[A refugee with inguinal lymfadenopathy and skin lesions].

We present a 30-years-old man with lymphadenopathy and itchy skin lesions. One lymphoblast and atypical lymphocytes were found in the peripheral blood. Histopathologic examination of a skin punch biopsy revealed scabies.

Continuous glucose monitoring during diabetic pregnancy (GlucoMOMS): A multicentre randomized controlled trial.

Aim: Diabetes is associated with a high risk of adverse pregnancy outcomes. Optimal glycaemic control is fundamental and is traditionally monitored with self-measured glucose profiles and periodic HbA1c measurements. We investigated the effectiveness of additional use of retrospective continuous glucose monitoring (CGM) in diabetic pregnancies.

Enterovirus Exposure Uniquely Discriminates Type 1 Diabetes Patients with a Homozygous from a Heterozygous Melanoma Differentiation-Associated Protein 5/Interferon Induced with Helicase C Domain 1 A946T Genotype.

In children at risk for type 1 diabetes, innate immune activity is detected before seroconversion. Enterovirus infections have been linked to diabetes development, and a polymorphism (A946T) in the innate immune sensor recognizing enterovirus RNA, interferon-induced with helicase C domain 1/melanoma differentiation-associated protein 5, predisposes to disease. We hypothesized that the strength of innate antienteroviral responses is affected in autoimmune type 1 diabetes patients and linked to the A946T polymorphism.

Humoral and cellular immune responses after influenza vaccination in patients with chronic fatigue syndrome.

Background: Chronic fatigue syndrome (CFS) is a clinical condition characterized by severe and disabling fatigue that is medically unexplained and lasts longer than 6 months. Although it is possible to effectively treat CFS, the nature of the underlying physiology remains unclear. Various studies have sought evidence for an underlying disturbance in immunity.

[Reimbursement for alternative medical treatment in the Netherlands, incomprehensible].

It is remarkable that, at a time when not only doctors but also the Health Care Inspectorate (IGZ) and the health insurance companies are paying increasing attention to the quality of conventional medicine, many alternative methods of treatments without a scientific basis are accepted in the Netherlands. Even though it has been conclusively demonstrated that most alternative therapies do not work and despite the absence of scientific proof of the safety and efficacy of alternative treatments, health insurance companies do often reimburse the incurred costs. Because the safety of alternative therapies is not guaranteed, these are neither in the interest of the patient nor of society.

Urinary heparanase activity in patients with Type 1 and Type 2 diabetes.

Background: A reduced heparan sulphate (HS) expression in the glomerular basement membrane of patients with overt diabetic nephropathy is associated with an increased glomerular heparanase expression. We investigated the possible association of urinary heparanase activity with the development of proteinuria in patients with Type 1 diabetes (T1D), Type 2 diabetes (T2D), or membranous glomerulopathy (MGP) as non-diabetic disease controls.

Methods: Heparanase activity, albumin, HS and creatinine were measured in the urine of patients with T1D (n=58) or T2D (n=31), in patients with MGP (n=52) and in healthy controls (n=10).

The effect of crossing legs on blood pressure.

Objective: To determine whether crossing of the legs at the knee or at the ankles during blood pressure measurement in sitting position has an effect on blood pressure.

Methods: One hundred and eleven patients, 60 women, mean age 52+/-17 years (19-80): 49 chronically treated hypertensives, 28 treated diabetics and 34 normotensives were measured by one trained investigator, with an oscillometric device (Omron 705CP) on the left arm. We looked for the difference of blood pressure with the ankle or the knee crossed versus the uncrossed position.

A brief behavioral feedback intervention in hospital outpatients with a high cardiovascular risk.

Objective: Examining the prevalence of risk behavior and motivation to change among hospital outpatients with a high cardiovascular risk, and the implementation and results of a brief behavioral feedback intervention by internists.

Methods: One hundred and sixty-one patients completed a lifestyle questionnaire and were given personalized feedback on the results by their internists. The delivery of the feedback was monitored.

Theophylline improves hypoglycemia unawareness in type 1 diabetes.

Iatrogenic hypoglycemias and the subsequent occurrence of hypoglycemia unawareness are well-known complications of intensive insulin therapy in type 1 diabetic patients that limit glycemic management. From a pharmacological point of view, the adenosine-receptor antagonist theophylline might be beneficial in the management of hypoglycemia unawareness. Theophylline stimulates the release of catecholamines and reduces cerebral blood flow, thereby facilitating stronger metabolic responses to and a prompter perception of decreasing glucose levels.