MedGenMed : Medscape general medicine最新文献

Background: More than half of the pregnant women in the world have hemoglobin levels indicative of anemia. Knowledge of the current situation of the condition in our environment is necessary. This knowledge will motivate antenatal caregivers toward early detection and prompt management of anemia in pregnancy.

Aims: Our aim was to determine the prevalence of anemia among pregnant women at registration for antenatal care at a major tertiary healthcare center in Enugu, southeastern Nigeria.

Methods: This was a retrospective study of 530 normal pregnant women registered with the antenatal unit of the University of Nigeria Teaching Hospital (UNTH), Enugu, between January 1, 2005 and October 30, 2005. Data on the age, parity, gestational age at booking, interval between last confinement and last menstrual period in the index pregnancy, hemoglobin concentration at booking, and HIV status were obtained and analyzed.

Results: The mean gestational age at booking was 21.7 +/- 7.1 weeks (range, 6-37). Two hundred fourteen (40.4%) of the women were anemic (hemoglobin [Hb] < 11.0 g/dL). The majority (90.7%) of these anemic patients were mildly anemic, whereas 9.3% were moderately anemic. There was no case of severe anemia (Hb < 7.0 g/dL). The prevalence of anemia at booking was significantly higher in those who registered for antenatal care in the third trimester than in those who registered in the second trimester, and in HIV-positive pregnant women than in HIV-negative ones (P = .00). The patients' age, parity, and the interval between the last confinement and the index pregnancy had no significant relationship with the hemoglobin concentration of pregnant women at booking (P > .05).

Conclusion: The prevalence of anemia in pregnancy at booking is still high in Enugu. Preconception care, including iron and folic acid supplementation, is advocated to reduce this problem. Early antenatal booking and improved antenatal care are also necessary for early diagnosis and treatment of the condition. All would ensure safe motherhood.

Context: Given the seemingly disparate nature of popular weight-loss diets (WLDs), consumers may have a difficult time choosing one. We hypothesized that because most of these diets differ greatly from the way most Americans spontaneously eat, the choice of a WLD may be less critical than the decision to adopt any WLD.

Objective: To assess the degree of similarity among several popular WLDs and that between average diets of Americans and the WLDs as a whole.

Design: One-day menus were randomly selected or constructed from 16 popular diet books (resulting in 17 distinct diets). Usual dietary intakes of individuals were derived from the Continuing Survey of Food Intakes by Individuals (CSFII) 1994-96, 1998.

Main outcome measures: Euclidean distances, based on 12 dietary variables, were calculated among the popular WLDs, as well as between the WLDs and intakes from the CSFII.

Results: Euclidean distances among the WLDs ranged from 1.99 to 15.24, with a mean of 6.12 +/- 2.83. Mean distance between individuals' intakes from the CSFII and the closest WLD was 3.63 +/- 1.24, while the mean distance between individuals' intakes and the farthest WLD was 10.58 +/- 1.10. Mean distance between individuals' intakes and the WLDs considered together was 6.04 +/- 1.10.

Conclusions: While the mean Euclidean distances between individuals' intakes and popular WLDs demonstrated meaningful differences, the differences among the WLDs were slightly greater and, in multivariate space, surrounded the diets consumed by Americans. This may have implications for the selection of a WLD in persons seeking to lose weight.

Acinetobacter species are becoming a major cause of nosocomial infections, including hospital-acquired and ventilator-associated pneumonia. Acinetobacter species have become increasingly resistant to antibiotics over the past several years and currently present a significant challenge in treating these infections. Physicians now rely on older agents, such as polymyxins (colistin), for treatment. This paper reviews the epidemiology, treatment, and prevention of this emerging pathogen.

By regulating matrix metalloproteinase (MMP) activity and controlling the breakdown of extracellular matrix components, tissue inhibitors of metalloproteinases (TIMPs) play an important role in the process of tumor invasion and metastasis. The present study was designed to clarify the role of TIMP-2 in nasopharyngeal carcinoma (NPC) patients and to evaluate its importance relative to clinicopathologic parameters. It was carried out in 30 patients with NPC and 20 controls. Tissue biopsies were studied and graded pathologically, and Western blot analysis was performed to assess TIMP-2 protein expression. Clinically, in accordance with TNM classification (T: tumor size, N: lymph node involvement, M: distant metastasis), 8 cases were diagnosed as stage II, 12 as stage III, and 10 cases as stage IV; however, pathologic typing with use of the World Health Organization (WHO) classification revealed the presence of 9 specimens of squamous cell carcinoma (WHO type 1), 6 cases of nonkeratinizing carcinoma (WHO type 2), and 15 cases of undifferentiated carcinoma (WHO type 3). The difference in percentage of TIMP-2 positivity between NPC patients (76.6%) and normal controls (30%) was statistically highly significant (P < .01). In addition, there was a significant positive correlation between TIMP-2 protein positivity and either the clinical staging or the histopathologic typing (P < .01) using Chi-square test (x(2)), suggesting that TIMP-2 can be used as a marker of the severity of NPC.Accordingly, we can assume that TIMP-2 may play a role in regional lymph node and/or distant metastasis and in progression of squamous cell carcinoma. Further studies are needed to investigate the role of TIMP-2 as a marker for tumor progression and to evaluate its potential value in the follow-up of patients.