In uremia, plasma levels of anti-protein C and anti-protein S antibodies are associated with thrombosis

BACKGROUND: Vascular access thrombosis is an important cause of morbidity in patients with end-stage renal failure on maintenance hemodialysis (MHD). However, little is known about its risk factors. The present study was undertaken to evaluate the role of coagulation factors, fibrinolytic factors, and anti-phospholipid antibodies (aPL). In particular, we have evaluated the role of anti-protein C and anti-protein S antibodies in patients on MHD with and without thrombosis because no data are available in the literature. METHODS: The study group comprised 30 patients with thrombotic complications (TC), 40 patients matched for age, sex, and dialytic age with no thrombotic complications (NTC) and 400 controls. We have measured: anti-protein C antibodies, anti-protein S antibodies, anticardiolipin antibodies (ACA), anti-beta2-glycoprotein antibodies (beta2-GPI), and anti-prothrombin antibodies (aPT), along with prothrombin time, fibrinogen, plasminogen, protein C, protein S, anti-thrombin III, APC-resistance test, D-dimer, tissue-type plasminogen's activator, plasminogen activator inhibitor-1 (PAI-1), prothrombin fragment 1+2, factors of the intrinsic and extrinsic pathway, C-reactive protein, and homocysteine. RESULTS: There were no significant differences between groups for prothrombin time, fibrinogen, plasminogen, protein C, protein S, anti-thrombin III, activated protein C (APC) resistance, D-dimer, tPA, C-reactive protein, Factors II, X, and VII. The anti-beta2-GP1 and aPT were elevated in both TC and NTC patients, compared to the control group. Significant differences between TC and NTC groups were found for anti-protein C and anti-protein S antibodies, ACA-IgM, PAI-1, Factor VIII, prothrombin fragments 1+2, and homocysteine. CONCLUSION: The most novel finding was a significant elevation of anti-protein C antibodies and anti-protein S antibodies in the TC group (i.e., in patients on MHD with thrombosis of vascular access). It indicates that other pathogenetic mechanisms in addition to endothelial damage may cause hypercoagulability in uremia.     

The effects of lower-extremity total joint replacement for arthritis on obesity

Total hip or knee replacement patients who are overweight or obese often consider their disabling joint disease a cause for their increased weight. This prospective study investigated weight change in 100 patients after successful total joint replacement to determine whether surgical treatment of hip or knee arthritis leads to weight reduction. Postoperatively, both hip and knee replacement patients gained weight, with no difference in weight gain between hip and knee replacement patients. Younger hip patients gained a significant amount of weight. Patients a with normal body mass index and obese patients did not lose weight, while overweight patients gained a significant amount of weight after surgery. These findings demonstrate successful treatment of lower-extremity arthritis does not lead to weight loss, and obesity should be treated as an independent disease that is not the result of inactivity from arthritis.     

A Japanese woman living with cervical uterine cancer: a case study with the social phenomenology approach

This is the study of the experience of a Japanese woman with cervical uterine cancer carried out in a hospital in the city of Osaka, Japan, using Alfred Schütz's "case study" with the Social Phenomenology approach. The aim was to grasp the meaning of the disease and of hospitalization for this woman, and to try to understand the reasoning around her action. Through the analysis of the data, it was possible to understand that the hospitalization process has to be seen respecting, in addition to individual characteristics, the cultural world, which remits us to human actions and is an important influence on the behavior and attitude regarding the disease and hospitalization.     

Short report: serological evidence of West Nile virus activity in El Salvador

Epizootics of encephalitis in El Salvador killed 203 equines between November 2001 and April 2003. During an investigation of the outbreaks, 18 (25%) of 73 serum samples collected from stablemates of deceased animals in 2003 had antibodies to West Nile virus. Ten of these infections were confirmed by plaque reduction neutralization tests, suggesting West Nile virus has extended its range and spread to Central America.     

Regulatory T cells: prospective for clinical application in hematopoietic stem cell transplantation

PURPOSE OF REVIEW: Regulatory T cells exert a dominant effect in controlling autoimmunity and maintaining peripheral tolerance. Regulatory T cells are also involved in preventing allograft rejection and graft versus host disease. Cellular therapy with expanded regulatory T cells represents a promising approach to control T-cell mediated pathology. In this review we will summarize the efforts to design new methods for expanding regulatory T cells and exploit their regulatory function as cellular therapy for the treatment of graft versus host disease after hematopoietic stem cell transplantation. RECENT FINDINGS: Among CD4+ T cells, the best described are the naturally occurring CD4+CD25+ regulatory T cells and type 1 regulatory T cells. Recent progress has been made in the characterization of both subsets in terms of isolation and induction, respectively. However, a clear definition of their mechanisms of action has still to be achieved. SUMMARY: Better understanding of the mechanisms of suppression mediated by regulatory T cells might enable their use to modulate specific immune responses. Moreover, the recent development of methods allowing the ex-vivo expansion of regulatory T cells, to provide sufficient number of cells for in-vivo infusion, represents the first step toward the use of these cells as cellular therapy for the treatment of immunologic and hematological diseases.     

The anti-inflammatory effect of glucocorticoid-induced phospholipase inhibitory proteins

The anti-inflammatory effect of glucocorticoids has been investigated in two standard models of experimental inflammation, i.e. rat paw oedema induced by carrageenin or dextran. Both types of oedema are suppressed by dexamethasone while indomethacin and BW755C only suppress carrageenin oedema. Dexamethasone inhibits dextran oedema according to the accepted mode of action of steroid hormones since the inhibition occurs after a 2-3 h time lag and is abolished by pretreating animals with actinomycin D. Dextran oedema and carrageenin oedema are also controlled by endogenous corticoids since adrenalectomy potentiates the paw oedema formation induced by low concentrations of phlogogenic agents. It has been shown that glucocorticoids induce both in vitro and in vivo the formation and release of antiphospholipase proteins which are anti-inflammatory in that they greatly suppress carrageenin oedema. However, these proteins have no effect on dextran oedema. We conclude that the inhibition of dextran oedema by glucocorticoids depends on the formation of another type of anti-inflammatory protein.     

Laboratory and clinical features of experimental feline leptospirosis

In order to assess the clinical, laboratorial and epidemiological aspects of feline leptospirosis, ten female and male adult cats were experimentally inoculated with pathogenic and autochthonous field isolate of Leptospira interrogans. Five of them were inoculated subcutaneously with serovar icterohaemorrhagiae (R-192) and the others five with serovar canicola. No clinical and laboratorial alterations were found in these animals. Antileptospiral agglutinins were detected in 90% of the infected cats, shortly after the 1st week after inoculation. The leptospiral agglutinins were detected for 8 to 12 weeks and the elimination of leptospires through urine was observed only in animals infected with serovar canicola, beginning 2 to 4 weeks after inoculation and lasting for 2 to 8 weeks. Isolations of leptospires from blood and kidneys were unsuccessful.