Suchergebnisse

Diabetes mellitus (DM) and gestational diabetes (GDM) are often diagnosed and their long-term progression monitored either by a fasting blood glucose test (FGT) or an oral blood glucose tolerance test (OGTT). These tests are well-standardized and are conveniently carried out via blood samples drawn from the patient's arm, which are later analyzed to measure blood glucose concentration.
Pre-analytical guidelines for laboratory analysis of blood samples intended for the measurement of plasma glucose maintain that the two principal factors which contribute to poor reproducibility of the OGTT are (i) the variable effects of administration of a hyperosmolar glucose solution on gastric emptying, and (ii) the ambient temperature while the blood sample is being captured. Although viewing ambient temperature as a purely random effect may be acceptable for routine diagnostic tests carried out in "the West", the substantially higher regular temperatures experienced throughout the year by many African, Asian and Middle-Eastern countries suggest that in some locations and circumstances, ambient temperature might be better regarded as a systematic influence on the OGTT.
The principal purpose of this short literature review is to highlight the potentially significant influence of ambient temperature (during the blood-draw) on the results of OGTT blood glucose measurements. Physicians and healthworkers should be aware of this phenomenon which not only can affect the diagnoses for particular patients but is also capable of producing a significant impact on subsequent prevalence estimates for both diabetes and gestational diabetes. Further studies should be conducted throughout the Arabian Gulf to elucidate the magnitude of this effect on local populations by making use of well-characterized patients under standardized conditions where temperature and humidity can be strictly controlled.

Background:Prostaglandins, in particular prostaglandin E2(PGE2), are elevated in adenomas and colorectal cancers (CRC). Experimental and epidemiological studies have demonstrated reduced incidence of adenomas and CRC by inhibitors of prostanoid synthesis (NSAIDs). This study aimed to characterize the expression and localization of key enzymes/receptors for PGE2synthesis in adenomas and CRC in comparison to normal colon.Methods:Immunoblotting and immunohistochemistry were used for semi-quantitative and qualitative analysis of COX-1, COX-2, mPGES-1 and the EP2receptor in biopsies from patients undergoing resection of adenomas or surgery for CRC (Dukes' A-C). Normal colon served as control for the corresponding tumor in each of the CRC patients.Results:COX-1 was decreased significantly in all groups of CRC (Dukes' A-C) compared to normal colon. In contrast, COX-2 was increased, but only in the combined group of CRC. Microsomal PGES-1 was increased in CRC (Duke's B), and EP2was augmented in adenomas and CRC. The localization was predominantly epithelial in normal colon and in adenomas, while in CRC both epithelial- and stromal expression was demonstrated.Conclusions:The results support the PGE2- pathway, with epithelial- stromal interactions, in the evolvement of adenomas and in the progression of CRC. Co-expression of COX-1 and COX-2 is in line with the preventive effects of non-specific NSAIDs on adenoma formation. The decrease of COX-1, in combination with an increase of COX-2, favors the potential use of selective COX-2 inhibitors as an adjunct therapy in CRC.