Pulmonary amyloidosis and multiple myeloma mimicking lymphoma in a patient with Sjogren’s syndrome: A case report

BACKGROUNDSjogren’s syndrome (SS), which affect salivary gland function, is an autoimmune disease. SS may involve extraglandular organs. Approximately 10 to 20 percent of SS patients have clinically significant lung disease, but presentation of pulmonary amylodosis is extremly rare. The incidence of benign monoclonal gammopathy in SS patients is high, but multiple myeloma is rare. No case involving the simultaneous occurrence of two rare diseases, pulmonary amyloidosis and multiple myeloma, in the same patient with SS has been reported so far. CASE SUMMARYA 41-year-old male patient was referred to our hematology department due to incidentally detected gastric plasmacytoma. He had been diagnosed with SS four years earlier. Multiple miliary nodules, ground glass opacity in both lung fields, and enlargement of both inguinal lymph nodes was observed on chest and abdomen computer tomography. Based on the pathological findings of lung and lymph node biopsied specimens, the patient was diagnosed with pulmonary amyloidosis and multiple myeloma. Pulmonary amyloidosis and multiple myeloma associated with SS has rarely been reported.CONCLUSIONThis is an extremely rare case of simultaneous pulmonary amyloidosis and multiple myeloma in the same patient with SS.     

First-episode psychosis patients recruited into treatment via early detection teams versus ordinary pathways: course and health service use during 5 years

Aim: To compare the 5‐year course and outcome of first‐episode psychosis (FEP) patients recruited via active outreach detection teams (DTs) versus ordinary referral channels (not‐DT). Methods: Longitudinal comparison of two parallel consecutive samples on the Positive and Negative Syndrome Scale Score and the Global Assessment of Functioning Scale. Altogether, 203 FEP patients were identified, of whom 42 refused to participate. Included were 161 patients: 56 DT and 105 not‐DT. Results: After 2 years, the DT group developed more cases of schizophrenia with poorer prognostic features. However, the two groups did not differ significantly on outcome measures. More DT patients were treated as outpatients only and had fewer admissions and shorter total time as inpatients during the observation period. Conclusions: We have previously shown that detection teams recruited more chronic patients with poorer prognostic features, but fewer symptoms and better functioning at baseline. After 2 years, the DT patients functioned as well as the not‐DT patients. At 5 years, both groups have stabilized to the same plateau of low symptom severity.     

Early detection strategies for untreated first-episode psychosis

Some studies in first-episode schizophrenia correlate shorter duration of untreated psychosis (DUP) with better prognosis, suggesting that timing of treatment may be important. A three-site prospective clinical trial in Norway and Denmark is underway to investigate the effect of the timing of treatment in first-episode psychosis. One health care sector (Rogaland, Norway) is experimental and has developed an early detection (ED) system to reduce DUP. Two other sectors (Ullev?l, Norway, and Roskilde, Denmark) are comparison sectors and rely on existing detection and referral systems for first-episode cases. The study ultimately will compare early detected with usual detected patients. This paper describes the study's major independent intervention variable, i.e. a comprehensive education and detection system to change DUP in first onset psychosis. System variables and first results from the four-year inclusion period (1997-2000) are described. It includes targeted information towards the general public, health professionals and schools, and ED teams to recruit appropriate patients into treatment as soon as possible. This plus easy access to psychiatric services via ED teams systematically changed referral patterns of first-episode schizophrenia. DUP was reduced by 1.5 years (mean) from before the time the ED system was instituted (to 0.5 years). The ED strategies appear to be effective and to influence directly the community's help-seeking behaviour.     

Comparison of American and French college students' stage of change for muscular fitness-promoting behaviors

PURPOSE: To examine psychosocial concomitants of stages of change for muscular fitness-promoting behavior among college students in America and France. METHODS: Participants were from Lyon 1 University (Claude Bernard), France (n=71) and Oregon State University, United States (n=3). The main variables of interest were nationality, gendes srage of change, cons, pros, and self-efficacy. RESULTS: The majority of Americans reported being in action or maintenance, whereas the majority of French reported being in precontemplation or contemplation (66.2% vs. 56.8%, respectively, p < .001). The only theoretical variable that Americans (adjusted mean [M(adj.) = 9.2) and French (M(adj.) = 7.7) differed on was perceived pros (p <.00 1). Nationality, self-efficacy, and pros were the most important stage-of-change concomitants. Stage-of-change classification accuracy was 47.9%. CONCLUSION: This study questions whether the transtheoretical model is fully generalizable when applied to this specific behavioral application using a mixed-culture sample.     

2,8-Decadiene-1,10-Diol Inhibits Lipopolysaccharide-Induced Inflammatory Responses Through Inactivation of Mitogen-Activated Protein Kinase and Nuclear Factor-κB Signaling Pathway

Amomum tsao-ko (A. tsao-ko) has been used as a traditional medicine for the treatment of infectious and digestive disorders. In the present study, we report the anti-inflammatory activity and molecular mechanism of 2,8-decadiene-1,10-diol (DDO) isolated from the extract of A. tsao-ko in lipopolysaccharide-stimulated RAW 264.7 cells. DDO treatment inhibited the production of nitric oxide and prostaglandin E₂ by downregulating inducible nitric oxide synthase and cyclooxygenase-2 expression, respectively. Moreover, DDO suppressed the production of pro-inflammatory cytokines such as interleukin-6 and tumor necrosis factor-α. These inhibitory effects of DDO on the expression of inflammatory proteins were found to be mediated through the inactivation of mitogen-activated protein kinases (MAPKs) such as extracellular signal-regulated kinase, c-Jun-N-terminal kinase and p38^MAPK, and inhibition of nuclear factor-κB (NF-κB) pathways including degradation of inhibitor of κB-α and nuclear localization of NF-κB. Taken together, these findings demonstrate the pharmacological roles and molecular mechanisms of DDO in regulating inflammatory responses, and suggest further evaluation and development of DDO as a potent therapeutic agent for the treatment of inflammatory disorders.     

Identification and Characterization of Baicalin as a Phosphodiesterase 4 Inhibitor

Asthma is a chronic inflammatory disease of lung airways, and pharmacological inhibitors of cyclic adenosine monophosphate‐specific phosphodiesterase 4 (PDE4) have been considered as therapeutics for the treatment of asthma. However, development of PDE4 inhibitors in clinical trials has been hampered because of the severe side effects of non‐selective PDE4 inhibitors. Here, screening of a plant extract library in conjunction with dereplication technology led to identification of baicalin as a new type of PDE4‐selective inhibitor. We demonstrated that while rolipram inhibited the enzyme activity of a range of PDE4 subtypes in in vitro enzyme assays, baicalin selectively inhibited the enzyme activity of PDE4A and 4B. In addition, baicalin suppressed lipopolysaccharide‐induced TNF‐α expression in macrophage where PDE4B plays a key role in lipopolysaccharide‐induced signaling. Furthermore, baicalin treatment in an animal model of allergic asthma reduced inflammatory cell infiltration and TNF‐α levels in bronchoalveolar lavage fluids, indicating that the antiinflammatory effects of baicalin in vivo are attributable, in part, to its ability to inhibit PDE4. Copyright © 2015 John Wiley & Sons, Ltd.