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To determine the impact of a family history of the common form of type 2 diabetes and the phenotype of the proband on anthropometric and metabolic variables in normoglycemic first-degree relatives, we studied 2,100 first-degree relatives of patients with the common form of type 2 diabetes (FH+) and 388 subjects without a family history of diabetes (FH-). All subjects participated in an oral glucose tolerance test to allow measurement of insulin secretion [30-min incremental insulin/glucose (I/G 30)] and insulin sensitivity [homeostasis model assessment (HOMA) of insulin resistance (IR)]. A subset participated in a euglycemic clamp (n = 75) and an intravenous glucose tolerance test (n = 300). To study the effect of a particular phenotype of the proband, insulin secretion and sensitivity were also compared between first-degree relatives of diabetic probands with high and low waist-to-hip ratio (WHR) and probands with early and late onset of diabetes. FH+ subjects were more insulin resistant, as seen from a higher HOMA-IR index (P = 0.006) and a lower rate of insulin-stimulated glucose uptake (P = 0.001) and had more features of the metabolic syndrome (P = 0.02, P = 0.0002) compared with FH- subjects. Insulin secretion adjusted for insulin resistance (disposition index, DI) was also lower in the FH+ vs. FH- subjects (P = 0.04). Relatives of diabetic probands with a high WHR had reduced insulin-mediated glucose uptake compared with relatives of probands with a low WHR (P = 0.04). Relatives of diabetic patients with age at onset 65 yr (highest quartile). We conclude that early age at onset of type 2 diabetes and abdominal obesity have a significant influence on the metabolic phenotype in the nondiabetic first-degree relative. insulin secretion; insulin sensitivity; metabolic syndrome; genetics of type 2 diabetes

Abstract: Introduction: The aim of this study was to investigate the fatty acid (FA) pattern in breast milk of obese mothers and their neonates'' plasma compared to those of normal weight mothers. Patients and methods: This was an observational study of 41 obese and 41 normal weight pregnant women. Twenty-nine obese women participating in a weight reduction program were investigated for comparison. FAs were analyzed in breast milk collected at 3 and 10 days and one and two months postnatally and in infant''s plasma 3 days after birth. Results and conclusions: The concentration of long-chain n-3 FA were lower and the ratio n-6/n-3 FA higher in neonates and in consecutive samples of breast milk of obese mothers compared to normal weight mothers. The obese mothers that participated in an intervention program with general dietary advice had FA concentrations approaching that of the normal-weight mothers. The study indicates importance of dietary advice in pregnancy. [Copyright &y& Elsevier]

Objective: To analyse the outcome of minor amputations (through, or distal to, the ankle joint) in patients with diabetes. l Method: All diabetic patients in a defined population undergoing one or more minor amputation between 1982 and 2006 were investigated according to a standardized protocol and were followed until final outcome (healing or death). A total of 410 consecutive amputations in 309 patients with a median age of 73 (32–93) years were identified. l Results: In 94% of amputations, deep infection (39%) and/or gangrene (55%) was present. Severe peripheral vascular disease or critical limb ischaemia was present in 61% of amputations. 261/410 (64%) of the amputations healed at a level below the ankle joint; 69/410 (17%) healed after a reamputation above the ankle joint; in 76/410 of amputations (19%), the patient died before healing could occur. In surviving patients, 79% of the amputations healed below the ankle. Median healing time for amputationsthat healed below the ankle was 26 (2–250) weeks; 21% of amputations required a re-amputation above the ankle. None of the analysed parameters excluded the possibility of healing below the ankle. l Conclusion: In this population-based survey, the goal of avoiding major amputation was achieved in almost two thirds of minor amputations, but at the price of long healing times. In almost all amputations, the patient had deep infection and/or gangrene. In spite of this, 64% of all amputations, and 79% of amputations in surviving patients, healed at a level below the ankle. This indicates that minor amputations in these patients are worthwhile. l Declaration of interest: None. [ABSTRACT FROM AUTHOR]

Study design:Retrospective study.Objective:To examine the functional results and effect on quality of life of continent cutaneous urinary diversion in spinal cord injured patients.Setting:Department of Urology, Sahlgrenska University Hospital, Göteborg, Sweden.Subjects:A total of 10 patients with spinal cord injury (SCI).Method:The patients were operated on with an ileal reservoir (Kock reservoir or T-pouch), Cr-EDTA clearance was determined preoperatively and at follow-up. The patients answered a questionnaire concerning reservoir function, various activities and quality of life. The patient charts were reviewed.Results:One patient died of pulmonary embolism 3 years after surgery. Two patients were reoperated on for reservoir perforation. All patients were satisfied/very satisfied with their reservoirs. Half of them reported improved ability to perform various activities. Eight out of nine patients reported improved quality of life.Conclusion:For a selected group of patients with SCI, continent cutaneous urinary diversion provides successful outcome with improved quality of life.Spinal Cord (2006) 44, 19–23. doi:10.1038/sj.sc.3101811; published online 26 July 2005 [ABSTRACT FROM AUTHOR]

Provides information on a study examining the deletion of human apolipoprotein A-I (apoA-I). Methodology and materials used to conduct the study; Results of the study; Information on antibody binding to nascent HDL; Discussion on the results.

Since the cost of formwork for a concrete struc-ture may be 35 to 60 percent of the total cost of the concrete, factors which affect its design, such as tolerances, can significantly affect the cost of the project. Tolerance requirements which are too re-strictive can unnecessarily increase form costs. On the other hand, tolerances which are not restrictive enough can produce structures not having their designed strength, can fail during operations by such conditions as cavitation erosion when subjected to high velocity flows, and do not produce aesthet-ically pleasing structures. This paper discusses Bureau of Reclamation con-crete tolerance requirements and the many factors, such as design needs, specifications, construction quality control, and supervision that influence whether or not those tolerances are achieved. Ad-mitting that acceptable tolerances are not always achieved, remedial measures are briefly discussed. Illustrations demonstrate the importance of toler-ances in concrete construction. [ABSTRACT FROM AUTHOR]

We studied whether there is an association between the single nucleotide polymorphism c.533A>C (K121Q) in the glycoprotein PC-1 gene and features of the metabolic syndrome in case-control and intrafamily association studies in 922 subjects from Finland and Sweden. No difference was observed in the Q allele frequency between control subjects and type 2 diabetic subjects (12.9 vs. 15.1%). The QK genotype was associated with higher fasting plasma glucose (FPG) concentrations than the KK genotype in type 2 diabetic patients (P <0.001) and their relatives (P <0.05). A permutation test of siblings discordant for the QK and KK genotypes also showed that the nondiabetic siblings with the QK genotype had higher FPG (6.1 +/- 2.0 vs. 5.4 +/- 0.6 mmo/l, P <0.001) and fasting insulin (7.0 +/- 3.6 vs. 4.8 +/- 2.6 mU/l, P <0.05) concentrations than the carriers of the KK genotype. In addition, diabetic siblings with the QK genotype had higher systolic blood pressure (147.0 +/- 18.0 vs. 140.0 +/- 18.7 mmHg, P <0.05) and higher fasting (9.9 +/- 3.0 vs. 8.8 +/- 2.8 mmol/l, P <0.05) and 2-h plasma glucose (17.3 +/- 8.5 vs. 12.9 +/- 4.2 mmol/l, P < 0.05) concentrations than the diabetic carriers of the KK genotype. The present study shows that, although the Q allele of the human glycoprotein PC-1 gene is associated with surrogate measures of insulin resistance, it may not be enough to increase the susceptibility to type 2 diabetes. [ABSTRACT FROM AUTHOR]

The article discusses the study on the perioperative aspects of abdominal aortic surgery with regard to choosing anesthetics. The study reportedly involved an examination of the hypothesis that sevoflurane-based anesthesia can also protect the heart in major non-cardiac surgery. The results revealed that volatile anesthetics offer no cardioprotection compared with total intravenous anesthesia.