Pulse contour analysis: Is it able to reliably detect changes in cardiac output in the haemodynamically unstable patient?

Three pulse contour systems for monitoring cardiac output - LiDCO Plus™, PiCCO Plus™ and FloTrac™ - were compared in postcardiac surgery patients. None of the three methods demonstrated good trending ability according to concordance analysis. Pulse contour systems remain unreliable in the haemodynamically unstable patient.     

Defective release of eosinophil chemotactic factor from peripheral leukocytes in patients with chronic urticaria.

Release of eosinophil chemotactic factor (ECF) and histamine was studied peripheral leukocytes of 16 normal and 12 ragweed allergic volunteers and compared to 15 patients with chronic urticaria. Cells were exposed to varying concentrations of anti-IgE or to ragweed antigen E in the case of allergic donors. Twelve of 15 patients with chronic urticaria showed defective release of ECF as well as histamine, while almost all normal and all allergic donors were able to release larger quantities of both mediators. Since the eosinophil is thought to have a modulating effect at sites of inflammation induced by anaphylactic mechanisms, the defective release of a factor attracting these cells may explain the persistence of symptoms in chronic urticaria.     

The role of basophils in inflammatory reactions.

This review demonstrates that basophils reflect skin and lung mast cell reactivity and show characteristic changes in mediator release associated with clinical disease. Although the numbers of IgE molecules and IgE receptors on basophils have been enumerated, these have, in most instances, little influence on the release of histamine after challenge. There is, rather, a parameter of "releasability" that may be a major variable in allergic disease states. Basophils contain and release histamine, the eosinophil chemotactic factor of anaphylaxis (ECFA), a slow reacting substance of anaphylaxis (SRS-A), and a kallikrein. The release process is controlled by hormone-basophil receptor interactions that determine the cyclic AMP level; plasma and tissue adenosine levels appear prominent in this control. Histamine feeds back to negatively modulate basophil and mast cell release through a specific histamine 2-receptor; it also inhibits lymphocyte and neutrophil function. Like neutrophils, basophils contain beta-glucuronidase while neutrophils contain SRS-A and a low-molecular-weight ECF. The stimuli for primary basophil and neutrophil release are, however, quite different, although phagocytic stimuli, which fail to cause basophil mediator release, potentiate the IgE response. It is concluded that basophols play a significant in vivo role in inflammation by acting as an interface between foreign antigens, the serum cascade systems, and other inflammatory cells.     

The lipid profile in psoriasis: a controlled study

BACKGROUND: Psoriasis is an inflammatory dermatosis that is characterized with hyperproliferation of keratinocytes and inflammatory infiltration in the epidermis and dermis. The high prevalence of atherosclerosis has been reported in psoriatic patients. High serum lipid level has been suggested in the pathogenesis of this phenomenon. In this study, our purpose was to compare the lipid profile in psoriatic patients with non-affected persons. METHODS: This study was designed and conducted as a case-control assay with 50 cases in the patient and control groups, respectively. The lipid profile, including serum level of triglyceride, cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL), were assessed in both groups. RESULTS: The patient and control groups each consisted of 50 cases (39 male and 11 female). The serum triglyceride, cholesterol, and LDL was significantly higher in psoriatic patients (P < 0.05) but not for HDL (P = 0.29). CONCLUSION: This study, like previous assays, shows that high serum lipid level is significantly more common in psoriasis. This fact may be responsible for higher prevalence of cardiovascular accident in psoriatic patients. It may be useful to do early screening and treatment of hyperlipidaemia in psoriasis to prevent the atherosclerosis and its complications.     

Impact of broadening definitions of anorexia nervosa on sample characteristics

Practical limitations and sample size considerations often lead to broadening of diagnostic criteria for anorexia nervosa (AN) in research. The current study sought to elucidate the effects of this practice on resultant sample characteristics in terms of eating disorder behaviors, psychiatric comorbidities, temperament and personality characteristics, and heritability point estimates. Three definitions of AN were created: meeting all Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria for AN (AN-DSM-IV), meeting all DSM-IV criteria except criterion D, amenorrhea, (AN-noD), and broadening DSM-IV AN criteria by allowing a higher body mass index value, eliminating criterion D, and allowing less stringent body weight concerns (AN-Broad). Using data from the Swedish Twin Registry, 473 women fit one of the three definitions of AN. Women with AN-DSM-IV reported significantly more eating disorder behaviors than women with AN-Broad. Women with AN-noD reported more comorbid psychiatric disorders than women with AN-DSM-IV and AN-Broad. Temperament and personality characteristics did not differ across the three groups. Heritability point estimates decreased as AN definition broadened. Broadening the diagnostic criteria for AN results in an increased number of individuals available for participation in research studies. However, broader criteria for AN yield a more heterogeneous sample with regard to eating disorder symptoms and psychiatric comorbidity than a sample defined by narrower criteria.