Utility of adiponectin as a biomarker predictive of glycemic efficacy is demonstrated by collaborative pooling of data from clinical trials conducted by multiple sponsors.

This study, conducted under the Metabolic Disorders Steering Committee of the Biomarkers Consortium (a public-private partnership managed by the Foundation for the National Institutes of Health (FNIH)), analyzed blinded data on 2,688 type 2 diabetes (T2D) patients from randomized clinical trials conducted by four pharmaceutical companies. An increase in the levels of adiponectin was observed after peroxisome proliferator-activated receptor (PPAR)-agonist treatment (P < 0.0001), but not after treatment with non-PPAR drugs.

Role of multidetector computed tomography in the assessment of cervical spine trauma.

Clearing the cervical spine has relied on individual and center-based experience. Not long ago, the screening modality of choice was radiography. The evidence now clearly supports multidetector computed tomography as the modality of choice for evaluating cervical spine trauma because of its higher accuracy and efficiency compared to radiography.

Activation of AMP-activated protein kinase by metformin improves left ventricular function and survival in heart failure.

Clinical studies have reported that the widely used antihyperglycemic drug metformin significantly reduces cardiac risk factors and improves clinical outcomes in patients with heart failure. The mechanisms by which metformin exerts these cardioprotective effects remain unclear and may be independent of antihyperglycemic effects. We tested the hypothesis that chronic activation of AMP-activated protein kinase (AMPK) with low-dose metformin exerts beneficial effects on cardiac function and survival in in vivo murine models of heart failure.

Grommets (ventilation tubes) for recurrent acute otitis media in children.

Background: Acute suppurative otitis media is one of the most common infectious diseases in childhood. Recurrent acute otitis media is defined for the purposes of this review as either three or more acute infections of the middle ear cleft in a six-month period, or at least four episodes in a year. Strategies for managing the condition include the assessment and modification of risk factors where possible, repeated courses of antibiotics for each new infection, antibiotic prophylaxis and the insertion of ventilation tubes (grommets).

Usefulness of NT-proBNP level for diagnosing left ventricular hypertrophy in hypertensive patients. A cardiac magnetic resonance study.

The presence of left ventricular hypertrophy (LVH) is associated with an increase in cardiovascular morbidity and mortality in hypertensive patients. We investigated the diagnostic value of the N-terminal probrain natriuretic peptide (NT-proBNP) level for detecting LVH in hypertensive patients with a conserved left ventricular ejection fraction. The study involved 27 consecutive patients.

A double-blind randomised clinical trial of the treatment of otitis externa using topical steroid alone versus topical steroid-antibiotic therapy.

The objective of the study was to determine if the addition of topical antibiotic increases the efficacy of topical steroid in controlling otitis externa. A double-blind randomised controlled trial was performed from February 2003 to April 2005 in an otolaryngology emergency clinic (acute urban teaching hospital) in the United Kingdom. Patients were followed up for 2 weeks.

MRI assessment of drug-induced fluid accumulation in humans: validation of the technology.

Purpose: The purpose of this study was to evaluate the feasibility of using proton and sodium magnetic resonance imaging (MRI) to detect fluid accumulation produced by fludrocortisone and nifedipine - two drugs known to cause salt/water retention by different mechanisms.

Materials And Methods: Twelve young healthy male subjects were randomly assigned to one of two groups and treated with either fludrocortisone or nifedipine for 14 or 25 days, respectively. The change in sodium MRI, as well as in proton T(2) value and T(1)-weighted signal intensity in the calf following postural change [referred to here as 'postural delta signal'(PDS)], was evaluated before, during and after drug administration.

[Prevalence of primary aldosteronism in hypertensive patients and its effect on the heart].

Primary hyperaldosteronism (PHA) is thought to have a harmful effect on the cardiovascular system and, in recent years, the number of cases of hypertension due to PHA has been increasing. The aims of this study were to determine the prevalence of PHA and to assess cardiac damage associated with the condition in 183 consecutive hypertensive patients. A full secondary hypertension work-up was performed, and included ECG and echocardiography.

Validation of a quantitative magnetic resonance method for measuring human body composition.

Objective: To evaluate a novel quantitative magnetic resonance (QMR) methodology (EchoMRI-AH, Echo Medical Systems) for measurement of whole-body fat and lean mass in humans.

Methods And Procedures: We have studied (i) the in vitro accuracy and precision by measuring 18 kg Canola oil with and without 9 kg water (ii) the accuracy and precision of measures of simulated fat mass changes in human subjects (n = 10) and (iii) QMR fat and lean mass measurements compared to those obtained using the established 4-compartment (4-C) model method (n = 30).

Results: (i) QMR represented 18 kg of oil at 40 degrees C as 17.

Trauma to the ankylotic spine: imaging spectrum of vertebral and soft tissue injuries.

The objectives of the study were to review the clinical entities that can cause ankylosis of the spine and to illustrate the spectrum of traumatic injury patterns. Ankylosing spondylitis, diffuse idiopathic systemic hyperostosis, degenerative spondyloarthropathy, and spinal canal stenosis can render the spine susceptible to trivial trauma. Multidetector computed tomography and magnetic resonance imaging can accurately diagnose vertebral and soft tissue traumatic injury patterns in this patient population.

Dislocation of the turbinate: a rare complication of middle turbinate surgery.

We describe a rare complication of turbinate surgery--dislocation of the turbinate--in a woman who had undergone surgical treatment for nasal obstruction 10 years earlier. Removal of the displaced yet still-viable turbinate resulted in resolution of her symptoms.

Radiological anatomy of the anterior ethmoidal artery for functional endoscopic sinus surgery.

Aim: This study investigated the extent to which the anterior ethmoidal artery and anterior ethmoidal foramen could be reliably identified on routine coronal sinus computed tomography scans. Where they could be identified, the relationship of these structures with the vertical height of the skull base, and their distance from an anterior landmark, were measured.

Methods: Fifty consecutive coronal sinus computed tomography scans were viewed independently by two observers.

What proportion of patients referred to an otolaryngology vertigo clinic have an otological cause for their symptoms?

Background: Dizziness is a common and often complex complaint. Between nine and 13 per cent of patients seen in general practice are referred to a variety of specialist clinics. The diagnoses and outcomes of these referrals are seldom reported.

Value of the critical flicker frequency in patients with minimal hepatic encephalopathy.

Unlabelled: Minimal hepatic encephalopathy (MHE) is mainly diagnosed using psychometric tests such as the psychometric hepatic encephalopathy score (PHES). Despite the clinical and social relevance of MHE, psychometric testing is not widespread in routine clinical care. We assessed the usefulness of the critical flicker frequency (CFF), for the diagnosis of MHE and for the prediction of the development of overt episodes of HE.

Low CD4 T cell immunity to pneumolysin is associated with nasopharyngeal carriage of pneumococci in children.

Background: Recent studies in mice have suggested that T cell immunity may be protective against pneumococcal infection.

Methods: CD4 T cell proliferative responses to the pneumococcal proteins pneumolysin (Ply), Ply toxoid (F433), and choline-binding protein A were investigated in peripheral blood mononuclear cells (PBMCs) and adenoidal mononuclear cells (MNCs) obtained from children undergoing adenoidectomy.

Results: Ply and F433 induce significant proliferation of CD4 T cells in both PBMCs and adenoidal MNCs, and both memory and naive phenotypes of CD4 T cells proliferated after stimulation.

Characteristics and trends of newly diagnosed HIV-infections, 2000-2004.

Objective: To describe the characteristics and trends of newly diagnosed HIV-infections.

Methods: We analysed all newly diagnosed HIV-infections among residents of the Canary Islands, Ceuta, La Rioja, Navarre and the Basque Country (Spain) between 2000 and 2004.

Results: In total, 1,807 HIV-infections -74.

A metabolomic comparison of urinary changes in type 2 diabetes in mouse, rat, and human.

Type 2 diabetes mellitus is the result of a combination of impaired insulin secretion with reduced insulin sensitivity of target tissues. There are an estimated 150 million affected individuals worldwide, of whom a large proportion remains undiagnosed because of a lack of specific symptoms early in this disorder and inadequate diagnostics. In this study, NMR-based metabolomic analysis in conjunction with multivariate statistics was applied to examine the urinary metabolic changes in two rodent models of type 2 diabetes mellitus as well as unmedicated human sufferers.

Quality of life outcome analysis in patients undergoing submandibular duct repositioning surgery for sialorrhoea.

Bilateral submandibular duct transposition is one of several surgical methods described to control sialorrhoea in the paediatric patient. The purpose of this study is to assess the effect of submandibular duct repositioning surgery on the quality of life of children using the Glasgow Benefit Inventory outcome measure. Consecutive children who underwent submandibular duct repositioning surgery were invited to participate in the study.

[The diagnosis of traumatic cervical lesions: a decade of evidence-based change].

The growing awareness of the need for emergency centers specializing in the care of trauma patients, together with advances in diagnostic imaging technology, have led to the occasional indiscriminate use of diagnostic methods to the detriment of ordering diagnostic tests based on the risk of fracture and of the clinical examination itself. In many institutions, this practice is carried out without appropriate controls and without analyzing the risks and benefits of a particular clinical conduct. This is particularly true in cases of multiple trauma with suspected traumatic lesions of the cervical spine.

Regulation of production of mucosal antibody to pneumococcal protein antigens by T-cell-derived gamma interferon and interleukin-10 in children.

Nasopharyngeal tonsils (adenoids) are part of human nasopharynx-associated lymphoid tissue, which may play an important role in local defense against pneumococci. Recent studies with animals have suggested that several pneumococcal proteins, including CbpA and pneumolysin (Ply), may be vaccine candidates. Our recent data obtained with children suggest that antibodies to these proteins may protect against carriage.

Functional endoscopic sinus surgery for chronic rhinosinusitis.

Background: Rhinosinusitis is a well-recognised clinical syndrome affecting patients of all ages and gender. FESS has now become a well-established strategy, comprising several techniques, for the treatment of chronic rhinosinusitis refractory to medical treatment.

Objectives: The aim of this review was to assess the effectiveness of functional endoscopic sinus surgery as a treatment for patients with chronic rhinosinusitis.

Imaging of blunt cerebrovascular injuries.

Arterial dissection, pseudoaneurysm, arteriovenous fistula, arterial laceration and occlusion are uncommon complications of blunt trauma. Angiography has been considered the primary method of evaluation to assess for vascular injuries but, due to the low frequency of these lesions, its screening role has been challenged. Non-invasive imaging, particularly CT angiography (CTA), offers definitive advantages and has emerged as a promising diagnostic screening method.