Recurrent skin infection with Rhodococcus in an immunosuppressed patient

A renal transplant patient taking prednisone and azathioprine has had repeated episodes of skin infection with the soil saphrophyte Rhodococcus. Human disease with this organism has not been proved before. Although the lesions have always responded to antibiotics, frequent recurrence makes the long-term outlook uncertain.     

Ouabain enhances basal and stimulus-induced cytoplasmic calcium concentrations in platelets

Incubation of platelet-rich plasma (PRP) with ouabain, an inhibitor of sodium/potassium ATPase (Na+/K+ ATPase), induced a significant rise in basal platelet intracellular calcium concentration [( Ca2+]i) when measured using fura 2. Ouabain induced an enhanced aggregation response to low doses of collagen in both PRP and washed platelets loaded with aequorin. In aequorin loaded platelets this enhanced aggregation response was associated with an enhanced rise in [Ca2+]i such that the relationship between [Ca2+]i and aggregation was unchanged. As inhibition of plasma membrane Na+/K+ ATPase would lead to a raised intracellular sodium ion concentration [( Na+]i) the results suggest that in the platelet, [Na+]i can modulate [Ca2+]i and hence influence the response of platelets to stimuli such as collagen.     

Lipids and lipoproteins in a young adult population. The Beaver County Lipid Study

Though atherosclerosis may have its origins in childhood, intervention studies on coronary heart disease risk factors have usually begun in older adults. Whether young adults exhibit similar relationships of lifestyle to coronary heart disease risk factors, and therefore might be suitable candidates for appropriate intervention, is poorly understood. The Beaver County Lipid Study is a 9-year follow-up study of a free-living young adult population (mean age 22 years) who were initially screened for hypercholesterolemia as seventh grade school children. This report focuses upon cross-sectional correlates of lipid and lipoprotein concentrations in 561 individuals (males n = 262; females n = 299) in 1981-1982. Body mass index was positively related to low density lipoprotein (LDL) cholesterol and triglycerides in men (r = 0.21; p less than 0.001 and r = 0.41; p less than 0.001) and women (r = 0.16; p less than 0.001 and r = 0.20; p less than 0.001). Cigarette smoking was inversely associated with high density lipoprotein (HDL) cholesterol in men (r = -0.11; p less than 0.001) and women (r = -0.20; p less than 0.001) but positively related to triglycerides in both sexes (r = 0.10; p = 0.05 for men and r = 0.19; p less than 0.01 for women). Alcohol consumption was positively related to HDL cholesterol and triglycerides only among men (r = 0.19; p less than 0.001 and r = 0.12; p less than 0.05, respectively). Educational achievement was also positively related to HDL cholesterol in men (p less than 0.01) and women (p less than 0.001). Multivariate analyses indicate that the sex difference in LDL cholesterol was largely eliminated by controlling for body mass index while significant sex differences in both HDL cholesterol and triglycerides remained after controlling for covariates. Results suggest that the known associations in older adults of body mass index and health-related behavior with lipoproteins are well established by young adulthood. Early intervention particularly for obesity may help ameliorate some of the male excess in cardiovascular disease risk.     

Lysosomal enzyme cytochemistry of blood neutrophils.

Patients with bacterial infection may show altered membrane permeability of the primary azurophilic lysosomes of blood neutrophils. A new enzyme cytochemical technique, sensitive to increased membrane permeability caused by contact of neutrophils with acetone, saponin, low pH, Streptolysin O, bacteria, and nylon wool, has been developed. The method is of potential value as a screening test for bacterial infection and for detecting neutrophil damage during filtration leucopheresis.     

The association between long-term diabetic control and early retinopathy

A study was performed to determine the relationship between level of long-term antecedent diabetic control and early diabetic retinopathy changes. Fifty-eight insulin dependent diabetics aged 14 to 17 1/2 years, with duration of diabetes of at least 8 years, were studied. Glycosylated hemoglobins were assessed a mean of 8.5 times per patient, over a mean period of 3.1 years, representing 28% of the mean duration of diabetes in this patient population. Fluorescein angiography, obtained according to a standardized technique, was assessed in masked fashion for number of microaneurysms, presence of abnormal areas of capillary nonperfusion, and presence of intraretinal dye leakage. Sixty-four percent of the study population showed some evidence of retinopathy. There was a high correlation found between degree of metabolic control as measured by glycosylated hemoglobin level, and presence of early retinopathy changes as defined by angiography.     

The pittsburgh diabetes mellitus study

A series of patients having onset of Type I (insulin-dependent) diabetes mellitus before age 17 years was identified from consecutive admissions to the Children's Hospital of Pittsburgh. Family history data were obtained yielding 1006 families (1085 cases) with complete information. The prevalence of diabetes among the children differed by birth order, with a greater number than expected among first born. There was also an increased prevalence among children born to mothers older than 35 years, as well as an increased prevalence among children of very young mothers. The increased prevalence of diabetes among offspring of older mothers was apparent even after life table age corrections were made. However, both the increased prevalence among first born children and the increased prevalence among children of very young mothers could be attributed to an older attained age of these children in this particular population. This indicated that the maternal age effect was present but a birth order effect was absent when age was taken into account.     

The effect of intensive glycemic treatment on coronary artery calcification in type 1 diabetic participants of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study

The Epidemiology of Diabetes Interventions and Complications (EDIC) study, an observational follow-up of the Diabetes Control and Complications Trial (DCCT) type 1 diabetes cohort, measured coronary artery calcification (CAC), an index of atherosclerosis, with computed tomography (CT) in 1,205 EDIC patients at approximately 7-9 years after the end of the DCCT. We examined the influence of the 6.5 years of prior conventional versus intensive diabetes treatment during the DCCT, as well as the effects of cardiovascular disease risk factors, on CAC. The prevalences of CAC >0 and >200 Agatston units were 31.0 and 8.5%, respectively. Compared with the conventional treatment group, the intensive group had significantly lower geometric mean CAC scores and a lower prevalence of CAC >0 in the primary retinopathy prevention cohort, but not in the secondary intervention cohort, and a lower prevalence of CAC >200 in the combined cohorts. Waist-to-hip ratio, smoking, hypertension, and hypercholesterolemia, before or at the time of CT, were significantly associated with CAC in univariate and multivariate analyses. CAC was associated with mean HbA(1c) (A1C) levels before enrollment, during the DCCT, and during the EDIC study. Prior intensive diabetes treatment during the DCCT was associated with less atherosclerosis, largely because of reduced levels of A1C during the DCCT.