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Amit P Shah
[email protected]
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Low blood vitamin D levels linked to diabetes.
(J Clin Endocrinol Metab. 2015;Feb 23:jc20143016)
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The relationship of 25-hydroxyvitamin D [25(OH)D] with obesity and type
2 diabetes is not completely understood. In this Spanish study, it was
tried to establish some relation between Vitamin D receptor (VDR)
expression in adipose tissue which is related to obesity and it is
hypothesised that it might be regulated by 1,25-dihydroxyvitamin D3
[1,25(OH)2D3]. It was observed that 25(OH)D levels are diminished in
Prediabetic and Diabetic compared to Normoglycemic subjects,
independently of body mass index, and are closely related to glucose
metabolism variables, suggesting that vitamin D deficiency is associated
more with carbohydrate metabolism than with obesity. Moreover, adipose
tissue has a different response to 1,25(OH)2D3 depending on the degree
of obesity. This is one of the various associations recently found with
Vitamin D level but the findings need to be confirmed by interventional
studies.
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Early pneumonia - A major risk factor for
adult chronic obstructive pulmonary disease. (Pediatrics.
2015;Mar 2: pii:peds.2014-3060)
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Decreased lung function and increased prevalence of asthma is reported
in children with a history of early lower respiratory illnesses,
including pneumonia. Whether these associations persist up to adulthood
has not been established and this study tried to look in to this and has
come out with eye opening conclusion that "Early pneumonia is associated
with asthma and impaired airway function, which is partially reversible
with bronchodilators and persists into adulthood. Early pneumonia may be
a major risk factor for adult chronic obstructive pulmonary disease."
This is an important finding and we need to educate parents and children
about this risk in later life.
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Estimation of GFR using b-trace
protein in children. (Clin J Am Soc
Nephrol. 2015;10:401-9)
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Gender may affect the performance of small molecular weight proteins as
markers of GFR because of differences in fat mass between the two sexes.
The hypothesis behind this study was that the diagnostic performance of
b-trace
protein, a novel marker of GFR, would be significantly better in boys
than in girls. In this study, GFR-estimating formulas on the basis of
b-trace
protein, creatinine, and height were derived using stepwise linear
regression analysis of log-transformed data. It was found that
b-trace protein was
more important than creatinine and height in the data generation groups.
The new formulas performed significantly better than the previous
Benlamri, White, and Schwartz formulas with respect to bias, precision,
and accuracy. We must start using these new improved and sex-specific
formulas for the estimation of GFR in children.
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Multimodal neuroimaging-based classification
of autism spectrum disorder – More perfect. (Cortex.
2015;doi:10.1016/j.cortex.2015.02.008)
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We have now more awareness about Autistic Spectrum Disorder (ASD) and a
number of neuroimaging techniques, such as functional MRI, structural
MRI, diffusion tensor imaging (DTI), and proton magnetic resonance
spectroscopy (1H-MRS), are used for its diagnosis. These techniques have
uncovered evidence for widespread functional and anatomical brain
abnormalities in ASD suggesting it to be a system-wide neural systems
disorder. Initial findings of this study showed increased cortical
thickness in ASD participants, compared to controls, across the left
cingulate, left pars opercularis of the inferior frontal gyrus, left
inferior temporal cortex and the right precuneus; reduced cortical
thickness in the right cuneus and right precentral gyrus; reduced white
matter connectivity (as measured by reduced fractional anisotropy and
increased radial diffusivity) for two discrete clusters on the forceps
minor of the corpus callosum; and reduction in N-acetylaspartate in the
dorsal anterior cingulate cortex. Multimodal imaging has potential to
better inform on the neural characteristics most relevant to the
disorder, and will help in diagnosis of ASD.
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Tonsillectomy for treatment of psoriasis! (J Am Acad
Dermatol. 2015;72:261-75)
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The relationship between streptococcal pharyngitis and psoriasis is well
known but it was unknown whether tonsillectomy decreases psoriasis
symptoms in those patients. To find out this, a systemic review of more
than 20 published studies dating back to 1960 was done. Surprisingly, it
was observed that tonsillectomy may be a potential treatment option in
patients with recalcitrant psoriasis associated with episodes of
tonsillitis, but there is a need for additional studies to examine both
the extent and persistence of benefit of tonsillectomy in psoriasis
patients.
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Guideline for first-line treatment of allergic rhinitis (Otolaryngol
Head Neck Surg. 2015;152:S1-S43)
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A very common disease encountered by pediatricians, Acute Allergic
Rhinitis, has now a new, comprehensive guideline from The American
Academy of Otolaryngology; 1,605 randomized, controlled trials, 31
existing clinical practice guidelines, and 390 systematic reviews of the
literature regarding allergic rhinitis in adults and children older than
age 2 years were studied and also compiled 14 key recommendations that
underwent extensive peer review. Guideline advocates that first-line
treatment for allergic rhinitis should include intranasal steroids, as
well as less-sedating second-generation oral antihistamines for patients
whose primary complaints are sneezing and itching.
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