Interferon-alpha as a mediator of polyinosinic:polycytidylic acid-induced type 1 diabetes

A number of studies and clinical case reports have implicated interferon (IFN)-alpha as a potential mediator of type 1 diabetes pathogenesis. Administration of polyinosinic:polycytidylic acid (poly I:C), a mimic of viral double-stranded RNA, induces diabetes in C57BL/6 mice expressing the B7.1 costimulatory molecule in islets. We investigated the potential role of IFN-alpha in this disease model. The quantitative correlation between IFN-alpha levels and time to diabetes, diabetes prevention with anti-IFN-alpha antibody, and ability of IFN-alpha itself to induce diabetes are consistent with the hypothesis that poly I:C in this model acts by induction of IFN-alpha in a genetically susceptible host. Numerous recent studies highlight the importance of the innate immune system and toll receptors in determining adaptive immune responses, and we speculate that for type 1 diabetes, viral and other environmental factors may act through induction of IFNs.     

Genetics of type 1A (immune mediated) diabetes

Type 1A (immune mediated) diabetes is genetically heterogeneous with important examples for man and animal models with major mutations (autosomal recessive and X-linked recessive) identified as well as oligogenic/polygenic inheritance. For the most common forms of type 1A diabetes alleles of DQ and DR within the major histocompatibility complex are important determinants of disease and allow identification of high risk individuals at birth. Further understanding of both common and rare genetic determinants of type 1A diabetes will contribute to understanding the pathogenesis of diabetes and of autoimmunity.     

Parecoxib sodium,a parenteral cyclooxygenase 2 selective inhibitor,improves morphine analgesia and is opioid-sparing following total hip arthroplasty

BACKGROUND: This study examined the opioid-sparing effectiveness, analgesic efficacy, and tolerability of postoperative administration of the parenteral cyclooxygenase 2 selective inhibitor, parecoxib sodium, in total hip arthroplasty patients. METHODS: This was a multicenter, multiple-dose, randomized, double-blind, placebo-controlled study to compare the opioid-sparing effects, analgesic efficacy, and tolerability of postoperative 20 and 40 mg intravenous parecoxib sodium with placebo in hip arthroplasty patients. The first dose of study medication was administered after surgery with an intravenous bolus dose of 4 mg morphine when patients first requested pain medication; remedication with the study medication occurred at 12 and 24 h. Subsequent morphine doses (1-2 mg) were administered by patient-controlled analgesia. Efficacy was assessed by total morphine used, pain relief and pain intensity, time to last dose of morphine, and Global Evaluation rating of the study medication. RESULTS: Parecoxib sodium, 20 and 40 mg, reduced the total amount of morphine required over 36 h by 22.1% (56.5 mg morphine) and 40.5% (43.1 mg morphine), respectively, compared with placebo (72.5 mg morphine; P < 0.01). Patients receiving 20 and 40 mg parecoxib sodium experienced significantly greater maximum pain relief compared with those in the placebo group (P < 0.05). Patients who received 20 and 40 mg parecoxib sodium discontinued PCA morphine earlier than patients receiving placebo and had significantly higher Global Evaluation ratings. Parecoxib sodium, 40 mg, plus morphine demonstrated a significantly lower incidence of fever and vomiting compared with placebo plus morphine. CONCLUSIONS: Administration of parecoxib sodium with PCA morphine resulted in significantly improved postoperative analgesic management as defined by reduction in opioid requirement, lower pain scores, reduced time on PCA morphine, and higher Global Evaluation ratings.     

Clinical aspects of patients with macrofocal myocardial infarction with a complicated or uncomplicated course

The clinical manifestations and parameters of the laboratory and biochemical diagnosis of uncomplicated and the healing course of complicated myocardial infarction were studied. Substantiation has been provided for recognition of patients with hypo- and hyper-reactive myocardial infarction.     

Effect of chalone-containing aorta extracts on regression in experimental atherosclerosis

The effect of chalone-containing aortic extracts on proliferative activity of smooth muscle cells was examined in conditions of experimental hypercholesterolemia. The tissue-specific cell proliferation inhibitor present in the extract is shown to depress mitotic activity of smooth muscle cells in postnatal rats. The area under aortic atherosclerotic lesion diminished twofold as compared to that of the controls. Morphologically, atherosclerotic changes are seen as lipid plaques.     

Fibronectin in acute and chronic hepatitis

Changes in plasma fibronectin in acute and chronic viral hepatitides have been investigated in 125 patients. In acute and chronic viral hepatitis B plasma fibronectin level lowered in parallel with changes in the disease severity.     

A randomised controlled pilot and feasibility study of music therapy for improving the quality of life of hospice inpatients

Background

Evidence about the effectiveness of music therapy for improving the quality of life of palliative care patients is positive but weak in terms of risk of bias.

Methods

This study aimed to determine the feasibility of a randomised controlled trial to evaluate the effectiveness of music therapy for improving the quality of life of hospice inpatients, as measured by the McGill Quality of Life questionnaire. Objectives included recruitment of 52 participants over 12?months and provision of data to support the calculation of the required sample size for a definitive randomised trial, taking into account the retention rates of recruited participants; and evaluation of the viability of the intervention and the acceptability of the assessment tool. The design was a single-centre, researcher-blinded randomised pilot and feasibility study involving two parallel groups. Participants were recruited from one inpatient hospice unit in Northern Ireland. Eligibility criteria were an Eastern Cooperative Oncology Group performance status of two or lower and an Abbreviated Mental Test score of seven or more. Consenting patients were randomly allocated to the intervention or control group using a 1:1 allocation ratio. The intervention group received up to six individual music therapy sessions over 3 weeks in addition to usual care. The control group received usual care only.

Results

Fifty one participants were recruited over 12?months. Twenty five were allocated to the intervention group and 26 to the control group. Seventy one percent of participants were lost to follow up by week 3, the proposed primary endpoint. The primary endpoint was moved from week 3, when 71% were lost to follow up to week 1, when 33% were lost. The McGill Quality of Life questionnaire was generally acceptable to participants. In order to detect a small to moderate effect size of 0.3, a fully powered study would require the recruitment of 698 participants.

Conclusions

A Phase III randomised controlled trial to evaluate the effectiveness of music therapy in improving the quality of life of hospice inpatients is feasible.

Trial registration

ClinicalTrials.gov: NCT02791048. Registered 6 June 2016.

     

Isometric Gluteus Medius Muscle Torque and Frontal Plane Pelvic Motion During Running

The objective of this study was to investigate the relationship between isometric GM torque and the degree of frontal plane pelvic drop during running. Twenty-one healthy, recreational runners (9 males, 12 females) who ran 8.05 km or more per week were obtained from a sample of convenience. GM maximal isometric torque was collected prior to the run. Subjects then ran on a treadmill for 30 minutes while bilateral three-dimensional pelvic kinematic data were collected for 10 seconds at each 2 minute increment. Left side pelvic drop showed a slight increase (effect size = 0.61); while, the right side pelvic drop remained stable (effect size = 0.18). Pearson’s Correlations showed no relationship between GM isometric torque and frontal plane pelvic drop for any of the data collection periods during the 30-minute run. These results suggest that isometric GM torque was a poor predictor of frontal plane pelvic drop. One should question whether a dynamic rather than static measure of GM strength would be more appropriate. Future research is needed to identify dynamic strength measures that would better predict biomechanical components of running gait.

Key points

• There is a lack of research linking static, clinical measures to dynamic running gait observations.
• Isometric gluteus medius muscle torque is a poor predictor of frontal plane pelvic drop in running.
• Future studies should identify dynamic strength measures that correlate with elements of running biomechanics.

Key words: Strength, kinematics, Trendelenburg, hip.