Relation of serum levels of homocysteine,vitamin B12 and folate to cognitive functions in multiple sclerosis patients

Background: Hyperhomocysteinemia, vitamin B12 and folate deficiency have been linked to cognitive dysfunction in multiple sclerosis (MS) patients.

Objective: This study aimed to investigate the relation of serum homocysteine (Hcy), vitamin B12 and folate to cognitive functions in MS patients.

Subjects and Methods: Forty-five MS patients and twenty matched healthy controls were included. Subjects were submitted to cognitive assessment using a selected psychometric battery and measurement of serum levels of homocysteine, B12 and folic acid.

Results: MS patients showed significant worse performance in cognitive scales compared to controls (P ≤ 0.05). Serum homocysteine, vitamin B12 and folate showed no significant difference between patients and controls (P > 0.05). Serum homocysteine was negatively correlated with total score of Addenbrooke's Cognitive Examination (ACE), paced auditory serial addition test and controlled oral word association test scores. Serum vitamin B12 was positively correlated with ACE language, visuospatial and total scores and negatively correlated with trail making B score. Serum folate was significantly positively correlated with ACE language and total scores. Homocysteine was the only significant predictor for cognitive impairment in MS patients.

Conclusion: Serum homocysteine may play a role in cognitive dysfunction in MS patients.     

The use of exenatide in severely burned pediatric patients

Introduction

Use of selective decontamination of the digestive tract (SDD) and selective oropharyngeal decontamination (SOD) in intensive care patients has been controversial for years. Through regular questionnaires we determined expectations concerning SDD (effectiveness) and experience with SDD and SOD (workload and patient friendliness), as perceived by nurses and physicians.

Methods

A survey was embedded in a group-randomized, controlled, cross-over multicenter study in the Netherlands in which, during three 6-month periods, SDD, SOD or standard care was used in random order. At the end of each study period, all nurses and physicians from participating intensive care units received study questionnaires.

Results

In all, 1024 (71%) of 1450 questionnaires were returned by nurses and 253 (82%) of 307 by physicians. Expectations that SDD improved patient outcome increased from 71% and 77% of respondents after the first two study periods to 82% at the end of the study (P = 0.004), with comparable trends among nurses and physicians. Nurses considered SDD to impose a higher workload (median 5.0, on a scale from 1 (low) to 10 (high)) than SOD (median 4.0) and standard care (median 2.0). Both SDD and SOD were considered less patient friendly than standard care (medians 4.0, 4.0 and 6.0, respectively). According to physicians, SDD had a higher workload (median 5.5) than SOD (median 5.0), which in turn was higher than standard care (median 2.5). Furthermore, physicians graded patient friendliness of standard care (median 8.0) higher than that of SDD and SOD (both median 6.0).

Conclusions

Although perceived effectiveness of SDD increased as the trial proceeded, both among physicians and nurses, SOD and SDD were, as compared to standard care, considered to increase workload and to reduce patient friendliness. Therefore, education about the importance of oral care and on the effects of SDD and SOD on patient outcomes will be important when implementing these strategies.

Trial registration

ISRCTN35176830.     

Role of ultrasound disease activity score in assessing inflammatory disease activity in rheumatoid arthritis patients

Aim of the work

To evaluate role of ultrasound disease activity score (DAS) in assessing joint inflammation in rheumatoid arthritis (RA), and its correlation with disease parameters.

Ammonium/methylammonium transport (Amt) proteins facilitate diffusion of NH3 bidirectionally

The ammonium/methylammonium transport (Amt) proteins of enteric bacteria and their homologues, the methylammonium/ammonium permeases of Saccharomyces cerevisiae, are required for fast growth at very low concentrations of the uncharged species NH(3). For example, they are essential at low ammonium (NH(4)+ + NH(3)) concentrations under acidic conditions. Based on growth studies in batch culture, the Amt protein of Salmonella typhimurium (AmtB) cannot concentrate either NH(3) or NH(4)+ and this organism appears to have no means of doing so. We now show that S. typhimurium releases ammonium into the medium when grown on the alternative nitrogen source arginine and that outward diffusion of ammonium is enhanced by the activity of AmtB. The latter result indicates that AmtB acts bidirectionally. We also confirm a prediction that the AmtB protein would be required at pH 7.0 in ammonium-limited continuous culture, i.e., when the concentration of NH(3) is < or =50 nM. Together with our previous studies, current results are in accord with the view that Amt and methylammonium/ammonium permease proteins increase the rate of diffusion of the uncharged species NH(3) across the cytoplasmic membrane. These proteins are examples of protein facilitators for a gas.     

The link between genetic polymorphism of glutathione-S-transferases, GSTM1, and GSTT1 and diffuse large B-cell lymphoma in Egypt

Background

Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma. A number of studies have examined the role of genetic polymorphisms in the risk of DLBCL, and several variants have been identified as potential susceptibility genes, of those glutathione-S-transferases T1 and M1 (GSTT1 and GSTM1).

Aim of the work

The aim of the current study was to investigate the influence of inherited genetic polymorphisms of GSTM1 and GSTT1 genes on the susceptibility to DLBCL in Egypt.

Methods

Genotyping of the candidate genes was performed for 71 Egyptian DLBCL patients and 100 age- and gender-matched healthy controls by multiplex polymerase chain reaction technique.

Results

The frequencies of GSTT1 null, GSTM1 null, and dual null genotypes among DLBCL patients were 47.9, 52.1, and 23.9?% respectively.

Conclusion

GSTT1 null genotype conferred almost fourfold increased risk of DLBCL (OR?=?3.9, 95?% CI?=?1.97–7.75), and the risk increased when confined to male patients (OR?=?4.4, 95?% CI?=?1.57–12.63), while GSTM1 null genotype was not associated with DLBCL risk. Further studies on the functional consequences of GSTT1 and GSTM1 genetic polymorphisms would pave the way to declare their role in the pathogenesis of DLBCL or as possible predictors for response to therapy.     

Thyroid hormone transport by the rat fatty acid translocase

We examined the hypothesis that rat fatty acid translocase (rFAT) mediates the cellular uptake of T(3) and other iodothyronines. Uninjected Xenopus laevis oocytes and oocytes injected 4 d previously with rFAT cRNA were incubated for 60 min at 25 C in medium containing 0.01-10 micro M [(125)I]T(3) and 0.1% BSA, or 1-100 micro M [(3)H]oleic acid and 0.5% BSA. Injection of rFAT cRNA resulted in a 1.9-fold increase in uptake of T(3) (10 nM) and a 1.4-fold increase in uptake of oleic acid (100 micro M). Total T(3) uptake was lower in the presence than in the absence of BSA, but relative to the free T(3) concentration, uptake was increased by BSA. The fold induction of T(3) uptake by rFAT was not influenced by BSA. By analyzing uptake as a function of the ligand concentration, we estimated a K(m) value of 3.6 micro M for (total) T(3) and 56 micro M for (total) oleic acid. In addition to T(3), rFAT mediates the uptake of T(4), rT(3), 3,3'-diiodothyronine, and T(3) sulfate. The injection of human type III deiodinase cRNA with or without rFAT cRNA resulted in the complete deiodination of T(3) taken up by the oocytes, indicating that T(3) is indeed transported to the cytoplasm. In conclusion, our results demonstrate transport of T(3) and other iodothyronines by rFAT.     

Amebiasis presenting as acute appendicitis

Amebiasis presenting as acute appendicitis is extremely rare. The case of a 38-year-old Hispanic man who presented to the hospital with symptoms and signs suggestive of acute appendicitis is reported. He underwent laparoscopic appendectomy and the pathologic examination of the appendix revealed multiple trophozoites of Entamoeba histolytica. The patient was treated postoperatively with metronidazole for amebiasis, and follow-up stool studies showed no sign of residual infection. The patient has remained asymptomatic.