A peculiar case of bilateral,spontaneous thromboses of the pampiniform plexi

Acute thrombosis of the pampiniform plexus is an uncommon clinical problem which causes a diagnostic conundrum in men presenting urgently to medical personnel. We present an unusual case of a young man who presented with metachronous thromboses of his pampiniform plexi and review the literature to explore potential aetiologies and therapeutic strategies.     

Interleukin-6 is a stronger prognostic predictor than high-sensitive C-reactive protein in patients with chronic stable heart failure

Heart failure is characterized by activation of the immune system which is strongly associated with disease severity and outcome. We sought to compare the prognostic impact of two established inflammatory markers — interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) — in patients with chronic heart failure. In stable, optimally managed outpatients with chronic heart failure, baseline levels of hsCRP and IL-6 were determined. Clinical follow-up was obtained and the rate of events (heart failure related deaths or hospitalizations) were recorded. We included 201 patients (32.7% female, NYHA class II [66.2%] or III [33.8%], mean age 70 years). During a median follow up of 614 (367−761) days, 64 (30.9%) patients experienced an event; those with an event had higher levels of hsCRP (median 2.93 [interquartile range 2.36−8.92] vs 2.23 [1.32−5.77] mmol/l) and IL-6 (7.8 [4.7−10.3] vs 4.3 [2.6−7.9] pg/ml). However, on Cox multivariate analysis, IL-6 but not hsCRP emerged as an independent predictor of prognosis (hazard ratio HR_adjusted 2.74, 95% confidence interval 1.17−6.43; P = 0.020). Our findings suggest that IL-6 is a better prognostic predictor than hsCRP in patients with chronic stable heart failure.     

嘌呤敏感途径影响视网膜节细胞轴突再生

目的：探讨影响视网膜节细胞轴突再生的细胞内信号传递途径。方法：采用金鲁视网膜节细胞培养及Western blot观察几种神经营养因子对视网膜节细胞轴突再生的影响。结果：AF－1、AF－2、CNTF能刺激视网膜节细胞轴突再生及GAP－43表达增强；6－硫鸟嘌呤（6－TG）能抑制AF－1、AF－2、CNTF对神经再生及GAP－43表达的促进；肌苷不仅能刺激视网膜节细胞轴突再生及GAP－43表达增强，而且能竞争性逆转6－TG对AF－1、AF－2、CNTF诱导神经再生的抑制。结论：上述几种神经营养因子通过一种嘌呤敏感途径的调节，能增强视网膜节细胞轴突再生及GAP0－43的表达。     

Sublethal and sex-specific cypermethrin effects in toxicity tests with the midge <Emphasis Type="Italic">Chironomus riparius</Emphasis> Meigen

We quantified sublethal and sex-specific cypermethrin effects in experiments (29 days) with the midge Chironomus riparius at different levels of sediment organic matter content (0, 5, and 20%). We found highly significant effects of cypermethrin concentrations and sediment type on emergence, mean development rate, and adult size. For example, emergence/survival rates were 70–100% below 0.8 μg/l and unaffected by organic matter content. At 3.2 μg/l, however, no larvae survived in sediment without organic matter, but survival successively increased to 26 ± 11% in sediment with 20% organic matter. Mean development rates were always higher for males than for females, and significant differences between sexes occurred consistently in controls and in treatments with our lowest concentration of 0.05 μg/l. Sex-specific differences in mean development rate decreased across the cypermethrin gradient, suggesting that male development was affected more than that of females at similar concentrations. We also found an increase in adult size across the concentration gradient in sediments lacking organic matter and suggest an increased feeding activity due to sublethal toxic stress as a probable causal mechanism. We speculate that the observed sex-specific effects on development rates and adult size can have strong repercussions on emergence timing and fecundity, respectively.     

Asthma Mortality Rates Among California Youths

Asthma mortality rates for California youths (ages 5-17 years) were examined over the period 1981-1995. Data were analyzed by Poisson regression from the California Departments of Vital Statistics, Finance, and the U.S. Census Bureau. Aggregate statewide mortality demonstrated a 2.01%, statistically insignificant, upward trend without geographic clustering. Stratified race/ ethnicity rates differed significantly, with African-American mortality twice that of the Caucasian population. In addition, an increased number of deaths occurred in households of African-Americans, Caucasians (including Hispanics), and Hispanics with incomes below statewide medians. This study on California youths differs from reports on larger populations with its minimal aggregate increase in asthma mortality, yet mirrors national trends of disproportionate impact on African-Americans and the economically disadvantaged.