Can ficolin‐2 (L‐ficolin) insufficiency be established by a single serum protein measurement?

Serum ficolin‐2 was measured in multiple (2‐27) samples from 68 paediatric sepsis patients. Fourteen individuals (21%) gave values that included a change in status from ‘normal’ to ‘insufficient’ or vice versa. Therefore, if possible, ficolin‐2 concentration should be determined in samples obtained when a disease is inactive.     

Short-term glucose variability in healthy volunteers is not associated with raised oxidative stress markers

It is unknown whether glycaemic variability adds to the risk of microvascular complications of diabetes over and above the mean glucose value for a patient. We examined the effect of purposefully induced short‐term glycaemic variability on oxidative stress markers. Eleven healthy subjects underwent three sequential glycaemic states; sustained hyperglycaemia, sustained euglycaemia and variable glycaemia, using glycaemic clamps for 3 h. Twenty‐four hours urinary 8‐isoprostane‐PGF2α was measured before and after each glycaemic state to assess oxidative stress. The median and interquartile range of the urinary 8‐iso‐PGF2α in ng/24 h were (1373, 513), (996, 298) and (1227, 472) for the euglycaemic, hyperglycaemic and variable states, respectively. There was no significant difference in urinary isoprostanes between the three different states; mean ranks 20.9, 11.9 and 18.2 for the euglycaemic state, hyperglycaemic state and glycaemic variability state, respectively, p = 0.083. In conclusion, we did not see a significant increase in the urinary isoprostanes when glycaemic variability was induced under controlled conditions in healthy individuals.     

Development of a single numerical expression for the results of multiple screening tests for immune complexes in diabetic patients: use in statistical comparison of clinically and biochemically defined patient populations

A series of 88 diabetic patients were studied for the presence of soluble immune complexes, proteinuria, microangiopathy, and diabetic complications. Results of the five different assays for immune complexes were analyzed individually, and four combinations of the individual results (i.e. four different immune complex "scores") were also analyzed. The only assay which consistently discriminated between the different patient groups was the PEG-IgG test, in which a ratio between the amount of IgG precipitated with 3% PEG 6000 and the serum concentration of IgG is determined. In contrast, all four of the immune complex "scores" detected significant differences between patients with and without the clinical or biochemical parameter in question. One combination, designated as the "weighted and corrected IC score", gave a particularly high probability of detecting differences between groups. These results indicate that proper compilation of the results of a battery of immune complex screening assays can provide definite advantages over the results of individual tests for the investigation of correlations between the presence of soluble immune complexes and the course and pathology of various diseases.     

Successful aztreonam treatment of acute typhoid fever after chloramphenicol failure

Aztreonam treatment was successful in 4 cases of typhoid fever. The patients were seriously ill with growth of Salmonella typhi in blood cultures despite treatment with chloramphenicol. Aztreonam appears to be a useful alternative to standard therapy of typhoid fever.     

Dexras1/AGS-1, a steroid hormone-induced guanosine triphosphate-binding protein, inhibits 3',5'-cyclic adenosine monophosphate-stimulated secretion in AtT-20 corticotroph cells

Dexras1 is a novel GTP-binding protein that shares structural similarity with the Ras family of small molecular weight GTPases and is strongly and rapidly induced during treatment with dexamethasone. The function of Dexras1 and its contribution to glucocorticoid-dependent signaling in the corticotroph cell are unknown. The present study was undertaken to examine the potential role of Dexras1 in the regulation of peptide hormone secretion in the AtT-20 corticotroph cell line. To determine the effects of Dexras1 expressed independently of glucocorticoid treatment, expression plasmids for wild-type and constitutively active mutant Dexras1 proteins were cotransfected with human GH (hGH), which provides an ectopic marker for the stimulus-coupled secretory pathway. GTP binding properties and the GTP to GDP ratio of wild-type and mutant Dexras1 proteins were examined in transiently transfected AtT-20 and COS-7 cells. Stimulated and constitutive components of secretion were assessed after 2-h incubations with 5 mM 8-Br-cAMP or control. cAMP treatment led to a 2-fold increase in hGH secretion relative to control. Cotransfection of wild-type Dexras1 had no effect on cAMP-stimulated hGH secretion, but a constitutively active mutant, Dexras[A178V], attenuated stimulated secretion by 86% (P < 0.01). A double-mutant containing a deletion of the carboxyl terminus isoprenylation site, Dexras[A178V/C277term], did not inhibit cAMP-stimulated hGH secretion, indicating that the effect is prenylation dependent. These findings suggest that activation of Dexras1 has important functional consequences leading to inhibition of stimulus-secretion coupling in corticotroph cells. Because Dexras1 messenger RNA is strongly and rapidly induced during glucocorticoid treatment, these results raise the possibility that Dexras1 may participate in the signal transduction pathways that govern the rapid regulatory effects of glucocorticoids on peptide hormone secretion in corticotroph cells.     

Stroke and conversion to high risk in children screened with transcranial Doppler ultrasound during the STOP study

The Stroke Prevention Trial in Sickle Cell Anemia (STOP) was a randomized multicenter controlled trial comparing prophylactic blood transfusion with standard care in sickle cell anemia (SCA) children aged 2 to 16 years selected for high stroke risk by transcranial Doppler (TCD). More than 2000 children were screened with TCD to identify the 130 high-risk children who entered the randomized trial. A total of 5613 TCD studies from 2324 children were evaluated. We also collected information on stroke. We describe the changes in TCD with repeated testing and report the outcome without transfusion in the STOP screened cohort. Risk of stroke was higher with abnormal TCD than with normal or conditional TCD (P <.001) or inadequate TCD (P =.002), and risk with conditional TCD was higher than with normal TCD (P <.001). Repeated TCD in 1215 children showed that the condition of 9.4% of children became abnormal during observation. Younger patients and those with higher initial flow velocities were most likely to convert to abnormal TCDs. Screening in STOP confirmed the predictive value of TCD for stroke. Substantial differences in the probability of conversion to abnormal TCD were observed, with younger children and those with higher velocity more likely to have an abnormal TCD with rescreening.