ABSTRACT
PURPOSE: To evaluate leptin levels in a sample of obese women with PCOS and compare the results with obese and non-obese control, to be ultimately correlated with BMI, and insulin sensitivity. METHODS: Leptin and insulin assays by immuno-radiometric method, glucose assay by enzymatic colorimetric method. RESULTS: Leptin levels were significantly different between obese and non-obese subjects, and were significantly different between insulin resistant and non-insulin resistant obese PCOS, but were not significantly different between obese non-insulin resistant PCOS, and obese controls. CONCLUSIONS: Body mass index and insulin resistance are the two main factors governing serum leptin levels.
Subject(s)
Hypoglycemic Agents/blood , Insulin/blood , Leptin/blood , Obesity/complications , Polycystic Ovary Syndrome/complications , Adult , Body Mass Index , Case-Control Studies , Female , Humans , Insulin ResistanceABSTRACT
This prospective study over 24 months aimed to evaluate the outcome of early management of disseminated intravascular coagulation (DIC) among high-risk patients (n = 50) admitted to a pediatric intensive care unit (PICU). It also included all cases presenting with overt DIC (OD) concomitantly (n = 30). The high-risk group (pre-DIC) was subdivided, according to their D-dimer assay, into negative (n = 14) and positive (n = 36) D-dimer groups. All three groups were evaluated, on admission, for their prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen level (Fi), fibrinogen degradation products (FDP), platelet count, and presence/absence of schistocytes in peripheral blood. The combination of D-dimer and FDP assay showed the best correlation for early pre-DIC diagnosis (r = 0.9048). FDP assay was the best parameter for followup of progress of DIC condition in the PICU. The lowest mortality was among negative D-dimer, followed by positive D-dimer and OD groups (28.6 per cent, 77.8 per cent, and 93.3 per cent, respectively). Among the positive D-dimer group the lowest mortality was encountered in the subgroup treated with plasma, heparin and tranexamic acid (33 per cent) while those treated with non-specific therapy, plasma only, or plasma and heparin showed higher mortality (100 per cent, 80 per cent, and 100 per cent, respectively). The deceased subgroup, among positive D-dimer cases showed a significantly higher number of patients presenting with multiple organ failure on admission compared with the discharged group. In summary, early diagnosis and proper management of pre-DIC, before overt bleeding, in high-risk patients admitted to a PICU using combined D-dimer and FDP assays had a positive impact on their prognosis.
Subject(s)
Disseminated Intravascular Coagulation/diagnosis , Disseminated Intravascular Coagulation/therapy , Early Diagnosis , Blood Coagulation Tests , Chi-Square Distribution , Child, Preschool , Combined Modality Therapy , Developing Countries , Disseminated Intravascular Coagulation/mortality , Egypt , Evaluation Studies as Topic , Female , Fluid Therapy , Heparin/therapeutic use , Hospitals, University , Humans , Infant , Infant, Newborn , Intensive Care Units, Pediatric , Logistic Models , Male , Partial Thromboplastin Time , Probability , Prognosis , Prospective Studies , Risk Assessment , Severity of Illness Index , Survival Rate , Treatment OutcomeABSTRACT
Eighty multi-transfused beta-thalassemics--40 of them on regular transfusion (RT) (every 3-4 weeks) and 40 irregularly transfused (IT)-and 20 age- and-sex-matched controls were evaluated for serum erythropoietin (sEpo) and soluble serum transferrin receptors (sTfr) as indicators of erythropoietic activity. All subjects were studied for pre-transfusion hemoglobin (Hb), reticulocytic index (RI), serum ferritin, sEpo and sTfr. Results showed that the mean RI, sEpo and sTfr values were significantly higher in the IT group (2.8; 80 mU/ml; and 19 microg/ml, respectively) compared to the RT group (1.2; 35.2 mU/ml; and 13.9 microg/ml, respectively) and controls (1.1; 22.6 mU/ml; and 7 microg/ml, respectively) (p < 0.05); while only the mean sTfr value was significantly higher in the RT group compared to controls. The mean pre-transfusion Hb was significantly lower in the IT group (8 g/dl) compared to both the RT group (9.3 g/dl) and controls (12.5 g/dl) (p < 0.05); while the RT group level was significantly lower than controls. There was an inverse correlation between Hb level on one hand and sEpo (r = 0.324,p < 0.05), sTfr (r = -0.651, p < 0.05) and RI (r = -0.451, p < 0.05) on the other. In summary, sEpo, sTfr and RI could be used as accurate and reliable indicators of successful erythroid marrow suppression and for the determination of optimal pre-transfusion Hb level in thalassemia on an individual basis, with sTfr being the most sensitive indicator.
