Comparisons of urinary versus serum cortisol in older persons

The present analysis compared urine- versus serum-based amounts of the stress hormone cortisol in two older adult samples, given that urine as a sample medium is a less expensive and less invasive method of determining cortisol amounts relative to serum. Seventy-three older adults provided urine samples as part of an ongoing study to assess levels of cortisol as a function of intellectual efficacy/performance; these data were compared to serum cortisol levels obtained from 96 older adults in a separate study examining health beliefs and cortisol levels. Analyses indicated that the cortisol levels did not differ across samples, i.e., cortisol amounts measured in serum or urine yielded similar, typical (within normal ranges) results. The data, though preliminary, indicate that urine may provide an alternative to serum when assessing cortisol in older persons.     

Early immune activation in acute dengue illness is related to development of plasma leakage and disease severity

T lymphocyte activation and increased cytokine levels have been described in retrospective studies of children presenting with dengue hemorrhagic fever (DHF). Serial plasma samples obtained in a prospective study of Thai children presenting with <72 h of fever were studied. Plasma levels of 80-kDa soluble tumor necrosis factor receptors (sTNFRs) were higher in children who developed DHF than in those with dengue fever (DF) or other nondengue febrile illnesses (OFIs) and were correlated with the degree of subsequent plasma leakage. Soluble CD8 and soluble interleukin-2 receptor levels were also elevated in children with DHF compared with those with DF. Interferon-gamma and sTNFR 60-kDa levels were higher in children with dengue than in those with OFIs. TNF-alpha was detectable more often in DHF than in DF or OFIs (P<.05). These results support the hypothesis that immune activation contributes to the pathogenesis of DHF. Further studies evaluating the predictive value of sTNFR80 for DHF are warranted.     

受体介导的凝血酶对成骨细胞增殖及分化的作用

目的 通过凝血酶对成骨细胞的增殖及分化作用的研究来探讨受体介导的凝血酶的功能.方法 原代成骨细胞分别取自于蛋白酶激活受体(protease-activated receptor,PAR)-1敲除鼠和野生对照鼠的头颅骨.并利用凝血酶,人工合成的PAR-1或PAR-4特异性激活短肽对细胞进行处理,通过对5.溴-2-脱氧尿嘧啶的嵌入及细胞碱性磷酸酶活性的测定探讨PAR-1或PAR-4激活对细胞增殖和分化的影响.结果 在野生鼠成骨细胞,凝血酶及PAR-1激活肽均能促进的细胞增殖和降低碱性磷酸酶的活性,但PAR-4激活肽却无这些作用.然而在PAR-1 敲除鼠的成骨细胞无论是凝血酶还是PAR-4激活肽均不能改变细胞的增殖及碱性磷酸酶的活性.结论 本研究结果 表明凝血酶促进成骨细胞增殖及抑制其分化是通过PAR-1介导的.其他凝血酶受体并不具有此作用.     

(v) Fractures of the adult elbow

Fractures of the elbow comprise 5% of fractures. Most are minimally displaced and can be managed conservatively. Displaced fractures or those associated with elbow dislocation are likely to require operative intervention. Displaced distal humeral fractures present a particular clinical challenge. Elbow stiffness is the most common complication and can follow seemingly innocuous/minimally displaced fractures.