SACRAH: a score for assessment and quantification of chronic rheumatic affections of the hands

OBJECTIVES: To establish a questionnaire to quantify the extent of the function and activities of the hand in patients with degenerative or inflammatory disease of the hand and finger joints. METHODS: One hundred and seventy-two patients with osteoarthritis (OA, n = 69) or rheumatoid arthritis (RA, n = 103) completed a new questionnaire, the SACRAH, that included 23 visual analogue scales covering the extent of hand function, stiffness and level of pain. SACRAH scores may range from 0 to 100. RESULTS: Comparing all studied patients, there was no significant difference in SACRAH scores between OA and RA patients (34 vs 32, not significant). Scores for both patient groups differed significantly from those for 30 healthy controls. Among patients taking NSAIDs only, individuals suffering from OA (n = 50) scored significantly lower than RA patients (n = 42) (36 vs 48, P < 0.004). Sixty-one RA patients taking DMARDs scored lower than the RA patient group treated with NSAIDs only (20 vs 48, P < 0.0001). Thirty-two RA patients were evaluated longitudinally at their first visit and 3 months after the initiation of DMARDs. Following therapy, SACRAH scores were significantly reduced from 50 to 11 (P < 0.0001). CONCLUSIONS: The questionnaire enables the quantification of compromised hand function, stiffness and pain in OA and RA patients, and is sensitive to therapy-related changes in RA patients.     

PDK1 regulates growth through Akt and S6K in Drosophila

The insulin/insulin-like growth factor-1 signaling pathway promotes growth in invertebrates and vertebrates by increasing the levels of phosphatidylinositol 3,4,5-triphosphate through the activation of p110 phosphatidylinositol 3-kinase. Two key effectors of this pathway are the phosphoinositide-dependent protein kinase 1 (PDK1) and Akt/PKB. Although genetic analysis in Caenorhabditis elegans has implicated Akt as the only relevant PDK1 substrate, cell culture studies have suggested that PDK1 has additional targets. Here we show that, in Drosophila, dPDK1 controls cellular and organism growth by activating dAkt and S6 kinase, dS6K. Furthermore, dPDK1 genetically interacts with dRSK but not with dPKN, encoding two substrates of PDK1 in vitro. Thus, the results suggest that dPDK1 is required for dRSK but not dPKN activation and that it regulates insulin-mediated growth through two main effector branches, dAkt and dS6K.     

Männliches Genitale

Ohne Zusammenfassung     

Reticuloendotheliomatosen

Ohne Zusammenfassung     

Purpura haemorrhagica nach gebrauch von sedormid (isopropyl-allyl-acetyl-carbamid)

Ohne Zusammenfassung     

Versicherungsrechtliche Medizin

International Journal of Legal Medicine -     

ORAL CONTRACEPTIVES ENHANCE THE RISK OF CLINICAL MANIFESTATION OF VENOUS THROMBOSIS AT A YOUNG AGE IN FEMALES HOMOZYGOUS FOR FACTOR V LEIDEN

In 29 patients (17 females) homozygous Arg 506 Gln mutation (FV Leiden) was identified. 25 had been investigated because of venous thromboembolism (VTE); four asymptomatic patients were found during family studies.
The first VTE had occurred significantly earlier in females (median age [m] 26 years, range 17–49) than in males (m=38 years, range 21–82) ( P  = 0.01). 12 females (80%) had taken oral contraceptives (OC, oestrogen content 0.02–0.1 mg) for 6–150 months prior to thrombosis. Further triggering conditions in females were hormone replacement ( n  = 1) and pregnancy ( n  = 2). In 8/10 males the first VTE had occurred spontaneously — in two after surgery. The sites of VTE were deep vein thrombosis, pulmonary embolism, caval vein thrombosis and superficial thrombophlebitis.
From our data we conclude that OC medication is the most important precipitating factor for VTE in females with homozygous FV Leiden.     

Albrecht von Graefe,seine Persönlichkeit,seine Zeit

Summary This essay leaves aside Graefe's achievements in science and ophthalmology to present the man—Graefe as human being—chiefly on the basis of his surviving letters and the correspondence with his friend Waldau, as well as with Donders, Horner and Jakobson.His brief life not only glowed with incredible scientific intensity, it was also distinguished by an imposing personality. The first half of his adult life was filled with the happy activity of a liberal-minded extrovert, tasting the pleasures of Nature on long mountain excursions; the second half was a courageous fight against severe illness and a variety of family troubles. Graefe won through as a man, and this is perhaps an even greater achievement than his fundamental work in ophthalmology. His humanity makes him attractive to us, brings the critical, questioning pathophysiologist, the skulles operator, the inspiring teacher and exceptional organizer to life for us, making him seem almost contemporary.