ABSTRACT
Hypoglycemia is not an independent diagnosis. It is a pathophysiological syndrome whose cause needs to be identified. Identifying it is just the first step to making the diagnosis as precisely as possible and to preventing brain damage. Timely diagnosis and treatment are factors of paramount importance for the prognosis of affected patients. The aim of this study was to present two of our patients with hyperinsulinemic hypoglycemia because of the rarity of the condition and to propose a diagnostic-therapeutic algorithm of hypoglycemic syndrome in childhood. Identifying the genetic mutations using DNA analysis for both children enabled us to determine the prognosis and to provide genetic counseling about the next pregnancies in the affected families. We make a detailed classification of different types of hypoglycemia and the various therapeutic modalities: dietary, medicinal and surgical depending on the etiology. It is concluded that the highly specialized examinations which ensure the etiological diagnose, treatment, prognosis and genetic consultation demand the participation of a well trained medical team--both in the clinical division and in the laboratory.
Subject(s)
Hyperinsulinism/diagnosis , Hypoglycemia/diagnosis , Algorithms , Combined Modality Therapy , DNA Mutational Analysis , Diazoxide/therapeutic use , Diet Therapy , Female , Genetic Predisposition to Disease , Glucose/administration & dosage , Humans , Hyperinsulinism/genetics , Hyperinsulinism/therapy , Hypoglycemia/genetics , Hypoglycemia/therapy , Infant , Infant, Newborn , Male , Point Mutation , Somatostatin/therapeutic useABSTRACT
AIM: The aim of the present study was to establish the discriminating value of dermatoglyphic traits between schizophrenic patients and mentally healthy individuals. PATIENTS AND METHODS: The study included 76 schizophrenic inpatients (43 men, 33 women, mean age 31.47 years), who satisfied the DSM-IV criteria for a diagnosis of schizophrenia and 82 mentally healthy subjects of Bulgarian origin of mean age 39.24 years. Fingerprints were obtained by the ink method. Ridge count was read by the method of Cummins and Midlo. RESULTS: The male schizophrenic patients showed a significantly higher total finger ridge count of each hand and TFRC than the control group. On the right hand, statistically significant differences were found for D2 and D5. On the left hand, the differences reached statistical significance for L1, L2 and L5. The schizophrenic females had lower ridge count than the control group females. The differences were most expressed for the total ridge count of the left hand (TFRCL) and total ridge count of both hands (TFRC), but did not reach statistical significance. On the right hand the greatest between-group differences were found for D1 and D4, which were just short of reaching statistical significance (p > 0.05). On the left hand the greatest differences (almost reaching statistical significance) were found for L1. Of the other fingers the greatest differences showed L3 and L4. CONCLUSION: Total finger ridge count appears to be a sensitive trait indicating disorders of prenatal neurodevelopment in schizophrenia.
