Objective
To assess appetite and gut hormone levels in patients following partial (PR) or total resection (TR) of the large bowel.
Methods
A comparative cross sectional study was carried out with ...healthy controls (n = 99) and patients who had undergone PR (n = 64) or TR (n = 12) of the large bowel. Participants consumed a standard (720 kcal) breakfast meal at 0830 (t = 0) h followed by lactulose (15 g) and a buffet lunch (t = 210 min). Participants rated the subjective feelings of hunger at t = −30, 0, 30, 60, 120, and 180 min. Breath hydrogen (BH) concentrations were also evaluated. In a matched subset (11 controls, 11 PR and 9 TR patients) PYY and GLP‐1 concentrations were measured following breakfast. The primary outcome measure was appetite, as measured using visual analogue scales and the buffet lunch. The secondary outcome was BH concentrations following a test meal.
Results
PR and TR participants had lower hunger and energy intake at the buffet lunch meal compared to controls. PR subjects had higher BH concentrations compared to controls and TR subjects. BH levels correlated with circulating GLP‐1 levels at specific time points.
Conclusions
PR or TR of the large bowel reduced feelings of hunger and energy intake, and PR increased gastrointestinal fermentation.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is importantly associated with various aspects of health and health-related behaviour, including ...musculoskeletal pain and associated disability. To explore its epidemiological characteristics, and how it can be specified most efficiently, we analysed data from an international longitudinal study. A baseline questionnaire, which included questions from the Brief Symptom Inventory about seven common symptoms, was completed by 12,072 participants aged 20-59 from 46 occupational groups in 18 countries (response rate 70%). The seven symptoms were all mutually associated (odds ratios for pairwise associations 3.4 to 9.3), and each contributed to a measure of somatising tendency that exhibited an exposure-response relationship both with multi-site pain (prevalence rate ratios up to six), and also with sickness absence for non-musculoskeletal reasons. In most participants, the level of somatising tendency was little changed when reassessed after a mean interval of 14 months (75% having a change of 0 or 1 in their symptom count), although the specific symptoms reported at follow-up often differed from those at baseline. Somatising tendency was more common in women than men, especially at older ages, and varied markedly across the 46 occupational groups studied, with higher rates in South and Central America. It was weakly associated with smoking, but not with level of education. Our study supports the use of questions from the Brief Symptom Inventory as a method for measuring somatising tendency, and suggests that in adults of working age, it is a fairly stable trait.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
We performed a multicenter study of preterm infants, who were about to undergo patent ductus arteriosus ligation, to determine whether echocardiographic indices of impaired myocardial performance ...were associated with subsequent development of catecholamine-resistant hypotension following ligation.
A standardized treatment approach for hypotension was followed at each center. Infants were considered to have catecholamine-resistant hypotension if their dopamine infusion was > 15 μg kg(-1)min(-1). Echocardiograms and cortisol measurements were obtained between 6 and 14 h after the ligation (prior to the presence of catecholamine-resistant hypotension).
Forty-five infants were enrolled, 10 received catecholamines (6 were catecholamine-responsive and 4 developed catecholamine-resistant hypotension). Catecholamine-resistant hypotension was not associated with decreased preload, shortening fraction or ventricular output. Infants with catecholamine-resistant hypotension had significantly lower levels of systemic vascular resistance and postoperative cortisol concentration.
We speculate that low cortisol levels and impaired vascular tone may have a more important role than impaired cardiac performance in post-ligation catecholamine-resistant hypotension.
The impact of repeated malarial infections on the school performance of children was investigated in 571 school children 6-14 years of age in a malaria-endemic area in southern Sri Lanka where both ...Plasmodium falciparum and P. vivax infections are prevalent. Malaria infections confirmed by microscopy were monitored over a six-year period. School performance was assessed by two specially designed, school grade-specific, test papers for Sinhala language and mathematics. The scores for Sinhala language and mathematics for each school term test for the year 1997 were obtained. Malarial infections were a major predictor of children's performance in language and mathematics after controlling for parent's education, monthly family income, and house type. The education of the father predicted language scores but not mathematics scores. A child who experienced more than five attacks of malaria scored approximately 15% less than a child who experienced less than three attacks of malaria. The data suggest that repeated attacks of malaria have an adverse impact on the school performance of children.
American Diabetes Association (ADA) has
officially endorsed glycosylated haemoglobin (HbA1c) as a
diagnostic tool. The recommended cut-off for diagnosing
diabetes is 6.5%.
To compare use of HbA1c ...and fasting plasma
glucose (FPG) to diagnose diabetes in an urban Sri Lankan
community.
This cross-sectional study is based on baseline
data from a prospective study on non-communicable
diseases in randomly selected individuals aged 35-64 years
in a selected community. HbA1c was measured by National
Glycohaemoglobin Standardization Program certified Bio
Rad Variant HbA1c HPLC method. Diagnostic performance
of HbA1c was evaluated in those without previous diabetes.
Receiver Operating Characteristic Curve was used to identify
optimum HbA1c threshold.
We studied 2516 individuals with no previous history
of diabetes. Of these 53.8% were women. Mean age was
52 ± 7.9 years. FPG was 7mmol/l in 245 (9.7%). HbA1c
was 6.5% in 173 (6.9%). Concordance between FPG and
HbA1c was 95% (both criteria positive: 5.8%; both criteria
negative: 89.2%). Compared to FPG, HbA1c cut-off of 6.5%
had specificity of 98.9% (95% CI 98.3-99.3) and sensitivity
of 60% (95% CI 53.6-66.2). Positive and negative predictive
values were 85% (95% CI 78.8-89.9) and 95.8% (95%
CI 94.9-96.6), respectively. Compared to FPG, optimum
HbA1c threshold for diagnosing diabetes was 5.9%
(sensitivity: 84%; specificity: 88.8%; area under the curve:
0.91).
In the study population, detection of diabetes
with ADA recommended HbA1ccriterion was 29% less than
with FPG criterion. Compared to FPG, HbA1c had high
specificity but sensitivity was low. Further research is needed
to refine the optimum HbA1c threshold in Sri Lankans.
In a cross-sectional study, carried out in January 1997 at the beginning of the school year, the impact of repeated attacks of malarial infection on the cognitive performance of children at school ...entry in moderate malaria-endemic areas of Sri Lanka was investigated. The cognitive performance of 325 schoolchildren in grade 1 (mostly aged 5–6 years) in 2 districts of Sri Lanka which are endemic for malaria (Anuradhapura and Moneragala) was assessed by an entry performance test developed by the National Institute of Education, Sri Lanka. The indices assessed included writing, language and mathematical skills. There was no difference in any of the cognitive performance indices between children from Anuradhapura and Moneragala districts. The scores of most of the indices decreased as the number of malaria infections experienced by a child increased and the ability to identify letters was significantly impaired by the number of malaria infections a child had experienced after controlling for socio-economic and nutritional status. These findings suggest that repeated attacks of malaria in children can have an adverse impact on their development.
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GEOZS, NUK, OILJ, SBCE, SBJE, UL, UM, UPUK
Carotid artery intima media thickness (CIMT) is a strong predictor of Coronary Heart Disease (CHD) and independent phenotype of early atherosclerosis. The global variation of CIMT and its demographic ...association is yet unclear. We evaluated regional variations of CIMT based on WHO regions and assessed the differences by age and sex. A systematic search was conducted on studies published between 1980 January up to December 2020. PubMed, Oxford Medicine Online, EBSCO, Taylor & Francis, Oxford University Press and Embase data bases were used for searching. Supplementary searches were conducted on the Web of Science and Google Scholar. Grey literature was searched in "Open Grey" website. The two major criteria used were "adults" and "carotid intima media". The search strategy for PubMed was created first and then adapted for the Oxford Medicine Online, EBSCO, Taylor & Francis, Oxford University Press and Embase databases. Covidence software (Veritas Health Innovation, Melbourne, Australia; http://www.covidence.org) was used to manage the study selection process. Meta-analyses were done using the random-effects model. An I.sup.2 greater than or equal to 50% or p< 0:05 were considered to indicate significant heterogeneity. Of 2847 potential articles, 46 eligible articles were included in the review contributing data for 49 381 individuals (mean age: 55.6 years, male: 55.8%). The pooled mean CIMT for the non-CHD group was 0.65mm (95%CI: 0.62-0.69). There was a significant difference in the mean CIMT between regions (p = 0.04). Countries in the African (0.72mm), American (0.71mm) and European (0.71mm) regions had a higher pooled mean CIMT compared to those in the South East Asian (0.62mm), West Pacific (0.60mm) and Eastern Mediterranean (0.60mm) regions. Males had a higher pooled mean CIMT of 0.06mm than females in the non CHD group (p = 0.001); there were also regional differences. The CHD group had a significantly higher mean CIMT than the non-CHD group (difference = 0.23mm, p = 0.001) with regional variations. Carotid artery segment-specific-CIMT variations are present in this population. Older persons and those having CHD group had significantly thicker CIMTs. CIMT varies according to region, age, sex and whether a person having CHD. There are significant regional differences of mean CIMT between CHD and non-CHD groups. Segment specific CIMT variations exist among regions. There is an association between CHD and CIMT values.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
We report the first measurement of monoenergetic muon neutrino charged current interactions. MiniBooNE has isolated 236 MeV muon neutrino events originating from charged kaon decay at rest ...(K^{+}→μ^{+}ν_{μ}) at the NuMI beamline absorber. These signal ν_{μ}-carbon events are distinguished from primarily pion decay in flight ν_{μ} and νover ¯_{μ} backgrounds produced at the target station and decay pipe using their arrival time and reconstructed muon energy. The significance of the signal observation is at the 3.9σ level. The muon kinetic energy, neutrino-nucleus energy transfer (ω=E_{ν}-E_{μ}), and total cross section for these events are extracted. This result is the first known-energy, weak-interaction-only probe of the nucleus to yield a measurement of ω using neutrinos, a quantity thus far only accessible through electron scattering.
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CMK, CTK, FMFMET, IJS, NUK, PNG, UL, UM
To study the characteristics and long term outcome of patients who had segment elevation myocardial infarction (STEMI) and treated with PTCA in a fee levying hospital in Sri Lanka.
A retrospective ...study was conducted among patients diagnosed with STEMI and treated with PTCA in a fee levying private hospital in Colombo from 1st January 2009 to 1st November 2012. Details of patients were obtained from medical records and the survival status, cause of death and date of death where relevant, were obtained from records, patients or close relatives.
197 patients (153 men; 77.7%) were included. More than 50% had a history of diabetes, dyslipidaemia or hypertension. The three year survival was 82.7% (95% CI: 77.9%-90.5%). Based on the Cox's Proportional Hazards model, site of arterial occlusion (proximal vs distal segment of left anterior descending artery LAD was significantly associated with mortality due to all causes HR 10.98; 95% CI: 1.09-110.20. Low ejection fraction, not on regular medication and delay of more than 3 hours between onset to door time were associated with death due to cardiovascular causes in patients whose right coronary artery or left circumflex artery was the culprit artery.
The three year survival of patients with STEMI and who had PTCA was 83%. Patients with proximal LAD occlusion were 11 times more likely to die within 3 years of PTCA as compared to those who had a distal LAD occlusion.
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