Severe Refractory Anemia in Primary Intestinal Lymphangiectasia. A Case Report.

Background: Primary intestinal lymphangiectasia (Waldmann's disease) is a rare disease characterized by dilated lymphatics in the small bowel leading to an exudative enteropathy with lymphopenia, hypoalbuminemia and hypogammaglobulinemia.

Case Presentation: We report the case of a 23 year-old male who presented with chronic anemia and in whom primary intestinal lymphangiectasia was diagnosed. A low-fat diet along with nutritional therapy with medium-chain triglyceride supplementation improved the protein-losing enteropathy, but did not solve the anemia.

Ratio of spleen diameter to red blood cell distribution width: a novel indicator for celiac disease.

Celiac disease (CD) is currently considerably underdiagnosed, setting the need for developing tools to select patients with probability of CD, who warrant further testing. Red blood cell distribution width (RDW) has been shown in previous studies to be a sensitive predictor for CD, but it lacks specificity. Splenic hypotrophy is also noted frequently in celiac patients.

MTNR1B Genetic Variability Is Associated with Gestational Diabetes in Czech Women.

The gene MTNR1B encodes a receptor for melatonin. Melatonin receptors are expressed in human β-cells, which implies that genetic variants might affect glucose tolerance. Meta-analysis confirmed that the rs10830963 shows the most robust association.

Hospital-based surveillance to estimate the burden of rotavirus gastroenteritis in children below five years of age in Romania.

Introduction: Rotavirus (RV) is a leading cause of acute gastroenteritis (AGE), affecting 95% of children below five years of age.

Methods: In this prospective, multi-center study, children below five years of age who were hospitalized or those who visited the emergency room (ER) due to AGE or who developed AGE at least 48 hours after hospitalization (nosocomial infection) and had a RV-positive stool sample were included (n=1,222). RV-positive samples were genotyped by reverse-transcriptase polymerase chain reaction.

Characteristics and prenatal care utilisation of Romanian pregnant women.

Objective: To describe the degree to which Romanian women access free prenatal care services, and to describe the demographic profile of women who are at risk for underutilisation.

Methods: Secondary data (n = 914) were taken from a large, nationally representative sample of Romanian mothers and children (N = 2117). Kotelchuck's Adequacy of Prenatal Care Utilisation Index was used to measure the adequacy of prenatal care.

Assessment of acid-base balance at birth in newborns from diabetic mothers.

Newborns from diabetic mothers are more frequently born prematurely, large for the gestational age, with difficult respiratory adaptation and risk of RDS (respiratory distress syndrome) and, subsequently, exposed to a higher risk of perinatal distress, hypoxia, metabolic stress and hematologic alterations. Comparing the status at birth of 120 newborns from mothers with diabetes, with 120 controls from uncomplicated pregnancies, over a period of 4 years, in a specialized tertiary center, no significant differences in the immediate outcome of such newborns and similar incidence of hypoxia at birth were shown, as illustrated by the parameters of the acid-base balance (cord pH, BE and HCO3). However, there are significant differences in the route of delivery, with a predominance of C-section deliveries in the diabetic group (4 out of every 5 cases), which might be an important contribution to the relative good status of these newborns at birth.

Neonatal hypoglycemia screening in newborns from diabetic mothers--arguments and controversies.

The most important known metabolic complication of the newborns from diabetic mothers, including diabetes type 1 and 2 and gestational diabetes, is the postnatal hypoglycemia. If unrecognized and undiagnosed, hypoglycemia in this particular high-risk group can determine severe neurological lesions and even death, in a significantly higher proportion than those from the general population. The present paper brings arguments for the crucial importance of screening for post-natal hypoglycemia in the early hours after birth, and discusses the management strategies and the topics that still remain in debate.

Severe punishment of children by staff in Romanian placement centers for school-aged children: effects of child and institutional characteristics.

The objective of this study was to determine whether children's characteristics and/or institutional characteristics were predictors of severe punishments (including beatings) and/or frequency of punishments that children received from staff in Romanian institutions. The data was hierarchical with institutionalized children (N=1391) nested within 44 institutions, and the measurement of punishments by the staff and frequency of punishments had a binary distribution. Thus, multilevel logistic regression models were used to examine the effects of individual and institutional level variables on reported punishments and to account for the clustering of the children within institutions.

Quantitative changes in macrophage distribution in normal mouse ovary over the course of the estrous cycle examined with an image analysis system.

Problem: The current study considered the distribution of macrophages within the major ovarian structures throughout the estrous cycle.

Methods: Immunohistochemical analyses were carried out using an avidin-biotin-peroxidase staining method and the rat anti-mouse macrophage monoclonal antibody anti-Mac-l was applied to stain macrophages. A computer-assisted image analysis system was used to quantify and compare the distribution of macrophages within individual ovarian structures during the estrous cycle.

Effects of products of activated immune cells and recombinant cytokines on spontaneous and ionophore-induced acrosome reaction.

Problem: The purpose of this study was to examine whether the products of activated immune cells influence spontaneous and ionophore-induced sperm acrosome reaction.

Method: The spontaneous and ionophore-induced acrosome reaction were evaluated by staining with fluorescein isothiocyanate (FITC) Pisum sativam agglutinin after incubation in capacitating media supplemented with either supernatants from Con-A activated leukocyte cultures or human recombinant (r) IL-1 beta, TNF-alpha, and INF-gamma.

Results: The supernatants from Con A-activated peripheral blood leukocyte cultures at 1:1 and 1:10 dilution significantly increased the rate of spontaneous acrosome reaction (P < 0.

Correlation of asthenozoospermia with increased antisperm cell-mediated immunity in men from infertile couples.

To investigate whether cell-mediated immunity (CMI) against sperm and/or antisperm circulating antibodies are associated with poor semen quality, a leukocyte migration inhibition factor (LMIF) assay and an enzyme-linked immunosorbent assay (ELISA) were performed in groups of men from infertile couples, men from fertile couples and sperm donors. Twenty-five of 102 men (25%) revealed positive CMI against sperm and 10 (10%) had positive antisperm antibody titers in their sera. Fifteen of 28 asthenozoospermic men (53%) from infertile couples revealed positive antisperm CMI.

A quantitative objective method for the evaluation of anti-sperm cell-mediated immunity in humans.

Anti-sperm cell-mediated immunity (CMI) is considered as a crucial facet of infertility in patients of both sexes. A precise and objective method is designed, based on a one-step agarose leukocyte migration inhibition factor (LMIF) assay. The migration areas are evaluated by a computer-assisted image analysis system.

Development and distribution of the white blood cells within various structures of the human menstrual corpus luteum examined using an image analysis system.

Problem: Emerging evidences suggest that immunoendocrine interactions play definitive roles during development and regression of the human menstrual corpus luteum (hmCL). We have studied the distribution of immune cells within individual structures of hmCL during various stages of its development.

Method: Immunoperoxidase-stained ultra-thin frozen sections were evaluated using light microscopy fitted with an image analysis system.

Prospects for higher infant survival.

Studies on trends in infant mortality and its constituent elements of early neonatal, late neonatal and postneonatal death, in developed and developing countries, point to ways of making further progress towards the target of infant mortality rates not exceeding 50/1000 live births in all countries by the year 2000.