ABSTRACT Objective: The aim of this study was to investigate the effect of childhood Type 1 diabetes (DM) on ocular parameters. Subjects and methods: Forty-six children with Type 1 DM without diabetic retinopathy (Group 1) and 76 healthy children (Group 2) were included in the study. Routine eye examinations and fundus photography were performed. Central corneal thickness (CCT), contract ultrasonic pachymetry and intraocular pressure (IOP) were measured. Retinal nerve fibre layer (RNFL) thickness was measured in four separate quadrants. Central 1-mm maximum retinal thickness and minimum full retinal thickness at the foveal pit (MFRT) were measured with the same Fourier-domain optical coherence tomography. Data for the two groups were then compared. Results: One hundred thirty-five children were included. Mean CCT and IOP values did not differ significantly between the groups (p > 0.05). Minimum foveal thickness (p < 0.05) and MFRT (p = 0.008) measurements in Group 1 were significantly lower compared to those in Group 2. No significant difference was determined between the groups in terms of mean, inferior, superior, nasal or temporal MFRT (p > 0.05). Conclusion: Variations may arise in IOP and CCT in children with Type 1 DM. Neurodegenerative processes in the retina may begin before the onset of diabetic retinopathy.

RESUMEN Objetivo: El objetivo de este estudio fue investigar el efecto de la diabetes tipo 1 (DM) en los parámetros oculares en la niñez. Sujetos y métodos: En el estudio se incluyeron cuarenta y seis niños con DM tipo 1 sin retinopatía diabética (Grupo 1) y 76 niños sanos (Grupo 2). Se realizaron exámenes oculares de rutina y fotografías de fondo de ojo. Se midieron el espesor corneal central (ECC), paquimetría ultrasónica y la presión intraocular (PIO). El espesor de capa de fibras ner-viosas de la retina (CFRN) se midió en cuatro cuadrantes separados. El espesor foveal central mínimo (EFCM) de 1 mm y el espesor retiniano completo mínimo en el pozo foveal (ERCM) se midieron con la misma tomografía de coherencia óptica en el dominio de Fourier. Luego se compararon los datos de los dos grupos. Resultados: Se incluyeron treinta y cinco niños. Los valores promedio de ECC y PIO no difirieron significativamente entre los grupos (p > 0.05). Las mediciones del espesor foveal mínimo (p < 0.05) y ERCM (p = 0.008) en el Grupo 1 fueron significativamente más bajas en comparación con las del Grupo 2. No se determinaron diferencias significativas entre los grupos en términos de ERCM medio, inferior, superior, nasal o temporal (p > 0.05). Conclusión: Pueden presentarse variaciones en la PIO y el ECC en los niños con DM tipo 1. Los procesos neurodegenerativas en la retina pueden comenzar antes de la aparición de la retinopatía diabética.

ABSTRACT Objective: The study aimed to assess tendon thickness in patients with chronic occupational lead exposure by using ultrasonography. Methods: Twenty-seven male workers (mean age 32.9 ± 6.2 years, range 25−44 years) with occupational lead exposure and 27 age- and body mass index (BMI)-matched healthy male subjects (mean age 33.1 ± 5.6 years, range 25−44 years) were enrolled. Ultrasonographic measurements were obtained from the supraspinatus and Achilles tendons by using a linear probe (5−10 MHz). Results: Mean Achilles tendon values at long axis (p = 0.034) and tendon cross-sectional area (p = 0.013) were significantly smaller in the lead-exposed group than the control group. On the other hand, no significant difference was found regarding the thickness of the supraspinatus tendon (p > 0.05). Conclusion: Our preliminary results imply that subjects with occupational lead exposure have smaller Achilles tendons than healthy subjects. Chronic lead exposure may affect the tendons due to reduction of collagen synthesis. Further studies are definitely needed to confirm our initial findings.

RESUMEN Objetivo: El estudio tuvo por objetivo evaluar el grosor del tendón en pacientes con exposición ocupacional crónica al plomo mediante el uso de la ultrasonografía. Métodos: Se alistaron veintisiete trabajadores varones (edad promedio 32.9 ± 6.2 años, rango 25−44 años) con exposición ocupacional al plomo, y 27 sujetos sanos pareados por edad e índice de masa corporal (IMC) (edad promedio 33.1 ± 5.6 años, rango 25−44 años). Se obtuvieron medidas ultrasonográficas de los tendones de Aquiles y supraespinosos utilizando una sonda lineal (5−10 MHz). Resultados: Los valores promedio del tendón de Aquiles en el eje largo (p = 0.034) y el área transversal del tendón (p = 0.013) fueron significativamente menores en el grupo de expuestos al plomo que en el grupo de control. Por otro lado, no se encontraron diferencias significativas en relación con el grosor del tendón supraespinoso (p > 0.05). Conclusión: Nuestros resultados preliminares implican que los sujetos con exposición ocupacional al plomo tienen tendones de Aquiles más pequeños que los sujetos sanos. La exposición crónica al plomo puede afectar los tendones debido a la reducción de la síntesis de colágeno. Definitivamente se necesitan más estudios para confirmar nuestros hallazgos iniciales.

ABSTRACT Objective: To evaluate femoral cartilage thickness in patients with ankylosing spondylitis (AS) by using ultrasonography. Methods: Eighty-four patients (55 M, 29 F) with a diagnosis of AS and 84 age-, gender- and body mass index-matched healthy subjects were enrolled. Demographic and clinical characteristics of the patients including disease duration, morning stiffness and medications were recorded. The femoral cartilage thicknesses of both knees were measured with a 7–12 MHz linear probe while subjects’ knees were held in maximum flexion. Three mid-point measurements were taken from both knees (lateral femoral condyle (LFC), intercondylar area (ICA) and medial femoral condyle (MFC)). Results: Concerning both ICA (p < 0.001) and left MFC (p = 0.013), cartilage measurements were significantly thicker in AS patients than control subjects. In a subgroup analysis (anti-tumour necrosis factor (TNF) users vs anti-TNF naive) cartilage thickness measurements – bilateral ICA (p = 0.000) and left MFC (p = 0.017) – were found to be greater in AS patients under anti-TNF treatment (n = 65) when compared with those of healthy controls. Conclusion: We imply that AS patients seem to have thicker femoral cartilage, which could be related to anti-TNF treatment.

RESUMEN Objetivo: Evaluar el grosor del cartílago femoral en pacientes con espondilitis anquilosante (EA) mediante el uso de la ultrasonografía. Métodos: Se reclutaron ochenta y cuatro pacientes (55 M, 29 F) con un diagnóstico de EA y 84 sujetos saludables apareados por edad, género e índice de masa corporal. Se registraron las características demográficas y clínicas de los pacientes, incluyendo medicamentos, rigidez matutina, y duración de la enfermedad. Los espesores del cartílago femoral de ambas rodillas se midieron con una sonda lineal de 7–12 MHz mientras que los sujetos sostenían sus rodillas en máxima flexión máxima. Se llevaron a cabo tres mediciones de punto medio desde ambas rodillas: cóndilo femoral lateral (CFL), área intercondílea (AIC), y cóndilo femoral medial (CFM). Resultados: En relación tanto en AIC (p < 0.001) como en CFM izquierdo (p = 0.013), las mediciones del cartílago fueron significativamente de mayor grosor en los pacientes con EA que en los sujetos del control. En un análisis de los subgrupos (usuarios de anti-TNF frente a pacientes anti-TNF-ingenuos), se halló que las mediciones del espesor del cartílago – AIC bilateral (p = 0.000) y CFM izquierdo (p = 0.017) – fueron mayores en pacientes bajo tratamiento anti-TNF (n = 65) en comparación con aquellas de los controles sanos. Conclusión: Eso implica que los pacientes con EA tienen al parecer un cartílago femoral más grueso, lo cual podría estar relacionado con el tratamiento anti-TNF.

The objective of the present study was to investigate the effect of leptin on the progression of colorectal carcinoma to metastatic disease by analyzing the serum leptin concentration and Ob-R gene expression in colon cancer tissues. Tissue samples were obtained from 31 patients who underwent surgical resection for colon (18 cases) and metastatic colon (13 cases) cancer. Serum leptin concentration was determined by an enzyme-linked immunosorbent assay (ELISA) and Ob-R mRNA expression by real-time polymerase chain reaction (RT-PCR) for both groups. ELISA data were analyzed by the Student t-test and RT-PCR data were analyzed by the Mann-Whitney U-test. RT-PCR results demonstrated that mRNA expression of Ob-R in human metastatic colorectal cancer was higher than in local colorectal cancer tissues. On the other hand, mean serum leptin concentration was significantly higher in local colorectal cancer patients compared to patients with metastatic colorectal cancer. The results of the present study suggest a role for leptin in the progression of colon cancer to metastatic disease without weight loss. In other words, significantly increased Ob-R mRNA expression and decreased serum leptin concentration in patients with metastatic colon cancer indicate that sensitization to leptin activity may be a major indicator of metastasis to the colon tissue and the determination of leptin concentration and leptin gene expression may be used to aid the diagnosis.

Competitive advantage is a dynamic concept. Competitive advantage focuses on a variety of competitive alternatives. These alternatives include for example people, quality, speed, innovation, service, leadership, time utility and place utility. Developing a competitive strategy is vital to the survival and prosperity of any organisation. The objective of this study is to establish to which extent employees perceive people as a competitive advantage factor and use employees to gain and sustain competitive advantage for success. The population focus on employees at a leading bank. The empirical study considers bank learnership candidates (employees) as sample and people as a competitive advantage factor. The study yielded a minimum response rate of 98.7%. Analysing and establishing which people factors contributes to establishing a competitive advantage will ensure future organisational success and provide leaders with direction. Skill development; empowering members of the work force; and treating employees well has been identified as the three most prominent factors to consider when establishing people as a competitive advantage factor with reference to the research group. Learning and skill development programmes are therefore recommended to enhance the people factor for sustainability. Leadership development and employee support empowerment are of essence.