The Boston Naming Test in Greek: Normative data and the effects of age and education on naming

Background: The Boston Naming Test (BNT) is widely used as a clinical assessment of language and cognitive deficits. It has been adapted and translated for use in other languages and cultures.

Aims: This study translated and adapted the test for use in Greece. Normative data were collected on the test for healthy Greek speakers of different ages and educational backgrounds.

Methods and Procedures: Participants in four different age ranges and with three levels of educational achievement were tested. They were screened for cognitive decline using a Greek version of the mini mental state examination.

Outcomes and Results: Strong effects of age and education were found on naming. The former replicates previous results. Results on the latter have been less consistent and their occurrence here reflects the greater inequality in educational opportunity that has existed in Greece until comparatively recent times. Significant interactions between age, education, and gender are interpreted as reflecting changing social and gender roles in Greek society. A reordering of items reflecting their difficulty for this Greek sample is presented for clinical use.

Conclusions: This study provides norms for a Greek version of the BNT. These highlight the effects of age and education on naming. Scores for many older and less‐educated participants might be taken to indicate pathology despite their lack of neurological or cognitive problems. This illustrates the need for norms that reflect local circumstances and the need to update norms as social and educational changes occur.     

Detection of colorectal circulating cancer cells with the use of a quantum dot labelled magnetic immunoassay method

Aim-Background

To evaluate the incorporation of cadmium selenide quantum dots (QDs) in the detection of colorectal cancer (CRC) circulating tumour cell (CTC) surface antigens.

Material and Methods

The principle of this assay is based upon the separation of CTCs from body fluids using magnetic beads (MBs) coupled with specific antibody biomarkers, such as the Epithelial cell Adhesion Molecule Antibody (EpCAM) and Cytokeratin 19 (CK19) antibody. The detection signal was acquired from the fluorescence signal of QDs. To evaluate the performance, the method under study was used to isolate the human colon adenocarcinoma cell line (DLD-1) and CTCs from CRC patients’ peripheral blood samples. Peripheral blood samples were obtained from 9 CRC patients (Table 1) and 5 healthy donors who gave their informed consent to their inclusion in the study. Peripheral venous blood was sampled immediately after CRC patients had received general anaesthesia, moments before surgery. In all patients, an intravenous cannula was used to collect blood into 7 ml vacutainers containing sodium ethylenediaminetetraacetic acid (EDTA). The first 7 ml of blood was discarded in order to reduce the risk of contamination from skin epithelial cells. Subsequently, 30 ml samples were collected at one-minute intervals (five 6 ml aliquots per 30 ml sample).

Results

The limit of detection (LOD) of the methodology described in the present study was determined at 10 DLD-1 cells/ml of sample as fluorescence measured with a spectrofluorometer. Fluorescence activated cell sorting (FACS) analysis and Real Time RT-PCR were also used to evaluate the performance of the method. Ultimately, in comparison to other methods currently in use, we developed a simple, sensitive, and more cost-effective method for the detection of CRC CTCs in human samples. Results were accomplished using magnetic bead isolation and subsequent QD fluorescence detection.

Conclusion

The present method can be readily adjusted to target a variety of proteins of either the CTC or the host.     

Prognostic value of C-reactive protein,fibrinogen, interleukin-6, and macrophage colony stimulating factor in severe unstable angina

BACKGROUND: Inflammatory process plays an important role in the pathogenesis of acute coronary syndromes. HYPOTHESIS: The study was undertaken to evaluate whether admission levels of C-reactive protein (CRP), fibrinogen, interleukin-6 (IL-6). and macrophage colony stimulating factor (MCSF) can predict short-term prognosis in patients with unstable angina. METHODS: C-reactive protein, fibrinogen, IL-6, and MCSF were measured on admission in 141 consecutive patients, aged 59 +/- 10 years, with unstable angina (Braunwald class IIIb). Patients were divided into two groups according to their in-hospital outcome: Group 1 comprised 77 patients with a complicated course (2 died, 15 developed nonfatal myocardial infarction, and 60 had recurrence of angina), and Group 2 comprised 64 patients with an uneventful course. RESULTS: Admission median levels of CRP (8.8 vs. 3.1 mg/l, p = 0.0002). fibrinogen (392 vs. 340 mg/dl, p = 0.008), IL-6 (8.8 vs. 4.5 pg/ml, p = 0.03), and MCSF (434 vs. 307 pg/ml, p = 0.0001) were higher in Group I than in Group 2. The MCSF levels were an independent risk factor for in-hospital events, with an adjusted odds ratio for eventful in-hospital outcome of 3.3 (95% confidence interval 1-10.9, p = 0.04), and correlated with levels of IL-6 (r(s) = 0.52, p = 0.0001), CRP (r(s) = 0.43, p = 0.0001), and fibrinogen (r(s) = 0.25, p = 0.004). CONCLUSIONS: These findings suggest that among the studied inflammatory indices only increased admission levels of MCSF are strongly and independently related with adverse short-term prognosis in patients with severe unstable angina.     

Thyroid function in humans with morbid obesity.

Morbidly obese subjects may present with abnormal thyroid function tests but the reported data are scarce. Therefore, we studied the thyroid parameters in 144 morbidly obese patients, 110 females and 34 males, to assess the prevalence of hypothyroidism. Eleven percent (11.8%) carried the diagnosis of hypothyroidism and were undergoing levothyroxine (LT4) replacement therapy, 7.7% had newly diagnosed subclinical hypothyroidism, 0.7% had subclinical hyperthyroidism and 7.7% were euthyroid with positive antibodies (anti-thyroid peroxidase antibodies [TPOAb]). From the 144 subjects, we selected a cohort of 78 euthyroid subjects with negative TPOAb, who did not receive LT4 replacement or suppression therapy (the experimental group) and compared them to 77 normal-weight euthyroid subjects, TPOA-negative, matched for age and gender who served as controls. The experimental group had higher serum levels of triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), and thyrotropin (TSH) compared to the control group. Serum TSH concentration was associated with fasting serum insulin levels and insulin resistance but not with serum leptin levels, body mass index (BMI), fat mass, and lean body mass. In conclusion, in morbidly obese individuals, the prevalence of overt and subclinical hypothyroidism was high (19.5%). The morbidly obese subjects have higher levels of T3, FT3, T4, and TSH, probably the result of the reset of their central thyrostat at higher level.     

The prolyl‐hydroxylase EGLN3 and not EGLN1 is inactivated by methylation in plasma cell neoplasia

EGLN1 and EGLN3 are members of the egg‐laying‐defective 9 (EglN) prolyl‐hydroxylases which during normoxia catalyse hydroxylation of the hypoxia‐inducible factor (HIF)‐1α, thereby promoting its ubiquitination by a complex containing the von Hippel–Lindau (VHL) tumour suppressor. EGLN3 also has pro‐apoptotic activity in some cell types. Analyses of a well‐characterised series of cases of plasma cell dyscrasias, including multiple myeloma (MM), Waldenström’s macroglobulinaemia (WM) and monoclonal gammopathy of undetermined significance (MGUS) surprisingly demonstrated that the CpG island of EGLN3, and not EGLN1, is frequently methylated in these disorders. Multiple myeloma patients with a methylated EGLN3 promoter showed trends towards an increased risk of death, bone lytic lesions, anaemia, advanced stage of disease and the presence of extramedullary disease. Those individuals with methylation in the EGLN3 CpG island also had significantly lower albumin levels. These data suggest that the prolyl‐hydroxylases may be a novel class of potential tumour suppressors in plasma cell neoplasia that warrant further investigation with regard to their potential utility as biomarkers. Moreover, we observed that EGLN3 is also methylated at high frequency in B‐cell lymphoma subtypes, implying that loss of EGLN3 is an important epigenetic event not only in plasma cell neoplasias but also in B‐cell neoplasias.     

Phantom cytomegalovirus infection in vasculitis patients: what it means and what to do

We report our experience and hypothesis on the diagnosis and treatment of patients with vasculitis who are simultaneously diagnosed with serum-positive cytomegalovirus (CMV) immunoglobulin (Ig)M antibodies and negative CMV DNA polymerase chain reaction (PCR). It remains unknown how to treat this kind of phantom CMV infection. In a patient diagnosed with Henoch-Schönlein vasculitis, CMV IgM titers were increased while angiitis and renal function deteriorated. Empiric treatment of phantom CMV infection with ganciclovir in this CMV IgM-positive and PCR-negative patient resulted in complete vasculitis remission, serum CMV antibody seroconversion, and renal function improvement. These results imply something more than coincidence.