Pregnant women with impaired tolerance to an oral glucose load in the afternoon: evidence suggesting that they behave metabolically as patients with gestational diabetes.

OBJECTIVE: In previous studies we observed the existence of a circadian variation of the blood glucose response to oral glucose in pregnant women with higher values at 4 PM. Some women with increased risk of diabetes with normal oral glucose tolerance tests at 8 AM also had values above maximum normal levels at 4 PM. The aim of this trial was to determine the clinical significance of this impaired tolerance in the afternoon. STUDY DESIGN: Seventy-seven pregnant women with normal risk of diabetes (65 of normal weight and 12 overweight), 75 with increased risk of diabetes (26 overweight), and 12 patients with gestational diabetes were incorporated in the study. All women underwent two oral glucose tolerance tests (1.5 gm/kg) at 31 to 32 weeks' gestation at 8 AM and 4 PM with a 1-week interval. At 33 weeks' gestation a whole-day blood glucose profile was performed with usual food intake; samples were withdrawn before each meal and at 30, 60, and 120 minutes after each meal. The weight of the newborns was recorded. RESULTS: (1) Results of oral glucose tolerance tests confirmed a circadian variation of the response in all groups; (2) 37 women with increased risk of diabetes had higher values after oral glucose tolerance testing than the normal threshold at 4 PM but not at 8 AM; (3) among women with normal risk of diabetes all values were within the normal range despite the circadian variation; (4) blood glucose levels during whole-day profiles were normal in women with normal risk of diabetes and with increased risk of diabetes with normal oral glucose tolerance testing at 4 PM, whereas all women with increased risk of diabetes and impaired tolerance in the afternoon showed hyperglycemic episodes; (5) the percentage of newborns with high weight (>90th percentile) among women with increased risk of diabetes and abnormal oral glucose tolerance tests at 4 PM was similar to the percentage found in women with gestational diabetes and much higher than the one observed in women with normal oral glucose tolerance tests in the afternoon. CONCLUSIONS: The impairment of the response to oral glucose tolerance testing seen in some patients with increased risk of diabetes at 4 PM but not at 8 AM seems of clinical significance in view of the abnormal whole-day blood glucose profile these women had and the weights of the newborns.

Avaliaçåo da eficácia, tolerabilidade e segurança da sertalina (50 mg a 200 mg) durante 8 semanas no tratamento de 150 pacientes ambulatoriais com depressåo maior / Evaluation of effectiveness, tolerance and safety of sertraline (50 mg to 200 mg) during 8 weeks in the treatment of 150 patients outpatients with major depression

Os resultados de um estudo multicêntrico, aberto e nåo comparativo, no qual foram avalaiados 150 pacientes com diagnóstico de depressåo maior de acordo com os critérios da DSM-III-R, såo relatados. Os pacientes selecionados foram inicialmente submetidos a um período simples-cego, durante 2 semanas. Após essa fase, aqueles que preenchiam os critérios de inclusåo e exclusåo iniciaram o tratamento com sertralina 50mg/dia que poderia ser aumentada gradualmente até 200mg/dia, incrementos de 50mg, e intervalos de no mínimo 2 semanas, caso a resposta ao tratamento fosse insatisfatória, segundo a avaliaçåo do investigador. O tratamento com sertalina mostrou-se altamente eficaz no alívio da depressåo. como também nos sintomas associados ao quadro depressivo como, ansiedade, transtornos do sono, agitaçåo ou inibiçåo psicomotora, trabalho e atividades, entre outros. Um total de 84,2 por cento dos pacientes responderam satisfatoriamente ao tratamento com sertralina em doses felíveis. Em relaçåo à tolerabilidade, um total de 54 por cento dos pacientes apresentaram algum efeito adverso ao longo do tratamento, porém estes efeitos foram geralmente de intensidade leve ou moderada e apenas 4,6 por cento dos pacientes interromperam o tratamento prematuramente devido à ocorrência de eventos adversos

Avaliacao da eficacia, tolerabilidade e seguranca da sertralina (50 mg a 200 mg) durante 8 semanas no tratamento de 150 pacientes ambulatoriais com depressao maior

Os resultados de um estudo multicentrico, aberto e nao comparativo, no qual foram avaliados 150 pacientes com diagnostico de depressao maior de acordo com os criterios do DSM-III-R, sao relatados. Os pacientes selecionados foram inicialmente submetidos a um periodo simples-cego de placebo, durante 2 semanas. Apos essa fase, aqueles que preenchiam os criterios de inclusao e exclusao iniciaram o tratamento com sertralina 50 mg/dia que poderia ser aumentada gradualmente ate 200 mg/dia, em incrementos de 50 mg, e intervalos de no minimo 2 semanas, caso a resposta ao tratamento fosse insatisfatoria, segundo a avaliacao do investigador. O tratamento com sertralina mostrou-se altamente eficaz no alivio da depressao, como tambem nos sintomas associados ao quadro depressivo como, ansiedade, transtornos do sono, agitacao ou inibicao psicomotora, trabalho e atividades, entre outras. Um total de 84,2 por cento dos pacientes responderam satisfatoriamente ao tratamento com sertralina em doses flexiveis. Em relacao a tolerabilidade, um total de 54 por cento dos pacientes apresentaram algum efeito adverso ao longo do tratamento, porem estes efeitos foram geralmente de intensidade leve ou moderada e apenas 4,6 por cento dos pacientes interromperam o tratamento premeturamente devido a ocorrencia de eventos adversos.

Fungal nucleic acids as interferon inducers.

Nucleic acids isolated from the fungi Aspergillus niger x11, Piptoporus betulinus and Ganoderma applanatum reduced the number of vaccinia virus plaques in chick embryo fibroblast (CEF) tissue culture and when administered intravenously to white mice protected them against lethal infection with tick borne encephalitis virus strain K5 (TBE). In CEF tissue culture the nucleic acids of the studied fungi were found to induce small but detectable amounts of a substance with the character of interferon. In vivo only ribonucleic acid from G. applanatum induced a substance showing interferon properties in the spleen of mice.