Alternative complement pathway in hypocomplementemic/normal C1s-C1 inhibitor complex patients with SLE

To test whether alternative complement pathway activation explains normal C1s-C1 inhibitor complex in hypocomplementemic (low CH50cl) patients with systemic lupus erythematosus, we examined alternative pathway hemolytic complement (CH50alt) factor B, and Ba fragment in hypocomplementemic sera with normal and with elevated C1s-C1 inhibitor complex. Sera with and without high C1s-C1 inhibitor complex were similar in CH50cl, C3, and C4. There was little evidence for important alternative complement pathway activation in either group, but patients with classical pathway activation (elevated C1s-C1 inhibitor complex) had slightly lower CH50alt and slightly higher factor B and Ba compared to patients with normal C1s-C1 inhibitor complex. Pregnant patients did not differ from non-pregnant patients. Alternative complement pathway activation does not account for hypocomplementemia in this group of patients.     

Cocaine and Marijuana Use Among Young Adults With Myocardial Infarction

Background

Substance abuse is increasingly prevalent among young adults, but data on cardiovascular outcomes remain limited.

Paving the way towards green catalytic materials for green fuels: impact of chemical species on Mo-based catalysts for hydrodeoxygenation

A series of Mo-based catalysts were synthesized by tuning the sulfidation temperature to produce mixtures of MoO₃ and MoS₂ as active phases for the hydrodeoxygenation (HDO) of palmitic acid. Differences in the oxidation states of Mo, and the chemical species present in the catalytic materials were determined by spectroscopic techniques. Palmitic acid was used as a fatty-acid model compound to test the performance of these catalysts. The catalytic performance was related to different chemical species formed within the materials. Sulfidation of these otherwise inactive catalysts significantly increased their performance. The catalytic activity remains optimal between the sulfidation temperatures of 100 °C and 200 °C, whereas the most active catalyst was obtained at 200 °C. The catalytic performance decreased significantly at 400 °C due to a higher proportion of sulfides formed in the materials. Furthermore, the relative proportion of MoO₃ to MoS₂ is essential to form highly active materials to produce O-free hydrocarbons from biomass feedstock. The transition from MoS₂ to MoO₃ reveals the importance of Mo–S and Mo–O catalytically active species needed for the HDO process and hence for biomass transformation. We conclude that transitioning from MoS₂ to MoO₃ catalysts is a step in the right direction to produce green fuels.

A series of Mo-based catalysts were synthesized by tuning the sulfidation temperature to produce mixtures of MoO₃ and MoS₂ as active phases for the hydrodeoxygenation (HDO) of palmitic acid.     

Comparable Rates of Glucocorticoid‐Associated Adverse Events in Patients With Polymyalgia Rheumatica and Comorbidities in the General Population

Objective

To investigate the use of glucocorticoids (GCs) and related adverse events (AEs) in a long‐term, geographically defined cohort of patients with polymyalgia rheumatica (PMR).

Methods

Using a population‐based inception cohort, details of GC therapy were abstracted from medical records of all patients diagnosed with PMR in 2000–2014. Age‐ and sex‐matched comparators without PMR were identified from the same underlying population. Cumulative and daily dosage of GC, rate of disease relapse, occurrence of GC‐related AEs, and rate of GC discontinuation were analyzed.

Results

The study included 359 patients with PMR and 359 comparators. The median time to taper below 5 mg/day for 6 months was 1.44 years (95% confidence interval [95% CI] 1.36–1.62), while the median time to permanent discontinuation was 5.95 years (95% CI 3.37–8.88). The mean ± SD cumulative dose of GC at 2 and 5 years was 4.0 ± 3.5 grams and 6.3 ± 9.8 grams, respectively. The mean ± SD daily dose of GC at 2 and 5 years was 6.1 ± 7.6 mg/day and 7.2 ± 9.5 mg/day, respectively. There were no differences in rates of AEs between patients with PMR and comparators for diabetes mellitus, hypertension, hyperlipidemia, or hip, vertebral, or Colles fractures (P > 0.2 for all). Cataracts were more common in patients with PMR than comparators (hazard ratio 1.72 [95% CI 1.23–2.41]).

Conclusion

Relapse rates in PMR are highest in the early stages of therapy. Despite often protracted therapy, with the exception of cataracts, the rates of studied morbidities linked to GC are not more common in PMR than comparators.

     

Tracheal or esophageal compression due to benign thyroid disease

Tracheal or esophageal compression was present in 91 (33 percent) of 273 consecutive patients with benign goiter during a 7 year experience. The underlying disease was nodular colloid goiter in 66 percent, adenoma in 21 percent, thyroiditis in 9 percent and Graves' disease in 4 percent. The incidence of tracheoesophageal compression was higher in patients with thyroiditis (67 percent) than in those with colloid goiter (46 percent). Thirty of 91 patients were completely asymptomatic but had marked tracheal deviation on roentgenography. Two thirds presented with significant dyspnea, or dysphagia or both. A long history of goiter preceding the onset of symptoms and progressive worsening of compression symptoms after its onset were common in the latter group. Previous radiographs demonstrating significant tracheal deviation during a previous presymptomatic period were available in 11 of 36 dyspneic patients. Sudden tracheal occlusion developed in 3 percent and required emergency treatment.Tracheal compression occurred more often and when present was a more ominous symptom. Compression manifestations were more frequent in patients with multinodular goiter, were more likely to appear when the underlying disorder was thyroiditis, affected the trachea more often than the esophagus and were generally gradually progressive with time.A clinical spectrum ranging from a presymptomatic tracheal compression stage to one wherein progressive worsening of symptoms occurs is suggested. After symptoms of tracheal compression become clinically manifest, the occurrence of complete airway occlusion may be sudden and unpredictable. Early operation whenever roentgenographic evidence of tracheal deviation becomes manifest is recommended.     

The efficacy of bupropion in winter depression: results of an open trial.

BACKGROUND: Seasonal affective disorder (SAD) refers to regularly recurring episodes of affective illness bearing a fixed relationship to season. Wintertime depression is its most widely recognized form. This study was undertaken to assess the efficacy of bupropion as a treatment for this disorder. METHOD: Fifteen consecutively presenting patients were treated with bupropion (200 to 400 mg/day). All met DSM-III-R criteria for major depression with a seasonal pattern. All were moderately to severely depressed. A modified version of the Hamilton Rating Scale for Depression (mHAM-D) including ratings of hypersomnia, increased appetite and carbohydrate craving, and weight gain was used to quantify the severity of illness. Up to 5 weeks of treatment was allowed before the subjects were categorized as nonresponders, partial responders, or responders. RESULTS: The mean +/- SD mHAM-D scores before and after treatment were 25.5 +/- 6.4 and 4.1 +/- 3.1, respectively. Ten (66.7%) of the subjects had a complete response to treatment (mHAM-D score less than or equal to 5). The other 5 (33.3%) had a partial response (mHAM-D score = 6-10). Five of the subjects had chronic pain and 3 had panic attacks restricted to episodes of depression. These problems resolved simultaneously with the symptoms of depression. CONCLUSION: The results of this open trial suggest that bupropion is an effective treatment for winter depression. However, controlled studies are required to confidently determine whether this is the case.     

Lung mitochondria in experimental asbestosis

Alterations in lung mitochondria were followed in guinea pigs at different periods after a single intratracheal injection of chrysotile dust. Cytochrome c oxidase and succinic dehydrogenase activities showed gradual increase after 90 days, whereas monoamine oxidase remained unaffected throughout the study. There was an increase in glutamate dehydrogenase activity in postmitochondrial as well as in mitochondrial fractions, the latter being accompanied by decreased latency of the enzyme. Mitochondria from asbestotic lung appeared to be more swollen than in normal animals at and after 90 days of exposure. There were fluctuations in the contents of different phospholipids as a result of asbestosis. Beyond 90 days, collagen and mucopolysaccharides also increased. The results confirm the contention that pulmonary mitochondria are among the major target sites in asbestosis.