Hereditary angioedema

Although the condition is rare, patients with hereditary angioedema often present because of abdominal pain or airway compromise. A 27-year-old woman presented to the emergency department in acute abdominal distress. Identification of the disease in this patient allowed for proper management and avoidance of invasive procedures. Pathophysiology, clinical manifestations, diagnosis, and therapy of hereditary angioedema are discussed.     

Evaluation of a rapid theophylline test strip assay in the emergency department setting

Test strips recently have become available to measure theophylline levels. One such test strip (AccuLevel) had not been tested in an actual clinical situation with nontechnician personnel. We prospectively evaluated the test strip on consecutive emergency department patients, comparing it with the agglutination inhibition method used by our hospital laboratory. Nurses and medics who ran the test were given only a brief demonstration and explanation of the manufacturer's instructions. The 61 test strip levels correlated highly with the laboratory results (r = 0.92, slope = 0.89, y-intercept = 0.99). The test strip results were available in less time (mean of 0.51 hours vs 1.89 hours for the laboratory, P less than .0001). The most accurate readings were obtained by those who ran the test most frequently. Caffeine intake did not influence the test. Cost was significantly lower than charges at local hospitals.     

Editorial Commentary: Which to Fix—the Biceps or the Labrum? The Shoulder SLAP Tear Is Still Controversial

A type II SLAP tear in a young and active patient remains a controversial and challenging clinical entity. Arthroscopic repair is generally a successful procedure for type II SLAP lesions, but the results can be unpredictable. Biceps tenodesis has become increasingly popular for the management of these lesions, with recent clinical literature suggesting that the results may be equivalent or superior to those of SLAP repair. Recent meta-analyses have summarized the available clinical data and offered some guidance on which patients may benefit most from either procedure.     

A description of a new DR allele, DRB1*1113

Abstract: We have discovered a previously unpublished HLA-DRB1 allele, observed in a patient (SB), his mother, and one sibling. The undefined allele gave sporadic positive reactions with sera in the DR52-associated group. SSOPH analysis utilizing both generic and group specific primers and probes also gave ambiguous results. SB typed clearly as a DRB 1*0301 (paternal allele) but the DNA from SB also bound probes specific for DRB 1*14 and DRB1*11. Sequencing revealed that the undefined allele was similar to a DRB 1*14 allele with a segment of sequence found in DRB1*11 alleles. The patient was MLC reactive with donors who express DRB1*0301, *1401 and *0301, *11 and was nonreactive solely to DRB 1*0301 (Dw3) homozygous typing cells.     

Lactobacillus rhamnosus CNCM I-3690 and the commensal bacterium Faecalibacterium prausnitzii A2-165 exhibit similar protective effects to induced barrier hyper-permeability in mice

Impaired gut barrier function has been reported in a wide range of diseases and syndromes and in some functional gastrointestinal disorders. In addition, there is increasing evidence that suggests the gut microbiota tightly regulates gut barrier function and recent studies demonstrate that probiotic bacteria can enhance barrier integrity. Here, we aimed to investigate the effects of Lactobacillus rhamnosus CNCM I-3690 on intestinal barrier function. In vitro results using a Caco-2 monolayer cells stimulated with TNF-α confirmed the anti-inflammatory nature of the strain CNCM I-3690 and pointed out a putative role for the protection of the epithelial function. Next, we tested the protective effects of L. rhamnosus CNCM I-3690 in a mouse model of increased colonic permeability. Most importantly, we compared its performance to that of the well-known beneficial human commensal bacterium Faecalibacterium prauznitzii A2-165. Increased colonic permeability was normalized by both strains to a similar degree. Modulation of apical tight junction proteins expression was then analyzed to decipher the mechanism underlying this effect. We showed that CNCM I-3690 partially restored the function of the intestinal barrier and increased the levels of tight junction proteins Occludin and E-cadherin. The results indicate L. rhamnosus CNCM I-3690 is as effective as the commensal anti-inflammatory bacterium F. prausnitzii to treat functional barrier abnormalities.     

Skeletal muscle satellite cell populations in healthy young and older men and women

The purpose of the present investigation was to assess satellite cell populations and morphology in m. vastus lateralis biopsies obtained from young (20-30 years) and older (65-75 years) healthy, sedentary men and women. Multiple muscle biopsies were obtained from 14 young individuals (men, n = 7; women, n = 7) and 15 older individuals (men, n = 8; women, n = 7). Muscle fibers were viewed longitudinally using a Zeiss EM 10 CA electron microscope. All myonuclei and satellite cells were counted and satellite cells were photographed for morphological analysis. The proportion of satellite cells [satellite cells/(myonuclei + satellite cells)] did not differ among the four subject groups (1.7-2.8%), nor did proportions differ when subject groups were combined for age and gender comparisons. Few morphological differences were noted between groups; however, lipofuscin granules were more prominent in satellite cells from older subjects and women demonstrated significantly larger satellite cell and satellite cell nucleus areas than men. Mitochondria from satellite cells (regardless of group) were more pallid and exhibited fewer cristae than mitochondria located in the adjacent muscle fiber. The results of the current investigation suggest that, despite findings in animal models, satellite cell populations are not significantly lower in healthy, sedentary older compared to young adult men and women.