Sex- and season-dependent differences in C-peptide levels at diagnosis of immune-mediated type 1 diabetes.

AIMS/HYPOTHESIS: The incidence of type 1 diabetes varies according to age, sex and season of diagnosis. We investigated whether these and other clinical, biological and anthropometric parameters were correlated with residual beta cell function in newly diagnosed patients, since it is possible that the nature of external and/or genetic disease accelerators may be (partly) reflected in the inaugural disease presentation. MATERIALS AND METHODS: The correlates of random C-peptide levels sampled shortly after diagnosis (median [interquartile range]: 3 [0-14] days) were studied by multivariate analysis in 1,883 islet-antibody-positive diabetic patients aged <40 years who were diagnosed between 1989 and 2000. RESULTS: Higher C-peptide levels (above percentile 50 of patients) were associated with older age at diagnosis, female sex, diagnosis in the high-incidence season (October to March), less-decreased BMI (expressed as a standard deviation score), lower insulin requirements after stabilisation, lower prevalence of ketonuria and a less-increased glycaemia at diagnosis (all p < 0.001). C-peptide levels were not correlated with calendar year at diagnosis, duration of symptoms prior to diagnosis, HLA-DQ2/DQ8 genotype or islet antibody status. CONCLUSIONS/INTERPRETATION: Sex- and season-dependent differences in residual functional beta cell mass and/or insulin resistance have been identified at diagnosis of type 1 diabetes. They may reflect differences in disease-precipitating external or lifestyle factors and should be further investigated longitudinally in prediabetes to further identify putative aetiological factors, which may provide targets for prevention.

[Screening for Staphylococcus aureus with a reduced susceptibility to vancomycin in: a Belgian hospital]. / Recherche de Staphylococcus aureus à sensibilité diminuée à la vancomycine dans un hôpital Belge.

The aim of the present study was to investigate the prevalence of vancomycin resistance in clinical methicillin resistant Staphylococcus aureus (MRSA) isolates in our hospital by screening on Mueller-Hinton agar with 5 mg/l teicoplanin (MH-Teico), as recommended by the Comite de l'Antibiogramme of the Societe Francaise de Microbiologie (CA-SFM). Seventeen of 1002 clinical MRSA isolated from 404 patients showed in 2003 growth of at least four colonies on this medium, but only one was confirmed as homogeneous vancomycin-resistant S. aureus (VISA) and five as heterogeneous VISA (hVISA) by population analysis. None of the patients presented with severe infection but awareness is needed and screening on MH-Teico as recommended by CA-SFM is a convenient method. Surveillance should be focused on patients with risk factors for selection of such strains: patients with a prolonged course of glycopeptide therapy and persistence of MRSA infection or colonization.