 10. Title: Electropherotypes and subgroups of group A rotaviruses circulating among diarrhoeic children in Kano, Nigeria. Author: Dzikwi A; Umoh JU; Kwaga JK; Ahmad AA; deBeer M; Steele AD Source: Annals of African Medicine. 2008 Dec;7(4):163-7. Abstract: BACKGROUND: It is estimated that about 600,000 children die annually as a result of severe dehydrating diarrhea caused by rotaviruses. The virus is a double stranded RNA (dsRNA) virus with 11 segments. Group A rotaviruses show a characteristic 4-2-3-2 pattern following electrophoresis. The VP6 subgroups, I and II exist. This work was carried out to study the prevalence of rotavirus infection among children 0-5 years with diarrhea in Kano, and to determine the circulating subgroups and electropherotypes and of the rotavirus isolates. METHODS: Two hundred and eighteen stool specimens from children 0-60 months (198 diarrheic and 20 non-diarrheic) were collected from different hospitals and health care centers in Kano and subjected to group A rotavirus enzyme linked immunosorbent assay (ELISA) to determine presence of group A rotavirus, subgroup ELISA to determine the VP6 subgroups and polyacrylamide gel electrophoresis (PAGE) to determine the electropherotypes present. RESULTS: The long electropherotypes (47.05%) of four variations dominated over the short electropherotype (17.64%). About 11.76% of the isolates were of mixed infection. Dominance of subgroup II (45%) over subgroup I (25%), and the presence of both subgroups I and II (10%) and neither subgroup I nor II (15%) was observed in this study. CONCLUSION: Information on the genomic diversity of the RNA electropherotypes in this region, Kano, is reported in this study. Language: English Keywords: NIGERIA | RESEARCH REPORT | PREVALENCE | CHILDREN | ROTAVIRUS | DEHYDRATION | DIARRHEA | RISK FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Metabolic Effects | Physiology | Biology | Health Document Number: 342269 |
| 11. Title: Infertility and polycystic ovarian syndrome: A study of association between body mass index and intrafamily marriages. Author: Haq F; Rizvi J Source: Gynecologic and Obstetric Investigation. 2008;65(4):269-274. Abstract: Polycystic ovarian syndrome (PCOS) is a common endocrine disorder which causes anovulatory infertility. Obesity is one of the factors which directly modifies the clinical, biochemical and metabolic expression of this syndrome. Recently a genetic association of PCOS with intrafamily marriages has been postulated. This study investigates the association of environmental factors such as BMI and intrafamily marriages with the clinical, biochemical and hormonal features of this syndrome. The objective was to determine the relationship of different clinical, biochemical parameters and hormonal assay with the BMI of women who are known to have PCOS, and to compare these demographic features with intrafamily marriages. From January 2005 until December 2006, patients attending the infertility clinic at Aga Khan University Hospital, Karachi, were evaluated for their clinical features. Couples were divided into 2 groups: group A had a history of first-degree intrafamily marriages, and group B had none. Complete biochemical evaluation was performed by day-2 serum FSH, LH, prolactin, testosterone and fasting serum insulin levels. The results were recorded on a data collection form. Ultrasonic evaluation was performed with transvaginal ultrasound to check the morphological appearance of the ovaries. A modified glucose tolerance test with 75 g glucose was performed and the results were recorded as normal, impaired and abnormal. Insulin resistance was calculated using the HOMA index method. During this period 203 patients were evaluated for demographic and biochemical features of PCOS. The prevalence of obesity was 70% with 59.3% women found to have hyperinsulinemia while 52.3% of patients had insulin resistance according to the HOMA index method. Univariate and multivariate analyses were used to compare the 2 groups. A linear relationship between oligomenorrhea, family history of diabetes, tonic LH, high fasting serum insulin levels, insulin resistance and an abnormal glucose tolerance test was revealed, keeping intrafamily marriage and BMI as dependent variables. In this population 48% of couples were in first-degree intrafamily marriages, suggesting the possibility of a high genetic predisposition for abnormal metabolic features beside ethnic predisposition. A linear relationship of high BMI and family marriages has been seen with insulin resistance, oligomenorrhea and impaired glycemic control. The number of obese women and the high rate of intrafamily marriages make our population genetically susceptible to metabolic complications. (author's) Language: English Keywords: PAKISTAN | RESEARCH REPORT | WOMEN | COUPLES | OBESITY | BODY WEIGHT | OVARIAN CANCER | OVARIAN CYSTS | INFERTILITY | DRUG RESISTANCE | GLUCOSE METABOLISM EFFECTS | TESTING | TREATMENT | Developing Countries | Asia, Southern | Asia | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Physiology | Biology | Cancer | Neoplasms | Diseases | Reproduction | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Carbohydrate Metabolic Effects | Metabolic Effects | Measurement | Research Methodology Document Number: 326619 |
| 12. Title: Determinants of insulin-resistant phenotypes in normal-weight and obese Black African women. Author: Jennings CL; Lambert EV; Collins M; Joffe Y; Levitt NS Source: Obesity. 2008 Jul;16(7):1602-9. Abstract: OBJECTIVE: Subsets of metabolically "healthy obese" and "at-risk" normal-weight individuals have been previously identified. The aim of this study was to explore the determinants of these phenotypes in black South African (SA) women. METHODS AND PROCEDURES: From a total of 103 normal-weight (BMI Keywords: SOUTH AFRICA | RESEARCH REPORT | WOMEN | BLACKS | GENETICS | BODY WEIGHT | LIPIDS | CARBOHYDRATE METABOLIC EFFECTS | OBESITY | SOCIOECONOMIC FACTORS | FITNESS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Biology | Physiology | Metabolic Effects | Economic Factors | Health Document Number: 328379 |
| 13. Peer Reviewed Title: Nosocomial infections among patients admitted to an urban diarrhoeal-diseases treatment facility in Bangladesh: A preliminary survey. Author: Khan AM; Rahman AK; Hossain MS; Faruque AS; Huq S Source: Annals of Tropical Medicine and Parasitology. 2008;102(1):89-92. Abstract: Nosocomial infections are important causes of morbidity and mortality in developed and developing countries. The frequency of such infections, which differs not only between countries but also between healthcare units within individual countries, is an indication of the quality of care and of the local infection-control programme. Surveillance to estimate the incidence of nosocomial infection, usually expressed as infections/1000 patient-days or device-associated infections/1000 device-days, is now routine in many regions and - provided the methodology is similar - permits valid inter-hospital comparisons. Unfortunately, the acquisition of such incidence data is labour-intensive and often too expensive for healthcare units in resource-poor areas. Thus, although nosocomial infections are considered to be a significant public-health problem worldwide, relatively little information is available on such infections in many developing countries. There appear to be no published reports on hospital-acquired infection among patients with diarrhoeal disease, for example, from Bangladesh or elsewhere. The aim of the present study was to collect baseline data on the incidence and types of nosocomial infection occurring at the hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) in Dhaka. Once collected, such data should allow temporal trends in nosocomial infection at the hospital to be followed and appropriate measures, to strengthen the local programme of infection control, to be taken and prioritized. (excerpt) Language: English Keywords: BANGLADESH | RESEARCH REPORT | RETROSPECTIVE STUDIES | SURVEYS | CLIENTS | INFECTIONS | HOSPITALS | AGE FACTORS | DIARRHEA | DEHYDRATION | RESPIRATORY INFECTIONS | MANAGEMENT | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Sampling Studies | Program Activities | Programs | Organization and Administration | Diseases | Health Facilities | Delivery of Health Care | Health | Population Characteristics | Demographic Factors | Population | Metabolic Effects | Physiology | Biology Document Number: 323109 |
| 14. Peer Reviewed Title: Prevalence of dyslipidemia and dysglycaemia in HIV infected patients. Author: Manuthu EM; Lule GN; Karari E Source: East African Medical Journal. 2008 Jan;85(1):10-17. Abstract: Highly active antiretroviral therapy (HAART) has dramatically reduced AIDS morbidity and mortality; however long-term metabolic consequences including dysglycaemia and dyslipidemia have raised concern regarding accelerated cardiovascular disease risk. Objective: To determine the period prevalence of dyslipidemia and dysglycaemia in HIV-infected patients. Design: Cross-sectional comparative group study. Setting: Kenyatta National Hospital, a tertiary HIV dedicated out-patient facility. Subjects: Consecutive HIV- positive adult patients. Main outcome measures: Dyslipidemia: presence of raised total or LDL cholesterol or low HDL cholesterol, or raised triglycerides. Dysglycaemia: presence of impaired fasting glucose or impaired glucose tolerance, or diabetes mellitus. Results: Between January and April 2006, out of 342 screened patients, 295 were recruited and 58% were females. One hundred and thirty four (45%) were on HAART, 82% of whom were on stavudine, lamivudine and either nevirapine or efavirenz. Overall prevalence of dyslipidemia was 63.1% and dysglycaemia was 20.7%. High total cholesterol occurred in 39.2% of HAART and 10.0% HAART naive patients (p<0.0001, OR 5.18, CI 3.11-10.86), whereas high LDL cholesterol occurred in 40.8% and in 11.2% respectively (p<0.0001, OR 5.43, CI 2.973-9.917). HDL levels were low in 14.6% and 51.3% among HAART and HAART naive patients, respectively, (p<0.0001, OR 0.16, CI 0.091-0.29) while high triglycerides occurred in 25.6% and 22.5% respectively (p=0.541 OR 1.184 C1 0.688-2.037). Among patients on HAART compared to HAART naive patients, diabetes was found in 1.5% against 1.2% (p=0.85), impaired fasting in 2.2% against 0.6% (p=0.30) and impaired glucose tolerance in 16.4% against 21.1% (p=0.221, respectively. Conclusions: HIV-infected patients demonstrated a high prevalence of dyslipidemia. HAART use was associated with high levels of total, and LDL cholesterol and high triglyceride levels, an established athrogenic lipid profile. However, HAART was not associated with low HDL cholesterol and had no significant effect on dysglycaemia. Language: English Keywords: KENYA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | CASE CONTROL STUDIES | PERSONS LIVING WITH HIV/AIDS | CARDIOVASCULAR EFFECTS | HIV INFECTIONS | ANTIRETROVIRAL THERAPY | SIDE EFFECTS | CHOLESTEROL | DIABETES | PREVALENCE | GLUCOSE METABOLISM EFFECTS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Physiology | Biology | HIV | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Lipids | Measurement | Carbohydrate Metabolic Effects | Metabolic Effects Document Number: 326585 |
| 15. Title: Home management of diarrhea among underfives in a rural community in Kenya: household perceptions and practices. Author: Othero DM; Orago AS; Groenewegen T; Kaseje DO; Otengah PA Source: East African Journal of Public Health. 2008 Dec;5(3):142-6. Abstract: INTRODUCTION: Diarrheal disease is a major cause of morbidity and mortality among under-fives especially in rural and peri-urban communities in developing countries. Home management of diarrhea is one of the key household practices targeted for enhancement in the Community Integrated Management of Childhood Illness (C-IMCI) strategy. OBJECTIVE: The aim of this study was to determine the perceptions of mothers/caregivers regarding the causes of diarrhea among under-fives and how it was managed in the home before seeking help from Community Health Workers or health facilities. DESIGN: A household longitudinal study was conducted in Nyando district, Kenya in 2004-2006 adopting both qualitative and quantitative approaches. SUBJECTS: A total of 927 mothers/caregivers of under-fives participated in the study. MAIN OUTCOME MEASURES: Perceived causes of childhood diarrhoea, action taken during diarrhea, fluid intake, recognition of signs of dehydration, feeding during convalescence, adherence to treatment and advice. RESULTS: Majority of the respondents 807 (87.1%) reported that their children had suffered from diarrhea within the last 2 weeks before commencement of the study. Diarrhea was found to contribute to 48% of child mortality in the study area. Perceived causes of diarrhea were: unclean water 524 (55.6%), contaminated food 508 (54.9%), bad eye 464 (50.0%), false teeth 423 (45.6%) and breast milk 331 (35.8%). More than 70% of mothers decreased fluid intake during diarrhea episodes. The mothers perceived wheat flour, rice water and selected herbs as anti-diarrheal agents. During illness, 239 (27.8%) of the children were reported not to have drunk any fluids at all, 487 (52.5%) drunk much less and only 93 (10.0%) were reported to have drunk more than usual. A significant 831 (89.6%) withheld milk including breast milk with the notion that it enhanced diarrhea. CONCLUSION: Based on these findings, there is need to develop and implement interactive communication strategies for the health workers and mothers to address perceptions and misconceptions and facilitate positive change in the household practice on management of diarrhea among under-fives. Language: English Keywords: KENYA | RESEARCH REPORT | KAP SURVEYS | LONGITUDINAL STUDIES | CHILDREN | RURAL POPULATION | HOUSEHOLDS | MOTHERS | HOME CARE | DIARRHEA | PERCEPTION | DEHYDRATION | BELIEFS | USER COMPLIANCE | RISK FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Family and Household | Sociocultural Factors | Parents | Family Relationships | Family Characteristics | Care and Support | Health Services | Delivery of Health Care | Health | Diseases | Psychological Factors | Behavior | Metabolic Effects | Physiology | Biology | Culture Document Number: 331267 |
| 16. Title: Clinical and metabolic effects of medroxyprogesterone acetate and ethinyl estradiol plus drospirenone in women with polycystic ovary syndrome. Author: Ozdemir S; Gorkemli H; Gezginc K; Ozdemir M; Kiyici A Source: International Journal of Gynaecology and Obstetrics. 2008 Oct;103(1):44-9. Abstract: OBJECTIVES: To investigate the effects of treatment with medroxyprogesterone acetate (MPA), 10 days per month for 6 months, on lipid and carbohydrate metabolism in women with polycystic ovary syndrome (PCOS). METHODS: Sixty-three women with PCOS were randomized to receive MPA or ethinyl estradiol plus drospirenone. RESULTS: There were no changes in lipid or carbohydrate metabolism in the MPA group, but serum levels of luteinizing hormone (P<0.001) and total testosterone (P<0.003) significantly decreased, as did the free androgen index (P<0.02) and acne (P<0.03) and seborrhea (P<0.04) scores. In the ethinyl estradiol plus drospirenone group lipid and hormone values significantly increased whereas acne, seborrhea, hair loss, and Ferriman-Gallwey scores decreased. There was no statistically significant change in the total cholesterol to high-density cholesterol ratio in either group. CONCLUSION: Treatment of PCOS patients with MPA provided good menstrual cycle control, beneficial changes in hormonal values associated with hyperandrogenism, and no significant changes in lipid or carbohydrate metabolism. Language: English Keywords: TURKEY | RESEARCH REPORT | WOMEN | OVARIAN CYSTS | MEDROXYPROGESTERONE ACETATE | CARBOHYDRATE METABOLIC EFFECTS | LIPID METABOLIC EFFECTS | Developing Countries | Europe, Southeastern | Europe | Demographic Factors | Population | Diseases | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Metabolic Effects | Physiology | Biology | Lipids Document Number: 329629 |
| 17. Peer Reviewed Title: Risk factors for pre-eclampsia in pregnant Chinese women with abnormal glucose metabolism. Author: Sun Y; Yang H; Sun WJ Source: International Journal of Gynecology and Obstetrics. 2008 Apr;101(1):74-76. Abstract: The objectives were to investigate the incidence and risk factors for pre-eclampsia in pregnant Chinese women with abnormal glucose metabolism. A retrospective cohort study was performed on 1499 pregnant women with abnormal glucose metabolism at Peking University First Hospital from January 1995 to December 2004. The overall prevalence of preeclampsia in women with abnormal glucose metabolism was 9.4% (141/1499). The prevalence of pre-eclampsia in women diagnosed with diabetes mellitus prior to pregnancy was higher than that of gestational diabetes mellitus and gestational impaired glucose tolerance patients (29.1% vs 8.7% and 7.8%, P less than 0.01). Pre-pregnancy body mass index was significantly higher in women with pre-eclampsia than in those without. A higher rate of pre-eclampsia was found in women with chronic hypertension and those with poor glucose control. The independent risk factors for pre-eclampsia were chronic hypertension and elevated pre-pregnancy body mass index. The type of diabetes, chronic hypertension, and elevated pre-pregnancy body mass index are high risk factors for pre-eclampsia in pregnant women with abnormal glucose metabolism. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | COHORT ANALYSIS | RETROSPECTIVE STUDIES | PREGNANT WOMEN | PREECLAMPSIA | INCIDENCE | RISK FACTORS | GLUCOSE METABOLISM EFFECTS | DIABETES | HYPERTENSION | BODY WEIGHT | BODY HEIGHT | Asia, Eastern | Asia | Developing Countries | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Pregnancy Complications | Diseases | Measurement | Biology | Carbohydrate Metabolic Effects | Metabolic Effects | Physiology | Vascular Diseases Document Number: 325435 |
| 18. Title: Breast-feeding-associated hypernatremia: Retrospective analysis of 169 term newborns. Author: Unal S; Arhan E; Kara N; Uncu N; Aliefendioglu D Source: Pediatrics International. 2008 Feb;50(1):29-34. Abstract: The aim of the present paper was to define the incidence, complications, morbidity and mortality of hypernatremic dehydration due to inadequate breast-feeding in a neonatal intensive care unit. A retrospective study was carried out between 2002 and 2005, to identify the term breast-fed neonates with serum sodium level greater than or equal to 150 mEq/L at the Ministry of Health Ankara Diskapi Children's and Research Hospital. The incidence of hypernatremic dehydration secondary to inadequate breast-feeding was 4.1%, occurring in 169 term infants among 4136 hospitalized term neonates with the following characteristics: mean gestational age, 39.1 weeks (37 - 42 weeks); birthweight, 3352 g (2200 - 4500 g); mother's age, 26.1 years (17 - 38 years); weight loss, 15.9% (5.4 - 32.7%); proportion of spontaneous vaginal deliveries, 75.7%; and proportion of first-time mothers, 74.6%. Major presenting symptoms were neonatal jaundice (47.3%) and poor infant suck (29.6%). The median sodium; blood urea nitrogen(BUN); and creatinine levels on admission were 155 mmol/L (150 - 194 mmol/L), 35 mg/dL (7 - 253 mg/dL), and 0.9 mg/dL (0.2 - 10 mg/dL), respectively. Major complications were as follows: acute renal failure, 82.8%; elevated liver enzymes, 20.7%; disseminated intravascular coagulation, 6.5%; brain edema, 5.2%; intracranial hemorrhage, 3.6%; cavernous sinus thrombosis, 1.2%; and bilateral iliac artery thrombosis, 0.6%. Ten patients (5.9%) developed seizure within the first 24 h of rehydration therapy with a mean sodium decrease of 11.9 mmol/L per day (4 - 19 mmol/L per day). Two patients (1.2%) died. There were positive correlation between weight loss and serum sodium, BUN, bilirubin levels (P less than 0.01); there was no correlation between weight loss and mothers' age, education level, delivery route, or first-born status (P greater than 0.05). Hypernatremic dehydration in neonates due to inadequate breast-feeding is a serious, potentially devastating and life-threatening disorder, and can damage the central nervous system. Follow up of infants for adequate breast-feeding is important. Pediatricians must maintain a high level of suspicion, especially in cases of pathologic infant weight loss after delivery. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | RETROSPECTIVE STUDIES | INFANT | BREASTFEEDING | DEHYDRATION | MORBIDITY | MORTALITY | Europe, Southeastern | Europe | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Metabolic Effects | Physiology | Biology | Diseases | Population Dynamics Document Number: 324161 |
| 19. Title: The correlation of plasma homocysteine with insulin resistance in polycystic ovary syndrome. Author: Yilmaz N; Pektas M; Tonguc E; Kilic S; Gulerman C Source: Journal of Obstetrics and Gynaecology Research. 2008 Jun;34(3):384–391. Abstract: Aim: This study aims to investigate the existence of any relationship between homocysteine levels and insulin resistance in Turkish women with polycystic ovary syndrome. Methods: A case-controlled, cross-sectional, observational study was undertaken in a total of 94 infertile Turkish women who required professional help in the Department of Infertility of Dr Zekai Tahir Burak Women's Health Research and Education Hospital. The correlation between serum homocysteine with age, body mass index, hormone profile, fasting insulin and glucose concentrations and insulin resistance were examined in patients with polycystic ovary syndrome and the results were compared to those of women with normal ovaries, who served as a control group. Results: The mean serum fasting glucose and insulin levels, thus insulin resistance index of women with polycystic ovary syndrome, were significantly higher than those of the control subjects. The mean serum homocysteine levels were significantly higher in women with polycystic ovary syndrome than those in the control group. A positive correlation was detected between the mean homocysteine, the insulin resistance index determined by homeostasis model assessment and the fasting insulin levels in polycystic ovary syndrome patients. Conclusions: Serum homocysteine levels are elevated in women with polycystic ovary syndrome, and this elevation is associated with the serum insulin level rather than androgen excess. The intense treatment of hyperhomocysteinemia in women with polycystic ovary syndrome might improve reproductive outcome and contribute to protection from cardiovascular risks. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | CASE CONTROL STUDIES | WOMEN IN DEVELOPMENT | OVARIAN CYSTS | INFERTILITY | AGE FACTORS | BODY WEIGHT | HORMONES | DRUG RESISTANCE | GLUCOSE METABOLISM EFFECTS | Developing Countries | Europe, Southeastern | Europe | Research Methodology | Studies | Economic Development | Economic Factors | Diseases | Reproduction | Population Characteristics | Demographic Factors | Population | Physiology | Biology | Endocrine System | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Carbohydrate Metabolic Effects | Metabolic Effects Document Number: 327384 |
| 20. Peer Reviewed Title: Very young children with uncomplicated falciparum malaria have higher risk of hypoglycaemia: A study from Suriname. Author: Zijlmans WC; van Kempen AA; Ackermans MT; de Metz J; Kager PA Source: Tropical Medicine and International Health. 2008 May;13(5):626-634. Abstract: The objective was to measure glucose kinetics and the influence of age, nutritional status and fasting duration in children with uncomplicated falciparum malaria (UFM) under the age of 5 years. Plasma glucose concentration, endogenous glucose production (EGP) and gluconeogenesis (GNG) were measured using [6,6-/2H/2] glucose and 2/H2O in 17 very young (less than 3 years) and 7 older (3-5 years) Surinamese children with UFM admitted to the Distrikt Hospital Stoelmanseiland and Diakonessen Hospital Paramaribo over 17 months. Plasma glucose concentration was lower in the group of very young children than in the older children (P = 0.028). There were no differences in EGP and GNG between the groups. Overall GNG contributed 56% (median, range 17-87%) to EGP, with no differences between the groups (P = 0.240). Glucose clearance was lower in the older children (P = 0.026). Glucose concentration did not differ between children with weight for length/height less than -1.3 SD and children with weight for length / height greater than -1.3 SD (P = 0.266). Plasma glucose concentration was not predicted by fasting duration (P = 0.762). Our data suggest a higher risk of hypoglycaemia in very young children with uncomplicated malaria as plasma glucose concentration was lower in this study group. Since this could not be attributed to an impaired EGP, and because glucose clearance was lower in the older children, we presume that older children were better capable of reducing glucose utilization during fasting. Studies on glucose kinetics are feasible in very young children with malaria and give more insight in the pathophysiology of hypoglycaemia. (author's) Language: English Keywords: NETHERLANDS | RESEARCH REPORT | NUTRITION INDEXES | CHILD | GLUCOSE METABOLISM EFFECTS | MALARIA | Developed Countries | Europe, Western | Europe | Nutrition | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Carbohydrate Metabolic Effects | Metabolic Effects | Physiology | Biology | Parasitic Diseases | Diseases Document Number: 325930 |
| 21. Title: Hormonal contraceptives have little effect on carbohydrate metabolism in healthy women. Author: Family Health International [FHI] Source: [Research Triangle Park, North Carolina], FHI, [2007]. [2] p. (Research Briefs on Hormonal Contraception) Abstract: A new Cochrane review from Family Health International suggests that the use of hormonal methods of family planning has little effect on how healthy women metabolize sugars and starches. However, little is known about the effects of these contraceptives on the use of carbohydrates in women at risk for diabetes. Language: English Keywords: GLOBAL | SUMMARY REPORT | LITERATURE REVIEW | CONTROL GROUPS | ORAL CONTRACEPTIVES, COMBINED | INJECTABLES | VAGINAL RING | CONTRACEPTIVE IMPLANTS | CONTRACEPTIVE AGENTS, SIDE EFFECTS | CARBOHYDRATE METABOLIC EFFECTS | Research Methodology | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents | Metabolic Effects | Physiology | Biology Document Number: 331732 |
| 22. Title: Prevalence of metabolic syndrome during menopausal transition Tehranian women: Tehran Lipid and Glucose Study (TLGS). Author: Ainy E; Mirmiran P; Zahedi Asl S; Azizi F Source: Maturitas. 2007 Oct;58(2):150-155. Abstract: This study was conducted to assess the prevalence of metabolic syndrome (MetS) in Tehranian women during menopausal transition. In this cross sectional study 2182 subjects, pre-menopausal (pre-M) n = 537, menopausal (M) n = 311 and postmenopausal (post-M) n = 1334 were selected from 15005 participants of the TLGS and assessed for MetS risk factors. All MetS components were evaluated following age adjustment according to the ATPIII criteria. The mean ages of post-M, M and pre-M women were 61.0+or-4.3, 53.0+or-4.0 and 47.0+or-1.9 years, respectively. The prevalence of MetS in subjects was 63% (53%, 54% and 69%) in pre-M, M and post-M women respectively. HDL-c levels was significantly higher in post-M women in comparison to pre-M women (p < 0.001). TG levels, FPG and waist circumference was significantly higher in post-M women in comparison to pre-M women (p < 0.05). The most frequent markers of MetS were low HDL-c and high diastolic blood pressure in post-M women. It is concluded that the frequency of MetS is significantly higher in post-M women as compared to pre-M women; low HDL-c and high diastolic blood pressure is the most frequent feature in comparison to other factors. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | MENOPAUSE | GLUCOSE METABOLISM EFFECTS | LIPID METABOLIC EFFECTS | PREVALENCE | AGE FACTORS | ANTHROPOMETRY | HYPERTENSION | Developing Countries | Middle East | Research Methodology | Economic Development | Economic Factors | Reproduction | Carbohydrate Metabolic Effects | Metabolic Effects | Physiology | Biology | Lipids | Measurement | Population Characteristics | Demographic Factors | Population | Vascular Diseases | Diseases Document Number: 321347 |
| 23. Title: Adenovirus infection in children with diarrhea disease in northwestern Nigeria. Author: Aminu M; Ahmad AA; Umoh JU; de Beer MC; Esona MD Source: Annals of African Medicine. 2007;6(4):168-173. Abstract: BACKGROUND: Adenoviruses, particularly enteric adenoviruses (EAds) type 40 (Ad40) and type 41(Ad41), can cause acute and severe diarrhea in young children worldwide. This study was conducted to delineate the epidemiological features of adenoviruses identified in children with gastroenteritis in Northwestern Nigeria. METHODS: All 282 specimens comprising 248 diarrheic and 34 non-diarrheic stools were randomly selected from 1063 stools previously analyzed for rotaviruses. These specimens were collected between July 2002 and July 2004 from children < 5 years of age. The specimens were screened for the presence of adenoviruses using monoclonal antibody-based Enzyme Immuno Assay (EIA), (Adenovirus RIDASCREEN r-Biopharm, UK) and the positive specimens were further examined for Ad40 and Ad41 using Premier Adenoclone -Type 40/41 EIA (Meridian Biosciences, USA). Negative staining electron microscopy was performed on selected specimens to confirm the presence of adenovirus particles. RESULTS: Adenovirus antigen was detected in 63/282 (23%) of the diarrheic diarrheic and in 6/34 (17.6%) of the non-diarrheic specimens. Adenoviruses were detected throughout the study period with most patients infected in the age group 25-36 months. The male-to-female ratio was 2.2:1 (43/20). Clinical features included fever (60%: 38/63), vomiting (56%: 35/63), mild dehydration (49%: 31/63), symptoms of upper respiratory tract infection (13%: 8/63) and abdominal pain (5%: 3/63). Analysis of stool specimen in adenovirus infected patients showed watery diarrhea in 87% (55/63), diarrhea with mucus in 19% (12/63) and diarrhea with mucus and blood in 3% (2/63). Ten (10) percent of the children were hospitalized due to gastroenteritis while 9 patients (14.3%) had co-infections with rotavirus. Human EAds were detected in 8% of specimens mainly in the dry season and among children older than 2 years. The principal symptoms were diarrhea (100%), dehydration (80%) and fever (80%). CONCLUSION: The findings of this study suggest that adenoviruses are important etiologic agents of gastroenteritis in Northwestern Nigerian children. Language: English Keywords: NIGERIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CHILDREN | PREVALENCE | DIARRHEA | ROTAVIRUS | VOMITING | SEX FACTORS | FEVER | DEHYDRATION | RESPIRATORY INFECTIONS | SIGNS AND SYMPTOMS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Diseases | Viral Diseases | Nausea | Body Temperature | Physiology | Biology | Metabolic Effects | Infections Document Number: 327460 |
| 24. Title: [Insulinotherapy, maternal glycemic control and perinatal prognosis-- difference between clinical and gestational diabetes] Insulinoterapia, controle glicemico materno e prognostico perinatal – diferenca entre o diabetes gestacional e o clinico. Author: Basso NA; Costa RA; Magalhaes CG; Rudge MV; Calderon ID Source: Revista Brasileira de Ginecologia e Obstetricia. 2007 May;29(5):253-259. Abstract: Purpose: to evaluate the insulin therapy protocol and its maternal and perinatal outcome in patients with clinical or gestational diabetes in a high risk reference service. Methods: descriptive and prospective study including 103 pregnant women with gestational or clinical diabetes treated with insulin and attended by the reference service from October 2003 to December 2005. Gemellarity, miscarriages, unfinished prenatal care and deliveries not attended by the service were excluded. The gestational age at the beginning of the treatment, dosage, doses/day, increment of insulin (UI/kg), glycemic index (GI) and perinatal outcomes were compared. ANOVA, Fisher's exact test and Goodman's test considering p<0.05 were used. Results: multiparity (92 versus 67.9%), pre-gestational body mass index (BMI) >25 kg/m2 (88 versus 58.5%), weight gain (WG) <8 kg (36 versus 17%) and a high increment of insulin characterized the gestational diabetes. For the patients with clinical diabetes, despite the highest GI (120 mg/dL (39.2 versus 24%)) at the end of the gestational period, insulin therapy started earlier (47.2 versus 4%), lasted longer (56.6 versus 6%) and higher doses of insulin (92 versus 43 UI/day) were administered up to three times a day (54.7 versus 16%). Macrosomia was higher among newborns from the cohort of patients with gestational diabetes (16 versus 3.8%), being the only significant neonatal outcome. There were no neonatal deaths, except for one fetal death in the cohort of patients with clinical diabetes. There were no differences in the other neonatal complications in both cohorts, and most of the newborns were discharged from hospital up to seven days after delivery (46% versus 55.8%). Conclusions: the analysis of these two cohorts has shown differences in the insulin therapy protocol in quantity (UI/day), dosage (UI/kg weight) and number of doses/day, higher for the clinical diabetes cohort, and in the increment of insulin, higher for the gestational diabetes cohort. Indirectly, the quality of maternal glycemic control and the satisfactory perinatal outcome have proven that the treatment protocol was adequate and did not depend on the type of diabetes. Language: Portuguese Keywords: RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PROSPECTIVE STUDIES | INFANT | PREGNANT WOMEN | PREVALENCE | GLUCOSE METABOLISM EFFECTS | PREGNANCY COMPLICATIONS | ABORTION, SPONTANEOUS | MULTIPARITY | RISK FACTORS | BODY WEIGHT | DIABETES | NEONATAL DISEASES AND ABNORMALITIES | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Carbohydrate Metabolic Effects | Metabolic Effects | Physiology | Biology | Diseases | Parity | Fertility Measurements | Fertility | Population Dynamics Document Number: 324630 |
| 25. Title: IAP Guidelines 2006 on hospital based management of severely malnourished children (adapted from the WHO guidelines). Author: Bhatnagar S; Lodha R; Choudhury P; Sachdev HP; Shah N Source: Indian Pediatrics. 2007 Jun 17;44(6):443-461. Abstract: Malnutrition in children is widely prevalent in India. It is estimated that 57 million children are underweight (moderate and severe). More than 50% of deaths in 0-4 years are associated with malnutrition. The median case fatality rate is approximately 23.5% in severe malnutrition, reaching 50% in edematous malnutrition. There is a need for standardized protocol-based management to improve the outcome of severely malnourished children. In 2006, Indian Academy of Pediatrics undertook the task of developing guidelines for the management of severely malnourished children based on adaptation from the WHO guidelines. We summarize below the revised consensus recommendations (and wherever relevant the rationale) of the group. (excerpt) Language: English Keywords: INDIA | SUMMARY REPORT | MANUAL | STANDARDS | WHO | MANAGEMENT | CHILD | MALNUTRITION | DEHYDRATION | DEFICIENCY DISEASES | EXAMINATIONS AND DIAGNOSES | TREATMENT | MONITORING | PREVENTION AND CONTROL | Developing Countries | Asia, Southern | Asia | Research Methodology | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Organization and Administration | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition Disorders | Diseases | Metabolic Effects | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Evaluation Document Number: 319155 |
| 26. Peer Reviewed Title: Clinical update: Adverse effects of antiretroviral therapy. Author: Calmy A; Hirschel B; Cooper DA; Carr A Source: Lancet. 2007 Jul 7;370(9581):12-14. Abstract: The adverse effects of antiretroviral therapy (ART) cause substantial morbidity and compromise adherence, which can lead to drug resistance. Treatment guidelines recommend against universal immediate ART, partly because of toxicities (table). The webtable lists licensed ARTs. HIV lipodystrophy is characterised by peripheral subcutaneous lipoatrophy, relative central fat accumulation, lipomatosis, dyslipidaemia, insulin resistance, and hyperlactataemia. Over the first 6 months of ART, limb and visceral fat increase, often followed by a progressive and selective loss of limb fat. Zidovudine and stavudine are the drugs most associated with lipoatrophy. About 30% of patients receiving stavudine for 2 years developed lipoatrophy compared with 6% of tenofovir recipients. Abacavir, emtricitabine, lamivudine, and tenofovir do not seem to induce much lipoatrophy; the protease inhibitor nelfinavir accelerated lipoatrophy, but another such drug, lopinavir, might prevent it. Lipoatrophy can be largely prevented by avoidance of stavudine and zidovudine. Switching stavudine or zidovudine to tenofovir or abacavir improves lipoatrophy, but normalisation can take years. Cessation of protease inhibitor therapy may improve visceral adiposity. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | CRITIQUE | RECOMMENDATIONS | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | TOXICITY | SIDE EFFECTS | ADMINISTRATION AND DOSAGE | TIME FACTORS | CARDIOVASCULAR EFFECTS | GLUCOSE METABOLISM EFFECTS | RENAL EFFECTS | Developed Countries | North America | Americas | Research Methodology | HIV Infections | Viral Diseases | Diseases | HIV | Behavior | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Population Dynamics | Demographic Factors | Population | Carbohydrate Metabolic Effects | Metabolic Effects | Urogenital Effects | Urogenital System Document Number: 318348 |
| 27. Title: Agreement among insulin sensitivity indexes on the diagnosis of insulin resistance in polycystic ovary syndrome and ovulatory women. Author: de Paula Martins W; Santana LF; Nastri CO; Ferriani FA; de Sa MF Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2007 Aug;133(2):203-207. Abstract: The objective was to compare agreement on the diagnosis of insulin resistance (IR) among insulin sensitivity indexes in both ovulatory women and those with polycystic ovary syndrome (PCOS). In an observational study, the 75-g oral glucose tolerance test was performed in 105 women with PCOS and 51 ovulatory women. The insulin sensitivity indexes used were insulin quantitative sensitivity check index (QUICKI), 1/homeostasis model assessment-insulin resistance (1/HOMA-IR), area under curve for insulin (AUC-I), and the Matsuda insulin sensitivity index (COMP). For the IR diagnosis we used cut-off values described in recent publications (insulin >12 µI/ml, 1/HOMA-IR < 0.47, QUICKI /= 7000 µI/ml 120 min, and COMP < 4.75. Excellent agreement was assessed among insulin, QUICKI, and 1/HOMA-IR. However, the rate of IR detected by these indexes in the PCOS group (44.8-51.4%) was lower than expected. New cut-offs were then determined based on COMP results. Using these values, 1/ HOMA-IR and QUICKI showed excellent agreement (k = 0.83) with COMP. The observed agreements among insulin, QUICKI and 1/HOMA-IR were higher than 93%. Therefore, clinicians may choose any of those obtaining similar results. For clinicians who prefer COMP, but are looking for a simpler test to detect IR in PCOS women, the use of QUICKI and 1/HOMA-IR with the new cut-offs seems reasonable. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | CORRELATION STUDIES | COMPARATIVE STUDIES | QUANTITATIVE RESEARCH | WOMEN | OVARIAN EFFECTS | ENDOCRINE EFFECTS | GLUCOSE METABOLISM EFFECTS | GLUCOSE TOLERANCE TEST | TESTING | South America, Eastern | South America | Latin America | Americas | Developing Countries | Statistical Studies | Studies | Research Methodology | Demographic Factors | Population | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Endocrine System | Carbohydrate Metabolic Effects | Metabolic Effects | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement Document Number: 318802 |
| 28. Peer Reviewed Title: Contraceptive vaginal ring use for women has less adverse metabolic effects than an oral contraceptive. Author: Elkind-Hirsch KE; Darensbourg C; Ogden B; Ogden LF; Hindelang P Source: Contraception. 2007 Nov;76(5):348-356. Abstract: This study compared metabolic, hormonal and lipid profiles before and during use of a contraceptive vaginal ring (RING) releasing 15 mcg ethinyl estradiol (EE) and 120 mcg etonogestrel per day (NuvaRing, Organon USA Inc., Roseland, NJ) versus a low-dose oral contraceptive (PILL) containing 20 mcg EE and 100 mcg levonorgestrel daily (Aviane, Barr Pharmaceuticals Inc., Pomona, NY). Sixty-five women were randomized to either the RING or PILL treatment for five cycles. In the pretreatment cycle (Cycle Days 2-5) and during Weeks 2 and 3 of the fifth treatment cycle, a 75-g oral glucose tolerance test (OGTT) was performed. Baseline samples were used to evaluate basal hormonal, metabolic and lipid levels. Forty-two women completed the study. Basal insulin resistance (HOMA-IR) was slightly decreased, whereas a significant reduction in the insulin sensitivity index (ISOGTT) was found in women on PILL therapy compared to those in the RING group (p less than .035). Pancreatic beta-cell function was not significantly altered with either treatment. The lower-dose, nonoral hormonal RING had a lesser impact on carbohydrate metabolism and greater reduction of free androgen and dehydroepiandrosterone sulfate levels than PILL treatment. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL RESEARCH | COMPARATIVE STUDIES | PROSPECTIVE STUDIES | WOMEN | ORAL CONTRACEPTIVES, LOW-DOSE | VAGINAL RING | TREATMENT | CARBOHYDRATE METABOLIC EFFECTS | Developed Countries | North America | Americas | Research Methodology | Studies | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Metabolic Effects | Physiology | Biology Document Number: 321663 |
| 29. Peer Reviewed Title: Hypoglycaemia in under-five children with diarrhoea. Author: Huq S; Hossain MI; Malek MA; Faruque AS; Salam MA Source: Journal of Tropical Pediatrics. 2007 Jun;53(3):197-201. Abstract: The present study aimed to observe the clinical features of hypoglycaemia, and identify predictors of hypoglycaemia in under-five diarrhoeal children requiring hospitalization for close observation and support. Such information could be useful to the clinicians and policy makers in developing appropriate management protocols both for identification of such children and optimizing their management. We performed a prospective study in 782 under-five children who presented with diarrhoeal illnesses. Blood glucose was determined when hypoglycaemia was suspected in 598 (62%), and 65 (11%) of them were hypoglycaemic (study group). From the other 533 non-hypoglycaemic children, 195 were randomly selected as comparison group. Bacteraemia was significantly (P = 0.026) often detected in 17 out of 260 (7%) children as opposed to 3 out of 184 (2%) children who did not have a rapid glucose test performed. Among hypoglycaemic children, 7 (11%) were bacteraemic and among non-hypoglycaemic children 10 (5%) had bacteraemia. In univariate analysis, history of shorter (< 72 h) pre-admission duration of diarrhoea (75 vs. 58%, P = 0.01), documented convulsion (28 vs. 11%, P < 0.001), shorter (<72 h) hospitalization (52 vs. 33%, P = 0.01), higher case fatality rate (28 vs. 14%, P = 0.02) were associated with hypoglycaemia. In logistic regression, bacteraemic children (with clinical sepsis) were 4 times more likely to develop hypoglycaemia (OR = 4.2, 95% CI = 1.4-12.9, P = 0.012). Therefore, in a diarrhoeal disease health care service with limited resources, a rapid bedside glucose test may be considered as an inexpensive alternative in the management decisions of diagnosing bacteraemia and initiating empiric antibiotic treatment. (author's) Language: English Keywords: BANGLADESH | RESEARCH REPORT | RESEARCH METHODOLOGY | CHILD | DIARRHEA | ANTIBIOTICS | GLUCOSE METABOLISM EFFECTS | TESTING | COST BENEFIT ANALYSIS | TREATMENT | Developing Countries | Asia, Southern | Asia | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Drugs | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Carbohydrate Metabolic Effects | Metabolic Effects | Physiology | Biology | Measurement | Quantitative Evaluation | Evaluation Document Number: 316984 |
| 30. Peer Reviewed Title: Intrapartum maternal glucose infusion and fetal acid -- base status. Author: Jamal A; Choobak N; Tabassomi F Source: International Journal of Gynecology and Obstetrics. 2007 Jun;97(3):187-189. Abstract: The objective was to compare the effects of an intrapartum infusion of a lactated Ringer solution or a glucose-boosted saline solution on the acid-base status of umbilical arterial blood. In a prospective clinical trial 178 women in labor were randomized to receive intravenously either a lactated Ringer solution or a saline solution boosted with 5% glucose. Umbilical arterial blood was then assessed for acid-base status. There were significant differences between the lactated Ringer group and the glucose group in umbilical artery pH values (7.25 ± 0.07 vs. 7.28 ± 0.06; P = 0.008), pCO/2 values (44.8 ± 5.6 mm Hg vs. 41.6 ± 4.1 mm Hg; P = 0.001), and base excess (-7.3 ± 2.1 mEq/L vs. -6.6 ± 1.8 mEq/L; P = 0.02). Intrapartum intravenous fluid containing a 5% glucose solution reduces umbilical cord acidemia and hypercarbia. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | CLINICAL TRIALS | COMPARATIVE STUDIES | FETUS | MATERNAL-FETAL EXCHANGE | GLUCOSE METABOLISM EFFECTS | HUMAN MILK | Developing Countries | Middle East | Clinical Research | Research Methodology | Studies | Pregnancy | Reproduction | Carbohydrate Metabolic Effects | Metabolic Effects | Physiology | Biology | Lactation | Maternal Physiology Document Number: 316676 |
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