Yield of the PMP22 deletion analysis in patients with compression neuropathies

Journal of Neurology - Hereditary neuropathy with liability to pressure palsies (HNPP) is a rare neuromuscular disorder, mostly caused by PMP22 deletion. To determine a yield of the genetic...     

Developing a model of perceptions of security and insecurity in the context of crime

The current study was carried out as part of the CITYCOP project exploring fear of crime, risk perception and feelings of security and insecurity. Participants (n = 272) from 11 European countries answered a questionnaire exploring measures of risk perception, fear of crime, anxiety, trust in police and related behaviours. A seven-factor structure is proposed incorporating ‘Signs of Social and Physical Disorder’, ‘Trust in Police’, ‘Trait Anxiety’, ‘Collective Efficacy’, ‘Perceived Risk of Victimisation’, ‘Fear of Personal Harm’ and ‘Fear of Property Theft’. Overall findings suggest that the measures associated with feelings of insecurity are negatively related to the measures associated with feelings of security. Efforts should be made to reduce feelings of insecurity through encouraging trust in law enforcement and community interaction and reducing signs of social and physical disorder.     

Day services for people with mental handicaps: A PURPOSE IN LIFE?

There is a continuing debate about the future of day services for people with mental handicaps. In this study people who attended adult training centres were interviewed to ascertain their views on their day placements. They were glad to have somewhere to go during the day and enjoyed elements of the daily programmes. However, most people felt that in the long-term the services did not make a positive contribution to their lives and wished for ordinary jobs.     

HIV‐associated psoriasis: Epidemiology,pathogenesis, and management

People living with HIV (PLWH) are affected by a higher incidence skin disorders, which are often associated with high morbidity and mortality. In particular, psoriasis affects PLWH severely and for a longer time than the general population. Human immunodeficiency virus (HIV) infection is characterized by a progressive decrease in CD4⁺ T‐cell count, and it could seem paradoxical that psoriasis exacerbations are more frequent in this subset of patients than the general population, even though it is commonly observed at any stage of infection. For a long time, there have been limited therapeutic choices for PLWH affected by psoriasis. The introduction of the combined antiretroviral therapy dramatically changed the natural course of both HIV and psoriasis in PLWH, leading to an improvement of quality and duration of life. However, the clinical severity of psoriasis in PLWH often requires the use of immunosuppressant drugs. Knowledge about their safety and efficacy are limited to case‐reports, small case‐series and studies, therefore their use has not yet entered the routine. Further studies are needed to determine if immunosuppressive drugs can be safely and effectively used in PLWH affected by psoriasis and other autoimmune disorders.     

Phase Evaluation,Mechanical Properties and Thermal Behavior of Hot-Pressed LC-YSZ Composites for TBC Applications

In this work, La₂Ce₂O₇-yttria-stabilized zirconia (LC-YSZ) composites with different weight fractions of YSZ (40–70 wt.%) were prepared by hot pressing at 1400 °C and investigated as a material for thermal barrier-coating (TBC) applications. For this purpose, the effect of YSZ addition on the phase composition, microstructure, mechanical performance and thermal behavior was studied. X-ray diffraction analysis showed that the LC-YSZ composites were mainly composed of a cubic ZrO₂ and La₂O₃-CeO₂-ZrO₂ solid solution with a pyrochlore structure, indicating that the reaction between LC and YSZ took place during hot pressing. Scanning electron microscopy revealed the high microstructural stability of the prepared composites, as the pore formation was significantly controlled and a high relative density (>97%) was obtained. The microstructure of LC-YSZ bulk samples was relatively fine-grained, with an average grain size below or very close to 1 µm. YSZ doping improved the Vickers hardness of the LC-YSZ composites; the highest hardness, with value of 12 ± 0.62 GPa, was achieved for the composite containing 70 wt.% of YSZ. The fracture toughness of LC-YSZ composites was in the range from 2.13 to 2.5 MPa·m^1/2. No statistically significant difference in heat capacity or thermal conductivity was found between the composites with different content of YSZ. The results showed that LC-YSZ composites have relatively low thermal conductivities from room temperature (1.5–1.8 W·m⁻¹·K⁻¹) up to 1000 °C (2.5–3.0 W·m⁻¹·K⁻¹). This indicates that the prepared LC-YSZ composite materials are promising candidates for TBC applications.     

Inflammation and Cardiovascular Disease: From Pathogenesis to Therapeutic Target

Atherosclerosis represents the most common pathological substrate of coronary heart disease (CHD), and the characterization of the disease as a chronic low-grade inflammatory condition is now largely accepted. A number of mediators of inflammation have been widely studied, both as surrogate biomarkers and as causal agents, in the pathophysiological network of atherogenesis and plaque vulnerability. The epidemiological observation that biomarkers of inflammation are associated with clinical cardiovascular risk supports the theory that targeted anti-inflammatory treatment appears to be a promising strategy in reducing residual cardiovascular risk on the background of traditional medical therapy. A large number of randomized controlled trials have shown that drugs commonly used in cardiovascular disease (CVD), such as statins, may be effective in the primary and secondary prevention of cardiovascular events through an anti-inflammatory effect. Moreover, several anti-inflammatory drugs are being tested for their potential to reduce residual cardiovascular risk on the background of validated medical therapy for atherosclerotic disease. In this paper, we review relevant evidence with regard to the relationship between inflammation and CVD, from pathogenesis to therapeutic strategies.     

Factors affecting blood loss in total knee arthroplasty patients

The aim of the study was to identify the factors affecting major blood loss in patients undergoing total knee arthroplasty (TKA), in order to reduce blood loss and requirements for blood transfusion. This prospective randomized study included 80/184 patients treated by TKA at University Hospital of Traumatology, Zagreb, Croatia, from January 2005 till December 2007. The following parameters were analyzed: patient age, sex, body mass index (BMI), arterial blood pressure, preoperative hemoglobin level and hemoglobin level preceding blood transfusion, length of surgery, blood loss and volume of blood transfused. According to patient age, there were no differences in the length of surgery, blood loss volume, hemoglobin level before blood transfusion and use of blood transfusion. Older patients had lower hemoglobin level before blood transfusion and received greater volumes of blood transfusion, but the difference was not statistically significant. Male patients had a significantly higher preoperative hemoglobin level as compared to female patients (P = 0.012). The mean volume of blood loss and of transfused blood was larger in male than female patients, however, the difference did not reach statistical significance. According to BMI, there were no differences in the length of surgery, blood loss, volume of transfused blood and hemoglobin level before transfusion. Patients with a lower preoperative hemoglobin level did not lose more blood during and after surgery, but the requirement for blood transfusion was significantly higher (P = 0.014). Hypertensive patients had a statistically greater perioperative blood loss (P = 0.038), but did not receive more transfused blood (P = 0.494). Preoperative hemoglobin level was higher in patients with elevated arterial blood pressure than in those with normal blood pressure, but the difference was not statistically significant (P = 0.595). Hemoglobin level before blood transfusion was also higher in hypertensive patients than in those with normal blood pressure, but it was not statistically significant (P = 0.288). In patients with longer duration of surgery, blood loss and volume of blood transfused blood were statistically significantly greater (P = 0.003 and P = 0.015, respectively). Study results yielded a significant positive correlation between the length of surgery and the volume of blood loss (r = 0.282; P = 0.011) as well as between the length of surgery and the volume of blood transfused (r = 0.362; P = 0.001). A significant negative correlation was established between the preoperative hemoglobin level and application of blood transfusion (r = -0.250; P = 0.025). Patients with hypertension had a significantly larger blood loss volume as compared to patients with normal arterial pressure (P = 0.038) and received more blood transfusions than patients with normal blood pressure, but the difference was not statistically significant (P = 0.494). Age, sex and BMI had no statistically significant effect on blood loss volume and application of blood transfusion. Male patients had a significantly higher preoperative hemoglobin level (P=0.012), larger mean blood loss volume (P = 0.057) and received more blood transfusions than female patients, however, the difference did not reach statistical significance (P = 0.562). Based on study results, it is concluded that requirements for blood transfusion will be greater in patients with hypertension and lower preoperative hemoglobin level as well as in all cases with longer duration of surgery. To reduce the use of allogeneic blood transfusion, it is necessary to correct arterial blood pressure before surgery in hypertensive patients and also to magnify preoperative hemoglobin level if it is lower.     

Aging affects the responsiveness of rat peritoneal macrophages to GM-CSF and IL-4

Macrophages undergo significant functional alterations during aging. The aim of the present study was to investigate changes of rat macrophage functions and response to M1/M2 polarization signals with age. Therefore, resident and thioglycollate-elicited peritoneal macrophages from young (3-month-old) and aged (18–19-month-old) rats were tested for phagocytic capacity and ability to secrete inflammatory mediators following in vitro stimulation with LPS and GM-CSF, and IL-4, prototypic stimulators for classically (M1) and alternatively activated (M2) macrophages, respectively. Aging increased the frequency of monocyte-derived (CCR7+ CD68+) and the most mature (CD163+ CD68+) macrophages within resident and thioglycollate-elicited peritoneal macrophages, respectively. The ability to phagocyte zymosan of none of these two cell subsets was affected by either LPS and GM-CSF or IL-4. The upregulated production of IL-1β, IL-6 and IL-10 and downregulated that of TGF-β was observed in response to LPS in resident and thioglycollate-elicited macrophages from rats of both ages. GM-CSF elevated production of IL-1β and IL-6 in resident macrophages from aged rats and in thioglycollate-elicited macrophages from young rats. Unexpectedly, IL-4 augmented production of proinflammatory mediators, IL-1β and IL-6, in resident macrophages from aged rats. In both resident and thioglycollate-elicited macrophages aging decreased NO/urea ratio, whereas LPS but not GM-SCF, shifted this ratio toward NO in the macrophages from animals of both ages. Conversely, IL-4 reduced NO/urea ratio in resident and thioglycollate-elicited macrophages from young rats only. In conclusion, our study showed that aging diminished GM-CSF-triggered polarization of elicited macrophages and caused paradoxical IL-4-driven polarization of resident macrophages toward proinflammatory M1 phenotype. This age-related deregulation of macrophage inflammatory mediator secretion and phagocytosis in response to M1/M2 activators may lead to the deficient control of infectious and/or inflammatory diseases in advanced age.